Supreme Court Health Care Decision Thread

[JFrankA]

Nice chart. Thanks, Frank.

Thanks. I'd like to keep this updated and correct too, so if anyone knows of an update or a mistake I might have made, please feel free to contact me.

By the way, in a discussion with my father over this, and he's actually discussing it even though he's a knee-jerk Fox News believer, he asked me what happens if an illegal immigrant tries to get health care. Basically, he's worried that, for example, if an illegal immigrants goes to the emergency room for some reason, gets the care, he still gets that care for free.

According to the ACA, as an illegal immigrant, he can't pay for any insurance, even in cash, so they don't pay income taxes either.

The way I see it, if they have a TIN card, they wouldn't be an illegal immigrant and if they had a fake SS card, they'd risk being arrested. Of course, that's just speculation on my part.

I haven't found anything yet explaining those scenarios without a lot bias. Anyone have any idea?

 

[Kestrel]

Some illegal aliens do use fake SS numbers to get jobs, some percentage of them will have perfectly valid insurance from their workplace. But under US law, emergency rooms are required to treat anyone who shows up, regardless of ability to pay. Illegal aliens who show up at the emergency room will continue to be treated. And hospitals will continue to shift the cost onto the bills of paying customers.

Do we really want to have a society where emergency rooms do a wallet biopsy before attempting to save a life?

 

[Sabretooth]

Where do the Americans go when they can't get health care? (see links below, it just might surprise you) I don't understand your argument. Here we are, the industrialized nation with ¹the highest per GDP health costs, fastest rising costs, little to no preventative medicine for a large section of the population. It's become so bad that many poor Americans are getting health care from ²Military personnel and ³volunteer doctors working in stadiums and country fairs. You don't think that is a sign of a broken system? Did you know that many Americans ⁴go to other countries for health care? Did you know that ⁵many Americans go to Canada? Did you know that ⁶Canadians are overwhelmingly happy with their system?

1. U.S. scores dead last again in healthcare study
2. A health care 'Judas' recounts his conversion
3. Using the military to provide health services
4. Medical tourism.
5. Americans go to Canada for health care to save money.
6. Canadians are (gasp!) happy with their health care system, and don’t want ours

What does all of that say about the comparison of the two systems? I'd take their system in a heart beat.

But, Rand, that really doesn't answer the question. Canada has Socialized medical. And despite their access to free health care, many come to the USA to pay for our services. Why?

Having many Canadian friends over the years, I can answer that...it's due to the extremely thin budgets and limited facilities of their system. Waiting lists extend out over many months...sometimes at the expense of a condition worsening during that period. So they come down here to get the testing/procedure/care and pay out of pocket because they don't have time to wait.

So, I ask again...is that a sign of a "working" system?

I realize that many Canadians are perfectly happy with their system...just as people in other countries are perfectly happy with a dictatorship...it's all they know. I can't help but take a poll like that with a huge grain of salt.

I'm not disagreeing with you that the American system is greatly flawed and that the new AHCA will help close some gaps...I'm just not sold on everything yet.

 

[Foolmewunz]

But, Rand, that really doesn't answer the question. Canada has Socialized medical. And despite their access to free health care, many come to the USA to pay for our services. Why?

Having many Canadian friends over the years, I can answer that...it's due to the extremely thin budgets and limited facilities of their system. Waiting lists extend out over many months...sometimes at the expense of a condition worsening during that period. So they come down here to get the testing/procedure/care and pay out of pocket because they don't have time to wait.

So, I ask again...is that a sign of a "working" system?

I realize that many Canadians are perfectly happy with their system...just as people in other countries are perfectly happy with a dictatorship...it's all they know. I can't help but take a poll like that with a huge grain of salt.

I'm not disagreeing with you that the American system is greatly flawed and that the new AHCA will help close some gaps...I'm just not sold on everything yet.

Whoa! I'm as fond of a good anecdote as the next guy, but this one would be better if it started off with "So these two Canadians and a duck walk into a clinic..." That way I'd know there was an actual punchline coming instead of the dogmatism.

You're citing your own anecdotal knowledge of some Canadian people who go to the US for treatment? Do you have any actual statistics to back that up? What would the figure be? 20% (6,000,000) of all Canadians? 10% (3,000,000? 5% (1,500,000)?
How about .61%? No, that's not 61%. It's 61/100ths of 1/100th(per cent). 18,000. In short, 99.39% do not opt to travel to the US for health care or medical services.

http://content.healthaffairs.org/content/21/3/19.full

There's a whole lot more of the population than 18000 people in Canada who could afford to buy health care or medical services in the US. They don't do it. Your anecdote is superficial and incorrect.

 

[Unabogie]

I took the time to make this graphic as to which states have chosen to take the ACA or not; or have at least accepted or rejected the grant that goes with it.


https://docs.google.com/open?id=0B__vxe9L0TijNVBHY0EyNFYtVzQ

This information is based upon this article, which I thought was very interesting.

http://m.apnews.mobi/ap/db_6776/contentdetail.htm?contentguid=S4ha0QCe

Thanks!

One minor quibble: Where you say that for red states, "you will not be part of the ACA", states that refuse to implement the exchanges (because of FREEDOM) won't be exempted from the law. The Feds will simply run the exchange for them until they get theirs online. If they continue to refuse, the Feds will just run them forever.

An interesting part of the exchanges is that it doesn't cost taxpayers anything. The whole thing is paid for by fees collected from the insurance companies who get to sell on the exchanges.

 

[Unabogie]

Whoa! I'm as fond of a good anecdote as the next guy, but this one would be better if it started off with "So these two Canadians and a duck walk into a clinic..." That way I'd know there was an actual punchline coming instead of the dogmatism.

You're citing your own anecdotal knowledge of some Canadian people who go to the US for treatment? Do you have any actual statistics to back that up? What would the figure be? 20% (6,000,000) of all Canadians? 10% (3,000,000? 5% (1,500,000)?
How about .61%? No, that's not 61%. It's 61/100ths of 1/100th(per cent). 18,000. In short, 99.39% do not opt to travel to the US for health care or medical services.

http://content.healthaffairs.org/content/21/3/19.full

There's a whole lot more of the population than 18000 people in Canada who could afford to buy health care or medical services in the US. They don't do it. Your anecdote is superficial and incorrect.

Yeah, I read somewhere that there are more people who travel to Canada for health care than the other way around. I have Canadian family, and while none of them claim their system is perfect, they all use it and laugh when I ask if they would swap systems with us. And one of them is pretty wealthy.

 

[boooeee]

Thanks!

One minor quibble: Where you say that for red states, "you will not be part of the ACA", states that refuse to implement the exchanges (because of FREEDOM) won't be exempted from the law. The Feds will simply run the exchange for them until they get theirs online. If they continue to refuse, the Feds will just run them forever.

An interesting part of the exchanges is that it doesn't cost taxpayers anything. The whole thing is paid for by fees collected from the insurance companies who get to sell on the exchanges.

A very good point, and more than a quibble in my opinion. No state is getting exempted from the ACA. All the insurance reforms apply, even if the state allows the Feds to handle much of the implementation.

As of 2014, regardless of your state:

You will be subject to the mandate if you don't have qualified coverage. You will be eligible for premium subsidies if you're below 400% of the Federal Poverty Level. You will not be turned down for pre-existing conditions.

JFrankA - While I applaud the effort, I think your chart focuses on the wrong thing. What you're really showing is whether the feds or the state will be running some of the day to day operations of the ACA, not whether the ACA itself will be enacted.

 

[SumDood]

...You will be eligible for premium subsidies if you're below 400% of the Federal Poverty Level...

The law provides subsidies for households that earn less than 400% of the Federal poverty level. The subsidy limits their total expenditures for health insurance to the range of 2% to 9.5% of total income.

A single person household earning minimum wage for 30 hours a week would be very near the poverty level and qualify for the highest subsidy. They would probably qualify for Medicaid, but if they didn't they would pay only 2% of their total income, or roughly $20 a month for health insurance.

Not that I doubt these claims, but can you provide sources?

 

[RandFan]

But, Rand, that really doesn't answer the question. Canada has Socialized medical. And despite their access to free health care, many come to the USA to pay for our services. Why?

But that really does answer the question. Why do so many American's go to Canada and other countries?

Having many Canadian friends over the years, I can answer that...it's due to the extremely thin budgets and limited facilities of their system. Waiting lists extend out over many months...sometimes at the expense of a condition worsening during that period. So they come down here to get the testing/procedure/care and pay out of pocket because they don't have time to wait.

Spin and propaganda.

So, I ask again...is that a sign of a "working" system?

Given that your claims are false you are begging the question.

I realize that many Canadians are perfectly happy with their system...just as people in other countries are perfectly happy with a dictatorship...it's all they know. I can't help but take a poll like that with a huge grain of salt.

I'm not disagreeing with you that the American system is greatly flawed and that the new AHCA will help close some gaps...I'm just not sold on everything yet.

We could have a meaningful discussion if you would soberly consider my premises and address those. Being dismissive and simply reasserting your claims without any evidence is rather poor form and not conducive to understanding. There is actually a point to my argument. Perhaps you could slow down, take a deep breath and consider what I'm saying.

Also, your point about polls and dictators is fatuous because people in autocratic societies are pressured to claim to love what they have and the polls are controlled by the self serving dictators. So there's reason to be skeptical of those polls. That's a false comparison.

 

[JamesDillon]

Sorry for the long delay on this. I had intended to step away from posting about this until I'd read the entire opinion. Still have 50 pages of dissent to go, but I think I've got the general sense of it.

No. In fact, their predictable need is just what they were counting on--but they were counting on them buying it from the within-quota market supply rather than satisfying that demand outside the market.

Then maybe I don't understand the point you're making about Wickard? If it's not that Congress could have justified a wheat mandate instead of a production cap, then what is it?

I disagree. Again, at the very least to assert that the plaintiffs were passive non-participants in the health insurance market they should at least have had to come up with plaintiffs who hadn't been migrating into and out of insurance coverage over time, and especially who hadn't in fact racked up healthcare costs that they couldn't afford to pay!

I'm not sure I see the relevance of this; people migrate into and out of markets all the time (see, e.g., the car-buying market). And no one denies that being uninsured has economic effects. But more on this below.

But IMO even if they had found such rare plaintiffs (if they exist at all), the fact that the health care system, which really is nearly 50% "socialized"--that is, almost 50% of healthcare costs are paid by public money--has to account for the known risk of the uninsured, taken in aggregate, of requiring federally mandated treatment regardless of their ability to pay that in fact they won't be able to pay for means that they really are participants in the system. The system really does have to provide for that risk. (And even if we managed to repeal EMTALA, we still have implied consent laws for unconscious accident victims.)



That's easy enough to distinguish from health insurance. People who opt not to buy or own a car (even for a time), taken in aggregate, are not a cost to the auto industry.

Someone here suggested that a person who buys a gallon of milk once a week is only an active participant in the milk market for that brief minute when they're actually purchasing the milk. That doesn't make any sense. And people who want to consider themselves part of the healthcare system only in the brief times when they need it represent exactly the kind of "gaming" of the system this law is intended to thwart.

Again, I think the activity argument here hinges on the fact that it really is impossible to opt out of the health care system. You can have every intention of never needing legally required treatment that you can't afford to pay for, but if you turn up at the ER unconscious, you must get that treatment regardless of your ability to pay. The healthcare system has to account for that cost.

I think I can respond to all of this together because you're relying on a basic point that Ginsburg's dissent puts a lot of weight on as well: uninsured individuals transfer a lot of costs to the health care system because the system is required to provide emergency care to those in need regardless of their ability to pay, which has the effect of transferring wealth from the insured to the uninsured through increased insurance premiums. That is an excellent policy reason for a health insurance mandate, and it's one that I agree with wholeheartedly. I'm not sure how it affects the Commerce Clause analysis or rebuts the activity/inactivity distinction. Again, the fact that being uninsured creates economic effects when an uninsured person participates in the market for health care doesn't change the fact that uninsured persons who are not active in that market just aren't doing anything that would seem to constitute "commerce." At most, it seems like Congress could insist that health care services cannot be provided for free and must be paid for through a qualified insurance plan rather than out-of-pocket. For obvious political and moral reasons, that isn't going to happen. But that in itself doesn't seem to me to expand the scope of Commerce Clause authority to cover people who have no present relationship to the regulated market.

Put differently, I just don't see how the regulatory scheme requiring health care providers to offer free services to some individuals can possibly create regulatory authority over those individuals that didn't exist before. To hold otherwise would seem to offer Congress a blank check to extend its Commerce Clause authority to any group just based on providing them some kind of federal benefit.

ETA re: Sabretooth: If we're trading anecdotes, my Canadian wife loves their health care system and has nothing but good things to say about her experiences with it (and those of her elderly mother, lest we suspect that my wife simply lacked adequate contact with the system as a young person.)

ETA (2): The joint dissent makes the point more articulately than I:

The [Ginsburg] dissent dismisses the conclusion that the power to compel entry into the health-insurance market would include the power to compel entry into the new-car or broccoli markets. The latter purchasers, it says, “will be obliged to pay at the counter before receiving the vehicle or nourishment,” whereas those refusing to purchase health-insurance will ultimately get treated anyway, at others’ expense. Ante, at 21. “[T]he unique attributes of the health-care market . . . give rise to a significant freeriding problem that does not occur in other markets.” Ante, at 28. And “a vegetable-purchase mandate” (or a car-purchase mandate) is not “likely to have a substantial effect on the health-care costs” borne by other Americans. Ante, at 29. Those differences make a very good argument by the dissent’s own lights, since they show that the failure
to purchase health insurance, unlike the failure to purchase cars or broccoli, creates a national, social-welfare problem that is (in the dissent’s view) included among the unenumerated “problems” that the Constitution authorizes the Federal Government to solve. But those differences
do not show that the failure to enter the health-insurance market, unlike the failure to buy cars and broccoli, is an activity that Congress can “regulate.”

By the way, I just noticed in pasting this that the joint dissent refers here to the Ginsburg opinion as "the dissent." More evidence that this was initially drafted as the majority opinion before Roberts switched his vote? Maybe.

 

[Sabretooth]

We could have a meaningful discussion if you would soberly consider my premises and address those. Being dismissive and simply reasserting your claims without any evidence is rather poor form and not conducive to understanding. There is actually a point to my argument. Perhaps you could slow down, take a deep breath and consider what I'm saying.

Fair enough, but I ask the same in return. I’ll take an in-depth look at your last response:

Where do the Americans go when they can't get health care? (see links below, it just might surprise you).

OK, let’s look:

Here we are, the industrialized nation with ¹the highest per GDP health costs, fastest rising costs, little to no preventative medicine for a large section of the population.
[*]U.S. scores dead last again in healthcare study

The headline is a bit misleading…considering only 6 countries were part of the comparison. I’m a bit skeptical of the data when mulling over other factors, such as lifestyles, coverage area, advanced care, etc. On a personal note, living in Western New York state, neither myself, nor anyone I know, has had much trouble receiving timely medical care. I’m not saying that it isn’t a problem, but it largely depends on the population and coverage within the area you live. Of course, I would expect densely packed population areas to have some difficultly in getting timely care. (I'm not saying that's OK, just making a statement.)

It's become so bad that many poor Americans are getting health care from ²Military personnel and ³volunteer doctors working in stadiums and country fairs. You don't think that is a sign of a broken system?
[*]A health care 'Judas' recounts his conversion
[*]Using the military to provide health services

Let’s just back up a bit…I’ve never said the American system was without flaws. Quite the contrary, in fact. I’ve also very plainly stated that I agree with nearly all the provisions of the AHCA, with the only exception to the penalty/tax mandate. Further, I said I understood why the mandate is there and that I’d reserve judgement on it once I see it in practice…because, honestly, I don’t think any one of us has a clear understanding on what this is going to cost everybody in the short and long term.

Did you know that many Americans ⁴go to other countries for health care? Did you know that ⁵many Americans go to Canada?
[*]Medical tourism.
[*]Americans go to Canada for health care to save money.

Do they? The only links you have here are from a wiki article that are cross-referenced to a broken Winnipeg Free Press article. I can’t confirm or deny that you are right or wrong. I’d be pretty interested to see how many poor folk from the US are traipsing across the border for cheap surgery…a quick search didn’t produce any meaningful results online. I can tell you that I don’t see that in my area and it’s predominantly vice-versa. As an example, my father is a sleep study specialist at a Buffalo hospital and about 20% of all his patients are Canadian.

Did you know that ⁶Canadians are overwhelmingly happy with their system?
[*]Canadians are (gasp!) happy with their health care system, and don’t want ours

So? I don’t really like ours either. But how many Canadians truly understand our system to begin with? I don’t see it as a fair poll/survey. It’s like asking the owner of an Xbox if he’d prefer a Playstation. Most people are going to stick with what they know and often say it’s the best. It’s just the nature of the beast.

What does all of that say about the comparison of the two systems? I'd take their system in a heart beat.

And that’s your opinion. But how can you not be a bit skeptical of the new AHCA? People are quick to point to Massachusetts and Canada as a “working” system, but you realize that those citizens pay significantly more in premiums and taxes (respectively)? MA currently has the highest premiums in the entire country.

I'll say it again...The USA Needs Healthcare Reform...I'm just not ready to say that the Obama AHCA is the answer to all our prayers.

 

[JFrankA]

Thanks!

One minor quibble: Where you say that for red states, "you will not be part of the ACA", states that refuse to implement the exchanges (because of FREEDOM) won't be exempted from the law. The Feds will simply run the exchange for them until they get theirs online. If they continue to refuse, the Feds will just run them forever.

An interesting part of the exchanges is that it doesn't cost taxpayers anything. The whole thing is paid for by fees collected from the insurance companies who get to sell on the exchanges.

A very good point, and more than a quibble in my opinion. No state is getting exempted from the ACA. All the insurance reforms apply, even if the state allows the Feds to handle much of the implementation.

As of 2014, regardless of your state:

You will be subject to the mandate if you don't have qualified coverage. You will be eligible for premium subsidies if you're below 400% of the Federal Poverty Level. You will not be turned down for pre-existing conditions.

JFrankA - While I applaud the effort, I think your chart focuses on the wrong thing. What you're really showing is whether the feds or the state will be running some of the day to day operations of the ACA, not whether the ACA itself will be enacted.

Thanks you guys. That's why I posted this here first, to make sure what I was posting was accurate.

I'll work on this tonight to fix the problems you guys pointed it.

 

[RandFan]

Fair enough, but I ask the same in return.

Thank you. I very much appreciate that and I promise to carefully consider your opinions and not to dismiss them out of hand.

¹The headline is a bit misleading…considering only 6 countries were part of the comparison. I’m a bit skeptical of the data when mulling over other factors, such as lifestyles, coverage area, advanced care, etc. On a personal note, living in Western New York state, neither myself, nor anyone I know, has had much trouble receiving timely medical care. I’m not saying that it isn’t a problem, but it largely depends on the population and coverage within the area you live. Of course, I would expect densely packed population areas to have some difficultly in getting timely care. (I'm not saying that's OK, just making a statement.)

²Do they? The only links you have here are from a wiki article that are cross-referenced to a broken Winnipeg Free Press article. I can’t confirm or deny that you are right or wrong. I’d be pretty interested to see how many poor folk from the US are traipsing across the border for cheap surgery…a quick search didn’t produce any meaningful results online. I can tell you that I don’t see that in my area and it’s predominantly vice-versa. As an example, my father is a sleep study specialist at a Buffalo hospital and about 20% of all his patients are Canadian.

³So? I don’t really like ours either. But how many Canadians truly understand our system to begin with? I don’t see it as a fair poll/survey. It’s like asking the owner of an Xbox if he’d prefer a Playstation. Most people are going to stick with what they know and often say it’s the best. It’s just the nature of the beast.

⁴But how can you not be a bit skeptical of the new AHCA? People are quick to point to Massachusetts and Canada as a “working” system, but you realize that those citizens pay significantly more in premiums and taxes (respectively)? MA currently has the highest premiums in the entire country.

I'll say it again...The USA Needs Healthcare Reform...I'm just not ready to say that the Obama AHCA is the answer to all our prayers.

1. Okay, so given your proposition and anecdotal evidence to the contrary which should I accept? Let me add that it wasn't long ago I was railing against UHC in general and Canadian UHC specifically. This is hardly the only study or evidence. I've seen much to make me skeptical of claims such as yours.
2. Yes they really do. Before I went on disability I looked into medical tourism. I'm not sure what you mean by a quick search. I google medical tourism and I get 20 million hits with lists of companies that provide these services. What exactly would satisfy you? http://www.medicaltourismassociation.com/en/index.html, http://www.medicaltourismco.com/, http://www.medretreat.com/, http://www.onlinemedicaltourism.com/medical-tourism.html Canada:http://www.findprivateclinics.ca/resources/general/medical-tourism.php If it's not a viable industry then why so much competition? And how can I compare your anecdotes with online evidence?
3. Okay, fair enough. How about a more in-depth look at health care? (see quote at bottom of post).
4. I'm not sure your link says what you think it says. In fact it says this: "When we look at employer health insurance premiums as a share of household income, in both 2003 and 2009, we find Massachusetts is among the least expensive states when considering the proportion of one's income required to pay for health insurance (and Arkansas is among the most expensive). "

I have posted this in other threads, but it bears repeating. T.R. Reid is a journalist who has written extensively, including two books, about how health care is delivered around the world. For this PBS "Frontline" special he went to several different countries and asked how they would treat his own old shoulder injury and how much it would cost, by way of illustrating how those systems work. The show is accessible online, along with some of his other reports:
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

This is what he says about the U.S. system:
".... These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus. When it comes to treating veterans, we're Britain or Cuba. For Americans over the age of 65 on Medicare, we're Canada. For working Americans who get insurance on the job, we're Germany. For the 15 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India..."
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html

How the systems work in five capitalist democracies:
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/

 

[Sabretooth]

1. Okay, so given your proposition and anecdotal evidence to the contrary which should I accept? Let me add that it wasn't long ago I was railing against UHC in general and Canadian UHC specifically. This is hardly the only study or evidence. I've seen much to make me skeptical of claims such as yours.
2. Yes they really do. Before I went on disability I looked into medical tourism. I'm not sure what you mean by a quick search. I google medical tourism and I get 20 million hits with lists of companies that provide these services. What exactly would satisfy you? http://www.medicaltourismassociation.com/en/index.html, http://www.medicaltourismco.com/, http://www.medretreat.com/, http://www.onlinemedicaltourism.com/medical-tourism.html Canada:http://www.findprivateclinics.ca/resources/general/medical-tourism.php If it's not a viable industry then why so much competition? And how can I compare your anecdotes with online evidence?
3. Okay, fair enough. How about a more in-depth look at health care? (see quote at bottom of post).
4. I'm not sure your link says what you think it says. In fact it says this: "When we look at employer health insurance premiums as a share of household income, in both 2003 and 2009, we find Massachusetts is among the least expensive states when considering the proportion of one's income required to pay for health insurance (and Arkansas is among the most expensive). "

1 & 2 - I'm aware of medical tourism, and I did see the links you mention, but I'm looking for numbers. I have not heard of Americans hopping the border into Canada for medical treatment, and I'm curious to see how often this really happens. My whole point/question is do we really wants Canada's system when it seems they have plenty of flaws...even after it's been around for so long? I find it odd that even the Prime Minister of Canada would come to the States for a procedure that is readily available in his country: http://blog.heritage.org/2010/02/09/the-canadian-patients’-remedy-for-health-care-go-to-america/

3 - Yes, yes...I agree with you. I didn't think I had to spell it out again. I'm not arguing that our healthcare system doesn't suck. I want to discuss why you think we should adopt something similar to Canada when it seems flawed...enough so that Canadians abandon free care to pay for services here.
(ETA - I'm seeing some links online that suggest that, even though Canadians pay for the services up front, they are reimbursed by the Canadian government. I have to give this some thought.)

4 - I see. But it also implies that the more you make, the more you pay. I can't say that it completely disregards my point.

 

[grunion]

Kaiser Family Foundation has put together a pretty good quiz here:

Health Reform Quiz

The health reform law promises to deliver big changes in the U.S. health care system. But, as with other sweeping pieces of legislation, it can be hard to get the real facts about what it does. And it is all too easy for misinformation about the law to spread.
Take our short, 10-question quiz to test your knowledge of the law, and then find out how you compare to the rest of the country, as represented by the findings of the Kaiser Family Foundation's monthly Health Tracking Poll.

I thought one of the questions was poorly worded and got it wrong, but I got the rest right.

 

[RandFan]

1 & 2 - I'm aware of medical tourism, and I did see the links you mention, but I'm looking for numbers. I have not heard of Americans hopping the border into Canada for medical treatment, and I'm curious to see how often this really happens. My whole point/question is do we really wants Canada's system when it seems they have plenty of flaws...even after it's been around for so long? I find it odd that even the Prime Minister of Canada would come to the States for a procedure that is readily available in his country: http://blog.heritage.org/2010/02/09/the-canadian-patients%E2%80%99-remedy-for-health-care-go-to-america/

3 - Yes, yes...I agree with you. I didn't think I had to spell it out again. I'm not arguing that our healthcare system doesn't suck. I want to discuss why you think we should adopt something similar to Canada when it seems flawed...enough so that Canadians abandon free care to pay for services here.
(ETA - I'm seeing some links online that suggest that, even though Canadians pay for the services up front, they are reimbursed by the Canadian government. I have to give this some thought.)

4 - I see. But it also implies that the more you make, the more you pay. I can't say that it completely disregards my point.

1, 2 & 3. Did you watch the program? The point isn't simply that America has a problem with health care. The point is that there is no simple answer to the question. There are pluses and minuses to each plan. There are flaws in every system. But I'm happy to admit that America excels in some way to cause Canadians to come here so what? Seriously? Sometimes it's better for Americans to go to Canada. Sometimes it's better for Canadians to come to America. What I don't get is what exactly do you think it proves? I'll tell you, it proves that in some ways America is better. Nothing more than that. You are trying to make something of that fact that just isn't justified. You dismiss my point that Americans go to Canada but want me to accept the point that Canadians come to America. Then admit that America has a lot of problems. ???? okay, and?

4 I've no problem personally with the more you make the more you pay. I think that is a very, very good system.

 

[Skeptic Ginger]

But, Rand, that really doesn't answer the question. Canada has Socialized medical. And despite their access to free health care, many come to the USA to pay for our services. Why?

Having many Canadian friends over the years, I can answer that...it's due to the extremely thin budgets and limited facilities of their system. Waiting lists extend out over many months...sometimes at the expense of a condition worsening during that period. So they come down here to get the testing/procedure/care and pay out of pocket because they don't have time to wait.

So, I ask again...is that a sign of a "working" system?

I realize that many Canadians are perfectly happy with their system...just as people in other countries are perfectly happy with a dictatorship...it's all they know. I can't help but take a poll like that with a huge grain of salt.

I'm not disagreeing with you that the American system is greatly flawed and that the new AHCA will help close some gaps...I'm just not sold on everything yet.

I have a number of American friends who wish they had the Canadian system. The long waits is a completely distorted issue. There is a shortage of available care in rural areas in both countries. There is a shortage of various specialties in both countries. And I can tell you that during a couple years there was a flu vaccine shortage here, Americans were flooding over the border to get vaccine there. People here go on drug purchasing trips over the border.

You cannot go by anecdotes. It leaves people open to believe the lies.

Some things are better, some worse on both sides of the border. But when you look at standard measures of care, the NHS systems in both the UK and Canada out-perform the US in the majority of measures.

 

[Skeptic Ginger]

Kaiser Family Foundation has put together a pretty good quiz here:

Health Reform Quiz



I thought one of the questions was poorly worded and got it wrong, but I got the rest right.

I got them all right except, I answered "don't know" on the Medicare cuts because I knew there was something addressing Medicare but couldn't remember the details.

It's very odd after the big fight over the "public option" that only 27% of the people answering realize we didn't get one.

Only 45% realize there are no death panels despite the saturation of corrections that went with the talking point lie marketing.

Only 25% realize businesses with under 50 employees don't need to provide insurance.

One can see where the Democratic talking points need to go with this kind of survey. I hope they are listening.

 

[Skeptic Ginger]

1 & 2 - I'm aware of medical tourism, and I did see the links you mention, but I'm looking for numbers. I have not heard of Americans hopping the border into Canada for medical treatment, and I'm curious to see how often this really happens. ....

It's not exactly a fair comparison given most Americans cannot access Canadian care. Do they have a means of collecting payment?

We do go there for cheaper pharmaceuticals and during the flu vaccine shortage people went there for flu shots.

As for medical tourism, you used the term so I assume you know it is big business in a number of countries that attracts Americans.

 

[RandFan]

It's not exactly a fair comparison given most Americans cannot access Canadian care. Do they have a means of collecting payment?

We do go there for cheaper pharmaceuticals and during the flu vaccine shortage people went there for flu shots.

As for medical tourism, you used the term so I assume you know it is big business in a number of countries that attracts Americans.

I was the one who originally brought up medical tourism. I did provide a link that shows that Americans do go to Canada to get health care. http://www.findprivateclinics.ca/res...al-tourism.php