...to answer your question. I'm continually dismayed at this kind of sloppy, socialist thinking that impugns making a profit (the pursuit of which benefits everyone). The insurance agent determining whether or not to cover me is beholden to the customer at the end of the day. In a free market the insurance companies would have to compete for customers, and the competition would be fierce if not for the meddling finks in Washington and our State capitals. I'll put my trust in the capitalist insurance companies who have superior motives when compared with the tyranny of top down control. What exactly is so liberal about being an unquestioning idolater of the State?

When I try to get things done for patients, I can usually get private insurance patients what they need after a denial by making a call or writing a letter. I think they strike a good balance between getting you what you need and taking care of their other customers.

I have found that Medicare/Medicaid bureaucrats are far more stingy, obstinate, stubborn, and (sorry) uneducated about medicine than private insurance bureaucrats. They answer to nobody, and it shows in their attitudes, unreturned phone calls, and unwillingness to help.

Again, it's all about who writes the check.

@ darwinist:

"The insurance agent determining whether or not to cover me is beholden to the customer at the end of the day. In a free market the insurance companies would have to compete for customers, and the competition would be fierce if not for the meddling finks in Washington and our State capitals."

Yeah, well, the insurance companies do compete for customers. Specifically, they compete for healthy customers who will probably not incur major medical expenses. If you loose your employer-provided health insurance and you have a medical condition, try finding affordable health insurance. In a single-payer system this is not an issue.

"I'll put my trust in the capitalist insurance companies who have superior motives when compared with the tyranny of top down control."

Yes, until you retire and you discover that health insurance premiums are eating up all of your income. Then Medicare won't seem like such terrible tyranny to you. Maybe that's why the AARP isn't lobbying to abolish the tyranny of Medicare.

Ok wise guy, you seem to have all the answers. No system is perfect. Single payer systems drag down the quality of health care, No competition Care is rationed , long lines for inferior care. Doctors leave or go into other professions as their work loads increase and their pay goes down. They spend 10 years and thousands of dollars in med training and then they become slaves to the government. Most say no thanks. I dont care what you believe. That is the truth.

I think if people were allowed to keep their insurance for say 1 year until they get another policy would be workable. As for medicare, everyone has been saying how both medicare and medicaid are both bankrupt and you are trying to use that as a good reason to go to govt healthcare.

If private medical insurance is so wonderful, it should have no problem competing for customers against a public option.

But they don't want to have to compete. Like all pseudo-capitalists, they're sitting on a bloated market reserve, and they know it.

I have a feeling my next checkup will be cheaper, when it no longer has to finance some fat Blue Cross executive's weekend at Pebble Beach.

the only reason Medicare and Medicaid are going "broke" is because they're stuck with the oldest, poorest population -- and therefore the sickest. The private insurance companies have a great racket in this country. They insure people through retirement, then dump them on the government just in time for the most expensive final years.

If medicare was able to sign up younger, healthier people, its books would balance out again. But that's exactly what the private insurance companies fear.

@ oldmanriver:

"Single payer systems drag down the quality of health care"

And where did you get that bit of truthiness? Faux News? According to a detailed assessment done by the World Health Organization, the U.S. ranks 37th in the world in terms of the overall performance of its health care system. <link> Countries with single-payer systems that rank higher than the U.S. include Canada, Japan, Britain, France, Italy, Germany, and Sweden. Facts are such stubborn things.

Please do tell us which single payer long line you've had to wait in. What care you needed was rationed? What inferior care you've received?

Care is rationed now by insurance companies. Doctors get paid whatever the insurance companies decide to pay them. And doctors have been leaving the profession for years.

Keep believing the scarey talk from the lobbiests. And be sure to say no thanks to Medicare when you're old enough.

As a doctor, I will tell you that private insurance companies are far more willing to cover expensive treatments when they are needed or have a chance to save a life. Sometimes it takes a letter or a call, but they do it. Medicare and Medicaid, not so much.

The new health care bill has a requirement that patients enter a medical home, which will give me (as an internist) financial incentives to not refer patients to cardiologists, orthopedic surgeons, and imaging tests. And it gives me direct financial rewards when I admit patients to cheaper hospitals (and there are some blech hospitals out there). So it will put cleverly put rationing on me. As it is, Medicaid patients have fewer options for physicians and don't get some procedures done because the reimbursement is below cost. A lot of you with private insurance will end up in that bucket under "healthcare reform" - especially as companies that do their own insurance will be required to comply with public option requirements within 5 years.

Please, spend some time with a doctor on the front lines one day. Go see how razor-thin the financial margins are. A lot of people seem to support a degradation of their own future care.

For starters, that's a U.N. measure, and if that doen't give you pause, then continue to enjoy the anti-American Koolaid by all means.The U.S. gets low marks for things like, % of GDP spent on healthcare. Yes, we spend a LOT more than Cuba, but we have fantastic, but expensive life saving technologies and drugs. Cuba is #39, while the U.S. is #37---do you really believe there is almost no difference between the two? If your kid had a emergency head injury would you be only 2% more confident going to HCMC than a hospital in Havana? No, you wouldn't. The low ranking also comes from infant mortality, but that's artificially lowered in the U.S. by the extremes we go to save premature and very sick newborns that wouldn't get a second glance in other countries. There's a lot to consider before uncritically swallowing criticisms of U.S. medicine. Unfortunately, these positive aspects of U.S. healthcare are terribly out of fashion, and hard to find. Another thing to consider is the degree to which socialized medicine in the world has been subsidized by America. Do you think France is going spend the tens/hundreds of millions to get a new drug or CT machine to the market? The answer is, no--America's been footing that bill for decades. When medicine is completely removed from the market, say goodbye to innovation.

The Insurance companies have decided human health is a money maker, and if you have none, tough....die...live on the streets if you can't afford your home after you developed your cancer...too bad...Jesus hates you and that's that....move to Oklahoma, where the real Christians live and they can lay hands on you beneath the red, white and blue flag.....you will be cured.....the insurance companies are doing god's work....and America's....

How do you explain how a private clinic in a large Canadian city can offer to do a colonoscopy for $800.00 Canadian, and schedule it for early August, when the same procedure could not be had around Atlanta for less than $3k.

Will they be using dirty scopes? Will it be nurse doing the scope?

Insurance companies will sometimes pay for care that is costly and controversial in the US while Medicare may not pay for some procedures that are of doubtful value. But then again, MC pays for Hyperbaric dives for chronic wound care patients with venous leg ulcers, how does raising the partial pressure of oxygen in the arterials help a patient who is not clearing the venous system? Canada will not pay for mostly this useless therapy!

Physiotherapists being paid to treat chronic wounds as primary terapists because they have a particularly strong lobby, is that a service we need??

Medicaid, lets not go there, it is the worst of all worlds because states rights are involved and states are supposed to cover half the cost. The whole system should be cleaned and burned.

I have been on Medicare for 3 yrs, no problems yet, the copays are reasonable and I have found a way around Rx drug costs, I insist that my physicians prescribe drugs that are available generically, simvastatin rather than Lipitor, Plan D is the most wasteful part of Medicare and all patients on Medicaid were forced nationwide to receive Plan D which was the real aim of the Pharma industry. Talk about a confusing plan, u r an MD, go online and see if you can find a plan that simple shopping around for generic meds would not beat by 70%.

Leo Harold

Hyperbaric treatment of wounds is to slow/reduce infectious processes by anaerobic bacteria (to which oxygen is toxic).

Medicare would not pay for any preventive treatment of WC, it would have to be improperly coded to get MC to pay. Diagnosis and treatment is what MC pays for.

Leo

You omitted the big factor in the USA's relatively poor ranking in the UN health stats - the countries ahead of the US cover all their citizens while 40-50 million Americans have no coverage and even more millions have virtually worthless insurance.

darwinist:

The U.S. gets low marks for things like, % of GDP spent on healthcare

.

No, that does not even enter onto the stats which are based on outcomes: longevity, infant mortality, etc. Why would a country be penalized for wanting to spend more on health care? If the US had a system where the benefits of all that spending were equitably distributed, it would show up in improved outcomes.

darwinist:

Do you think France is going spend the tens/hundreds of millions to get a new drug or CT machine to the market? The answer is, no--America's been footing that bill for decades.When medicine is completely removed from the market, say goodbye to innovation.

So American drug consumers are supposed to subsidize the innovation of the phramacuetical industry? More likely is that single payer systems, such as the VA, are able to use their market power to drive a hard bargain with the drug companies.