The Change Begins.

[flintlock]

Re: The Change Begins.

A perfect storm is brewing. Health care, deficit spending, Defense spending, entitlements. I can't help but see a bleak future for the US.

People are so worried about having things perfect that they are willing to lose the whole thing. There is no give and take. It is going to boil down to a fight between those receiving reasonably good health care( medicare, medicaid, government employees, Cadillac plans, etc) and the private sector that is being squeezed out. Even though the fight is not being presented that way now, I think that is what it will boil down to. A lot of these plans are govt subsidized and costs are growing at an unsustainable rate. Eventually only an elite will have good care under the current system.

I think we either scale back the level of care people feel they are entitled to( free knee replacements, drugs, etc) or the whole thing will collapse to a point it will take years to recover. I think the common sense approach would be to establish a minimum standard of care for all, with those who can afford it allowed to pay extra into a premium care plan. Of course, some will claim that is not "fair".:rolleyes:

[flintlock]

Re: The Change Begins.

Flounder, you can't spend your whole life worrying about your mistakes! You fucked up - you trusted us!

-Otter from Animal House.

[ThePythonicCow]

Re: The Change Begins.

I think the common sense approach would be to establish a minimum standard of care for all, with those who can afford it allowed to pay extra into a premium care plan. Of course, some will claim that is not "fair".:rolleyes:

The problem lies not with the little guy complaining about what's "fair". The problem lies with the big (medical and drug) guys wanting to continue their revenue streams.

[Jay]

Re: The Change Begins.

Isn't assuming that Serge, a self-professed fascist, believes in genocide kinda like believing that you are a talk show host because your first name is Jay?

You may disagree with fascism, but don't let it detract from Serge's point regarding Mula's anti-Christian fanaticism. Mula is off base here (per usual), not Serge.

I asked him if he believes in genocide. I didn't assume anything.

[flintlock]

Re: The Change Begins.

I agree that Big Medical and Pharma wants to continue it's income stream, but how do we stop that?

[flintlock]

Re: The Change Begins.

Yep, most of those types don't really believe in anything past their next bonus check. Most people in general really don't have strong political convictions. Its not like they sit around discussing it or giving it much thought. Many an election was won or lost based on a few sound bites.

[Thailandnotes]

Re: The Change Begins.

I agree that Big Medical and Pharma wants to continue it's income stream, but how do we stop that?

I'll keep kicking a dead horse...

Come to Thailand.
I have freinds coming in the next two months for
root canals, colonoscopies, bone density scans, heart stress tests, and cataract surgery.
Some have been here before.
The efficiency, English, care level, and record keeping blows you away.

High blood pressure?
You can board the plane back to your home with a year's prescription of the exact same medicine you are taking in the states and pay 6 %, so cheap you won't bother filing a claim.

[flintlock]

Re: The Change Begins.

I'll keep kicking a dead horse...

Come to Thailand.
I have freinds coming in the next two months for
root canals, colonoscopies, bone density scans, heart stress tests, and cataract surgery.
Some have been here before.
The efficiency, English, care level, and record keeping blows you away.

High blood pressure?
You can board the plane back to your home with a year's prescription of the exact same medicine you are taking in the states and pay 6 %, so cheap you won't bother filing a claim.

Yes, your posts are what give me hope things can be fixed here. How can Thailand do it so cheaply?

[Rajiv]

Re: The Change Begins.

That is because, Pharma adopts differential pricing --

Infrastructure and Differential Pricing

Differential pricing
In order to achieve the Millennium Development Goals, global efforts have to be concentrated where they are needed most – those countries that are poorest and/or carry disproportionate disease burdens.

The majority of pharmaceutical companies have developed some form of "differential pricing" for some of their product range. For low income countries, as defined by the Department for International Development in 20051, this is commonly at or around cost; for middle income countries prices are at levels substantially less than in the developed world.

For both low and middle income countries, it is worth noting that about 95 per cent of medicines on the World Health Organisation's (WHO) list of essential medicines are off-patent

Also, the wage structure is lower in $ terms - reflecting the lower cost of living in the developing world. The medical costs are expensive for much of the local population in terms of their own wages and earnings.

[jk]

Re: The Change Begins.

drug pricing can be viewed as a subsidy that the wealthy u.s. gives to the rest of the world. we pay for the profits and the r&d, the rest of the world gets cheaper drugs.

[ThePythonicCow]

Re: The Change Begins.

Yes, your posts are what give me hope things can be fixed here. How can Thailand do it so cheaply?

It's the incentives. The day that Thai medicine doesn't offer something of special value to Americans, Americans quit coming.

As for the incentives on American provided "medical" care ... well what can I say ... not much (this is a family forum.)

[ThePythonicCow]

Re: The Change Begins.

drug pricing can be viewed as a subsidy that the wealthy u.s. gives to the rest of the world. we pay for the profits and the r&d, the rest of the world gets cheaper drugs.

They (non-Americans) get drugs at costs that are a reasonable markup of manufacturing costs, while we Americans get an increasing array of government funded or mandated toxins at enormous profits to a few large corporations.

[Thailandnotes]

Re: The Change Begins.

drug pricing can be viewed as a subsidy that the wealthy u.s. gives to the rest of the world. we pay for the profits and the r&d, the rest of the world gets cheaper drugs.

To some degree, yes. Generally, drugs are expensive to develop, but cheap to manufacture. Many countries have controls which limit the price of a drug which forces the manufacturer to charge more in the US in order to recoup the cost of development.

But, there is a lot of BS going on too. Take generic drugs. In the US, generic drugs produced after a drug comes off patent often cost as much as the orginal. Production of the generic is limited, over regulated in favor of big pharma.

[Thailandnotes]

Re: The Change Begins.

Yes, your posts are what give me hope things can be fixed here. How can Thailand do it so cheaply?

Cheap labor, obviously, but there are many other factors.

If you go see a doctor, his or her office is usually in a hospital.
So is the lab that does your blood work. So is the pharmacy that handles your prescription.

In Alexandria, Virginia, I would be driving a mile from the doctor's office to get lab work done, driving another two miles, dropping off a prescription, driving back to the pharmacy, waiting three days for lab results, and revisiting the doctor or a nurse practioner.

In Thailand the above visit - lab work, prescription, etc, - would take 90 minutes. At the end I would go over the lab results with the doctor and would be billed for a single visit. While I was waiting I might go to the bank inside the hospital, and/or buy a sandwhich or some Thai food to take to work the next day.

Thai medical records are all digital. It's obvious the second you walk in that Thai healthcare is much more efficient than in the states. Most larger hospitals have a rep from the major health insurance providers working in an office. This cuts lots of red tape, and saves you, the patient, lots of phone calls and frustration.

Dentists, opthamologists, and specialists are in the same building. I can make appointments online just as I would pick out a seat on a flight. Often I kill two birds with one stone: Get my teeth cleaned and have that pre-cancerous growth on my arm zapped in the same hour.

[Thailandnotes]

Re: The Change Begins.

I agree that Big Medical and Pharma wants to continue it's income stream, but how do we stop that?

The only way I can think of is regulating the food industry. Americans are on the cutting edge of getting sick.