This is the Government that You Want to Run Health-care?

[jimbob]

Jerome,

I was mearly pointing out that there is a cost associated with not having universal healthcare. I am not arguing that the US should adopt the NHS, but I am arguing that you are ignoring some of the costs of the private system.

Furthermore I am arguing that healthcare is inherently too expensive for the poor to have adequate cover without some form of state help. You say that a frree market will reduce the costs, but I can't see how the free market could reduce the costs sufficiently to make healthcare affordable.

How can the free market reduce the cost of healthcare to make adequate cover affordable for someone on USD7/hour, without state intervention?

Are my figures in post #289 anything other than extremely conservative estimates of costs?

I have not made any proposals, I am only pointing out that there are universal healthcare systems that are cheeper than medicare and which are truly universal.

 

[JEROME DA GNOME]

Jerome,

I was mearly pointing out that there is a cost associated with not having universal healthcare. I am not arguing that the US should adopt the NHS, but I am arguing that you are ignoring some of the costs of the private system.

Furthermore I am arguing that healthcare is inherently too expensive for the poor to have adequate cover without some form of state help. You say that a frree market will reduce the costs, but I can't see how the free market could reduce the costs sufficiently to make healthcare affordable.

How can the free market reduce the cost of healthcare to make adequate cover affordable for someone on USD7/hour, without state intervention?

Are my figures in post #289 anything other than extremely conservative estimates of costs?

I have not made any proposals, I am only pointing out that there are universal healthcare systems that are cheeper than medicare and which are truly universal.

The current high costs are related to government interference. More government interference will not lower the costs.


We see the same circumstance with higher education. The more government interference with the market the higher the cost. Have we not seen dramatic increases in college education costs with the government intrusion into that market?

 

[Tsukasa Buddha]

Not really. What is the tax rate in the UK compared to the tax rate in the US?

Yes it is. He said it was "free at the point of need," not just the "FREE" strawman you made.

Also, why is paying less money in taxes to government worse than paying more money to an insurance company?

 

[zooterkin]

The current high costs are related to government interference. More government interference will not lower the costs.

And yet the UK system, which has more "government interference", costs less and provides health care for all. How do you reconcile that?

 

[volatile]

Do all doctors/nurses in the NHS work for the state?

No.

Do they draw a fixed salary or do their earnings depend upon their patient service and performance?

The new GP contract is adjusted for performance metrics, as far as I am aware. NHS dentists receive a fee per treatment, if I understand it correctly. How this applies to the broader NHS, I do not know.

Are doctors required to work for the NHS?

No.

Can they open an independent practice and pick and choose their patients and set their own rates?

Yes.

Oh, and why not contact Lloyds of London for an insurance quote on that last question.

You live in the US. You must be at least vaguely aware of standard insurance rates. Just a ballpark figure - how much would a totally comprehensive, unlimited, no-excess health policy cost, roughly?

 

[jimbob]

The current high costs are related to government interference. More government interference will not lower the costs.


We see the same circumstance with higher education. The more government interference with the market the higher the cost. Have we not seen dramatic increases in college education costs with the government intrusion into that market?

But you are claiming that a true free-market will enable the poor to afford sufficient healthcare.

How cheap would this have to be for someone on $7/hour to afford?

Or to put it another way, what is the maximum cost that you think someone on such an income could bear?

You are claiming that somehow, a fully free-market system would mean that all necessary healthcare would cost less than this.

You could break it down further: What is the maximum one-off cost that someone on $7/hour could bear, and what is the maximum annual cost that someone on $7/hour could bear?


Are medical wages going to fall?
Are equipment costs going to fall?
Are capital costs of hospitals going to fall?
Is depreciation going to fall?
Will people decide they don't need insurance? Will small insurance co-operatives outperform the economies of scale of large insurance companies?


You have accepted the need for large organisations, so maybe their beauracracies will vanish.

How will it work?

 

[jimbob]

Government regulation created the large insurance companies.

In a deregulated market, will economies of scale suddenly vanish?

Nope.

These economies of scale lead to large insurance companies

The cost of health-care will dramatically decrease if people pay out of pocket for care as opposed to the current system.

Health-care practitioners want to sell their services and they will charge fair market value set by the consumers and the competition. Currently the costs are determined by the insurance companies regulated by the government.

How about a system in which the consumer and doctor decide the cost of health-care?

The inherent costs are still there, which you seemed to accept:

Will the capital cost and depreciation of medical equipmens suddenly reduse?

Nope.

Will medical treatment and diagnosis suddenly not need highly qualified workers? Will highly qualified workers, in a field where there is demand for their services suddenly not command high wages?

Nope and nope.

Will large hospitals not be needed, or will the capital cost of the hospital also not need to be covered? Will the land value of new hospitals vanish.

Nope and nope.

Without regulation, how do you protect against cartels?

Why should I protect against cartels?

There will still be the demand from the rest of society who can afford to pay. The poor don't have much economic power. Why should the inability of the poor to pay reduce the price, unless the market is saturated?

A doctor would get a better price for performing additional "luxury" procedures for people who can pay ainstead of life-saving ones for people who couldn't.

And you want to protect against cartels as they distort the market, and can be dealt with effectively.

 

[JEROME DA GNOME]

And yet the UK system, which has more "government interference", costs less and provides health care for all. How do you reconcile that?

Lower quality. Besides you are comparing apples to oranges. Keep in mind also that many costs in America are inflated because the health-care equipment producers need to gain extra from the American consumer. This is caused by the nationalized systems dictating what they will pay. If there was no America to over pay than these national systems would either have to pay more or not have access to the equipment.

 

[zooterkin]

Lower quality. Besides you are comparing apples to oranges. Keep in mind also that many costs in America are inflated because the health-care equipment producers need to gain extra from the American consumer. This is caused by the nationalized systems dictating what they will pay. If there was no America to over pay than these national systems would either have to pay more or not have access to the equipment.

So, you're asserting that you are in fact subsidizing the UK NHS? Cool, thanks!


I don't suppose you've got any evidence for that?

 

[Rolfe]

I'm kind of enjoying watching people deal with the Gnome. However....

At this point I don't see how we can transition to a similar system. Doctors, hospitals, clinics, labs, MRI facilities, etc. are all essentially independent businesses (or charities). If you nationalize heath care service, the best doctors will leave for greener pastures and the disgruntled will change jobs or retire. Compensating for the seizure so much convolutedly owned private property and coordinating all the resultant mess will take a bureaucracy of staggering proportions many years.

I can see that getting from where you are to a universal system of some sort is not a simple task. However, it has been accomplished in other countries, and it would be constructive to investigate how they managed it. Nationalising the health service here did not result in the best doctors leaving for pastures new. There is in fact great competition for NHS jobs and (subject to the system working correctly, just look up "Modernising Medical Careers" if you want to see what I mean), it takes its pick of the best candidates. If you want to opt for private treatment for some reason, perhaps to get surgery faster if you're not an urgent case, then the best advice is to make sure you get a surgeon who has a senior NHS appointment. Anyone working outside the NHS is not subject to its quality control and may be suspect.

The problems of getting from where you are to a universal system was why I started an earlier thread asking how Hillary's proposals might work, or how else might it be accomplished. There were some interesting suggestions, in between the Gnome sniping about how it could never work because he is ideologically opposed to it.

I think it's counterproductive just to look at the potential problems without finding out how they have been solved by other societies, in quite diverse ways actually. It most certainly can be done.

Do all doctors/nurses in the NHS work for the state? Do they draw a fixed salary or do their earnings depend upon their patient service and performance? Are doctors required to work for the NHS? Can they open an independent practice and pick and choose their patients and set their own rates?

Well, there you go. Lots of questions indicating that you really don't understand the system at all. No reason why you should, except that if you have an interest in the subject, finding out would be very educational.

I did explain some of this in another thread - in the Science forum, about chiropractic. I don't have time now to repeat it. However, I think you'd find a lot of useful information in how things work here, and in Canada and France and all sorts of other places. Yes, we have problems and sometimes things go wrong. But overall it is such a desirable system that I doubt if you'd get 10 people in the country who would opt to switch to your system.

Perhaps the key to this point is what I said before. The NHS is universal. The service is good enough that there is little demand for private treatment. The NHS cherry-picks the best, and has the clout to make sure it gets them. All the teaching hospitals and so on. If you do want to go private, then you know to choose somenoe with a top NHS post, because the overwhelming chances are that he will be the best.

Rolfe.

 

[jimbob]

Further to volitile's answers in post #305. Often the NHS consultants have additional private practices, and often they pay to use NHS facilities, getting the benefits of scale of a large hospital.

 

[balrog666]

How can the free market reduce the cost of healthcare to make adequate cover affordable for someone on USD7/hour, without state intervention?

Medicaid already covers those people. In fact, in Florida, the state constantly advertises for people to sign up for the "free" medical insurance.

 

[volatile]

Medicaid already covers those people. In fact, in Florida, the state constantly advertises for people to sign up for the "free" medical insurance.

Jim is responding to Jerome, who wants to eradicate Medicaid entirely and let the unregulated free-market take over. That's what that part of the conversation is about.

Nevertheless: Medicaid costs more and gives less than the UK system. Plus, you want to "reform" it, in as yet unspecified manner.

In what respect is Medicaid better than, or preferable to, nationalised healthcare?

 

[balrog666]

You live in the US. You must be at least vaguely aware of standard insurance rates. Just a ballpark figure - how much would a totally comprehensive, unlimited, no-excess health policy cost, roughly?

I know what my primary coverage costs. And it is cheap as far as I am concerned.

Unlimited? AFAIK, all policies have limits, even if the limit is $100,000,000. If you want a larger limit, it costs more.

No-excess? I'm afraid I don't know what that means.

Coverage for how many people in your family? What ages? In what current health? You want dental coverage, eyeglass coverage, substance abuse coverage, chiropractic coverage, acupuncture, reiki healing and all that peripheral woo too? Shall I point you at a web site for a quote?

 

[volatile]

I know what my primary coverage costs. And it is cheap as far as I am concerned.

Cheaper than $3,000 a year?

Unlimited? AFAIK, all policies have limits, even if the limit is $100,000,000. If you want a larger limit, it costs more.

The NHS has really only has limits when it comes to the prescription of very expensive drugs (e.g Herceptin).

No-excess? I'm afraid I don't know what that means.

An excess on an insurance policy is an amount of money you have to pay before a claim can be made. Say, the first £500 or so. In the NHS system, no-one parts with any cash, ever (except for a flat rate fee paid by the minority of people for prescription drugs, by some for eye exams, and small fees for NHS dentistry).

Coverage for how many people in your family? What ages? In what current health? You want dental coverage, eyeglass coverage, substance abuse coverage, chiropractic coverage, acupuncture, reiki healing and all that peripheral woo too? Shall I point you at a web site for a quote?

All of my family, irrespective of current health. For all health problems, no matter what their origin. Hell, the NHS actually does cover some silly things like homoeopathy, much to my chagrin, so hey, throw that it too.

Is it less than $3,000 per year, do you think? Just gimme a rough estimate how much I'd have to pay in the US for the same level of coverage I get here, free at the point of use.

 

[balrog666]

I'm kind of enjoying watching people deal with the Gnome. However....




I can see that getting from where you are to a universal system of some sort is not a simple task. However, it has been accomplished in other countries, and it would be constructive to investigate how they managed it. Nationalising the health service here did not result in the best doctors leaving for pastures new. There is in fact great competition for NHS jobs and (subject to the system working correctly, just look up "Modernising Medical Careers" if you want to see what I mean), it takes its pick of the best candidates. If you want to opt for private treatment for some reason, perhaps to get surgery faster if you're not an urgent case, then the best advice is to make sure you get a surgeon who has a senior NHS appointment. Anyone working outside the NHS is not subject to its quality control and may be suspect.

The problems of getting from where you are to a universal system was why I started an earlier thread asking how Hillary's proposals might work, or how else might it be accomplished. There were some interesting suggestions, in between the Gnome sniping about how it could never work because he is ideologically opposed to it.

I think it's counterproductive just to look at the potential problems without finding out how they have been solved by other societies, in quite diverse ways actually. It most certainly can be done.




Well, there you go. Lots of questions indicating that you really don't understand the system at all. No reason why you should, except that if you have an interest in the subject, finding out would be very educational.

I did explain some of this in another thread - in the Science forum, about chiropractic. I don't have time now to repeat it. However, I think you'd find a lot of useful information in how things work here, and in Canada and France and all sorts of other places. Yes, we have problems and sometimes things go wrong. But overall it is such a desirable system that I doubt if you'd get 10 people in the country who would opt to switch to your system.

Perhaps the key to this point is what I said before. The NHS is universal. The service is good enough that there is little demand for private treatment. The NHS cherry-picks the best, and has the clout to make sure it gets them. All the teaching hospitals and so on. If you do want to go private, then you know to choose somenoe with a top NHS post, because the overwhelming chances are that he will be the best.

Rolfe.

Yes, the problems associated with transitioning to a NHS type system are large and the benefits uncertain.

In particular I find the idea of initiating a new class of protected government workers (doctors, nurses, lab workers, technicians) abhorrent. As government workers, will they be protected from malpractice or outright incompetence? Will they unionize like other government workers and bankrupt the state even further? It looks like a very ugly situation to me.

 

[balrog666]

Jim is responding to Jerome, who wants to eradicate Medicaid entirely and let the unregulated free-market take over. That's what that part of the conversation is about.

Nevertheless: Medicaid costs more and gives less than the UK system. Plus, you want to "reform" it, in as yet unspecified manner.

In what respect is Medicaid better than, or preferable to, nationalised healthcare?

As for reform, I specified the Oregon Health Plan of 1989. Feel free to look it up.

Medicaid doesn't seize the private property of medical practitioners or health care investors.

 

[volatile]

As for reform, I specified the Oregon Health Plan of 1989. Feel free to look it up.

Medicaid doesn't seize the private property of medical practitioners or health care investors.

How does nationalised healthcare seize the private property of medical practitioners or health care investors?

 

[volatile]

Yes, the problems associated with transitioning to a NHS type system are large and the benefits uncertain.

The benefits uncertain?

Which bit of "costs you less, but gives you more" don't you understand?

In particular I find the idea of initiating a new class of protected government workers (doctors, nurses, lab workers, technicians) abhorrent. As government workers, will they be protected from malpractice or outright incompetence? Will they unionize like other government workers and bankrupt the state even further? It looks like a very ugly situation to me.

What are you talking about? Is the UK, France, Sweden, Australia or any other country with national health "bankrupt"? What, exactly, is your issue with unionisation, and how would this be "ugly"?

I see lots of (paranoid) assertion, but not much evidence.

 

[balrog666]

How does nationalised healthcare seize the private property of medical practitioners or health care investors?

What part of "nationalize" don't you understand?