Myth vs Fact: The truth about Obama whining about health care.

A doctor friend of mine just sent me a link to this website that I think is very enlightening on the subject of healthcare, health insurance, access to care, etc. Some of the myths pointed out I've summarized below, but if you want to check out the references/validity of the facts/figures, here's the website:

http://www.drwalt.com/blog/2009/07/08/health-myth-2-“about-46-million-americans-lack-access-to-health-insurance”/

First off, it should be understood that there is a difference between "health care" and "health insurance." ANYONE can go to their local ER and by law, they are required to be seen and treated appropriately. That is health CARE! Many people in office are trying to throw in this sob story about how so many people are without health care when that's just wrong!

Health insurance...now that's a different story!

MYTH - About 46 million Americans lack access to health insurance.

FACT -
-~14 million of the uninsured were eligible for Medicaid and SCHIP 2003. These people would be signed up for government insurance if they ever made it to the ER.
-70% of uninsured children are eligible for Medicaid, SCHIP, or both programs, according to a 2008 study from Georgetown.
-18.3 million of the uninsured were under 34 who may simply not think about the need for insurance.
-And of those 46 million without insurance, an estimated 10 million or so are non-U.S. citizens who may not be eligible for Medicaid or SCHIP

MYTH - The uninsured can’t afford to buy coverage.

FACT - Many may be able to afford health insurance, but for whatever reason choose to not buy it.
-17.6 million (38%) of the uninsured made more than $50,000 per year, and 10 million of those made more than $75,000. That means 38% of the uninsured likely make enough to afford health insurance, but for undetermined reasons choose not to buy it.
-So, although about 60% of Americans cannot afford to buy health insurance, a surprisingly high percent can — but choose not to.
-Many people think that most of the uninsured do not have health insurance because they are not working and so don’t have access to health benefits through an employer.

MYTH - Most of the uninsured do not have health insurance because they are not working and so don’t have access to health benefits through an employer.

FACT - About half of the uninsured in 2009 fall into one of the following three categories. Some people will be in more than one of those categories at the same time:
-Nearly one out of three, 30%, will be offered, but will decline, coverage from an employer.
-Nearly one out of five, 18%, will be eligible for, but not enrolled in Medicaid; and
-More than one out of seven, 17%, will have family income above 300% of the poverty level (about $65,000 for a family of four);

What is potentially the real number for the poor uninsured? According to a 2003 Blue Cross study, 8.2 million Americans are actually without coverage for the long haul, because they are too poor to purchase health care, but earn too much to qualify for government assistance.

MYTH - The estimated 45 million people without health insurance lacked health insurance for every day of the year.”

FACT - The Congressional Budget Office’s (CBO’s) 45 million estimate reflects individuals “without health insurance at any given time during 2009.” But that does not mean that all 45 million people spend every day of 2009 without insurance. It is a point estimate - on any particular day, there will be 45 million individuals without health insurance.

MYTH - Government-run universal health care would increase the international competitiveness of U.S. companies.

FACT - Replacing employment-based health care with a government-run system could reduce employers’ payments for their workers’ insurance, but the amount that they would have to pay in overall compensation would remain essentially unchanged. Cash wages and other forms of compensation would have to rise by roughly the amount of the reduction in health benefits for firms to be able to attract the same number and types of workers.

MYTH - The cost of uncompensated care for the uninsured significantly increases hospital costs.

FACT - Hospitals provided about $35 billion in uncompensated care in 2008, but represented only 5% of total hospital revenues. In addition, half of the $35 billion in uncompensated hospital costs were offset by Medicare and Medicaid. And the cost of uncompensated care for the uninsured is “unlikely to have a substantial effect on private payment rates,” the CBO says, adding that shifting costs from uninsured to private insurance premiums is “likely to be relatively small.”

MYTH - Nationalized health care would not impact patient waiting times.
It’s very interesting to me to hear those in favor of any form of nationalized health insurance (especially “Obamacare”) state that the issue of waiting for care in countries with nationalized health care is a “myth.”

FACT - Waiting time for elective surgery is lower in the US than in countries with nationalized health care. In fact, in 2005, only 8% of U.S. patients reported waiting four months or more for elective surgery. Countries with nationalized health care ALL had higher percentages with waiting times of four months or more, including:

Australia (19%);
New Zealand (20%);
Canada (33%); and
the United Kingdom (41%). <----That's almost HALF!! (compared to our 8%?)

MYTH - Insurers cover less today than they did in the past.

FACT - No, medical insurance companies are actually covering more costs. Much more!. Consumers paid for 33% of their total, personal health care expenditures in 1975. But by 2000, consumers’ personal share had fallen to 17%, and it declined to 15% in 2006.

As someone who aged out of MediCal (as Medicaid is called in California
0 at 21 since I had no children, I can tell you that those doctors and the service there is completely lousy to the point that I'd rather not visit them at all if I didn't have to.

Even if you are eligible for Medicaid, there's stills prescriptions and if you want the good stuff, you're still gonna have to spring for it.

It's possible those making that much money and still don't buy health insurance are racking up expenses elsewhere on a big car note or house payment. Whether they should have bought that house or car is another discussion entirely.

On this, I agree with you. I've heard horror stories of people waiting up to six hours...the waits are so infamous that I think Async mentioned once that schoolkids in France were being taught that people in America die outside the ERs on a regular basis. (Then again...it's France. :/)

I choose not to buy health insurance mainly because it's an expense I'd rather not have, even though I could afford it.

^
You better not have a medical emergency in the near future. Medical expenses from accidents are the biggest reason people declare bankruptcy, and once you're fucked up, most places won't insure you.

It's true, and a lot of the reason for it is...Medicaid! Gubmint health insurance!

Since they have no co-pays, they can come into the ER for a zit, or just a fix of their favorite narcotic.

With all due respect, fuck Dr. Walt. Waiting to go to the ER before you worry about health insurance is part of what got us into this mess in the first place.

ER's are not designed to deliver sustained medical care. They stabilze you until you can get to your doctor or admit you if you are in bad enough shape... but by that time, you might as well call a bankruptcy lawyer because an average stay in the hospital is astronomical in cost. When you do file bankruptcy and the hospital is forced to eat that loss, then the price for them to provide those medical services goes up. A vast majority of bankruptcies involve healthcare expenes....

As a healthcare proffessional myself, I'm more concerned with the practice of private insurers of dropping patients that manifest chronic diseases.... or, what is more common, a patient's insurance is attached with thier employment, but when they need a round of chemo and can't work, then guess what... the insurance goes away.... and guess what happens to price of chemo then? This happens in hospitals all over the country every day.


These are some of the reasons why the American Medical Association and the American Hospital Association has decided to support President Obama and his Healthcare reform.

And not for nothing, things like elective surgeries, diagnostic exams and thing like that are way over utilized in the US. There is no reason for a doctor to order an MRI that will cost thousands of dollars for a shoulder or knee injury when a referral to a competent Orthopedic surgeon can produce a diagnosis and corrective surgery if necessary. When people use examples of people waiting months for an MRI in Canada for a knee injury I really just want to laugh.

... and our national plan doesn't have to look like Britan's or Canada's. Copays, Co-insurance and deductibles are there to curb healthcare utilization. They exist to prevent the mindset of "free healthcare." This is a good thing, IMHO, but the freaking combination of the premium, deductible and co-pays today end up being way more than just paying for the procedure out of pocket. The extra money goes to some fat guy on Wall Street that's giving Dr. Walt and me a hard time while eating his lunch in a corporate jet off of gold rimmed plates and silverware. The point is, that some form of copays and deductibles should be included in our national plan.

I'm more concerned with the gov't setting all sorts of mandates for what private insurance has to cover. Gov't should keep it's nose out of these things. If there is a market for it, it will be available at some price. There is no Constitutionally guaranteed Right of Health Coverage.

No, it shouldn't. The only thing preventing your health insurers from raking you over the coals when you need them are government regulations. They do this dance with patients and doctors that result in the least amount of care for you that keeps them from getting sued.

No, free market competition would do that much much better.

Link?

As you wish.

What exactly is it about government regulations that's stopping them from doing that now?

^Regulations mandating coverage for everything from autism to hangnails.

So you're saying if they weren't required to provide as many services.... they'd happily provide more services?

No, you illiterate fool, they'd provide the fewer services people actually want, better.

There's a very questionable premise in there. Why should an MRI cost thousands of dollars? Why do you accept that premise without challenging it? These things were not exactly invented to make medicine more costly. In theory, shouldn't a good MRI help the othopod do his job even more efficiently?

Diagnostics are only said to be "overutilized" because they find conditions that most people don't have. To say they are "overutilized" suggests that we don't want to pay the price of checking everyone to identify the small minority who actually have the condition.

Does that mean the doctor is not liable for failing to find the condition, if we agree that it's "overuse" for him to even look for it? B/C I suspect doctors consider themselves on the hook for finding/failing to find the conditions these "unnecessary" procedures are looking for. And even more importantly, do trial lawyers think doctors are on the hook for finding these conditions?

Alpha you're off the ranch. I've had my knee scoped and worked on by an Ortho. The first fucking thing he did was get an MRI so he could see what he was dealing with. If youre in the medical field and don't even understand that it says a lot about why you're opinions are so wacked.

Yup. Trying to find the right analogy, but I'm inclined to say that's like saying it would be pointless to x-ray a Christmas present because a competent person can tell what it is by picking it up and shaking it.

It's worse than that. Insurance companies, of course, don't mind getting sued so long as the savings from denying claims is greater than the losses from lawsuits. They aim to provide the least amount of coverage such that a denial of coverage has a positive profit-expectation. Given the disparity in the ability of consumers and insurance companies to navigate the legal system, that actually means budgeting for a fair high number of lawsuits against insurance companies, because for every lawsuit brought there are many more that are justifiable but never brought at all. Insurance companies frequently see expected profits in willful breaches of contract, even though a policy of breaching contract makes some number of lawsuits inevitable.

I think a little bit of regulation in the right places is a good thing. What we have is a whole lot of government regulation in the wrong places.

If people really didn't want those services, it shouldn't be an issue, should it? What's the cost of providing a service no one takes advantage of?

Or are people using these services regularly despite not actually wanting them?

Interesting bit of trivia - yes you can make too much to be on medicaid, but if you are an adult and not pregnant you can make too LITTLE to.

Last time we applied, I was told that if I couldn't prove a regular income, i was disqualified (I can't) and on the other hand, if i did have a regular income, if it was higher than roughly $140 a week, i would make too much.

I'm not banging the drum for the gov to do more to take care of me (you guys know me better than that) but $7,500 a year for a family of 4 (enough to make more than $140 a week on average) is very VERY low income.

What kind of regularly paying job could anyone get that paid less than $140 a month?

My point is, even when they are "helping" - they aren't really.
(Albeit yes my kids are covered)

random comments on the subject

#1 - anyone ever considered maybe the great one WANTS unemployment high so more people will be worried about not being covered?

#2 - wasn't it cool how he accused Doctors of milking patients for money the other night? Not only are they unethical, according to BO, but worse - a pediatrician, who does no surgery, might prescribe unnecessary surgery so the surgeon can profit so there has to be some further layer of deceit there.

Well, I have heard of doctors prescribing unnecessary procedures and treatments before. Some of that is ignorance, but some of it is their being convinced of the merits of certain things (bribed, basically) by sales reps.

A ot of it is fear of liability too.

My friends dad is a doctor... we used to go to his office and get free lunch from the sales reps. He didn't seem too influenced by their pitches, but the sales reps are very obviously doing their best to give loads of free stuff to the docs in order to get them to prescribe their crap.

If you want to compare a person who went to school and studied anatomy, physiology and pathophysiology for 8 years and has a good history and physical exam on his side along with incidences and prevelence of conditions to shaking a present, then go ahead. Most doctors know what's wrong with a patient after 5 minutes of talking to them if not the second they lay eyes on you when they open the door. An MRI to understand the shape and location of an internal cancerous tumor, OK, but shoulder and knee injuries? It's a pure luxury.

But keep this in mind... An MRI cost thousands of dollars. A portion of that goes to the doctor who interprets the MRI.

If you're walking through Central Park at night and all of a sudden, a blackout occurs and it's pitch black out.... And off in the distance you hear galloping, why would you assume it's a zebra when you know there are cops riding horseback as well as vendors offering horse drawn carriage rides?

I don't want to criticize a doctor ( I am not a doctor ) but chances are, they gleaned no more information from the MRI than they did the initial history and physical exam with regards to what was wrong with you.

I think you're onto something here, Alpha. Furthermore, I think we can really speed up the boarding process at airports by doing away with the X-ray machines and just having competent baggage screeners look out for bags with bombs.