The Free Market for Health Care Works

[apple0154]

Here's a great example how the free market works.

http://www.aolhealth.com/health/cig....com/health/cigna-employee-gives-woman-finger

EXCERPT: In 2007, 17-year-old Nataline Sarkisyan needed a life-saving liver transplant, but CIGNA, her insurance company, wouldn't pay for it. Nine days later -- amid a media maelstrom and public outcry -- the company reversed its decision. Sadly, it was too late. Nataline died just hours after the decision was overturned.(END)

Some folks have said a government run health care would prevent people from suing for malpractice. According to them private practice allows redress. Also, those same (intentionally?) misinformed folks like to talk about waiting lists and death panels.

Check this out from the same article. EXCERPT: The Sarkisyans filed a wrongful death complaint in 2008, stating that CIGNA's refusal to pay for the transplant led to Nataline's death. But a Los Angeles court threw out the case, citing a 1987 US Supreme Court ruling protecting employer-paid healthcare plans from damages over their coverage decisions. (END)

Isn't that great. The company reverses their decision too late, the person dies, then "oops" is considered adequate justice.

Obviously people do not understand universal medical care. Under a universal plan if liver transplants are covered then they are covered. If a liver is available and one requires a liver that's all that's necessary. There is no such thing as questioning if a person is entitled.

If ones doctor recommends a transplant then a transplant is done. Either everyone requiring a transplant is eligible or no one is. The only people involved in the decision are the patient and their doctor. The government is not involved in individual cases.

 

[Annie]

Here's a great example how the free market works.

http://www.aolhealth.com/health/cig....com/health/cigna-employee-gives-woman-finger

EXCERPT: In 2007, 17-year-old Nataline Sarkisyan needed a life-saving liver transplant, but CIGNA, her insurance company, wouldn't pay for it. Nine days later -- amid a media maelstrom and public outcry -- the company reversed its decision. Sadly, it was too late. Nataline died just hours after the decision was overturned.(END)

Some folks have said a government run health care would prevent people from suing for malpractice. According to them private practice allows redress. Also, those same (intentionally?) misinformed folks like to talk about waiting lists and death panels.

Check this out from the same article. EXCERPT: The Sarkisyans filed a wrongful death complaint in 2008, stating that CIGNA's refusal to pay for the transplant led to Nataline's death. But a Los Angeles court threw out the case, citing a 1987 US Supreme Court ruling protecting employer-paid healthcare plans from damages over their coverage decisions. (END)

Isn't that great. The company reverses their decision too late, the person dies, then "oops" is considered adequate justice.

Obviously people do not understand universal medical care. Under a universal plan if liver transplants are covered then they are covered. If a liver is available and one requires a liver that's all that's necessary. There is no such thing as questioning if a person is entitled.

If ones doctor recommends a transplant then a transplant is done. Either everyone requiring a transplant is eligible or no one is. The only people involved in the decision are the patient and their doctor. The government is not involved in individual cases.

Actually that isn't the whole story, shocked I am:

http://online.wsj.com/article/SB120001235968882563.html?mod=opinion_main_commentaries

While the story's thesis is on Edwards, the 'facts' of UCLA and her condition are clear:

By SCOTT GOTTLIEB

Campaigning in the primaries, former Sen. John Edwards is leveraging the tragic story of Nataline Sarkisyan -- the 17-year-old California woman who recently died awaiting a liver transplant -- to press his political attack on insurance companies and argue for European-style, single-payer health care. But the former trial lawyer, accustomed to using anecdotes of human suffering to frame his rhetoric, is twisting the facts. Organ transplantation, like many areas of medicine, provides a poor basis for his political thesis that single-payer health care offers a more equitable allocation of scarce resources, or better clinical outcomes.

Late last year, Ms. Sarkisyan developed liver failure, apparently a result of blood clotting that stemmed from the high doses of chemotherapy and a bone marrow transplant she had received to treat relapsed leukemia. She was put on life support as her doctors at the University of California-Los Angeles tried to get her a new liver, and asked CIGNA, the insurer that was acting as administrator to her father's employer-provided, self-insured health plan, to pay for the transplant. CIGNA deemed the transplant unproven in its medical benefit and ineffective as a treatment. It recommended that her father's employer not cover the procedure.

After an appeal, CIGNA hired an oncologist and transplant surgeon to review the case. According to CIGNA, these experts agreed that the transplant exceeded appropriate risk-taking, with little support from existing medical literature.

CIGNA never reversed its administrative decision. But after significant pressure from the California Nurses Association, a powerful union lobby -- and legal threats -- it made a clumsily-announced concession, a one time "exception" to pay for the transplant itself, despite sticking to its judgment that the procedure constituted an experimental use of a scarce organ. But CIGNA's concession came too late. The same day it was made Ms. Sarkisyan was taken off life support and died.

From here, facts are in dispute. Her family says a liver became available while CIGNA wrung its hands over the matter. Some news accounts question this turn, since institutions like UCLA would typically proceed with transplants, even before insurance plans are settled, once an organ becomes available....

 

[apple0154]

Actually that isn't the whole story, shocked I am:

http://online.wsj.com/article/SB120001235968882563.html?mod=opinion_main_commentaries

While the story's thesis is on Edwards, the 'facts' of UCLA and her condition are clear:

I read the article.

EXCERPT:Ideally, everyone who can benefit from an organ transplant would receive one, especially a young patient like Ms. Sarkisyan. But with more patients than available organs, some form of allocation procedure involving administrative judgments is inevitable. In Ms. Sarkisyan's case, that judgment was made by CIGNA, in an advisory capacity to her father's employer, interpreting the terms of the employer's health-insurance contract. In the U.K. and other European systems -- and in the U.S. single-payer system favored by Mr. Edwards -- those judgments are made solely by a government agency. The available data suggests that the government allocation procedures do a somewhat worse job, as far as health outcomes are concerned, than private allocation procedures in the U.S.(END)

Can we spot the difference? While some form of allocation is necessary when there are more patients than organs the ability to pay is not taken into account under a universal plan and that's the whole point of having a universal plan.

The ability to pay should not enter into the decision, at all. That's the purpose of a universal plan. For Mr. Gottlieb to suggest or allude to the factoring in of the ability to pay results in a better outcome than other factors being considered borders on the vile.

As for his stating "judgments are made solely by a government agency" that is misleading. Once again, universal plans do not judge individual cases. The decision is between the patient and the doctor. The government does not take the roll of the typical health insurer.

Let's be clear. Under a private plan a person visits a doctor. The doctor suggests a procedure. The patient agrees. That recommendation is then sent to a health insurance company and the company decides if it will pay for the procedure.

Under a universal plan a person visits a doctor. The doctor suggests a procedure. The patient agrees. That's it. It doesn't go any further. The procedure is done and the doctor is paid.

If liver transplants are covered they are covered for cancer or hepatitis C or alcoholism or accident or.....it doesn't matter what the reason or cause. No one has to OK the procedure or decide if it's covered. Individual cases are not judged by a government agency contrary to what people like Mr. Gottlieb and more than a few Conservatives like to imply. That's why the idea of so-called death panels are absurd.

Once, again, individual cases are not judged by anyone under a universal plan. It is between the doctor and the patient. For anyone to suggest otherwise is either due to ignorance or outright lying.

 

[USFREEDOM911]

I read the article.

EXCERPT:Ideally, everyone who can benefit from an organ transplant would receive one, especially a young patient like Ms. Sarkisyan. But with more patients than available organs, some form of allocation procedure involving administrative judgments is inevitable. In Ms. Sarkisyan's case, that judgment was made by CIGNA, in an advisory capacity to her father's employer, interpreting the terms of the employer's health-insurance contract. In the U.K. and other European systems -- and in the U.S. single-payer system favored by Mr. Edwards -- those judgments are made solely by a government agency. The available data suggests that the government allocation procedures do a somewhat worse job, as far as health outcomes are concerned, than private allocation procedures in the U.S.(END)

Can we spot the difference? While some form of allocation is necessary when there are more patients than organs the ability to pay is not taken into account under a universal plan and that's the whole point of having a universal plan.

The ability to pay should not enter into the decision, at all. That's the purpose of a universal plan. For Mr. Gottlieb to suggest or allude to the factoring in of the ability to pay results in a better outcome than other factors being considered borders on the vile.

As for his stating "judgments are made solely by a government agency" that is misleading. Once again, universal plans do not judge individual cases. The decision is between the patient and the doctor. The government does not take the roll of the typical health insurer.

Let's be clear. Under a private plan a person visits a doctor. The doctor suggests a procedure. The patient agrees. That recommendation is then sent to a health insurance company and the company decides if it will pay for the procedure.

Under a universal plan a person visits a doctor. The doctor suggests a procedure. The patient agrees. That's it. It doesn't go any further. The procedure is done and the doctor is paid.

If liver transplants are covered they are covered for cancer or hepatitis C or alcoholism or accident or.....it doesn't matter what the reason or cause. No one has to OK the procedure or decide if it's covered. Individual cases are not judged by a government agency contrary to what people like Mr. Gottlieb and more than a few Conservatives like to imply. That's why the idea of so-called death panels are absurd.

Once, again, individual cases are not judged by anyone under a universal plan. It is between the doctor and the patient. For anyone to suggest otherwise is either due to ignorance or outright lying.

In your attempt to promote your agenda, again, and by only presenting a cherry picked version of an incident, you have failed.

 

[apple0154]

In your attempt to promote your agenda, again, and by only presenting a cherry picked version of an incident, you have failed.

I was just following the Repub way. You know, pick out one person in a country with a universal plan who waited in line for an operation and spread it all over the news.

Death panels. Killing the elderly.

Two can play the game.

The fact remains not one country with a universal plan has reverted to the old "pay or suffer" system and every country started out with a "pay or suffer" system. Every single country had a "pay or suffer" system and not one has reverted back.

What more needs to be said? Universal health care has proven itself all over the world. Opponents can't point to one country and say, "See, it didn't work there so they changed back."

All opponents can do is question the sustainability of a universal plan, yet the figures show the US spends more per capita on medical care than any country that has a universal plan. It's just craziness.

 

[USFREEDOM911]

I was just following the Repub way. You know, pick out one person in a country with a universal plan who waited in line for an operation and spread it all over the news.

Death panels. Killing the elderly.

Two can play the game.

The fact remains not one country with a universal plan has reverted to the old "pay or suffer" system and every country started out with a "pay or suffer" system. Every single country had a "pay or suffer" system and not one has reverted back.

What more needs to be said? Universal health care has proven itself all over the world. Opponents can't point to one country and say, "See, it didn't work there so they changed back."

All opponents can do is question the sustainability of a universal plan, yet the figures show the US spends more per capita on medical care than any country that has a universal plan. It's just craziness.

Sorry; but after failing so bad, you don't get more chances to work you agenda

 

[apple0154]

Sorry; but after failing so bad, you don't get more chances to work you agenda

Me thinks it's you who is trying to work an agenda.

Universal plans have proven themselves for over 50 years. Big countries, small countries, rich countries, poor countries, capitalist countries, communist countries.....every country that implemented a universal plan has kept it.

Give it up. You have no case.

 

[PostmodernProphet]

.every country that implemented a universal plan has kept it.

once you've thrown the baby out with the bath water you aren't getting the baby back......

 

[apple0154]

Originally Posted by apple0154: every country that implemented a universal plan has kept it.

once you've thrown the baby out with the bath water you aren't getting the baby back......

Another completely untrue argument. Several countries with universal plans also have private services. The reality is the governments of countries that have a universal plan have to stop vulture capitalists.....er, venture capitalists from trying to overtake the system.

There is no shortage of people wanting a piece of the health care jackpot.

 

[PostmodernProphet]

Several countries with universal plans also have private services.

should we review the definition of "universal"?......

 

[apple0154]

should we review the definition of "universal"?......

That's the beauty of universal plans. Some have a token user fee of a few dollars. Others have no charge, whatsoever. Some cover the doctor's visit to a person's home. Others do not.

The bottom line is every plan is better than a "pay or suffer" plan regardless of minor differences.

 

[USFREEDOM911]

Me thinks it's you who is trying to work an agenda.

Universal plans have proven themselves for over 50 years. Big countries, small countries, rich countries, poor countries, capitalist countries, communist countries.....every country that implemented a universal plan has kept it.

Give it up. You have no case.

Your attempt