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View Diary: Universal Health Care -- it's different this time (41 comments)

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  •  Prevention is a major key (3+ / 0-)

    to controlling costs. If fewer people get sick by not smoking, by geting exercise, having a good diet, etc, the effect on healthcare costs is huge. But currently, only tiny amounts oof money are spent on prevention. Another thing is spending on keeping older people out of nursing homes by developing systems and technologies that maintain their independence. None of these things are really possible without a national healthcare system. Our system is focused on waiting until someone gets sick and then going all out to cure them or preserve their lives for a short time. While that is a good objective, prevention has got to be the central onjective of a rational healthcare system.

    Ambition is when you follow your dreams. Insanity is when they follow you.

    by Batfish on Sun Aug 05, 2007 at 10:13:13 AM PDT

    •  Prevention is the best medicine (0+ / 0-)

      but it isn't always a money-saver.  In the medicare population, particularly, prevention doesn't help the budget if you prevent someone from dying abrubtly, so a few years later he dies of a prolonged, expensive illness.  Not that I want to sound ghoulish, but the biggest favor an elderly person can do Medicare's budget is to 'fall off his perch' so abrubtly nobody even calls an ambulance.  Of course, this ghoulish economic point comes  from  not assigning any value (i.e., by default assigning zero value) to prolonging someone's life.

      Preventive medicine probably is cost effective for children even in the unenlightened analysis.  

      We're all pretty crazy some way or other; some of us just hide it better. "Normal" is just a setting on the dryer.

      by david78209 on Sun Aug 05, 2007 at 10:30:09 AM PDT

      [ Parent ]

      •  That's when they have the illness (1+ / 0-)
        Recommended by:
        david78209

        It's not true if they don't get it. We also have the technology, or could have, to delay the inevitable for a long time. Andy Grove outlined this in his Shift Leftlecture at UC Berkeley a while back. By keeping people out of intensive care units by providing them with the tools to manage their health and trigger early intervention so people get treated when their illness becomes hugely expensive. That's an issue that is becoming very important as we all age.

        Ambition is when you follow your dreams. Insanity is when they follow you.

        by Batfish on Sun Aug 05, 2007 at 10:44:28 AM PDT

        [ Parent ]

        •  The hospitals have already (1+ / 0-)
          Recommended by:
          david78209

          built ICUs and equipped them.

          Prevention can save and improve many lives, but it really will only save a small amount of money by reducing ambulance fuel and insurance costs and ICU nursing costs.

          •  Wrong (1+ / 0-)
            Recommended by:
            david78209

            The cost of construction is not the ongoing cost you have to worry about. An ICU bed runs around $2000 per day. That's the minimum wiothout anything being done to the patient. You are way, way off with this one. It is well established that prevention programs have huge benefits in reducing healthcare costs. But just ask yourself a simple question would it be better for you to take care of your health by simple steps every day, or wait until you are so ill you spend a few weeks and score a $200, 000 bill at the end. Multiply that choice by many millions and you have a big part of the reason why helathcare costs in the USA are crazy. National healthcare systems as in Canada, Europe, Australia, etc, have a vested interested in keeping people healthy, and in fact their populations are healthier, by any measure, than Americans are.

            Prevention saves many lives, and many dollars, whether you believe it or not.

            Ambition is when you follow your dreams. Insanity is when they follow you.

            by Batfish on Sun Aug 05, 2007 at 11:57:13 AM PDT

            [ Parent ]

            •  Prevention is great (1+ / 0-)
              Recommended by:
              david78209

              But, the reality is that it delays the end.  Until something is available to make us immortal -- and I bet it'll be expensive -- sooner or later we are all going to fall off the perch (thanks david).

              Since our technology is ever increasing we will spend ever more on health care until we do.

            •  One nurse paid $50 an hour (0+ / 0-)

              hovering over a patient 24 hours a day costs $1200 a day.

              Intensive care is not anywhere near that intensive.

              The cost may be $2000 a day, but the marginal cost is probably $300 a day.

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