American medical care

[awa355]

A reality check?. Copied from another forum. It was a post from an elderly man in America. I guess our health system could be worse. 60 days would not be long enough to recover from his injuries.


I tried it again last year but!
I was hit from behind and almost died. Fractured skull, collapsed lung, punctured lung, four broken ribs and a crushed ankle. They tossed me out of the Nursing Home in Illinois after sixty day, as my Insurance ran out. My helmet probably saved my life. It's been 11 months and I'm still in physical therapy back in Florida. My Scarabeo was totaled. I doubt if I will ever ride again, I'm too frightened of having another accident and being so vulnerable on a Scooter / Motorcycle. The pain was unbelievable. Thanks for remembering "the good times" with me and thank you again Jesus for sparing my life. All the gear all the time! I hope all is well with you Gordy.

[Akzle]

and your point is....

[awa355]

and your point is....

My point is it's sad to see someone have to give up riding because of a bad accident and restricted health care.

[Ocean1]

A reality check?. Copied from another forum. It was a post from an elderly man in America. I guess our health system could be worse. 60 days would not be long enough to recover from his injuries.

And he had insurance. If he didn't he would have got fuck all health care.

And yeah, our overall healthcare system provides significantly more health care and costs about 60% of the US system.

[P38]

That's how they roll in the good ole US of A.

What hasn't been mentioned is the hefty pay out from his pending law suit.

Pain, suffering, medical expenses and inability to ride again will likely see him win tens of thousands of $$$$$ from the person who hit him from behind.

If that's what actually happened of course.

Judge Judy will sort it for him.

Cheers
Pete

[RDJ]

That's how they roll in the good ole US of A.

Actually, it's not quite that simple. The US system in practice provides emergency- and medium-term health care to anybody and everybody including people who can never and would never be able to afford it if they had to pay for it, largely but not only because of the EMTALA laws.

What is problematic is

(1) the long-term care of patients who can't afford the long-term care; but emergency care is delivered to all, freely. This is one of the reasons why it is so expensive to look after all the illegal immigrants because they just turn up and expect to get treated. And they do.

And

(2) the very significant premium imposed on top of actual healthcare costs because of the bastard tort-litigation legal system which an endless stream of ambulance-chasing parasite lawyers freeload on and profit from anything that doesn't work out as people would want, in medical care. Bastards (lawyers that is). That's one of the things which, despite all its clearly manifest inadequacies, the NZ ACC system has kept us insulated from. And is arguably one of the reasons why NZ car drivers do not give a flying f**k at a rolling ring donut about hitting a motorcyclist because they know they can't be sued. Did I mention bastards?

[RDJ]

And he had insurance. If he didn't he would have got fuck all health care.

And yeah, our overall healthcare system provides significantly more health care and costs about 60% of the US system.

Overall, our healthcare system provides significantly less health care at the top end of the system... and that's the reason why it costs less. Top-end US health care results in the best survival rates in the world, bar none, especially for oncology, major trauma, and neonates. Other countries including our own may not wish to spend that amount of money on the most vulnerable populations, that's their decision, but let's not fool ourselves that we get better care for less money. We don't.

[RDJ]

They rekon with the TPPA there will be even less money available to spend on medicines due to a higher cost being imposed.

That seems to be a likely outcome.

[Ocean1]

Overall, our healthcare system provides significantly less health care at the top end of the system... and that's the reason why it costs less. Top-end US health care results in the best survival rates in the world, bar none, especially for oncology, major trauma, and neonates. Other countries including our own may not wish to spend that amount of money on the most vulnerable populations, that's their decision, but let's not fool ourselves that we get better care for less money. We don't.

But we are getting better healthcare for less money. We literally spend less than the US does and by any rational metric we get more public healthcare interventions per public dollar. That's why Obama sent a bunch of bureaucrats here to find out why our outcomes per dollar were far better than theirs. The fact that Obamacare isn't shaped more like our system is more to do with political reality than medical reality.

And if the top end want better care we can do exactly what top end Americans do: pay for it ourselves. Which many of us do.

Your cost breakdown of US costs should include a wee rant about insurance rorts alongside the grasping lawyer thing. You might also mention the multitude of backhanders clinicians get for bumping clients and or referring them for unnecessary specialist consults. All dodgy as fuck and all parasitic, unproductive overheads to the industry.

And are you sure about universal access? I know of at least one that died from a burst appendix after a week trying. I understand it's not an unusual occurrence.

[RDJ]

Fair comment about the insurance rorts... Space did not permit etc, but a considerable amount of the cost of US health care is creamed off for insurance profits, you are absolutely correct.

In terms of universal access... even, or especially for people who can't afford to meet the bills... yes, I can vouch for that from consistent and persistent professional observation over years as a physician. That's not to say there are exceptions, but there are also those exceptions in memory system, including ours. Sometimes the plural of anecdote is indeed data.

No offence intended, but quoting Obamacare doesn't enhance any argument...

Even when we spend top dollar in New Zealand terms, we can't match the best outputs of the best American hospitals. It may not be nice to believe that, because it conflicts with our number 8 fencing wire Kiwi approach to optimum and affordable solutions, but it's an observed fact. IMO. YMMV.

That also said, believing what is the "best" healthcare system in the world is more a political than a clinical argument so generally, I don't push to convince anybody. I do observe that people vote with their feet and their money, and net medical tourism for best results is inbound to the US not outbound to the so-called socialist healthcare paradises of England and France for example...

[Ocean1]

Fair comment about the insurance rorts... Space did not permit etc, but a considerable amount of the cost of US health care is creamed off for insurance profits, you are absolutely correct.

In terms of universal access... even, or especially for people who can't afford to meet the bills... yes, I can vouch for that from consistent and persistent professional observation over years as a physician. That's not to say there are exceptions, but there are also those exceptions in memory system, including ours. Sometimes the plural of anecdote is indeed data.

No offence intended, but quoting Obamacare doesn't enhance any argument...

Even when we spend top dollar in New Zealand terms, we can't match the best outputs of the best American hospitals. It may not be nice to believe that, because it conflicts with our number 8 fencing wire Kiwi approach to optimum and affordable solutions, but it's an observed fact. IMO. YMMV.

That also said, believing what is the "best" healthcare system in the world is more a political than a clinical argument so generally, I don't push to convince anybody. I do observe that people vote with their feet and their money, and net medical tourism for best results is inbound to the US not outbound to the so-called socialist healthcare paradises of England and France for example...

No problem with any of that. Only, in the face of real world budget limits I insist that the legit way to evaluate public healthcare performance is life quality/duration units per dollar spent. NZ outperforms almost every other nation in that regard. Which is not to say we couldn't do better, keeping political opportunists out of the equation is probably the first goal in any improvement.

In the long run it's about adherence to the concepts that generated the original health policy set: spend it where it does the most good first. Which means, as you say, that high tech treatments, expensive drugs and procedures with shorter term or less likely results don't get funded. A policy that brings every idiot out of the undergrowth demanding "fair" and "equal" treatment for their particular sob story. To which the correct answer is "Who do you suggest shouldn't receive a more effective, cheaper treatment so that you can have your more expensive, less effective procedure?"

Yes that means our services aren't geared to supply those high tech procedures and hideously expensive drugs you talk about, that's a natural corollary to the above policy, but as I said those that can afford it can get it easily enough, if not in Singapore then in Boston.

[Winston001]

In terms of universal access... even, or especially for people who can't afford to meet the bills... yes, I can vouch for that from consistent and persistent professional observation over years as a physician. That's not to say there are exceptions, but there are also those exceptions in memory system, including ours. Sometimes the plural of anecdote is indeed data.

No offence intended, but quoting Obamacare doesn't enhance any argument...

Even when we spend top dollar in New Zealand terms, we can't match the best outputs of the best American hospitals. It may not be nice to believe that, because it conflicts with our number 8 fencing wire Kiwi approach to optimum and

That also said, believing what is the "best" healthcare system in the world is more a political than a clinical argument so generally, I don't push to convince anybody. I do observe that people vote with their feet and their money, and net medical tourism for best results is inbound to the US not outbound to the so-called socialist healthcare paradises of England and France for example...

An excellent post but of course I am going to argue this.

Agreed that despite outside obserations, sick and hurt Americans get free healthcare at county hospitals. Indeed in Hawaiii there is universal healthcare.

But the US is a fearful society. Most people are scared of getting ill and needing medical help.

Yes you are absolutely right about the quality of US healthcare but most people on the the planet cannot affotd to go to America to be treated.

[Ocean1]

Shameless dredge...

331828

[TheDemonLord]

Heh - Go the NHS....

[HenryDorsetCase]

What hasn't been mentioned is the hefty pay out from his pending law suit.

Pain, suffering, medical expenses and inability to ride again will likely see him win tens of thousands of $$$$$ from the person who hit him from behind.

If that's what actually happened of course.

Judge Judy will sort it for him.

Cheers
Pete

So here's a thing. All very well having a legal remedy against someone. He can sue to his heart's content. But the trick ALWAYS is getting paid, i.e. enforcing the remedy. So if the fuckwit who hit him had no insurance and/or no money then likely there would be no recovery.

Anyone who bags ACC gets a hearty fuck you from me because that scenario is EXACTLY what ACC was designed to prevent.

[Honest Andy]

So here's a thing. All very well having a legal remedy against someone. He can sue to his heart's content. But the trick ALWAYS is getting paid, i.e. enforcing the remedy. So if the fuckwit who hit him had no insurance and/or no money then likely there would be no recovery.

Anyone who bags ACC gets a hearty fuck you from me because that scenario is EXACTLY what ACC was designed to prevent.

Yep I agree. I use bad words when I pay the levy but I pay it. Sometimes it doesn't seem to be working for some people, but the differences in apparent access and treatments is caused by the cyclic political influences of the day, the basic system is still the best way.
(similar things can be said of Pharmac, I'm continually amazed at their ability to play hardball with those shameless pharmaceutical companies)

[RDJ]

Anyone who bags ACC gets a hearty fuck you from me because that scenario is EXACTLY what ACC was designed to prevent.

Well here is an equally hearty Fuck You right back at ya then. Because in full accordance with the Law of Unintended (but Entirely Predictable) consequences, ACC has all but removed individual and organisational (and local and central Guvvermin Agents') accountability for bad behaviour injuring and killing other people; it has failed to keep pace with the costs of losing your income because of some other fuckwit; it means we hugely subsidise individual irresponsibility especially but not only of sportspeople; it means we pay for horrendously expensive long-term treatment and costs for short-term travellers who are injured in New Zealand; and it's basically the Nanny State writ large if you win the injury lottery (because there's nothing like an available if you lose the illness lottery).

A major part of the problem is that there has been a huge departure from the original intent and implementation of the Woodhouse report, which intended a compensation scheme primarily designed not to allow people who could not pay for justice (and secure financial redress), to be treated unjustly. What we have now, is rather than the injustice taking place on an individual case by case basis due to the legal process (and as you say, an ability or inability to pay lawyers who could win for you...), it is now entrenched and institutionalised for all.

[BMWST?]

I still say those with an "At Fault" history should be paying more not those who decide a less safe mode of transport than others.
that is your right but it is against the principle of the original scheme.Taken to its logical conclusion we would be back to "normal" insurance schemes ie totally user pays.And then you are faced with the scenario above.Soemone hasnt or couldnt get insurance, and their victim cant get recompense.

[pritch]

I still say those with an "At Fault" history should be paying more .

Well you completely miss the point, but that's hardly a surprise. ACC is a no fault scheme. Previously to claim workers compensation you had to more or less be able to prove the employer had been negligent. ACC as it was conceived did away with all that. People get pissed off when, to use a popular cliche, a prisoner who breaks his leg escaping from jail gets ACC. OK, that's what happens with a no fault system, no problem.

Previously if you were bowled off your bike by an idiot driver, you had to take them to court. You had to get the MoT to attend the accident, because they would prosecute and you could use the outcome of that in court. If the Police attended they were likely to not be that interested in prosecuting. If there was no prosecution, you had no evidence, therefore no payout. Sometimes T boned riders didn't feel up to phoning the MoT, and there were no such things as cell phones, again no payout.

Even though it has been severely stuffed about, ACC is better than what we had. And it's much better than the US insurance system which is designed to enrich the insurance companies.

[RDJ]

Even though it has been severely stuffed about, ACC is better than what we had. And it's much better than the US insurance system which is designed to enrich the insurance companies.

Not disagreeing with you pritch, but 'better than what we had' is a low bar. And we're barely clearing it. Just sayin'.

[Ocean1]

Well here is an equally hearty Fuck You right back at ya then. Because in full accordance with the Law of Unintended (but Entirely Predictable) consequences, ACC has all but removed individual and organisational (and local and central Guvvermin Agents') accountability for bad behaviour injuring and killing other people; it has failed to keep pace with the costs of losing your income because of some other fuckwit; it means we hugely subsidise individual irresponsibility especially but not only of sportspeople; it means we pay for horrendously expensive long-term treatment and costs for short-term travellers who are injured in New Zealand; and it's basically the Nanny State writ large if you win the injury lottery (because there's nothing like an available if you lose the illness lottery).

A major part of the problem is that there has been a huge departure from the original intent and implementation of the Woodhouse report, which intended a compensation scheme primarily designed not to allow people who could not pay for justice (and secure financial redress), to be treated unjustly. What we have now, is rather than the injustice taking place on an individual case by case basis due to the legal process (and as you say, an ability or inability to pay lawyers who could win for you...), it is now entrenched and institutionalised for all.

Holding people accountable has some unintended consequences also. It disburses half of the, (occasionally) recovered cost to the legal system to start with. But probably the main problem with pinging the living fuck out of the "at fault" party is that it doesn't actually reduce "at fault" behaviour.

So why not admit that everyone fucks up sometimes, split the bill amongst all of us and pocket the savings in shonky legal costs? I suspect that's the main reason for the difference in health costs, half of the US health bill... isn't.

[RDJ]

Holding people accountable has some unintended consequences also. It disburses half of the, (occasionally) recovered cost to the legal system to start with. But probably the main problem with pinging the living fuck out of the "at fault" party is that it doesn't actually reduce "at fault" behaviour.

So why not admit that everyone fucks up sometimes, split the bill amongst all of us and pocket the savings in shonky legal costs? I suspect that's the main reason for the difference in health costs, half of the US health bill... isn't.

Cap damages & do tort reform and the lawyers' perversion of outcomes would be seriously constrained.

[Honest Andy]

Cap damages & do tort reform and the lawyers' perversion of outcomes would be seriously constrained.

Or simply remove lawyers altogether? With a system a bit like ACC perhaps...?

[Ocean1]

Cap damages & do tort reform and the lawyers' perversion of outcomes would be seriously constrained.

Why bother? like I said it doesn't make for fewer injuries.

The other issue with a legally driven system is the quantity of unnecessary referrals and tests involved, health providers being hugely professionally risk averse at the clients cost.

Not to mention the unnecessary referrals and tests driven purely by the bottom line...

[Akzle]

Or simply remove lawyers altogether? With a system a bit like ACC perhaps...?

or.... bullets


vote akzle.

[RDJ]

Or simply remove lawyers altogether? With a system a bit like ACC perhaps...?

Removing lawyers from the process would be great but... unpossible. Too many politicians are lawyers for a start.

[HenryDorsetCase]

Removing lawyers from the process would be great but... unpossible. Too many politicians are lawyers for a start.

Everybody hates lawyers. Except THEIR lawyer. He/she is a GC who helps you when you need it. But those other fuckers? Up against the wall!

[Akzle]

Everybody hates lawyers. Except THEIR lawyer. He/she is a GC who helps you when you need it. But those other fuckers? Up against the wall!

nono. i flat out hate the lot of the cunts and think they should all be drowned in buckets in every town square.

[Swoop]

So here's a thing. All very well having a legal remedy against someone. He can sue to his heart's content. But the trick ALWAYS is getting paid, i.e. enforcing the remedy. So if the fuckwit who hit him had no insurance and/or no money then likely there would be no recovery.

An American company that I have dealings with, publicly states on all of its paperwar/advertising/etc that it is uninsured.
If someone wishes to sue them, that person will not get anything resembling a "payout" and will simply force the company to close up shop and re-open under a different name.

[oldrider]

Perhaps N Zuland could learn something here? https://www.armstrongeconomics.com/international-news/nature/nature-taking-care-of-the-elderly/ :doctor: