America's border flooded by foreigners seeking better medical care

Of course the border is the Mexican border, and the foreigners are Americans heading south:

Meanwhile, on our northern border (full paper available at link):

It's good to finally see some empirical study of these issues. Anecdotes of Canadians who can't get needed services at home and cross into the U.S. may make good scare tactics on behalf of those opposing a universal coverage plan for the U.S., but the empirical reality seems to be that very few Canadians come to the U.S. specifically for medical care and a good chunk of those who do do so simply for reasons of proximity to urban centers, a matter unrelated to health care policy. Meanwhile a tremendous number of Americans look outside our country for medical services. Hopefully the Democrats will do a better job of fighting back the scare stories this time around.

^Too many Democrats, like Republicans, are in the pockets of the insurers and the pharma companies. And too many Americans want to believe the horror stories from other countries, I guess, no matter how bogus.

Really? The Green Room?

Yes. Really. Oddly, sometimes folks want to talk about stuff without being called names. To argue an issue on merits rather than ad hominems. Weird shit like that.

Yup:

Also sprach Lanzman.

I'm not sure I can get worked up about Mexicans returning to Mexico for health care. The remaining 500,000 aren't detailed. Could it be they're getting prescription medicine and dental work?

Medical vacations are an interesting trend.

medical vacation dates?

^Singapore's quite the hotspot for plastic surgery, particularly for men. Can't just walk into a clinic in Beverly Hills; they might run into someone they know. But head off to Asia for an exotic vacation and come back looking 10 years younger? Very chic.

Some cruise lines are even offering one-day facial reconstructions. Traveler has the option of hiding in their cabin and claiming seasickness until the bruising goes away.

This will either fail or divide the board even further.

It's not just that; the cost of medical school is enormous and every doctor has it beat into them that they deserve a BMW.

And doctors practicing in the U.S. face enormous insurance costs AND a government that has a "soak-the-rich" tax policies. All of which combines to drive medical costs in the U.S. way up. So, if you're able or if you've already got connections in Mexico, why not go there for health services?

Supply and demand speaks again.

Not to mention they need to work 80 hours a week in order to get paid for 25 - what with HMOs and PPOs taking all thier money.

And too many patients expect their doctors to drive one. Not really. But Americans have come to expect a level of experience when they walk into their Dr's office (or hospitals) that requires high overhead. When I saw doctors in France, whether they were French or from another country, their offices were simple; they were equipped with a stethoscope and themselves. Need an EKG or blood workup, they send you to a lab. This was true for GPs and specialists.

The market fails here because insurance is paying and hospitals and Dr's are competing for patients. The actual consumer goes where they think they'll get the best care (if they have time to make a choice). This has nothing to do with cost, very little to do with education and experience and more to do with the building's facade. If there were no insurance, costs would be reasonable.

Perhaps we should outlaw insurance?

And that for every minute they spend seeing patients, they spend three minutes doing paperwork for the multiplicity of insurers...

Are you aware that you're talking about Liet, here?


Whatever. Enjoy your neutered, child-friendly green room thread.

And, yet, people insist our 'system' isn't broke.

Computerization can cover a lot of that. But the real killer is government setting reimbursement schedules so that doctors either don't cover their costs or they're forced to stop seeing government patients.

That's another reason why government is looking for single-payer plans.

The average patient apparently can't figure out that the reason they've been in the waiting room for over an hour, and the doctor's looking at his watch while they're complaining about their hemorrhoids is because he's choking on paperwork.

As long as they've got good coverage - and, preferably, their employer is paying all or at least some of it - they think everything's fine.

It's a lack of information, and a lack of interest in educating themselves, that's the problem.

Then some media shill starts screaming "Socialized Medicine!" and they have hysterics.

Doctors themselves aren't choking on the paperwork unless they're such bad managers they can't figure out how to hire good help. In addition, ED docs don't face that challenge so heavily. They're just overwhelmed with work.

The problem with Socialized Medicine is that people know how bad those systems can be, not just that they're being hyper-politicized. The media coverage is mostly a result of how easy it is to find examples of just how bad government-run healthcare is.

Veteran's Administration, anyone? Single-payer is not the answer unless you're in Congress and have Gulfstream IV quality healthcare plan paid for by the taxpayers that can only be sustained for a small group of beneficiaries.

The problem is insurance companies only 1/3 of the bill. And if they find out the doctor accepted less than full payment for a cash-paying, less fortunate, uninsured joe blow off the street, they will pay that much less for the same procedure from that day forward.

The problem is the fucking insurance companies.

Make them all non-profit and the problem goes away.

ED, erectile dysfunction?

Doctors shouldn't have to hire people to handle insurance paperwork. Insurance companies shouldn't have to hire people to vet medical claims.

Single payer eliminates both of these functions and puts the doctors and patients back in control (within limits).

Your confidence is underwhelming.

The system doesn't have to have a 'single payer' system to work. It just needs to be non-profit.

Uh, the Veteran's Administration has been stellar these days.

Well, the other option is that people will flock to the Green Room and render the Red Room moot.

Thus confirming people's calls for more moderation in the other room.

Alright, someone list the pros and cons of the current system. Let's break it down into simple blocks.

Con:
-High Overhead
-Lack of Coverage

Pro:
-Freedom of Choice

That paperwork is never going to go away. They're claims that have to be submitted and then the insurance company has to review them.

Single payer doesn't eliminate those functions at all. They're still necessary no matter who does the job. The doctors and patients have even less control under that plan. Instead of the threat of an insured person giving up on an incompetent insurance company and going elsewhere with their money, people would have to face a government bureaucracy with the efficiency of the Post Office and the soul of the IRS.

No, the problem is a consumer base that expects favorable options to fall in it's lap without the need for private citizens to influence things by educating themselves and taking the longer, less "instant gratification" route of organizing and voting with their money.

Next time you see your doctor, ask him how much time he spends either on the phone or writing letters of medical necessity explaining to some droid at the insurance company why Patient A really needs this procedure and could they please, please, please cover it for him?

Office staff can fill out the initial coding forms, but there are innumerable little details that require the doctor's direct involvement.

Go on. Ask him.

And once again we have the Baby & Bathwater dilemma.

A system that started out simple, streamlined, affordable and efficient has turned into a bloated mass of inequity and no one's willing to fix it.

Government-run healthcare is an end-stage "solution." It doesn't have to be that way, but it's trending that way because nobody wants to fix the inequities in the private sector.

That could drive a lot of them out of business altogether. Less choice always make for more expensive service in a truly free market.