America spends $30 billion a year fixing medical errors – the worst rate among advanced countries. Why? Among other reasons because we keep patient records on computers that can’t share the data. Patient records are continuously re-written on pieces of paper, and then re-entered into different computers. That spells error.
Meanwhile, administrative costs eat up 15 to 30 percent of all healthcare spending in the United States. That’s twice the rate of most other advanced nations. Where does this money go? Mainly into collecting money: Doctors collect from hospitals and insurers, hospitals collect from insurers, insurers collect from companies or from policy holders.
This rings so true to me. I saw a patient today and spent 3/4 of my time in such tasks as re-writing med lists with my quill and ink well and trying, through scrawled notes and talking to the patient, to figure out what he needed for home care. Next I get to call his insurance and wait on hold. I love being a nurse, I just wish I had gone to secretarial school first.
That’s part of the problem. Part of the solution is to open Medicare to all, enlarge the risk pool, cut administrative costs and also save lives and money by ensuring that a patient’s records are available to their doctors.
Reich mentions that home nursing helps prevent costly re-hospitalization, and that is my job. I spend more of my time filling out paperwork than I think is necessary for patient care, so I see some of the frustrating waste and inefficiency firsthand.
Another side of this that is not much mentioned is the terrible drain on our society by letting people get sick enough to go to the emergency room instead of helping them keep well with primary care. Well people who work and pay taxes are good, but if you talk about investing in health care it’s seen as charity for the unworthy and mindless sentimentality. Well, I’ve got news– there’s nothing pragmatic about letting people suffer– we pay more later.
This is from a recent research article from Open Medicine...
Canadian health care has many well-publicized limitations. Nevertheless, it produces health benefits similar, or perhaps superior, to those of the US health system, but at a much lower cost. Canada’s single-payer system for physician and hospital care yields large administrative efficiencies in comparison with the American multi-payer model.60 Not-for-profit hospital funding results in appreciably lower payments to third-party payers in comparison to for-profit hospitals61 while achieving lower mortality rates.62 Policy debates and decisions regarding the direction of health care in both Canada and the United States should consider the results of our systematic review: Canada’s single-payer system, which relies on not-for-profit delivery, achieves health outcomes that are at least equal to those in the United States at two-thirds the cost.
But let’s get down to the important issues. Americans are 10% more overweight than Canadians. This number takes into account the different ethnic makeup of the populations– with all the adjustments, Canadians can still fit into our old jeans.
Canada is a country where people consider a plate of french-fries sprinkled with cheese and smothered with gravy a light appetizer. Their main export is donuts. It’s freezing up there, and dark eight months of the year, so Canadians have no reason to go outside. Snow shoveling may burn some calories, but Canada is full of old people because their elderly just keep living and living. They just attach a snowblower to their scooter and ride to the Tim Hortons.
After careful analysis, I have to rule out diet and lifestyle
The only possible explanation is that a single payer health care system keeps people slim.
Just got back from a candlelight vigil for health care at the State House. Organizers from Progressive Democrats of America estimated the crowd at over 200.
The three Town Hall meetings were exercises in facing hostile crowds but this rally was like coffee hour after church. A few counter-demonstrators tried to interrupt the speeches, but the moderator, Dave St.Germain, had a bullhorn and the antis were pretty much ignored. Dave kept things focused and paced the event so well that people stayed to talk afterward. He introduced speakers who shared a personal perspective on our health care system–
Hanna Watson, a medical student, had a patient who brought her small daughter to a gyn office visit. The woman had no general medical doctor, and she did not dare to go to the emergency room for a cardiac workup she desperately needed. They say you can always go to the emergency room, but the bill will soon follow, and the bill collectors are relentless.
Nancy St. Germain, (not related to Dave) who was introduced by Rep. Langevin at the Warwick Town Hall, shared her experience of losing her job and her home when she was hospitalized for brain cancer. She had good insurance–until she got sick. Her story shows how easy it is to lose all you’ve worked for when your benefits are tied to your job.
We broke up into small groups to share our stories. A full moon was rising, downtown was beautiful and the candles were flickering. I spoke with a pediatrician, a med student and a small business owner. There was a woman whose friends, in their fifties and too young for Medicare, could not get insurance. There was a man who was self-employed, could not get insurance, and ended up with a huge debt when he had an accident.
I was struck by the diversity of the group, in age, race and politics. Some held signs for single-payer, some for public option. All of us were there because we want to see every American get health care when they need it. In the greatest country in the world we shouldn’t settle for less.
One legislator who supports health insurance reform, and who knows more than most about survival–Jim Langevin, spoke at a rally at Women and Infants earlier today. Rhode Island’s Future covers the event.
ProJo.com covers both, and the comment section is active.
Good article by Richard Salit in today’s Providence Journal about scammers marketing fake health insurance…
“Medical discount cards are spreading like kudzu because so many people are being laid off and going without health insurance or simply can’t afford premiums anymore. They are looking for affordable ways to cut their medical costs and discount cards are springing up in response to an urgent market need,” says James Quiggle, spokesman for the Coalition Against Insurance Fraud, a group that includes consumer advocates and insurance companies. “Unfortunately, much of that response is fraudulent and abusive.
It’s easy enough for even amateurs to put up a website, print cards, run a TV commercial and take hundreds of dollars monthly out of a bank account via direct withdrawal. Just like the big guys. But they don’t spend much on phone support…
After being put on hold, the line went dead. When the reporter called back, a man answered the phone, “Bob’s Abortion Clinic.” The screen on the reporter’s phone showed it was the same number. The reporter asked to speak to a supervisor. A man who called himself “Stuey” eventually got on the phone. He insisted it was an abortion clinic in St. Louis and then the line went dead again. [the rest of this sordid tale here]
The big guys are more accountable. They answer their phone, and most of the time they give coverage for the money. But don’t get yourself too sick, or you might find out that they operate on the same basic principle as “Stuey”–charge the most money for the least service. It’s not that they’re evil, it’s the profit principle–a shark has to keep moving.
A single payer system would clean out the parasites. A government sponsored affordable insurance plan would give people a safe alternative to the shady, complicated, ‘buyer beware’ system we have now. This system sucks money from the people who can least afford it, and really dishes out the pain when they get sick.
Update– via Daily Kos this link to a NYT editorial about a process called ‘recission’ that allows big insurers to cancel benefits when a subscriber gets sick and needs to make claims.