Covid-19 and Medicare for All

[Alan Klein]

Alan, how do the American hospitals deal with elective surgeries and cancer treatments? Still performing them or putting them on hold?
Do you have any data on such backlogs in NY and NJ? If so, how many elective procedures are performed normally per week in each state?

My nephew who's a anesthesiologist up at Mass General in Boston told me they stopped elective surgery at the beginning of the virus.  But then later he went back to work.  He's also a researcher.  But that work has been stopped entirely. 

I don't know what's going on in my area of NJ and NYC.  But I suspect most hospitals are backlogged.   My 97 YO mother-in-law's cardiologist's office called us today cancelling her appt Monday with the comment that we should call if there are any emergencies.  That was nice of them to let us know we should call. Of course, she's in an assisted living center and we can't visit her and they don;t let her out.  She has to eat in her room like a convict rather than the main dining room.  Fortunately, the staff seems to be well equipped now with PPE and have procedures down so infections don't spread.  But who really knows?  I've skipped some doctor appts I should have been too.  But right now I need some dental work that's not getting done.  The whole world seems on hold.

[Alan Klein]

Alan, if you have no medical insurance in the US, how do you get that MRI test? The US has 28M people with no medical insurance and most likely growing as people get laid off and losing their insurance. Another tidbit...the number one reason for personal bankruptcy in the US is dealing with medical bills.

Personally I'd wait a few months for my elective surgery than filing for bankruptcy to get it sooner. Like I said, the elite have no issues on either system...it's how the poor are dealt with that really separates the two medical systems.

Again, my friend in Georgia is forced to work to pay for his wife's medical...with nothing left over to get his knee replacement. He's been in this situation for the last 5 years...that's some wait list. 

I'm sorry about your friend.  You never answered the question whether she's over 65 and eligible for Medicare.  Is she?

I do agree that something had to be done with medical care in this country.  Before Obamacare, approximately 85% of America had care through their place of employment or privately paid or were on Medicare for the elderly or Medicaid from the state for the poor.  It would have been better, simpler and cheaper if they just figured out a way to add people who don't have any insurance and cover preexisting conditions rather than throwing the baby out with the bathwater and making a mess of the whole system.  That's Obama's and the Democrats fault.

Regarding how people who are getting laid of get medical insurance, that's a great question.  This country is broke.  We, the people and the government, have over-extended ourselves in debt for years.  The bill has just come due and we will suffer.  It's our own fault.  You can't print your way to prosperity. Your can't borrow your way into wealth.   We pissed away our money, didn't save for a rainy day like today, and then when the SHTF, we run around like chickens without heads trying to figure out how to cover all this stuff.  Well, you can't.  We're in a fix and we're going to suffer, a lot, unfortunately.

Trump is just as guilty as the Democrats.  He ran up a trillion dollar deficit before the virus.  Now, with the COngress, they're runnin up trillions more printing 'til the cows come home. That's even more debt we have to pay back.  I just read that California now has a $54 billion dollar deficit.  That's just one state.  Where are they getting the money to complete that multi billion high speed railroad line they're building.  It's a joke.  Well, LaLaLand is in California.

[LesPalenik]

As of May 1, approximately 20 states in USA had resumed some elective surgeries, with more states planning to do so it soon. This phased-in approach seems a good and safe way to start clearing the backlog and learn how to deal with the Covid-19 situation challenges.

In Canada, BC and Ontario announced plans to re-open the elective surgeries, but no dates have been announced yet. The offices of the surgeons and specialists are still closed.

It could take up to two years and at least $250 million in extra funding to address the extensive backlog of elective surgeries postponed in B.C. since the peak of its pandemic, the provincial government announced Thursday. Officials said there are 30,000 patients whose surgeries were postponed or not scheduled at all after the province put restrictions on non-urgent surgeries in mid-March. Those patients joined or remained on a pre-existing wait-list, bringing the total number of patients waiting for surgery in B.C. to 93,000.

https://www.cbc.ca/news/canada/british-columbia/elective-surgeries-resuming-in-bc-covid-19-1.5559340

[John Camp]

Alan, if you have no medical insurance in the US, how do you get that MRI test? The US has 28M people with no medical insurance and most likely growing as people get laid off and losing their insurance. Another tidbit...the number one reason for personal bankruptcy in the US is dealing with medical bills. 

If it's an MRI for elective surgery, you're pretty much out of luck. But if it's an MRI for critical surgery -- anything from broken bones to cancer -- you'll get it. You may later lose your house, if you have one, but you'll get it. That's one reason many healthy young people evade the insurance requirement -- they know that if they get hurt, a hospital can't turn them away if the need is critical. If they do get turned away, the hospital will get its shirt sued off, and there are many, many attorneys ready to do that for a cut of the proceeds. A young person with few or no assets may therefore make a fairly logical the decision to evade the insurance requirements, especially given the requirement of the Obamacare law that people can't be turned away for previous existing conditions. Get cancer? Sign up for insurance. No cancer? Evade it. Broken bone? You'lll get treatment, but you'll pay through the nose for it, since that doesn't fall under the "previous existing condition" requirement.

[Robert Roaldi]

There is a recent NPR Fresh Air podcast interview with Nelson D. Schwartz, author of The Velvet Rope (https://www.npr.org/books/titles/833042780/the-velvet-rope-economy-how-inequality-became-big-business). The book is about all the special perks that the "super"-wealthy can purchase for themselves these days, and they talk about numerous interesting examples, but the one relevant to this thread is the availability of what the author calls "concierge" medical services. If you can afford it, you pay someone a retainer and you can be on a priority list for tests, appointments, etc. The podcast is about an hour long, it was interesting to hear what you can buy if you have the money.

[Alan Klein]

There is a recent NPR Fresh Air podcast interview with Nelson D. Schwartz, author of The Velvet Rope (https://www.npr.org/books/titles/833042780/the-velvet-rope-economy-how-inequality-became-big-business). The book is about all the special perks that the "super"-wealthy can purchase for themselves these days, and they talk about numerous interesting examples, but the one relevant to this thread is the availability of what the author calls "concierge" medical services. If you can afford it, you pay someone a retainer and you can be on a priority list for tests, appointments, etc. The podcast is about an hour long, it was interesting to hear what you can buy if you have the money.

Everyone in America wants to be rich.  That's why everyone comes here.  Stirring up wealth disparity is an old, socialist trick.  It feeds on envy and ends with stealing. 

[JoeKitchen]

There is a recent NPR Fresh Air podcast interview with Nelson D. Schwartz, author of The Velvet Rope (https://www.npr.org/books/titles/833042780/the-velvet-rope-economy-how-inequality-became-big-business). The book is about all the special perks that the "super"-wealthy can purchase for themselves these days, and they talk about numerous interesting examples, but the one relevant to this thread is the availability of what the author calls "concierge" medical services. If you can afford it, you pay someone a retainer and you can be on a priority list for tests, appointments, etc. The podcast is about an hour long, it was interesting to hear what you can buy if you have the money.

In a medicare for all system, I would see this type of service increasing. 

Smart doctors realize you cant make a good amount taking only medicare and medicad patients, especially with student loans that account for 7 to 11 years of training.  Plus why spend that much time training to only make an okay living. 

Many of those smart doctors will just set up co-opts with other doctors/specialists and take on a list of clientele that would not just be the rich, but would go as far down as the upper middle income.  It would become a big market in the USA over night.  Most  people are not stupid when it comes to this either and would realize that a government run system is going to be inferior to a market run one, and would be happy to pay to become a client of such an operation. 

This is not something you could outlaw either, and if they did the Supreme Court would strike it down. 


What gets me about all of this is that those who push these liberals policies rarely ever live by them.  Hollywood pushes medicare for all but I can guarantee that all those same actors advocating for it would buy into things like this.  Just like when actors say it is okay to have a baby out of wedlock and we should not criticize doing so, but yet the elites never do this themselves. 

They often push liberal ideals, acting as if there is nothing wrong with them, but in their own personal lives practice all of the conservative ideals, benefitting from them. 

[Alan Klein]

In a medicare for all system, I would see this type of service increasing. 

Smart doctors realize you cant make a good amount taking only medicare and medicad patients, especially with student loans that account for 7 to 11 years of training.  Plus why spend that much time training to only make an okay living. 

Many of those smart doctors will just set up co-opts with other doctors/specialists and take on a list of clientele that would not just be the rich, but would go as far down as the upper middle income.  It would become a big market in the USA over night.  Most  people are not stupid when it comes to this either and would realize that a government run system is going to be inferior to a market run one, and would be happy to pay to become a client of such an operation. 

This is not something you could outlaw either, and if they did the Supreme Court would strike it down. 


What gets me about all of this is that those who push these liberals policies rarely ever live by them.  Hollywood pushes medicare for all but I can guarantee that all those same actors advocating for it would buy into things like this.  Just like when actors say it is okay to have a baby out of wedlock and we should criticize doing so, but yet they elites never do this themselves. 

They often push liberal ideals, acting as if there is nothing wrong with them, but in their own personal lives practice all of the conservative ideals, benefitting from them. 

My sister when she was alive had concierge service.  She was not a rich person by a long shot.  She had a small pension and SS and lived in Florida in a 55+ community.  It seems to be a lot more prevalent down there maybe because so many oldsters live there.

I recall that was about five years ago that she had concierge service for around $1600 a year.  That's out-of-pocket; no reimbursement from Medicare or insurance companies. He was a personable internist who would coordinate other requirements my sister had also acting like an advocate for her.  I think he also did some direct services which would be chargeable separately and paid by Medicare. She had cancer the last few years and did a lot of chemo etc.  The concierge doctor would coordinate with the hospital and various doctors and make sure everything went smoothly.  Otherwise, what happens is you have numerous specialists who don't talk to each other and you have to act as your own advocate with little knowledge and less power.  If she had a problem, she'd have the concierge call the other specialists and get info.  Doctors talking to doctors work better.  They're more accommodating to each other.  When the hospital wasn't providing proper services to my sister, I called her concierge and got him to push buttons at the hospital when I couldn't get anywheres.  It's like having an attorney on retainer.

[Robert Roaldi]

Everyone in America wants to be rich.  That's why everyone comes here.  Stirring up wealth disparity is an old, socialist trick.  It feeds on envy and ends with stealing.

First off, everyone everywhere wants to be rich. I don't know why you think that's an American phenomenon. That's a bit egocentric.

I mentioned the article/podcast because I thought it was interesting and had not been previously aware of some of what was presented. There was no "socialist" agenda at work, please stop interpreting every posting as an attack that you have to respond to with an on-message response. I am not campaigning against you, this is a discussion forum. As it happens, the writer of that book was making the point, as I understand it, that although the rich are always able to buy more, what is being offered now is unprecedented. Maybe you don't agree with the thesis, that's ok, but without listening to or reading what he said, your opinion of it is not very relevant. I posted the reference as an FYI for everyone, it was not about you.

Moreover, your silly aphorism that reporting on such behaviour ends with stealing is an inane platitude. Unless you want feudalism to come back, that is, but I thought you hated British monarchist rule.

Look we get it, you don't like socialism. Wake up, there's no one on these forums, nor most anywhere else on earth, that does anymore. You're fighting imaginary shadows.

[Alan Klein]

First off, everyone everywhere wants to be rich. I don't know why you think that's an American phenomenon. That's a bit egocentric.

I mentioned the article/podcast because I thought it was interesting and had not been previously aware of some of what was presented. There was no "socialist" agenda at work, please stop interpreting every posting as an attack that you have to respond to with an on-message response. I am not campaigning against you, this is a discussion forum. As it happens, the writer of that book was making the point, as I understand it, that although the rich are always able to buy more, what is being offered now is unprecedented. Maybe you don't agree with the thesis, that's ok, but without listening to or reading what he said, your opinion of it is not very relevant. I posted the reference as an FYI for everyone, it was not about you.

Moreover, your silly aphorism that reporting on such behaviour ends with stealing is an inane platitude. Unless you want feudalism to come back, that is, but I thought you hated British monarchist rule.

Look we get it, you don't like socialism. Wake up, there's no one on these forums, nor most anywhere else on earth, that does anymore. You're fighting imaginary shadows.

No one's immigrating to eastern Europe or Russia.  They come to America, still a million legally a year.  And more illegally.  It was the poor who came here wanting to start over and America gave them the opportunity they didn't have where they came from.  Europe and other places were class societies.  They still are in many places.  You couldn't make it even if you had the brains and moxie to work hard.  But America was (is) the land of opportunity where you can make it.

Regarding socialism, it is a big thing here today.  Leftists are pushing the income inequality as justification for giant redistribution of wealth.  That's socialism.  That's looking enviously at others with more and then justifying stealing their money to give to others who have not earn it.  I call a spade a spade.  Others can stick their heads in the sand. 

[Alan Klein]

I will add that now there is socialist capitalism on the right where the government redistributes to people and companies who are successful. That's the PPP CARES plan and other giveaway programs of the government to corporations.  That's also stealing and redistribution and it's just as wrong.

[LesPalenik]

No one's immigrating to eastern Europe or Russia.  They come to America, still a million legally a year.  And more illegally.  It was the poor who came here wanting to start over and America gave them the opportunity they didn't have where they came from.  Europe and other places were class societies.  They still are in many places.  You couldn't make it even if you had the brains and moxie to work hard.  But America was (is) the land of opportunity where you can make it.

There is a steady inflow of immigrants coming also to eastern Europe, especially to Czechia and Slovakia.

“The Czech Republic has become a standard destination country for legal immigration during the past twenty years, or so. It is now normal that we process dozens of thousands of legal applications for entry and long-term stay of foreign nationals.”

The vast majority of that increase in population – 26.1 thousand people – is credited to net migration into the country. 43.1 thousand people immigrated into the Czech Republic over the first nine months of 2018 while 17 thousand left the country, resulting in a net migration gain of 26.1 thousand.

During the past three decades, Czechia has quickly transformed from a land of emigration to one of transit migration and currently, rising immigration. Today, it is by far the most attractive destination for migrants in post-communist Central and Eastern Europe. In 2017, just under 5 percent (524,000) of the population of 10.6 million was comprised of legally resident migrants—up from less than 1 percent in 1993. Estimates of the number of unauthorized migrants stretch from 15,000 to 300,000, depending on the forms of irregularity studied.

The capital city, Prague, is home to 37 percent of the country’s migrants, who are also more likely to be found in other big Czech cities and in border areas.

https://news.expats.cz/weekly-czech-news/czech-population-has-increased-by-27700-this-year-largely-due-to-migration/

[Alan Klein]

There is a steady inflow of immigrants coming also to eastern Europe, especially to Czechia and Slovakia.

https://news.expats.cz/weekly-czech-news/czech-population-has-increased-by-27700-this-year-largely-due-to-migration/

I'll assume that the same reason America drew people to its shores, the same reason draws immigrants to Czechia and Slovakia:- a chance to do better.  Do the people who go there become citizens as in America?  Or do they maintain their ties to their pasts?  Most people who came to America knew they were giving up all ties to their pasts.  America is a long way from Eastern Europe and other places.  Especially in days when travel was long and hard.  Eastern European immigrants are not, so may be just there for work and will return to their nearby original countries. In any case, people vote with their feet.

[DP]

There is a steady inflow of immigrants coming also to eastern Europe, especially to Czechia and Slovakia.

you mean people from Eastern Eastern Europe moving to Western Eastern Europe :-)... like from ukraine to CZ and Poland

[Alan Klein]

The article mentions that 27000 people immigrated to Czechia in one year.  That doesn;t sound like a lot.  We've got that many illegal gardeners in my community just mowing the lawns. 

[DP]

No one's immigrating to eastern Europe or Russia. 

you are so wrong... latinos or ne... africans don't of course, but people from former xUSSR republics /Central Asia mostly - than ukraine, trans-Caucasians, Belarus, trans-Dniestr/ are coming a lot (not on scale like US has of course).

[Alan Klein]

you are so wrong... latinos or ne... africans don't of course, but people from former xUSSR republics are coming a lot (not on scale like US has of course).

No one's denying people don;t move from one area to another.  We were discussing how American opportunity has attracted people here for hundreds of years.  A virgin land, isolated, remote, unoccupied, uncivilized, a land for the taking.  Getting wealthy and having something new.  That's what's attracted immigrants here for a long time.  Huge opportunity for advancement and for escape from tyranny. 

American hasn't been the only place, just the most prominent in the last few hundred years.  Because America doesn;t have an established peoples and classes like Europe, newcomers could become successful and part of the power structure.  I Europe, if you don;t belong to the culture of the country, it's hard to overcome the prejudice.  Of course there's prejudice here too.  But we're big enough and diverse enough where people can still make good. 

[LesPalenik]

you are so wrong... latinos or ne... africans don't of course, but people from former xUSSR republics /Central Asia mostly - than ukraine, trans-Caucasians, Belarus, trans-Dniestr/ are coming a lot (not on scale like US has of course).

Yes, that's the general tendency, but Prague attracts also many West Europeans and even Americans. A friend of mine who moved after his retirement with his wife and grown-up daughter from Virginia to the central mountain area in Mexico and has lived there for several years now, visited recently Prague and now they plan to move there.

[LesPalenik]

The article mentions that 27000 people immigrated to Czechia in one year.  That doesn;t sound like a lot.  We've got that many illegal gardeners in my community just mowing the lawns. 

Czechia is a small country, with only 10M population vs 328 in USA. But they drink more beer per capita than any other country in the world. In the restaurants there, great beer is cheaper than bottled water. It must be also mentioned that beer is healthier than milk. As to its effect on Covid-19, consuming beer will not destroy the virus, but it is much less harmful than drinking disinfectants.

Beer has been shown to help keep bones from going brittle, among other health benefits. According to Harvard Medical School, more than 100 prospective studies show that moderate alcohol consumption can lower the risk of heart attack, strokes caused by clotting, and death from all cardiovascular causes. In addition, moderate drinking may help prevent gallstones and type 2 diabetes.

https://www.peta.org/blog/got-beer-ad-madison-wisconsin/

[Alan Klein]

Czechia is a small country, with only 10M population vs 328 in USA. But they drink more beer per capita than any other country in the world. In the restaurants there, great beer is cheaper than bottled water. It must be also mentioned that beer is healthier than milk. As to its effect on Covid-19, consuming beer will not destroy the virus, but it is much less harmful than drinking disinfectants.

https://www.peta.org/blog/got-beer-ad-madison-wisconsin/

Beer also tastes better than Lysol.