http://autonews.com/apps/pbcs.dll/ar...B&refsect=1078

An article of intrest to this thread. I didn't read it but it was posted over on C&G and I read a clip of it.

 

Agreed that this is not the proper place for such a discussion, my bad. But it seemed as though you were going down that road so I went also. BTW the best term to apply to non MD providers is Alternative Healthcare Providers, who typically operate under a vitalistic model rather than an allopathic one.

Preventative Chiropractic care or other provider's care could help lots of people and save lots of money but because INS companies are in the AMA's pocket lots of people will never find out or when they do they will be to far along to correct the problem.

 

I disagree completely. This is more of a social problem in that most of the patients when they are young and shoudl be taking care of themselves and coming in for yearly visits do not, and only come in when something is wrong. Also most people expect to be able to get a pill or some sort of procedure to cure whatever problem they have after ignoring advice about prevention.

 

So wait lets get this straight. MDs for generations have taught people that to come in when they get sick and get a pill that will fix it. If that one doesn't work you get a different pill or a different dosage level. That is the patient's fault? Also how could someone not think that there is a pill for everything they see tons of commericals in print, TV, and the internet showing a pill for almost anything! Why shouldn't the patient, or as the drug companies see them, consumers think that? As for people not recieving prevenative care why should they pay for it themselves if the insurance companies don't think it is important enough to include it in the basic coverage?

 

By the way, I do take exception to that blanket statement...differences in approach to treating illness/problems aside, some MDs are much more concerned with helping their patients maintain a healthy lifestyle and staying healthy than are others and are not so quick to simply hand out a drug rather than find other ways to help their patients.

Spinal manipulations and accupuncture may have their place and may do a lot of good but I don't see them as being any more "preventative" than a MD referring me to a nutritionist to help me learn to make better chonces about what and how much I eat, etc.

 

Obviously you are entitled to your opinion however MDs practice under the allopathic model of healthcare which means that they are by nature not prevenative in training. They may do test to watch out for problems but they don't do anything if they see a small problem. A Chiropractor will correct a small problem before it becomes a big one. A MD if he sees a small problem with say your knee joint will generally do nothing about it until it becomes so severe that surgery is required. That is the difference right there. They operate differently. I don't expect you to understand it because you and most people live in an allopathic model. If you saw things vitalistically then you would see the difference.

 

91_z28_4me,

I think you are being just a bit oversensitive about the fact that traditional medicine tends to be held in higher regard than non-traditional medicine which can be seen in how most insurance providers treat non-traditional treatments.

True “prevention” is not about “correcting a small problem” nor the medical approach used to correct it; it’s about taking actions to keep the problems from happening in the first place.

All this is very far from the point anyway which is that if individuals were making the decisions, rather than insurance companies, then MDs and Chiropractors and other treatment providers would be free to state their respective case to the patient/consumer who could then decide for him/her self what treatment to spend money on.

 

What do you propose should be done to "fix" the broken model? I do agree it's outdated and not really applicable for current business practices. That's why new corporations and even new employees at GM are not offerened pensions and the health care is not nearly as comprehensive as even several years back.

But what can be done? I'm not for the government healthcare either. But I do believe that the domestic brands have done just about all that can be done. Building a better mouse trap won't erase a $1500 per vehicle healthcare charge. Especially when the steel in the vehicle is under $800.

I don't think the American buisness model was wrong. Paying workers well and building a middle class with good health benefits has made the United States what it is today. But along the way the game changed. Free trade could be looked at both good and bad. Cheeper goods but more manual labor jobs lost. With that foreign car makers with a plan to undercut the domestic costs came in. Originally they built a better mouse trap and now have a better buisness model. Part of that buisness model requires help from their governments. That's ok for them but not ok for the American brands right, they don't need help! Well maybe they do.

 

Thats your opinion and you are welcome to it. I have huge respect for MDs and have no problem with them but to put them above another provider that goes through just as rigorous training is just assinine. They have the power because the AMA got in good with the gov a long time ago. They even lost antitrust lawsuits for trying to run other provider out of business for crying out loud.

So correcting a small problem before it becomes a big one is not preventing the large problem? Yeah that logic is real clear, so why is it that is why all those cholesterol tests are performed on people that aren't showing any major problems?

Your argument would be valid IF people had the opportunity and the knowledge about other providers and each year both open up but until the insurance companies see people as more of a human being and less than a bag of money I don't think things will change.

 

Amen!!!

Actually, there's a plan that's a bit like this - the Health Savings Account. The idea is that small-ticket stuff comes from an individual account, which is built-up using pre-tax money and is allowed to grow via interest (think of a 401(k) that's used for health costs). Big, catrostrophic stuff is covered by insurance, and at least in the case of the policy that my wife and I are covered under, the major stuff (you know, the events that would put a lot of people into bankruptcy with 90/10 or 80/20 coverage) are covered 100%.

The current system is indeed broken. It's kinda like expecting your car insurance company to pay for all the routine maintenance and repairs on your vehicle. Putting it in control of the government or leaving it in control of for-profit corporations won't allow the current model to be repaired; it just changes that way that it's f*cked up.

91_z28_4me,

If you wish for people to take seriously your opinion on alternative medicine, then I would recommend not painting traditional medicine with broad strokes such as "MDs practice under the allopathic model of healthcare which means that they are by nature not prevenative in training" and "they don't do anything if they see a small problem". That's simply not accurate with regards to my excellent family physician, and I don't believe that it's a fair statement in general.

 

Eric with all due respect, the allopathic model is the model of healthcare which is taught to MDs. It is their philosophy. Perhaps you are not sure what Allopathy means so here is a definition: "the treatment of disease by conventional means, i.e. with drugs having effects opposite to the symptoms." This is from Wikipedia and is as true as you can plainly see. Now with reguard to preventative care and your particular doctor, he may perform some forms of preventative care but will not offer you all that could be done simply because he wouldn't get paid by insurance, if you wish to pay out of your own pocket then I am sure he would go along with it but in all likelyhood you wouldn't. For example are you on a vitamin C regiment to fight colds? Do you get your flu shot? Are your triglyceride levels check every 6 months? What about postural screenings on every visit? How often does he go above and beyond listening to your heart, taking your blood pressure, and looking in your ears? Does he do an eye exam on each visit? What about a hearing test?

The answer to most of these is no because they aren't trained in a preventative model. I am not faulting the MDs I think they do a great job of what they do, but they don't do all they can for a number of reasons. That being said take me as seriously as you want, I have worked in healthcare and know a lot about it I am getting a degree in it and will work in it for the rest of my life. That being said I just think that people don't know what all is open to them and as a result don't get all the care that they need.

 

91_z28_4me,

You are the only one who seems intent on feeling that one is being put “above the other”; I simply don't accept your definition of "prevention" as being the only viable one.

That aside, this simply isn’t the proper forum to debate the societal inequities, whether real or imagined, that may exist between various and sundry healthcare approaches and theories of practice…I’m sure there is any number of forums out there where they argue such things all day long.

I would assume, since you are a chiropractic student that you chose that direction because you feel it is the better way but regardless of how slighted you feel the chiropractic discipline is by the AMA or the insurance industry or people in general, those issues aren’t going to be settled here.

 

Let’s first of all keep in mind that our employers are NOT responsible for our healthcare or providing healthcare insurance…over the years, what was just a benefit offered voluntarily by employers to entice people to work for them has now become a “right” (at least in some people’s minds). The last time I read the Constitution, I didn’t see anything in there about either private employers or the government being responsible for providing either healthcare or healthcare insurance to citizens.

However, I suspect employers who now offer healthcare insurance would gladly cover some of the costs being shifted to employees (in the form of more base pay) in exchange for getting off the merry-go-round of ever increasing healthcare insurance premiums.

That said…

What I’m suggesting is building upon the MSA model that already exists and that’s already been mentioned.

Essentially, everyone would be required to fund their own medical expenses through a combination of something like the already existing Medical Savings Account coupled with catastrophic healthcare insurance to handle major/extremely expensive procedures (cancer treatments, heart bypass, etc).

The major component is the medical savings account which acts and is administered much like a 401(k). There would be a mandatory minimum deduction from an employee’s paycheck every month (although the employee could contribute more up to some predetermined ceiling) which could be invested in various investment vehicles (just like a 401(k)) is today. Employers could “match” contributions to a point if they wished.

This savings account would be funded with before-tax dollars and would grow tax-free and so long as the money was used to pay for healthcare expenses, there would never be any tax consequences. At age 59 ½ (or some other predetermined age), any funds in the savings account would be available to use for other purposes including retirement income with no tax consequences – in fact, there would probably need to be some mandatory draw-down provision like there is with IRAs.

The person receiving the healthcare from their doctor/provider would be responsible for paying for it – they would either do so out of pocket or by utilizing their savings account funds…this would have the advantage of bringing free-market pressure/competition on the healthcare industry as people began to take real responsibility for their healthcare expenses and be intimately involved in the payment for those services rather than being insulated from all of that as they now are. I suspect a lot of people would opt to pay for most of their minor expenses totally out of pocket rather than “unplug” their medical savings and deplete it for minor costs but the main point is that THEY would make that decision.

Obviously, the premium payments for the catastrophic coverage would also have to be a mandatory deduction from pay as well but of course, the premium amount would vary depending on the amount of the deductible and health of the person applying for coverage.

Here is how the math might work for the savings portion:
Let’s assume we have an 18 y/o employee just starting out earning $10/hour gross ($1,733/month (before tax) and $1,300/month after tax). If the MSA mandatory were 5% of his gross pay; that would be a deduction of $86/month or about $1,040/year. Assuming he never used his savings account but paid for minor costs out of pocket, after 40 years (age 58) he would have approximately $894,000 in his MSA (at an average 12% return which would be an average rate of return for a decent mutual fund). Note that this example is assuming that this person never gets a pay raise or promotion in that 40 year period!

Even if a person never did ANY other saving of any kind he would be able to retire with some real dignity and might not have to become a Wal-Mart greater just to keep food on the table…if he did any savings at all over and above the minimum he could be very wealthy when he reached retirement age.

At the same time, if the individual person who is getting medical care is truly paying for it himself, he is going to be a much more cautious consumer than are most patients today…as it is right now, most of us don’t really care if an annual physical costs $150 or $95 because we’ll probably never know what it really costs and even if we know we don’t really care because “insurance is taking care of it”…we pay our $20 (or whatever) co-pay and that’s were it ends for us. If, however, we were writing the check out of our MSA account or our personal checking account, we might start to care if our doctor is charging us a lot more for the same physical than a doctor just up the road and healthcare providers would feel some pressure to “compete” on price with the other providers that are looking for business.

Obviously, the above is just one example and a very simplistic one at that but the point is that there are other options to simply expanding the current broken system…there are ways to make people personally responsible for their health and their healthcare and the payment for that healthcare.

 

What doesn't make sense is that the Big 2.5 are getting their butts handed to them by Import brands that build most of their cars here, where there is no socialized healthcare..

What I find dumb is that GM/Ford's argument is they can't compete because they have to pay for healthcare.

Well:

1. Honda/Nissan/Toyota are building most of their cars here...which means they are paying for healthcare too, making it moot what the Big 2.5 pay.

2. Even if we socialized the system, taxes would have to go up substantially to pay for it, wiping out the benefit or "savings" to GM. YOu think workers are just going to sit and take having their payroll taxes go up 25-40% to cover the cost of govt insurance? No, they'll strike for higher wages.

3. Govt run healthcare doesn't do anything but change who's paying the bills...it does NOTHING to address the root cause, which is a lack of pressure to keep prices low. If anything, pricing should be more transparent to the beneficiary and we should have greater incentive to shop for the lowest cost and to not make unnecessary trips to the Dr.

I reject the common logic that Socialized medicine is somehow better, more fair, or most laughably, more economical. That's why Canadians take vacations in the US to have surgeries and the waiting lists in the UK for routine stuff are months-long.

The biggest issues that cause the Big 2.5 not to be as competitive are:

1. Unions....they've historically driven up wages to comparably unsustainable levels when the competition does not have unions.

2. Location of their plants. Most of the non-union import facilities are in southern states where wages have been historically lower and the local governments have been more willing to grant tax breaks and incentives to land the jobs....thereby reducing overhead for the auto maker.

Fact is the big 2.5 have squeezed all the blood they are going to get out of the union turnip, and the next thing to squeeze is healthcare. Its a fairly short sighted agenda IMO and it depends on us accepting the myth that import cars are actually made overseas when all the best selling ones are made here. GM has a ton of production in Canada, where they do have socialized medicine...if it was such a boon why not go ahead and move all the production up there?

I think in another 20 years all "imports" will be built in the US and all "domestics" will be built in Canada, Mexico, Down Under or Korea...and people will still get branded traitors for buying the "imports".

 

This is a gross simplification that is incorrect, and on this topic I consider myself a better source of information than the wikipedia article. Conventional means, not to mention medical education itself, is constantly evolving and prevention of disease is an important concept that is taught. Your example of the knee problem does not make much sense in that the patient has already presented with a problem. It is impossible to prevent it at that stage because although powerful, MDs cannot travel back through time.

I fail to see how insurance not covering well visits (although my horrible insurance even covered 2 well visits per year but did not cover sick visits) is in any way a fault of the MDs. MDs exercise no control over insurance companies, outside of that wielded by any other consumer. Insurance companies are created to make money for their shareholders, so the free market is what dictates what you get for your premiums.

I also disagree that other healthcare professionals undergo as rigorous training as MDs. I'll let total hours of education speak for me on this.