I'm hoping this won't devolve into a discussion of the Affordable Healthcare Act (so-called "Obamacare"). Let's do that under a more specific topic.

Rather let's discuss the current system in America, what's wrong with it and what's right, whether it needs fixing, and how to fix it. Non-Americans are encouraged to chime in.

Here's my take:

1) There is no healthcare system on a national level beyond Medicare and Medicaid. Any other systems are local to some degree or other.

2) Pretty much everyone who doesn't have their head up their hind end can see that the current way of handling healthcare is not sustainable. within a decade or two, assuming costs continue to rise, healthcare will become unaffordable for most Americans.

3) Healthcare isn't a normal market where competition functions to lower cost. Yes, insurance companies exclude certain high-risk, high-cost people in an effort to maximize their profits and keep their rates down. However, that doesn't work because for the excluded people the local ER becomes the primary care provider. Somebody has to pay for this care, so it's passed along to the people who are insured through their insurance company. This is one reason why hospital Tylenol can cost $25. The marketplace actually RAISES costs.

4) Do you think it's ethical to throw 30+ million under the healthcare bus in order to keep rates low for those with insurance, especially considering that it  ends up (as explained in the 3rd point) making costs higher anyway.

5) 30+ million people need affordable healthcare, and indigents need free healthcare. Is it so bad to have socialized healthcare for them, especially if it will function to bring costs down for the rest?

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That's an interesting problem. I might be ok with that ruling. Once a drug is generic, I expect it to automatically meet a generic standard that doctors and pharmacists should be familiar with, and patients should become familiar with.

A generic drug should get just one, approved, standard, generic label, no matter who's the manufacturer. The manufacturer should just be responsible for quality manufacturing, unless they're also publishing or approving additional research on the drug. 

At the consumer level, I want my pharmacist and doctor to understand that generic label and be able to answer my questions, and educate their other patients to the extent they can be educated.

cautions are given to u by the pharmacists exactly as they are with a brand name drug. for example quinolones come with a warning for knee joint rupture and stuff and pharmacies give u a monograph explaining everything, even simple stuff like skin sensitivity to sunlight is on there too. all u have to do is read.

One can't be sure.

I didn't say pharmacies, I said shelves, where the average person chooses what to buy. (I'm just pointing out how ignorant most people are about medicine in general.)

and u can just go politely to the pharmacy counter and ask the question for free.

ER problem is fixed with urgent care centers for simple sniffles, routine monitoring of blood work for diabetes, cholesterol etc. even pharmacies are pitching in where a CNP is available to help with chronic condition maintenance and also ear aches and stuff like that. the problem lies in personal responsibility. when u make it free for some, the free loaders don't think where they go and how much it costs the other people for a simple visit to ER for a minute reason which could easily wait till the next day. Just ask yourself a question, assuming u have insurance, that if u have a runny nose or a headache and u can buy stuff for it OTC and take care of symptoms now and can call the doc in the morning, and not have to foot a bill for $400 for a visit to ER, i think u will wait till AM, but on the other hand if u know, the meds will be free and u don't pay shit and u can go the ER and get the Rx, u get my drift......if u don't believe it just go the nearest ER and find for yourself or ask any pharmacist as they see all those scripts on the weekend. the other biggest expense for rise in hospitals expense is end of life care. another biggest hurdle is why should others pay for your bad lifestyle, like a person with asthma who smokes, why aren't their penalties with this stuff(the only penalties are for folks who pay for their insurance, i think utah was implementing something like that but haven't brushed up on it lately), there are only rewards like women on medicaid in ohio get vouchers for different shops just for keeping the appointments with ob/gyn. even with this said i like the law, for a variety of reasons like keeping kids on parents insurance till 26 etc.

I agree with...all of that.

I'd say our healthcare system obviously needs fixing, that shouldn't even be up for debate.  How to do it is the real discussion.  Where to start?  I'd say the cost of is pretty much the dominant issue of the system itself.  I think it's absurd that we allow anyone to make money off of sick people, be it hospitals, insurance companies, pharma companies, etc.  Perhaps they could be regulated  like utilites where they only make a certain percentage profit?  I'd like to see a single payer system so that people could get the preventative care they need to avoid the costly care down the road from untreated conditions.  Ultimately though, the best prevention is better nutrition.  That is really why we are spending so much money at the doc.  But just think if everyone started being healthy, how many people would that put out of a job?  Our economy is so dependent on people being sick how do we reverse without collapsing everything?  I kjnow quite a bit of what we spend is on the seniors, but what the hell do we do there?  Only thing I can figure is to start with one generation and make them healthy and pave the way to less healthcare in general. 

When the automobile was invented, 99% of all blacksmiths were out of a job - we adjust, we re-educate, and we move on.

This conversation is one that really gets me heated. I honestly believe that if you're for a system where one person can go bankrupt because they or someone in their family got a disease or was involved in an accident they had no control over and another person is ok because they have the money to pay to take care of that same disease or accident, you're a borderline psychopath. I mean, really? How many years of evolution and we're still at "Thag can't swing club, Thag should go into woods and die"? Even at the highest (state) minimum wage in the country ($9.04 in Washington) working a 40 hour week yields $18,803.20 (before taxes). Who the hell is going to be able to take care of a family member who gets something like cancer with that amount of money? Who is going to be able to take care of a family member who gets something like cancer with *twice* that amount of money? So the solution is "just let 'em die"? The inability to show empathy and sympathy in these cases; the inability for someone to say "what if someone said that to me about my family member or friend?" is why I have no problem saying that people who feel this way are borderline psychopaths.

This isn't a question of business or economy, this is a question of basic human necessity and basic human dignity. There are plenty of other countries that understand this. It's too bad America can't be one of them.


Wow, powerful words, wonderfully put together, and such an important message - thumbs up X 10!

Thank you very much Heather!


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