Universal Health Care in the US. Yea or Nea?

[Toke]

Wise words, paupers and expensive diseases, they are asking for it.

 

[ponderingturtle]

A guy I was talking to in America last year said, "We live in a socialist country. We have socialist education, we have socialist policing, we have socialist firefighting, we have socialist highways, and lots of other things. But for some reason the idea of socialist medicine really presses some people's buttons."

Rolfe.

Hey in anchient rome they had great private firefighting. The fire brigade would show up and buy the property at a reduced price before putting the fire out. It ran at a wonderful profit.

 

[ponderingturtle]

Wise words, paupers and expensive diseases, they are asking for it.

Of course, they chose to get cancer with out being able to afford it, why should I pay for them?

 

[Rolfe]

Y'all seem to forget that, aside from the multitude of state, county, local and independent "health care" systems here that all dominated or heavily influenced by fed policies, the US Federal Government already directly runs at least four major and independent medical service systems providing a substantial portion of the delivery said of medical services in the US.

And they are disasters.

And, almost without exception, anyone who has had to rely on them, hates them with a white-hot passion.

So we know exactly what the US government has to offer with respect to medical services and we don't want any part of it and we sure don't want it to be our only option.

Are you suggesting that the US could expand Medicare and Medcaid to cover everyone and yet save money doing it?

We've had this discussion before. You seem to believe that of all the countries of the world, the USA is amost uniquely incompetent in this area. Well, it's your country, you should know. But it really does seem a fairly unlikely premise, on the face of it.

Maybe, in your eyes, the US couldn't do that. Because of the aforementioned unique incompetence. However, simple observation demonstrates that this is entirely achievable. Is it genetic stupidity, or do you have to work at it?

I think you've been working quite hard on your own behalf. Because either you have reading comprehension difficulties, or you choose to forget everything said in other threads that doesn't suit your agenda. You mention yet again the concern that a universal system, were it to be adopted, would exclude all other options. That you would be "forced" to rely on this system, which because of the unique incompetence of your countrymen, would (you believe) inevitably be a disaster.

It has been explained to you, patiently and repeatedly, that in many, probably most, of the countries at present operating a universal health-care system, citizens are completely at liberty to access whatever healthcare they choose, either by taking out additional insurance (which is quite inexpensive as it is not required to be so comprehensive as insurance has to be in the USA), or simply by paying for it up front. In Europe, these options include the option to access healthcare in other EU countries.

I even related to you the experience of my mother, who decided not to wait the year she was quoted for cataract surgery, and simply paid for the surgery herself. As a clergyman's widow living on a pension, she was still able to afford this fairly easily from her savings (it cost just over £3,000 for both eyes).

Oh, shock horror, people who choose to do this don't get a tax refund! How inequitable! This is so unfair, it would be better to continue with the present system than consider it!!

Oh come on.

• You wouldn't actually be paying out any more than you are now, to fund healthcare that you can't access. At least under a universal system you could access it if you chose to.
• You don't get a rebate on your education tax, if you don't have children, or if you choose to send your sprogs to private school. You don't get a rebate on your highway taxes, if you choose never to set foot on a road. You don't get a rebate on police costs if you hire a private security guard or detective. And yet, somehow, civilisation survives.

While I was typing this, an advert came on the television for BUPA, the major private health-care provider in Britain. Their insurance isn't terribly expensive, but most people don't bother, because they know the NHS is there and usually manages to cope. The great thing is, BUPA is a luxury, not a necessity.

I honestly can't understand why you'd remain carping on the sidelines rather than even consider the possibillities of a system like this.

Rolfe.

 

[Segnosaur]

Are you trying to argue for private healthcare as the cheapest?

No, I wasn't. I was trying to suggest that paying 'only $100' for partial care in a private system doesn't necessarily mean that paying $100 into a 'socialist' system will necessarily give better coverage. Socialized medicine will cost money and it may mean some people have smaller take-home paychecks as a result.

That's why I suggested in an earlier post... a simple poll which just asks "do you want universal health care" might be misleading if people aren't asked at the same time whether they'd be comfortable with the costs.

The us spend the most and still have 47 million uncovered.

Yes, they do spend the most. On the other hand, according to the WHO, they have the most responsive health care system in the world, meaning shorter wait times, faster adoption of new technology, etc. Is it better to have an expensive (but uneven) situation where people can get treatment as soon as needed (but for which some people will have trouble affording)? Or is it better to have more equal access but get stuck on waiting lists? (There is no real answer to that...)

http://www.who.int/whr/2000/media_centre/press_release/en/index.html

And no, I dont think they are just between jobs or dont want healthcare even through they could afford it.

Really? Do you have any statistics to back that up?

After a quick googling I found the following: http://www.businessandmedia.org/articles/2007/20070718153509.aspx (Note: This is from a 'right-wing' site, so I understand if you're skeptical. But, they are using information from the U.S. Census).

Of the 47 million uninsured....
- Approximately 10 million are not US Citizens (Should illegal aliens be covered under a universal health plan?)
- Around 17 million have incomes over $50,000 (should be more than enough to afford insurance)
- Almost half of the people earning less than $50,000 but not eligable for government programs will actually be uninsured for less than 4 months.

So, if you are interested in the people who are citizens, and who really can't afford coverage and have been without for a significant length of time, you are dealing with only 2-3% of the U.S. population. Those people DO need to be helped... the question is, do you want to risk the good qualities of your health care system (e.g. the responsiveness) in order to benefit the 2-3%, if you can find another way?

 

[Toke]

Well, I live in a system where we pay 50+% income tax in return for free education and healthcare. We don´t have to buy health insurance or save up for college.

The basic idea is "to each according to need, from each according to ability" or something like that.

A socialiced medical system saves the cost of insurance company profit and the administrative cost of allocating the bills.
It looks like that will easily make the difference between the us and europe. Perhaps you are victim of insurance company propaganda?


Yes, I have seen sicko by michael more and was chocked that it described a western nation, it must have been exagerated, but how much?

 

[egslim]

Yes, they do spend the most. On the other hand, according to the WHO, they have the most responsive health care system in the world, meaning shorter wait times, faster adoption of new technology, etc. Is it better to have an expensive (but uneven) situation where people can get treatment as soon as needed (but for which some people will have trouble affording)? Or is it better to have more equal access but get stuck on waiting lists? (There is no real answer to that...)

According to your own link, France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan. [...]The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds.

While the US ranks highest in responsiveness, that's only one category of several. And either it's not a very important one, or the US must suck pretty bad in the other categories to pull its average down all the way to 37th place. (Of course you might argue 37th out of 191 isn't that bad, but for a wealthy, developed nation to finish in front of developing and chronically undeveloped nations is nothing to be proud of - it should be a given.)

 

[Miss_Kitt]

Just saying, that's the first time I've ever read through a long post of yours. I found it interesting, thoughtful, and informative.

Maybe you posted stuff that good before, but mauve serifed font wasn't really a good vehicle.

Rolfe.

rolfe -- Thank you for the nice comment on my post.

Per the other thread, I changed my text back to the default when I found out that it appeared differently on other folks' screens than mine. (I *think* that means it will retroactively change my 'standard' format in old posts, but am not sure.)
Can we just get off the font thing, please?? I think I've been hammered on that enough, dude!

 

[Segnosaur]

Well, I live in a system where we pay 50+% income tax in return for free education and healthcare. We don´t have to buy health insurance or save up for college.

You're right, you don't. But then, if you were paying less in income taxes, you might be able to save up for college yourself.

And is it necessarily right that an individual who chooses to enter the workforce without going to college first ends up having some of his tax money going to pay for someone who wants to take "Underwater Basket Weaving 101" at the local college?

A socialiced medical system saves the cost of insurance company profit and the administrative cost of allocating the bills.

Yes it does. But it also adds the administrative cost of government overhead, and removes (at least in part) any savings that would be gained by competition. In addition, the public sector often has significant union involvement, which could drive costs even higher.

Even if socialized medicine did reduce costs, it might have the unexpected consequence of harming the system's flexibility, as any decisions might have to be made by government officials (rather than the people who are involved in the actual treatment).

It looks like that will easily make the difference between the us and europe. Perhaps you are victim of insurance company propaganda?

Actually, I'm in Canada. We have socialized medicine (and thus I am quite aware of the problems that can occur if things aren't handled right). In fact, our rules regarding private medicine are probably the most restrictive of all western countries.

Yes, I have seen sicko by michael more and was chocked that it described a western nation, it must have been exagerated, but how much?

Well, I've already pointed out some statistics that show his overestimation of the problem of uninsured people. (Admittedly I haven't seen the movie, but I've read enough about what was presented in it.)

Plus he apparently glossed over the problems inherent in the health care system of Canada (lengthy wait lists for things like MRIs, many people unable to find family doctors) and Cuba (treatment given to foreigners is different than that given to the citizens themselves.)

 

[Toke]

As I stated in post #27 what have americans done to deserve less than europeans with regards to healthcare.?

 

[Toke]

Yes it does. But it also adds the administrative cost of government overhead, and removes (at least in part) any savings that would be gained by competition. In addition, the public sector often has significant union involvement, which could drive costs even higher.

Even if socialized medicine did reduce costs, it might have the unexpected consequence of harming the system's flexibility, as any decisions might have to be made by government officials (rather than the people who are involved in the actual treatment).

This might horrify you but it seems that the goverment is more effective at healthcare than private providers.
You could be victim of the "goverment ineffective/private effective" hoax.

Any organication will experince losses as it gets bigger. Goverments seems better at handeling it than privates. Sorry if it contrasts with your favorite prejudices.

 

[Segnosaur]

According to your own link, France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan. [...]The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds.

While the US ranks highest in responsiveness, that's only one category of several. And either it's not a very important one, or the US must suck pretty bad in the other categories to pull its average down all the way to 37th place.

You're right, it is only one category. (As is equality in access, cost, general health, etc.)

The problem is, how it relates to the other categories is probably a very personal thing. Some people might think that it is the only category that matters.

Put it this way... if you were diagnosed with cancer (or some other disease), would you want treatment as quickly as possible, or would you be happy waiting, content in the knowledge that at least others will be waiting just as long as you do?

 

[Ivor the Engineer]

http://www.chsrf.ca/mythbusters/pdf/myth17_e.pdf

Researchers have also looked at the variation in waiting times within countries, based on the co-existence of public and private care. Studies in both Australia and England have found the more care provided in the private sector in a given region, the longer the waiting times for public hospital patients.ix, x

This backs up Canadian evidence from the province of Manitoba where, until 1999, patients paid an additional facility fee or “tray fee” if they chose to have cataract surgery in a private facility (the surgery itself was still paid for by the provincial health plan). At the time the fee was in place, the Manitoba researchers found that patients whose surgeons worked only in public facilities could
expect a median wait of 10 weeks in 1998/99; however, patients whose surgeons worked in both public and private facilities could expect a median wait of 26 weeks.vii

 

[Segnosaur]

This might horrify you but it seems that the goverment is more effective at healthcare than private providers.
You could be victim of the "goverment ineffective/private effective" hoax.

Really? Is that why, in Canada (where health services are single-payer only) we have a significant problem with waiting lists?

In fact, in one case, someone even launched a lawsuit against the government (and won!) because he was on a waiting list for so long and was not allowed (by law) to pay for private treatment.

Any organication will experince losses as it gets bigger. Goverments seems better at handeling it than privates.

Ummm.... just out of curiosity, what exactly is your justification that governments can be more efficient than private industry when their size grows? The only real advantage that the government has over private industry is that they have the legal means to force others to support their activities.

 

[Toke]

Ummm.... just out of curiosity, what exactly is your justification that governments can be more efficient than private industry when their size grows? The only real advantage that the government has over private industry is that they have the legal means to force others to support their activities.

How about the cost of healthcare in europe versus the US.
Would that do?

 

[Ivor the Engineer]

<snip>

Put it this way... if you were diagnosed with cancer (or some other disease), would you want treatment as quickly as possible, or would you be happy waiting, content in the knowledge that at least others will be waiting just as long as you do?

If 100 other people who were richer than you were also diagnosed with cancer (or some other disease), would you be happy waiting, content in the knowledge that their illness might not be a severe as yours, but that they're getting treatment ahead of you because they can afford to pay more?

 

[Ivor the Engineer]

<snip>

Ummm.... just out of curiosity, what exactly is your justification that governments can be more efficient than private industry when their size grows? The only real advantage that the government has over private industry is that they have the legal means to force others to support their activities.

The NHS has 1.3million employees and is one of the lowest cost comprehensive health services in the world.

 

[Toke]

I belive there are books written on private companies´s wastefulness.

 

[Beerina]

Another opinion:

http://www.cato.org/pub_display.php?pub_id=8852

"A bad idea to improve quality is a government-run "pay for performance" system. In theory, it is an excellent idea. The government would figure out what sorts of processes and treatments are most effective, and it would pay bonuses to providers who use such best practices. In practice, as the United Kingdom has found, "P4P" is a system that is ripe for gaming, because it is political. Doctors in the UK were able to build in an "exception" system, where they could designate certain patients as requiring exceptions from best practices."

Actually, like all such anti-freedom measures, it is a horrible idea.

As more treatments are developed, there's simply more things to buy, and more shiny, new, expensive stuff to buy.

There isn't a "health care thing" you buy. There are thousands of drugs and treatments, with more coming daily, to buy.

High costs should be seen as a sign of phenomenal success of freedom, not as a thing that needs "fixing". If someone produces a cure for cancer tomorrow, but wants to charge $10,000 for it, who the flying hell are you to tell them they can't? You are a dirt-grubbing worm squirming around waiting for people to throw scientific miracles at you. But no, you want to fix it.

But if you "fix" it, you will slow the rate of technological development. This will harm more people than you can possibly conceive of helping. We only have hundreds of large-scale economic experiments last century to demonstrate this beyond a reasonable doubt.

It does, however, have all the necessary properties of a meme that spreads as a parasite, i.e. it harms in actuality, all the while creating a fraudulent representation in your mental model of reality. I notice your religious-like knee-jerking activating the meme's defense mechanisms, the way a religious fanatic resorts to "well, the ways of God are mysterious indeed", when faced with questions like why does God allow babies to be microwaved.

Yes, I know "everyone wants it". Yes, I know "everyone in Canada and Europe are pleased with it." Are these arguments skeptics accept?

No, so if you are intellectually honest, you will reject them as arguments.

​

 

[macdoc]

. if you were diagnosed with cancer (or some other disease), would you want treatment as quickly as possible,

Spare us the polemics - if you have a potentially critical condition in Canada you are treated immediately. Period.
I was in exactly that situation 7 days ago, I got the ultrasound and blood work I needed the same day the potential condition was detected, specialist appointment the next morning and he scheduled surgery this Monday.

Non - life threatening situations like hip and knee replacements yes there are waiting lists and yes some very few go to the US or India to get them.

All systems can be improved - the US is a mess in comparison to Canada both in costs and outcomes.

US = poor outcomes for the highest cost.
25% of spending on administration alone and that's of the highest per capita - it's a joke amongst first world nations and a predator friendly zone.