CFLs vs LEDs vs incandescents: round 1,538

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I know dozens of Canadians with 100% rate of being at-least-highly unwilling to trade their healthcare coverage for what they would get if they moved to USA.
I know more USA citizens than I know Canadians, and my experience of such larger number of USA citizens is that a "large and substantial minority" of my family members, friends, co-workers and neighbors would prefer to have USA copy what Canada has over what USA has.
In fact, this "minority" of my USA-citizen family members, friends, neighbors and co-workers that are very dis-satisfied by what USA has is big enough to be barely a minority. I hope that my fellow USA citizens would have high rate of being dis-satisfied with what USA has, due to gubmint spending %-of-GDP by gubmint on healthcare coverage being about the same as is the case for Canada, while the average USA working family (and employer thereof) spend in addition $12K, maybe $13K annually for private healthcare coverage.
- Don Klipstein ( snipped-for-privacy@misty.com)
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wrote:

..
    Or maybe can't afford it. They end up with poor healthcare (the emergency room) and we all end up paying for their care which is delivered at a much higher cost than normal care and since they don't get preventative care, they are less healthy and therfor cost even more while recieveing less care.
    That is the way compition has worked in this non-free, non-competitive market.
...

    I would agree that current regulations need major revisions.
    I would like to take the profit motive out of the system as much as possible.
    For example no doctor should recieve any benefit from sending a paticent for a test, or procedure. They should be isolated from the profit of MRI's and perscriptions etc.
    As an example: I have a back problem. When it comes up I need help now.
    In the US I end up in the emergency room. There they start with my insurance card, I see three or for people, all taking information over the first 20 minutes or so that I am there. I finally see the doctor and each time, the send me to get one of those fancy X-ray test that cost a ton. Each time I am taking up a room in the emergency area of the hospital. Each time they come back with the same conclusion, and prescribe several perscriptions.
    In the UK I get to the emergency room, talk to the lady behind the desk and I am asked to wait. I was infromed that they knew what the problem was, but they needed to find a doctor free to write the prescription. Doctor came we talked while he examined me and within 15 minutes of arriving, I was on a stretcher in the hallway waiting for the drugs to take effect. I was out of there in less time than it took to finish the text in the US. Yea, I did not have a private room, and I was not on an IV and I did not get more X-rays and I had no bill to pay, nor did they even care that myUS insurance covered me there.
    Let's see, US more time more test and more cost to me and my insurance company vs faster care, less X-Ray exposure and less than thirty minutes total vs two to three hourse in the US.
    Why in the world would you want the public medical service when you can get much more expensive care in the US. Of course I can see where a lot of our commerical medical industry might want to keep things as they are.
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snipped-for-privacy@hotmail.com wrote:

No, it's been documented that in that uninsured 14% there are a good number of mostly young and healthy folks who choose to take the gamble and use the funds that would be their contribution to health insurance coverage for other purposes. It would be good if those other purposes were a down payment on a house or something else good, but most of the time it's for something silly like a new car or ipod. Either way, it's their life and their right to take that risk.

So you're saying that the emergency room, the same emergency room that handles those with health insurance, provides substandard care?

Well, this applies to the portion of that 14% who do not have health insurance available, difficult to quantify, but perhaps it's 8% or so of the total population. This is where the system needs refinement, not reform, to better target preventative care at those 8% who do not have access to health insurance.

You bring up two basic issues here:
The first is the efficiency of records access in the UK public health system, vs. the US. In the US, unless you are going to see your regular doctor, the people treating you won't know didly about your past medical history. This is one of the reasons for the longer wait time and additional test.
They have been trying to streamline medical records in the US, but keep running into the privacy issue (we have more privacy rights in the US generally). I think they will eventually settle on some form of standardized medical ID card to keep in your wallet with a chip containing your records.
A standardized chip card with records would ensure they are in your custody, not some central server subject to hacking, and can be provided to any medical personnel treating you for the duration needed. In the case you don't have the card with you, it's no worse than it is today, so no disaster, just a bit less efficiency.
The second issue is that doctors in the US are currently incentivised to order extra tests for a number of reasons. They get additional payment for ordering those tests, and with insurance companies paying rather low, they try to get as much as they can by ordering more tests. The next incentive for extra tests is for protection from the insanely litigious US population, who will sue for the tiniest error and those extra tests help to cover the doctors posterior. And of course the third reason for those extra tests was covered above, lack of access to previous medical records which leads to redundant testing.
Again, all this points to a need to refine the US system, not "reform" it by ripping it out and starting over.
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Even then there is insurance available. I worked at a County General hospital that is about 80% Medicare/Medicaid billing. A few years ago they started getting aggressive in referring people and found that around 20% of their uninsured charity care qualified for a federal program. I realize that is n=1 study, but still though that was interesting.

Or just an electronic medical records. Around 50 different hospitals, health systems, freestanding surgery centers and all attached physicians in Indiana are all able to talk to each other. So, if I am a patient in Indy and I have a problem in Ft. Wayne, the hospital there can most likely access all of my medical records in real time. That is all that is needed. In fact, last month they rolled out a version that will send a subset of my records to an ambulance as it speeds to my aid. Okay, as soon as they get there and find out who hte patient is (g).

Before you get all obnoxious about low insurance company payments, both MCare and MCaid pay much less than the Evil Insurance Companies for similar procedures. The rest is correct, though.
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snipped-for-privacy@hotmail.com wrote:

Or maybe they're illegal aliens (~15 million). Or maybe they're incarcerated (~2.6 million). Or maybe they're between jobs (~2.2 million). Or maybe they're between 18 and 27 and choose to spend their money otherwise (~3.3 million) Or maybe they're eligible for Medicaid or S-CHIPS and will apply when they get sick (?) Or maybe they're self-insured (?)

Try to wrap your mind around this fact: It is the profit incentive that drives innovation. Without the profit motive, we wouldn't have breast implants and all manner of other wonderful advances.

If the referral is to another company, that practice is already illegal.

That's you. I place a call to my doctor and drive to the pharmacy. There I pick up a bottle of 60 Vicodin and hand over $5.00. I'm done.
I'm glad I'm not you.
Look up. Do you see a black cloud following you around? Sure sounds like it.

Because I CAN GET more expensive medical care in the U.S.
I read about a case recently involving an 82-year-old woman from the UK who had suffered for several years with pain in her finger joints. Many visits to her local GP all resulted in the same diagnosis and treatment: This happens when you get old and take Tylenol.
She visited her granddaughter in rural New Hampshire and had an episode. In fact, her left hand even swelled a bit. Her relatives took her to their local doctor, who, within two hours had X-rays, blood work, and an MRI. Diagnosis: GOUT!
She got some pills.
Mind you, all this was at a small hospital in rural New Hampshire. Oh, the whole episode cost a few hundred dollars, but years of suffering went away.
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snipped-for-privacy@hotmail.com wrote:

Interesting line of studies from ~1990 or so showing that there are often MORE insureds using emergency rooms for non-emergent reasons. EDs are open at more convenient hours for those that work, maybe closer, and other reasons. There is also an interesting line of studies showing that even large numbers of those insured don't get preventative care. Again, lack of convenient hours, not wanting to hassel with it etc. I think both of these "fixes" are not going have the cost savings impact people think they will have.

I would suggest that to address obvious conflicts of interest. I wouldn't however, try to take the profit motive out of the doc running their office or the (independent) MRI operator or drug store.

See what happens when (1) things are paid on a per service basis and (2) one has to practice defensive medicine to avoid law suits.
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