TED Conversations

Sharon Stone

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How will Obamacare or any universal health reduce skyrocketing healthcare costs. It will not. Why? Problem not tackled. See why.

90 % of a person's healthcare is spent in the last ten days of their life. If we are required by law to wear seatbelts, why are we not required by law to have a medical directive? Let us just say that half of us want everything possible done for us; The others just choose to be comfortable.

This removes the courts, unnecessary tests, heroics for diminished return, ethical and religious concerns, etc. Can you imagine what research might look like again, with the dollars of the 50% who choose for comfort? Not because society or insurance companies decided or allotted (Obamas appointed council as well. But, because we as individuals answered for ourselves.

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    Jul 1 2013: The insurance company has been the culprit in the past for rising costs and unneeded testing, by mandating protocols that doctors must follow. In other words, a doctor must do A first, then B, and then C. The doctor cannot go from A to C. If "standard of care protocols"are not followed there is no malpractice insurance issued to the doctor.

    Obamacare is bringing a lot of good with preventive screening and detecting things early, removing lifetime maximums, and a minimum level of coverage that is the same across the board.

    Let's suppose you have a heart attack and cannot communicate with the doctor, how are you going to convey your wishes?

    See TEDTALK PETER SAUL: Let's Talk About Dying.
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      Jul 2 2013: Good points,
      Except when I heard there was to be a better national health care system, I envisioned a system of health care clinics across the country staffed by young primary care doctors and staff who received medical school scholarships in exchange for clinic service, Administered by the Public health Service. All the free screenings and other services wold have been provided. The plan we got went to Insurance. They are profit orientated companies and they will make profits..
      As I said, I am not sure medical directives before or as needed would have changed the results of final cost.
      In either case some people will want to stay as long as possible, others go softly into the night.
      I am not sure the timing will change. If unable to personally tell doctors in an emergency, if they save you, as soon as you are able, the Medical Directive will be offered. That is very common protocol.
  • Jul 1 2013: I am in Fort Worth, Texas, and I have seen few people knowledgeable or objective about Obamacare. You make a good point Maybe we should talk to the Docs. heck you may be one. But the ones I know do not advocate great pain for a very limited reward.
    I did recently read an incredible story The great physicist and great American Richard Feynman asked when he was dying not to be given so much pain killer that he could not clearly experience this event he would only once experience. Now that's hard corp But who knows what people want, and what they should want paid by others is another issue. Feynman's request was cheaper.
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      Jul 1 2013: Hi again George:>)

      I agree....few people are knowledgeable or objective about Obamacare. I am not very knowledgeable about it either, but I DO pay attention when I am directly, positively impacted!!!

      I volunteered in a terminal care facility for a couple years, and the only person I observed in pain was a woman who chose not to take the prescribed dosage of pain meds because she also wanted to fully experience the process of dying...like Feynman I guess. While I enjoy experiencing most of the life/death cycle, I'm not sure if I would be brave enough to do such a thing!
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    Jul 2 2013: You are entitled to your opinion as am I. I certainly didn't expect that under the discission of debate that people were necessaily berexpected to agree. Further if the mission is to inform and challenge with new idea, I did not expect personal attacks and inuendos.
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    Jul 1 2013: Medical Directives. These are really not a problem that would have a great impact on sky rocketing care.
    Case in my point.

    I recently felt a little poorly and went to see a doctor. A fever that looked like a great basketball score, blood test reveled that my blood was a petry dish for the CDC, so they put me into intensive care. As I lay there in delirium, they shoved a clipboard in my face to sign for a battery of procedures. Included there was a medical directive. The nurse asked if they could not get me better would I like to be on life support or pull the plug.. I asked why they hadn't pulled the plug already.
    Here is my point. Medical Directives are now presented if not already in place. People will make those decisions. I am not sure that made early or late will change any outcome or the new healthcare cost, The real new cost will be borne by relatively healthy young people who will be force to buy insurance or pay a tax. Those monies will feed the bottom line of Insurance companies and used to hire lawyers find ways to keep it. Like lobbying congress. Doctors will consolidate into giant WalMart like medical stores to keep cost controlled if they stay in the business at all.
    Am I being overly dramatic....maybe, but I've been stung before
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    Jul 1 2013: I am retired disabled. However, for thirty five years I was a Benefits Manager for NYSE 500 companies. First woman President of a Regional Benefits Conference with some of the leading attorneys, consultants, IRS officials and insurance companies. I have bought, budgeted, and communicated for millions of dollars and thousands of employees.

    If I had filled out my profile correctly (which I will do), one of my passions, besides being a self-help author, is that we get healthcare right.

    The states are wrapping up whether they will be setting up their own state cooperative. Advertising is almost ready, American Library Assoc. Is training librarians as we speak to counsel people in October to enroll for 2014.

    I can understand how someone could see my question as politically charged (another lesson learned in participating); however, now is the time to get it right instead of once it is fully inplemented.

    Perhaps the question worded differently is: We grant, as citizens, certain rights to our goverments to make laws laws regarding our safety, as in my example of the seatbelt. Is a medical directive something that should be mandated because of the enormous cost and universality of healthcare?

    And, to answer the unasked question, I have faced death seversl times now and it has not yet been my time. Yes I have a medical directive. I have had several conversations with my children that they would have preferred not to have so that they would understand the choices I have made.
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        Jul 2 2013: Respectively, I am wondering if insurance company and rationing healthcare be "hot terms" for you.

        Why would I have an ulterior motive any more than you might in responding?

        I have watched employee benefits of all kinds for 35 years...all the fads, all the laws to govern employee rights, spouses rights, children's medical support and progressing taxing (and thereby diminishing ) of employee benefits.

        It appears to me that you are possibly responding as a consumer as compared to a time horizon or interpretting laws and then explaining those benefits to thousands of people choosing their benefit coverages.

        I have researched the board duties.

        Lastly you and I have more in common than we have in differences: affordable health care, doctor and patient relationship, necessary medicine and informed decisions.

        The initial premise of 90% of healthcare is delivered in the last 10 days of life. That is a fact not an agenda. It is neither RW nor LW.

        What are you doing to help Obamacare to succeed?
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        Jul 2 2013: I believe my question was first. That question was what are you doing to help obamacare succeed.?

        Yes i support obamacare,

        I find your words "throwing out" words , "disinformation" to be inflamatory in the discussion. You were also the one that brought "rationing" to the discussion, not me,

        This discussion is about medical directives.
  • Jul 1 2013: When I first heard about the Affordable (Health) Care Act, I already had some doubt about the cost management of the law. The important difference of health care expenses between the U. S. and many other countries with national health insurance is that the latter usually have government controlled medical service prices. For example, all the physicians are usually hired by, or contracted with, the government. So these expenses can be strictly controlled. Here under the ACA, the costs of physician or hospital care are not controlled by the government, but by the insurance companies in negotiation with the medical service providers. Any arrangement with multiple players would usually jack up the total prices of a program, similar to many cost overruns by the government contractors and subcontractors.
    Let's also look at the individual cost items. The physicians in the U. S. have to charge more from the patients because they have to pay very high malpractice insurance premium for their services. This is also the reason that so many unnecessary tests are ordered for the defense of the medical providers in a law suit. The drug companies, spent huge research fund to discover new drugs, but they can't recoup research cost from foreign countries so they have to sell them at lower price than they charge to patients in the U. S. The government doesn't help these medical/drug providers trying to lower their cost of providing services, but even assess taxes to the medical device providers and the insurance companies to increase the cost.
    According to what my friend told me, a physician has to spend 40 minutes on one patient to straighten his medical record and some additional time to talk to the patient about some preventive measures to make him "healthier". It is just not best use of physicians time on such doubtful success outcome. I also don't like the directives on respite/comfort care, believe that it should be left between the patient and attending physician.
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    Jul 1 2013: My take on the AHA is it completely miss the target of providing reasonable health care to all Americans It is the most egregious case of: "the road to hell is paved with good intentions" What it did has given Health insurance companies potentially is 50 mil more customers who will have to buy insurance or pay a tax. It is like running all the chickens into the fox house.... den.
    It lowers fees to doctors for services paid by current government health insurance and know that insurance companies will not pay higher fees then the government.
    It does nothing to help end the shortage of tens of thousands of primary care medical positions currently vacant.
    So, let see... potentially higher demand by new insurance holders for medical services and lessor supply of doctors who are bailing out of practice ( two of mine have already quit) equals.... higher prices.
    ECON 101.
    So, I am not worried about medical directives in my more senior years, I am going to starve to death trying to keep up with rising HC cost this year
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    Jul 1 2013: Hi Sharon, and welcome to TED:>)

    I personally, like the idea that we can answer for ourselves regarding health care and advance directives. I believe that if more people took responsibility for their health, the cost of healthcare might decrease. Part of the emerging healthcare plan, and often incorporated in insurance coverage, is to encourage preventative medicine and/or good health practices.

    When the first healthcare initiatives began during Obama's first term, it helped me a LOT. That was before I was eligible for Medicare, and I was paying $700.00 a month for insurance premiums. I am a relatively healthy person, and rarely see a doctor, but I felt I needed insurance....just in case!

    Some of the first legislation, required insurance companies to provide policies that had a higher deductible and much lower premium (mine dropped from the $700.00, to $200.00). So that was a HUGE difference for me.

    I'm not sure what you mean with the statement..." Can you imagine what research might look like again, with the dollars of the 50% who choose for comfort?"

    It looks like you are supporting mandatory medical directives with the statement..."If we are required by law to wear seatbelts, why are we not required by law to have a medical directive?"

    Then you say...."Frankly, the individual should be appalled by anyone other than themselves making that decision. Are we so afraid so as not to make any choice at all."

    Personally, I'm not afraid to make the choice, and I encourage others to make choices for themselves as well.:>)
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    Jul 1 2013: The concept of the appointed Oversight board is ratioining where society diictates the outcome of the individual. That is not the issue first of all with having a mandate for a medical directive where the individual decides yheir choice.

    Frankly, the individual should be appalled by anyone other than themselves making that decision. Are we so afraid so as not to make any choice at all.

    No choices no savings.
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    Jul 1 2013: By rationing.