Wasted Wealth and Health Care in the U.S.

I saw this article on the news tonight and it frightens to see that there is so much more out there that people do not know about. I work for a Home Infusion company, most of the patients that need this care are covered on Medicare Part D RX plans. Five times out of ten their drugs are denied with all kinds of problems, there Co-Pays can be $60.00 or more per drug. With infusion it can take 5 or more drugs to furnish the patient with their needs to continue therapy at home for the fraction of the cost to stay in the hospital. They are sent home for their therapy but don't understand what they will owe the companies who provide such wonderful care and are losing their shirts to do so. More and more disabled and elderly people are turned over to collection agencies because they need the care, we provide the care, but they can not pay for it. We are treated just like a Retail Pharmacy...they at no means can provide these helpless people with the care our kind of pharmacies provide. But yet we won't turn them away because they need our help.
Just let the public aware of how many thousands of people are sent home with infections they get in the hospitals they have had their surgeries in, at no fault of their own but they have to pay for it.
Outstanding government of ours who spends so much helping others when the U.S. Citizens dye from starvation or no health care because we can't afford it. Let's take a look at other countries and how they manage....SOMETHING HAS GOT TO CHANGE.

Thank you

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.

The one thing that bothers me more than anything else.Is what about the poor and poor healthcare.I am forced into tis situation currently.I am on the Oregon Health Plan and it is a unfornutate joke.Like thousands of Oregonians the state healthcare does not provide us with proper care.I have to have a referaal to see any speacialist which can take weeks for apporval.I suffer from severe osteoarthtis in both knees and I have fibormyalgia and all the lovely things that go with that diease.I cant see a rheumatoligst till the first of Dec.I cannot see my own DR.till Nov 1st.I have had 3 knee surgeries at OHSU and still live in consant pain.I asked my Ortho for knee replacements back in April.His answer was simply this You have fibormyalgia why bother.I am 46 years ols i have 4 beautiful childern .My 2 youngest still live at home.My 11 year old doesnt understand why I cant be up instead of bed why we cant do the things we used too.I have gained so much wieght and the drs say excerise ok .But I can hardly walk.They give me plenty of drugs but that doesnt fix the problem at all its a band aide.While i wait for my disibilty to maybe be approved I sink deeper and deeper into debt.Yet noby seems to want to change things in the State.I write lots of letters ,sign lots of petitions and maybe one day someone will listen.

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.

It really does confuse me on how our government can't get a hold of this issue. Maybe if our congress and officials didn't have health care like the majority of the people they "represent" maybe then things would get done. And every election year they all began to talk about how things need to change. I understand that people have disagreements over how exactly it should be changed. However, we need to take a moment to realize it is becoming a crisis. Oh and Bush's support of the new bankruptcy laws don't really help the matter. Now it's impossible to get out of medical debt, no matter how bad your situation is. We need a system that balances the situation, right now health care is EXTREMELY to high priced for the average working class family to reasonalbly afford. Like I said, maybe we should start electing people "without" health care to fix the plan.

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.

YOu are right about other European countries being far ahead of America in health care.
If I remember correctly, the European Union decided many years ago to make their people's basic, decent, health care one of their top priorities in each country--which they have successfully done. But in the United States, apparently excessive profit for many top health care profeasionals takes the front seat--over and above the needs of the people they are supposed to serve. And it probably won't get resolved until enough Americans take the time to actively fight back--collectively. It is beginning to look like we no longer live by any decent National Constitution --due, as always, to the never ending hunger for more and more profits/ WHEN THE PRIMARY FOCUS IS ON MONEY EARNED FOR SPECIALIZED GROUPS, THEN THE WHOLE SYSTEM BECOMES EVENTUALLY CORRUPT- LIKE WE ARE RIGHT NOW. So, how much longer will it take to realize that too many people are being killed by our own system . No love or hope left for America's future ??

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.

I think it goes much deeper, than we can all admit. My wife works at an emergency room, most of the patients are people who don't take care of themselves, either drug users, who go off there required meds or non-compliant patients.

We need to deal with these people not through the emergency rooms but some other fashion, that helps the patient and reduces the emergency room resources.

Even of greater concern, is the high cost of insurance, and multiple tests that are done to avoid mistakes, at what cost is this to our system.

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'm all for cutting out the "middlemen" in our health care system--private health insurance companies who do nothing but push papers, create bureaucracy and add NOTHING to the health of our citizens. However, I'm not ready to jump into a single payor system modeled after the Canadian system until we implement health care reforms that minimize inefficiencies and maximize quality within our current health care system; otherwise, we risk adding another layer of bureaucracy instead of better health care for more people.

Universal health care is not a panacea to our country's health care problems. Canada does have issues with being an under funded system (long waits and medical labor shortage) and just last year their Supreme Court struck down arbitrary laws that prevented Canadians from purchasing private secondary health insurance in the province of Quebec. By all definition, France's health care system is a two-tiered system where wealthier citizens bypass the constraints of their national health care system. The U.K.'s health care system is a huge source of contention amongst its government leaders because of long wait times and disparities in access to healthcare amongst it's urban and rural citizens. Japan is having difficulties meeting the health care needs of its citizens because of its rising elderly population and declining birth rate. Dignitaries from all over the world come to the U.S. for their healthcare needs so we must do some things right. We need to implement health care reforms that improve how we deliver actual healthcare to consumers and then affordable healthcare for all will be a result of those reforms.

With all the high tech medical innovations developed in this country, it is ironic our health care delivery system has not invested in high tech information technologies that could eliminate a huge chunk of the estimated 30 cents of every dollar we spend on administrative costs. Obviously, we have the capability to apply high tech information systems to health care. Look to any large American company- they could not operate without such systems. President Bush's health care plan does include a nationalized heath care information system and efforts to implement this system are underway. In the meantime, private insurers are not willing to invest capital needed to bring this to fruition until standards are specified by the federal government.

Since a nationalized health care information system is absolutely necessary to implement any kind of efficient universal health care program, I would rather wait until this system is developed before attempting to nationalize our entire health care system. I, for one, cringe at the thought of having government employees as customer service agents within a nationalized government run health care system (think post office, drivers' license bureau, IRS, etc.) I think we can originate innovative solutions that combine public and private entities and maintain a regulated profit incentive to prevent another overbloated federal program. I think we should experiment with various health care reforms within indivdual states willing to tackle the issue (such as Massachusetts required health insurance for every resident) and determine what incremental health care reforms can achieve the best results with the least costs. Rushing in with new huge entitlement programs without improving and investing in our current healthcare infrastructure is a recipe for disaster and we can do better.

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 am an early stage Alzheimer patient and have been on EXELON about three years---now I hear they are trying to ban this medicine as well as other Alzheimer meds. This really scares me. I have had some good years and have my business in order. I am so much better than I was before going on the med. I DO NOT WANT TO GO BACK TO WHAT I WAS OR EVEN WORSE.

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.

I was talking to a Britian about health care. I told him of our AHCCCS and he said all the 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.

The answer is NOT computers or electronic records, that's a very expensive, simplistic avoidance of the real problems. Too many people with "unlimited free access" to emergency rooms, where hospitals must spend way too much for way too little--and frequently lost $ in the process. Too many doctors doing what the courts say needs to be done to cover themselves, rather than what mades medical sense. Too much wasted time and $ on administrative nonsense--like prior approvals for radiology--even though that doesn't guarantee coverage. Too much of the insurer dictating what and when. My family doc said they could cut their charges in half if they didn't have to deal with medicare and insurance compalies, and still be ahead financially--and none of that would involve electronic records. Look at all the high-paid employees of insurance companies, including docs and nurses who could actually be productive, all of them skimming off a huge percentage of our healthcare dollars. Tim, maybe you should talk to some actual PRACTICING docs, hospital administrators, nurses, rather than blaming them.

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

I think everyone must bear blame--and responsibility--hospitals, doctors, insurance companies, government and the public. Those who stand to profit will of course try to do so--doctors, hospitals, pharmaceutical and insurance companies. And because defining "medical necessity" is an ill defined term, profitable procedures and those demanded by the public (e.g. aggressive and early breast cancer screening and heroic interventions for the advanced elderly and terminally ill) will be emphasized, and preventive health care and basic primary care will be downplayed. We know that mental health problems drive much of the demand for general health care. How do we respond? Illogically. For example, providing mental health care isn't profitable, so we underpay psychiatrists and psychologists and limit benefits, and instead order tests and prescribe ineffective and expective treatments. I predict that our health care system will continue as is until it collapses under its own weight.

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...