Subsidized healthcare
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| Sat, 09-20-2008 - 1:12pm |
i'm starting a new thread because this is buried somewhere else.
another poster referred to "subsidized healthcare." this article is old but raises important questions about who pays for what and who has access.
http://www.annals.org/cgi/content/full/129/6/514
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State funding, Medicare, Medicaid, CHIP, and HIPAA make up a subsidized system that targets specific needy groups and may be a gradual approach to U.S. health care coverage for all citizens. For now, however, it seems that anyone who knows the ins and outs of the health care system can obtain health care regardless of whether he or she has insurance.
We pay for community outreach programs, state and federal programs, Medicaid, Medicare, and tax breaks for large corporations. However, although the movement toward a national health insurance system is inching forward, it would immediately halt if people saw a paycheck deduction labeled "tax money to fund health insurance for those who do not have it.>>
the points that resonate for me:
-Those who oppose higher taxes also seem uninterested in finding out how much the lack of health care costs; illness and disease are costlier in the long run.
why don't we place more emphasis on prevention? why do we think paying for prevention is wasteful?
- Any investment in guaranteed health care, even if just for children, would have an invaluable return.
especially, why do we think prevention of disease in children is wasteful?
- The hidden subsidized medical system is already costing taxpayers, but Americans are more willing to pay for it because the taxes are hidden in the federal income tax that is deducted from each worker's paycheck... it would immediately halt if people saw a paycheck deduction labeled "tax money to fund health insurance for those who do not have it."
(assuming they are talking about specifying how much of your tax dollar goes to Medicare/Medicaid) ARE we so opposed to spending money to help those who are not covered - when they do not have other means and did not choose to reject those means?
-it seems that anyone who knows the ins and outs of the health care system can obtain health care regardless of whether he or she has insurance.
how many know the ins and outs? i don't because i don't need it. but why does it require a special knowledge? when you are sick, why can't the system be more transparent - especially for those who "fall through the cracks"?
Bea

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thanks, i asked for that. it's still part of an opinion piece and i could write one with new numbers just as easily - unless you can find where the author pulled up his statistics.
on the other hand, the website as a whole is interesting and i found other articles to read.
Bea
"A PCP can tell alot about a patient within 5 minutes of an interview.
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unless your daughter or son is the 25 year old with the asymptomatic and potentially life-altering condition, then you're right. it doesn't matter.
Bea
Some posters have been quite judgmental, smug, even, about people who "know" that smoking and obesity are bad for them, yet persist in their bad habits. I think if one is going to bang the "personal accountability" drum, it ought to go for prevention as well. I could say "everyone KNOWS that an ounce of prevention is worth a pound of cure", but it would be no more true than the statement that "everyone knows that smoking is bad". There are whole subsets of citizens who don't know that smoking is bad: children who live in families with smokers, for one example. (We tend to learn what we experience, not what we are told.) Prevention saves money. It saves lives. It should be a national priority that our children learn to care for their health from an early age. I don't buy the argument that young people with decent jobs and a high school education and families of their own are somehow too juvenile to take responsibility for their own health. "Prevention" doesn't mean nonstop screening for uncommon conditions. It means regular checkups and wise lifestyle choices. It means that if you have a family history of breast cancer, that you don't bury your head in the sand and refuse to get an assessment of your risk. Etc. Before reading a couple of threads on this board, I did think that reasonable people would take charge of their health and that of their families as a matter of course. Now I've discovered that they don't, because "it's not cost efficient". That's a pretty good argument for changing the way the we approach the health of our nation's citizens.
let's revisit
diabetes:
<<46 years of age is the average age it is diagnosed. How are increased check-ups for 20 somethings going to change that?>>
The "average" age of diagnosis is not a useful statistic in terms of screening. Type 2 diabetes is often diagnosed in very old people (insulin production decreases, and insulin resistance decreases as we age), and it takes a lot of young people to bring the "average" age of diagnosis down. If the "median" age of diagnosis were 46, it would mean that ONE HALF of people with type 2 have been diagnosed by the age of 46. Those of us who are intimately familiar with the diabetes "epidemic" know that type 2 diabetes is no longer uncommon even in teens.
cholesterol:
from http://www.circ.ahajournals.org/cgi/content/full/93/6/1067
"The proposed ACP guidelines1 and the accompanying background article by Garber et al4 recommend screening for lipid abnormalities only in men aged 35 to 65 years and women aged 45 to 65 years and using only a total cholesterol level. Even in these people, it is considered appropriate but not mandatory. Cholesterol measurement might be considered 5 to 10 years earlier if there is evidence of a familial lipoprotein disorder or two other characteristics that place the individual at increased risk of coronary heart disease."
Note the second half of the quote, which describes conditions in which it is useful to screen men as young as 25 years.
breast cancer:
Again, "average age of onset" is pretty meaningless. I couldn't find this mentioned in the link, although it did note that breast cancer is more common over the age of 40. The following link is possibly more useful, because it gives a lifetime risk for the development of breast cancer:
http://www.halls.md/breast/risk.htm
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I think that one explains itself. >>
Yes, but you missed this part, from the very top of the page of that link:
"Young women CAN and DO get breast cancer. While breast cancer in young women accounts for a small percentage of all breast cancer cases, the impact of this disease is widespread: There are more than 250,000 women 40 and under in the U.S. living with breast cancer, and over 11,100 young women will be diagnosed in the next year. But, despite the fact that breast cancer is the leading cause of cancer death in women ages 15 to 54"
Fifteen: not even old enough to vote, but old enough to get breast cancer.
The American cancer society has a list of guidelines for appropriate breast cancer screening, based on age and family/genetic history:
http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_Can_breast_cancer_be_found_early_5.asp
One final thing:
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This is a tricky sentence. I've already addressed the concept in two other posts. If you don't have money or insurance, you don't have access. Care for the indigent is often substandard for some chronic conditions. You can say as often as you like that "all people have access to healthcare", but it is NOT TRUE that all people have access to appropriate health care. Medicaid will pay for a kidney transplant needed because of complications of diabetes, but it and other programs often do not provide the tools needed to monitor blood glucose levels closely enough to PREVENT complications in the first place. One kidney transplant will pay for a lot of blood glucose test strips, even at the inflated prices consumers pay. (Strips cost almost a dollar apiece; they are manufactured for pennies. It can be hard to complain about cost when your life depends on a strip. But that's another story.)
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unless your daughter or son is the 25 year old with the asymptomatic and potentially life-altering condition, then you're right. it "
Wow, don't debate facts, pull the heart strings instead.
LOL do i know you?
Bea
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