Wasted Wealth and Health Care in the U.S.

Fix health care. Ask United Health’s Dr. William McGuire to give back some of the 1.1 billion dollars in options and some of his 530 million dollar salary(since 1992). Physicians in practice(I am one) are not the problem.Could someone explain to me what this CEO does that warrants this kind of compensation while my physician colleagues are giving up and retiring due to the ever escalating costs of malpractice insurance and dwindling Medicare and pvt. insurers reibursals.

Thank you for speaking up. I too am a healthcare worker and fixing America’s healthcare is a bigger bite of the apple than many people are ready to accept. Navigating through the different specialties, consultation after consultation and the cost of each and every office visit, even if means getting the results of a test. It is frightening to know that if I leave my present place of employment, and go somewhere-else, I have to worry that not only should my salary cover my present living expenses, but will the next plan cover my present personal healthcare team. For a number of years, and not that long ago, when my children were small, I too denied healthcare coverage for myself because it meant a reduction in my salary that would take food from my table. Now, people have much higher illness acuities. They are in one door, and out the door faster than the ink dries in a chart/key stroke. This is madness. The people who need care, don’t get it, and alarmingly the number of people who fill the emergency departments in many hospitals with issues that can be taken care of in a physicians office don’t go because of the upfront copay, putting hospitals at risk for the true EMERGENCY. Then, there is the physicians practice that is in business for the sake of business and a profit margin only. They upcode just enough for insurance to pay a few dollars more. Why. Code right, get paid right. It steals money for the people who truly can’t afford to pay. Why in America does a family that is willing to work, works hard, get charged for exceeding their Medicaid limit for a temporary employment episode? This is not an incentive for people to seek employment. It tells them, you are in this well, it is coated with oil. If you successfully climb higher, we will coat the walls with more oil, and by the way, we are adding more water.

Everyone talks about how “difficult” the problem is. The only difficulty is convincing people to realize the truth that universal health care doesn’t mean socialism, but simply organization. We’re already paying (exhorbitant!) costs to treat everyone, but it’s done in such a round-a-bout, totally inefficient manner. Dozens of countries show us how to insure everyone and do it for a fraction of what we’re now paying while living longer, healthier lives – we just have to take a look at the various models and pick one.
I’ve been living in Germany for over 12 years – as a student, as an employee, and even unemployed – and at no time did I ever have to think about my health insurance, other than informing them of my current status. Quality of care has been good to excellent, appointments with primary care physicians (whom I’m free to pick) are possible at short notice, appointments with specialists (also freely chosen) take maybe a week or two, most dental and medication costs are covered – Americans really have no idea what they’re missing.
If someone’s telling you universal health coverage means socialism, find out where their money is coming from!
PS: Speaking of the organizational aspect, I just got my new insurance “smart” card (smart, because it has a chip with my data), and I can now use it for treatment in most other European countries if I become ill while outside the country. If the widely diverse European countries can achieve such a phenomenal organizational feat as that, I think Americans can finally get off their butts and make a functioning system.

I am a married, 38 year old female who has gone without health insurance most of my adult life. I was diagnosed with HYPOTHYROIDISM, commonly know as HAIDIMOTO’S SYNDROME in 1996, a year after the birth of my first child. I refused to seek treatment until my husband and I deceided to have our second child in 2000. I did this because without health care coverage we could not afford the necessary medication to control my condition. I went thru 2 different specialists before finding my current specialist, DR # 3 to keep count. The first wanted to treat only juveniles and dropped me without so much as a how do you do, complete lack of professionalism, no notification or anything. The second was an old fart who didn’t listen to any of my concerns, and caused me to regain all of the baby weight i lost after having my son, who was premature due to the high risk nature of my illness. Only my current Dr treats me with respect and concern for my health and well being.
It is disgusting how many people who dearly need coverage cannot get access to it because of prohibitive cost. My illness has also caused me to be clinically obese. I am not proud to say that I am 60 lbs overweight, but even with my system in check due to the proper dosing of medication, I cannot lose weight without the aid of other medications to stimulate loss of appetite. WHY DOES MEXICO HAVE BETTER HEALTH CARE FOR THEIR CITIZENS THAN THE GREATEST COUNTRY ON EARTH? I am an American, 3rd generation born and bred in NYC, my children were born there, my husband just became a naturalized citizen on Sept. 1, 2005, yet we are made to feel inferior. I just filled a RX at my local CVS Pharmacy and they were out of SYNTHROID so they deceided on their own to fill my RX generically, without my permission and disregarding the DAW clearly marked on the RX. To add insult onto injury, I had to wait 1 hour for the RX and then they had the nerve to tell me my ‘coverage’ was no good for this RX. When I asked what coverage were they referring to as I am uninsured, they just repeated that my coverage was no good. Please, explain what the problem is, because I just don’t understand.

Physicians who treat medicare patients do not receive payment that covers there cost. Many MD’s are refusing to accept medicare patients.
Large HMO’s actively recruit large numbers of patients to their practice. They receive payment from the government, but again, not enought to provide adequate care. They are overburdened with patients and effectively ration health care, by making it difficult to be seen, by withholding tests such as colon cancer screening after age 80.

I suggest the following simple solutions to reduce the cost of medical care in this county;
Increase medical school enrollment so that every qualified applicant can attend. About half of the number of qualified applicants each year are turned away due to lack of space. The number of practicing doctors is artificially limited by restricting the number of medical schools and residency positions. Every other college program such as engineering, teaching, and law, increases their enrollment as qualified applicants increases. By allowing the number of doctors in this country to be set by the free market at least service should improve even if cost is not reduced.
Reduce the cost of drugs by requiring the drug companies to sell their products to the government at the best price. This requirement has been in place for many years for manufactures selling products to the military. Our government more then deserves the same low price charged in other countries considering we pay a large part of the research involved in the drug development.

I have been in Arizona since 1984, and would have to apply for health care through the access dept. and for my family every 6 months or every year, and my family has been covered since. Once, a Britian and his family was travelling through at a restaurant and I told him about our health care and he said all people are covered there.

Yeah, Dr. Tim Johnson! Your words on the television and in print are music to my ears!
We may very well need to establish the political will from a public demand. However it occurs, we CAN change health care so it can become better for the patient — and better for our national pocketbook. Yes, indeed, via a national health program, sometimes called single-payer universal health care … PLUS additional contributions, such as electronic health records and individual responsibility. The latter topic of individual responsibility needs to occur to stop and reverse the sick conditions and resulting chronic diseases that are killing so many people each year … in addition the unnecessary deaths due to lack of (adequate) insurance.

So far I have heard not one politician suggest a healthcare fix that was not enormously fragmented and bypassing huge groups of people. They do not seem to be aware that the more complicated they make it, the less effective and more costly it will be. (Hint: Medicare Part D). Here are my suggestions. The beauty is in their simplicity.
Healthcare cannot be tied to “Employment” because employment is unstable. There are recessions (remember 11% in 1982?); many businesses go bankrupt; the number of disabled will only grow as we age, and at the pace and compassion of our government’s disability program many will die before they are “approved” as unable to work. And many will retire early for various reasons.
The government should never control healthcare. However, it can be set up by private companies and regulated by govt. such as our utilities and other insurance companies; and they do quite well on the stock exchange in spite of this, thank you. For those whose pre-existing conditions guarantee huge costs perhaps a cap on the companies liability could then divert the balance to a govt. subsidy program, such as for dialysis and transplants.
Also, the medical profession should be forced to clean their house so as to protect the patients and reinstill some degree of integrity. At the moment they are in total denial of the extent of their negligence. Let us be honest about this. And if they do this the trial lawyers will almost automatically disappear on their own.
The hospitals should be forced to clean up their plant, their employees, and their visitors with rigid standards and inspections through Joint Commission. And they should be forced to publish their charges. Presently they will not share that information. This breaks every principle of capitalism and free markets.
Having worked in a hospital from age 16 until 51, and now a frequent patient with a chronic illness, I believe I may have a bit more clarity than most about this problem. The moral to this story is, above all, K-I-S-Stupid, a talent that seems to have alluded our politicians no matter how much experience they have in D.C. They could use more than a little honesty about their self-made chaos as well.
Thank you for listening. Dale A. Yarbrough

Well, Tim, it was nice to see you made the big time (grew up with WCVB…)
My major concern with computerized health records is Capability Creep. The government — and worse, major oligarchic corporations — have displayed a disturbing habit of commencing data collection for purposes the public is happy with, and then re-purposing that data for other uses inimical to the interests of the people who provided it.
Since the US *purposefully* doesn’t have the data-privacy laws Europe does, this is unlikely to stop anytime soon (google “public corporation sociopath” if you need more on that), and the outcome of that is likely to require deeper than obvious consideration.
I think that the best approach is likely to be finding a way for the government to subsidize currently available medical coverage — in a fashion that won’t degenerate in a nasty fashion itself…

While writing my book, I researched the local Department of Health and several other government agencies that get grants from the federal/state governments to help the public out with medical expenses and found the people that run them “inept.” i.e. they are clueless to what their program is suppose to offer in terms of healthcare benefits, and it scared me that I had to explain it to them. And what about the pharmaceutical companies that offer drug assistance programs to those in need, but make it impossible for you to find out information about them…hmmmmm. I have seen doctor’s salaries decrease in the past 10 years by 40%, which will be decreasing another 4% in a year and another 39% in the next 9 years while insurance providers and drug companies get increases of salaries and say they offer services that make themselves look good…so it seems, but don’t provide them, or make it easy for those that need them? The government needs to look into how healthcare money being allocated is spent and the healthcare consumers need to start being their own advocates…..it might take a bunch of people pulling out of their health insurance companies and putting a savings aside, like we would for a “college fund” and negotiating with our healthcare providers in cash, rather than paying a company to do it for us, as well as question some of the programs that are out there and who is running them…..

My husband age 43 has Charcot Marie Tooth disease and Rheumatoid Arthritis. He was hospitalized in December for a collapsed colon and in January for a stroke. He lost his job since he has not been at work and along with it went our health insurance. In September we filed bankruptcy with $50,000 of medical bills. With the December and January hospital stays he was insured but we still owe almost $20,000.00 ($10,000 was deductible and the rest uncovered). My employers do not offer insurance. (I have 2 jobs) I make less than $30,000 per year but I make too much to be covered under any state plan. COBRA is $810.00 per month – that’s almost one of my bi-monthly pays. Medicaid will not cover my husband because I make too much AND they will not consider us a 4 person household because I have 2 kids from a previous marriage and since they are not HIS biological children, they don’t count. He pays for everything for them, raises them, disciplines them, does their homework with them but they are not HIS according to Medicaid. For him to get Medicare he has to be disabled for 2 years. He applied for disability in January but there is a five month waiting period for which you receive no compensation so the earliest we will get money is June and he can’t get Medicare until 2 years from June. Insurance Agents tell me not to even try to get him a policy. If I change jobs and get insurance then all his conditions will be pre-existing and won’t be covered anyway. Arthritis has eaten away at his elbow joint and he is in alot of pain but we can’t get that fixed. He has a hernia where his stomach protrudes through the abdominal wall. Social Security wants documents from all his doctors to prove his disability. The doctors are reluctant to fill them out until he comes in for an office visit so they can talk to him and they want him to go for testing but we don’t have the $90 to $120 for the visit and forget paying for the tests. So we may get turned down for disability and then we can’t get Medicare either. We see nothing but a deep dark hole that we keep descending down. My second job is preparing bankruptcies for lawyers. I see alot of medical bills that are outrageous and the credit card bills are usually where people have charged their medical bills or medicine on or they have used their credit cards to pay for their regular household bills and used their cash to pay for the medical bills and prescriptions. Of course there are always abusers of credit cards and people who don’t plan for a loss of income but most of what I see are people struggling just to get what they need. I have been doing bankruptcies for about 17 years now so I know what I am talking about. We don’t need to lay blame, we just need to figure out where to go from here so people aren’t devastated by medical conditions. When someone is struck with a disability they have to change everything about their life. We had to move from our 2 story home to a one story, we had to get an automobile to accomodate the mobility cart, we had to get a ramp installed, we had to change where we go so we can get the cart in there and even my job as a spouse needs to change because I lost my insurance. Then there’s the total debt from the medical bills. Then you have hospital social workers tell you that you need to use coupons and manage your money better so that you can afford insurance. Saving fifty cents off cereal isn’t going to balance out to pay $810 a month for just me and my husband in COBRA insurance payments!! I do use coupons and buy anything I can at a discount but it still won’t pay the insurance. So we are without. My husband isn’t getting the care he needs. His condition is deteriorating and it’s hopeless. I beg of our government to find a new way to handle the health care system so everyone can afford to be taken care of and get the help they need. I’m not against paying for it but it has to be at a reasonable price.

My mind is like a bunch of nothing. I’ve just been letting everything wash over me lately. Oh well. Such is life.

Preemies under a certain weight typically have very poor outcomes. With modern imaging technology it is often determined that some have no brain or very limited brain function. Many have GI tract problems that is for the most part incompatible with life. These patients are like a gift to the hospitals and medical providers. They will never recover and will never be able to tell of the horrors of the procedures preformed upon them. The hospitals and medical providers can maintain a heartbeat thereby qualifying this patient as living and can continue to provide treatments. Treatments and medications and hospitalization cost the insurance companies millions of dollars (sometimes for a single patient). The hospitals and the doctors and the medical providers all know the probable outcome will be death yet they are greedy and will maintain that heartbeat for as long as possible. Without intervention this patient would have died at birth or soon after. With intervention this patient will die sometime later, perhaps weeks or even months later. The outcome is the same. Without intervention is a difficult decision and millions of dollars less costly. With intervention is a difficult decision and cost mega millions of dollars. The outcome is substantially the same for both decisions for the patient. But with intervention the hospitals and the doctors and the many medical providers make a lot of money. Would this money be better used for a heart bypass or hip replacement on a patient who will recover and have a better quality of life because of it? I think so. Suggestion…go to a level IIIc NICU and do your own unbiased investigation.
The level I and the level II and the lower acuity level III NICU’s have good outcomes. These are not wasted dollars. It is the higher acuity NICU’s that are the cash cows for the providers and are where substantive savings can be realized without changing the outcome for the patients.