Health Service Blues

[Undertoad]

It would appear you have chosen to lecture me about the nature of The Cellar and online community.

[Cicero]

Originally Posted by Undertoad

It would appear you have chosen to lecture me about the nature of The Cellar and online community.

Oh jeez.........

See what you started? Now I'm getting the lectures........

That's a neat trick UT.

[elSicomoro]

Jesus...knock it the fuck off.

[Sundae]

I don't want you to think I was lecturing you. If you didn't mean me I eat a huge slice of humble pie & please ignore the following text.

It may not have come across well, but honestly I was trying to slip some personal advice to someone whose posts I enjoy. There have been some issues in the Cellar recently, but they have been almost exclusively between established Dwellars. I can't remember what has happened since you joined (a year ago) but we have had some very confrontational newbies and also some slow burning issues.

Oh I don't know why I'm typing this... I can't explain it intelligently but I adored Shawnee and she's gone. She was a support, a comfort and made me laugh. Often in posts, sometimes in PMs. She had her own issues with other Dwellars but never tried to get me "on board".

I like you. And I worry that if I'd spoken more to Shawnee on the board and less on PM she'd still be here & making many people laugh.

[Cicero]

.................................?

[Sundae]

Sorry if I have got thnigs completely wrong Cicero.
I'd prefer if you gave me a clue though.

[Aliantha]

you can't read minds either SG? lol

[Cicero]

Originally Posted by Aliantha

you can't read minds either SG? lol

Oh, so since when did you guys quit reading my mind?!? Oh....you only read my mind when it's convenient for you.....great.


No harm, no foul SG! All my comments were directed at UT in that scenario...so don't worry 'bout it.

[SamIam]

Originally Posted by jinx

"Something like 30%" is a lot more than 16%, don't you think?

My bad for not going back and reveiwing my information. According to the latest info from the US Census (Press release of August 28, 2007), more than 30% and close to 40% of Americans do not have insurance through work. I think this is the statistic that lodged in my mind. At any rate, we still have 47 million Americans with no insurance at all. This is not a good situation, and according to the Census, the percentage of uninsured continues to climb.

As far as Mediciaid versus Medicare, the question is complicated because Medicaid is administered by the states with some federal guidelines. Thus, what Medicaid coverage will do for you can vary widely from state to state. Medicare is the same throughout the US, and administered strictedly by the Feds. Thus, I can say with some confidence that inflated hospital costs will also turn up as more charges to Medicare and Medicare premiums across the board. If someone has Medicaid in addition to Medicare, the two programs will share the costs, but again Medicaid is more variable in who get coverage and what gets paid, so if I'm going to generalize, I'd rather generalize about Medicare.

This is actually a rather dry topic. Do you guys always get so mad at each other over trivia?

[TheMercenary]

Originally Posted by SamIam

My bad for not going back and reveiwing my information. According to the latest info from the US Census (Press release of August 28, 2007), more than 30% and close to 40% of Americans do not have insurance through work. I think this is the statistic that lodged in my mind. At any rate, we still have 47 million Americans with no insurance at all. This is not a good situation, and according to the Census, the percentage of uninsured continues to climb.

As far as Mediciaid versus Medicare, the question is complicated because Medicaid is administered by the states with some federal guidelines. Thus, what Medicaid coverage will do for you can vary widely from state to state. Medicare is the same throughout the US, and administered strictedly by the Feds. Thus, I can say with some confidence that inflated hospital costs will also turn up as more charges to Medicare and Medicare premiums across the board. If someone has Medicaid in addition to Medicare, the two programs will share the costs, but again Medicaid is more variable in who get coverage and what gets paid, so if I'm going to generalize, I'd rather generalize about Medicare.

This is actually a rather dry topic. Do you guys always get so mad at each other over trivia?

Medicare is for old people, Medicaid is for poor people.

[SamIam]

Originally Posted by TheMercenary

Medicare is for old people, Medicaid is for poor people.

Well, that's one way of looking at it. Actually, some, but not all, poor people get Medicaid. Most poor people get Medicare. Some, but not all, elderly get Medicaid. Almost everyone over 65 gets Medicare. So, it is Medicare, NOT Medicaid which is the constant.

But what interests me goes beyond the difference in Medicare vs. Medicaid. What interests me most is those 47 million Americans with no health insurance at all, even "-caid" or "-care."

I mentioned that those with no insurance at all must resort to a very expensive hospital ER visit. In many cases, the law requires the hospital to treat, at a high cost, whomever darkens the hospital ER's door. Well, should these laws be changed? Taxpayers and/or private health insurance consumers are the ones paying for these costs.

Do we, as a people, write off 47 million fellow Americans? If so, why? Is it a matter of eugenics and/ or xenophobia? Is it a matter of the bottom line and what we will and won't tolerate as a society? Do we figure that the people who get treated in an ER are either illegal immigrants, or homeless alcoholics, or poor white trash trying to beat the system? Where are the statistics on THAT?

Are we willing to throw 47 million people to the dogs in our cities and towns with no medical care, what-so-ever? Some of those people would die. Let's get real. We kill convicted murderers. Shall we also kill wetbacks for daring to transgress, the old man who DOESN'T have Medicaid, the young mother of two trying to escape an abusive situation, the Afro-American "welfare queen" PLUS her children, the white trash drunk passed out on a park bench, etc., etc.?

In a different thread, RK mentioned the HUNDREDS of billions that Congress is planning to appropriate to Defence Department. A large percentage of this will go to conducting our current wars, where both enemy soldier AND civilian will be killed. WE are willing to spend billions killing others in the name of the defense of the United States. How do we best spend our money defending ourselves at home?

THAT is my question. AS a society, how shall we determine who lives and who dies and for what end?

[DanaC]

So...what? Is the NHS just not reducing its spending when moving services over to contractors or private peeps?

Well. It is different in different situations. But what often happens is, political and business interests collide and a scheme gets under way which goes drastically wrong and needs rescuing to avoid somethng catostrophic happening, or where the relationship between the state sector and the business sector skews all the advantage to the business sector. PFI hospitals gave a quick fix solution to the problem of out of date (from years of underfunding) or inadequate hospital facilities, but whereas the old buildings were ownwed by the NHS, the new buildings, built partially with government funding, end up as the property of the company. Effectively we pay a large percentage of the building costs and then lease the building from the private body.

Attempts to plug the service gaps (again, caused by years of underfunding) by bringing in third party organisations (so for instance a particular type of testing may be done by a private firm, with their own private staff. This has been trialled in some areas using, I think, a South African company, with their own staff). Another way of plugging service gaps is to utilise current Private medical facilities (such as Bupa hospitals). Naturally this costs more.

Thing is, the doctors who work at Bupa, also work in NHS hospitals, and have been trained by the NHS. Not all work carried out in private hospitals is private medicine.....not all work carried out in the NHS hospitals is social medicine. The lines have become confused. An attempt to meld a universal social medicince system has resulted in a massive culture clash within medical provision.

The whole thing has been further complicated by the drive to 'decentralise' medicine, resulting in "Primary Care Trusts". These essentialy run medical provision in some areas. Problem is, as with the Police and Fire services, these areas are larger than any single authority. My local authority and two others are covered by our Primary Care Trust. We as an authority, have our targets and mission statement on health, involving building a partnership with various bodies, including the PCT. They have their targets and mission statements and they are supposed to achieve that in partnership with each of the authorities. These partnerships don't always run smoothly. Because Councils are represented to the trust but have no democratic powers over it, there is very little democratic accountability.

At the point that they broke everything up into this decentralised system, they also broke the funding up, so that Trusts operate their own seperate budgets. This has led to some serious problems in terms of universality in the services which are available in any ne area.

It's better than it was ten years ago, in many ways. Service levels are better, waiting times are lower and most people, though they'll express an opinion that the NHS is going down hill, will if asked say that their own personal experience of it has been fine. But...with the amount of money we've poured into it we should have fixed it a damn sight more than we have. It was broken when we got hold of it...and we've fixed a lot of stuff, but we're busy unbolting some fairly important components along the way.

[DanaC]

Oh yeah....and the PFI hospitals are really quite shoddily built. Very shiny, lots of glass and pretty desk at reception...but very shoddily built.

[DanaC]

What a Trot! *grins*

[Cicero]

Waiting: In 3-2-1.........