I'm not sure that makes sense Bucket, you say that you don't mind taxes going towards Medicaid (which in part helps those in need, there are still some that are not covered), you must realize that you also pay for your own health insurance as well?

So, I don't understand why you are not for universalizing health coverage. You would probably pay less than you do right now if we had UHC. You are already familiar with the concept of paying for the less fortunate because you don't mind paying for Medicaid, but somehow you draw the line at covering everyone? That is kind of a weird stance if you ask me.

So if your argument is purely about money, what you believe vs. reality is in conflict. If in principle you oppose UHC because you don't think everyone should have basic health care then that is somewhat in conflict with your stance on Medicaid.

First, "socialism creep". Did I say that? I like it. Anyhow, at the risk of going WAY off topic let me try to explain. Government is sanctioned to use force in order to protect the rights of individuals from the use of force by others. I am not santioned to use force to wage a war on this country's behalf. By definition, they must be members of the government in order to carry the out sanction of the government. Doctors need no such sanction. They are sanctioned through private license to save people's lives and to heal them. When someone decides to be a soldier, they are implicitely deciding to use force either against a particular government or on its behalf. There is no other purpose of a soldier. A person enters the profession of doctor without making any allegiance to a country or state. They do so to utlize their own abilty for their own reasons which need not be expressed in terms of loyalty to anyone but themselves.

Edited to fix quotes. Bela

Um yeah I did realize that. My taxes are also used to help feed and house children and families who are in need..and yet I buy my own food and pay my own mortgage.
If you want medical coverage to be considered a basic right..which I agree... then why not treat it as such? It is a basic commodity..just like food..just like shelter..just like water and I have no problem being asked to purchase it I just wish it was made as widely available, easily accessed and price controlled like our govt does with food, water and shelter.

I also stated right off that to me it was something more than monetary.


There is absolutely no proof an American UHC system would cost less.
As for my stance..which is not weird just not yours...If your standing on the side of street..young able to work and leaning against your Rolls Royce asking me for a dollar so you can get some lunch I am unlikely to give it to you I would feel it would better serve it's purpose or even my purpose to give it to the hungry little girl...or the crazy old guy..those in need.

I never claimed the system was perfect..I stated from the start it is in need of reforming just not this kind. There are other options to pursue other than just the buzz term UHC.

Did I just understand what I was reading... Health care is a right. Shelter is a right. Food and water are rights? Those things are needs, not rights. You cannot make a right out of something that comes from another person's production. If someone lives near a public stream, you may say he has a right to drink that water. A person has no right to water that is delivered to him. That would mean enslaving the person responsible for its delivery. A person has no right to shelter other than the shelter he produces or pays for. Otherwise, it requires someone else's labor. You cannot make a right on the backs of others. Healthcare is not a right. Doctors and nurses provide that service, and to declare it a right would be to force those people into a forced public servitude. It is bad enough that people are declaring the government responsible for providing the needs of others, it is an absolute abomination when we begin to confuse needs with rights. You have the right to life, liberty, and the pursuit of happieness (ie. property). That is it. Everything else is need.

ibelsd..

If food, shelter and water are needs..and unquestionably needs in order to sustain life...and you agree life is a right..how can you deny anyone access to their needs in order to fulfill their right to life...or as you even go so far to claim happiness..wow that is subjective!
My children do not produce or pay for their food or shelter by means of their own labor and yet if I was to deny them access to my food supply or my shelter I would be not only infringing on their right to happiness but also life. Not to mention I would be breaking the law. So how can we not hold society as whole accountable for a child like we would a parent? If it is a crime for a parent to starve or deny needed medical access based on financial reasons..why should society be excused of the same?

Either you feel you have some kind of moral obligation to provide the same for any other child or you don't. I do...any other child who is in need of one of the basic requirements for life and has no adult capable or able to provide for them I feel ultimately then becomes my responsibility or our society's.

I feel the same way about basic health care..protection from disease, medication for illnesses etc.

I am sorry I honestly don't understand your pov. It seems to me you are saying..and I will make this a very extreme example to get my point across ...that if you were to see a child drowning you would say that you or I or anyone else has no obligation to save that child because our labor of doing so will not be compensated. Yet not every compensation or exchange in life is that of a monetary one. Some people would not even hesitate to put forward labor to save that child's life because they feel it is their moral responsibility and to do anything else would be considered a crime.

Everyone has a right to life meaning they have the right to purchase/access healthcare, food, and shelter. That does not give them a right to anyone else's labor. You do conede a shelter needs to be built, supplies, need to be acquired, land needs to be utilized for the purpose of any shelter, don't you? By saying someone has a right to these things, you are saying that the people who would build the shelter, supply the material, and purchase the land are somehow indebted to the person that needs them???? Whatever I may feel obliged to do, out of respect for my own self-interests, shoud not be an act of mandate. You are confusing, for sure, the right I have to help others versus the right of others to expect my help. By the way, notice I placed "(property)" next to happiness. In fact, that was the original word which was to end that phrase. Of course, nothing is subjective about one's own happiness. It is only subjective when one attempts to figure out someone else's. I agree completely with your last statement, by the way. Not every form of compensation is monetary in form. You are implying though, that compensation is an aspect of any act between individuals.

Bucket, I am thoroughly confused as to what your position is here then, because in principle you are advocating that "basic health care should be available to all" in this post.

Now whether or not you agree with any of the plans proposed under the umbrella of UHC is probably another story, but everything you have said leads me to believe you think everyone should get health care. That is what UHC means - everyone gets care.

So is the debate we are having about whether people should get care or is the debate about how that should be done (i.e. plans)?

I think it should be about both.

One argument is that people lack access to health care. While I agree that many people cannot afford insurance, I am not sure I agree that they do not have access to health care. They may be lacking the means to pay for it, or they simply may choose not to.

I'll give a real life example. I have a friend who owns a company that provides health insurance to its employees, and offers dependant care for a nominal sum. Many of his competitors do not offer this benefit. It is very expensive. According to a Kaiser Family Foundation study, premiums average $3,379 for single coverage and $9,068 for a family, with employers picking up most of the tab. Since his competitors don't offer it, they can afford to pay their employees more on an hourly basis.

Many people simply choose to work where they get more money, rather than the health insurance.

I'm not really sure what relevance your example has. Do the 40 million some-odd people in America who have no insurance have that same choice? What sort of company does your friend run? Is it the sort of business that employs the people who are trying to work their way out of poverty?



Here's an interesting dilemma. If you accept that people have a RIGHT to care then questions of plans are irrelevant if one of those plans (private insurance for example) does not mean that everyone has access to care. So, if you concede that people do have a right to basic health-care (which we agree the uninsured do not) then you can't really support the current system as millions of people do not have that right.



I'm sorry, but that is one sentiment you're going to have to prove. I've never seen anything to suggest that a majority, or even a substantial minority of the uninsured simply choose not to get insurance. It seems to fly in the face of logic, unless you accept that the poor are simply too lazy or disinterested to improve their condition; which is the subject of another debate.



Everyone makes conscious choices; they do not always dictate the circumstances of the life we leave. For the people who wash dishes, or work two jobs to make ends meet, or require social assistance to pay the rent while they make minimum wage, or the millions of people who cannot find work at all choice doesn't really matter. Can you demonstrate that uninsured people are that way because they don't want it?

No, and I never said they did. But many people choose higher pay over health care. It happens everyday. I’ve known people who have left the state to go work in private business because they would be making more money, but they wouldn’t have health care insurance.



I’m not sure this question has any relevance to the debate. It’s a company that provides insurance.



And that has relevance to my example, how?



Hmmm, I don’t remember stating that people have a right to health insurance. I simply stated that the question of whether it’s a right should be part of the debate.



Well, it’s not an opinion and I never said majority. I said, “many”. And Joe, my argument has nothing to do with poor people or lazy people. I take offense your condescending tone.

My post was meant to be inquiring, not condascending. I was trying to understand your position clearly.

The fact remains that you seem to be arguing that many people choose not to have health-care, and I was trying to suggest that "choice" is a subjective term that requires exploration. If people choose between health-care and paying the rent, I'm not sure how much of a choice that really is (which was why I brought up the question of the sort of people your friend's company employs.)

Sorry if I inferred that you thought health-care was a right. I must have you confused with someone else.

Still, I'm not sure what your position is in regards to the question for debate. UHC is unnecessary because people choose not to have insurance?

I think Bela was making the point that most people who do have insurance, have chosen not to pay for insurance. They are younger peopple and single middle aged people without families or the very wealthy he have no trouble paying medical bills as the arrise. This is documented and with some effort, I am sure I could find the numbers to back Bela's statement. It doesn't mean they forego health care. It means they don't pay for it by using an insurance provider or state assisstance.

None of these are Natural Rights, they don't exist in the wild. The right to Life is a tautology, if you're not alive, you have no rights. Once alive, you have no right to continue living. I don't think the wolf honors the doe's right to life. Liberty? creatures in the wild are only free to take what they can get. What are these 'Natural Rights'? If they're so Natural, why is it that they can be taken away? If they can't be taken away, why are we debating this?

I believe people should have these rights, however, I recognize that they are the rights afforded to individuals by society at large. Therefore, I have no ideological opposition to UHC.

I would have no opposition to a government who required physicians to see a certain number of indigent patients as payment for the government recognizing their license to practice. I don't think that any of the UHC plans would be anywhere near that extreme.

Joe, (((((((((( ))))))))))) I apologize if I took your post wrong and thank you for clarifying.

I don’t know where I stand on this issue. I voted “sitting on the fence”. I do not believe health care is a right as I don’t see it listed anywhere in the Constitution, but I also would like to see everyone have access to preventative care at a very affordable price.

I do not believe replacing the insurance company bureaucrats with government bureaucrats is the answer. However, I recently read an article that really has me thinking. Here’s an excerpt from it:



This debate is interesting to me, in that I am hoping it will help me decide where I stand.

I already provided such info..I will again being you did not see it.

Of the 11.2 million children in America who are uninsured the gov claims that 72% of them are in fact eligible for some kind of state or federal medicare/medicaid and the only reason they are not insured is because no one has bothered to enroll them.

I am also sure many Americans who are offered ins. through work in fact choose not to enroll themselves either...I know I have done this myself.

I don't know why you have such a problem understanding my points Cube Jockey. I explained it and even gave other examples..do you feel because I think it is ok for my tax money to be spent on programs to help feed and house families in need that I must then reject the idea of paying for my own food or rent?

I believe health care is a high valued commodity in our society..and I believe it should be treated as such. Health choices, health lifestyles and health services are very private aspects of our life and our laws reflect this. It is a very personal and unique service..and one that must ultimately always approach itself with the individual in mind.

I like going to the supermarket and buying the food I like best to make the meals my family enjoys..I like having the choice to spend as much or as little as I like on my groceries..to decide what level of quality I desire or feel is necessary...and so I should my family's diet is a private, very individual choice to make and I don't see why the government or my employer should be dictating any of it...the only thing that dictates this is the amount of funds I have to spend on it..and why not?
So why should we then treat health care differently? Why can I choose how to insure my vehicle or my life but my health is treated as something completely separate?

I don't feel like it is being treated too much like a monetary exchange and is in need of being made a public service..but instead I think it is treated too little like what it really is..a basic human need that should be easily, widely and fluently available..it needs more means of monetary exchanges.

South Africa has a really interesting system of health ins..as does Switzerland. Not every industrial nation out there is doing either the American system or UHC. It is not a black or white issue..there are many others ways we could address our problems ..UHC is not the only answer.

I found this link on the Swiss healthcare system: http://www.civitas.org.uk/pdf/Switzerland.pdf

I like it just as much as single-payer, perhaps more, It's long and I'm tired. I did note (and I am apt to make errors on this)
run individually by the cantons, which are much smaller than US states
Compulsory Insurance for all from 80+ insurers for 7M people.
Insurance must pay any willing provider that the paitent chooses
Means tested Subsidy for those who would spend more than 10% on premiums
Third most expensive system (behind US and Germany)
Insurers are compelled to accept all applicants at the same rate schedule
Lowered premiums for high deductibles
supplemental insurance for dental, more privacy, acceess to private for-profit hospitals
75% of hospitals are public or not for profit

It is a good thing we aren't wild animals and have the ability to respect the right to life of other individuals. This right to life is a social construct that we agree to as Americans. That is a far cry from being mandated to provide the means for life which is a demand made in country's that are less free than ours.

I could support not system where the government is “the single payer”. This situation, as with Medicare, leads to massive fraud and mismanagement.

If we look at countries like Canada and the UK and even Germany we find that the cost of these systems is often far more than expected requiring higher taxes to pay for the increased costs.

http://www.dcmsonline.org/jax-medicine/200...Oct2001/evp.htm

Lunacy of the highest magnitude is for the Congress to continue to look at Canada's system of universal healthcare as a model of anything besides what not to do in our country. The most liberal of politicians in Canada are calling their system of national healthcare a failure and even talking in some of the Provinces about a private sector solution. Once called a "one-tier" healthcare system it now resembles a no-tier system where everyone gets virtually no healthcare.
For example, I recently read in an article by Kerri Houston that the Minister for Health in Newfoundland closed some of their major health facilities between May and September in order to accommodate staff vacations. Can you guess what would happen in Jacksonville if Shands, Baptist, St. Vincent's or St. Luke's closed down between May and September for staff vacations?

Comments on the British system: http://technologyreports.net/firstcasualty/?articleID=3548

Those who favor the British solution are blind to the fact that the system in Britain is large, bulky, and intricately wrapped in large quantities of bureaucratic red tape. In fact, 11 percent of the British population have opted out of the system, and purchased private health insurance. For a family of four in England, that may mean voluntarily paying more than $200 a month, just to be free from the cumbersome socialized system.

Canada’s system is just as inefficient as England’s. Their system, in place since 1947, is in so much disarray that many provinces are pushing to privatize it. With up to 40 percent of a province’s budget dedicated to healthcare, it’s easy to understand why. And the Canadian population has also seen a hike in insurance premiums and deductibles. In response, many Canadians are crossing the border into the U.S. to deliver babies or receive cancer treatments.


Ask any doctor about Medicare and he will tell you he is buried in forms and has to have extra staff to do the paperwork. The “efficiency” of Medicare is an illusion.

Ted, while I agree that it is important to be cautious with regard to instituting changes in the US health care system, I have to say that your links are unconvincing. First, a blog written in 2001 with anecdotal references to problems in the Canadian health care system does not demonstrate that such a system is broken. Second, the red tape description of the British health care system could just as well apply to the current US health care system. The issues referenced in either of those links can be found within the US private insurance industry as well. This implies to me that the problems with health care insurance derive from something deeper than just who provides the coverage.

There are many ways in which UHC (or limited UHC) can be instituted. The US' particular brand of capitalism/democracy/social framework may mean that neither the British nor the Canadian models are appropriate. But, this does not have to mean that all models of UHC will not work for the US. Basically, I feel that those making such sweeping generalizations have ideological rather than pragmatic reasons for doing so.

Part of the problem with Medicare is determining which insurance is primary when the patient also has some private health insurance. Yes, it is confusing. And straightening it out can take an enormous amount of time and trouble.

Whenever I go to a doctor's office, they want to see my insurance up-front. When I worked and I was also covered by my husband's insurance, I had to shuffle the cards out and I was told whether I was covered or not. There were cases, for instance, that I was not covered because my insurance was "PPO" and the doctor's office was a participant in only "PPOM" programs so, you guessed it, it didn't matter at all if I had one insurance carrier or two, because it wasn't the "right" insurance. It's like trying to play a mediocre poker hand, except you can't bluff your way out of it.

The insurance companies are rife with problems, and as a result they are also rife with corruption, because it is easy for a functionary in one of these companies to find a way to siphon off funds intended to go to the hospitals or doctor's office and, with the inefficiency of the system as we have it, the office manager at one of these offices will simply tell the client that the insurance didn't pay, so the patient is 100% responsible. Then the office manager will sick a collection agency on the unfortunate (now ex-) client, who can't pay in the first place and was counting on the insurance to cover the procedure/visit/hospital stay. Here comes that freshly screwed-over feeling again.

Is fear of getting a system that is worse sufficient reason to keep a system that is not serving the American public? Apparently to some people it is. But get good and angry about it a few times, and you start to think that either you need to get the right lottery numbers, or that there must be a better way. To me, it is more likely for my government to have a good single-payer health insurance system than it is for me to win the Super Lotto or get a sufficiently high-paying job where I can stop having to fool with these health insurance companies altogether. Who wouldn't rather pay for these things 100% up-front, if they could?

I wouldn't have a problem paying %100 up front if I could. Of course, UHC isn't about paying %100 up front. It is about some people paying %200, others paying %1 and others making up the difference.

That isn't correct ibelsd. The approaches for how people pay for UHC vary widely and many of them have been discussed in this thread. There is also the possibility that something completely new might be implemented.

UHC is about everyone having some level of health care, in other words a principle. Squabling about how we are going to implement it and pay for it is a whole different discussion in my mind.

To be fair, ibelsd, all insurance schemes are essentially that. Or rather, many people throw money into a pool; some "withdraw" more than average while others "withdraw" less than average. The burn rate had better not deplete the resource pool, otherwise the scheme goes bankrupt. An insurance scheme uses this burn rate data to calculate a charge which will keep the scheme afloat (where afloat could mean profitable).

Moreover, an insurance scheme essentially acts as a broker, that is, it "negotiates" a fair market value for the rendered service and pays that amount. However, unlike traditional market place transactions where one would determine the "best" price/value ratio by surveying many providers, an insurance scheme instead treats all providers of a given service as essentially the same. Specifically, an insurance scheme cares mostly about the service rendered and not who renders it. This means that there is very little "value" consideration in its analysis. In effect, it "socializes" the market place by ignoring a key component for determining fair market value.

Anyway, all these words are my way of saying that all insurance schemes share your statements in common. Thus, implying that this is a unique attribute of UHC is rather disingenuous (assuming, of course, UHC uses an insurance scheme which, if it didn't, your statements would likely be invalid).

ibelsd, "Who wouldn't rather pay for these things 100% up-front" was a rhetorical question--I sure would rather have the money to pay it and not have to fool around with some insurance company that might/might not pay for the procedure!

Sometimes, though, it just isn't possible to have the necessary money to pay the difference of what the health insurance company covers and what is owed. And the bottom line is that it affects your quality of life and hurts your credit if you can't pay the doctors/hospitals on a timely basis, especially for those who have fixed incomes.

Catastrophic illness or trauma can take place at any point in a person's life, but health issues generally take place as a person gets older, the very time when s/he does not have the youth and vitality to just take another job, work 60 or 70 hours per week, and pay those debts down. In addition, insurance companies examine the health of those who sign on, and may reject their application for insurance on any number of "pre-existing conditions." (As I told one insurance guy, Life is a "pre-existing condition." )

Universal health coverage would not reject people due to pre-existing conditions; they would be included. A single-payer program which treats everyone and is accessible to everyone as a goal is not socialistic--it is fair. Accessible health care to all can concern itself more with preventive, not just secondary or tertiary medicine.

It strikes me as very inconsistent that officials in our government concern themselves with what I read or buy at Barnes & Noble or the library, my bank and loan records, and what I saw the doctor for, ostensibly to fight terrorism and protect my person; BUT those same officials see no need to improve my general health and the health of our countrymen. It sure looks a lot like snooping by people who like to delve into other people's lives but not to improve them. Why is one measure labeled "socialistic" and the other not, unless it is fascistic or totalitarianistic?

Edited the punctuation

PE, I see your point on the level of interest the gov't pays in our personal lives and the contrast with their lack of interest in our personal well-being...it's not ok for us to be blown up by a car bomb, but it's ok for us to go without preventative healthcare.

Socialism seems to be a bad word today, heck, a year ago, I thought it was a bad word. We've made a lot of progress in the last century, but we work more and play less, what's the gain? Success today is ephemeral as it ever was, and it seems that the deck is stacked against you if you don't come from money, or get lucky in some speculative boom. Where is the middle class? What happened to working-class values? Hey, I'm getting off-topic. I'll just say that if the government's going to spend $3T a year, no one in the US should go hungry, cold, uneducated, or without healthcare. And I don't even like welfare.

I posted some notes earlier on Switzerland's healthcare system, one of the best, if most expensive, in the world. The idea, is that everyone must choose a healthcare plan from a private provider. The healthcare plans have minimum standards as set by their version of our states. Some are broader & better than others, but the basic is still very good by US standards, and the cost of plans varies over there. There are means-tested subsidies for those who don't make enough to pay, however they do not pay the whole difference, encouraging those who recieve them to still be consciencious shoppers. The key is, every plan must accept any and all applicants, which requires the plans to set their premiums for the total risk pool, and prevents the plans from 'cherry picking' healthy customers. The individual plans still have to compete with each other to provide the best bang for the buck. I'm not sure how disputes btw carrier and insured are resolved, I believe there is a state level review board or some such thing.

It is a principle that guarentees someone else's labor (a doctor's) without that person's consent. You cannot say, in principle, everyone has a right to healthcare, and then turn around and try to establish some arbitrary means for that condition to exist. It is either something you feel is a right, or something you don't.

In regards to insurance companies acting in a similar manner as a state provider. There is a difference. The insurance companies work throuhg mutual agreement with clients and doctors. No such arangement could exist utilizing a government mandate.

Well, that is patently wrong LOL- in fact, a Doctor HAS to provide treatment under certain conditions, it is part of his licensing. In fact, in many ways, a doctor already serves at the pleasure of the system- since his ability TO practise comes from a set of regulations he must abide by in order to practise.

That being said- there are some general assumptions by the general public, though not always here - that we have a "free enterprise capitalist system" of medical care- which is completely untrue. The AMA is an entity that does not allow Drs to be produced in order to keep up with demand- in fact, purposely limits the number of practising Drs in order to keep prices up. Then, you have agencies like JACHO- accredidation agencies that are actually an arm of the insurance companies themselves- with absolutely no oversite or responsibility except to the insurance companies- they are in charge of making useless rules for hospitals- it is not the goverment that over-regulates the health industry, it is the insurance industry. The goverment, when it does the regulating, is far more efficient and has some type of oversite or accountability when it does something stupid- you can call your senator etc- no such check on Jacho's behavior

The obvious wrong doing of the drug companies- don't even need to go there, it is so obvious.

Scrapping health insurance as we know it, scrapping the AMA, Jacho, would be the first best step to reforming and improving our health care system. Making those goverment entities with checks and balances and ways to air greivences would save billions. Also, similar to socialized or universal health care in other countries, going to some kind of tort reform that exempted or limited damage against the DIRECT CARE component of the health care industry would be good.

First, I think it's a little unrealistic to require, say, a patient with moderate Alzheimer's disease at the edge of functionality , or one going through, say, chemotherapy to take on the burden of all of that ridiculous paperwork in the hopes that maybe, one day, if we all pull together just so, the burden will lift.

Second, even in countries with NHS-type set-ups, it's not exactly against the law for a doctor to be in private practice for those who will pay, and remove him- or herself from the System altogether. If a tiny number of docs think that's where the money is, more power to 'em. In practice (no pun intended), the vast majority of doctors in such countries do participate in the NHS.

Third, there does need to be some attention given to the level of debt that newly minted doctors carry right out of school. I have not seen much attention paid to this as a pressure that pushes medical costs upward in our private system. If you've got $250,000 in student loans, etc., coming out of school, it seems to me you're likely to charge patients/insurance companies whatever you can get away with.

Fourth, there is a fundamental misunderstanding of the sort of baseline care that those in the US actually receive. To simply speak of legally mandated emergency room treatment is to look through a keyhole at medical care for the uninsured.

Yes, they have to treat you when you are dragged in by the paramedics. The ambulance ride cost you $400, a minor emergency room visit is $800-1000. Understandably, they will do their best to collect... of course, it doesn't matter if what brought to the ER requires ongoing medications that cost $1200 a month.

So, do you buy the meds, or go to follow-up care with your Dr, or pay your hospital bill? In so many instances, you can only choose one option..... So decide.

I do wish those who advocate leaving uninsured people to their own devices would just 'fess up and say what it really means. The thing they have no problem with is lots of people suffering and dying because they can't afford medical care. To admit it would be honest, at least.

Lastly, the idea (far) above that privatizing social services lowers their cost is perhaps largely true. But it does so in TWO ways, not just one: financial incentive breeding efficiency AND fewer people getting helped. We ought not treat the latter as just something to be shrugged off.

Check you facts man. Countries that utilize a UHC system tend to allow private practice at first. Eventually, though, such an allowance is severely limited or removed. Canada is in the process of removing all private practices. Every UHC system in the world suffers from a shortage of doctors. I have provided some stats on this in previous messages. The only way to keep the system afloat is to manadate participation.

I have shown proof that doctors in foreign countries make less money and work longer hours when using a UHC system. Telling me the current system is not a free market system is not an arguement to create a more socialistic system.

Apparently everyone is suffering a doctor shortage, not just Canada and those with some form of UHC. link

International salary comparisons mean very little, with various salary & benefit packages, and different costs of living. Also, it's difficult to see the connection between physician's salaries and the 'rightness' of any system.

In my eyes there are only two measures of 'rightness', Effectiveness & Efficiency, our current system has neither.

ibelsd - what is your proposal? Why do you think it would work better? The current system is failing, as evidenced by widespread dissatisfaction.

Umm, you're going to have to explain that, because I have no clue what you're talking about. My GP runs a private practice, as do the rest of the GP's in the entire country.

Here are a few links to articles on the Swiss healthcare system:

A pretty straightforward factual description of Switzerland's system:
http://strategis.ic.gc.ca/epic/internet/in.../gr116905e.html

Swiss health insurance is provided by private companies who must accept any customer, cannot alter it's rates based on age, gender, or health, and must provide for a prescribed (fairly generous) level of insurance.

All persons domiciled in Switzerland must purchase insurance, there is payment assistance for low income persons.

Spiraling healthcare costs are a problem there, as well (as in just about everywhere, I guess)

One comparing it to Canada's, by a man cut from the same cloth as ibelsd:
http://www.fcpp.org/publication_detail.php?PubID=795

Another proposing slightly more market driven solutions based on the Swiss model:
http://www.managedhealthcareexecutive.com/...=58559&pageID=2

I'm a bit confused with this idea that everyone has a basic right to health care. I mean, health care is a for-profit service provided voluntarily by specially trained medical people. We can't force them to take care of everyone with a problem. That would be like slave labor or indentured servitude or something. Health care services, like any service, are rendered voluntarily. As such, they can't really be more than a privilege. So it is only the privilege of health care that everyone has a right to. In other words, so long as health care services are voluntarily made available, can we by law require that they be made available to anyone who can pay for them.

A non-profit, tax funded federal UHC program sounds like a nice idea as long as it replaces all private for-profit medical services and everyone gets covered. Otherwise, it wouldn't be fair on taxpayers who get private doctors nor would it be fair on private doctors who can't compete with UHC.

Here's the problem with socialized health care, in a nutshell: Health care, like any other good or service, is a scarce resource. Just because you label a good or resource a "right," as some want to classify health care, isn't going to make it any more plentiful.

In fact, it will result in a shortage, as you see in other countries that have socialized their health care systems. Since the consumer of the service is not directly bearing its costs, there is no incentive for consumers to economize their use of the service. On the flipside, since physicians will not be compensated at that rate at which they otherwise would be under a free market, their incentives to continue in the business, and provide good service, will diminish.

So, the end-result is actually less quality health care than when you started.

1. Do you support an effort for Universal Health Care (UHC) system in the US?

Absolutely not. It will be a complete drain on our money. It will be abused, and it will be too expensive.

"If you think health care is expensive now, wait until you see what it costs when it's free." - P.J. O'Rourke

2. How realistic is the concept of UHC system in the US? Why or Why not?

It could happen, but it will take a long time, and a lot more money.

3. What are the pros and cons of UHC in the States?

Pro: Better health
Cons: Major increase in taxes, I will be paying for some kid who just swallowed a worm to get it removed...

I am not so much for Socialized medicine as it appears to be defined here, as much as single payer health insurance. I would also like to see the AMA, and JACHO type agencies disbanded, and the restructuring of Big Pharma profit guidelines. I think that would be a much better hybird of public and private health systems than we have now. The current system is not anywhere near true free enterprise capitalism, much more like a type of corporatism, and it needs to be busted up and some oversight placed by elected officials in some of these areas, with a public review process as well.

I don't quite accept that Americans, in general, would have "better health" under a universal health care program. As Michael Cannon of the Cato Institute recently pointed out in his September 8, 2004, article, "Clinton Got Quick Care, Unlike Canadian Heart Patients,"


For example, according to According to Nadeem Esmail and Michael Walker of Canada's Fraser Institute,


Esmail and Walker cite studies confirming that longer waits for heart surgery result in a higher risk of heart attack and death.

Consequently, I find it questionable whether Americans in general would enjoy "better health" as a result of UHC, such as the program currently operating in Canada.

A few posts seem to have missed some key points. WE don't wait for services in Canada like the insurance lobby would have you believe. As I stated earlier, I went from a dignosis of cancer to surgery in less that a week and was getting my treatment 8 weeks later (I had to wait for the surgery to heal).
I never spent a dime and never waited ina line. Canada's life expectancy is a few years above that of the US. Americans are not only lining up here for cheaper drugs, but now for flu shots. We were actually trying to find the cut-off point, but it appears we have more than enough for both Canadians and the Americans that travel over for it. I think Americans pay 30 bucks for the shot...but that I cannot confirm.

I'm not Canadian, so I can't speak from personal experience. Canada's Fraser Institute reports, however, that the total waiting time between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, was 17.9 weeks in 2004. (Source: http://www.fraserinstitute.ca/shared/readm...?sNav=pb&id=705.) Further, a whopping 74 percent of Canadians were concerned about long waits for access to emergency room services, while seven percent said they or a member of their household had suffered deteriorating medical conditions as a result of delays in access for care over the past year. Two percent of Canadians actually reported that a member of their household had died waiting for health care. (Source: Dennis Bueckert, "Access to Health Care Worse: Poll," CNews (Sun papers), Canada, February 25, 2004.)

I don't know about you, but I find that unacceptable.

For starters, the Fraser Institute is comprised of a bunch of guys (I don't want to use the term "academic" because one of their members is a college dropout) who are committed to privatizing health-care. That colours their research to a great degree.

By itself though bias isn't enough to dismiss research. However, if you can find countervailing evidence then we have a whole new ball game, so to speak.

Now, nobody in Canada would argue that everyone here gets the same quality coverage available at the private hospitals and to those who can afford premium health care in the states. However, for LESS money we are able to provide a health-care system to EVERY Canadian that results in us living longer healthier lives. Beyond the Canadian example, other nations also have various forms of single-payer or socialized health insurance. So I fail to see how skewed and misleading statistics demonstrates that it cannot work.

That all being said, our Health Care has suffered in the past decade through a period of economic restructuring and political in-fighting. However, funding levels are improving, reform is coming and wait times are being reduced in most provinces.

Another problem is in order to achieve this, you would have to either cut military spending dramatically, or raise taxes. Those are two things americans arent crazy about. That combined with long wait times, and philosophical differences on whether or not it is the role of the government to provide everyone with health care?

Its a tough situation to pass, and i dont see universal healthcare in the U.S. in the near future. I think its more likely to give families tax credits and breaks towards the cost of healthcare, making it more affordable, instead of just giving out free healthcare.

Either way, we are all in agrement about the price of healthcare, and want to see it decrease.

Well not everyone can afford good health care, so what do you plan for the population i guess. Preventative medicine is a good way to go about things from what i have learned by studying the medical systems of various nations and the health problems people face. Catching health issues early drastically cuts costs of treatment and keeps the population much healthier in the first place. If all jobs in america paid like around 5g a month i doubt such a program as universal healthcare would be needed. You also have to look into the cost of living and the spectrum of issues that tie into the healthcare program. I know as the population increases that wont help things either, for then you just have to keep growing to keep standards of living well or high or just being able to survive. I imagine this will also play into healthcare like most things. If you can say without a doubt that such a program is needed, which i think it is, then the next step is to make it available. This can be done by government, or by your work or something, or just plain out regulate the costs and accessibility so that people can reach it, or some kind of a combination of things. First though is the program needed, and in my opinion it is.

Considering that there are over 40 million people without healthcare, and millions more who can BARELY afford the limited care they have, this sort of setup would also demand a cut in military funding or a tax increase.

Yes but you have to be realistic too. Any type of program that raises taxes and decreases our ability to defend ourselves will never get passed on congress. To do this, to award universal healthcare in spite of those other two issues, is to assume it is the governments job to pay for and provide healthcare for you.

I persoanlly do not believe in big government. Your country's healthcare system is a mess. Look at the wait times, shortages of doctors, disadvantages in surgery. If universal health care is so good, why then am I reading a poll right now from IPSOS-REID Canada that states the follwing:


Two Thirds (67%) Of Canadians Say That They Or A Family Member Waited Longer Than Reasonable For Access To Health Care Services.

Why should i pay more taxes and expect those proud service men and women to possibly lose their jobs or have less armory and protections so I can pay for someone else's healthcare, and have then wait too long to get medical service?

Another polls from the same outfit said 4 in 10 Canadians were less than satisifed with the Health care system and service they got.

Look, it may be more money here, but at least we are paying for quality. I would prefer that than your inadequate and average healthcare that you pay so much in taxes for.

National Defense, tax cuts, and lowering the cost of healthcare without socializing the program is a much better option for me.

We dont need Canadian Socialism in our hospitals. We have seen how well it is working for you in Canada; Many Canadians come here for surgery and operations because your system has failed you.


I agree healthcare is expensive, but socialized medicine is not the answer.

1. Do you support an effort for Universal Health Care (UHC) system in the US?

I definately support it. I don't understand why it can't work in the US if it works in so many other countries (we are the only industrialized country without universal care). This is not a radical policy, it just makes sense. It is cheaper AND it ensures no-one goes without needed care.

Many people have mentioned the reduced cost of such a plan, but one topic that hasn't been addressed in depth: Why is Universal Health Care a more efficient system?

Here are some reasons:

First, the administrative costs have been proven to be less in a single-payer system for a variety of reasons. No one has to be employed to collect the money, to make sure nobody gets care without paying for it, or to promote the product to maintain profits. Nobody has to collect profits, and because of this opportunities for crime are diminished. Hospitals and clinics do not have to competing against each other for employees, also adding to administrative costs.

With a multi-payer system (the US system of HMOs), each insurance company and payment source needs to be billed. Each insurance plan needs to be analyzed to check if a procedure is covered. Each company also pays their CEO's and top administrators high salaries. They pay for advertising, marketing, lobbying, and other administrative costs which would not be necessary under socialized medicine.

At the same time, each doctor, hospital, nursing home, pharmacy, etc. needs to hire tons of billers, plan analysts reviewers, etc. to accommodate the multiple payers. In Also, each employer offering health benefits needs to expand hire more people to spend time negotiating with all of the insurance plans for rates and coverage.

It is estimated by many national and local studies that up to 60% of administrative costs would be saved if a single payer system were implemented. Two studies commissioned by the Massachusetts Medical Society in 1998 found that under a Single Payer system, enough money would be saved in Massachusetts to enable the state to provide comprehensive health coverage for all residents.

There is also more preventive medicine under a democratically socialized system because people can afford it, the system is regulated to require it, and it is a non-profit system and thus would rather have people in better health than be paid for a big operation that could have been avoided with preventive medicine. Preventive medicine is very much more cheaper as well as more effective than a large operation or caring for an extended illness.

I think this represents a misunderstanding of what Universal Health Care is TD. Certain elements of our society have framed it in a negative light and I believe that is why you hold the opinion you do of it. You also have some incorrect views on Canada.

I think you might greatly benefit by going back to read the entire thread. Joe has explained quite a bit about the Canadian healthcare system and I'm sure he'd be willing to answer specific questions.

Additionally, there are some good plans out there, and Kerry's wasn't one of them. You should check out this post where I described Kucinich's UHC plan and this post where I provided some more detail. You aren't going to fix this problem with the same thinking that got us here in the first place, it is time to actually analyze the problems and find a solution.

Again, I stress the idea of going to a Universal System as not only a mistake, but an oxymoron. I'll explain what I mean, and why we do not need to raise our taxes and cut our military who protects us.


For starters, Many theorists today are fond of discussing "positive" and negative" rights. A negative right is the kind of right upon which the American Dream was founded. You have a right to your own life. You have a right to your property (I know we denied it to many groups in our nation's history, and that is wrong). You have a right to not get beat up for no reason.


A positive right is something like the "right to work" or the "right to universal healthcare." It is not something that others cannot do to you (like kill you). It is something that society (and hence, others) must do for you. Positive rights are largely employed in places like Sweden, but were noticeably absent from the Constitution of the United States and from the prominent writings of the Founders.

So when did the "right to universal healthcare" suddenly become a part of the American dream, and what does that phrase even mean.

You see, no society, not even ours, can provide universal healthcare. This is because people die (naturally) and we have limited resources (this is called scarcity). As far as I can tell, universal healthcare would have to be free healthcare extended to all people within a nation for all infirmities for the entirety of their lives. This is, of course, as absurd as Al Sharpton's haircut. Sometimes people die. When the very old reach a point at which they can no longer function, when their brains die and they are kept alive by machines, most people would note that it is no longer the responsibility of taxpayers to keep their lifeless body fully functional. The extension of healthcare is not universal, it must be handled with reason. Sometimes it is natural for someone to pass away, and, as we are not likely to beat death, it is not society's responsibility nor is it morally right to keep corpses breathing on the taxpayer dime. Even in a world of unlimited resources, sometimes people must pass away.

The bigger problem, however, is that there is not only the biological but the economic necessity of an end to healthcare. As long as one person is on life support they are using money and resources that could be used on someone else. Americans would live longer if everyone had regular MRIs and physicals, if everyone had a personal trainer and a daily visit to the physician. But this, even in our wealthy nation, is impossible. People always have limited or major infirmities, and we could literally bankrupt any system by diverting all resources to prevention and alleviation of all medical necessity--and still be unsuccessful. There are not enough MRIs for every person. Doctors must be paid. Every time someone is on life support, someone else is not (as Dr. Epstein has so brilliantly pointed out); and in a world of limited resources, nothing material is universal.

This is not to say that some basic medical necessities should not be provided by the state. Maybe they should. But the extension of a limited and clearly defined set of medical procedures to those who cannot afford such treatment is not universal healthcare. Universal healthcare is an oxymoron and will always be an oxymoron as long as scarcity and death exist. That is why I think my head will explode if I hear one more politician promote universal healthcare--in essence, promising to promote the destruction of an already successful medical care system that innovates more effectively than any in the world, all in pursuit of a ridiculous ideological, political platform.

That is universally stupid.

Again, look at the mess in Canada. Sure it is free, but is the service worth the price you pay in high taxes? Is it really free then? Consider this again.


In Canada where they attempt to provide universal healthcare, emergency room trips can take days - often resulting in greater infirmities and sometimes death - simple check-ups must be booked months in advance, tests must be booked almost a year in advance. Canadians constantly jump the border to America, because our system is simply better. It's not perfect, but it is self-correcting. Because we pay for our system, because we are inconvenienced with cost, we use our emergency rooms for emergencies, and we take better care of ourselves to allay later medical costs. Our system provides for the payment of doctors and medical supplies, while their system frequently knows shortages. Their system must frequently face decisions such as having to choose between an elderly grandfather who will likely make it through a disesase but live for only a year after and a child who has less of a chance of making it but has her whole life ahead of her.

People I know in Canada have had to wait over a year for their kids to get surgery on an injury they suffered in sports related injuries! That is inexcusable. At least in America you get what you pay for, outrageous taxes does not make canada's system free.


So Do you still want universal healthcare similar to that in Canada? I am not so sure I am ready to make that jump.

Besides, a dennis kucinich type plan will never get passed, be realistic please.


Why should my taxes be raised to pay for inadequate service for someone else?

We need to find ways to drive down the costs and make healthcare more affordable, look at what howard dean did in vermont, he did not raise taxes, he provided healthcare for 99 percent of the public! The governor dean was different from the presidential candidate, and he deserves a lot of credit for that. We do not need to go down these road of canadian socialized medicine; we will surely regret it.

The truth about Canada is much more complex than that. The Canadian system is easily superior in routine and preventative care, which is really the most important part of medicine, as it decreases the need for more specialized care. However, the system also has advantages in more complicated care. A 1992 study found that three-year mortality rates following surgery were better in Canada than in the States for eight out of 10 types of surgery (including bypass surgery). A 1997 U.S. General Accounting Office study found that Canadians are 5-per-cent more likely to survive lung cancer than Americans, 4-per-cent less likely to survive breast cancer, and do equally well with colon cancer, Hodgkinson's disease and hip fractures -- at far less cost to the patient.

The waiting lists for some things might be longer than in the US, but part of that is because a larger percentage of the population actually gets health care. More importantly, however there has been a recent financial crisis in the government and funding was cut back. Go to France (which has UHC), you will find that most waiting lists are actually shorter than those in the US, not longer.

The United States has higher infant mortality, higher surgical mortality and lower life expectancy than Canada. The United States has a much lower rate of access to primary care doctors than Canada. Canada has the same acute care bed-to-population ratio as the United States. Patient satisfaction, quality of care and outcome of care in Canada equal or exceed that in the United States, according to the U.S. General Accounting Office.

As for the idea that many Canadians come over to the US for care, that is mostly a myth. Barely anone has done this. Studies have shown that most Canadians who recieved care in the US didn't come over for the care.

As for disatifcation, sure many Canadians are unhappy (this is largely because of underfunding in certain provinces, which is being solved now, and because of privatization) but what about compared to Americans? Percent of people who believe their health care system needs fundamental change:

United States 60%
Sweden 58
United Kingdom 52
Japan 47
Netherlands 46
France 42
Canada 38

The US is the only with without Universal Care.



While the United States spends approximately 24% of our health care dollar on administration, Canada spends only 11%.

I think the "right" part of it is stupid. I don't believe in some policy because someone has this right or another. I believe in policies because they make people's lives better.

Of course "universal health care" by your definition is impossible. "Universal" just means everyone gets the care they need. Your argument is like saying "universal sufferage" is impossible - everyone cannot vote on every law, minors cannot vote, criminals cannot vote, etc.

I discuss Canada in my other post, but as for cost, what does it matter how the money is taken from you? In single payer you pay more taxes, but you don't pay insurance companies. In single payer your total health care expenses are less.