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Why does America not have single-payer healthcare?Because single payer plans like the UK’s NHS and Canada’s national healthcare system are running into the same exploding financial problems that the United States is having due to the tremendous costs of new technologies and new expensive drugs. Those systems are not handling the growth in expenses well either.But they react differently. Instead of rapidly building new facilities and installing new high tech machines as occurs in every city in the United States, the UK and Canada slow things down with budget creep. They can’t commit political suicide with huge tax increases that would hurt their economies so they incrementally pass increases. That signNowly delays but doesn’t prevent new technologies coming into play (Most cities in the US have more MRI and PET scanners than entire Canadian provinces.It’s a form of government rationing because budget restrictions create a shortage for everyone in the system, resulting in waiting lists that some patients never get off. Their citizens mostly accept that for non-emergencies because fortunately, as in the US, most people don’t require sophisticated or advanced medical care. When they cannot accept it, they leave the system and fund their own private healthcare.Before Obamacare, more than 85% of Americans expressed approval of their healthcare. That number has fallen somewhat but still represents a sizable majority.Most Americans don’t want what a federally run program would entail. They don’t want their options reduced. They don’t want to be put on waiting lists. They don’t want to lose their choice of physicians and hospitals. They don’t want bureaucratic layer upon layer getting in the way of their healthcare. In short, they don’t want what Medicaid patients currently get. They also don’t want what we’ve been hearing that a signNow number of American’s veterans get.Many Democrats say they want Medicare for all. Medicare simply doesn’t pay the bills of hospitals and doctors. Medicare exists at it’s current high level of care because a signNow part of the care is cost shifted from the 170 million Americans who have employer based health insurance.I’ve used Nobel Prize winning liberal economist Paul Krugman’s response to Bernie Sanders’ Medicare-for-All plan time and time again. Krugman was a big supporter of Obamacare and also of Hillary Clinton’s candidacy. So here goes again:My column and Bernie Sanders’ plan crossed in the mail. But the Sanders plan in a way reinforces my point that calls for single-payer in America at this point are basically a distraction. Again, I say this as someone who favors single-payer — but it’s just not going to happen anytime soon.Put it this way: for all the talk about being honest and upfront, even Sanders ended up delivering mostly smoke and mirrors — or as Ezra Klein says, puppies and rainbows. Despite imposing large middle-class taxes, his “gesture toward a future plan”, as Ezra puts it, relies on the assumption of huge cost savings. If you like, it involves a huge magic asterisk.Now, it’s true that single-payer systems in other advanced countries are much cheaper than our health care system. And some of that could be replicated via lower administrative costs and the generally lower prices Medicare pays. But to get costs down to, say, Canadian levels, we’d need to do what they do: say no to patients, telling them that they can’t always have the treatment they want.Saying no has two cost-saving effects: it saves money directly, and it also greatly enhances the government’s bargaining power, because it can say, for example, to drug producers that if they charge too much they won’t be in the formulary.But it’s not something most Americans want to hear about; foreign single-payer systems are actually more like Medicaid than they are like Medicare.And Sanders isn’t coming clean on that — he’s promising Medicaid-like costs while also promising no rationing. The reason, of course, is that being realistic either about the costs or about what the system would really be like would make it a political loser. But that’s the point: single-payer just isn’t a political possibility starting from here. It’s just a distraction from the real issues.Health Reform Is HardHospital waiting lists at seven-year high as 3.4m need treatment193,000 NHS patients a month waiting beyond target time for surgeryhttp://www.telegraph.co.uk/news/2017/03/30/hip-knee-surgery-waiting-lists-lengthen-nhs-focus-ae-cancer/Hip and knee surgery waiting lists to lengthen as NHS focus on A&E and cancer careNHS Health Check: Hospital op 'long waiters' rise by 163% - BBC NewsCanada lags G7 in cost-saving IR proceduresHealthcare wait times hit 20 weeks in 2016: reportWaiting Your Turn: Wait Times for Health Care in Canada, 2015 ReportCanadians increasingly come to US for healthcare: https://www.usnews.com/news/best...
What is your best customer service experience in hotels?My favorite hotel service experience was the one where the hotel staff actually turned a negative experience into an incredible positive.I was staying 2 nights at the Aloft Downtown Chicago on business. On the first morning, I went to iron a dress for my meetings. The minute I put the iron on the dress, I realized the protective coating on the iron was melting and it immediately put a sticky stain on a beautiful silk Theory dress.I brought the dress to the front desk and told them what happened. They apologized and told me they’d have it cleaned while I was at work that day.When I returned to the hotel, they had indeed had it cleaned but sadly the iron had left burn marks that couldn’t be removed. The staff had checked the dress on return and, realizing this, had found already found an identical replacement. To take it a step further, Theory was no longer selling the dress, but they had found one online in my size and color at a department store. It was not in the Chicago so they had it express delivered to my apartment in New York City - it was waiting for me when I got home from my trip.That dress cost more than my 2 night stay at that hotel.Perhaps the iron WAS the hotel’s fault and they WERE liable, but they went out of their way without so much as a complaint from me and it absolutely made my day. I’ve told so many people this story and recommend that Aloft every time someone tells me they are headed to Chicago. Doesn’t hurt that it is also home to my all-time favorite hotel cafe and restaurant (Beatrix).
How can the UK honestly view their healthcare as better than that of the US?I understand the American attitude but we are a bit on the arrogant side of health care. We think we're the best at everything. Each system has their strengths but the USA is built on ability to pay.I have had the fortunate experience of living in both the USA and UK. I have spent the better part of 50 years with good Blue Cross insurance in the USA and now I'm under the NHS in Scotland. I've found that I have received good care under both systems. What's the difference? For one thing, when I visited the doctor in the USA I had to pay a co-pay of 25 dollars plus the fact that I also paid about 100 dollars out of my paycheck every month though my employer paid the bulk of it. When I had a problem last week in Scotland I received a phone consultation with the doctor who made an appointment for me. I got in at 3:40 that same day. The doctor thought it would be good for me to get an x-ray so he contacted the hospital radiology and made an appointment then and there. I went to the hospital and had my x-ray done. I was out and on my way home by 4:15. The cost? Nothing. If I had needed a prescription it would have cost me nothing.Now I know what you're thinking. Nothing is free. That's true. I pay taxes to cover my NHS care. However in the USA when I was caught up in a layoff I lost my employer provided health care. To keep that care I would have paid 800 dollars a month and that coverage was limited to a year. In current dollars health insurance paid for under the same Blue Cross policy would be fifteen hundred or more dollars a month.So what are my taxes to pay for this socialised medicine? My payroll taxes (of which NHS is only a portion) amount to much less than half what my health care alone would cost me in the USA.Conservatives in the USA complain and resist socialism. It is anathema to them. And the propaganda from the right paints all these horror stories that are extreme or overblown cases that you can find even more examples of in the USA. We Americans tend to love our Medicare and VA hospitals. That is socialized health care. The USA has plenty of social systems in place that we take for granted. Every government has some form of socialistic programs. Most western nations have established national health care because its citizens want it. And I know of no countries with national health care that have remotely considered it a mistake. Once established they have never gone back. It is only a matter of time before the USA adopts some form of it. It's possible it will start as state programs in California or other large states. It is a much more cost effective system. And everyone qualifies no matter what their income status.Who in the USA would not want it? Doctors for starters. Pay for them would not be in the millions. Pharmaceutical companies also since the national system would negotiate competitive prices. And some conservatives would rather have no coverage and die than have socialized medicine.The British like their NHS and I can't complain at all. It's their choice to keep it and it serves them and me well. If Obama had managed to sell the idea to America you would have bitched and moaned but in the end you would have used it and gotten used to it. Then you would have never given it up.Now that I'm retiring it is the NHS that will keep me in Scotland rather than returning to the USA. The troubles we're currently experiencing with the NHS are the result of the conservative government's penchant for cutting budgets when they really should be increasing taxes.In short, the USA has some of the best health care in the world but it comes at an extreme cost and neglects those without adequate funds. The UK has very good health care but a far superior system. There is more to health care than technology alone.
How annoying is filling out hospital forms when arriving? Will it go away eventually?It's annoying but no they will never go away. Those forms you fill out are important. They are needed for insurance, identification and also for your medical file. If you walk into an emergency room and they don't have your information how will they know who you are? How will they know who to bill ? How will they be able to look at your history and know your medical information? How will they know who your doctor is? How old you are? If you have allergies? Who they should call incase of an emergency ? It's a nuisance but it's necessary. Even if we live in a country were medical treatment is free they will still need to know a lot of things about you before or after treating you.
What advice would you give to a stepmother on how to handle a difficult biological mother?Obviously each case is different. In my case the biological mother was causing considerable financial difficulties. Before I married him he was very naive where his exwife and children were involved. She was married again but the husband controlled the finances so in order to have her own money she would tell my husband I didn’t get the child support check and he would fire off another one after checking and finding it had not been cashed. She did this on a regular basis and cash both checks. (He was very generous with the support). She would also convince his youngest son he was “sick” . Back then it was not unusual for drs to hospitalize you and “run test” then we would get horrendous bills. We had to pay what insurance didn’t. Then one day I got a letter at our home addressed to my husbands work. It had her return address on it so I wondered what the hell was going on so I opened it. Low and behold it was a form filled out telling the insurance office to make checks payable to her!!! I was furious!! No wonder we were being buried with medical bills she was getting the insurance payments not the provider. Not only that I knew from my stepson that he was also covered under her husbands insurance so I figured she was doing the same to them. Another thing she did was send a list of clothes he needed for school and expect us to get them while he was visiting.I offered to take him to goodwill. Sooooo first I went to the bank and asked what I could do about her holding checks. They told me I could fill out paperwork to have the bank not honor any check over 60 days. So I did, I notified her of the change and told her if she held a check too long it would not be honored and since we had met our obligation it would not be replaced!! Then I called my husbands job and filled them in and told them all insurance payments were to go directly to the provider not to her. She had been signing my husbands signature on the forms (she signed it exactly like my husbands signature) I also informed them she had other insurance on him. She even got her dentist to do work on her (personal friend) and bill us as though it had been done on his son. When he came for his normal visit I took him to our dentist and gave him a list of what they supposedly had done……surprise none of it had been done. I called the dentist and told him if we didn’t get a refund immediately I would report him. That he would have to get payment from her. Once we got the refund I reported him anyway!! After all that it was amazing how quickly my stepchildren’s biological mother was no longer difficult.So all I can say to you is figure out the areas she is difficult in and go from there. Good luck!!
Why are patient forms at hospitals such a pain to fill out?Usually there is a one or maybe a two-page form. I don't think they are that difficult to fill out. They copy my insurance card and that's it. Generally they include a brief list of history questions and current symptom questions. If it is a current doctor, only the current symptom questions. As I am not the one with the medical degree, I hope they use those answers to put two and two together in case my sore throat, indigestion, headache or fever is part of a bigger picture of something more seriously wrong. The HIPAA form is long to read, but you only need to do that once (although you'll be expected to sign the release each time you see a new doctor or visit a new clinic or hospital).
What do doctors do when a patient can't pay for life-saving surgery? Will the surgeon let the patient die, or perform the surgery at his/her own expense?Here's the answer as it pertains to my specialty, orthopedic surgery, and the hospitals where I work.When a patient comes into the hospital and there is a limb threatening emergency, there is no consideration to the patients financial status to provide emergency surgical management, PERIOD.Interestingly, I will take the scenario a bit further. We have patients who come in to the emergency room all the time with non-emergent orthopedic problems that to require surgery. These problems if left untreated would create signNow disabilities to the patient. However, they do not represent emergency situations.For example, a patient who has a displaced ankle fracture needs to have plate fixation in order to stabilize it. The patient who has a hip fracture, knee fracture, elbow fracture, wrist fracture, etc., may require surgery in order to restore appropriate function for the long term.Whenever a patient presents to the emergency room with this situation, the ER physician will give me a call. At no time do I make any request to determine what the patients financial status, including insurance status is. We review the x-rays, medical history, and appropriate social history. If based on these factors the patient needs to be admitted to have the problem corrected, then it is done. We will then manage the patient surgically to correct the underlying problem during that hospitalization.After that, it will be up to the hospital to decide how they want to manage the finances with the patient. However, the important point here is that the decision to admit and move forward with surgery is my own. It is not directed by hospital administration.This is the way that we manage it at two different hospital systems. One of them is a large community based system that has many hospitals throughout the state. The other hospital system is a level II trauma center.My experience may be different then the way that other hospital systems manage it with their orthopedic surgeons.Dr. Brian HattenMy Knee Guide
What is the most emotional encounter you've ever had with a beggar?Berry R. Thanks for the A2A.Normally, I just shoo away beggars as I am pretty much aware that this is a huge scam going on.But these 2 encounters with needy folks stand out. I can never erase it from my mind. Not that it made me feel nice that I could do my bit, but made me realize how blessed my life is and not to keep complaining of what I don’t have.Please note, they were not beggars, they just had no money when they needed it the most.Encounter #1I was en route to work and stopped midway for a smoke break. As I parked my bike on the side of the road, lit up and was watching the traffic go past me, I noticed a man walking and coming from a distance towards me. I paid no heed and just thought him to be part of the crowd. He was dressed decently and had a half empty bottle of water in his hand. He came near to me and stopped next to me, and this was the conversation that ensued. The entire conversation happened in Hindi and this is the literal translation.He : “Sir, do you understand Hindi?”Me : “Yes, I do.”He : “Sir, I have been walking for quite a while and I don’t think I can walk some more. I am lacking Rs. 7/- for a bus ticket back to home. Please, can you lend me Rs. 7/-”Without a thought, I yanked out my wallet and signNowed out for a note. Alas, my wife had raided my wallet, without telling me, and all that was left was just a 20rs note. Without hesitation, I gave him that twenty rupees. He profusely thanked me and left.Encounter # 2I was coming back from a meeting when my wife called me and told me to buy some stuff before coming home. So I got off and went to a provision store just near home, purchased what was wanted and exited the store. The time was around 10pm.As I came out of the shop, a guy selling balloons came to me and said, “Sir, please buy some balloons.” I replied, “No, my kids are too old to be playing with balloons. I don’t need any”He replied, “Please buy some. I sold nothing and I don’t have a single rupee to feed my family dinner tonight”I signNowed for my wallet and took out Rs. 100/- and gave it to him and told him, “Just ensure, no one in your family sleeps hungry tonight”. He instantly packed his wares and left the place on his bicycle.We spend so much money without blinking an eye on stupid things. It’s the least that I could have done. Want to contribute more towards giving back to society
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People also ask
What to do if you can't afford medical bills?Make sure the charges are accurate. Don't ignore your bills. Don't use credit cards to pay off your medical bills. Work out an interest-free payment plan. Ask for a prompt pay discount. Apply for financial assistance. Deal with collection agencies. Summary.
How do you negotiate a hospital bill?Learn to Spot Common Medical Billing Errors. ... Go Into a Procedure Knowledgeable of Fees. ... Ask If You Qualify for Discounts. ... Familiarize Yourself With Health Care Mumbo Jumbo. ... Visit the Hospital's Billing Department. ... Be Polite, But Not a Pushover.
Can you negotiate a medical bill?Feel empowered to negotiate It's a little-known fact that it is possible to negotiate your medical bills, all the way from before you've received the care to the point at which you've been treated, your insurance company has paid its share and the doctor or hospital has sent you a final bill.
How can I get my hospital bill lowered?Negotiate with your doctor's office. You can often get a discount on services simply by asking. ... Create a payment plan. ... Talk to your insurance company. ... Establish a health savings account.
How can I pay my hospital bill without insurance?Shop for Doctors, Urgent Cares, and Hospitals. Hero Images / Getty Images. ... Ask for Reduced Rates or Pay in Advance. Innocenti / Getty Images. ... Call and Pay in Cash. Glow Images / Getty Images. ... Save on Medications. Sandra Baker / Getty Images. ... Set up a Savings Account to Cover Medical Expenses. ... Consider Getting Insurance.