Full Version: Universal Health Care
A couple of points about UHC:
One of the problems with the current system is the lack of any connection between the recipient of care and the pricetag. Most health insurance is covered by employers, and employees (i.e. insurance users) have no connection to how much their care costs the company they work for. In all cases, such a disconnect between the price and the demand causes price to skyrocket. I think a program such as DP is advocating (where employers contribute to the plans of their employees, but the employee is ultimately responsible for the costs) would work much better.
Loved To Death: Will Canada's "Universal" Health Care System Come to America?
In Canada and Britain, there is a shortage of doctors, especially in certain specialties. Young doctors are leaving Canada in large numbers. More young doctors leaving Canada:
We're losing docs
This article was from last week. After reading that, an actual scenario of the negatives caused by UHC, who wants to sign up?
-Lower pay
-Lower research opportunities
-Worse working conditions
Bright young minds will turn to law or business rather than medicine.
Canadian Health Care in Crisis
The British model has similar problems. Americans, especially, do not want to be inconvenienced, which is what a single payer system will do, regardless of the economics involved. It will create a disincentive for people to become doctors if the government mandates what can be charged by whom.
Someone once said that the trend of the 20th century was abandoning what works for what sounds good. Unfortunately, centralized health is one of those plans which sounds good on paper but doesn't work as well in real-world implementation.
One of the problems with the current system is the lack of any connection between the recipient of care and the pricetag. Most health insurance is covered by employers, and employees (i.e. insurance users) have no connection to how much their care costs the company they work for. In all cases, such a disconnect between the price and the demand causes price to skyrocket. I think a program such as DP is advocating (where employers contribute to the plans of their employees, but the employee is ultimately responsible for the costs) would work much better.
Loved To Death: Will Canada's "Universal" Health Care System Come to America?
In Canada and Britain, there is a shortage of doctors, especially in certain specialties. Young doctors are leaving Canada in large numbers. More young doctors leaving Canada:
We're losing docs
QUOTE
More than 3.6 million Canadians didn't have a regular doctor last year, and many suffered a lack of basic preventive care, winding up in emergency rooms at far higher rates than those with doctors, according to a Statistics Canada survey released last month.
Add steadily growing patient waiting lists and an aging population of doctors swamped by demand and an economic crisis lies quietly in wait.
"We're short 10% and some specialties more than others. It has a tremendous ripple effect throughout communities," said Rapin, an emergency room doctor who also teaches at Queen's University.
"The practice environment has deteriorated and Ontario is no longer a preferred destination for newly trained doctors."
Add steadily growing patient waiting lists and an aging population of doctors swamped by demand and an economic crisis lies quietly in wait.
"We're short 10% and some specialties more than others. It has a tremendous ripple effect throughout communities," said Rapin, an emergency room doctor who also teaches at Queen's University.
"The practice environment has deteriorated and Ontario is no longer a preferred destination for newly trained doctors."
This article was from last week. After reading that, an actual scenario of the negatives caused by UHC, who wants to sign up?
-Lower pay
-Lower research opportunities
-Worse working conditions
Bright young minds will turn to law or business rather than medicine.
Canadian Health Care in Crisis
QUOTE
CJ: You know, there seems to be a belief that somehow Canadian health care is free to Canadian citizens. Is it free?
Crowley: Well, as we say in the technical language, it’s free at the point of service. You don’t pay when you go to see the doctor. On the other hand. . .
CJ: You pay, though.
Crowley …You do pay. There is no free lunch. It takes about seven percent of the Canadian GDP. In other words, seven percent of the national wealth, in order to pay for the public health care system in Canada, and that’s an amount that’s been rising faster than GDP growth. It’s rising faster than tax revenues. It’s rising faster than all other forms of public spending, so it’s really become quite unsustainable, and clearly it’s going to get worse.
CJ: Now how long can that go on, if costs are continuing to rise?
Crowley: The average Canadian province—which provides most of the health care services, it’s like an American state—used to spend 30 percent of its budget on health care. It now spends 50 percent of its budget on it. That’s up over the last 30 years.
CJ: Half of its budget in health care?
Crowley: Half of every dollar spent by the provinces in Canada. The provinces are much bigger than states. Their budgets are much bigger. They have much bigger responsibilities. Fifty percent of the average province’s spending now goes on health care. It’s growing faster than their economy. It’s growing faster then their tax revenues. They’re just falling behind all the time.
CJ: Now, I find that fascinating, because one of the myths that you hear about the Canadian system is that it’s able to keep costs under control, while the criticism of the U.S. system is that it really encourages over-consumption, because there’s no relationship between, for most of us, what we pay for a service and what the actual cost is for that health care, so it sounds to me like you’re saying the Canadian system is not more efficient.
Crowley: Well, my view is that it’s not a great system for keeping costs under control. It’s very good at making sure that bureaucrats decide who gets what health service. You know, if they decide that you should be queuing up for an MRI or if it’s going to take eight months to get a hip replacement, or whatever, they can do that. But they’re not very successful at reducing costs, and indeed, if Canada hadn’t enjoyed very significant faster economic growth than the United States in the ’70s and ’80s, we would’ve had the most expensive health care system in the world. It was our faster economic growth that was keeping us afloat.
CJ: One vexing question that we deal with here in this country is the question of the uninsured. Now, the Canadian system covers every citizen as I understand it. But there’s a tremendous wait for services, is there not?
Crowley: Well, we have to be a little bit careful, but it’s certainly true that for many services there are significant waits. The worst I’ve heard is for an MRI scan in Saskatchewan is 22 months. Recently the province of Ontario had to send cancer care patients to New York state because the cancer treatment waits were simply too long in Ontario.
CJ: Now one of the common beliefs about the Canadian system is that somehow it empowers poor people, while the criticism of the U.S. system is that our system either ignores the poor or it provides them with sometimes substandard or untimely care. Is the Canadian system really better at providing service for the poor?
Crowley: Well, the poor don’t think so. If you look at polling results, what the poor actually say, more poor people are interested in being able to buy private coverage and pay for health-care services than people who are better off and better-educated. People under $25,000 a year, about half of them want to be able to buy private insurance for their own health care, whereas people over $75,000, it’s less than 40 percent of them are interested in that. And in my view, and I think this has been borne out by the research that has been done on the Canadian system, is that medical care in the Canadian system is distributed in middle- class networks; you know, the articulate, the smart, get around the obstacles in the system, they get in the face of providers, they get what they need. But if you’re not able to — you know, payment makes you powerful. I think one of the things that we’ve learned from the Canadian system is that when you deprive people of the ability to pay for health care if they think it’s important to them, that you really do disempower them.
Crowley: Well, as we say in the technical language, it’s free at the point of service. You don’t pay when you go to see the doctor. On the other hand. . .
CJ: You pay, though.
Crowley …You do pay. There is no free lunch. It takes about seven percent of the Canadian GDP. In other words, seven percent of the national wealth, in order to pay for the public health care system in Canada, and that’s an amount that’s been rising faster than GDP growth. It’s rising faster than tax revenues. It’s rising faster than all other forms of public spending, so it’s really become quite unsustainable, and clearly it’s going to get worse.
CJ: Now how long can that go on, if costs are continuing to rise?
Crowley: The average Canadian province—which provides most of the health care services, it’s like an American state—used to spend 30 percent of its budget on health care. It now spends 50 percent of its budget on it. That’s up over the last 30 years.
CJ: Half of its budget in health care?
Crowley: Half of every dollar spent by the provinces in Canada. The provinces are much bigger than states. Their budgets are much bigger. They have much bigger responsibilities. Fifty percent of the average province’s spending now goes on health care. It’s growing faster than their economy. It’s growing faster then their tax revenues. They’re just falling behind all the time.
CJ: Now, I find that fascinating, because one of the myths that you hear about the Canadian system is that it’s able to keep costs under control, while the criticism of the U.S. system is that it really encourages over-consumption, because there’s no relationship between, for most of us, what we pay for a service and what the actual cost is for that health care, so it sounds to me like you’re saying the Canadian system is not more efficient.
Crowley: Well, my view is that it’s not a great system for keeping costs under control. It’s very good at making sure that bureaucrats decide who gets what health service. You know, if they decide that you should be queuing up for an MRI or if it’s going to take eight months to get a hip replacement, or whatever, they can do that. But they’re not very successful at reducing costs, and indeed, if Canada hadn’t enjoyed very significant faster economic growth than the United States in the ’70s and ’80s, we would’ve had the most expensive health care system in the world. It was our faster economic growth that was keeping us afloat.
CJ: One vexing question that we deal with here in this country is the question of the uninsured. Now, the Canadian system covers every citizen as I understand it. But there’s a tremendous wait for services, is there not?
Crowley: Well, we have to be a little bit careful, but it’s certainly true that for many services there are significant waits. The worst I’ve heard is for an MRI scan in Saskatchewan is 22 months. Recently the province of Ontario had to send cancer care patients to New York state because the cancer treatment waits were simply too long in Ontario.
CJ: Now one of the common beliefs about the Canadian system is that somehow it empowers poor people, while the criticism of the U.S. system is that our system either ignores the poor or it provides them with sometimes substandard or untimely care. Is the Canadian system really better at providing service for the poor?
Crowley: Well, the poor don’t think so. If you look at polling results, what the poor actually say, more poor people are interested in being able to buy private coverage and pay for health-care services than people who are better off and better-educated. People under $25,000 a year, about half of them want to be able to buy private insurance for their own health care, whereas people over $75,000, it’s less than 40 percent of them are interested in that. And in my view, and I think this has been borne out by the research that has been done on the Canadian system, is that medical care in the Canadian system is distributed in middle- class networks; you know, the articulate, the smart, get around the obstacles in the system, they get in the face of providers, they get what they need. But if you’re not able to — you know, payment makes you powerful. I think one of the things that we’ve learned from the Canadian system is that when you deprive people of the ability to pay for health care if they think it’s important to them, that you really do disempower them.
The British model has similar problems. Americans, especially, do not want to be inconvenienced, which is what a single payer system will do, regardless of the economics involved. It will create a disincentive for people to become doctors if the government mandates what can be charged by whom.
Someone once said that the trend of the 20th century was abandoning what works for what sounds good. Unfortunately, centralized health is one of those plans which sounds good on paper but doesn't work as well in real-world implementation.
I regard UHC as a great idea - however I view German system as a model, in which there's a very low degree of government intervention. Essentially, there's a comprehensive network of self-governed, decentralized "health and sickness funds" which provide coverage to nearly 100 percent of the population. My wife lived in Germany for several years in mid-1990s and she has very fond memories about how the entire system works. She said that she never heard the horror stories that people like to tell about Canadian/British system and she personally never had to wait more than a couple of weeks for a doctor's appointment. For a more detailed description on how the German system works see here or here.
P.S. Truth to be told they have been experiencing some financial difficulties recently and in 1997 a bill was passed which changed some details of how the system works, but the basic principle remains the same.
P.S. Truth to be told they have been experiencing some financial difficulties recently and in 1997 a bill was passed which changed some details of how the system works, but the basic principle remains the same.
Amlord, you realize that you are citing an interview with a right-wing ideologue, one who provides no evidence or sources for his opinions, don't you?
Has UHC declined in Canada? Yes, to a degree. In many areas this decline can be attributed to a "neo-liberalization" of government. The federal government cut transfer payments to the individual provinces extensively in the early 90's, and the provinces, instead of maintaining funding levels chose to instead cut services and blame the federal government; publicly positioning themselves for the continuing debate on provincial versus federal rights.
This process is most visible in Ontario where an extremely conservative government chose to cut funding to health-care quickly and haphazardly; specifically to create room for private-health care services. If you want to use Ontario as an example of the weakness of health-care, all you are doing is demonstrating yet again that the politics of privatization are a failure. Sorry; nice try though. I really do wish you'd actually provide some context though.
More to the point, the veiled criticism on social-programs that your 'citation' provides is more a criticism of the current implimentation of UHC; not the basic concept itself. The fact is that health-care costs are growing just as fast if not faster in the United States. These cost expansions have nothing to do with politics or organization; but rather with factors such as a rapidly-aging population, the proliferation of new technology and techniques, and poor infrastructure planning (in Canada); whereas the latter in the U.S. can be exchanged with the rising costs of liability (which is more tempered in Canada.)
Has UHC declined in Canada? Yes, to a degree. In many areas this decline can be attributed to a "neo-liberalization" of government. The federal government cut transfer payments to the individual provinces extensively in the early 90's, and the provinces, instead of maintaining funding levels chose to instead cut services and blame the federal government; publicly positioning themselves for the continuing debate on provincial versus federal rights.
This process is most visible in Ontario where an extremely conservative government chose to cut funding to health-care quickly and haphazardly; specifically to create room for private-health care services. If you want to use Ontario as an example of the weakness of health-care, all you are doing is demonstrating yet again that the politics of privatization are a failure. Sorry; nice try though. I really do wish you'd actually provide some context though.
More to the point, the veiled criticism on social-programs that your 'citation' provides is more a criticism of the current implimentation of UHC; not the basic concept itself. The fact is that health-care costs are growing just as fast if not faster in the United States. These cost expansions have nothing to do with politics or organization; but rather with factors such as a rapidly-aging population, the proliferation of new technology and techniques, and poor infrastructure planning (in Canada); whereas the latter in the U.S. can be exchanged with the rising costs of liability (which is more tempered in Canada.)
QUOTE(Ultimatejoe @ Jul 29 2004, 01:33 PM)
Amlord, you realize that you are citing an interview with a right-wing ideologue, one who provides no evidence or sources for his opinions, don't you?
You do realize that I am a right wing ideologue? (read: one who disagrees with a liberal)
Canada's health system is simply a no-go for most Americans.
Here's another article: Can 7,700 Doctors Be Wrong About Health Care?
QUOTE
Claim No. 1: Canada's System of Socialized Medicine Provides Sufficient Money to Deliver Care to All.
Canada spends about 9% of its GDP on health care and provides coverage for all, while the U.S. spends 14% and has millions of people uninsured. Proponents of a Canadian model thus conclude that the federal government could cover every American for what the country is spending now -- or less.
That argument ignores the fact that there is no government-run health care system in the world that is adequately funded. And the reason is simple: health care must compete with education, welfare, defense and other valid claims on government funds. As a result, every government-run system rations care, with bureaucrats and elected officials deciding who gets what and when.
Case Study: Canadian hospitals need money. On Dec. 24, 1999, the Toronto Star reported, "The Ontario government is bailing out deficit-ridden hospitals to the tune of $196 million." This infusion marked "the second year in a row the Tory government has come to the rescue of about half of the province's hospitals." Indeed, the Ontario hospital system was forced to absorb a 10% decrease in funding between 1997 and 1999.
Case Study: The shortage of doctors. Just one day earlier, Dec. 23, 1999, the Toronto Star ran the headline: "Ontario Government Report Calls For Up To 1,000 More MDs." In response to the report, the province's health minister said the government would provide "$11 million in 'short-term' aid . . ." and try to attract more foreign doctors, according to the article.
Case Study: Shortages in the ER. Residents of Montreal can rest a little easier this summer. Doctors reached an agreement with the provincial government in Quebec so that emergency rooms will remain open, according to the Montreal Gazette (June 20, 2003). "In the summer and fall of 2002," the paper reports, "Quebec's general practitioners fought a pitched battle against Bill 114, a new law that compelled doctors to work in understaffed ERs or face $5,000 fines."
Canada spends about 9% of its GDP on health care and provides coverage for all, while the U.S. spends 14% and has millions of people uninsured. Proponents of a Canadian model thus conclude that the federal government could cover every American for what the country is spending now -- or less.
That argument ignores the fact that there is no government-run health care system in the world that is adequately funded. And the reason is simple: health care must compete with education, welfare, defense and other valid claims on government funds. As a result, every government-run system rations care, with bureaucrats and elected officials deciding who gets what and when.
Case Study: Canadian hospitals need money. On Dec. 24, 1999, the Toronto Star reported, "The Ontario government is bailing out deficit-ridden hospitals to the tune of $196 million." This infusion marked "the second year in a row the Tory government has come to the rescue of about half of the province's hospitals." Indeed, the Ontario hospital system was forced to absorb a 10% decrease in funding between 1997 and 1999.
Case Study: The shortage of doctors. Just one day earlier, Dec. 23, 1999, the Toronto Star ran the headline: "Ontario Government Report Calls For Up To 1,000 More MDs." In response to the report, the province's health minister said the government would provide "$11 million in 'short-term' aid . . ." and try to attract more foreign doctors, according to the article.
Case Study: Shortages in the ER. Residents of Montreal can rest a little easier this summer. Doctors reached an agreement with the provincial government in Quebec so that emergency rooms will remain open, according to the Montreal Gazette (June 20, 2003). "In the summer and fall of 2002," the paper reports, "Quebec's general practitioners fought a pitched battle against Bill 114, a new law that compelled doctors to work in understaffed ERs or face $5,000 fines."
If you liked that one, you should read their debunking of three other myths:
QUOTE
Claim No. 2: Canada Provides Universal Access to Care.
Claim No. 3: The Quality of Care in Canada Is as Good as or Better than the U.S.
Claim No. 4: In Canada's System, Everyone Is Treated the Same.
Claim No. 3: The Quality of Care in Canada Is as Good as or Better than the U.S.
Claim No. 4: In Canada's System, Everyone Is Treated the Same.
The Canadian system has serious flaws in it. It is rationed health care, just like any other government service. Unexplainably, it is illegal to seek private care for things that the government covers. The waiting lines are onerous.
The Canadian example alone should make people do a double take over UHC. That is in a system with 1/10 the participants that a system in the United States would have.
QUOTE(Amlord @ Jul 29 2004, 11:17 AM)
QUOTE(Ultimatejoe @ Jul 29 2004, 01:33 PM)
Amlord, you realize that you are citing an interview with a right-wing ideologue, one who provides no evidence or sources for his opinions, don't you?
You do realize that I am a right wing ideologue? (read: one who disagrees with a liberal)
I think what was meant is that the article you cited is the equivalent of citing an interview with Ann Coulter or O'Reilly as proof of something.
Additionally, the article I cited is from the American Medical Student Association. I would tend to think that is a more credible source than some conservtaive paper. Pundits commenting on something or doctors and medical students commenting on something, hmmm who to believe.
The points in the article I cited are in almost direct conflict with your source. Therefore, one of them is wrong and I'm thinking it probably isn't American doctors.
QUOTE
MYTH: Canadian physicians are unhappy with their system.
FACT: Nearly two-thirds are either "satisfied" or "very satisfied." About 500 Canadian doctors emigrate to the United States each year-representing about 1 percent of all Canadian doctors. Some return to Canada.
MYTH: U.S. physicians don't want a single-payer universal health plan.
FACT: Despite pervasive negative spin, 57.1 percent of U.S. physicians believe a single-payer system with universal coverage would be the best option for the United States, according to a 1999 New England Journal of Medicine survey.
FACT: Nearly two-thirds are either "satisfied" or "very satisfied." About 500 Canadian doctors emigrate to the United States each year-representing about 1 percent of all Canadian doctors. Some return to Canada.
MYTH: U.S. physicians don't want a single-payer universal health plan.
FACT: Despite pervasive negative spin, 57.1 percent of U.S. physicians believe a single-payer system with universal coverage would be the best option for the United States, according to a 1999 New England Journal of Medicine survey.
QUOTE(Amlord @ Jul 29 2004, 06:17 PM)
The Canadian example alone should make people do a double take over UHC. That is in a system with 1/10 the participants that a system in the United States would have.
It is incredible how much these right-wing biased American think tanks know about Canada. I mean, their reports dig into the hidden parts of canadian life, so hidden in fact that I have never seen them.
I, nor my family, nor anyone I know have never had to wait at ALL for any kind of urgent proceedure, and never had to wait more than about 10 days for any kind of optional proceedure, and that one 10-day wait was the exception.
To listen to the far-right American pundits you would think we were all standing in line bleeding out wating for the next opening next month to have the bullet wound in our guts healed. Yet astonishingly, despite the claims of these far-righters, Canada maintains a higher average standard of life, a higher average lifespan, a lower infant mortality rate, a lower surgical nortality rate, a similar doctor-to-patient ratio, and a lower incidence of post-operative infections then the US.
How can this be if our medical system is so badly on the verge of collapse? Are Canadians really genetic supermen?
Yes, there was a bailout of some Ontario hospitals recently. That was already explained by UltimateJoe of course, but regardless.
QUOTE
The Canadian system has serious flaws in it. It is rationed health care, just like any other government service. Unexplainably, it is illegal to seek private care for things that the government covers. The waiting lines are onerous.
Actually little of this has any basis in truth. Certainly there are problems with canadian health care, it is not a perfect system, and needs some tweaking. The fact that it is illegal to seek private care is not inexplicable at all, it is against the canada health act, preventing a 2-tier system. The waiting lines are vastly exaggerated, and in general are the ame as the US.
If the US decides that it would rather have its poor die then have medical care, that is entirely up to them. But don't pretend that the reason you will not develop health case has anything to do with the 'failure' of the system in canada. By ANY MEASURABLE MEANS, health care in canada is better than in the US.
Do you think there might be a reason why the US is the ONLY first world nation NOT to have some form of universal health care system?
Yes, ONE possibility is that ONLY the US is correct, and everyone else made a stupid decision which will result in the collapse of their economies and the ruination of their population. Mind you, thats certainly not the case so far, but I guess it is a possibility.
If not a very likely one.
Gee, thanks for ignoring everything I wrote in my last post after the first sentence. As I explained above; the crisis in Ontario's health-care system was the result of political mismanagement under the Conservative government which was in power from 1995-2003. You have done nothing to disentangle your argument from that fact.
The Toronto Star, which is a decidedly liberal paper; ran extensive coverage of the Ontario Government's mismanagement of hospitals. Hospitals which had had their funding reduced dramatically in the past four years so the government could press on with income tax cuts of 30%; crippling their ability to manage. This is an issue I know of first hand as I watched first hand the entire proceedings, and an uncle of mine was at various times the head of two different hospitals and responsible for the amalgamation of hospital services; as well as implimenting government procedure. He will tell you what I am telling you (and you are ignoring or unable to comprehend), the government sacrificed health-care quality to push forward tax-cuts, and proceeded with their spending cuts in a hap-hazard fashion, with no long-term planning and no understanding of the mechanics of what they were trying to do.
I see once again you have taken to relying on a right-wing political rag which is more intent on securing quotes and headlines than actual evidence. Are there problems with UHC? Of course. Some rationing does take place. In the U.S. care is rationed by how much money you have. In Canada it is rationed on how much tax revenue it receives. That's it. A simple little difference. Instead of digging up this trash why don't you actually argue that a system where individual circumstance determines the quality of care is better. People would still disagree with you; but at least you would be engaging in a real debate instead of a cheesy polemic.
Here's something your research (to use the term loosely) hasn't dug up; most Canadians LOVE their health-care. The fact that it has become victim to a small yet vocal chorus of right-wing groups that would dismantle it does nothing to diminish it's successes.
Here's an idea; lets look at some facts. The World Health Organization provides an easy breakdown of six statistical indicators to measure health-care. I will provide a comparison between Canada and the United States.
Life Expectancy
Canada: 77.2/82.3
United States: 74.6/79.8
Healthy Life Expectancy at Birth
Canada: 70.1/74.0
United States: 67.2/71.3
Child Mortality (per 1000 births)
Canada: 6/5
United States: 9/7
Adult Mortality (per 1000)
Canada: 95/58
United States: 140/83
Total Health Expenditure per capita
Canada: $2,792
United States: $4,887
Expenditure as % of GDP
Canada: 9.5
United States: 13.9
So if our health-care system is in such a shambles, I guess Canadians are just by nature more long-lived since we live longer, healthier lives at less of an expense. Of course, my evidence makes a poor substitute for your op-ed pieces.
The Toronto Star, which is a decidedly liberal paper; ran extensive coverage of the Ontario Government's mismanagement of hospitals. Hospitals which had had their funding reduced dramatically in the past four years so the government could press on with income tax cuts of 30%; crippling their ability to manage. This is an issue I know of first hand as I watched first hand the entire proceedings, and an uncle of mine was at various times the head of two different hospitals and responsible for the amalgamation of hospital services; as well as implimenting government procedure. He will tell you what I am telling you (and you are ignoring or unable to comprehend), the government sacrificed health-care quality to push forward tax-cuts, and proceeded with their spending cuts in a hap-hazard fashion, with no long-term planning and no understanding of the mechanics of what they were trying to do.
I see once again you have taken to relying on a right-wing political rag which is more intent on securing quotes and headlines than actual evidence. Are there problems with UHC? Of course. Some rationing does take place. In the U.S. care is rationed by how much money you have. In Canada it is rationed on how much tax revenue it receives. That's it. A simple little difference. Instead of digging up this trash why don't you actually argue that a system where individual circumstance determines the quality of care is better. People would still disagree with you; but at least you would be engaging in a real debate instead of a cheesy polemic.
QUOTE
The Canadian example alone should make people do a double take over UHC. That is in a system with 1/10 the participants that a system in the United States would have.
Here's something your research (to use the term loosely) hasn't dug up; most Canadians LOVE their health-care. The fact that it has become victim to a small yet vocal chorus of right-wing groups that would dismantle it does nothing to diminish it's successes.
Here's an idea; lets look at some facts. The World Health Organization provides an easy breakdown of six statistical indicators to measure health-care. I will provide a comparison between Canada and the United States.
Life Expectancy
Canada: 77.2/82.3
United States: 74.6/79.8
Healthy Life Expectancy at Birth
Canada: 70.1/74.0
United States: 67.2/71.3
Child Mortality (per 1000 births)
Canada: 6/5
United States: 9/7
Adult Mortality (per 1000)
Canada: 95/58
United States: 140/83
Total Health Expenditure per capita
Canada: $2,792
United States: $4,887
Expenditure as % of GDP
Canada: 9.5
United States: 13.9
So if our health-care system is in such a shambles, I guess Canadians are just by nature more long-lived since we live longer, healthier lives at less of an expense. Of course, my evidence makes a poor substitute for your op-ed pieces.
QUOTE
Here's an idea; lets look at some facts. The World Health Organization provides an easy breakdown of six statistical indicators to measure health-care. I will provide a comparison between Canada and the United States.
The facts you know...numbers. The WHO ranks the US 37th in the world for health care..wow that is shameful don't you think!? And that is just the facts you know..the numbers. They take all the numbers UJ just threw up here and the numbers don't lie do they? Yet numbers give so little of the reality of the situation.
I personally am not at all surprised that the US has lower life expec. rates, life expec. at birth and overall morality rates. Yet I am not going to say the US is worse off for this..or has a worse health system for it. What you don't take into account is people with severe health conditions who will undoubtedly die a young age will not be so easily sacrificed in the US as other countries, that more money will be spent on their health, their comfort and to provide for their ultimate level of abilities. That little boy Mattie who just died comes to mind.
Oh I know it is nice to have a high level of happy healthy people living long in life..but unfortunately many humans are not born happy or healthy may in fact suffer accidents or health issues in their lives that in return shorten their lives, increase their health costs and reliance on the health system.
Do you think other countries have as high a rate as helping babies who have been determined to have critical health issues in utero complete birth and strive for life? Do you think other countries have as high a rate of providing intense medical procedures and interventions to try and save a person's life after a critical health accident or illness? If to score big with the WHO means to sacrifice your most needy countrymen.... no thank you..I am content with the America's own source of standards.
I am not in support for a UHC. I do think the American health system is in need of a lot of reform but not this kind of reform.
QUOTE(bucket @ Jul 29 2004, 01:33 PM)
Do you think other countries have as high a rate of providing intense medical procedures and interventions to try and save a person's life after a critical health accident or illness? If to score big with the WHO means to sacrifice your most needy countrymen.... no thank you..I am content with the America's own source of standards.
I am not sure where you are getting your information from bucket, but all of the facts presented thus far seem to suggest completely the opposite conclusion. That is Canadians (and other countries with UHC) have longer life expectancies because they get better care and they get timely care.
In the United States, if you don't have tons of money or a great insurance plan, you are going to get left out in the cold when it comes to expensive diseases like Cancer, Transplants, etc. I haven't heard of any Canadians complaining they had to sell their house to pay for their cancer treatment or brain tumor removal.
If you are poor in this country and you get something like cancer or need a transplant you are done for unless you just want to bury yourself in financial debt. Most people however just die, because they can't afford to pay for treatment and drugs.
I fail to see how you drew the conclusion that the top ranked WHO countries "sacrifice the most needy countrymen". If you have some facts to back that up, please do provide them.
QUOTE(bucket @ Jul 29 2004, 04:33 PM)
I personally am not at all surprised that the US has lower life expec. rates, life expec. at birth and overall morality rates. Yet I am not going to say the US is worse off for this..or has a worse health system for it. What you don't take into account is people with severe health conditions who will undoubtedly die a young age will not be so easily sacrificed in the US as other countries, that more money will be spent on their health, their comfort and to provide for their ultimate level of abilities. That little boy Mattie who just died comes to mind.
Wow. You used the numbers to argue against yourself, but didn't realize it.
If the US is so gung-ho to keep people with severe health conditions alive, why would mortality in the US be higher? Mortality is the death rate, by the way, not the life rate. If we spend so much more on their health, then they should at least live longer, right?
Just wow.
QUOTE(bucket @ Jul 29 2004, 08:33 PM)
Do you think other countries have as high a rate as helping babies who have been determined to have critical health issues in utero complete birth and strive for life? Do you think other countries have as high a rate of providing intense medical procedures and interventions to try and save a person's life after a critical health accident or illness?
Now the rationalisation is descending into the utterly absurd.
So, if I may be very sure here, you are arguing that the reason the US rates lower across the board in terms of medical care then canada is because in Canada we let babies die? Because the US, being a 'more compassionate society' will fight to keep the elderly and infirm alive while other countries will do less for them? Thatthe US is SO MUCH more caring for their children and elderly then the rest of the world... at least as long as they have money, as we are talking about the same country without universal health care, right?
Please, PLEASE tell me you realise how insane that sounds.
Sorry to dissapoint you, but every nation in the first world treats their elderly as well or better then in the US. The lask of Universal health care targets the poor and the elderly most of all, who find themselves unable to pay for the medical proceedures that might save or extend their lives. Apparently the 'super-compassionate' US doesnt extend to people without money.
Guess what? The number one North American destination for sick children in most nations in the Middle East is the Children's Hospital of Eastern Ontario. Not the US, but Canada, where their children stand a better chance of surviving. Canadians go just as far if not more for the sick and the infirm as in the US, and to Canadian doctors compassion does not stop when the patient runs out of money. my nephe was born badly premature, and was given little hope of survival, yet the doctors at CHEO busted their butts working hundreds of man hours to keep him alive, and they suceeded.
I honestly hope your post was meant as a joke, even if it wold have been at best a sick and isulting joke. If you SERIOUSLY believe that the US ranks lower in every single measure of patient care and medical service that can be measured then Canada on average because you "care more about saving sick babies" then the rest of the world, then you really need to go splash some cold water on your face.
QUOTE
MYTH: U.S. physicians don't want a single-payer universal health plan.
FACT: Despite pervasive negative spin, 57.1 percent of U.S. physicians believe a single-payer system with universal coverage would be the best option for the United States, according to a 1999 New England Journal of Medicine survey.
FACT: Despite pervasive negative spin, 57.1 percent of U.S. physicians believe a single-payer system with universal coverage would be the best option for the United States, according to a 1999 New England Journal of Medicine survey.
And could this be, perhaps, because they then wouldn't have to deal with issues of non payment for services--ie, financially motivated support, rather than philosophical or medical reasons for supporting UHC? Doctors, being in business like everyone else to make money, don't strike me as neutral observers in this.
QUOTE
Life Expectancy
Canada: 77.2/82.3
United States: 74.6/79.8
Canada: 77.2/82.3
United States: 74.6/79.8
Perhaps that's because Canadian's don't have to deal with the constant stress of being hated by everyone else around the world (oops, sorry, wrong thread)
As to the other statistics here--I am not against UHC because I think it will be ineffective (although that is a possibility). My concerns stem from the likely additional costs. The issue is really quite simple. There are millions (was 30 million the figure?) of uninsured people out there. Demonstrate to me that we can insure those 30 million people without costing me any more money, and my objections go away. If you fail to do that, you need to quantify to me what benefits I am receiving for the additional money I will be spending. I don't need aggregate statistics here. I need to know how I will benefit. If you can't show me that, then you haven't shown that the benefits of the system outweigh the costs. Many here will still likely be in favor of UHC for its benefits to the uninsured regardless. I don't fault them for that--but I can almost guarentee you that that will never be enough to create such a system in the US.
QUOTE
Do you think there might be a reason why the US is the ONLY first world nation NOT to have some form of universal health care system?
Yes, there is. The US, as has been pointed out in numerous other threads, is far more conservatively oriented than other first world nations. Therefore, as a whole, we are less likely to look to such solutions, or accept any proposals of such unless there can be quantified benefits for all.
Let's stop with the belittling tone some of you are starting to take with each other in this thread. No one is sick, crazy, insane or joking if they state their opinions. If someone is being unconstructive, please report it. Remember to stick to the issues:
1. Do you support an effort for Universal Health Care (UHC) system in the US?
2. How realistic is the concept of UHC system in the US? Why or Why not?
3. What are the pros and cons of UHC in the States?
1. Do you support an effort for Universal Health Care (UHC) system in the US?
2. How realistic is the concept of UHC system in the US? Why or Why not?
3. What are the pros and cons of UHC in the States?
QUOTE(bucket @ Jul 29 2004, 04:33 PM)
Do you think other countries have as high a rate as helping babies who have been determined to have critical health issues in utero complete birth and strive for life? Do you think other countries have as high a rate of providing intense medical procedures and interventions to try and save a person's life after a critical health accident or illness? If to score big with the WHO means to sacrifice your most needy countrymen.... no thank you..I am content with the America's own source of standards.
Why is that that some Americans tend to think that normal human traits (such as, in this case, compassion) are featured in Homo Americana exclusively? What proof do you have to suggest that Canadians, Western Europeans, or Russians don't try to save a person's life after a critical accident or debilitating illness? Here's a link to a random Russian organization which tries to help oncological patients; it took me 1 minute to find it, I am sure there're many similar groups in every country.
If anything, our standards are somewhat lower than in many other countries... just look at all those senior citizens packing bags at Wal-Marts so they can afford the medicines they need.
QUOTE
Yes, there is. The US, as has been pointed out in numerous other threads, is far more conservatively oriented than other first world nations. Therefore, as a whole, we are less likely to look to such solutions, or accept any proposals of such unless there can be quantified benefits for all.
Wouldn't the benefit for Americans under UHC be having healthcare? That seems pretty quantifiable. You may be lucky enough to have health insurance at this point, but if you lost your job, or some other unfortunate circumstance befell you, you'd have to rely on the DGS plan - Don't Get Sick. I have a great health insurance plan, but I'd trade it for universal coverage in a second - what if I get laid off, want to try a different career, etc.
Additionally, isn't there some benefit, of a less tangible sort, in knowing that you live in a country that takes care of its own? Isn't that worth an extra percentage point of taxes, or whatever? Having grown up outside the country, I've never understood this peculiarly (at least in terms of intensity of feeling) American thing of avoiding taxes at all costs. The Swedish tax rate hovers at 50%, but they also have the highest standard of living in the world.
Rereading the quoted post, realized you're probably talking about actual health-care, benefits, as opposed to "benefits" in the more generic sense. Sorry, I'm an idiot. Doesn't change the thrust of my argument, though...
I vited no:
I actually think that much of the problem we have with rising Health Care costs is Health Insurance itself.
Every sniffle means a trip to the Doctor.
Every pain means a trip to the Doctor.
Doctors have become businessmen first and healers second. If we dropped all health insurance, and Doctors had to compete for a smaller portion of patients, costs would fall dramatically.
Just my humble opinion.
Red
I actually think that much of the problem we have with rising Health Care costs is Health Insurance itself.
Every sniffle means a trip to the Doctor.
Every pain means a trip to the Doctor.
Doctors have become businessmen first and healers second. If we dropped all health insurance, and Doctors had to compete for a smaller portion of patients, costs would fall dramatically.
Just my humble opinion.
Red
QUOTE(Ultimatejoe @ Jul 29 2004, 11:51 AM)
I guess Canadians are just by nature more long-lived since we live longer, healthier lives at less of an expense.
Actually, that is sort of what it indicates. Canadian lifestyles are more healthy in general. Teen births rates in the US are over twice that of Canada. Babies born to teen mothers are smaller and have a higher mortality rate. We also have higher drug rates, murder rates, work more hours on average, and have higher obesity rates than Canadians. That leads to a more complete picture of the reasons behind those statistics for which differences in healthcare might or might not be a factor.
QUOTE
Rereading the quoted post, realized you're probably talking about actual health-care, benefits, as opposed to "benefits" in the more generic sense....
Actually, Countrockula, these are exactly the benefits I do mean. Here is the basic gist of what I think needs to be defined. Essentially, to convert to UHC, you are indicating that a group of people who currently don't have insurance will be given insurance. This is a large group, so providing that insurance, on the face of it, is going to be expensive. Who are the ones who are going to be paying for this, then? Those who already have insurance. It seems only natural that these people are going to want to know two things: First, how much will it cost them, and Second--what benefits are they deriving from it. I think there are aspects of our current system that, if corrected in UHC, will make the cost much less than it might initially appear to be. But the actual cost needs to be defined much more clearly. For the benefits, 'soft' or intangible benefits are certainly part of the picture. I think many of us in the currently insured camp would be willing to pay a certain percent more for the safety net UHC would provide, and also a certain percent purely for the goodness of providing insurance to those who need it and wouldn't otherwise have it. However, we are very concerned over just what that percentage is really going to be, and exactly what benefits will be derived from it. Basically, health insurance is expensive. Most of us with health insurance are already bearing a fairly high burden just keeping ourselves insured. The prospect having to pay for other people's insurance as well is going to be with a great deal of scepticism. That scepticism will have to be overcome in order for UHC to have any chance of being passed, and clearly defining the costs and benefits is the way to do that. FWIW, I think this is what Hillary's commission attempted to do, but they were unsuccessful. This further adds to the scepticism, as it lends credence to the argument that it may sound good on the surface, but that when examined in detail, the costs outweigh the benefits of implementing UHC in the United States.
Right now, those of you who are insured are paying (or your employer is paying - it all comes out in the wash) 20-30% of your insurance premiums for overhead, including medical provider compliance costs.
Under UHC you would continue to pay the same amount (bear with me), but instead of going to overhead, it goes to insuring currently uninsured people.
The benefit to you, besides a warm, fuzzy, feeling, is that the American workforce experiences fewer sick days, and it becomes relatively cheaper to employ American workers. It should be a boon to the American economy.
Supposedly the additional payroll taxes involved would be offset by the reduction in premiums. I'd like to see more facts & figures as well.
I'd prefer to see reduction in spending and giveaways elsewhere used to offset the increase in deductions from my paycheck, but I suppose that's another topic altogether. I will note that we spend as much on our military as the next 10 countries do.
Under UHC you would continue to pay the same amount (bear with me), but instead of going to overhead, it goes to insuring currently uninsured people.
The benefit to you, besides a warm, fuzzy, feeling, is that the American workforce experiences fewer sick days, and it becomes relatively cheaper to employ American workers. It should be a boon to the American economy.
Supposedly the additional payroll taxes involved would be offset by the reduction in premiums. I'd like to see more facts & figures as well.
I'd prefer to see reduction in spending and giveaways elsewhere used to offset the increase in deductions from my paycheck, but I suppose that's another topic altogether. I will note that we spend as much on our military as the next 10 countries do.
QUOTE(Hobbes @ Jul 30 2004, 09:22 AM)
Actually, Countrockula, these are exactly the benefits I do mean. Here is the basic gist of what I think needs to be defined. Essentially, to convert to UHC, you are indicating that a group of people who currently don't have insurance will be given insurance. This is a large group, so providing that insurance, on the face of it, is going to be expensive. Who are the ones who are going to be paying for this, then?
In answer to this question Hobbes I'm going to draw some information from Kucinich's Plan and some of the related links at the bottom of the page. So far his plan is the best I have seen and it is in my opinion the model we should strive for, but that doesn't necessarily mean that is what we'll end up with. However, in the absence of a real plan being debated, this will do.
First, lets look at the real costs of healthcare that you pay directly or indirectly:
1. Payroll deductions from each paycheck - these vary depending on the plan you have but it isn't small change by any means, generally $100+ a month.
2. Your employer pays for the rest of your coverage via payroll taxes - these are current about 8.5 % based on industry estimates (source)
3. You pay a co-pay when you see the doctor - usually $5 to $20 for most plans.
4. You pay a co-pay when you pick up drugs - usually $5 to $20 unless your insurance doesn't cover the drug and then you pay full price.
5. You pay for deductables for some types of treatments such as ER visits and hospital stays. These vary widely with healthcare plans but the sky's the limit here and it can get expensive.
So, that is what you currently pay for if you are fortunate enough to be covered. Now under Kucinich's plan, guess how much you pay? Nothing, in fact you keep more of your paycheck.
1. The employer payroll tax would be reduced from 8.5% to 7.7% to pay for healthcare. That would raise about $920 Billion according to Kucinich and it would reduce the burden on employers putting more money in their pocket to increase your salary or grow the business.
2. The government currently spends about $1 Trillion dollars a year on state, local and federal health care according to the data on Kucinich's website. This money would be redirected into the single consolidated system.
That's basically it - no more payroll deductions, no more co-pays, no more deductables, no additional taxes. If the needs of the system were increased, it seems like a fairly simple matter of increasing the employer payroll tax slightly, since you have about .8% to work with from the current system.
The premise of Kucinich's system however is that health care coverage is a non-profit deal and private insurance companies would go the way of the dodo bird in a phased in approach. I personally very much agree with this.
So, based on that information Hobbes, what do you say about getting healthcare for everyone in the United States and paying less from your own paycheck?
QUOTE
So, based on that information Hobbes, what do you say about getting healthcare for everyone in the United States and paying less from your own paycheck?
Based on that information, it looks promising. I do still have some concerns, though.
QUOTE
1. The employer payroll tax would be reduced from 8.5% to 7.7% to pay for healthcare. That would raise about $920 Billion according to Kucinich and it would reduce the burden on employers putting more money in their pocket to increase your salary or grow the business.
This money was previously being used to pay for other items, so I'm assuming it is going to be replaced from other funds. I would need to see reassurance that those other funds won't in fact be additional taxes.
QUOTE
2. The government currently spends about $1 Trillion dollars a year on state, local and federal health care according to the data on Kucinich's website. This money would be redirected into the single consolidated system.
I would need to see evidence here that this will be sufficient to cover the costs of the new system.
QUOTE
The premise of Kucinich's system however is that health care coverage is a non-profit deal and private insurance companies would go the way of the dodo bird in a phased in approach. I personally very much agree with this.
I would have to see more of the plan details. Losing private insurance companies has the advantage of taking out the middle man, with the disadvantage of lack of competition. Losing the middle man saves money, taking out competition can have the effect of increasing costs or decreasing service--most likely the latter. There would need to be guarentees built in to the plan that neither would happen--this would also be the way to ensure bureacratic efficiency, for which there would be no other incentive.
On the surface, though, this has potential. However, it is seldom that you get something for nothing. I am not familiar with the details of Kucinich's plan, so I am unable to tell, from what you have provided here, exactly how this plan addresses the question of how do you provide health care for all those uninsured without raising the costs to the insured. The redirected payroll costs, to me, wouldn't seem to fully cover that, but that is a guess on my part. This plan may have a workable solution to that included--but many have some very optimistic assumptions about administrative efficiencies. However, I am open to the idea, and would be willing to support a system that did successfully address my concerns (ie, I am not philosophically opposed to the idea).
QUOTE(Hobbes @ Jul 30 2004, 11:54 AM)
This money was previously being used to pay for other items, so I'm assuming it is going to be replaced from other funds. I would need to see reassurance that those other funds won't in fact be additional taxes.
This money is solely taken out to cover your health insurance based on my understanding, this is how employers pay for their employees health care. I did look around a bit and I can't find anything specifically dealing with this point, but maybe if there is anyone in here that runs a small business which offers health care to their employees they can comment.
QUOTE(Hobbes)
Losing private insurance companies has the advantage of taking out the middle man, with the disadvantage of lack of competition. Losing the middle man saves money, taking out competition can have the effect of increasing costs or decreasing service--most likely the latter.
A good point until you consider this post by Wertz over in the Tort Reform thread. If that information is correct then there is no competition amongst health care companies, because they are not subject to anti-trust laws.
QUOTE(Hobbes)
I would need to see evidence here that this will be sufficient to cover the costs of the new system.
A very prudent reservation, but unfortunately it isn't something we can address until someone puts a "real" plan on the table and we depart the realm of discussing theory.
I basically agree with Hobbes. I am also not very familiar with Kucinich's plan but I will familiarize myself with it. From what you've posted Cube Jockey, I don't quite understand how the numbers add up. Still, it seems more promising than any other plan I've run across.
As a purely philosophical supposition, I'm not sure if insurance companies fall into the traditional competitiveness framework of free market economic theory. The "insurance product" is essentially a financial resource pool pricing statistical likelihoods of certain medical events divided by the number of participators in that pool. If everyone "runs the bank", you would get a bankrupt insurance company. Of course, this doesn't happen or rather is statistically unlikely to happen. Nevertheless, the shear amount of inertia due to number of participants (which makes insurance a viable product) must make moves towards greater efficiency problematic at best.
It seems in an insurance company's best interest to "drag its feet" to avoid payment as long as possible. This allows money that would have been paid earlier to accumulate interest for the insurance company. Also, since consumers never fully feel the pain of filing and reimbursement, there isn't a large incentive for consumers to demand change. This means that insurance companies have little motivation to improve services. Right now, the only motivation (that I can see) is to increase efficiency which will improve the bottom line. However, the cost of improving efficiency may be greater than the cost associated with the statis quo at least in the short or medium term.
As a purely philosophical supposition, I'm not sure if insurance companies fall into the traditional competitiveness framework of free market economic theory. The "insurance product" is essentially a financial resource pool pricing statistical likelihoods of certain medical events divided by the number of participators in that pool. If everyone "runs the bank", you would get a bankrupt insurance company. Of course, this doesn't happen or rather is statistically unlikely to happen. Nevertheless, the shear amount of inertia due to number of participants (which makes insurance a viable product) must make moves towards greater efficiency problematic at best.
It seems in an insurance company's best interest to "drag its feet" to avoid payment as long as possible. This allows money that would have been paid earlier to accumulate interest for the insurance company. Also, since consumers never fully feel the pain of filing and reimbursement, there isn't a large incentive for consumers to demand change. This means that insurance companies have little motivation to improve services. Right now, the only motivation (that I can see) is to increase efficiency which will improve the bottom line. However, the cost of improving efficiency may be greater than the cost associated with the statis quo at least in the short or medium term.
QUOTE(logophage @ Jul 30 2004, 03:15 PM)
Right now, the only motivation (that I can see) is to increase efficiency which will improve the bottom line. However, the cost of improving efficiency may be greater than the cost associated with the statis quo at least in the short or medium term.
Unfortunately, improving the bottom line for a publicly traded insurance company just means that more money ends up being put in the hands of shareholders and doesn't bring down the price of an insurance policy. That's usually up to the state insurance commissioner, who is usually an elected person and needs campaigning funds and where do you think he gets THAT from?
The existing system is rigged. A change is needed.
QUOTE(amf @ Jul 30 2004, 02:20 PM)
QUOTE(logophage @ Jul 30 2004, 03:15 PM)
Right now, the only motivation (that I can see) is to increase efficiency which will improve the bottom line. However, the cost of improving efficiency may be greater than the cost associated with the statis quo at least in the short or medium term.
Unfortunately, improving the bottom line for a publicly traded insurance company just means that more money ends up being put in the hands of shareholders and doesn't bring down the price of an insurance policy.
So the benefits of improvements in efficiency go 100% to the capitalist with zero going to labor and the consumer. I don't even think Marx would have agrred with that.
The fact is government expenditures on healthcare, as a percentage of GDP, are already on par with expenditures of other Western governments that do have a single-payer system. We need to look at why our health care costs are so high.
If you subsidize a good you will get increased demand for that good. Any health care program should address costs.
QUOTE
Questions for debate:
1. Do you support an effort for Universal Health Care (UHC) system in the US?
2. How realistic is the concept of UHC system in the US? Why or Why not?
3. What are the pros and cons of UHC in the States?
1. Do you support an effort for Universal Health Care (UHC) system in the US?
2. How realistic is the concept of UHC system in the US? Why or Why not?
3. What are the pros and cons of UHC in the States?
1. Yes. There is a looming health care crisis in this country. Health care costs are rising rapidly.
At the end of 2002 at my work insurance meeting, it was projected that health care costs will double in 5 years -- in other words, health care costs which were already far too expensive in 2003 will be double in 2008.
With the increased costs will come more game playing by insurance companies, making you fight to get routine things covered. They will cover less and less while companies and individuals will be paying more and more for the insurance.
If we don't adopt a universal health care plan, only the rich will be able to afford health care, and anyone less than rich will go into a lifetime of debt if any substantial health problems surface.
2. I believe that we need to look at the UK and Canada to find models that will work.
I do believe that there will be a big fight from the right on this one, which might make it unrealistic for our country. It will take millions more people (further up the economic ladder and Republicans) suffering from lack of care or under tremendous financial burdens from health care costs before there will be anyone looking to reform the current system.
3. Kind of covered this in #1.
Health care for everyone is a very good thing. A healthy nation is a strong nation.
I can't think of anything bad about it, except for maybe a small increase in taxes, but well worth it if I ever need any medical attention.
Until or even if a national heath program is instituted, my advice for the next few years is not to get sick unless you are very well off.
QUOTE(Hugo @ Jul 30 2004, 03:40 PM)
The fact is government expenditures on healthcare, as a percentage of GDP, are already on par with expenditures of other Western governments that do have a single-payer system. We need to look at why our health care costs are so high.
The cost of drugs in the USA is higher than other countries. Our higher prices help subsidize the drug in nations that could not otherwise afford it... so that the drug companies can make a profit on their investment in new drugs.
Uninsured patients have significantly higher medical costs than insured ones. Insurance companies negotiate lower rates with their doctor network that uninsured patients cannot do. Also uninsured patients wait longer for medical care, usually making whatever their problem is into something much worse.
Some kind of universal basic health plan where the government could reasonably negotiate with drug companies to lower prices -- unlike the Bush drug plan that is unpopular by a 2-1 margin based on recent polls and doesn't allow the government to negotiate better prices -- is the best way to solve the above cost issues.
I won't go say that we need to set up a system that covers everything, but I think basic major medical coverage with a $20 doctor co-pay and 70/30 split (up to $2000 out-of-pocket) for other services would go a long way toward solving a lot of problems. Especially if we let other insurance companies come in with supplemental insurance to cover the difference if people want it.
Costs can be managed through benchmarking against other countries' UHC systems, and performance based management of the gov't employees running the UHC system. I think one big step in managing costs would be to KEEP copays for non preventative, non-chronic visits. I'm specifically thinking of the thousands of people I've seen call 911 for an ambulance, merely because they didn't want to stay at home, or needed a ride to the hospital, for non-emergency care. Most of these people were uninsured anyway, so it didn't cost them a dime to waste the taxpayers money.
Likewise, 'good' doctors should be able to make more money than 'bad' doctors under any proposed system.
One thought for managing liability costs, would be using some sort of AFLAC-style reimbursement rate for specific injuries. Not sure of the legality of the process, though.
Likewise, 'good' doctors should be able to make more money than 'bad' doctors under any proposed system.
One thought for managing liability costs, would be using some sort of AFLAC-style reimbursement rate for specific injuries. Not sure of the legality of the process, though.
I never singled out a specific country like Canada or any other...I used the WHO health ratings which placed the US 37th..that is many countries we fall behind that I am comparing to..and doesn't anyone around here wonder..why? I mean if we spend that much money and have some of the best hospitals and doctors and some of the most advance medical technology in the world how are we 37th?
My point is the indicators or numbers being used to rate American health care by the WHO are not exactly good measurements or realistic ones.
Take a look at Down Syndrome birth rates in places like Europe, Asia to America...why is America's birth rate of down Syndrome babies nearly twice what it is in France, Switzerland, Belgium, England, Japan? What do you think is the overall main factor that determines differing DS rates in populations?...it is the access or practice of termination of pregnancy.
Paris France has a rate of over 70% of screened DS children being terminated compared to the US Atlanta being 33%. France Just happened to get the number one place rating on WHO's list. source
There have been cases outside the US in Europe and Asia of Down's children having life saving operations withheld. Which could account for lower costs. The US I believe has one of the most aggressive, intervening and defensive health systems in the world..and I am sure that translates into high costs.
On Mortality rates ..which I at first thought meant in regards to surgical procedures... doesn't violence, auto accidents play a big role in things like this? What does that have to do with the health care system?
There are plenty of health indicators that the WHO and obviously no one else around here takes into consideration.
Mrs Pigpen pointed out one..teenage pregnancies.
In regards to the infant mortality rates..I know a lot of women in the US who go thru. extensive fertility treatments, or pursue very risky pregnancies. There has been an increase in the US IMR ...doesn't anyone here wonder why? It's gone up 3% ..that is really high. Well guess what this increase in some studies is not being shown amongst young, poor, uneducated, uninsured women..the exact opposite in fact..it is among middle class , white, educated, suburban private insured women. It has to do with this countries high rate of use of fertility implantation...which in itself leads to low birth rates, multiple births and premature births which again all lead to a higher IMRs. Is it fair to count this against the US?
U.S. Infant Mortality Rate Rises 3%
Increasing Infant Mortality Among Very Low Birthweight Infants
Also infant mortality rates and fetal mortality rates ...two very different things..and in the US babies are being born as young as 22 wks and being kept on life support systems in an attempt to fight for their lives. If this 22 wk old baby is birthed and kept alive by means of support and does make it for a few wks it then counts as an Infant mortality...whereas in other countries where these babies are doa and intensive intervention medical methods are not sought to attempt to sustain their lives..these babies do not get listed under IMR. Doctors here in the US using their aggressive intervention methods will detect problems in utero and most often decide to have the baby delivered preterm in order to attempt to save the child's life..again this is a risk..and not all babies make it but the shift occurs..these babies get listed as infant mortalities rather than stillbirths or fetal deaths.
Also not all countries have the same criteria to defining what a fetal and what a infant mortality is.
Also there are reports that many countries under report the IMR and FMR too.
The WHO findings have been very controversial because of their reliance on the life expec., IMR, and mortality rates. It seems to me it is an archaic way of trying to rate a very complicated and now highly advanced system.
Again I don't support a UHC system because I feel the cons to such a system are the removal of the individuals importance..like Down Syndromes children's right to life and access to medical procedures and mothers rights to try and conceive and access to all medical procedures to assist her to do so. To me it ultimately is about your right to decide and to define what makes something of a medical importance to you.
My grandfather had to live the last two yrs of his life in pain..because a hernia in the UK is considered a non-risk op and has a long waiting list..he spent his whole life working like mad for that country, paying his taxes, paying for the NHS and this is what he got in return... just sit at home and take the pain old man. If my grandfather had been wealthy ..just like the case in the US... he would not of had to wait..he would have had access to a better, superior system. Sorry but having a UHC is not going to end the fact that the more money you have the better treatment you will receive.
My point is the indicators or numbers being used to rate American health care by the WHO are not exactly good measurements or realistic ones.
Take a look at Down Syndrome birth rates in places like Europe, Asia to America...why is America's birth rate of down Syndrome babies nearly twice what it is in France, Switzerland, Belgium, England, Japan? What do you think is the overall main factor that determines differing DS rates in populations?...it is the access or practice of termination of pregnancy.
Paris France has a rate of over 70% of screened DS children being terminated compared to the US Atlanta being 33%. France Just happened to get the number one place rating on WHO's list. source
There have been cases outside the US in Europe and Asia of Down's children having life saving operations withheld. Which could account for lower costs. The US I believe has one of the most aggressive, intervening and defensive health systems in the world..and I am sure that translates into high costs.
On Mortality rates ..which I at first thought meant in regards to surgical procedures... doesn't violence, auto accidents play a big role in things like this? What does that have to do with the health care system?
There are plenty of health indicators that the WHO and obviously no one else around here takes into consideration.
Mrs Pigpen pointed out one..teenage pregnancies.
In regards to the infant mortality rates..I know a lot of women in the US who go thru. extensive fertility treatments, or pursue very risky pregnancies. There has been an increase in the US IMR ...doesn't anyone here wonder why? It's gone up 3% ..that is really high. Well guess what this increase in some studies is not being shown amongst young, poor, uneducated, uninsured women..the exact opposite in fact..it is among middle class , white, educated, suburban private insured women. It has to do with this countries high rate of use of fertility implantation...which in itself leads to low birth rates, multiple births and premature births which again all lead to a higher IMRs. Is it fair to count this against the US?
U.S. Infant Mortality Rate Rises 3%
Increasing Infant Mortality Among Very Low Birthweight Infants
Also infant mortality rates and fetal mortality rates ...two very different things..and in the US babies are being born as young as 22 wks and being kept on life support systems in an attempt to fight for their lives. If this 22 wk old baby is birthed and kept alive by means of support and does make it for a few wks it then counts as an Infant mortality...whereas in other countries where these babies are doa and intensive intervention medical methods are not sought to attempt to sustain their lives..these babies do not get listed under IMR. Doctors here in the US using their aggressive intervention methods will detect problems in utero and most often decide to have the baby delivered preterm in order to attempt to save the child's life..again this is a risk..and not all babies make it but the shift occurs..these babies get listed as infant mortalities rather than stillbirths or fetal deaths.
Also not all countries have the same criteria to defining what a fetal and what a infant mortality is.
Also there are reports that many countries under report the IMR and FMR too.
The WHO findings have been very controversial because of their reliance on the life expec., IMR, and mortality rates. It seems to me it is an archaic way of trying to rate a very complicated and now highly advanced system.
Again I don't support a UHC system because I feel the cons to such a system are the removal of the individuals importance..like Down Syndromes children's right to life and access to medical procedures and mothers rights to try and conceive and access to all medical procedures to assist her to do so. To me it ultimately is about your right to decide and to define what makes something of a medical importance to you.
My grandfather had to live the last two yrs of his life in pain..because a hernia in the UK is considered a non-risk op and has a long waiting list..he spent his whole life working like mad for that country, paying his taxes, paying for the NHS and this is what he got in return... just sit at home and take the pain old man. If my grandfather had been wealthy ..just like the case in the US... he would not of had to wait..he would have had access to a better, superior system. Sorry but having a UHC is not going to end the fact that the more money you have the better treatment you will receive.
QUOTE(bucket @ Jul 30 2004, 02:48 PM)
The WHO findings have been very controversial because of their reliance on the life expec., IMR, and mortality rates. It seems to me it is an archaic way of trying to rate a very complicated and now highly advanced system.
Ok bucket, let's assume for a minute or two that you have a few valid points about the WHO. I still see no tie between your argument that the WHO ranks the United States as 37th worldwide and your position that because of that fact you don't support Universal Health Care.
I'm not sure how the statistics from WHO are necessarily relevant to the discussion here which basically boils down to -- should the poor and those without insurance be insured? Is that fundamentally what your arguement is? That our health care system is good, nevermind that the poor can't afford it and pay the price with their health, so why should we have universal care?
QUOTE(bucket)
If my grandfather had been wealthy ..just like the case in the US... he would not of had to wait..he would have had access to a better, superior system. Sorry but having a UHC is not going to end the fact that the more money you have the better treatment you will receive.
But your grandfather got care, and that is something many in this country don't even have the luxury of having available to them. It doesn't sound just a little bit wrong to you that you would have to pay more money to get proper care? Don't you think that means we have a health care system that favors the rich in the United States?
UHC will end the "I have more money so I get better care problem" by its very definition. It provides equal care to everyone, and your fears that means reduced care are unfounded as Vermillion and others have demonstrated in this thread.
NO my grandfather did not get care..he died with that hernia and they called my grandmother 6 mo after his passing to tell her they were ready for is op.
But I guess it doesn't matter I mean that hernia was not threatening his life just his life's quality..right? And after all he was an old guy..not working..retired he could afford to wait and be placed as a much lower priority. His individual priorities were not the ultimate considerations.
But I guess it doesn't matter I mean that hernia was not threatening his life just his life's quality..right? And after all he was an old guy..not working..retired he could afford to wait and be placed as a much lower priority. His individual priorities were not the ultimate considerations.
QUOTE(Cube Jockey)
First, lets look at the real costs of healthcare that you pay directly or indirectly:
1. Payroll deductions from each paycheck - these vary depending on the plan you have but it isn't small change by any means, generally $100+ a month.
2. Your employer pays for the rest of your coverage via payroll taxes - these are
1. Payroll deductions from each paycheck - these vary depending on the plan you have but it isn't small change by any means, generally $100+ a month.
2. Your employer pays for the rest of your coverage via payroll taxes - these are
Ok I am confused.
1. Is this general $100 employee payment covering just themselves, their spouse or children, or family?
2. Makes no sense to me, I am not sure where this 8.5 % payroll tax comes from. I have never seen one and I see payroll tax reports 2x a month for the past 10 years. The only tax that could come close to this is medicare (employee pays 1.45% and employer pays 1.45% with no wage cap) and social security tax (employee pays 6.2% and the employer pays 6.2% with a 2004 wage cap of $87,900). source (pdf file). This is a combined employer tax of 7.65% Now since I don't think he (or maybe he is) considering getting rid of social security the only tax I can think of is the medicare and that is 1.45% cost to the employer.
Yes an employer contributes to a plan, if it wishes, some don't, but every plan I have worked on the employer contributed a heck of lot more then 8.5% of the cost, excluding what they contribute to medicare and Social Security.
Could you clarify this for me.
QUOTE(DreamPipEr @ Jul 30 2004, 03:25 PM)
1. Is this general $100 employee payment covering just themselves, their spouse or children, or family?
It may be more or less for you DP - basically the intent here is to show your contribution to health insurance coverage from your paycheck. For myself and my wife I think I pay in the neighborhood of 100+ dollars, I can't remember. So if you have a more extensive plan or your employer pays less for coverage then you might pay more than that.
QUOTE(DreamPiper)
2. Makes no sense to me, I am not sure where this 8.5 % payroll tax comes from. I have never seen one and I see payroll tax reports 2x a month for the past 10 years.
This is the amount that your employer pays for your coverage. I may not have used the correct term or the term you are familiar with. However, most companies pay for a significant portion of their employees health insurance premiums. Health insurance costs far more than the amount that is take out of your pay check unless your employer makes you pay for 100% of it.
QUOTE(Cube Jockey @ Jul 30 2004, 06:48 PM)
QUOTE(DreamPipEr @ Jul 30 2004, 03:25 PM)
1. Is this general $100 employee payment covering just themselves, their spouse or children, or family?
It may be more or less for you DP - basically the intent here is to show your contribution to health insurance coverage from your paycheck. For myself and my wife I think I pay in the neighborhood of 100+ dollars, I can't remember. So if you have a more extensive plan or your employer pays less for coverage then you might pay more than that.
QUOTE(DreamPiper)
2. Makes no sense to me, I am not sure where this 8.5 % payroll tax comes from. I have never seen one and I see payroll tax reports 2x a month for the past 10 years.
This is the amount that your employer pays for your coverage. I may not have used the correct term or the term you are familiar with. However, most companies pay for a significant portion of their employees health insurance premiums. Health insurance costs far more than the amount that is take out of your pay check unless your employer makes you pay for 100% of it.
CJ I am not trying to be vague but in order for me to understand where you are coming from then I need to ask again, Is this $100 per month covering:
employee only coverage,
employee + spouse coverage,
employee + children coverage, or
employee + family coverage
Every one of these has a different general price tag that is paid monthly. What a single person contributes monthly is going to be different then what a family pays.
If we are going to look at the real cost (in general terms) then we need to be clear as to what we are comparing here.
I will address the second part once I can have something to go on with point 1.
QUOTE(DreamPipEr @ Jul 30 2004, 04:03 PM)
CJ I am not trying to be vague but in order for me to understand where you are coming from then I need to ask again, Is this $100 per month covering:
employee only coverage,
employee + spouse coverage,
employee + children coverage, or
employee + family coverage
Every one of these has a different general price tag that is paid monthly. What a single person contributes monthly is going to be different then what a family pays.
employee only coverage,
employee + spouse coverage,
employee + children coverage, or
employee + family coverage
Every one of these has a different general price tag that is paid monthly. What a single person contributes monthly is going to be different then what a family pays.
I was just trying to use a simple example... I don't think it really matters. Let's just say it is what a married couple with no kids pays.
The point I was trying to make is that currently the vast majority of us with health insurance pay some portion of our paychecks to have that coverage. I don't know that we can get into specifics because of the very nature of health insurance.
- Some employers pay more than others do
- Some employers have multiple plans (i.e. PPOs, HMOs, etc)
- Every level of coverage costs a different amount
- Different Insurance companies charge differently
- The amount witheld in your pay check sometimes depends on deductables for your insurance.
I could go on but I think you can probably see my point by now. The number I threw out there was a general example.
Something is wrong in this debate. Everyone is talking about whether it is realistic, can it work, will UHC be as good. How about, is it right? Somehow, somewhere, someone will pay for the services rendered. That someone won't be asked, won't be compensated, won't be consulted. The money will be taken by authority of the state at the point of a gun. Is it right, morally right to steal? I understand doctors aren't cheap. Medicine isn't cheap. Science isn't cheap. Knowing all this, I ask again, is it ok to steal? There are no compromises here. It is either moral to steal or it isn't. If you find a contradiction, check your premises.
QUOTE
There are no compromises here. It is either moral to steal or it isn't. If you find a contradiction, check your premises.
First, there are always compromises, my friend. On everything in life. However, I admire your spirit, and agree, in general, with your position. However, there is a big difference between stealing and voluntary contribution. This is why I have been asking for clarification on the costs and benefits. If those are explained clearly, and the benefits are worth the costs, then it is something I'm willing to contribute my money to. If the costs to me seem to outweigh the benefits, then I'm not willing to contribute, and it does become more like stealing. Basically, health costs are much like the police example given--people are willing to pay for the police because of the security they provide. Ditto for health coverage.
ibelsd - well, the question of morality certainly comes to mind, though I would think the morality espoused by most major religions would weigh on the side of "you are your brother's keeper".
If you are of the opinon that all taxation is theft, then I hope you don't drive or walk on any public roads, raise your own food, and live completely off the grid.
Taxation is inevitable, just like death. Who pays the user fees on Public Goods? Tax may be reformed, but we will be taxed.
IF UHC is 'right', and I believe that it is, there IS a way to make it work. I don't mind the rich being able to buy better health care, as long as everyone gets adequate healthcare. I don't believe that gov't provided healthcare should perform heroic, expensive measures with little chance of success. Cold, I know, but for every $100,000 procedure that we fund, there are 100 $1000 procedures we can't fund.
A government run insurance program could shift it's modus operandi from 'maximizing profit, given a level of benefit' to 'maximizing benefit, given a level of funding'.
My best guess, is that we ought to create a system of coverage that provides 90% of the population all the services you could possibly medically want, as soon as you want it, over the course of their lifetime. The 10% with extra needs, would receive the base care, plus whatever they could afford or find through charity.
I have no idea how much this would cost.
We certainly should give preventative care and medication to everyone, it's cheaper for us all.
If you are of the opinon that all taxation is theft, then I hope you don't drive or walk on any public roads, raise your own food, and live completely off the grid.
Taxation is inevitable, just like death. Who pays the user fees on Public Goods? Tax may be reformed, but we will be taxed.
IF UHC is 'right', and I believe that it is, there IS a way to make it work. I don't mind the rich being able to buy better health care, as long as everyone gets adequate healthcare. I don't believe that gov't provided healthcare should perform heroic, expensive measures with little chance of success. Cold, I know, but for every $100,000 procedure that we fund, there are 100 $1000 procedures we can't fund.
A government run insurance program could shift it's modus operandi from 'maximizing profit, given a level of benefit' to 'maximizing benefit, given a level of funding'.
My best guess, is that we ought to create a system of coverage that provides 90% of the population all the services you could possibly medically want, as soon as you want it, over the course of their lifetime. The 10% with extra needs, would receive the base care, plus whatever they could afford or find through charity.
I have no idea how much this would cost.
We certainly should give preventative care and medication to everyone, it's cheaper for us all.
I must say that I am in almost total agreement with ibelsd.
I pay a bit over 6K per year for health insurance, my employer contributes another 6K. We have a $2,000.00 per year deductable plus co-pay after co-pay after co-pay
.
The problem, as I see it is that we are trying to fix a problem that simply would not exist if we dumped the whole "health insurance system" completely.
What Health Insurance has created is a Welfare System for Doctors!
Recently I had a skin cancer removed from the cheek of my face. My Father over most of is life had dozens of these (Which are very common on farmers). I told the Doctor exactly what it was, and that he could cut it off at his leisure.
Nope, not good enough, even when I told him I would sign a waiver of liability. No, since I had Health Insurance he REQUIRED a biopsy be performed because he was sooooo worried that it might be worse then he thought.
6 WEEKS later the Doctor, who was soooooo very concerned about this deadly zit finally checks the biopsy report and, bless his heart, finds its EXACTLY what I told him it was.
But wait, theres more.
He, after waiting 6 weeks calls in a SPECIALIST to consult on a "cell" that was of concern. 6 MORE WEEKS later he decides that it is now time to remove this thing.
So, now 3 1/2 months pass and the zit is removed at a grand total cost of $4,200.00.
When I protested the cost ($2,000.00 which was my deductable), the Doctor said, "Hey, whats the big deal, you've got Health Insurance!".
No, I don't think we should fund this system, either on the private (of course that will never happen) or by the Government forcing coverage on tax payers.
UHC is robbery, and it's not Robbing from the Rich to give to the poor, it's Robbing from the Rich to give to the Wealthy.
Red
I pay a bit over 6K per year for health insurance, my employer contributes another 6K. We have a $2,000.00 per year deductable plus co-pay after co-pay after co-pay
.The problem, as I see it is that we are trying to fix a problem that simply would not exist if we dumped the whole "health insurance system" completely.
What Health Insurance has created is a Welfare System for Doctors!
Recently I had a skin cancer removed from the cheek of my face. My Father over most of is life had dozens of these (Which are very common on farmers). I told the Doctor exactly what it was, and that he could cut it off at his leisure.
Nope, not good enough, even when I told him I would sign a waiver of liability. No, since I had Health Insurance he REQUIRED a biopsy be performed because he was sooooo worried that it might be worse then he thought.
6 WEEKS later the Doctor, who was soooooo very concerned about this deadly zit finally checks the biopsy report and, bless his heart, finds its EXACTLY what I told him it was.
But wait, theres more.
He, after waiting 6 weeks calls in a SPECIALIST to consult on a "cell" that was of concern. 6 MORE WEEKS later he decides that it is now time to remove this thing.
So, now 3 1/2 months pass and the zit is removed at a grand total cost of $4,200.00.
When I protested the cost ($2,000.00 which was my deductable), the Doctor said, "Hey, whats the big deal, you've got Health Insurance!".
No, I don't think we should fund this system, either on the private (of course that will never happen) or by the Government forcing coverage on tax payers.
UHC is robbery, and it's not Robbing from the Rich to give to the poor, it's Robbing from the Rich to give to the Wealthy.
Red
QUOTE(SWM28WDC @ Jul 31 2004, 01:30 AM)
ibelsd - well, the question of morality certainly comes to mind, though I would think the morality espoused by most major religions would weigh on the side of "you are your brother's keeper".
If you are of the opinon that all taxation is theft, then I hope you don't drive or walk on any public roads, raise your own food, and live completely off the grid.
Taxation is inevitable, just like death. Who pays the user fees on Public Goods? Tax may be reformed, but we will be taxed.
IF UHC is 'right', and I believe that it is, there IS a way to make it work. I don't mind the rich being able to buy better health care, as long as everyone gets adequate healthcare. I don't believe that gov't provided healthcare should perform heroic, expensive measures with little chance of success. Cold, I know, but for every $100,000 procedure that we fund, there are 100 $1000 procedures we can't fund.
A government run insurance program could shift it's modus operandi from 'maximizing profit, given a level of benefit' to 'maximizing benefit, given a level of funding'.
My best guess, is that we ought to create a system of coverage that provides 90% of the population all the services you could possibly medically want, as soon as you want it, over the course of their lifetime. The 10% with extra needs, would receive the base care, plus whatever they could afford or find through charity.
I have no idea how much this would cost.
We certainly should give preventative care and medication to everyone, it's cheaper for us all.
If you are of the opinon that all taxation is theft, then I hope you don't drive or walk on any public roads, raise your own food, and live completely off the grid.
Taxation is inevitable, just like death. Who pays the user fees on Public Goods? Tax may be reformed, but we will be taxed.
IF UHC is 'right', and I believe that it is, there IS a way to make it work. I don't mind the rich being able to buy better health care, as long as everyone gets adequate healthcare. I don't believe that gov't provided healthcare should perform heroic, expensive measures with little chance of success. Cold, I know, but for every $100,000 procedure that we fund, there are 100 $1000 procedures we can't fund.
A government run insurance program could shift it's modus operandi from 'maximizing profit, given a level of benefit' to 'maximizing benefit, given a level of funding'.
My best guess, is that we ought to create a system of coverage that provides 90% of the population all the services you could possibly medically want, as soon as you want it, over the course of their lifetime. The 10% with extra needs, would receive the base care, plus whatever they could afford or find through charity.
I have no idea how much this would cost.
We certainly should give preventative care and medication to everyone, it's cheaper for us all.
You avoid the question by shifting the debate. The question is not whether it is moral for a government to build roads. I can argue, that this too, is an unfortunate position taken by the federal government. It would be outside the scope of this discussion. We are talking about a business. The business of medicine in which each individual has individual needs. You are basically saying it is ok to steal if it meets someone else's needs. Religions may consider you as your brother's keeper, but that same religion also preaches self-determination. It does not say your brother is your keeper. Christianity has a commandment regarding stealing. It says, very simply, "Don't!". I am not a Christian, but believe in that particular rule. Morality presumes a choice. If I give a sick man a dollar because he points a gun at my head, I am not providing charity and am not acting morally. I am simply attempting to preserve my life. The man holding the gun is stealing and is clearly acting immorally, even though his need dictates he takes my dollar. Yet, when we call that man the government, and that dollar is millions of dollars, we call it the common good. No, I am afraid there can be no contradictions here, no compromises. One is either stealing or he isn't. If the sick man gave me change for my dollar, he may be stealing less, but he is still stealing.
CJ I suppose was purposefully vague as I wasn’t sure how I would address (agree or not agree) your previous post until I fully understood the post itself. So sorry if I was berating, it wasn’t meant to be, I was confused. Anyway, I looked over the K. Plan and realized what he is talking about with the 8.5% and it makes a little more sense to me as I believe he is talking about how much an employer pays as a total percentage of their payroll. I think 8.5% high. I definitely think it is high for a small business. Imposing a 7.7% tax could run them in the ground. For example, the company I consult for is a small business; they do not offer benefits to part time employees, full time staff (which is the bulk of their payroll) receive a fairly decent package considering the cost. Their cost for offering medical benefits is approximately 4% of their total payroll. Last year market conditions caused them to barely turn a profit, if they had to pay almost 4 % more they would have been in the red and not just by a little but significantly. How long do you think it would take for the first round of lay offs? I would suggest not long at all. Eventually if we were in a down turn they would just close their doors. Kucinich’s plan, while admirable, would take the breath out of entrepreneurship and truly only the large corporations would be left. There are already so many instances that government make entrepreneurship more difficult do we really want to take the little life that is left out? Is that something we would want to risk?
I think there could be a way to address health care in this country and it is an important thing to address. We have to look at the entire picture and I must say that I am agreeing with Mrs. P more and more. Let's fix the reason health care is skyrocketing first.
I think there could be a way to address health care in this country and it is an important thing to address. We have to look at the entire picture and I must say that I am agreeing with Mrs. P more and more. Let's fix the reason health care is skyrocketing first.
I- The question of the state taking your money at the point of a gun isn't really up for debate, here or in the real world. That was the point I was making. I'm sorry if you thought I was shifting the debate, so let's shift it back, and I'll try and address your points.
Your point seems to be that, we as a nation, have no moral right levy taxes; with this goes the unsaid point that without taxes, we cannot pay for universal healthcare.
I cannot argue this point while remaining within the scope of this debate.
Back to the thread at hand:
I believe that there is sufficient evidence that the benefits to the whole under UHC outweigh those under our current plan. The question is, what will the effect be on individual's paychecks and coverages.
QUOTE
Questions for debate:
1. Do you support an effort for Universal Health Care (UHC) system in the US?
2. How realistic is the concept of UHC system in the US? Why or Why not?
3. What are the pros and cons of UHC in the States?
1. Do you support an effort for Universal Health Care (UHC) system in the US?
2. How realistic is the concept of UHC system in the US? Why or Why not?
3. What are the pros and cons of UHC in the States?
Your point seems to be that, we as a nation, have no moral right levy taxes; with this goes the unsaid point that without taxes, we cannot pay for universal healthcare.
I cannot argue this point while remaining within the scope of this debate.
Back to the thread at hand:
I believe that there is sufficient evidence that the benefits to the whole under UHC outweigh those under our current plan. The question is, what will the effect be on individual's paychecks and coverages.
QUOTE(ibelsd @ Jul 30 2004, 07:12 PM)
We are talking about a business. The business of medicine in which each individual has individual needs. You are basically saying it is ok to steal if it meets someone else's needs.
And that is a big part of the problem ibelsd, that Health Care is a business. The health care industry cares more about making money and increasing its bottom line than it does about helping people, I find it hard to believe that you don't see anything wrong with that?
As to whether or not it is right... is it right that health care is so expensive that it is a "luxury" for 40+ million Americans? Maybe you believe that only the rich should be able to have a good quality of life and maintain their health, but I believe that Health Care is a fundamental human right.
QUOTE
IF UHC is 'right', and I believe that it is, there IS a way to make it work. I don't mind the rich being able to buy better health care, as long as everyone gets adequate healthcare. I don't believe that gov't provided healthcare should perform heroic, expensive measures with little chance of success. Cold, I know, but for every $100,000 procedure that we fund, there are 100 $1000 procedures we can't fund.
Ugh that is not cold..that is frightening! This is exactly the point I was trying to make. In a lot of cases I don't mind that the US is not keeping up with other countries standards. America's health system exists the way it does and produces the results it does because often it is pursuing a different standard or approach to care.
I can not imagine having a doctor tell me because my child has DS he/she will not be eligible for an operation to save their life because the state feels the risk is too high. First deny the physically disabled..next the socially..all drug users, alcoholics will no longer be eligible for liver transplants..too risky. Just freaks me out.
It reminds of the movie I just saw I Robot where the lead explains why he hates robots so much...because when he was drowning the robot calculated he had the better chance of survival over the little girl and opted to sacrifice the child's life to save his. How he resented the fact a robot was allowed to make that decision because no human ever would.
So I guess I agree with the robbery example..except I think it robs us of something far more special and valuable then money...our individual worth.
I guess I should look at my healthcare plan, I'm not sure what it covers, but I'm sure there are limits, just as there'd be limits under UHC. I don't think the operate/don't operate decision would be made on an individual basis, but rather the rules would be set up overall to give the best health to the most people at a given level of taxation.
As for 'business', most doctors don't become doctors for the money...you could make much more money doing something else for the six - eight years you spend in medical school and as a resident. I think very few people feel a 'calling' for the insurance industry.
Could one of the Canadians explain the need for eliminating a two-tier system? Especially since most wealthy Canadians can simply come to the US for care outside the gov't system.
As for 'business', most doctors don't become doctors for the money...you could make much more money doing something else for the six - eight years you spend in medical school and as a resident. I think very few people feel a 'calling' for the insurance industry.
Could one of the Canadians explain the need for eliminating a two-tier system? Especially since most wealthy Canadians can simply come to the US for care outside the gov't system.
QUOTE(Hobbes Posted on Jul 29 2004 @ 04:04 PM)
If you fail to do that, you need to quantify to me what benefits I am receiving for the additional money I will be spending. I don't need aggregate statistics here. I need to know how I will benefit. If you can't show me that, then you haven't shown that the benefits of the system outweigh the costs. Many here will still likely be in favor of UHC for its benefits to the uninsured regardless. I don't fault them for that--but I can almost guarentee you that that will never be enough to create such a system in the US.
QUOTE
Essentially, to convert to UHC, you are indicating that a group of people who currently don't have insurance will be given insurance. This is a large group, so providing that insurance, on the face of it, is going to be expensive. Who are the ones who are going to be paying for this, then? Those who already have insurance. It seems only natural that these people are going to want to know two things: First, how much will it cost them, and Second--what benefits are they deriving from it. I think there are aspects of our current system that, if corrected in UHC, will make the cost much less than it might initially appear to be. But the actual cost needs to be defined much more clearly. For the benefits, 'soft' or intangible benefits are certainly part of the picture. I think many of us in the currently insured camp would be willing to pay a certain percent more for the safety net UHC would provide, and also a certain percent purely for the goodness of providing insurance to those who need it and wouldn't otherwise have it. However, we are very concerned over just what that percentage is really going to be, and exactly what benefits will be derived from it. Basically, health insurance is expensive. Most of us with health insurance are already bearing a fairly high burden just keeping ourselves insured. The prospect having to pay for other people's insurance as well is going to be with a great deal of scepticism. That scepticism will have to be overcome in order for UHC to have any chance of being passed, and clearly defining the costs and benefits is the way to do that. FWIW, I think this is what Hillary's commission attempted to do, but they were unsuccessful. This further adds to the scepticism, as it lends credence to the argument that it may sound good on the surface, but that when examined in detail, the costs outweigh the benefits of implementing UHC in the United State.
Let's see if I can tackle this part of the equasion, Hobbes.
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Most of us with health insurance are already bearing a fairly high burden just keeping ourselves insured. The prospect having to pay for other people's insurance as well is going to be with a great deal of scepticism.
First of all, note that you will no longer be paying for personal insurance, plus paying taxes for UHC as well, causing an additional "burden". You will be part of the UHC system, and your private insurace payments would go away.
As to the other benefits?
Each uninsured person loses the equivalent of between $1,645 and $3,280 annually in lost wages and benefits, according to "Hidden Costs, Value Lost," a recent report by the National Academy of Sciences' Institute of Medicine. The millions of uninsured Americans cost the nation between $65 billion and $130 billion annually because many of them receive inadequate medical care, leading to a poorer quality of life and a shorter life span. Atlanta Business Journal
Uninsured workers at small companies account for 57 percent of all uninsured workers, according to The Commonwealth Fund, a health research group. Those workers contribute to overcrowded emergency rooms and increased health care costs for everyone. Springfield News-Leader
A recent report by the Kaiser Family Foundation found that "the uninsured receive less preventative care, are diagnosed at more advanced disease stages, and once diagnosed, tend to receive less therapeutic care and have higher mortality rates."
National Bureau of Economic Research
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For society as a whole, the cost of uninsurance extends beyond the lost value due to worse health outcomes for individuals (i.e., more illness and shorter life) – important as this is. Additional costs to society are associated with assorted consequences of uninsurance, including:
- Developmental deficiencies rooted in childhood.
- Expenses borne by families, especially those with a member who suffers a chronic health condition, catastrophic illness or injury.
- Lost income due to reduced employment and job productivity.
- Constrained capacity of the public health system.
- Diminished public health (e.g., due to low immunization rates, lack of access to preventive health).
- Uncompensated care (worth about $35 billion in 2001; an estimated 75-85 percent is paid from public sources.).
- Higher public program costs (Medicare, Social Security Disability Insurance, the criminal justice system).
Cover the Uninsured Week.Org- Developmental deficiencies rooted in childhood.
- Expenses borne by families, especially those with a member who suffers a chronic health condition, catastrophic illness or injury.
- Lost income due to reduced employment and job productivity.
- Constrained capacity of the public health system.
- Diminished public health (e.g., due to low immunization rates, lack of access to preventive health).
- Uncompensated care (worth about $35 billion in 2001; an estimated 75-85 percent is paid from public sources.).
- Higher public program costs (Medicare, Social Security Disability Insurance, the criminal justice system).
The criminal justice system? Yep, and here's why - according to the article:
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Over 3 million adults have schizophrenia or manic-depressive disease and 20 percent of them are uninsured. "Ironically," concludes the Institute of Medicine, "contact with the criminal justice system increases the chances that someone with a severe mental illness will receive specialty mental health services.
However, those mental health services last only as long as the person involved is in the criminal justice system. Once they are out of the system, ie; released from jail, fine paid, etc., it's unlikely that someone uninsured will be able to continue to purchase the meds they need. Thus, if they have already had a brush with the law in some capacity due to not being on their meds, it's likely the criminal justice system will see them again in the future, once they are no longer getting treatment, courtesy of the state. That's because a large portion of these people, because of their illnesses, are self destructive in other ways, or cannot cope with normal responsibilities and end up homeless, and on the streets without proper medication and treatment.
So, if you want quantifiable benefits, here they are:
For those that work, insured employees are healthier employees. They seek treatment for illnesses and accidents at an earlier point, when the problem is more preventative, more easily (and usually more cheaply) treated, and has yet to become serious to catastrophic.
A savings to business, in terms of lost employee productivity. Example: an employee has mild chest and stomach pains that he attributes to hearburn, over several days. Insured, he may well call his doctor and go in for a diagnosis. He discovers he has an ulcer, and is given the proper medication, and is back at work the next day. Uninsured, he can't afford to see a doctor, and buys some over the counter heartburn medication. A few weeks (or months) later, when the pain gets to be too much, he finally goes to the emergency room, where they discover the problem, but now it requires extensive treatment, perhaps even surgery, and he's out of work for at least a week. Not only does he lose pay, but his employer loses his services for that additional time. By the way, the second example is real, it happened to a friend of mine with no insurance.
A drop in personal bankruptcies in the country. Medical debt affects 20 million families, or about 43 million Americans, often causing them to delay seeking subsequent medical care, according to a recent report from the Center for Studying Health System Change.
Two-thirds of those families also report difficulty paying for basic necessities, such as rent or mortgage payments, transportation costs and food. Although the uninsured are twice as likely to have medical debt, the insured are not immune. Two-thirds of families with medical debt have health insurance. About half of the country's personal bankruptcies are due, at least in part, to medical debt.
Law enforcement that can spend more time dealing with real criminals, rather than those that are "criminal" because of untreated mental health problems. And, of course, then a drop, however slight, in the number of crimes committed due to these untreated persons.
Hope these have been helpful in framing the argument, Hobbes.
QUOTE(bucket @ Aug 1 2004, 01:46 AM)
So I guess I agree with the robbery example..except I think it robs us of something far more special and valuable then money...our individual worth.
I don't understand this at all. Insurance companies are far more ruthless and assign far less 'value' to an individual than the government, at least here in Canada.
When my grandfather flew to Palm Springs six years ago he got private insurance from an American firm (OHIP doesn't cover expenses outside the country.) He suffered kidney failure and passed away on the trip; but his hospital expenses (which ended up being around $30,000) when all was said and done was covered by the insurance. However, a few months later the insurance company informed my grandmother that they wouldn't cover the expenses. Why? Because they found a note in his medical records a year before the trip, advising him to visit a cardiologist; which they claim voided the policy. Nevermind that he saw the cardiologist, and said doctor found that A) his heart was in excellent shape for an 83 year old man, and
there was no reason for him not to travel.Now, the insurance company knew this, and in reality they had no legal leg to stand on. They did however have more than enough to deny payment and force my grandmother into a lawsuit; which they did. Why? Because most people can't afford a long or emotionally difficult lawsuit.
This is somehow preferable to UHC? Insurance companies care?
I don't mean this to sound belittling, but it sounds to me that you have some sort of government boogy-man complex here; that anything run by government will inherently be inefficient, cruel, and unworkable. This is a decidedly American phenomenom. Government has it's failings, and so do corporations. They are endemic of any large scale beauracracy. All UHC does is amalgamate health-insurance beauracracies and remove the profit motive.
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Could one of the Canadians explain the need for eliminating a two-tier system?
I don't understand; and are you talking about in Canada, or the United States. In Canada the two-tier encroachments are dangerous because they have been found to LESSEN the quality of care for those who use the public system.
QUOTE(bucket @ Jul 31 2004, 10:46 PM)
I can not imagine having a doctor tell me because my child has DS he/she will not be eligible for an operation to save their life because the state feels the risk is too high.
That happens today Bucket, if your insurance company feels that a procedure is too risky then they will not cover it. You could shell out your own money to pay for the procedure, but I see no reason why UHC would change that.
It is even worse if you happen to be with a HMO, because often you have people in accounting making decisions about what procedures are ok to perform and what procedures aren't.
Your argument isn't going anywhere, because that is the way the current system is. The difference is that millions of people don't have any coverage today and they don't get the luxury of even deciding with a doctor if a procedure is too risky.
Why does everyone around here even moderators keep calling me crazy..all I have is a different opinion..not a mental disease.
UJ my point is NOT monetary. It is cultural. America's health systems is very unique.
CJ I was hoping you would address my point I made with my grandfather's story (which is not fictional) You were thankful he got care...which he would have if it was life threatening ...but he didn't because it was only threatening his quality of life are you ok with this or not?
My point made with the child with DS is there have been cases in Europe and Asia of children with DS being denied life saving ops not because the op itself was too much a risk but the child..being they are physically disabled.
Public agencies fail us here in America..from the school system to the prison system. I can just see it now...not only will I have to pay more and be selective about the neighborhood I live in to ensure I have access to a good public school for my children, and a low crime rate..but add to the list access to a good hospital and good doctor offices.
I already mentioned I would like to see reform..just not this kind of reform. So just because I reject the idea of a UNC does not mean I embrace the idea of the current system either.
Personally I would like to see something more like what I had in Switzerland just Americanized.
UJ my point is NOT monetary. It is cultural. America's health systems is very unique.
CJ I was hoping you would address my point I made with my grandfather's story (which is not fictional) You were thankful he got care...which he would have if it was life threatening ...but he didn't because it was only threatening his quality of life are you ok with this or not?
My point made with the child with DS is there have been cases in Europe and Asia of children with DS being denied life saving ops not because the op itself was too much a risk but the child..being they are physically disabled.
Public agencies fail us here in America..from the school system to the prison system. I can just see it now...not only will I have to pay more and be selective about the neighborhood I live in to ensure I have access to a good public school for my children, and a low crime rate..but add to the list access to a good hospital and good doctor offices.
I already mentioned I would like to see reform..just not this kind of reform. So just because I reject the idea of a UNC does not mean I embrace the idea of the current system either.
Personally I would like to see something more like what I had in Switzerland just Americanized.
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Why does everyone around here even moderators keep calling me crazy
Assuming this was directed at me, it is wrong. I never called you crazy. All I was doing is suggesting that your opinion of UHC is tarred by the anti-government cultural character of America.
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My point made with the child with DS is there have been cases in Europe and Asia of children with DS being denied life saving ops not because the op itself was too much a risk but the child..being they are physically disabled.
What you are describing is a problem that relates not to a system of UHC, but rather the specific implimentation in those particular countries. That would be like me suggesting that Democracy doesn't work because it has failed in Russia; the problem lies in Russia, not in democracy.
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Public agencies fail us here in America..
They also succeed. America has some of the best public colleges and universities in the world. The problem is not one of public organizations, but the way those organizations are structured in America. Are you suggesting that since Americans fail (as you say) to develop working public agencies, then they will necessarily fail with UHC?
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I can just see it now...not only will I have to pay more and be selective about the neighborhood I live in to ensure ... but add to the list access to a good hospital and good doctor offices.
I don't understand this. In Canada UHC is universal. If I'm not happy with my doctor I can take my health-insurance and use it for any other doctor in Canada.
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