In the summer of 2013, I was in excellent shape at 57 years of age, and I received a notice from my healthcare provider, Kaiser Permanente of Ventura, that my premium was increasing from $224.55 in 2013 to $496.55 in 2014, with no changes made to my healthcare coverage, other than HIGHER out-of-pocket copays.
By 2023, my “private” healthcare costs increased to more than $1500/month.
America: affordable healthcare delivered anything but affordable healthcare. My primary care provider has been a revolving door of well-meaning strangers. And, we all know what it’s like to wait for a delayed appointment for necessary medical procedures.
Lou, you’re absolutely right. The devil isn’t the healthcare industry — it’s government meddling.
The only thing I think about Obama is how he would swagger up to a podium. Fortunately, he finally crashed and burned during this last election. And we have Pelosi's Obamacare comment "We have to pass the bill so that you can find out what is in it." What a bunch of idiots we have in government.
Up until 2010-2011 I had been paying into my private healthcare insurance, Fortis, since 1980. My reward for doing this was that I had not just good but great insurance that covered me and my family for every conceivable thing (including conception). All for about $300/mth.
Then came Obamacare which essentially forced my insurer to flee the state and I lost 30+ years of disciplined premium payments every month even though I didn’t need it because…it was the responsible thing to do. I got to see the doctors I wanted when I wanted and I just flashed my Fortis card at any medical facility and was given immediate attention…
With Obamacare My family and I were forced into buying crap insurance (Anthem Blue Cross) for 3-5x the monthly premium and we had to scramble every year now to see what changed and re-apply like a test for admission to see what subsidies we qualified for.
Of course all my employees had to find their own insurance because it was too expensive to have the company pay for it. I was able to get most of them something called Healthnet for a little while but then the government removed the profit motive for our broker and then Healthnet fled the market as well, at least for everyone who was not a government employee at the university…those guys got a special waiver …the era of life by government edict and competition for exemptions and special treatment waivers had begun
We fundamentally err when we use the term "health care". Health care today is in fact a commodity. Care is endless and humane; health treatment is finite and needs to be assessed for its effectiveness. "Health care" today in fact is system of treatments and billable procedures.
Some of these procedures work, many do not, many chase unsubstantiated surrogate metrics. and most are not even tracked for effectiveness or appropriateness. They are used today almost exclusively to determine who will be paying for the billed procedures. Will it be the individual or someone else: government, charities, third parties, absorbed within the system, or settled in a bankruptcy court. That is the crux of the what we call the "health care" debate today. Who pays and for what.
First step: define what in fact is "health care". Define its full dimensions before writing a blank check to cover this amorphous term in order that this thing gets paid for by someone. Those delivering these procedures have a right to compensation for their services that are included in the delivery of this thing called "health care" - from the intake clerks, to the intermediary screening procedures, to the trained professional personnel delivering the agreed procedures, to the administrative staff that sorts out the applicable procedures, billings and reimbursement codes to the buildings, equipment, maintenance and replacement of all of the above.
Many outside factors drive "health care" today: medical malpractice threats, legislation, third party assessed standard of care protocols, need for revenue generation, rationing, outside pressures to "do something", interfamily dynamics worked out at the bedside, sanitizing the dying process, wide variety of cultural belief systems about "western medicine" .......all of the above and more are embedded in what is loosely called today"health care".
Solutions? Who pays, what should someone else pay, and why. Settle the threshold argument: is health care a right or a commodity? It is a commodity.
When there is such a wide ranging diversity of opinions about "health care", the easiest way out is to just keep paying, stay emotionally black mailed, and never deny anything. Until the system we have today collapses under it own weight. Let us hope, with some of the inconoclastic new government appointments to oversee this highly cumbersome system today, they can get back to grappling with the fundamentals - what in fact is "health care". And who pays.
Obamacare wrongly assumed just providing health insurance for everyone was providing health care for all. How do we dig ourselves out of that wrong turn? What responsibilities must we assume as individuals for our own "health care". Do we take two different routes, one to cover incidents of trauma and another to cover the sequelae of chronic, often lifestyle conditions?
First step is to admit we really don't know what any of us are talking about when we use the term "health care", let alone when we demand universal health care for all.
Yes, our healthcare delivery system is a complete mess, but it’s still the best and most advanced in the world. Technology, advances, discoveries all made because of our capitalist system. The possibility of making advances only comes with the possibility of making a return for the shareholders and investors. Hospitals, physicians, pharma and biomedical all (in my view), must be able to make as much as reasonably and ethically possible. This is what spurs innovation.
Of course, we have major problems with fraud, abuse, malpractice, delivery, reimbursement, the list goes on. Our Workers Compensation system is on life support. Fraud and abuse are at the core of its pending collapse. Unscrupulous doctors and lawyers eating from the same trough. Workers Compensation reform is needed now.
The problems we are now seeing in property/ causality insurance is the tip of the iceberg and is bound to affect health insurers. Simply put, if insurance companies can’t make an adequate profit, they will move to other more profitable markets. As it is now, 2/3 of all residents of SB County are on subsidized plans. Many of which are non employed, undocumented and have zero ability to pay. This spells disaster for private insurance and the taxpayer. Ever wonder how Cencal was started? The simple answer is that SB County reimbursement is so undervalued relative to our cost of living that it was “negotiated “ with Medical and local healthcare executives for our geographic area in order to get more favorable rates.
This ratio has been similar for decades. Infant mortality rate in Cuba is 4.0 deaths per 1,000 live births. In the United States, it's 5.9. In other words, an American infant is, by official statistics, almost 50 percent more likely to die than a Cuban infant.
LT; Sure, but you’re comparing apples and oranges with the “quality” of healthcare. The US rates at, or near, the top countries in the world in terms of “training” future medical doctors. Unfortunately, that does not translate into better overall medical “care”.
Norway, Australia, New Zealand, and the UK are the top performers in administrative efficiency, which is how well health systems reduce paperwork and other bureaucratic tasks that patients and clinicians often face during care, whereas the United States again ranks last.
In terms of US mortality rates, other highly developed countries have a much higher life expectancy rate. Hard to argue with that statistic!
The US does excel in specialized trauma care, which is why this needs to be segregated from routine "health care" when we assess universal health care needs and costs. How far should routine health care dollars be also asked to fund highly specialized but far less routine catastrophic care?
A shocking poll just found that 41% of those polled, under 30 years old found it “acceptable” to have gunned down United Healthcare CEO, Brian Thompson. This result illustrates how the liberal left views violence as a means for social change. Surprised? I’m not. This is right out of their playbook. Confront, harass, bully, threaten, assault and now targeted assassination. Sure, whether it be on a subway or walking down the street, minding your own business and then shot in the back, this is what the left does. Even to the point of assassinating our President elect in an effort to silence him. The left is NO longer the party of “peace and love” but has now morphed into a violent, terrorist, death cult. Why is it we never hear the conclusions as it relates to these criminals motivations? The transgender shooter at the Christian school in Nashville, did we ever see the manifesto? Why not?
The time has come for our FBI, under the direction of Kash Patel, to investigate and come down hard on these left wing, bigoted hate groups. As the left’s poster child for hate and discourse, Malcom X once proclaimed, “any means necessary.”
"any means necessary" is exactly what the liberals, (Dems) believe and preach to their feeble minded followers. It follows their simplistic mind, "It feels good, so do it".
APPLAUSE APPLAUSE APPLAUSE 👏🏼👏🏼👏🏼👏🏼 When Obamacare was being discussed, I tried to tell the employees working for me at the time that it was not a good thing, that I could virtually guarantee that they would not be able to keep their doctor or medical plans, that it would be more expensive, and that, in the end, they would definitely not be happy. You would not believe the pushback I received from these statements! And guess what? ALL OF IT CAME TRUE!!
Back then I was paying about $239 per month for a platinum medical plan with an extremely low copay for visits and medication. After Obamacare came into effect, a similar plan but with less benefits and twice the cost of visits and medication was $879 per month! And no, I could not keep my doctor!
Not to be a conspiracy theorist, but I have to wonder about the similarities between this situation of shooting United's CEO and school shootings. Neither are acceptable under any circumstance, at any time, for any reason (except self-defense when your life is in imminent danger and I don't just mean because of a poor health care plan).
When school shootings occur, gun activists turn to their playbooks and fight for more gun control. When a massive health care CEO is assassinated, the left turns to their socialist playbook and demands more government oversight in health care. See the similarities?
Neither are okay. Less government control will always be better regardless of the subject.
I used to be against guns and against the death penalty because of my upbringing in a Christian household. However, the older I have become and the more I have learned about life, the better I understand the need for LEGAL guns and even the death penalty. I believe everyone deserves multiple chances for grace, redemption, and forgiveness. However, there are some people who are just too consumed by evil, violence and hatred and are determined to destroy.
In any case, excellent article. I wholeheartedly agree that Obamacare was a disaster, a sham, and an intentional ploy to begin taking over America's healthcare system. And, of course I agree that deadly violence is, and will never be, the answer.
Remember the stack of documents created for Obamacare. I think one thing we all missed was somewhere in those stacks of paper was a basic equation which makes the more "wealthy" pay for the much less "wealthy." Your healthcare costs went up to pay for those that can't afford it, the classic American Democratic Party way, classic redistribution.
Exactly! My assistant at the time was a staunch Democrat. We had many interesting conversations, one of which was about Obamacare. She tried so hard to convince me that, as a Christian, I should be willing to give up my hard earned money to help pay for those less fortunate. We went back and forth on this quite a bit as you can imagine, especially since I was running a nonprofit.
I think the concept that finally helped her understand, was when I presented her with a situation that was more close to home. There was a young man in his early twenties that would come on our property and sleep under one of the trees. We had people on site during the day and we could not risk having someone that we didn't know on the property so we called the police. They informed us that he was a child of a very wealthy couple that lived nearby and they had given him an ultimatum that he had to get a job or leave the house. He decided he would rather sleep under a tree and ask people for money rather than get a job. Mind you, he had no disabilities, he was very articulate, and seemed to be in excellent health. And this was all according to the police because they knew him.
She knew about this guy of course being my assistant. So I asked how she would feel if I took out $400 from each of her paychecks to help pay for his medical care, even if he didn't need it every month. That I took it out just in case he needed it because he was irresponsible and drinking and using drugs instead of getting a job. I asked how she would feel about having to give up a vacation she was planning because this guy in our parking lot might need medical care. Maybe. And that she had no choice in the matter of the amount I took out but that if she got medical care, he should have it too even though he's not working.
I asked if she wouldn't prefer being able to give him money as she felt she was able in the amount and at the time she wanted instead of being forced to hand over $400 every paycheck because I wanted to do it.
Dems always thinks it's someone else's money and not their own. The "rich" kid must have thought he was privileged and didn't have to work. Even with engineers that were some that thought that way because they are really smart and shouldn't have to do that much to make a living. There are some interesting "what I have to do" concepts out there!
I agree wholeheartedly! I cannot believe how many dummies are idolizing that murderer! Plain and simple, that's what he is, a murderer. Murder is never ok for anyone, never! And the ones who idolize him are just as bad, they may have just killed him as well. This CEO is leaving behind a wife and babies! You want something done, then go to our so called government, and demand they change it! They are there to serve us! We, the people, pay their salary, we pay far too much to them for what? Heartache, because we fork out all this money we don't have, to pay them, for them to give us nothing! I'm a grandmother of 5, in very bad health and can't get better, but I'm not going to kill anyone over it. I believe God will judge everyone in His own time. We need to bring God back to our lives. He is the only one who can restore goodness, because Biden and his whole administration has blanketed us in evil, and given the ok to victimize others. We have to look forward. Stop idolizing evil, because all it does is make the sickness grow and become toxic for everyone, then innocent become victims again, it's a circle, and not the circle of"life", but instead, a circle of torture and death! So don't kill, and don't idolize those that do. Pray for them, pray for the victims, pray for the government, pray for one another and most importantly, pray to your maker, God, Jesus Christ, our only Lord and Savior. Blessings to the world!
I suspect that the young man who planned the killing and lay in wait, was himself seriously mentally ill. My guess, paranoid schizophrenic. I am not a psychiatrist, but my life has been rooted in familial mental illness since my earliest childhood memories. The killer's personality change was quick and dramatic. He was a brilliant mind, valeictorian of his high school class, and well liked. His old friends are stunned. His mother had reported him as a missing person prior to the murder. I write this now because mental health is not properly recognized and treated: by the health care industry, by the government. It's a nightmare for the families of severely mentally ill to navigate a system such as ours. The "right to privacy" laws too often excludes the families from being able to get care, the folks who know their loved one best. The choices for severe mentally ill are limited: life on the streets; life in a prison or public institution; suicide. Absolutely, early death. And absolutely, a life of loneliness and isolation. And here, the threat to others, inckuding murder. A shot of medication to control schizophrenia runs $14,000.00. We are all at the mercy of such a system.
As more people receive free (as in Cencal, Medical, Medicare) or subsidized Obamacare plans the greater the cost to those left paying either through premiums or taxes. Perhaps an even greater problem with government intervention into healthcare is that now the customer is not the patient but the government or the insurance company. Gone is the incentive to provide a quality product at an affordable price. Fortunes are made behind the scenes between providers, hospitals, insurance companies, pharma and politicians. The act of getting a single new drug approved by medicare is the approval for billions of dollars to change hands. If you think these decisions are made with the well being of the patient in mind you are a fool. Witness the push to get weight loss drugs which cost thousands per month approved for children citing the obesity epidemic among our children. As a patient, the only agency we ever had was as the customer paying the bill. There is nothing so expensive as that which the government has sought to make affordable.
What do you mean castigating the coddled Left and using terms like gunning down, a man walking to work.
It has been clear for decades the opposition has been moving to a radicalized position where any person or group that would dare to expose their centralized control of government is guilty.
I am just old enough to remember when my lower middle class parents of the 1950's needed care for me and went to my former pediatrician. Without a thought she treated me and then gave the same bill for a child.
"Give me...." has become the password for these spoiled children who are now Grandparents.
Oh and have I neglected to mention pardons?
Your comment "...dangerous is not because of the callous reaction of so many people to it (although that is very troubling......" exposes the we are right crowd. Any means including destruction of the Constitution, and social hammering of anyone who would openly express the need for a discourse are their enemies.
Lou, terrific! Hopefully, I can tell my story to SBC readers in January, having just experienced the nightmare that is French socialized médecine. I fell and broke my wrist and had to wait 2 agonizing days on my sofa, full of morphine and other too powerful drugs, for a place at the local hospital to operate! Stay tuned! Calla
As a retired neurosurgeon, 31 years in private practice, I know that there are many problems with the healthcare industry. Years ago I could do a case, bill the insurance, get paid, take care of the patient and everyone was happy. Now if a doctor wants to do surgery while seeing a patient with private healthcare the doctor has to get prior authorization from the insurance company, which is not all an easy endeavor since the insurance company try to deny the treatment recommended. The insurance companies pay doctors to review such cases and then deny the procedures to be done in which case the treating doctor has to speak with the reviewer to reverse their decision to deny care. This takes a lot of time, energy not to mention it enrages the patients who may believe it's their treating doctor who is delaying care. Medicare does not require prior authorization but the reimbursement is often very low which leads to fraud and abuse by the doctors to increase volume to make up for the low reimbursements. There is not enough time to go into that issue at this time. In addition to the above, doctors now use "physician extenders" who are PA's, etc., who do not know as much as the doctor but are now largely directing health care. This is done so the doctor can increase the number of patients and "care" provided which will increase the bottom line.
I vividly remember a case I did about 25 years ago. It was a child about 1 year of age who had what is called craniosynostosis of the sagittal suture which translates into premature fusion of the sagittal suture which is a normally created space between bones of the skull which enables the skull to normally grow into a nice roundish skull. With this condition the suture prevents side to side growth of the skull which means the head elongates more in a front to back growth and not side to side which leaves one with what is commonly known as a "boat head" as per the appearance of the keel of a boat. This condition does not prevent normal intelligence, but if it is not surgically corrected by the time the child is 2-3 years old the surgery will not be effective and the child will have to live their entire life with a boat head. I had obtained prior authorization from the insurance company. After the operation I was not paid. I got a call from someone in the insurance industry who called me up and asked if that operation was a "plastic procedure." I said, "yes" and with that they flatly denied any payment. I did not hide the condition when we obtained prior authorization. The story would have been one of ongoing anger against the insurance company, but when I retired 6 years ago my office sent out notices to patients I would be retiring. Prior to fully retiring this 25 year old man came to my office with his parents to show me how nicely he healed and he had a perfectly shaped skull. He and his family were very happy with what I had done taking care of him. That was enough for me to see him with the gratitude they had for my care.
I could go on and on about healthcare, fraud and abuse, bad doctors, horrible insurance companies, but that would take a book to fully describe. Since I have been in Santa Barbara I personally have experienced physicians who lie about their care for me but on the other hand I have seen some physicians who remind me of what it's like to take care of patients and how many physicians are not solely driven by making money. These are the doctors who should be praised.
I currently review personal injury cases for the defense. In other words, I'm the doctor who reviews cases where, mostly car accidents, the patients lie about their injuries and the attorney's lie about the injuries for both sides just to make money. Since I retired I have seen about 350 personal injury cases and I can honestly say that only about 10 cases were legitimate and all others were fabricated lies. I know this since I reviewed all the medical records, all the radiologic studies, the operative reports and then a separate IME which is an independent discussion and examination of those who are alleging injuries. The personal injury cases are largely fraud with what I have seen. There are, of course, legitimate injuries that should be compensated, but the doctors and lawyers involved in the majority of personal injury cases are fraudulent. This raises our car insurance rates, etc., etc. This does not mention that the attorneys and doctors involved in these cases charge usually at 10 times what the private doctor would make performing a similar case through regular health insurance. This fraud and abuse has to be dealt with for what it is. Again, I could go on and on.
I reject all schemes that place a third party between the patient and the provider. In all cases this perverts healthcare from the patient's health to the financial health of the providers, insurance companies, pharma and politicians. A confederacy of pricks all trying to get a piece of the action, the patient Is reduced to a vehicle to profit from. And most of these pricks have no useful role from the point of view of the health of the patient.
You may not be able to recognize when a doctor is part of a scheme. Look into the Physician Owned Distributor model. Look into the Pacific Hospital of Long Beach where the owner of the hospital, Mr. Drobot, paid a regular machinist to make spinal implants which were not FDA approved and had solvents and other materials left on the implants that could be absorbed into the body of unknown recipients. Needless to say, over time, this came out. Drobot and quite a few spinal surgeons went to prison. But try telling that to the 1,000 or more patients who had fake implants put in their spines. Again, all about money.
Several decades ago when third parties were intervening in "health care", a prescient book "Strangers at the Bedside " foretold where we find ourselves today. Describing the phantom forces we could not see, who were standing behind the doctor or between the doctor and the patient at the bedside.
Fascinating experience you had in the medical field. Traveling from Dalton, GA to Chattanooga, TN many of the freeway billboards are for auto accident attorneys. Same with local TV commercials ... auto accident attorneys. That's a lot of fake claims you mention. Georgian's make good liars.
Absolutely true. Then Covid abd now our system is increasingly different to get to see any doctor. Many doctors are retiring or quitting. Obama did a terrible thing to all of us.
I had a major neurosurgery after an accident in 2018 and the fee was $2.5 MILLION. Obamacare covered all but $15,000 out-of-pocket. But I continued to receive bills for more than 2 years, so apparently those providers and the hospital were not being reimbursed by the system. Then I aged into Medicare, and finding that Sansum would make me wait months for appointments (and at one point when I tried to switch primary care doctors it was 18 months to have an appointment to start with him) I moved over to one of the local UCLA clinics for my primary doctor. Now 35% of my Social Security pays for Medicare and the various supplementary plans necessary to cover possible events. I know from reviewing my records for that month in the hospital after surgery that the jokes about $10 aspirins are accurate, and now I am convinced having adequate "coverage" is crucial. Thankfully I have an excellent agent who navigates through the minefield of options for me, and like all insurance I hope it is money thrown away and that I never need the health care it would buy for me.
Shows the stupidity of a hospital when charging ridiculous prices. If they had an ounce of intelligence, obviously they would charge nothing and raise the price on something else that nobody would notice. It's this sort of hospital stupidity that makes me wonder if I'd be better off avoiding a hospital even if I'm vomiting blood for a week.
It reminds me of the many who celebrated and honored Kyle Rittenhouse when he murdered some folks he disagreed with. Guns are not the answer, but for too many, it seems to be their favorite way of communicating disagreements.
Joseph Rosenbaum was the first person Rittenhouse shot on that chaotic night.
Rosenbaum was at the unrest after having just been discharged from a hospital in Milwaukee, his fiancée, Kariann Swart, testified at the trial.
The 36-year-old crossed paths with Rittenhouse in a used-car lot as Rittenhouse brandished an AR-15-style rifle. Rosenbaum, meanwhile, was unarmed and carried a plastic bag containing a toothbrush, toothpaste, socks, deodorant and some papers.
According to Rittenhouse's lawyers, Rosenbaum approached Rittenhouse and attempted to "engage" him. Afraid, Rittenhouse took off running and Rosenbaum gave chase. Videos of the incident show that Rosenbaum eventually threw the plastic bag he was carrying at Rittenhouse, who responded by firing four shots at the man.
So, you have a kid feeling threatened and killing someone and another who felt threatened by someone, and he killed that person. Both were unnecessary murders being condemned or celebrated by people who agreed with the actions or not.
With Obamacare, I was finally able to get insurance. I’d been denied because of a pre existing condition.
Also, I have cousins in England and Canada. They have all had excellent care. The only situations with long wait times are optional, not urgently needed or even recommended, procedures.
You are always free to pay for your own healthcare. All of our healthcare woes originate with the notion that a patient cannot or should not pay their own bills. Comprehensive healthcare schemes of insurance or government intervention drive costs and pervert treatment protocols from the interest of the patient to the greed of providers, insurance. companies and politicians. The only place for health insurance is as a high deductible plan to cover catastrophic events. This will dramatically reduce cost and improve care.
In the summer of 2013, I was in excellent shape at 57 years of age, and I received a notice from my healthcare provider, Kaiser Permanente of Ventura, that my premium was increasing from $224.55 in 2013 to $496.55 in 2014, with no changes made to my healthcare coverage, other than HIGHER out-of-pocket copays.
By 2023, my “private” healthcare costs increased to more than $1500/month.
America: affordable healthcare delivered anything but affordable healthcare. My primary care provider has been a revolving door of well-meaning strangers. And, we all know what it’s like to wait for a delayed appointment for necessary medical procedures.
Lou, you’re absolutely right. The devil isn’t the healthcare industry — it’s government meddling.
Obamacare has been one giant bummer.
The only thing I think about Obama is how he would swagger up to a podium. Fortunately, he finally crashed and burned during this last election. And we have Pelosi's Obamacare comment "We have to pass the bill so that you can find out what is in it." What a bunch of idiots we have in government.
Up until 2010-2011 I had been paying into my private healthcare insurance, Fortis, since 1980. My reward for doing this was that I had not just good but great insurance that covered me and my family for every conceivable thing (including conception). All for about $300/mth.
Then came Obamacare which essentially forced my insurer to flee the state and I lost 30+ years of disciplined premium payments every month even though I didn’t need it because…it was the responsible thing to do. I got to see the doctors I wanted when I wanted and I just flashed my Fortis card at any medical facility and was given immediate attention…
With Obamacare My family and I were forced into buying crap insurance (Anthem Blue Cross) for 3-5x the monthly premium and we had to scramble every year now to see what changed and re-apply like a test for admission to see what subsidies we qualified for.
Of course all my employees had to find their own insurance because it was too expensive to have the company pay for it. I was able to get most of them something called Healthnet for a little while but then the government removed the profit motive for our broker and then Healthnet fled the market as well, at least for everyone who was not a government employee at the university…those guys got a special waiver …the era of life by government edict and competition for exemptions and special treatment waivers had begun
We fundamentally err when we use the term "health care". Health care today is in fact a commodity. Care is endless and humane; health treatment is finite and needs to be assessed for its effectiveness. "Health care" today in fact is system of treatments and billable procedures.
Some of these procedures work, many do not, many chase unsubstantiated surrogate metrics. and most are not even tracked for effectiveness or appropriateness. They are used today almost exclusively to determine who will be paying for the billed procedures. Will it be the individual or someone else: government, charities, third parties, absorbed within the system, or settled in a bankruptcy court. That is the crux of the what we call the "health care" debate today. Who pays and for what.
First step: define what in fact is "health care". Define its full dimensions before writing a blank check to cover this amorphous term in order that this thing gets paid for by someone. Those delivering these procedures have a right to compensation for their services that are included in the delivery of this thing called "health care" - from the intake clerks, to the intermediary screening procedures, to the trained professional personnel delivering the agreed procedures, to the administrative staff that sorts out the applicable procedures, billings and reimbursement codes to the buildings, equipment, maintenance and replacement of all of the above.
Many outside factors drive "health care" today: medical malpractice threats, legislation, third party assessed standard of care protocols, need for revenue generation, rationing, outside pressures to "do something", interfamily dynamics worked out at the bedside, sanitizing the dying process, wide variety of cultural belief systems about "western medicine" .......all of the above and more are embedded in what is loosely called today"health care".
Solutions? Who pays, what should someone else pay, and why. Settle the threshold argument: is health care a right or a commodity? It is a commodity.
When there is such a wide ranging diversity of opinions about "health care", the easiest way out is to just keep paying, stay emotionally black mailed, and never deny anything. Until the system we have today collapses under it own weight. Let us hope, with some of the inconoclastic new government appointments to oversee this highly cumbersome system today, they can get back to grappling with the fundamentals - what in fact is "health care". And who pays.
Obamacare wrongly assumed just providing health insurance for everyone was providing health care for all. How do we dig ourselves out of that wrong turn? What responsibilities must we assume as individuals for our own "health care". Do we take two different routes, one to cover incidents of trauma and another to cover the sequelae of chronic, often lifestyle conditions?
First step is to admit we really don't know what any of us are talking about when we use the term "health care", let alone when we demand universal health care for all.
Dead-on balls accurate. Great comment.
Yes, our healthcare delivery system is a complete mess, but it’s still the best and most advanced in the world. Technology, advances, discoveries all made because of our capitalist system. The possibility of making advances only comes with the possibility of making a return for the shareholders and investors. Hospitals, physicians, pharma and biomedical all (in my view), must be able to make as much as reasonably and ethically possible. This is what spurs innovation.
Of course, we have major problems with fraud, abuse, malpractice, delivery, reimbursement, the list goes on. Our Workers Compensation system is on life support. Fraud and abuse are at the core of its pending collapse. Unscrupulous doctors and lawyers eating from the same trough. Workers Compensation reform is needed now.
The problems we are now seeing in property/ causality insurance is the tip of the iceberg and is bound to affect health insurers. Simply put, if insurance companies can’t make an adequate profit, they will move to other more profitable markets. As it is now, 2/3 of all residents of SB County are on subsidized plans. Many of which are non employed, undocumented and have zero ability to pay. This spells disaster for private insurance and the taxpayer. Ever wonder how Cencal was started? The simple answer is that SB County reimbursement is so undervalued relative to our cost of living that it was “negotiated “ with Medical and local healthcare executives for our geographic area in order to get more favorable rates.
We have the most expensive healthcare but only of mediocre quality.
Best and most advanced healthcare system in the world? I don’t think so.
https://www.internationalinsurance.com/health/systems/
This ratio has been similar for decades. Infant mortality rate in Cuba is 4.0 deaths per 1,000 live births. In the United States, it's 5.9. In other words, an American infant is, by official statistics, almost 50 percent more likely to die than a Cuban infant.
Oh really? Why then do practitioners from all over the world want to come to the United States for training and Residency?
LT; Sure, but you’re comparing apples and oranges with the “quality” of healthcare. The US rates at, or near, the top countries in the world in terms of “training” future medical doctors. Unfortunately, that does not translate into better overall medical “care”.
Norway, Australia, New Zealand, and the UK are the top performers in administrative efficiency, which is how well health systems reduce paperwork and other bureaucratic tasks that patients and clinicians often face during care, whereas the United States again ranks last.
In terms of US mortality rates, other highly developed countries have a much higher life expectancy rate. Hard to argue with that statistic!
The US does excel in specialized trauma care, which is why this needs to be segregated from routine "health care" when we assess universal health care needs and costs. How far should routine health care dollars be also asked to fund highly specialized but far less routine catastrophic care?
I'd propose one major reason they come here is for the income they could make if they stay.
A shocking poll just found that 41% of those polled, under 30 years old found it “acceptable” to have gunned down United Healthcare CEO, Brian Thompson. This result illustrates how the liberal left views violence as a means for social change. Surprised? I’m not. This is right out of their playbook. Confront, harass, bully, threaten, assault and now targeted assassination. Sure, whether it be on a subway or walking down the street, minding your own business and then shot in the back, this is what the left does. Even to the point of assassinating our President elect in an effort to silence him. The left is NO longer the party of “peace and love” but has now morphed into a violent, terrorist, death cult. Why is it we never hear the conclusions as it relates to these criminals motivations? The transgender shooter at the Christian school in Nashville, did we ever see the manifesto? Why not?
The time has come for our FBI, under the direction of Kash Patel, to investigate and come down hard on these left wing, bigoted hate groups. As the left’s poster child for hate and discourse, Malcom X once proclaimed, “any means necessary.”
Sometimes I think it's watching too much television with the casual killing of people in the storylines.
"any means necessary" is exactly what the liberals, (Dems) believe and preach to their feeble minded followers. It follows their simplistic mind, "It feels good, so do it".
Ya, and a liberal judge believes the assassin is the victim. He'll get off on insanity.
APPLAUSE APPLAUSE APPLAUSE 👏🏼👏🏼👏🏼👏🏼 When Obamacare was being discussed, I tried to tell the employees working for me at the time that it was not a good thing, that I could virtually guarantee that they would not be able to keep their doctor or medical plans, that it would be more expensive, and that, in the end, they would definitely not be happy. You would not believe the pushback I received from these statements! And guess what? ALL OF IT CAME TRUE!!
Back then I was paying about $239 per month for a platinum medical plan with an extremely low copay for visits and medication. After Obamacare came into effect, a similar plan but with less benefits and twice the cost of visits and medication was $879 per month! And no, I could not keep my doctor!
Not to be a conspiracy theorist, but I have to wonder about the similarities between this situation of shooting United's CEO and school shootings. Neither are acceptable under any circumstance, at any time, for any reason (except self-defense when your life is in imminent danger and I don't just mean because of a poor health care plan).
When school shootings occur, gun activists turn to their playbooks and fight for more gun control. When a massive health care CEO is assassinated, the left turns to their socialist playbook and demands more government oversight in health care. See the similarities?
Neither are okay. Less government control will always be better regardless of the subject.
I used to be against guns and against the death penalty because of my upbringing in a Christian household. However, the older I have become and the more I have learned about life, the better I understand the need for LEGAL guns and even the death penalty. I believe everyone deserves multiple chances for grace, redemption, and forgiveness. However, there are some people who are just too consumed by evil, violence and hatred and are determined to destroy.
In any case, excellent article. I wholeheartedly agree that Obamacare was a disaster, a sham, and an intentional ploy to begin taking over America's healthcare system. And, of course I agree that deadly violence is, and will never be, the answer.
Remember the stack of documents created for Obamacare. I think one thing we all missed was somewhere in those stacks of paper was a basic equation which makes the more "wealthy" pay for the much less "wealthy." Your healthcare costs went up to pay for those that can't afford it, the classic American Democratic Party way, classic redistribution.
Exactly! My assistant at the time was a staunch Democrat. We had many interesting conversations, one of which was about Obamacare. She tried so hard to convince me that, as a Christian, I should be willing to give up my hard earned money to help pay for those less fortunate. We went back and forth on this quite a bit as you can imagine, especially since I was running a nonprofit.
I think the concept that finally helped her understand, was when I presented her with a situation that was more close to home. There was a young man in his early twenties that would come on our property and sleep under one of the trees. We had people on site during the day and we could not risk having someone that we didn't know on the property so we called the police. They informed us that he was a child of a very wealthy couple that lived nearby and they had given him an ultimatum that he had to get a job or leave the house. He decided he would rather sleep under a tree and ask people for money rather than get a job. Mind you, he had no disabilities, he was very articulate, and seemed to be in excellent health. And this was all according to the police because they knew him.
She knew about this guy of course being my assistant. So I asked how she would feel if I took out $400 from each of her paychecks to help pay for his medical care, even if he didn't need it every month. That I took it out just in case he needed it because he was irresponsible and drinking and using drugs instead of getting a job. I asked how she would feel about having to give up a vacation she was planning because this guy in our parking lot might need medical care. Maybe. And that she had no choice in the matter of the amount I took out but that if she got medical care, he should have it too even though he's not working.
I asked if she wouldn't prefer being able to give him money as she felt she was able in the amount and at the time she wanted instead of being forced to hand over $400 every paycheck because I wanted to do it.
Then she understood.
Dems always thinks it's someone else's money and not their own. The "rich" kid must have thought he was privileged and didn't have to work. Even with engineers that were some that thought that way because they are really smart and shouldn't have to do that much to make a living. There are some interesting "what I have to do" concepts out there!
Well, at least the Dems making policy think it's someone else's money because it usually IS! It's OUR money!
I agree wholeheartedly! I cannot believe how many dummies are idolizing that murderer! Plain and simple, that's what he is, a murderer. Murder is never ok for anyone, never! And the ones who idolize him are just as bad, they may have just killed him as well. This CEO is leaving behind a wife and babies! You want something done, then go to our so called government, and demand they change it! They are there to serve us! We, the people, pay their salary, we pay far too much to them for what? Heartache, because we fork out all this money we don't have, to pay them, for them to give us nothing! I'm a grandmother of 5, in very bad health and can't get better, but I'm not going to kill anyone over it. I believe God will judge everyone in His own time. We need to bring God back to our lives. He is the only one who can restore goodness, because Biden and his whole administration has blanketed us in evil, and given the ok to victimize others. We have to look forward. Stop idolizing evil, because all it does is make the sickness grow and become toxic for everyone, then innocent become victims again, it's a circle, and not the circle of"life", but instead, a circle of torture and death! So don't kill, and don't idolize those that do. Pray for them, pray for the victims, pray for the government, pray for one another and most importantly, pray to your maker, God, Jesus Christ, our only Lord and Savior. Blessings to the world!
Well said!
I suspect that the young man who planned the killing and lay in wait, was himself seriously mentally ill. My guess, paranoid schizophrenic. I am not a psychiatrist, but my life has been rooted in familial mental illness since my earliest childhood memories. The killer's personality change was quick and dramatic. He was a brilliant mind, valeictorian of his high school class, and well liked. His old friends are stunned. His mother had reported him as a missing person prior to the murder. I write this now because mental health is not properly recognized and treated: by the health care industry, by the government. It's a nightmare for the families of severely mentally ill to navigate a system such as ours. The "right to privacy" laws too often excludes the families from being able to get care, the folks who know their loved one best. The choices for severe mentally ill are limited: life on the streets; life in a prison or public institution; suicide. Absolutely, early death. And absolutely, a life of loneliness and isolation. And here, the threat to others, inckuding murder. A shot of medication to control schizophrenia runs $14,000.00. We are all at the mercy of such a system.
As more people receive free (as in Cencal, Medical, Medicare) or subsidized Obamacare plans the greater the cost to those left paying either through premiums or taxes. Perhaps an even greater problem with government intervention into healthcare is that now the customer is not the patient but the government or the insurance company. Gone is the incentive to provide a quality product at an affordable price. Fortunes are made behind the scenes between providers, hospitals, insurance companies, pharma and politicians. The act of getting a single new drug approved by medicare is the approval for billions of dollars to change hands. If you think these decisions are made with the well being of the patient in mind you are a fool. Witness the push to get weight loss drugs which cost thousands per month approved for children citing the obesity epidemic among our children. As a patient, the only agency we ever had was as the customer paying the bill. There is nothing so expensive as that which the government has sought to make affordable.
My Dear Mr. Segal:
What do you mean castigating the coddled Left and using terms like gunning down, a man walking to work.
It has been clear for decades the opposition has been moving to a radicalized position where any person or group that would dare to expose their centralized control of government is guilty.
I am just old enough to remember when my lower middle class parents of the 1950's needed care for me and went to my former pediatrician. Without a thought she treated me and then gave the same bill for a child.
"Give me...." has become the password for these spoiled children who are now Grandparents.
Oh and have I neglected to mention pardons?
Your comment "...dangerous is not because of the callous reaction of so many people to it (although that is very troubling......" exposes the we are right crowd. Any means including destruction of the Constitution, and social hammering of anyone who would openly express the need for a discourse are their enemies.
Well done.
Lou, terrific! Hopefully, I can tell my story to SBC readers in January, having just experienced the nightmare that is French socialized médecine. I fell and broke my wrist and had to wait 2 agonizing days on my sofa, full of morphine and other too powerful drugs, for a place at the local hospital to operate! Stay tuned! Calla
The elected representatives and staff should have the same opinions as we, their subjects do.
Government mandates procedures, such as trans surgery and abortion that increases your insurance premiums.
On another note it our elected representatives and staff were mandated to, as we are, to pay social security that fund wouldn’t be in trouble.
How come social security is going to run out but not welfare or the billions we send to countries that hate us?
As a retired neurosurgeon, 31 years in private practice, I know that there are many problems with the healthcare industry. Years ago I could do a case, bill the insurance, get paid, take care of the patient and everyone was happy. Now if a doctor wants to do surgery while seeing a patient with private healthcare the doctor has to get prior authorization from the insurance company, which is not all an easy endeavor since the insurance company try to deny the treatment recommended. The insurance companies pay doctors to review such cases and then deny the procedures to be done in which case the treating doctor has to speak with the reviewer to reverse their decision to deny care. This takes a lot of time, energy not to mention it enrages the patients who may believe it's their treating doctor who is delaying care. Medicare does not require prior authorization but the reimbursement is often very low which leads to fraud and abuse by the doctors to increase volume to make up for the low reimbursements. There is not enough time to go into that issue at this time. In addition to the above, doctors now use "physician extenders" who are PA's, etc., who do not know as much as the doctor but are now largely directing health care. This is done so the doctor can increase the number of patients and "care" provided which will increase the bottom line.
I vividly remember a case I did about 25 years ago. It was a child about 1 year of age who had what is called craniosynostosis of the sagittal suture which translates into premature fusion of the sagittal suture which is a normally created space between bones of the skull which enables the skull to normally grow into a nice roundish skull. With this condition the suture prevents side to side growth of the skull which means the head elongates more in a front to back growth and not side to side which leaves one with what is commonly known as a "boat head" as per the appearance of the keel of a boat. This condition does not prevent normal intelligence, but if it is not surgically corrected by the time the child is 2-3 years old the surgery will not be effective and the child will have to live their entire life with a boat head. I had obtained prior authorization from the insurance company. After the operation I was not paid. I got a call from someone in the insurance industry who called me up and asked if that operation was a "plastic procedure." I said, "yes" and with that they flatly denied any payment. I did not hide the condition when we obtained prior authorization. The story would have been one of ongoing anger against the insurance company, but when I retired 6 years ago my office sent out notices to patients I would be retiring. Prior to fully retiring this 25 year old man came to my office with his parents to show me how nicely he healed and he had a perfectly shaped skull. He and his family were very happy with what I had done taking care of him. That was enough for me to see him with the gratitude they had for my care.
I could go on and on about healthcare, fraud and abuse, bad doctors, horrible insurance companies, but that would take a book to fully describe. Since I have been in Santa Barbara I personally have experienced physicians who lie about their care for me but on the other hand I have seen some physicians who remind me of what it's like to take care of patients and how many physicians are not solely driven by making money. These are the doctors who should be praised.
I currently review personal injury cases for the defense. In other words, I'm the doctor who reviews cases where, mostly car accidents, the patients lie about their injuries and the attorney's lie about the injuries for both sides just to make money. Since I retired I have seen about 350 personal injury cases and I can honestly say that only about 10 cases were legitimate and all others were fabricated lies. I know this since I reviewed all the medical records, all the radiologic studies, the operative reports and then a separate IME which is an independent discussion and examination of those who are alleging injuries. The personal injury cases are largely fraud with what I have seen. There are, of course, legitimate injuries that should be compensated, but the doctors and lawyers involved in the majority of personal injury cases are fraudulent. This raises our car insurance rates, etc., etc. This does not mention that the attorneys and doctors involved in these cases charge usually at 10 times what the private doctor would make performing a similar case through regular health insurance. This fraud and abuse has to be dealt with for what it is. Again, I could go on and on.
I reject all schemes that place a third party between the patient and the provider. In all cases this perverts healthcare from the patient's health to the financial health of the providers, insurance companies, pharma and politicians. A confederacy of pricks all trying to get a piece of the action, the patient Is reduced to a vehicle to profit from. And most of these pricks have no useful role from the point of view of the health of the patient.
You may not be able to recognize when a doctor is part of a scheme. Look into the Physician Owned Distributor model. Look into the Pacific Hospital of Long Beach where the owner of the hospital, Mr. Drobot, paid a regular machinist to make spinal implants which were not FDA approved and had solvents and other materials left on the implants that could be absorbed into the body of unknown recipients. Needless to say, over time, this came out. Drobot and quite a few spinal surgeons went to prison. But try telling that to the 1,000 or more patients who had fake implants put in their spines. Again, all about money.
We agree on this one!!!
Several decades ago when third parties were intervening in "health care", a prescient book "Strangers at the Bedside " foretold where we find ourselves today. Describing the phantom forces we could not see, who were standing behind the doctor or between the doctor and the patient at the bedside.
Fascinating experience you had in the medical field. Traveling from Dalton, GA to Chattanooga, TN many of the freeway billboards are for auto accident attorneys. Same with local TV commercials ... auto accident attorneys. That's a lot of fake claims you mention. Georgian's make good liars.
Excellent overview Dr. Lederhaus.
Absolutely true. Then Covid abd now our system is increasingly different to get to see any doctor. Many doctors are retiring or quitting. Obama did a terrible thing to all of us.
Just seeing the name of that stinking Traitor makes me want to puke.
I had a major neurosurgery after an accident in 2018 and the fee was $2.5 MILLION. Obamacare covered all but $15,000 out-of-pocket. But I continued to receive bills for more than 2 years, so apparently those providers and the hospital were not being reimbursed by the system. Then I aged into Medicare, and finding that Sansum would make me wait months for appointments (and at one point when I tried to switch primary care doctors it was 18 months to have an appointment to start with him) I moved over to one of the local UCLA clinics for my primary doctor. Now 35% of my Social Security pays for Medicare and the various supplementary plans necessary to cover possible events. I know from reviewing my records for that month in the hospital after surgery that the jokes about $10 aspirins are accurate, and now I am convinced having adequate "coverage" is crucial. Thankfully I have an excellent agent who navigates through the minefield of options for me, and like all insurance I hope it is money thrown away and that I never need the health care it would buy for me.
Shows the stupidity of a hospital when charging ridiculous prices. If they had an ounce of intelligence, obviously they would charge nothing and raise the price on something else that nobody would notice. It's this sort of hospital stupidity that makes me wonder if I'd be better off avoiding a hospital even if I'm vomiting blood for a week.
I have to believe that our insurance/government based healthcare system inflates prices by 10X.
It reminds me of the many who celebrated and honored Kyle Rittenhouse when he murdered some folks he disagreed with. Guns are not the answer, but for too many, it seems to be their favorite way of communicating disagreements.
Rittenhouse didn’t murder “some folks he disagreed with”. He was violently attacked and defended himself.
Rittenhouse shot in self-defense. Why premise your comments on a lie, Gene?
Joseph Rosenbaum was the first person Rittenhouse shot on that chaotic night.
Rosenbaum was at the unrest after having just been discharged from a hospital in Milwaukee, his fiancée, Kariann Swart, testified at the trial.
The 36-year-old crossed paths with Rittenhouse in a used-car lot as Rittenhouse brandished an AR-15-style rifle. Rosenbaum, meanwhile, was unarmed and carried a plastic bag containing a toothbrush, toothpaste, socks, deodorant and some papers.
According to Rittenhouse's lawyers, Rosenbaum approached Rittenhouse and attempted to "engage" him. Afraid, Rittenhouse took off running and Rosenbaum gave chase. Videos of the incident show that Rosenbaum eventually threw the plastic bag he was carrying at Rittenhouse, who responded by firing four shots at the man.
So, you have a kid feeling threatened and killing someone and another who felt threatened by someone, and he killed that person. Both were unnecessary murders being condemned or celebrated by people who agreed with the actions or not.
A couple of points.
With Obamacare, I was finally able to get insurance. I’d been denied because of a pre existing condition.
Also, I have cousins in England and Canada. They have all had excellent care. The only situations with long wait times are optional, not urgently needed or even recommended, procedures.
You are always free to pay for your own healthcare. All of our healthcare woes originate with the notion that a patient cannot or should not pay their own bills. Comprehensive healthcare schemes of insurance or government intervention drive costs and pervert treatment protocols from the interest of the patient to the greed of providers, insurance. companies and politicians. The only place for health insurance is as a high deductible plan to cover catastrophic events. This will dramatically reduce cost and improve care.
Less can often be more, when it comes to "health care".