Healthcare e-visits?

[LongBlade]

In Canada it was deemed inequitable that those with less money could not afford proper health care coverage.

It's a myth that there are (were) people with no health care in the US.

It is also a myth that preventative care lowers costs.

Could the system have been improved? Yes.

Unfortunately we're still finding nasty easter eggs in this new health "care" law. That's the problem. It made things worse.

[Longdan]

I do not know where those "myths" come from but they surely are widespread
and both are quite arguable.  I do not know that the system in place here would
be a good fit in the USA but my question remains.  Why the tyranny of the insurance
company (profit based) is preferable to the state being a nonprofit provider?
I know the state is not necessarily efficient but you will  never know if your insurance
company is efficient.  It may provide for your needs but at what cost?
One thing I do sense is health care reform should not be built on the tottering, jury rigged
non system that is there.

[Jack Nastyface]

It's a myth that there are (were) people with no health care in the US.
It is also a myth that preventative care lowers costs.

You need to back those statements up with evidence....
If by "no health care" do you mean "there were people who had / have no health care coverage" or do you man that "the health care system never turned any one away who truly needed help"?
And I'd need to see your source re: preventative care, because again, statistical information from basically every industrialized nation tends to disprove that that statement.

Respectfully,

Jack Nastyface

[LongBlade]

It's a myth that there are (were) people with no health care in the US.
It is also a myth that preventative care lowers costs.

You need to back those statements up with evidence....
If by "no health care" do you mean "there were people who had / have no health care coverage" or do you man that "the health care system never turned any one away who truly needed help"?
And I'd need to see your source re: preventative care, because again, statistical information from basically every industrialized nation tends to disprove that that statement.

Respectfully,

Jack Nastyface

I mean that if you broke your arm you could go to an emergency room. Not the most elegant or cost effective way to manage things, but if you were ill, you could get help.

Here's a simple article, not a study. I apparently need to dig a bit further to get you the study I'm thinking of.

http://articles.cnn.com/2009-03-17/health/preventive.care.costs_1_preventive-medicine-preventive-care-health-care

The point of the study is that preventative care ends up generating false positives which send the patient and doctor down the path of needless extra screenings and test. Ergo, it costs more, not less.

That isn't to say that your quality of life is probably better catching diseases early. But it isn't cost effective.

Ah, here's another article:

"Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall," Elmendorf wrote. "That result may seem counterintuitive.

"For example, many observers point to cases in which a simple medical test, if given early enough, can reveal a condition that is treatable at a fraction of the cost of treating that same illness after it has progressed. In such cases, an ounce of prevention improves health and reduces spending — for that individual," Elmendorf wrote. "But when analyzing the effects of preventive care on total spending for health care, it is important to recognize that doctors do not know beforehand which patients are going to develop costly illnesses. To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. ... Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness."

http://abcnews.go.com/blogs/politics/2009/08/congressional-budget-expert-says-preventive-care-will-raise-not-cut-costs/

[Longdan]

From the point of view of the insurance companies it is not cost effective.  They do not necessarily need you alive.
Their best case solution is you never need health care, pay them thousands of dollars, buy extra insurance
and then drop dead.  Preferably from a preexisting cause.

[Jack Nastyface]

Thanks...definately an interesting find.  I am admittedly going to have to give this a read over.  FWIW...there is admittedly going to be some "more" truth to this statement in the current US healthcare system vis-a-vis the Canadian or European models, as certain types of preventative medicine have been so marginalized in US healthcare that providing them is more costly than simple addressing the outcome via well-supported infrastructure, later on.

@longdan....I'm trying to keep insurance companies out of the conversation.  From my perspective, the thread began with a discussion of primary health care delivery methods (e-visits) and I'd therefore prefer to discuss healthcare outcomes rather than "who is going to pay for this".  While the question of payment is important, the questions behind all this are really:  Is healthcare a right or a priveledge?  Can it be made worthwhile if made univesal...and is it affordable?

Interstingly, the US provides some absolutley stellar examples of making healthcare satisfy all these criteria.  Kaiser Permante and the Mayo Clinic are two such examples...many other exists.

FWIW...the same kind of arguments we are hearing in the media against Obamacare were once made about universal public education (to name but one public issue) at the end of the 19th  / early 20th century.  There are always some fairly constant lines of argument / rhetoric within the public conversation, namely:

   
• futility (what you propose is useless and won't make a difference);
• jeopardy (what is propsosed will cause unacceptable cost and loss, and that which we lose is far more precious than what we gain), and
• perversity (what you propose will not only fail but it will make everything worse).

Most respectfully, your diatribe against insurance companies (right or wrong) does little to dispel any of these arguments.  In the end, arguments for and against Obamacare need to vetted, cross-referenced and evaluated against a variety of outcomes and results. In the end, universal healthcare may NOT be viable (like democracy in China?) but we won't know if we don't ask and try...and it is a question worth asking and trying.

As I have said elsewhere in this thread, the exploration of universal healthcare in the US is going to be very tough ride indeed.

[LongBlade]

FWIW...the same kind of arguments we are hearing in the media against Obamacare were once made about universal public education (to name but one public issue) at the end of the 19th  / early 20th century.  There are always some fairly constant lines of argument / rhetoric within the public conversation, namely:

   
• futility (what you propose is useless and won't make a difference);
• jeopardy (what is propsosed will cause unacceptable cost and loss, and that which we lose is far more precious than what we gain), and
• perversity (what you propose will not only fail but it will make everything worse).

Unfortunately, since there has been a Cabinet level Department of Education, the quality of education in America has fallen.

I haven't spent any time looking into any studies which might provide (or dispell) a causal link, but there is.

[Longdan]

There is nothing wrong with e-visits per se.  It is hard to determine the difference
between cheaper and more cost effective.  My only diatribe about insurance is the
refusal of some to understand that they are a money making business responsible
to turn a profit for their shareholders.