I just saw an investigative report on what the new Obama care will bring. The issue of wait time and lack of medical practitioners were both key downsides as to what is to come. Many doctors that are close to retirement plan to retire and others plan to follow other fields of endeavor which do not inclue seeing patients.
Flu and broken bones are simple protocol. When it comes to many diseases there is not a standard course of treatment and protocols are not one size fits all. Dementia is a symptom, not an illness and there is no standard course of treatment possible.... yet all cognitive issues seem to be lumped into one. That is like trying to treat all cancer cases alike. I know this causes a problem in both British and Canadian medicine. Dementia patients have psychological symptoms but they do not fit into the psych protocol because of the dementia. Other have problems with activities of daily living but no other medical problems until very late in the disease. We know the wide variances of symptoms this disease presents... it doesn't fit into a flow chart that you can put on paper.
In the US we have choices. If we do not agree with the first diagnosis we can get follow up opinions and find the best fit for us. We don't wait extended times for treatment. We don't have anybody telling us what we can and can not have. We can search out the best procedures available. In the case of Endomitriosis. Standard protocol in Canada is laparoscopic ablation and hormonal treatments which have major side effects. After several laparoscopic treatments in Canada they just want to do it again. Here in the US there is the option of an extensive excision surgery that has a much greater potential for success. It is not available in Canada. I do know somebody that is trying to come to the US for that surgery but has been refused coverage by the Canadian system. So she lives in pain. The extent of her Endomitriosis is extreme but treated with standard protocol. This does bother me.
In NC we do not have state institutions as in Medicaid facilities. A facility can have Medicaid patients but a portion of their facility has to be private pay as well. This was done to keep the standard of care elevated because they do have to attract those private pay patients. It went a long way in elevating the general care level in this state. I know that part of the cost of private pay is a supplement to the Medicaid payees. What the state pays is not sufficient.... and is being cut further. So what happens when everybody is on a similar system of single payee? Our health care system is expensive. Part of that is due to the due to the individualized care we receive. Part is due to litigation. Part is due to the low payments afforded by Medicare and Medicaid to the facilities. Look at any medical bill you have for someone over 65. Example... Mom had a hand X-ray. The charge for just the X-ray was $115. The "Medicare Approved" cost was only $31.02. Medicare paid $24.82. Mom's secondary insurance picked up the remaining $6.20. There is no way for the X-ray provide to recoup the other $83.98. If you are not on Medicare then your bill is $115 which includes the supplemental income needed to make up for those paying $31.02. So insurance and cost go up to cover the disparity of government coverage and cost... plus profit because every business has to make a profit to survive.
There is just so much about what is going on in our medical care here that is troublesome to me and I can't make it make sense.
Wish some from other countries would chime in..