Don Kissick wrote:
But, but, but... universal health care will make medicine more equitable for all!
It's unfair that your Canadian woman could afford to send a biopsy sample to California! What about all those people who can't afford it! If they can't have it she shouldn't be able to get that test, either!
That's what will be so great about Obamacare!
If hundreds or even thousands of people must die to make everything equal, it's a sacrifice Obama, Reid, and Pelosi are willing to make.
It's unfair that your Canadian woman could afford to send a biopsy sample to California! What about all those people who can't afford it! If they can't have it she shouldn't be able to get that test, either!
That's what will be so great about Obamacare!
If hundreds or even thousands of people must die to make everything equal, it's a sacrifice Obama, Reid, and Pelosi are willing to make.
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10 January 2010 10:58:52
Mozilla Firefox 3.5.7 on Windows Vista10 January 2010 10:58:52
Lucente wrote:
Don,
That is the promise of communism, isn't it? Everyone equally miserable and in poverty.
~tjl~
That is the promise of communism, isn't it? Everyone equally miserable and in poverty.
~tjl~
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10 January 2010 22:04:33
Google Chrome 4.0.266.0 on Windows XP10 January 2010 22:04:33
Bill wrote:
Uh Tom...since you concede in your column that Medicare, which last time I looked was a US government run program, will pay for Oncotype DX test, isn't this an example of how the Canadian system sucks, and not an example of how much the American system will suck?
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11 January 2010 14:58:42
Internet Explorer 8.0 on Windows XP11 January 2010 14:58:42
Lucente wrote:
Bill,
Good question. And, of course, I have an excellent response.
When I say Medicare "pays" for anything, you have to take it in the least literal sense possible. Medicare pays what it wants, when it wants. Additionally, many health care providers have stopped accepting Medicare. All that, of course, would have been off point of what I was discussing. Additionally, one could argue that the only reason Medicare pays for it is because private insurers do. Without the market setting that standard, perhaps Medicare would not provide it, either, or, like in the Canadian system, still be debating whether it should.
~tjl~
Good question. And, of course, I have an excellent response.
When I say Medicare "pays" for anything, you have to take it in the least literal sense possible. Medicare pays what it wants, when it wants. Additionally, many health care providers have stopped accepting Medicare. All that, of course, would have been off point of what I was discussing. Additionally, one could argue that the only reason Medicare pays for it is because private insurers do. Without the market setting that standard, perhaps Medicare would not provide it, either, or, like in the Canadian system, still be debating whether it should.
~tjl~
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11 January 2010 22:43:39
Internet Explorer 8.0 on Windows XP11 January 2010 22:43:39
Bill wrote:
Ok...so let me see if I get this straight. I have to ignore that Medicare, the US government insurance, pays for this test because some health care providers no longer accept Medicare. And because Medicare pays only the amount it wants to pay for the test. I guess I also have to ignore that private insurance companies also pay what they want when they want. I should also ignore that not all insurance companies will pay for this test either. Because, that would be off point. Also, it kind of calls to question your premise that Medicare only pays for this test because private insurance companies do. After all, if some aren't paying for it, using your argument, Medicare should likewise feel it no longer has to pay for these tests.
Face it, on this one the government insurance company, Medcicare, got it right. So to hold this test up as an example of the bureaucratic nightmare that national health care will cause is silly. Why do I have a feeling this column was written with the deadline clock ticking?
Face it, on this one the government insurance company, Medcicare, got it right. So to hold this test up as an example of the bureaucratic nightmare that national health care will cause is silly. Why do I have a feeling this column was written with the deadline clock ticking?
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13 January 2010 17:53:39
Internet Explorer 8.0 on Windows XP13 January 2010 17:53:39
Lucente wrote:
Bill,
Not at all. You are ignoring huge differences between Medicare and private insurance. Medicare pays what it wants and the medical providers have to accept it. Private insurance cannot do that. It can negotiate the price, but the provider can refuse or pass on the difference to the patient. So if Medicare covers a $4,000 test but says it will only pay $1,000, providers can either bend over and take a $3,000 loss or refuse to see the patient. I don't see how that is "getting it right."
Also, you are ignoring the pressure that private competition has in forcing Medicare to pay for a test. If all insurance companies cover a test, Medicare has little choice but to cover the test. This is not some a victory for government-run health care.
You also mischaracterize my comment about Medicare. I was in no way holding that up as an example. I merely pointed out that EVEN Medicare covers this test. This demonstrates that bureaucracies have no common sense in their decisions. I am sure there are many tests Medicare does not cover that it should. This just happens to not be one of them. Nor does the column mention how long it took for Medicare to finally decide to cover the test once it became available.
That you feel the need to latch on to the Medicare comment as somehow negating my point proves to me the soundness of my column and my argument.
~tjl~
Not at all. You are ignoring huge differences between Medicare and private insurance. Medicare pays what it wants and the medical providers have to accept it. Private insurance cannot do that. It can negotiate the price, but the provider can refuse or pass on the difference to the patient. So if Medicare covers a $4,000 test but says it will only pay $1,000, providers can either bend over and take a $3,000 loss or refuse to see the patient. I don't see how that is "getting it right."
Also, you are ignoring the pressure that private competition has in forcing Medicare to pay for a test. If all insurance companies cover a test, Medicare has little choice but to cover the test. This is not some a victory for government-run health care.
You also mischaracterize my comment about Medicare. I was in no way holding that up as an example. I merely pointed out that EVEN Medicare covers this test. This demonstrates that bureaucracies have no common sense in their decisions. I am sure there are many tests Medicare does not cover that it should. This just happens to not be one of them. Nor does the column mention how long it took for Medicare to finally decide to cover the test once it became available.
That you feel the need to latch on to the Medicare comment as somehow negating my point proves to me the soundness of my column and my argument.
~tjl~
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13 January 2010 18:12:34
Google Chrome 4.0.266.0 on Windows XP13 January 2010 18:12:34
Bill wrote:
I latched onto the Medicare comment because it is at best inconsistant to write a column about the horrors of governement health care and its needless bureaucracy and hold as an example a test that the government health care system pays for.
As for the pressure of private competition forcing Medicare to pay for the test, you may have a point that if all insurance companies cover the cost of a test, Medicare will have to as well. But int this case, as you pointed out in your column, most but not all pay for this test. Thus, the idea that pressure from private companies is forcing Medicare to pay for this test is not proven.
And private insurance, especially the larger companies, do dictate what price they will pay the health care provider, just like Medicare does. And health care providers do not have to accept it, just as they do not have to accept a private insurance company. That is why you see so many doctors no longer accepting Medicare. They don't like how much they are being paid.
Tell you what. To see if Medicare got this one right or not, why don't you look it up. See how much Medicare truly does pay for this test. Don't just throw out hypotheticlal numbers, but find out how much they really pay. Then find out how much two or three large insurance companies pay for the same test. You pick the companies. If Medicare only pays 25% of the cost of the test, as your example suggests, and private insurance companies pay substantially more, like say 90% of the cost of the test, I will buy you as much beer as you can drink for a night and will only post a comment saying "Gee Tom, you're right. How could anyone doubt you." on every column you write for the next month, regardless of the topic or whatever you say in the text.
As for the pressure of private competition forcing Medicare to pay for the test, you may have a point that if all insurance companies cover the cost of a test, Medicare will have to as well. But int this case, as you pointed out in your column, most but not all pay for this test. Thus, the idea that pressure from private companies is forcing Medicare to pay for this test is not proven.
And private insurance, especially the larger companies, do dictate what price they will pay the health care provider, just like Medicare does. And health care providers do not have to accept it, just as they do not have to accept a private insurance company. That is why you see so many doctors no longer accepting Medicare. They don't like how much they are being paid.
Tell you what. To see if Medicare got this one right or not, why don't you look it up. See how much Medicare truly does pay for this test. Don't just throw out hypotheticlal numbers, but find out how much they really pay. Then find out how much two or three large insurance companies pay for the same test. You pick the companies. If Medicare only pays 25% of the cost of the test, as your example suggests, and private insurance companies pay substantially more, like say 90% of the cost of the test, I will buy you as much beer as you can drink for a night and will only post a comment saying "Gee Tom, you're right. How could anyone doubt you." on every column you write for the next month, regardless of the topic or whatever you say in the text.
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15 January 2010 19:01:38
Internet Explorer 8.0 on Windows XP15 January 2010 19:01:38
Lucente wrote:
Bill,
I understand what you are saying, but you are missing the point.
No one is arguing that government-run health systems do not cover things. Clearly they do. The point is that when a system as large as the Canadian system is (and as large as the U.S. system will be) is faced with a new procedure or test, it could take years before they agree to cover that procedure or test. The market, on the other hand, reacts quickly to new procedures and tests with private insurers quickly choosing to cover tests that will save them money. The private insurers have an incentive to respond whereas the government system has no incentive because it really does not care about profits and losses.
You also miss the point on Medicare and private insurance. If private insurance agrees to only pay a portion of a procedure, the health care provider can either write it off or bill the patient. With Medicare, there is no option. The health care provider MUST take the payment from Medicare as payment in full.
As for your question about how much Medicare pays for this test, that can't be determined because Medicare sets the prices for its coverage based on location so the amount it pays varies from facility to facility based on numerous factors.
~tjl~
I understand what you are saying, but you are missing the point.
No one is arguing that government-run health systems do not cover things. Clearly they do. The point is that when a system as large as the Canadian system is (and as large as the U.S. system will be) is faced with a new procedure or test, it could take years before they agree to cover that procedure or test. The market, on the other hand, reacts quickly to new procedures and tests with private insurers quickly choosing to cover tests that will save them money. The private insurers have an incentive to respond whereas the government system has no incentive because it really does not care about profits and losses.
You also miss the point on Medicare and private insurance. If private insurance agrees to only pay a portion of a procedure, the health care provider can either write it off or bill the patient. With Medicare, there is no option. The health care provider MUST take the payment from Medicare as payment in full.
As for your question about how much Medicare pays for this test, that can't be determined because Medicare sets the prices for its coverage based on location so the amount it pays varies from facility to facility based on numerous factors.
~tjl~
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17 January 2010 19:30:06
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[COLUMN] Bureaucratic nightmare on horizon
Although a Canadian, Americans could learn much from the story of Coree Hanczyk.
Hanczyk is an example of everything that is wrong with government-run health care systems.
This is not your typical horror story about a person living in a country with socialized medicine and who dies while on a waiting list for a medical procedure Americans take for granted. While those things happen with alarming regularity under socialized medicine, they probably only affect a small percentage of the population.
No, Hanczyk's story, while not as tragic, is more typical of what Americans should begin to expect when the federal government completes its unconstitutional seizure of our health care system.
Hanczyk is a 45-year-old flight attendant who lives outside Toronto. Canadian doctors found a tumor in her breast.
The problem arises, however, in determining whether chemotherapy is necessary.
When faced with small, estrogen-receptor-positive tumors, with lymph nodes free of cancer, chemotherapy is beneficial to only a few. The trick is in determining who they are.
While the tumors look the same under a microscope, a test -- the Oncotype DX test -- can determine if the cancer is likely to return within the next decade by analyzing 21 genes.
Without the test, women must make a choice: undergo chemotherapy, with its possible side effects of leukemia, neurological damage, infertility and premature menopause, or risk a recurrence in the next decade.
Herein lies the problem. Government bureaucracies move at a snail's pace and are certainly ill-suited when it comes to working in the fast-paced world of personalized medicine.
Here in the United States, most insurance companies and Medicare will fund the test. The decision makes sense because the test is cheaper than chemotherapy. In fact, an estimated $100 million was saved last year in the United States because some 50,000 women took the test, according to the U.S. National Institutes of Health.
In Canada, however, the health care bureaucracy has yet to approve funding for the test, and any such approval, if it comes, is at least a year away, which is bad news for the estimated 12,000 Canadian women, such as Hanczyk, who need the test every year.
Hanczyk, who watched her mother slowly die under chemotherapy, decided not to be a slave to a sluggish medical bureaucracy. In September, she paid $3,776 to have a chunk of her tumor sent from Toronto to California and be tested. Fortunately for her, the test indicated she did not need the chemotherapy that Canadian doctors, and the health care bureaucracy, wanted her to undergo.
Here comes the irony.
The Canadian government was willing to pay the $10,000 for chemotherapy, but it refused to reimburse her the $3,776 for the test, which essentially saved the government almost $6,000 and saved Hanczyk such horrible side effects, such as hair loss and nausea.
This is what happens when government bureaucrats are entrusted with making decisions about health care, or any other thing for that matter. They have rules and regulations and within that framework there is simply no room for common sense. Anyone who has ever had any dealings with a government bureaucracy knows this to be the case.
During the past few months, we have all heard liberals tout the wonders of the French, German and British health care systems. However, it was no accident that Hanczyk sent her tumor to the United States. It is a common practice in the rest of the world that when the socialized medical systems fail to provide, which is often, the patients turn to the United States for help.
That is because the United States, without exception, has the finest health care system in the world. We have the best doctors, the best medical equipment and the best medical research labs in the world.
Unfortunately, during the last 40 years, the financial side of the system has been in cardiac arrest because of government "reforms" to the system. With each new government "reform," health care in this country becomes more costly.
This latest attempt at "reform" could be the coup de grâce that finally kills our free-market system, which has been the Democratic goal for more than 50 years.
Be prepared for the bureaucratic nightmare that is to come. Just ask Coree Hanczyk.
category | Column
author | Lucente