I don't support UHC on the national or federal level. Too bulky and far too restrictive.
I would support something on the state level with a very aggressive negotiation of services policy. Really keep competition to keep costs down strongly supported. Say reviews every 5 years. The needs of Arizona are not the same as California or New York. Give us the freedom to negotiate for ourselves and tailor our coverage to meet our needs, not those of everyone else. CHOICE CHOICE CHOICE, not the UHC case of one size fits none.

Demand unrelenting transparency of the economics. No chances to fudge numbers to make a company or programs numbers look better and allow an early warning capability for heading problems off at the pass.

I think another vital aspect that will determine the effectiveness of any health care reforms involves a look at how patents are treated in this country. Allowing companies to benefit from their discoveries is critical but so is the eventual freeing of the ideas to allow competition to occur. For some reason support for the Free Market seems to fade from the political will when it comes to this.

Add in that many companies will patent any variation they can think of just to suppress competition and the Free Market does help keep drug prices artificially high.

The health care industry is taking HUGE steps towards reducing administration costs. They deserve a big hurrah. I would encourage and support standardizing several of the forms used by doctors and hospitals to allow more effective consolidation of medical information.
This will aid the reduction of Admin costs and allow technologies such as the ever increasing build towards wireless networked hospitals to help dramatically reduce costs. There is no good reason for every hospital to have a different set of forms for everything.

But if each state had a different plan, it would be more complicated to move between states. I don't understand how choice would be restricted by a national plan. A single-payer system can offer a lot of flexibility by allowing patients to go to different types of providers. Providers would have to pay attention to patient needs. Under a single-payer system patients can go to any provider they like. In a managed care environment choice is often more restricted. Currently people often do have the opportunity to choose between two different health plans, but the differences between health plans is often superficial.

TennesseeDemocrat, I believe I've already responded to just about every criticism you've had for a single-payer system, so I would suggest you go back and re-read some of the posts from people who have an understanding of how Universal Health Care works in Canada (and elsewhere.)



Your taxes would be raised, but you wouldn't be paying for private insurance; so assuming you do have insurance you would probably end up paying LESS. The only way that that is a problem is if you just don't like paying taxes in general; in which case you should admit your argument has nothing to do with money and everything to do with ideology.

Every policy must be evaluated on the incentives that it creates, rather than the goals it aims to reach. Because unless you're creating the right incentives, you're never going to reach those goals.

Economically speaking, UHC falls into the same category as every other governmental policy that ends up exacerbating the problem it attempts to cure, such as price controls on housing and food.

As I've said in a previous post, all resources are scarce, including medical services and supplies. Hence, we should enact policies that promote the most efficient use of these resources. Generally speaking, free markets promote a more efficient use of resources than government control. This general principle applies equally to medical supplies and services as it does to all other resources.

So... let's say you place an artifically low ceiling on the prices that can be charged for medical services. What happens? First, at an artificially low price, demand will undoubtedly exceed supply. People will be willing to go to the doctor for things that they otherwise might not if they had to pay a free-market price for the doctor's time. Second, supply will decrease. Doctors will be less inclined to incur the costs of providing medical care, in both time and money, if, at the end of the day, it's not worthwhile.

Beyond that, you'll also see quality deterioration in the services that are supplied, because doctors will no longer be required to compete for patients. As Stanford economist Thomas Sowell discusses in his book, Basic Economics,



In short, there is a finite amount of every resource -- medical services and supplies included. If the government were to come up with a "plan" for "universal access" to medical care, that would not change the underlying scarcity of these resources. Rather, with a given population and a given amount of resources, rationing without prices would have to take place by bureaucratic fiat, political favoritism, or random chance -- but the rationing would still have to take place. A price-driven system promotes the most economical use of these resources.

If that is true then why so many developed nations on the planet outside the United States run a form of health-care that features (on average) a higher quality of care, with greater public satisfaction?

What source(s) are you relying on? According to a recent poll entitled The National Pulse on Health Strategy, 80 percent of Canadians want major reforms to the health care system:


Environics Research Group, "New Survey: Canadians Want Health System to Change," Press release, October 17, 2002, at erg.environics.net/news/default.asp?aID=501(August 11, 2004).

What? What does that have to do with Universal Health Care? Who ever said that we would have to put artifically low price ceilings up?

Are there no price controls under your UHC system?

While UHC is a decent system that works in other countries, implementing in the United State's as of now would have an unsustanable price tag because the coverage prices would extend to every citizen. Take medi-care and multiply the cost by hundred's.

I dont have health insurance and the last time I went to the doctor was four year's ago. Why should I have to pay for someone else's cold?

In 2003 insurance companies payed billions of dollar's out to doctor's for people that went to see them for a common cold.

Why on earth would you see a doctor for a cold?

Because it only cost's them $30 but it cost the insurance company $150+.

If UHC is passed expect this to happen more often because it wont cost them a penny more than they are allready paying.

Hospitals grossly overcharge medicare, and they also charge medicare for unnecessary procedures. By that I mean they actually setup unnecessary follow up exams with their patients soley so they can charge medicare again, and also overcharge for there services. Not only will this drive up the cost of health care for the government, it will also make getting the care a longer proccess because of unnessesary and additional appointments.

There are much better alternative's than UHC to reduce the cost of health care in the United States.

http://www.forbes.com/premium/archives/pur...requestid=12710


This mean's that they will only use they insurance when it is really needed and that minor health problems will be mainly payed for by the individual. The money spent on health care is also tax free and earns interest.

A tax incentive can be given to establish and HSA. The government is not actually paying for the HSA but is simply giving a tax credit to establish the HSA which mean's that instead of taking your money from taxes they are diverting the money you make and putting it into an HSA for your own health care. So you will be paying for it, but it would be money that would have gone to the government for other uses and you wouldnt have it to spend anyway.

With the expansion of HSAs, this will bring more competition and better quality health care because the health care provider's will have to compete for better health care because it is now the individual that is paying them and not the insurance company. So the individual will decide who they would like to see and not the insurance company and will decide that on previous experience's, if they get bad health care they simply go somewhere else.

Also lower health insurance prices will result because insurance companies are no longer widely abused, and the health care is virtually tax free for the individual.

Create AHP's (assosiated health plan).

http://pwiis.nfib.com/cgi-bin/NFIB.dll/jsp/ahp/ahphome.jsp

It work's by having a list of small businesses that sign up to negotiate a health care plan together, effectively giving them the buying power of a large business. Also you can expand AHP's to establishment's such as church's, charitable groups, and other types of organizations so an induvidiual who seek's to purchase health care on their own can buy it from an organization with the buying power of a large company instead of an employer.

Of course there are, just like there are under the corporate insurance system. Why do they have to be artificially low though?

(1) I'm not defending the current U.S. system. I think Vampiel has already pointed out many of the problems with it.

(2) I say "artificially low" because the government caps prices at a level below which they would otherwise be if determined by the supply and demand of the free market. I don't think you're suggesting that the government under a UHC system would place an artificially high price "floor" on medical care care.

Nor am I saying that free market prices would necessarily be significantly higher than those imposed by government mandate. The lifting of price caps generally invites more investment, or supply, thus driving down the cost of the subject good or resource.

For example, when the U.S. government ended its control of gasoline prices in 1981, many feared that it would lead to drastically higher prices. Prices did, in fact, rise shortly after the price caps were lifted, but the higher prices led to a greater quantity of gasoline being supplied and a smaller amount demanded. Oil exploration shot up and existing wells whose costs could not have been covered at the controlled prices began pumping oil again. Within months, gasoline prices fell below what they had been under government control. And, the fall of prices continued over the years until gas prices reached an all-time low in real terms. (Of course, once that happened, taxes were piled onto the prices at the pump -- but the gas itself was cheaper than ever. And the waiting lines that had existed under the government price-control system no longer existed.)

(3) Again, it all boils down to what incentives you are creating. The current U.S. system fails for a reason similar to that of UHC systems -- patients have no incentive to economize their use of medical care. In our system, third parties (insurance) pay the vast majority of costs for even routine medical checkups. Unlike a UHC system, however, the U.S. has an abundance of medical providers (at least in those states with tort reform), because they are generally free to charge huge prices for their services. A UHC limits doctors' ability to charge for their services and, therefore, decreases the amount of supply.

The U.S. needs to shift the burden of paying for routine medical services from third parties to the actual consumers of such services. (Catastrophic illness or injury is still an appropriate subject of insurance coverage.) That way, demand for these services will decrease, and prices will follow. We also need national tort reform, but that's another topic.

Why are we so deformed that we can't do what everyone else is about to manage? I think us in the USA are pretty capable. Right, one form of single-payer health care is an expansion of medicare. Take medicare and apply it to everyone, and do away with insurance companies. I dont' know if you read the fact that the bureaucracy of the employer-based managed-care system consumes 9 to 15 cents of every health-care dollar. Medicare, a single-payer plan for seniors, spends only 2 to 3 cents of every dollar on bureaucracy. But don't think it would be as expensive for everyone as it is for seniors. The old require a lot of care, and therefore are much more expensive to take care of than your average citizen.



Why would this be more likely to happen with national insurance than with insurance companies?




I'm not against such a policy for those who can afford it. It might make sense to have national health insurance complimented by HSAs. I don't know if I would want to tie this to companies though, it should be personal. And for the poor insurance should pay for everything. My one concern would be if someone messes up with the money in their HSA. Maybe they just get duped, who knows. No-one should go without needed health care, especially ruitine care. Sure, its great to have insurance for needed emergencies, but if you don't get ruitine care (preventative medicine) because you can't afford it, you are more likely to need emergency care in the future, which in the end costs more.

What wouldn't make sense would be to keep insurance companies and intruduce HSAs to compliment them. Single-payer health insurance is proven to be less expensive than using insurance companies.



This will happen with single-payer too. The consumer choses the provider, and the single-payer insurance pays for it. Of course there have to be some restrictions, but very reasonable ones. Many countries which have instituted single-payer have found increased freedom to chose health care providers.



It does seem like there is some less possibility for fraud and absuse if the consumer is responsible for paying. However, the question is how large the savings would they be compared to the savings associated with having a single-payer system. In a previous post I listed the reasons single-payer is more efficient, including lower overhead and more preventative medicine. Are there any studies showing the saving associated by switching to HSAs?



But wouldn't this be so much easier if it was one organization? 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. It seems like creating a network of AHP's, all with different policies, and keeping insurance companies, would only serve to complicate the situation even more. Even if you did the more sensible thing, and had some procedures coverd by national health insurance, having all these AHP's seems like we might lose the administrative savings associated with single payer.

Finally, consider this benefit of delinking health care funding from employment: People don't have to worry about losing insurance if they switch jobs. They have more freedom to change profession/employer. They are also more likely to move to the job where they are most efficient because health care plans are no longer a factor.



I think you are trying to apply an economic concept that does not work in this situation. I agree that artificially set prices are stupid; if the government wants stuff to be cheaper, it should come up with the money to subsidize it.

I'm not sure how this applies to health insurance though. I'm not suggesting that the government would set an artificially low or high price for care. No-where in any plan for universal care have I ever seen anything about this. Where are you getting this from?

catquas makes the best points for a single payer system- for one, it will save everyone in the US money!

Insurance companies are a fundamental flaw in our system- it is completely incompatable with the mission of the medical model. Thier entire mission is to deny service and NOT pay, and therefore, make a profit. The medical profession is to provide service and healing.

My Union is a classic example of the massive savings that can be had by eliminating insurance companies. We went to self insurance and dumped Aetna- in the first year, we saved 26% in administrative costs alone! With a 43 million dollar health trust per year, 16 million was saved overall by simply paying the claims, the only caveat was having a "stop loss" insurer, but it was only 7.50 cents per member fee, out of 700 dollar per month total contribution.

Insurance companies are criminal in thier behavior, and need to be treated as such. Thier routine denial of care just to see if patients would be alive to fight the claim (as some landmark civil suits have proven, say, against Aetna) should have earned those boards of directors the death penalty.

I am not really for "universal health care" as much as a single payer system. It just makes good financial sense as well as ethical sense.

I never said we are not so deformed that we can't do what other (not everyone else) can manage. I said there are much better alternatives. I also have a moral issue with paying for other people, unless it's a dire emergency.



Because there are more people with coverage and the cost is free. That greatly increases the amount of people going to the doctor for minor ailments no matter how you look at it.



Then you are not really understanding the policy. It's tied to insurance companies because you still have coverage for certian conditions. Basically it's the opposite of alot of HMO's because you have a high decutable. This means that you still have insurance, but you have to pay up to $2,600 out of pocket meaning if you want to see the doctor for minor conditions then you are going to pay for most of the cost and not the insurance company. But if you have a serious condition then the insurance company covers most of the cost. This is how health insurance should work, not because you have a cold and want to hit your insurance company up for $150+. That is the driving factor behind the raising cost of insurance companies, ask any expert inside an insurance company or even a negetiator for a large corperation. I got this information from a person high up in Wal-Mart and they have lost over 40+ HMO's in the past 10 years. And this is Wal-Mart.

But keep in mind that this will work much better when coupled with the tax incentive that I outlined in my post because it becomes money that you are making but the government is simply setting it aside for you. This is optional of course, the government can take that money and spend it on other things instead if you wish. You dont pay any extra taxes for it.



And it does. It's called medi-care.



How can you mess up the HSA? It's a tax free 'savings account', it's basically the same thing as putting it into a savings account, which earns guarentee'd interest, but you dont pay any taxes with the money when it is spent.

The only way you can 'mess it up' is if you abuse it yourself.

Ive seen the doctor twice in ten years and the dentist once in ten years. Call me lucky, but I also dont see why I should pay for someone else's problems. I dont have a problem with serious conditions but I do have a problem with people that abuse the system, or maybe dont believe they are abusing the system when they decide they need to have the government give them some health care because they have the sniffles. Everytime you walk outside of your house you are increasing your risk of death. You could be hit by a car, hit by a bicker, trip over a rock, etc.. should I pay for a helmet for everyone because perhaps it could save their life? Where do you draw a line between forced charity and absurdity? Forced charity is never a good concept and once implemented it will always become a system with systematic abuse. Why do you think the USSR fell? Once you take away the incentive for an individual to take responsibilty for their own actions, in the case of HSA's they pay out of pocket, then there will always be large amount's of abuse on the system. Not to say that it doesnt work especially when the system is payed for by a capitalist society (and not a socialist one) but there are much better alternative's that can "make it affordable" and "drive" health care and not simply "make it available".



I dont see how. Canada has a "list" of providers you have to goto. Furthermore you have to put your faith in the provider that they will actually care for you. If they dont do the best job possible then 'tuff hooey because it was free and they get payed anyways, there's no incentive for them to want you to come back to them.



The cost may go down for you maybe, but it will not go down for the government. The only way the cost will be reduced with UHC in the United State's is if the government pays doctors less then they are currently making, pays drug companies less then they are currently making, pays hospitals less then they are currently making, and hospital's are given a set amount of money per year (this would be to curb the abuse from doctors that currently exist in medi-care) which would also decrease quality (explained above) OR raise taxes in order to pay the additional cost.

Again this goes back to my question of why I should have to pay for someone to see the doctor for minor treatments. That should be up to the individual not for the individual to abuse my money.

HSA's are relatively new so there is not much data behind them but I allready posted an article above from Steve Forbes that calls it "The cure to the health care crisis".



Sure, life would be much easier if the government provided everything for you.

They completely dumped the insurance company? Self-insurance is a good alternative to insurance companies but I believe they should co inside with each other but only have the insurance company kick in on critical health problems that cost a fortune. This would cut back the administrative costs AND the monthly payment because you would only be paying for minor problems and not a $300,000+ triple bypass surgery.

That was the part about "stop loss" I mentioned- basically, we have a 250K deductable.

There is this notion that the goverment is always less efficient than private enterprise- and in most cases, this is true. But it will never be true in the medical industry, with the exception of "elective" type medical practises (like plastic surgery) - simply because it's mission is incompatable with the profit motive- similar to for public safety- overall, I am happy that police do not have a profit motive to "make them more efficient"- hence, make more arrests to make a profit.

I think this is a classic example of a confuled public vs the realities of the industry. We have a philosophy issue here as much as a policy issue- should only the rich have access to health care in this country?

Single payer is so obvious an answer to our health care issues in our nation- but the corporate world will never let it happen in our current political system. GW is bought and controlled by the hospital industry. It is obvious just from his stance on pharm issues.

Oh, and hey vamp- might want to stop double posting- the mods will whack you one LOL

[QUOTE=Vampiel,Nov 12 2004, 10:49 PM]
I also have a moral issue with paying for other people, unless it's a dire emergency.
[/quote]

Well that is a whole other debate. To summarize my position: Any taxation is forced. Why is forced charity immoral, yet forced taxation for military isn't? If being forced to pay money is wrong, then it is wrong in all cases.

[quote]Because there are more people with coverage and the cost is free. That greatly increases the amount of people going to the doctor for minor ailments no matter how you look at it.[/quote]

OK, more people with coverage, true. The decuctable will not necessarily be cheaper though, at least for those who can afford it.

As for going to the doctor's for a cold, I don't think that is a major component of health care costs. OK, it is certainly there, and if you add it up in a big country it can look like a large number. But percentage-wise, is it significant? Consider cutting administrative costs by 60%. I am sure that would more than make up for it.

As for the part about being forced to pay for useless things, we pay for useless things all the time because in a situation without these costs, we would be paying even more. Consider advertising. In a competitive market there is often advertising. Much of the stuff I see on TV today gives you absolutely no information about the product, but just tries to make you feel good about it. So its useless, but we have to pay for it because it is reflected in the price. But if these industries were monopolies, we would be paying a lot more than the advertising costs. So its a necessary evil sometimes to pay for useless things.

And really, who would really go to a doctor if they didn't need to? Sure they are a few, but I don't want to waste my time in the waiting room, seeing the doctor, etc. if I'm not going to get any benefits from doing so.

Regarding your suggestion before that there are uneccessary procedures performed if there is medical insurance: Here are some suggestions I found on how to reduce this: "One approach is to compare physicians’ use of tests and procedures to their peers with similar patients. A physician who is “off the curve” will stand out. Another way is to set spending targets for each specialty. This encourages doctors to be prudent stewards and to make sure their colleagues are as well, because any doctor doing unnecessary procedures will be taking money away from other physicians in the same specialty. Another way is to continue to develop expert guidelines by groups like the American College of Physicians, etc. to shape professional standards – which will certainly change over time as treatments change."
(Physicians for a National Health Program)

[quote]I'm not against such a policy for those who can afford it. It might make sense to have national health insurance complimented by HSAs. I don't know if I would want to tie this to companies though, it should be personal.[/quote]

[quote][quote]And for the poor insurance should pay for everything[/quote] And it does. It's called medi-care.[/quote]

I was talking about under a new system, where there would be no medicare or medicaid because everything would be consolidated. But even if you are talking about now, that is not quite true. About 30% of the poor never qualify for Medicaid. Medicaid has many restrictions in order to qualify. Most Medicaid payments are for chronically ill people in long term care facilities.

[quote]How can you mess up the HSA? The only way you can 'mess it up' is if you abuse it yourself.[/quote]

OK, I'm trying to figure out this plan. I didn't know the insurance companies were so involved. Of course you couldn't mess up if the insurance companies dictate what you can spend your money on. But if that is the case, how is competition increased?

[quote]Forced charity is never a good concept and once implemented it will always become a system with systematic abuse. Why do you think the USSR fell?[/quote]

It was a corrupt athoritarian dictatorship which created an economy run by bureaucrats completely unnacountable to the people and therefore extremely abusable by the elite. One thing it didn't fall from was single-payer health insurance, which it didn't even have.

[quote]I dont see how. Canada has a "list" of providers you have to goto. Furthermore you have to put your faith in the provider that they will actually care for you. If they dont do the best job possible then 'tuff hooey because it was free and they get payed anyways, there's no incentive for them to want you to come back to them.[/quote]

Of course you have to have a list, you can't just let any random witch doctor practice. As for the second part, of course there is an incentive for them to want you to come back. They only get paid when the perform a procedure for you. The more you come back, the more they get paid. Like usual.

[quote]The cost may go down for you maybe, but it will not go down for the government. The only way the cost will be reduced with UHC in the United State's is if the government pays doctors less then they are currently making, pays drug companies less then they are currently making, pays hospitals less then they are currently making, and hospital's are given a set amount of money per year (this would be to curb the abuse from doctors that currently exist in medi-care) which would also decrease quality (explained above) OR raise taxes in order to pay the additional cost.[/quote]

Actually, the facts show that the costs are less. I have never heard of a study expecting them to go up. The US pays the most per person for medical care, yet we are the only industrialized nation without universal care.

[quote][quote]But wouldn't this be so much easier if it was one organization?[/quote]
Sure, life would be much easier if the government provided everything for you.

[/quote]

No, I mean administrative costs would be less.



I don't know what is up with the quote stuff...

Not necessarily. I dont mind being taxed for things that I actually use such as the military, roads, electricity, gas, etc... Again I hardly ever goto the doctor and I do not believe I should pay for other's to goto the doctor for minor ailments, especially but not limited to people who make the same amount or more money than I do.



It will cost the government more no matter how you look at it because the number of people covered will increase by millions. The administrative cost does not factor in because im talking about our current medi-care system's cost. I dont see how you can implement a government program to millions of more people without it costing significantly more than the government programs we already have in place. The millions of people with the added coverage will cancel out any type of streamlining you do to the system. And yes, currently billions of dollars are shelled out by insurance companies to treat the common cold, so if everyone has this through the government you can expect the dollar amount abused to be even higher. Billions of dollars is always significant no matter what the percentage. Perhaps the coverage should be limited.



A good suggestion but all of that cost's money.

Though I really dont see how that would work very well. Compared to similar patients? How? How do you know if someone really had a more complicated condition of the same type that needed additional tests and the other did not?



Medicare you mean. Medicaid is for dentist's. I never said we should get rid of Medicare, but I agree that it need's to be reformed.

Here's the problem with medicare. If you dont have a job it's easy to qualify. If you do have a job and are struggling to make end's meet, you cant get medicare and there are not even tax deductables to help you with health insurance. That's the major problem with the system right now.



The insurance companies dont dictate what you can spend it on. Like I said the HSA is there for you to spend, the only person that can "mess it up" is yourself. It's like a savings account in a bank that you can only use for medical purposes.



Which brings us back to systematic abuse.



I'm talking about the cost for the government will be astronomical in the United State's if you dont want to sacrifice health care quality. France has as many people as a few of our larger state's.


Having problem's with the quote button? My eye's where going while I was reading your post.

The concept of not enough resources is a good one and a point i stick to when talking about the damage we inflict on the environment and the various ecosystems that incorporate into it or make it up. The fact is the earth does not have infinite mass and humans only can use the earth currently for survival and so on. Sure environmental damage in various forms can cause collapse or bankruptcy depending on how you want to look at it, but back in the states this is not mainstream or accepted thought right now. In terms of people that cannot or do have health care, you end up with health care that is done via emergency rooms, which in that case the problems are worse and require more energy and resources. So to me its a problem again that touches on many things in a broad spectrum. A blood clot, depending on location can cost around 300$ to fix, after the fact medicine is around 16000$. This also again requires the use of more energy and resources.

To me to pawn the problem off is no good, save you make hospitals capable of saying whom it will treat and when based on whatever the hospital feels. So overall this would just lead to large portions of Americans, young, old and in-between to have little to no healthcare on a constant base, until it balanced out via death or something. Cancer research and cures for various things can lead to less need of healthcare, so can education on proper ways to take care of yourself, the making illegal of various things like pollution, alcohol, tobacco, firearms, and fast cars, etc...

I still firmly believe healthcare is needed.

EDIT: added a ,

I'm sure pacifists mind being taxed for the military. Again, you should pay for someone elses minor ailments because in the end it saves the system money. Sure, maybe a minute fraction of your money would go to an unneccessary procedure, but the savings resulting from universal health care would greatly outweigh that amount.



Now before we go too far on this, sometimes is it helpful to go to the doctor for a cold, depending on how bad it is. The cold can develop into pnemonia, which can be much more expensive to treat. That said, I am up for more restrictions if some procedure is being covered now that really is always useless.

Secondly, do you have any exact or even approximate statistics on abuse, from some source?

Finally, you can say that the inceased amount of people treated will outweigh the decreased administrative costs, as well as the other savings of universal care (more preventative medicine means less expensive procedures, the system can buy medical supplies in bulk), but the facts do not back you up. As I have said, look at real countries with this system; it is cheaper. Also look at studies done about how this would work in the United States; it is predicted we would save money.



It costs money, but considering the fact we will save so much money, we will be able to afford it. Compared to similar patients means looking at a list of patients over time. They should tend to average out in terms of whether they need additional tests or not.



You are right in some ways, although you are thinking of medicaid. Medicare is for the elderly, medicaid is for the poor. Many working poor cannot get medicaid, but it is hard to get even if you are unemployed. And if you are middle class and cannot afford health insurance, you are not going to get much help either.



OK, maybe it is hard to mess it up, but what if you just have a lot of procedures you need. Maybe you have some long-term health problem. You might run out of the money in your HSA.



True, but we have more money to work with. It doesn't matter how much it costs total. It doesn't matter how much it costs the government. It matters how much it costs per person. Universal care systems cost less per person. That means we as a country would save. We would have higher taxes, but you wouldn't have to pay for insurance. Most people would pay less total money for health insurance. That is what the concept "cheaper" means.

Sorry for the quote thing in the last post, I don't know why it didn't work right. Something wrong with the site or something.

I accendentally hit the back button and my long post got deleted.

I will make this short.

The cost can also be lowered per person through HSA's, and for those of us that do not make regular visit's to the doctor do not pay for other people's health care. Why should I have to pay for someone else's health care? I dont get any "savings" because I dont pay for it in the first place.

Vampiel- your whole argument seems to be based on utilization.

There is no evidence that free health care has any higher cost overall than any other system- because, in the end, the average consumer uses 90% of his benefits in the last 90 days of his life- so utilization also frequently finds stuff earlier, which is cheaper.

Again, I see many problems resulting from this. People with significant health care needs maybe quickly use all the money in their accounts and then have to pay large amounts of money out of their pockes, which they might not be able to afford. Such people could instead be on different plans with more comprehensive coverage. Since healthy people would not chose such plans, and would rather chose HSAs, the prices of comprehensive plans would be driven up, because only high-cost people would be paying in. This would not help those who actually are hurt by rising medical costs. By placing everyone in the same pool, as under single-payer, the cost of high-risk people is diluted by the larger amount of relatively healthy individuals, keeping health insurance costs affordable for everyone. Also, since healthy people cannot possibly predict whether they will suddenly take a turn for the worse, they can eliminate that potential by being included in the comprehensive pool with everyone else.

Furthermore, wouldn't you at least have HSAs but replace insurance companies with single-payer? This would reduce costs even more, and it ensure that no-one who needs insurance is without it.



As above, what happens if you suddenly have a problem? Secondly, you should contribute to the system because it the system that works the best, and it requires that everyone contribute. You might say that it doesn't work the best, but that is a different argument. If single-payer works the best, you should pay into it. Of course if it doesn't work the best you shouldn't have to pay, because it shouldn't be the system. This moves the argument to the subject of the relative merits of different systems, instead of "why should I have to".

Secondly, if you don't have enough money after taxes to pay for your necessities, then that is a problem with the tax code. If you do, then surely the money is being better spent on health care, which is a basic necessity.

PS. I'm sorry about your post being lost, I hate when that happens

Vampiel, you've said so much that is just plain wrong in your last few posts that I don't really know where to start. Here's a good one:



See this is NOT EVEN CLOSE to how the system works. Do you even understand what the phrase "single-payer" means? I know that english isn't your strong suit, but you seem to be labouring with a terribly false assumption. Nothing is "Free" in Canada. Doctors bill for their services just like they do in every other capitalist country on the planet. The difference in Canada (and elsewhere that employ a similar single-payer scheme) is that ONE organization pays those bills. Still not following? I'll explain it in even more simple terms.

When I go to see my GP every year (which you should do too by the way. The long term savings that early detection of problems present far outweigh any immediate costs... but hey, it's your life), they ask for my OHIP card. OHIP stands for "Ontario Health Insurance Plan." I give them my card information, I have my checkup, and they subsequently bill MY INSURANCE provider. If I feel my doctor isn't doing a good job I am more than free to simply switch doctors. I like my GP though... despite the fact that he ocassionally starts speaking in french to me. He caught a rare vascular condition in my feet that most doctors would have dismissed out of hand.



I see your understanding of economics is just as sharp... Look, you bare none of the costs yet, or so you suggest. But I ask, does your state finance any public hospitals? You know what happens whenever they take a patient who doesn't have insurance? You get stuck holding the bill. Here's where it gets really interesting: All of that money could be saved IF that person had a GP because a visit to your local doctor is infinitely less expensive than a trip to the hospital; and GP's are able to prevent and diagnose illness before they become costly. So YOU ARE PAYING in the first place, you just don't know how your state tax-system works.

Of course you seem to have a poor understanding of how medicine works anyways so perhaps I should move on:



People who go to the doctor SAVE THE PUBLIC MONEY. How, you ask? Because they are generally healthier and more productive, they DON'T end up in the hospital as much (which is infinitely more expensive), they consume medication which generates economic activity, and they are able to enjoy a longer life of contributing to society. Do you even understand the concept of "long term benefits", in health care or otherwise?



Political pressure from within, economic problems stemming from the overdependance on industrial manufacturing, and broader global economic instability. How is that relevant, unless you are making another fact-less attack on anything you perceive as socialism?



Umm, believe it or not, the rest of the developed world IS capitalist. Maybe not to the degree that the U.S., but if you were to develop a spectrum (since an either-or understanding is completely ridiculous) you would find countries like Canada and Switzerland awfully close to the U.S. Now, what are these alternatives? You seem hung up on this ponzi scheme called "Health Savings Accounts." You'd have a much easier time convincing us that they would work if you'd go out and do some research. Find me a link where DOCTORS, or other health-care experts, explain how it would work, and would be an improvement. Go ahead, we can wait. All you have been doing for the past three days is telling us that "socialized medicine is bad," "why should I pay," and "HSAs would make people responsible" without actually using any facts to explain why.

I dont see how I was off. Admittedly I dont know the inner workings of the Canadian health care system, but from my understanding you are limited as to what hospitals you can visit.



I am paying for emergency room visit's not for someone to have a cold treated. Which was my original beef so it seem's that you convientely left that part out.



Maybe im failing to understand the proposal.

http://dictionary.reference.com/search?q=socialism

Any of various theories or systems of social organization in which the means of producing and distributing goods is owned collectively or by a centralized government that often plans and controls the economy.

How does UHC not fit this definition?



That's what I said. I said it works especially when it is driven by a capitalist society, which includes the countries you listed.



Sorry you take such offense that something could perhaps be better than Universal Health Care, which Canada just had to increase funding to. I allready posted an article by Forbes.com that called it "The Solution to the Health Care Crisis". Is the source not worthy?

Here is more info.
http://www.msainfo.net/


Combine that with a tax incentive to create the HSA. Initially the government could provide a $500 incentive to create the HSA and also have an optional choice for the government to allocate money from your taxes and put into the HSA.

And that is another area where you are dead-wrong. Now, granted, ambulances are directed by a centralized routing station, but that has nothing to do with public or private health-care management. When my grandfather suffered a cerebral hemmorage about ten years ago, he was taken to the emergency room at one hospital (the closest one naturally), we moved him into another hospital for the followup surgery, he was then transferred to a long-term care hospital; and when we weren't impressed with the service there we put him in another facility until he passed away.

Where exactly are you getting your information on how our Health Care system works, because you've been wrong on almost every step; yet you profess to know what you're talking about.



I didn't leave it out. The issue of paying for someone else's BASIC medical concerns was a central part of my post. Go back and reread it.



I never said that Universal Health Care wasn't socialized medicine; I was just explaining the numerous ways you were wrong in your understanding of how it works.

However, there is a difference between a government owned insurance company and socialism. If you can't see that then I don't understand how to proceed with the debate. UHC is no different than any number of programs offered by the U.S. (such as welfare), yet the United States isn't a socialist state. More to the point, I don't see what relevance this has? That was the point of my statement... Although I can see how you would misunderstand that given that I used the phrase: How is that relevant



Huh? I don't understand. I don't take offense to alternate ideas of health care. I do dislike your gross and insulting misrepresentations though, which you have made no effort to either refute or condede to.

As for the Forbes article, I suggest it is YOU are the one who needs to reread it. Regardless, when I'm looking for an intelligent source on HEALTH-CARE, a business magazine isn't the first place I look, but that's just me.

Now your other citation is interesting, if only that it exposes the flaw in your reasoning. You will notice that there is NO DISCUSSION of UHC. All it does is suggest that an HSA system is preferable to the current American system. No kidding. Just about any reorganization of American health-care would result in a better system.

There is an interesting trend in your posts that is worth interrogating a bit. You are opposed to paying for other people's health services, but you are all for a "tax incentive" or "tax deduction." You do understand that either term describes an indirect COST to the government, which you would in the end pay for, correct?There are what, about 120 million people who already have and pay for health insurance, right? (That's excluding the elderly and dependents, and those who have no insurance costs because they can't afford it.) If you figure that the average person in the U.S. pays about 17% in taxes on their income a $500 deductible would cost, wait for it... $10.2 BILLION DOLLARS. Now, if instead of a deductible we instead we have an actual rebate or grant of $500 directly for said account, then all of a sudden you're looking at $60 BILLION DOLLARS. That money would be paid for through your taxes, or a cut in military spending. Given that the U.S. government cannot legally incur any more debt, that would be a problem, no?

Now, I won't claim that this would be cheaper (for the government) than UHC. My point is to demonstrate that you would still end up paying for the system you propose.

According to Health Canada the system is;

"Canada's publicly funded health care system is best described as an interlocking set of ten provincial and three territorial health insurance plans. "

On the Alberta insurance web site it lists;

"How do I find a health service provider in Alberta?
Contact the College of Physicians and Surgeons of Alberta, which is responsible for licensing and monitoring physicians in the province"
http://www.servicealberta.ca/pages/faq.asp?EK=112&CK=12826

Again, admittedly I could be wrong but from my understanding you are limited as to whom you can visit.





If it's not life threatening they are rejected or billed depending on the circumstances. If they dont pay the bill then they will certianly be rejected next time. That's how it should work.



You may not believe that is relevant but for those of us that do not hold the belief that we should take things away from you for the behalf of the common good it is relevant.

You are also assuming that I do not hold issue's with the current American system.



I dont hold an issue of my taxes being raised for my HSA because all of that money goes directly to me.



Exactly how does it "expose" the flaw in my reasoning? HSA's are relatively new so there are not many statistics and data to back them up.

http://www.bankrate.com/brm/news/insurance/20040114b1.asp



This outlines the main benefit of HSA over UHC.

http://www.bizjournals.com/sanantonio/stor.../12/focus7.html



http://www.4therapy.com/consumer/condition...categoryid=112&



http://sanjose.bizjournals.com/sanjose/sto...24/daily13.html

You ARE wrong. They don't TELL you who you can visit. The College of Physicians and Surgeons of Alberta is no different than any other professional Medical Organization on the continent. If you called the Illinois branch of the American Medical Association, I'm sure they'd point you to a doctor or other specialist as well. So you ARE wrong. If you could accept that fact then you wouldn't have so much trouble comparing the two systems.



True. Of course that means that there are 40 million people out there who when their life isn't threatened, just have to be sick and deal with it.



Actually I assumed that you did. However, since you framed the discussion in terms of practical assessments I figured it would bethe best way to engage you.



There is two ways to look at HSA's. One, it would include EVERYONE in the U.S. If that's true then it won't all go to you, your taxes will be paying for those people who don't pay the same amount of taxes as yourself. Also, since the wealthy pay a disproportionate amount of taxes, they will be paying a disproportionate amount as well... unless you only care when YOU have to pay for the common good, that's a problem.

Now, I have a question regarding those last two articles you cite? What relevance do they have? We all know that medical care is expensive. As far as I can tell they contribute nothing to the debate.



Umm, no it doesn't. I don't know if I can explain this is any more simple terms: HSA's have only been compared to the CURRENT AMERICAN SYSTEM. They have not been compared to ANY form of UHC.

OK so I am wrong. Let's drop that and focus on my main point, which you seem to misunderstand (explained below).



First of all HSA's will not include EVERYONE they will simply be AVAILABLE to everyone. The government is not actually paying for the HSA but is simply giving a tax credit to establish the HSA which mean's that instead of taking your money for taxes they are diverting the money you make and putting it into an HSA for your own health care. No one pay's for anyone else's HSA. $500 in taxes is easily made up by any job. See it as a private social security account. All of the money that is put into it you actually made.



You are completely missing the point that I was making. UHC seriously opens up the system to abuse because people will see the doctor for such minor ailments such as a cold or because they think it will help them with their stress because they dont have to pay for it (or at least that is how they see it). Also doctor's are more likely to abuse a system that is funded by the government, take medicare for example. Doctors overcharge medicare for drugs and what is to prevent them from making unnecessary appointments so they can get payed more?

HSA's are exactly the opposite. That is the comparison that I am making, and that is what the links where about. With that in mind, take a look at the quotes I pulled from the links again.

In my opinion, I believe that a universal healthcae system is a very poor option for considering revaluating the United States Healthcare System. Who would want to wait in lines for a heart transplant, bone marrow, or blood just so that they do not have to pay for it. I feel that they way our government runs our health care is sufficient. I believe that private insurace company's provide the benefits and services that are needed in order to get premium healthcare. I would rather pay a little money in order to get my heart transplant fast enough so that I do not die. If there needs to be any reform to consider in this system, I would suggest putting more money towards medicare for those who cant afford other private insurances. This way, almost everyone in the country is guaranteed a chance at life.

In a single-payer health system I don't think there would be people waiting in lines for heart transplants, but in our current system I know that many people who need life-saving surgery have to do without it because they cannot afford it.

And I guess it boils down to this: if you cannot afford to receive medical treatment, is it because you don't deserve it, or your kid goes without because he or she was born into the wrong (poor) family? Was it the intention of the Founders to have a non-monarchial aristocracy in this country that alone enjoyed the benefits the government provided? Of course not; first, there were no medical benefits to be had aside from having a physician make a house call; secondly, their responsibilities did not include some 280,000,000 people living here from coast to coast, with two states outside of our natural borders. The fact remains, though, that there was no classist structure placed within the Preamble, the Bill of Rights, or the Constitution proper.

The response of many to these questions is, Is it my fault they are living in such poor circumstances? The answer is no. But is it their fault when they are aware of people in such circumstances and opt to do nothing to help them out when they could? The predominant religious/moralistic thinking in our nation would indicate yes.

So how do we make the government's health policies more in accordance with the majority's professed values regarding our treatment of fellow human beings?

Neither a bleeding heart nor a stone-cold heart is terribly helpful when it is a citizen's will that ultimately dictates the message that will go to Congress regarding continuing needs in our health care system.

I have seen too many commendable concepts implemented as societal liabilities. That the government can do a good job of ensuring that everyone has health care requires a leap of faith or suspension of disbelieve that is beyond me in this case.

Also, I have lived all my life beside Canada, listening to and watching their media. The state health care system there is a progressively deteriorating heartbreak.


We might expand corporate medicine, aggrandize insurance companies, and buracratize our hospitals, but whether this would actually give us Universal Health Care seems doubtful.


Optimism and hope are the main pros weighing in for UHC.

The USA has a strong, independent medical tradition.

Insurance companies have a vested interest in the status quo.

Well-resourced people would likely see impairments to the quality of the health care they receive.

Unresourced folks presently have to be creative, dicker with the system. Under UHC, they would suddenly have lots of new company.

I am only going to say this one more time. Beyond that, either you choose to ignore me, or you are incapable of understanding what it is I am saying...

Canada's Health Care system is NOT failing. It DOES have problems, but I've seen numerous sentiments here and elsewhere, expressed by people who have had little or no first hand experience, and only bad second-hand journalism; that suggest that it is. The facts are that Canadians still live longer and healthier lives than Americans, we still have regular coverage regardless of where we live or how much money we work, and we ALL have access to advanced medical services when we need it.

I fail to understand how someone can tell me that our Healthcare system is failing when the VAST MAJORITY of Canadians all feel it is still working. There are problems, as I said, but they pale in comparison to the problems that private health-care present. Ted, shallow generalizations prove nothing, only the dearth of facts that you bring to this debate.

Here in the UK we have a more "socialist" medical system than anything in Canada - instead of private companies being paid out of a government run fund, the medical system itself is government-funded. (In recent history, somewhat under-funded).
It's incontrovertibly true in such a system that most non-urgent elective surgery (for example, a hip replacement) is rationed according to available resources, which in most cases does not mean surgical equipment or even operating theatres, but more usually surgical staff. It does not mean that the surgery is of an inferior standard when it does happen.
However, prospective heart, bone marrow, or other transplant patients in the UK are not held in lines because there are no resources to carry out the transplant but because it takes time to find a suitable donor organ that is a correct tissue match. This will be the case for transplant patients in the US healthcare system, as anyone who thinks about it for a moment will understand.

I'm not really saying that there aren't some advantages to a largely private healthcare system for those that are covered by it - more that you couldn't have picked worse examples!

It seems to me, though, that the whole case against a more socialised medical system in America (i.e. more than currently, not necessarily to the extent of the UK) is a prime example of the best being the enemy of the good. Sure, the top end of US medical care is the best in the world. However, very few people have easy access to it - even a rich man with chronic problems is going to run out of money (or become uninsurable) eventually.

On the national scale, America spends on health care one of the highest proportions of GDP in the developed world - the bulk of which is made up of private transactions - yet on most of the broadest measures of health (infant mortality & longevity in particular) the US lags behind countries with more "socialised" medicine.

Looked at from the perceptive of the whole of American society, it must surely be worthwhile to accept a slight deterioration in the standard of care for a select few (actually this probably wouldn't happen - even a socialised system like ours doesn't prevent rich people buying medical care privately - after they've paid their taxes, of course) in return for a good basic standard of care for everyone.

However, while it seems to make eminent good sense to do it, I can't see it ever happening in the US, because the combination of individualism and mistrust of government that on their own can be very healthy things seems to coalesce into a kind of why-should-I-pay-for-someone-else, tax-o-phobia when considering health care (or welfare), as exemplified in this thread by Vampiel

In reply to which, Vamp, why should you pay for someone else's healthcare out of your taxes, especially if you knew that they would be footing the bill if you ever needed it?

I have never really understood the argument that you shouldn't pay any tax that you do not get the full monetary value of personally. Did you pay for your own education? (No) Did the taxes your parents paid while you were in school pay in full for the cost of the education you received? (It's very doubtful). If your answers at all correspond with the ones I've anticipated in parentheses, you started out owing your fellow citizens. Why should you pay taxes for defence if you aren't personally getting a 24-hour bodyguard? Why should you pay taxes for roads if you don't drive? This line of argument is a slippery slope that leads to anarchy, not to liberty. If you think that's a good idea, fair enough.

While im not a big fan of our education system and would like for it to be privatized (though with heavy government involvment) I will address your other points. Do I use roads, uh yea. Will I send my children to school should I have any, uh yea. Does the military protect me, uh yea. Do I use health care, maybe, perhaps, sometime. When I do use health care would I have not been able to pay for it? Not me. I have seen a doctor twice in my entire life. Once for strep throught when I was 15 and another time for an ear infection which I payed for in full.

As I stated before I have absolutely no problem with paying for roads, power lines, water treatment plants, the military, and other various luxeries I simply never use health insurance. And when I do I would like to be able to have that provided as an option for me to get health insurance. If there is something that is life threatining I have no problem paying for someone elses heart transplant. However I do have a problem with paying for someone elses cold, stress, or other minor ailments. Which is also what I fully expect from others. I dont have health insurance and if im on the verge of death I would hope the tax payers would pick up the bill as I have no problem doing. However if I have a cold and dont have health insurance..... tuff.

According to Alberta Health's website :