single-payer system ... singled out

[elbe]

Not that this happened is, say, the UK or other countries where we still have the choice.....

I haven't, to be honest, seen any evidence that western democracy governments really have a goal to enslave their populace.

 

[Rolfe]

Well, exactly. I'm getting slightly tired of Americans telling us that we're all slaves, because we have a universal healthcare system. (Why doesn't having publicly-funded schools, or libraries, or a fire service, or roads, make us slaves? Well, because Americans have these too. It's only publicly-funded healthcare that makes you a slave it seems.) According to one poster, we are being held at gunpoint. We aren't free. The government controls our lives. And all because, when we're sick, we can go to the doctor without any worry about how much it's going to cost.

And yet the concern seems genuine. Some US posters genuinely worry that if they had universal healthcare, the next thing that would happen would be all sorts of bizarre restrictions on their lives. I've lost count of the things people have suggested would happen, from compulsory government-provided food to a smoking ban.

Take your heads out of your backsides and look around. Has any of the other western countries that provides universal healthcare gone down that sort of road? Well, no. In fact, the availability of univeral healthcare provides very important freedoms to citizens that many US citizens currently lack, such as the freedom to change jobs without affecting healthcare entitlement. There is simply no example of universal healthcare having led to any loss of freedom in any other country.

The clue here might be that democracy thing. We elect our politicians. And even though we seem to make a pretty bad job of it a lot of the time, this imposes certain limits on what they can do. By and large, people don't vote for parties that introduce unpopular measures. And if such measures get pushed through anyway, the opposition is likely to get elected next time round to undo them. If we want universal healthcare, we vote to introduce/retain it. And if we don't want a universal food plan, we don't vote for the party proposing it. We don't lie awake at night worrying that we have to vote against the healthcare package because if we accept that we might find ourselves automatically voting for the food plan next time round.

Yes, governments do introduce restrictions on freedom by the back door. Ours has done it and the US government has done it. But in neither case has the excuse been healthcare. If you're concerned about loss of freedom, look at your anti-terrorism legislation. Healthcare legislation, in contrast, doean't have a track record of leading to loss of civil liberties. It has a track record of vastly improving the lives of hundreds of thousands of ordinary people.

Wake up and smell the coffee.

Rolfe.

 

[Neally]

-The government is able to provide health care in a more cost-effective manner, in which case it seems single-payer or even "socialised medicine" would be a logical imperative.

So far, not so good:

A new study I've completed, published by the Pacific Research Institute, takes all health-care spending in the United States and subtracts the costs of the two flagship government-run programs, Medicare and Medicaid. It then takes that remaining spending and compares its cost increases over time with Medicare's cost increases over time.

The results are clear: Since 1970 — even without the prescription drug benefit — Medicare's costs have risen 34% more, per patient, than the combined costs of all health care in America apart from Medicare and Medicaid, the vast majority of which is purchased through the private sector.

Since 1970, the per-patient costs of all health care apart from Medicare and Medicaid have risen from $364 to $7,119, while Medicare's per-patient costs have risen from $368 to $9,634. Medicare's costs have risen $2,511 more per patient.

http://www.investors.com/NewsAndAnalysis/Article.aspx?id=480067

 

[Darat]

Then, to paraphrase Rolfe, stop trying to fix the old banger, it's knackered, buy a new car!

 

[Prometheus]

Well, exactly. I'm getting slightly tired of Americans telling us that we're all slaves, because we have a universal healthcare system. (Why doesn't having publicly-funded schools, or libraries, or a fire service, or roads, make us slaves? Well, because Americans have these too. It's only publicly-funded healthcare that makes you a slave it seems.) According to one poster, we are being held at gunpoint. We aren't free. The government controls our lives. And all because, when we're sick, we can go to the doctor without any worry about how much it's going to cost.

That's a good point, that I'll have to remember next time one of my countrymen tries to convince me that UHC will ruin all our lives, just like it has done to the Brits.

And yet the concern seems genuine. Some US posters genuinely worry that if they had universal healthcare, the next thing that would happen would be all sorts of bizarre restrictions on their lives. I've lost count of the things people have suggested would happen, from compulsory government-provided food to a smoking ban.

In all fairness, the concern is genuine, albeit perhaps a bit too paranoid. I support UHC wholeheartedly, but I'm not at all confident that the US government could pull it off. Still, I'd like to at least try to find out if it can. I wonder if a lot of other Americans actually realize how dysfunctional our democracy really is, but just can't/won't admit it when arguing about health care.

Take your heads out of your backsides and look around. Has any of the other western countries that provides universal healthcare gone down that sort of road?

Has any other western country elected [insert either "George W. Bush" or "Bill Clinton" here, as you prefer] -- Twice?

Well, no. In fact, the availability of univeral healthcare provides very important freedoms to citizens that many US citizens currently lack, such as the freedom to change jobs without affecting healthcare entitlement. There is simply no example of universal healthcare having led to any loss of freedom in any other country.

We hate you for your freedoms.

The clue here might be that democracy thing. We elect our politicians. And even though we seem to make a pretty bad job of it a lot of the time, this imposes certain limits on what they can do. By and large, people don't vote for parties that introduce unpopular measures. And if such measures get pushed through anyway, the opposition is likely to get elected next time round to undo them. If we want universal healthcare, we vote to introduce/retain it. And if we don't want a universal food plan, we don't vote for the party proposing it. We don't lie awake at night worrying that we have to vote against the healthcare package because if we accept that we might find ourselves automatically voting for the food plan next time round.

Won't anyone think of all the insurance industry fat cats who might have to delay their early retirement a few years, or buy a smaller private island to enjoy it on if we temporarily interrupt their profit-making potential for such an experiment?

Wake up and smell the coffee.

Rolfe.

Why do you hate tea?

 

[elbe]

So far, not so good:

The problem with medicare/medicaid as I see it is that they weren't designed to be a public health care option, they were designed to be a healthcare safety net shoehorned into the existing private system. It doesn't fit well in there and certain lobbyists, like the insurance industry, most likely "encourages" congress to reduce its availability and benefits. If the US were to do a public option it would have to be designed differently, not just by patching up the existing services.

 

[Rolfe]

Yes, exactly. What that man just said.

Has any other western country elected [insert either "George W. Bush" or "Bill Clinton" here, as you prefer] -- Twice?

I see your contenders, and I raise you Tony Blair. (I would say Margaret Thatcher, but my crawling suspicion is that you guys actually approved of the bloody woman.)

Rolfe.

 

[Prometheus]

Yes, exactly. What that man just said.




I see your contenders, and I raise you Tony Blair. (I would say Margaret Thatcher, but my crawling suspicion is that you guys actually approved of the bloody woman.)

Rolfe.

Good point! Though aside from being the butt of a good joke in Austin Powers, I can't really think of much use for Thatcher, either.

Actually, though, I'm worried that there may well be a very real problem with the prospect of the U.S. government running a UHC system. It's the tendency of both political parties to play political football with hot button issues like health care, and the way in which this plays out in our political system. For instance, a common technique that is often employed by whichever party holds the White House is to undermine laws that they oppose by drasticly reducing the staff/resources of whichever agency is required to enforce them, or deliberately appoint incompetent staff who are loyal to their party to oversee them. Does the same thing happen over there?

I'm worried that with the level of political mudslinging going on over health care, it's a sure bet that if we get UHC, it will be actively, if sporadically, sabotaged from within.

 

[ARubberChickenWithAPulley]

Actually, though, I'm worried that there may well be a very real problem with the prospect of the U.S. government running a UHC system. It's the tendency of both political parties to play political football with hot button issues like health care, and the way in which this plays out in our political system. For instance, a common technique that is often employed by whichever party holds the White House is to undermine laws that they oppose by drasticly reducing the staff/resources of whichever agency is required to enforce them, or deliberately appoint incompetent staff who are loyal to their party to oversee them. Does the same thing happen over there?

That's another reason I'm far more inclined to support a multi-tiered system administered privately, but regulated Federally.

The politicians will still have their boogeymen (Health insurers), and we can still ensure everyone has access to healthcare.

 

[Neally]

The problem with medicare/medicaid as I see it is that they weren't designed to be a public health care option, they were designed to be a healthcare safety net shoehorned into the existing private system. It doesn't fit well in there and certain lobbyists, like the insurance industry, most likely "encourages" congress to reduce its availability and benefits.

So the lobbyists are responsible for the cost of Medicare increasing 34% more per patient than private health care?

 

[elbe]

So the lobbyists are responsible for the cost of Medicare increasing 34% more per patient than private health care?

I'd say it's complicated. In general, I would blame it on the people who don't want medicare to succeed. The whole of the insurance industry would rather medicare to fail, and all the "small-government" politicians who think it's wasteful and have no interest in improving it for ideological reasons.

On average I would guess medicare would pay more per patient than normal insurers because it covers the elderly and the elderly tend to need more more medical services.

 

[ARubberChickenWithAPulley]

I'd say it's complicated. In general, I would blame it on the people who don't want medicare to succeed. The whole of the insurance industry would rather medicare to fail, and all the "small-government" politicians who think it's wasteful and have no interest in improving it for ideological reasons.

Do you have any proof that Medicare's failures are the fault of the insurance industry?

This seems awfully convenient: Blame the failures of the private system on the insurance industry. Blame the failures of the government's system on... the insurance industry.

That's even ignoring the fact that (as I cited more than once in this thread), the insurance lobby isn't even close to the largest health care lobby in country.

 

[elbe]

Do you have any proof that Medicare's failures are the fault of the insurance industry?

This seems awfully convenient: Blame the failures of the private system on the insurance industry. Blame the failures of the government's system on... the insurance industry.

That's even ignoring the fact that (as I cited more than once in this thread), the insurance lobby isn't even close to the largest health care lobby in country.

I believe, whether rightly or wrongly, I blamed both the insurance industry and the government. I was making a hypothesis based on the situation as I perceive it.

The private system's failures are the fault of the private system. If the government isn't running it it can't break it, can it? The existing public systems failures are because the government doesn't care, or want to fix it. The lobbyists from the public systems probably encourage it's downfall, but in the end it is the choice of the government to actually do something about it.

I don't feel that everything is the fault of the private sector, but health care should be too important for people who's only real concern is their bottom line.

I choose not to say the health care industry because I didn't want to include the doctors, and such, but the bureaucracy of it is also at fault for the way our system is working.

 

[Professor Yaffle]

I linked to this in a previous thread, perhaps you might like to take a look:

http://scienceblogs.com/denialism/2009/05/what_is_the_cause_of_excess_co.php

Medicare used to be one of the most efficiently-administered systems in government until the Bush administration got its hands on it. By subcontracting administrative work to private contractors, suddenly 30% of the costs just go to profit, and payments to physicians for reimbursement have decreased accordingly. Most physicians I know under this regime have complained that they create barriers to registration, barriers to reimbursement, have very little recourse for rejected reimbursement, and then finally when everyone gets fed up with one of these subcontractors the government jumps to a new one. Then you have to start the process over again, learn the quirks of the new company, start a complaint file with them, and by the time you're used to them, a new company gets the contract. This is the lie of the private system being better than government no matter what. I'm sure private contractors can do something better than public servants, but it certainly isn't healthcare administration, and the data shows it, as costs ramped exponentially under this system despite relatively stable numbers of medicare subscribers.
The argument for public administration of health care is strengthened by these numbers, and based upon historically medicare administration costing only about 10% as much as private insurers' administrative costs. One may also look at other public systems like the VA, in which administrative costs are a fraction of those with private insurers. Or, one may point out that in health care systems with public and private payers in competition, or highly regulated private payers, these costs are also substantially reduced, as should be clear from the first figure - most the comparison countries have private insurers, they are just better regulated.

Finally, the largest problem is that our government, hijacked by these companies during the last legislation over health care, was forbidden from collectively bargaining for lower drug prices under medicare part D. A decision no other country in the world would be so stupid as to make as they didn't have a political parties hugely corrupted by pharmaceutical interests like we do.

 

[ARubberChickenWithAPulley]

I believe, whether rightly or wrongly, I blamed both the insurance industry and the government. I was making a hypothesis based on the situation as I perceive it.

Yes. And I challenged you to provide some proof for the hypothesis.

The private system's failures are the fault of the private system. If the government isn't running it it can't break it, can it?

Sure it can. The government regulates it and taxes it. It can slap mandates on businesses (as it has with health insurance mandates, forcing them to cover, say, mental health or alcoholism treatment whether or not people want to buy it), it can levy taxes on services (for example, many states tax health insurance premiums, which is passed on to the consumer), it can create extremely complicated laws that cost a lot of money to learn and comply with (especially when every state has its own laws), it can encourage certain types of companies and systems via regulation (see ERISA and the HMO Act of 1973, for example), and discourage other types (see the tax code, which exempts employer-based benefits but not individually purchased benefits), etc. etc. Whether the government "broke" the system is perhaps debatable, but it can certainly have a serious, often adverse, impact.

I don't feel that everything is the fault of the private sector, but health care should be too important for people who's only real concern is their bottom line.

I choose not to say the health care industry because I didn't want to include the doctors, and such, but the bureaucracy of it is also at fault for the way our system is working.

Most doctor practices, many hospitals, not to mention pharmaceutical companies, medical supply companies, etc. are "for profit." So if profit is the issue (as you seem to indicate above), that would implicate a large portion of our system aside from the payers.

 

[Neally]

I linked to this in a previous thread, perhaps you might like to take a look:

http://scienceblogs.com/denialism/20..._excess_co.php

So if Bush broke it, Obama should be able to fix it, no? Regardless of whether he gets his new program implemented or not.

 

[elbe]

Yes. And I challenged you to provide some proof for the hypothesis.

What you had done was asserted that I said something I hadn't, and I corrected you. And no, I don't have any evidence to back up my opinion, aside from any presented earlier in these threads. I tried not to make claims as to the factuality of topics I don't have evidence for, but instead focused on my perception of them. If you felt I had, I apologize.

Sure it can. The government regulates it and taxes it. It can slap mandates on businesses (as it has with health insurance mandates, forcing them to cover, say, mental health or alcoholism treatment whether or not people want to buy it), it can levy taxes on services (for example, many states tax health insurance premiums, which is passed on to the consumer), it can create extremely complicated laws that cost a lot of money to learn and comply with (especially when every state has its own laws), it can encourage certain types of companies and systems via regulation (see ERISA and the HMO Act of 1973, for example), and discourage other types (see the tax code, which exempts employer-based benefits but not individually purchased benefits), etc. etc. Whether the government "broke" the system is perhaps debatable, but it can certainly have a serious, often adverse, impact.

I was being sarcastic. Perhaps I should have used one of those accursed smileys. Of course the government can "break" industries it doesn't directly control, but I don't believe that is the cause of the skyrocketing cost of medical care in this country. I believe the greater medical system is primarily at to blame for the massive faults in our system.

Most doctor practices, many hospitals, not to mention pharmaceutical companies, medical supply companies, etc. are "for profit." So if profit is the issue (as you seem to indicate above), that would implicate a large portion of our system aside from the payers.

Whether for profit or not doesn't change the actual goals of various members of the health care industry. I would like to think, but maybe I'm wrong, that most doctors and nurses are in it for the patients, not the money. While I doubt all of them are, I didn't want to lump them all together. But even then, the ones I feel are most likely to blame are the bureaucrats. Health care is a necessity and people are remarkably likely to pay for medical care to save their lives, even if costing more than in every other civilized country. There are people who will use that to their advantage, people who don't want to help or heal, but who just want to maximize profits.

I was not, as you may have felt, attempting to criticize "profit", just exploitation of people who are in need.

 

[Oliver]

President Obama's presser on the Public Option

 

[Rolfe]

The proposal doesn't sound that great to me. It's interesting how many people on the discussion thread are arguing for "single-payer".

The private for-profit health insurance industry isn't actually concerned with providing healthcare to its customers. The business model for the health insurance industry is clearly to sell as much insurance as possible, BUT to pay for as little healthcare as possible. How does that serve the public?

He's got a point.

But then there are still those who have swallowed the lies about universal healthcare systems hook, line, sinker and rowboat.

I am a small biz owner. I pay for my own Health insurance. I watch every penny and do not go an ER room for a cold. My husband was diagnosed with stage 4 cancer (we are in our 40's). I thank God everyday that I live here instead of a socialist country where his late stage cancer would not have been seen by a doctor for 6 months. He is cured. He would not have lived the 6 months waiting. I suggest all on this site grow up and start taking your health as your own responsibility NOT the GOVERNMENT'S. You will face a health issue, Let's hope that you won't have to wait (or be too old) to get help. I'll pray for all of you that this will not pass.

No, you stupid woman, you do not have to wait six months to see a doctor if you have cancer. Or appendicitis, or Mexican flu, or pleurisy, or DVT or anything else.

Rolfe.

 

[Distracted1]

President Obama's presser on the Public Option

I feel as if the president consulted my post (#694) before his press conference