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Stossel Solves the Health Crisis with Capitalism

There are over 4 million live births in the USA per year. If the significant factor in this difference is the availability of universal healthcare (and this seems very likely), then this implies that the lives of about 6,000 babies every year might be saved.
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I don't understand how insurance comes into play here. Why are you guessing that not having UHC is a contributor here?
 
Oh, I see. You made a claim on someone else's insurance.

An excessive, inflated claim, that allowed you to pocket a lot of money.

Freeloader.

But even so, I'm pretty sure insurance companies here aren't that easy to take for a ride.

Rolfe.
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OT:
I had very little to do with the whole process. The other persons insurance company sent a rep to my house, the guy had a look at my car, and a few days later I had a check in the mail.
 
DaN K. StAnLeY said:
I don't understand how insurance comes into play here. Why are you guessing that not having UHC is a contributor here?
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Would you care to speculate on any other reason? It's certainly the most obvious difference between the two countries concerned. Another poster also provided some statistics that specifically linked poorer outcomes in this and other areas to lack of insurance cover.

Rolfe.
 
DaN K. StAnLeY said:
OT:
I had very little to do with the whole process. The other persons insurance company sent a rep to my house, the guy had a look at my car, and a few days later I had a check in the mail.
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Well, it's not that off-topic, it links to Stossel's claim that "when things are free, everybody just grabs everything they can." The fallacies in that have been discussed above, particularly in relation to the "demand curve". However, can we just agree that insurance companies in the US may be astoundingly bad at cost control/loss adjustment, and that this bad management may extend to health insurance administration?

This still has no relevance at all to the discussion of universal healthcare, because in such systems there is no evidence that patients are given any opportunity to "grab everything they can". The doctor prescribes what the patient is to have. The doctor is incentivised to save money, both by numerous prescribing guidelines aimed at ensuring he's aware of how he should be prescribing, and by risking a financial penalty to his business if he exceeds his annual prescription drug quota.

It's common for the "NHS" version of stuff to be so basic that the patient decides to pony up some cash to get something a bit slicker. NHS spectacle frames, for example, are notoriously cheap and nasty and uncool. Everybody coughs up for designer frames. Stossel seems to have some fantasy where everyone can just go in and demand the latest Gucci spectacles, free, as of right. Doesn't happen. He's just messing with your mind because he wants you to reject the idea of universal healthcare.

Another one was insulin needles, the very fine ones that don't hurt. Expensive. The NHS was only supplying the cheaper 25g standard needles, and diabetic patients either had to put up with it, or buy the fine needles themselves. This was changed after a campaign by mothers of diabetic children who protested that their children were suffering distress as a result. But you still can't go and pick up unlimited numbers of needles to sell to your friends or start an acupuncture clinic - you get what you need, that's all.

That's how it works. So the insurance company profligacy is copletely irrelevant.

In fact, it's worse than irrelevant. It's yet another example of pointing to a flaw or a gripe which exists in your present system, and using that as an excuse not to consider something different. This is reasonable, how?

Remember, we spend 7.7% of GDP to cover everyone, you spend 14.8% of GDP not to cover everyone.

Rolfe.
 
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shuttlt said:
Doesn't this make the US military a little bit socialist? Has this been said already?
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It has been touched on, yes. I think there's a standard libertarian answer to that. Can't have our military relying on voluntary contributions for funding, can we? And how can our military be communist? No, there's an "Answer"[TM].

Rolfe.
 
GStan said:
I have a headache. My worldview has been sufficiently disrupted over the past few months by this and other threads on the subject of healthcare to the point where my idle thoughts seem to dwell on nothing else. (It doesn't help that I also work in healthcare :)). I have alot more I wish to discuss, but a family issue is going to keep me away from the forums/away from internet access for a few days.

Just wanted to post this so I don't get pegged as someone who flees from difficult threads. Don't solve everything without me. I'll be back next week.
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Looking forward to it. It will be interesting to hear from someone working in the system. I find that people often have unrealistic ideas about how a particular eventuality might be handled in a universal healthcare system, which lead them to attack straw men, and it would be instructive to examine some examples.

Rolfe.
 
Rolfe said:
Would you care to speculate on any other reason? It's certainly the most obvious difference between the two countries concerned. Another poster also provided some statistics that specifically linked poorer outcomes in this and other areas to lack of insurance cover.

Rolfe.
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Nobody really knows what's going on with our infant mortality. I have the dubious honor of living in the city with the worst infant mortality in the country, and in the zip code with the worst in the city. It's as bad as a third world country here.
I've looked into the research on what causes it here, and a lot of it is the result of a shockingly high rate of prematurity. What causes the prematurity is a mystery, but they've ruled out maternal behaviors (such as smoking, drug and alcohol use, etc) and lack of prenatal care.
Maternal stress seems to be the most significant risk factor. What causes the working class to be so stressed out is complex, but the lack of UHC certainly is involved, albeit indirectly.
 
You want to see some of the working class living conditions round here. There are parts of Glasgow that have been compared unfavourably with the Gaza strip.

I would question whether lack of healthcare access was a significant contributor to maternal stress if in fact inadequate antenatal care was not an issue. How is antenatal care funded for mothers in this group anyway? Medicaid? Is it adequate?

Here, everybody shows up for their routine appointments regardless of social background, and while provision is not even across all areas attempts are made to improve provision for poorer areas, including allocating more NHS funds to areas of known deprivation. I imagine there are swanky antenatal units in private hospitals if you're in the right place, but to be honest I haven't heard of this outside London. Elsewhere, antenatal care is a great leveller!

I wonder if rates of prematurity in your area are actually that much different from a comparable area in Britain. Of course care of premature infants is a very costly exercise, with special care baby units and intensive care neonatal cots. I wonder if that's the difference? Or does Medicaid really provide for such infants just as well as an insurance company would? I would think someone would have looked at this though.

I'm only speculating, and it was only an example. Even if there were no difference in neonatal mortality, I still think the advantages of universal access to healthcare are overwhelming.

Rolfe.
 
That's true. I freely admit I was conflating problems there.

We're so not perfect either. And the NHS doesn't even rank among the best of the universal healthcare systems. But I wouldn't trade it for the US system on a bet.

Rolfe.
 
I would question whether lack of healthcare access was a significant contributor to maternal stress if in fact inadequate antenatal care was not an issue. How is antenatal care funded for mothers in this group anyway? Medicaid? Is it adequate?
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The state has a program for extremely low income pregnant women, but you basically have to be unemployed to qualify. I tried to get on it when I was pregnant with my first, and I was told, flat out, to stop working so I could qualify.
If you are unwilling or unable to do that, you work out a self-pay deal with the teaching hospital. So, I worked overtime while pregnant and gave almost everything I earned to the hospital/clinic. I have no idea what % of people choose what option, but I think most go with the former. Whichever option one goes with will be stressful, though.

The care one recieves there is evidence based and comprehensive, even if it's a bit impersonal and assembly-line-like. But that shouldn't matter in terms of outcomes, I don't think.

I wonder if rates of prematurity in your area are actually that much different from a comparable area in Britain.
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Unless certain areas in the UK have infant mortality rates similar to third world countries, I think our rate has to be higher? It would be interesting to look into, though.

Of course care of premature infants is a very costly exercise, with special care baby units and intensive care neonatal cots. I wonder if that's the difference? Or does Medicaid really provide for such infants just as well as an insurance company would? I would think someone would have looked at this though.
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The teaching hospital has (supposedly) one of the best NICUs in the country. It recieves state funding to stay open. They can only work so many miracles with so many babies being born on the cusp of viability, though.

Here's some links if anyone is curious:

http://www.commercialappeal.com/mca/local/article/0,2845,MCA_25340_4757196,00.html

http://www.usatoday.com/news/health/2007-11-10-infantmortality_N.htm

And here's an editorial on a symposium held on the infant mortality problem here:

http://www.ncbi.nlm.nih.gov/pubmed/18507578

(from the fulltext)

Healthy pregnancy outcomes
have little to do with access to health care.
Moreover, the consortium found that contrary to conventional
wisdom, poor pregnancy outcomes could
not be attributed initially or primarily to ignorant,
immoral, or irresponsible maternal behavior. I want
to repeat that slowly, deliberately, and succinctly:
Poor pregnancy outcomes and infant mortality are
not a consequence of poor prenatal care or mothers
behaving badly.
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In summary, the Commission discerned three
sturdy and interwoven strands of ideology running
throughout the history of gathering and interpreting
infant mortality data. The first strand that most
explicitly continues to inform public policy today is
the notion that pregnancy is a pathological condition,
or so nearly so that it requires medical supervision.
The second strand lifted up for examination is distinctly
misogynist and not so silently portrays women,
especially women of color, as ignorant, immoral,
and/or incompetent to the task of childbearing and
childrearing. The third strand examined was the most
subtle yet consistent and consistently ignored. That is,
throughout the history of infant mortality studies an
awareness is evident that toxic social relationships,
social conditions, or both adversely affect maternal
and child health.
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That is, throughout the history of infant mortality studies an
awareness is evident that toxic social relationships,
social conditions, or both adversely affect maternal
and child health.
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I have heard of minx farmers complaining and suing over lowflying fighterjets.
The problem was that the minx lost their kittens/whelps?.
 
Would you care to speculate on any other reason? It's certainly the most obvious difference between the two countries concerned. Another poster also provided some statistics that specifically linked poorer outcomes in this and other areas to lack of insurance cover.
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I was just thinking that there are a bunch of programs you can get on if you have a sick baby, so it seemed like HC wouldn't be a factor.


Remember, we spend 7.7% of GDP to cover everyone, you spend 14.8% of GDP not to cover everyone
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Could this have anything to do with our per capita income being higher? It seems like that was discussed before but I don't feel like link fishing. My reasoning here is that since we make more money, we are more inclined to spend it on our health care. More income to spend on health = more per capita HC spending.

As for the post 529, I have nothing to add.
 
DaN K. StAnLeY said:
I was just thinking that there are a bunch of programs you can get on if you have a sick baby, so it seemed like HC wouldn't be a factor.
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You may be right, I don't have the information to make a judgement. It was only an example.

DaN K. StAnLeY said:
Could this have anything to do with our per capita income being higher? It seems like that was discussed before but I don't feel like link fishing. My reasoning here is that since we make more money, we are more inclined to spend it on our health care. More income to spend on health = more per capita HC spending.
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You think? You think then, that it's all voluntary, nobody is in any way struggling to meet the cost of their healthcare needs, and everybody is just a happy little consumer?

You think it's all good value for money?

Do you have any evidence that any other country with a per capita income similar to the US chooses to spend as much as 15.8% of GDP on healthcare?

I have to say that as my per capita income increases (and I'm well above the average US figure), I'm not totally gagging to spend a big chunk of it on essential healthcare.

There's actually a lot about that suggestion that doesn't add up, but I'm off for an early(ish) night here, so I'll see if anyone else has any comment. Francesca?

DaN K. StAnLeY said:
As for the post 529, I have nothing to add.
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Agree? Disagree?

Your new position, that high healthcare spending is just voluntary preferential spending by the affluent, would suggest that you disagree, and yet, if you disagree, I'd have hoped that you might be able to highlight specific points.

Goodnight for now.

Rolfe.
 
Remember, we spend 7.7% of GDP to cover everyone, you spend 14.8% of GDP not to cover everyone
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Could this have anything to do with our per capita income being higher? It seems like that was discussed before but I don't feel like link fishing. My reasoning here is that since we make more money, we are more inclined to spend it on our health care. More income to spend on health = more per capita HC spending.
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I think you got it the wrong way around.

Assuming that a x-ray mashine cost a fixed amount from the manufacturer, the cost would be a lower percentage of your money if you were richer.

Payscales tend to be higher in richer countries, but I would expect it to follow GNP giving you the same percentage.
Unless you have a more uneven distribution of income, where hospital staff in general get a smaller share of GNP than in the UK.
Then you would end up with a lower percentage.
 
You think? You think then, that it's all voluntary, nobody is in any way struggling to meet the cost of their healthcare needs, and everybody is just a happy little consumer?

You think it's all good value for money?

Do you have any evidence that any other country with a per capita income similar to the US chooses to spend as much as 15.8% of GDP on healthcare?

I have to say that as my per capita income increases (and I'm well above the average US figure), I'm not totally gagging to spend a big chunk of it on essential healthcare.

There's actually a lot about that suggestion that doesn't add up, but I'm off for an early(ish) night here, so I'll see if anyone else has any comment. Francesca?
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Pffft, I didn't even think about that.

Agree? Disagree?

Your new position, that high healthcare spending is just voluntary preferential spending by the affluent, would suggest that you disagree, and yet, if you disagree, I'd have hoped that you might be able to highlight specific points.

Goodnight for now
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If everything is truly like you say it is, it sounds like a great system. I don't have a new position, just a couple questions.

Goodnight, Rolfe .
 
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It will be interesting to see what happens in the next 10 years with this issue. I wonder how it will be to revisit this thread after living under a soc-UHC system. I'm sure that it's going to be tried soon and I think I remember hearing someone suggesting it would be done on the state level first.
 
DaN K. StAnLeY said:
It will be interesting to see what happens in the next 10 years with this issue. I wonder how it will be to revisit this thread after living under a soc-UHC system. I'm sure that it's going to be tried soon and I think I remember hearing someone suggesting it would be done on the state level first.
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Do you, at this point, have a problem with the idea of trying out UHC? Are you sort of agnostic at this point on the issue? I'm getting the impression that you're feeling sort of ambivalent about it. Is that correct?

And I think you might be right about the states individually implementing programs. My state just started this very recently:

For children:

http://www.covertn.gov/web/cover_kids.html

CoverKids provides free, comprehensive health coverage for qualifying children 18 and younger.
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"Qualifying" status is explained here:

http://www.covertn.gov/web/coverkids_income.html

For a mom, dad, and 2 kids...you're in if you make under $55,000 a year, which is well into middle class.

For adults, it's not free, but it's cheap:

http://www.covertn.gov/web/cover_tn.html

CoverTN relies on voluntary partnerships between the state, individuals and employers where each commit to pay one-third of the monthly premium of the low-cost product.

CoverTN offers affordable, portable health insurance options that meet the needs of small business owners, the self-employed and individuals who otherwise couldn't afford coverage. CoverTN is a limited-benefit health insurance plan that provides low-cost coverage for basic medical services.


CoverTN is based on three key concepts
• Affordable
» Low premiums shared equally by the state, employer and employee
» Individual's monthly premium shares range between $37 and $109
» Premiums vary depending on age, weight and tobacco use

• Portable
» Owned by the individual
» Members keep coverage even if they leave an employer
» Provides continued coverage during brief periods of unemployment
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Even the top end of $109 per adult per month is dirt cheap compared to most insurance.
And the income eligibility for the adult program is stated here:

http://www.covertn.gov/web/covertn_eligible.html

• Earns $55,000 or less per year in adjusted gross income
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You have to be bordering on "well off" to not qualify. And the person receiving the insurance still pays in monthly, just like with regular insurance.

Dan, you said you're going to be self employed soon and maybe going without insurance for a short while. If a program like this was available where you live...and they say this:

Self-Employed Eligibility
Self-employed individuals are eligible to apply for CoverTN. Self-employed means that you are in business for yourself or are an independent contractor and your business does not have any employees. Self-employed applicants, to be eligible for CoverTN, must be able to show income from the business equal to at least 20 hours per week at minimum wage, or about $6,800 per year.
• Tennessee resident for six months
• A U.S. citizen or qualified legal alien
• 19-years-old or older
• Works an average of 20 hours per week
• Earns $55,000 or less per year in adjusted gross income • Has not had health insurance in the previous six months (individual or group coverage)*
• Must agree to pay two-thirds of the premium
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Would you want to do that? Or would you rather just go without insurance?
 
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