Metro Jacksonville

Quote from: stephendare on September 17, 2010, 10:22:01 AM

Quote from: Cricket on September 17, 2010, 10:06:00 AM
The problem with NotNow (and this is true of most conservatives)  he sees social issues through the same prism: "Every man is an island".

Except of course if you are paying to invade iraq and afghanistan or pay for public police departments or subsidize veterans.

naturally this has nothing to do with his own personal interests.

Have you ever met me StephenDare!?  You know nothing of my personal interests.  But should I now speculate about yours?

Quote from: Dog Walker on September 17, 2010, 09:54:53 AM
ALL of the OTHER developed countries in the world have some form of "universal" health care and they ALL have better morbidity and mortality statistics (better health outcomes) than we do.  ALL of them also spend less of their GDP on health care.

Switzerland and Germany use highly regulated, private insurance companies and everyone is required to have insurance.  France, Spain, Italy, Scandinavian countries all have a single payer, government unit that pays for health care.  Britain has a dual system.  National Health Service has physicians as employees and owns hospitals or you can buy private insurance from a private insurance company and go to private physicians and hospitals.

There are several models out there and all of them have their drawbacks, but all of them are better and less expensive than what we have now.

And yet the upper crust of those countries consistently come to the US when facing serious medical issues. 
What is the source of your statements about these havens of medical care? 
The CBO has already said that our NEW system will be MUCH more expensive than what we have now.  How does that square with your theory? 

Although you guys like to rush to judgement and demonize me for disagreeing with you politically by accusing me of "intentionally" ignoring facts and "reviling" someone,  it is just obvious to me and many others that this "health care reform" will do just the opposite of what we have been told.  The quality of care for the majority will deteriorate and the cost of that care will rise substantially.   And yet, just as in the "war on poverty" of the last fifty years many of you can feel morally superior supporting unprecedented spending and worsening the lot of the poor souls you think you are helping.  A large central government has never been the "savior" of the people.  The largest majority of citizens have ALWAYS fared best under a free enterprise system throughout history. 

This country was founded with a great distrust of government, and a great respect for the empowerment of the individual.  It is a concept that I agree with heartily. 

Now, on with the name calling.

I am always struck by all this bellyaching about the cost of Health Care Reform by the same people who had no problem with this government plundering the budget surplus to wage an unnecessary war that did absolutely nothing to iimprove the lives of our citizens.

I would also like to hear a little less about the rich foreigners who come to the US for our superior medical care and more about the poor sucker in this country who can't afford it.

Quote from: JC on September 18, 2010, 12:00:01 PM

Quote from: NotNow on September 17, 2010, 10:40:53 PM

Quote from: Dog Walker on September 17, 2010, 09:54:53 AM
ALL of the OTHER developed countries in the world have some form of "universal" health care and they ALL have better morbidity and mortality statistics (better health outcomes) than we do.  ALL of them also spend less of their GDP on health care.

Switzerland and Germany use highly regulated, private insurance companies and everyone is required to have insurance.  France, Spain, Italy, Scandinavian countries all have a single payer, government unit that pays for health care.  Britain has a dual system.  National Health Service has physicians as employees and owns hospitals or you can buy private insurance from a private insurance company and go to private physicians and hospitals.

There are several models out there and all of them have their drawbacks, but all of them are better and less expensive than what we have now.

And yet the upper crust of those countries consistently come to the US when facing serious medical issues. 
What is the source of your statements about these havens of medical care? 
The CBO has already said that our NEW system will be MUCH more expensive than what we have now.  How does that square with your theory? 

Although you guys like to rush to judgement and demonize me for disagreeing with you politically by accusing me of "intentionally" ignoring facts and "reviling" someone,  it is just obvious to me and many others that this "health care reform" will do just the opposite of what we have been told.  The quality of care for the majority will deteriorate and the cost of that care will rise substantially.   And yet, just as in the "war on poverty" of the last fifty years many of you can feel morally superior supporting unprecedented spending and worsening the lot of the poor souls you think you are helping.  A large central government has never been the "savior" of the people.  The largest majority of citizens have ALWAYS fared best under a free enterprise system throughout history. 

This country was founded with a great distrust of government, and a great respect for the empowerment of the individual.  It is a concept that I agree with heartily. 

Now, on with the name calling.

LOL.. Have you not heard of Medical Tourism?  http://medicaltourism.com/

I personally have a very wealthy friend that had his life threatening cancer treated and put in remission in South Africa because it was less expensive and he felt the care was superior.  He was living there during his diagnosis but came back to the states and then traveled for his treatments, how do you account for that?  How do you account for insurance companies paying their 'customers' to travel abroad for treatment?

Sorry, NN.  The upper-crust from those countries does NOT come to the US for medical care.  They may come from developing countries in the Middle East or South America, but not from Europe or the Scandinavian countries and more and more of them are even going to India and Thailand because they can get our quality of health care at a much reduced cost.

For many years I designed and manufactured surgical implant devices and traveled this country and the world training surgeons to use my equipment.  I've been IN the hospitals and surgical suites of these countries.

If we persist in the perverse financial incentives we have in place now in our health care system, then the new system we are moving to will cost as big a percentage of our GDP as it does now or even more.  Again, I have inside knowledge.  Equipment of my design (I sold the manufacturing company) allows the surgical procedures that use them to be done faster, better and cheaper than the alternatives by at least an order of magnitude.  This equipment is used OUTSIDE the United States at a rate ten times the use inside the US although manufactured here.   ????  By using more expensive implants that use more operating room time, US hospitals actually make more money since they use a percentage mark up in their charges.

The two American companies to whom I licensed my patents, market the equipment heavily outside the US, but don't bother doing so inside the US.  Instead they market their more expensive stuff here instead of the more cost effective stuff.

If we are to control the costs of our "reformed" health insurance scheme, then these sorts of things are going to have to addressed.

Medical tourism anyone? As an expatriot and 100% disabled Vietnam service connected veteran, I have been under the knife in Colombia... several times. Never went to the hospital in Colombia because we have better health care there then here, but because I lived there. I am here to tell y'all that I in my many surgeries and procedures have NEVER had better or more deluxe professional care and/or facilities. In all the years I spent in South America I have yet to feel a single needle! Here is a sneak preview:

Quote...The city Escobar made infamous for cocaine is inviting you to see its safer new face. And while you’re down there, maybe you can get a new face yourself. Or some new bone marrow, for that matter. Medellín is back, and this time it’s touting itself as the hot new spot for medical tourism. It’s a poetic turn of events: A city once ravaged by globalization is diving into the growing trend of globalized medicine, where people priced out of the United States fly to South Africa for a two-in-one rhinoplasty and safari, or to India for a fast organ transplant. Medellín is in a great position to do this. The city is closer than Asia or Africa, has a functioning infrastructure, and an educated workforce. And, in a culture where plastic surgery is de rigeur, it has the specialists to deliver the goods.

Medical tourism has real potential to revive Medellín’s economy, but it also raises the question: At whose expense?

Why Medellín? Once a wealthy city in Colombia’s coffee-growing region, the city fell on hard times in the post-WWII-war period after the country opened itself up to global markets, which brought massive internal displacement. This exposed the city to narco-trafficking and spectacular violence. In recent years, however, the Medellín government has thrown itself into a huge, well-publicized urban-renewal campaign. With the help of the national government, headed by Medellín native Álvaro Uribe, the city has reduced the murder rate by two-thirds( despite a recent spike), built shiny new mass-transport to integrate the population, refurbished parks, and opened new libraries and museums.

A key part of the six-pronged revival plan is promoting Medellín as a destination for medical tourism. The point is to bring in people who aren’t quite rich enough at home but are affluent by Colombian standards. The task of chasing those dollars falls to the so-called Medical Cluster, a public-private partnership between the municipality of Medellín and the Chamber of Commerce. Its mission is to create superior medical and research centers that lure travelers from North Americaâ€"mostly Hispanics from New York, New Jersey, and Floridaâ€"the Caribbean, and Spain. By 2014, the city aims to host 15,000 foreign patients a year and to rank as one of the top three medical tourism sites in Latin America. (The current medalists are Mexico, Costa Rica, and Brazil, though the continent is far behind Asia in terms of the volume of foreign patients and money its hospitals attract.) Since its launch in December 2008, the Medical Cluster program has secured 5,000 foreign patients and $7 million in revenue.

For this to succeed, however, the care must be top-notch. No problem. The Medical Cluster and its government backers have found all kinds of boosters: public financing to educate specialists abroad, plus credit from private banks to develop the city’s medical infrastructureâ€"to the tune of $250 million over three years to build clinics with new technology. That means 1,000 more hospital beds, 10 million-12 million jobs in the city, and some very happy construction companies.

This is an impressive investment for any municipality, let alone one with such a troubled past and a population of just 2.5 million. But is it worth it for the average resident of Medellín? The classic dilemma of medical tourism is that it redistributes scarce resources away from those who need it toward people who simply want it. Hospital bedsâ€"or, in the worst-case scenario, organsâ€"go to gringos shelling out for elective procedures instead of the locals who are actually ill.

Medellín’s government argues that is not the case. They say the new clinics will provide better health care to localsâ€"and that part of the investment can be recuperated off of the backs of foreigners who spend still more on local hotels as they recover before the flight home. The government also argues that it’s a good use of human capital, which was wasted during the heyday of narco-trafficking. Colombians, and Medellín locals in particular, are highly educated. And they live in a largely developed and functioning state. Plus, it’s the perfect confluence of supply and demand. Most foreign patients come for plastic surgery (for rhinoplasties and breast augmentations). And in a culture where plastic surgery is so common that boob jobs are regularly raffled off on the radio, it’s no surprise that good plastic surgeons abound. The relatively small Medical Cluster member Clínica las Américas boasts no fewer than 12.

Moreover, the Colombians have preempted the thorniest issue of all: organ transplants. In 2005, the national parliament passed a law that gives Colombians the priority on all solid organ transplants. For this reason, medical tourists are limited to transplants of relatively plentiful bone marrow.

So Medellín seems to have this sown up. And that’s great, except that it obscures many reasons medical tourism existsâ€"and this is worth keeping in mind now that everyone seems to think health care’s a battle won. Medical tourism is a market response to the medical inequity in America. “Most medical tourism uses doctors that are underutilized at the destination, and the people who use it are people who have been priced out at home,” says Tarun Khanna, a professor at the Harvard Business School who has studied medical tourism to emerging markets. People go abroad for health care because they are uninsured, or because their health insurance doesn’t cover the procedure and they can’t afford it.


Source:
http://www.themedellinblog.com/can-plastic-surgery-save-a-former-cocaine-capital

OCKLAWAHA

Quote from: Dog Walker on September 18, 2010, 03:00:02 PM

Quote from: JC on September 18, 2010, 12:00:01 PM

Quote from: NotNow on September 17, 2010, 10:40:53 PM

Quote from: Dog Walker on September 17, 2010, 09:54:53 AM
ALL of the OTHER developed countries in the world have some form of "universal" health care and they ALL have better morbidity and mortality statistics (better health outcomes) than we do.  ALL of them also spend less of their GDP on health care.

Switzerland and Germany use highly regulated, private insurance companies and everyone is required to have insurance.  France, Spain, Italy, Scandinavian countries all have a single payer, government unit that pays for health care.  Britain has a dual system.  National Health Service has physicians as employees and owns hospitals or you can buy private insurance from a private insurance company and go to private physicians and hospitals.

There are several models out there and all of them have their drawbacks, but all of them are better and less expensive than what we have now.

And yet the upper crust of those countries consistently come to the US when facing serious medical issues. 
What is the source of your statements about these havens of medical care? 
The CBO has already said that our NEW system will be MUCH more expensive than what we have now.  How does that square with your theory? 

Although you guys like to rush to judgement and demonize me for disagreeing with you politically by accusing me of "intentionally" ignoring facts and "reviling" someone,  it is just obvious to me and many others that this "health care reform" will do just the opposite of what we have been told.  The quality of care for the majority will deteriorate and the cost of that care will rise substantially.   And yet, just as in the "war on poverty" of the last fifty years many of you can feel morally superior supporting unprecedented spending and worsening the lot of the poor souls you think you are helping.  A large central government has never been the "savior" of the people.  The largest majority of citizens have ALWAYS fared best under a free enterprise system throughout history. 

This country was founded with a great distrust of government, and a great respect for the empowerment of the individual.  It is a concept that I agree with heartily. 

Now, on with the name calling.

LOL.. Have you not heard of Medical Tourism?  http://medicaltourism.com/

I personally have a very wealthy friend that had his life threatening cancer treated and put in remission in South Africa because it was less expensive and he felt the care was superior.  He was living there during his diagnosis but came back to the states and then traveled for his treatments, how do you account for that?  How do you account for insurance companies paying their 'customers' to travel abroad for treatment?

Sorry, NN.  The upper-crust from those countries does NOT come to the US for medical care.  They may come from developing countries in the Middle East or South America, but not from Europe or the Scandinavian countries and more and more of them are even going to India and Thailand because they can get our quality of health care at a much reduced cost.

For many years I designed and manufactured surgical implant devices and traveled this country and the world training surgeons to use my equipment.  I've been IN the hospitals and surgical suites of these countries.

If we persist in the perverse financial incentives we have in place now in our health care system, then the new system we are moving to will cost as big a percentage of our GDP as it does now or even more.  Again, I have inside knowledge.  Equipment of my design (I sold the manufacturing company) allows the surgical procedures that use them to be done faster, better and cheaper than the alternatives by at least an order of magnitude.  This equipment is used OUTSIDE the United States at a rate ten times the use inside the US although manufactured here.   ????  By using more expensive implants that use more operating room time, US hospitals actually make more money since they use a percentage mark up in their charges.

The two American companies to whom I licensed my patents, market the equipment heavily outside the US, but don't bother doing so inside the US.  Instead they market their more expensive stuff here instead of the more cost effective stuff.

If we are to control the costs of our "reformed" health insurance scheme, then these sorts of things are going to have to addressed.

I will defer to your experience, but my original point was that the "health reform" that we are undertaking will actually increase medical costs and decrease service for the average American.  Does our system need to change?  Yes, but the current reform, or worse a single payer system will only add to our problems. 

"Medical tourism" is largely fueled by the refugees of Canada and other government's medical solutions.

For the benefit of anyone needing major medical care, check this out - then COME ON DOWN!

Quote
MARKETWATCH
Colombia’s Universal Health Insurance System

Ursula Giedion and Manuela Villar Uribe

By insuring more than 80 percent of its population, Colombia provides a valuable opportunity to gather evidence on a hotly debated health policy issue. Results from three studies evaluating the impact of universal health insurance in Colombia show that it has greatly increased access to and use of health services, even those that are free for all, and has reduced the incidence of catastrophic health spending. The impact has been more dramatic among those most vulnerable to health shocks: those living in rural areas, the poorest, and the self-employed.

SOURCE:
Health Affairs - http://content.healthaffairs.org/cgi/content/abstract/28/3/853

QuoteThere are two different kinds of Colombia health insurance: one is private insurance that you buy and pay 100% of the premiums. The second belongs to Colombia's official health system; you can be a part of it, if you work in Colombia; the payments depend on you salary or income; the rate is 12.5% of your income, you pay a third of it and your employer will pay the rest. This is mandatory even if you are an independent worker (in that case, of course, you will have to pay the full 12.5%).

SOURCE:
Medellin Visitor Guide - http://www.medellinvisitorguide.com/healthinsurance.html

International ranking of Health Care, note USA and COLOMBIA

QuoteColombia has the best healthcare system in America

http://www.photius.com/rankings/healthranks.html



Rank Country

1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 United States of America
38 Slovenia
39 Cuba
40 Brunei
41 New Zealand
42 Bahrain
43 Croatia
44 Qatar
45 Kuwait
46 Barbados
47 Thailand
48 Czech Republic
49 Malaysia
50 Poland
51 Dominican Republic
52 Tunisia
53 Jamaica
54 Venezuela
55 Albania
56 Seychelles
57 Paraguay
58 South Korea
59 Senegal
60 Philippines
61 Mexico
62 Slovakia
63 Egypt
64 Kazakhstan
65 Uruguay
66 Hungary
67 Trinidad and Tobago
68 Saint Lucia
69 Belize
70 Turkey
71 Nicaragua
72 Belarus
73 Lithuania
74 Saint Vincent and the Grenadines
75 Argentina
76 Sri Lanka
77 Estonia
78 Guatemala
79 Ukraine
80 Solomon Islands
81 Algeria
82 Palau
83 Jordan
84 Mauritius
85 Grenada
86 Antigua and Barbuda
87 Libya
88 Bangladesh
89 Macedonia
90 Bosnia-Herzegovina
91 Lebanon
92 Indonesia
93 Iran
94 Bahamas
95 Panama
96 Fiji
97 Benin
98 Nauru
99 Romania
100 Saint Kitts and Nevis


Viva Colombia!

Some of the details from the World Health Organization and Pan American Health Organization give some idea of how it works in Colombia's free market economy.

Quote

Four fundamental forms of support:

• The National Council on Social Security for Health, under the Ministry of Health, is a professional group that is responsible for standardizing, regulating, controlling, and directing the system. The Ministry of Health relies on the sectional health services (one per department) to carry out its duties at the territorial level.

• The National Solidarity and Guaranty Fund is responsible for financing the system. All persons with incomes higher than the equivalent of two minimum wages are required to support the system with contributions, while the poor, the unemployed, and peasants are subsidized.

• The health promotion enterprises are the fundamental organizational nuclei of the system. They are responsible for the basic mobilization of financial resources, health promotion, and organization and delivery of medical services. These entities also have the related responsibility of managing the disabled and providing health services in the event of work-related accidents and occupational diseases as well as organizing complementary health plans, which may be public, private, partnership-based, or mixed and that compete for subscribers in the population.

• The institutions that provide health servicesâ€"the hospitals, outpatient consultation offices, laboratories, basic health care centers, and other health service centers, plus all the professionals who, either individually or in groups, offer their services through the health promotion enterprises.

Law 100 reaffirms the administrative, technical, and financial autonomy of the public hospitals originally established in Law 10 of 1990 and Law 60 of 1993, and for this purpose it stipulates that public hospitals will be turned into social enterprises of the State as a special type of decentralized public entity; that staff will be governed by the provisions of Law 10, and that private law shall apply in contractual matters. As of June 1997, 104 of the 142 secondary- and tertiary-level hospitals had been turned into social enterprises of the State, and there were 165 health partnership enterprises, 67 family compensation funds, and 30 health promotion enterprises.

Law 100 also specifies that, as part of the Compulsory Health Plan, initiatives executed by the local government to promote health and prevent disease must be provided free to the entire community and should respond to the needs expressed by the people. All the system’s subscribers have the right to be covered under a basic plan, which includes emergency care, hospitalization, consultations, and medication.

SOURCE:
http://www.paho.org/english/sha/prflcol.htm

I really think Obama should have spent a bit more time looking south of the border! I have seen nothing but GOOD coming from this system in a country that has remade itself.

OCKLAWAHA

Ock, where is China on that list?

India is not on it either.  I think that health care in both of those countries is so diverse and so spread out that meaningful statistics can't be gathered.

I am surprised that Germany is so far down on the list.  Even after two decades they must still be feeling the impact of the Easties on their numbers. 

Seeing France and Italy ahead of everyone else doesn't surprise me at all.  France probably has the most advanced neurosurgical care in the world.  Some French neurosurgeons of my acquaintance at the Center for Neurosurgery in Lyons pioneered the trans-oral approach to surgery of the cervical spine  (Through the mouth)  and Italy is way ahead of everyone else in cardiac surgery. 

Most advanced orthopedic surgery in the world is still done in Germany and Switzerland.

I don't know about that but I spent a lot of time at Mayo Clinic in the early part of this decade. They were set up more to take care of people from other places coming to the clinic than us locals. They handled people as if they were only in town a short time.

Interesting info here...
http://en.wikipedia.org/wiki/Medical_tourism

A few excerpts...

QuoteA forecast by Deloitte Consulting published in August 2008 projected that medical tourism originating in the US could jump by a factor of ten over the next decade. An estimated 750,000 Americans went abroad for health care in 2007, and the report estimated that a million and a half would seek health care outside the US in 2008. The growth in medical tourism has the potential to cost US health care providers billions of dollars in lost revenue.[9]

A large draw to medical travel is convenience and speed. Countries that operate public health-care systems are often so taxed that it can take considerable time to get non-urgent medical care. Using Canada as an example, an estimated 782,936 Canadians spent time on medical waiting lists in 2005, waiting an average of 9.4 weeks.[10] Canada has set waiting-time benchmarks, e. g. 26 weeks for a hip replacement and 16 weeks for cataract surgery, for non-urgent medical procedures.[11]

QuoteUnited States
Although much attention has been given to the growing trend of uninsured Americans traveling to foreign countries, a McKinsey and Co. report from 2008 found that a plurality of an estimated 60,000 to 85,000 medical tourists were traveling to the United States for the purpose of receiving in-patient medical care;[66] the same McKinsey study estimated that 750,000 American medical tourists traveled from the United States to other countries in 2007 (up from 500,000 in 2006).[67] The availability of advanced medical technology and sophisticated training of physicians are cited as driving motivators for growth in foreigners traveling to the U.S. for medical care,[66] whereas the low costs for hospital stays and major/complex procedures at Western-accredited medical facilities abroad are cited as major motivators for American travelers.[67] Also, it has been noted that the decline in value of the U.S. dollar is offering additional incentive for foreign travel to the U.S.

Over, you are correct.  None of the Mayo Clinic sites could survive on the local populations in their areas alone.  Rochester, Mn just isn't that big and they were first.  So most of their patients come from other parts of the country and, indeed, some from other countries.

Medical care at Mayo is absolutely first rate mostly, in my opinion, because they are a group practice.  They are also highly selective of who they employ.  The physicians are employees who also earn shares in the corporation over time.  They don't have the incomes of physicians in private practice, but they don't have the overhead of office staffs, insurance, rent, etc. to manage.  And they have a much lower pressure life style with more vacation and continuing education time.  

Mayo uses a close team approach to treatment and since they are all in the same place there is no problem with referrals, schedules, record transfer,etc.  They are all together and focused on each patient.  The difference in efficiency, communication and consultation alone makes a huge difference in the care everyone receives.