Healthcare reform looks inevitable
Nothing matters as much as this.
The healthcare battle will shape America and impact the lives of everyone here, but it will also shape world perceptions of America, which are as much affected by US domestic foibles and strengths as by foreign polic. In fact more so, I think.
Today happens to be "pump night" at the Washington Children's Hospital. Newly diagnosed Type One diabetes patients (my son included) will be told about the benefits and disbenefits of the various pieces of technology that can deliver insulin into their bodies on a regular basis.
There are - as ever in America - choices to be made. And - as ever in the American healthcare system - huge prices to be paid, though not necessarily by those doing the choosing.
In the UK, meanwhile, a friend writes to say that in his local health authority there is no pump night, because there are no pumps: the local decree is that children can inject themselves regularly (and cheaply) for exactly the same clinical benefit.
How are Americans to make an informed and sensible choice? In particular, how are they to get to grips with a system that seems so utterly devoid of cost controls? And what about the risk of crimping future medical progress by crimping profits?
Some British doctors are issuing warnings to the Obama Nation about what reducing healthcare expenditure actually could mean.
On the other hand, some Americans are willing to be arrested for the cause of socialised medicine.
I am glad Sam has the right to a pump. On the other hand, I can see the benefits of keeping costs down and clinical benefits in the driving seat. On the other hand again, I know that a wealthy person in the UK will simply get the damned pump anyway and where is the fairness in that?
Barack Obama will need every ounce of his steely self confidence to persuade the nation that this step - whatever it turns out to be - is wise.
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Justin:
Health Care reform Yes, and that is very good news, that it is on the road of being reform in the nearby future....
Such as these warning that are dire in nature, are being made...Because some parties are afraid that the cost will be shifted....
~Dennis Junior~
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I would agree that single-payer is the best way to go; the Obama plan would probably crowd out private insurers anyway if people can chose a government plan as an alternative to a private, for-profit one. If the rich get better care anyway, they can just pay for supplemental insurance to get better treatment than what they might get from a universal system. My take on it is, if every other 1st world country can make it work, then it's embarrassing that the USA has to be the lone standout. (I guess our priorities are in Iraq...)
I'm a big supporter of free markets in most areas but when it comes to health care, I think that private companies have no place. Demand is inelastic and health care costs literally bankrupt people; this hurts our economy as a whole. Not to mention that the lack of universal coverage tightens the labor market since people stick to jobs (or marriages) for the sole purpose of keeping health insurance. I've decided to leave my job and cycle cross-country for charity this summer, but this means losing my coverage (unless I pay $559/month in COBRA). Just today I applied for my own insurance, but I may yet be denied for a temporary heart problem I had 2 1/2 years ago. If I lived in Canada, I wouldn't have to deal with this.
And to those who cry socialism: have you ever attended a public school, or borrowed a book from the library, or needed to call 911?
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We are now at the point that approximately .16 of every Federal dollar spent goes toward Medicare, our program for the health care of our elder population. Add to that our expenditures for Medicaid (for those on the bottom rungs of the ladder), and that total grows. A local version of Medicaid, administered by the State of Tennessee(TennCare), nearly bankrupted the state, and was shot through with criminal fraud.
It is not heartless to say that a top-down command-and-control single-payer system from Washington cannot possibly work, and will end up doing much more harm than good. And this is the style of Obama and company, firing auto company execs, forcing through illegal bankruptcy deals, demanding to limit executive compensation of companies that have no financial obligations to Washington, the list stretches on toward the horizon.
The free-enterprise model, flawed as it is,has produced the pump that makes 'pump night' possible. GE is rolling out a new generation of products that minimize costs and localize delivery. WalMart now makes a host of generic prescriptions available at nominal cost, and its competitors now follow suit. All this without command-and-control from DC.
This will vanish once Washington takes charge. That eventual cure for JD that your family so urgently needs will be buried in a pile of bureaucratic refuse, never to emerge, and any who dare complain will be labelled 'heartless' or 'unenlightened'.
Notably missing from the ObamaSpin is the absence of tort reform, which would prevent the awarding of massive damages by juries. Nearly unnoticed in the breathless coverage of Sen. Edwards' campaign was the fact that following the multi-million dollar settlement he won from an obstetrician, OB/GYN services simply disappeared from many rural areas. Kentucky was especially hard-hit, with physicians shutting down and moving away, due to the spike in malpractice premiums.
Himself will never touch the trial lawyers, and never countenance tort reform. I doubt seriously if this bill will even receive committee review, and instead will presented in the dead of night in early July or early September(while the press is on vacation), for an up-or-down vote.
To paraphrase Mrs. Thatcher: The problem with socialism is that eventually you run out of other people's money to spend.
We are long past that point already.
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Healthcare reform is bound to happen, the question is what will the end result be? I do not expect socialized medicine in the USA for many years to come, the most likely outcome of the ongoing discussions is a government program that covers most Americans, but continues to use insurance companies as mediators between them and the service providers.
Anything that even resembles socialized medicine would be dead on arrival, and President Obama is well aware of that. The fact that industry is backing the administration says it all, this may turn out to be an unprecedented bonanza for insurance companies.
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Well, I doubt anyone agrees that health care in America is too cheap! It is past time to buckle down and figure out how to get the most benefit to the most people for the least amount of dollars spent by public and private sources. As for Sam, Justin: my husband worked for the company that markets insulin pumps...it's the way to go for a young, otherwise healthy individual. We are sponsoring a rider in the Tour de Cure this year in Italy for a cure for Juvenile Diabetes.
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"The healthcare battle will shape America and impact the lives of everyone here, but it will also shape world perceptions of America, which are as much affected by US domestic foibles and strengths as by foreign policy. In fact more so, I think."
How and why is that, I wonder? I'm serious! It doesn't make sense to me. One could lojicly surmise that given...O I don't know...the revelation that we tortured terrorist suspects for 8 years, lied about it endlessly, and proudly and emphaticly proclaimed that we believed in the rule of law, innocent until proven guilty, fair trial, equality under the law, etc all throughout our engagement in these practices only to have those proclaimations proved down right false after a few years and a change over of administration would have a far more severe and longer lasting affect on foreign opinions and perceptions of us than the fact that 50 million Americans can't aford to get sick lest they potencially die. Couldn't one? Or have I gone completely insane?
Regardless, it is not comforting in the least to know that there is nothing the United States does, foreign or domestic, that is safe from the probing eyes of the world, and that even in the smallest measurement helps to shape the world's perception of us less. It just doesn't make sense! What? So some Frenchmen is sitting in France, and instead of lamenting over the fact that we utterly and shamelessly turned our backs on our founding principles, or volentarily got ourselves into a war that was totally unnecessary, their fretting over some person in this country, whom they can't tell apart from Atom, who are unensured and wondering if they are healthy enough to carey on without ensurance? Somehow I highly doubt that that is the case or even likely. I doubt that the thing that gets foreigners' blood boiling about America the most is our lack of universal health care coverage. Please explain this to me. After all, I'm just another dumb yank and as such I need things explained to me a bit more extensivly.
Thanks
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Universal Health Care. One of the few things in life where everybody wins and nobody loses!
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The only way health care can be made affordable is to cut out the middleman and clamp down on drug prices. Neither is going to happen. And as for Medicare, payments are to rise next year. Obama is not looking too good, but I bet the drug companies the the insurers are happy.
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But regarding the recommendations on the system's improvement, I know the British one is flawed; what system isn't? But give me the single payer system over our current one any day!!
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Ref 4 saintDominick
Wrote, "Anything that even resembles socialized medicine would be dead on arrival"
What do you mean by 'socialized medicine'?
Why would it be 'dead on arrival.'?
Ref RhodyDriver
What do you mean by 'single payer'?
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Richard_SM wrote:
"Universal Health Care. One of the few things in life where everybody wins and nobody loses!"
I'm guessing you are meaning this as someone who has not seen family endure it? It means the State is governing what treatment you will receive and when. For an example of ow this is likely to look in the US you don't even need to look overseas. The VA system is a government run health provision and look at how efficient they are at that. I have seen users of that complain about the nine week wait for their procedures. Family have complained of the queues for their NHS treatment where queues have been longer.
I think some people think that a national health system is free. It is not. The funding for it is just top-sliced. The earlier comment about the intersection of the legal and medical industries is I think spot on and is no doubt a contributing factor to what are clearly extremely high running costs for healthcare in the US.
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Ref 6, NoRash
"I doubt that the thing that gets foreigners' blood boiling about America the most is our lack of universal health care coverage."
My foreign friends and relatives are not too concerned about what kind of healthcare coverage we have, they are simply amazed we, the people, pay so much for one of the most inefficient and unfair medical systems in the developed world.
The answer, in my opinion, is universal healthcare similar to what is in place in Western Europe, but that is not going to happen any time soon. What is likely to happen is a program that uses public and private funds to provide healthcare services to all Americans, using private insurance companies as mediators. Not a perfect solution, but better than what we have now.
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Well I don't know what is going to happen, but we really need to reform our health care system. We need reform it in such away that everyone in this country has access to health care. How we do that I don't know but I don't see how we can not do it.
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The American health care system is not broken. UN and other reports to the contrary, the US has the finest health care available. It seems there isn't a town that doesn't have an MRI and it's put to work all day long to pay for it. But the system to pay for medical care is broken. Nobody dies because of lack of available health care but the quality of care may depend on your financial resources or insurance plan at work. Even illegal aliens who have no money receive health care. At an oncology department at a large hospital in Texas, doctors lamented that they would no longer be able to deliver the finest cancer treatment in the world free of charge to illegal aliens. Guess who was paying for that and got sick and tired of it.
Drugs are available more cheaply in other countries. Some of it is counterfeit made in places like China where little or no medication of the type indicated is in the dosage. Some is legitimate. American pharmaceutical companies spend a lot of money to research and develop new medications which meet the FDA's criteria of safe and effective. it costs on average $100 million to bring a new drug to the market and each one that makes it must also cover the cost of nine others that don't. In all likelihood, socialized medicine in the US would spell a severe brake on the advancement of medical technology development as the profit motive proves that the profit motive is the strongest driving force for bringing about improved quality of life. Only government funded research and that funded by charities would remain. Foreign countries often buy the US developed drugs at reduced cost because of their buying power or because of human need considerations by the drug companies themselves, or because of threats to pirate the drugs by foreign governments like India. Name one innovative drug or treatment of great medical value that was ever introduced by a truly socialist nation like the USSR. There aren't any. As things stand now, for many pharmaceutical companies, the pipeline for new drugs is drying up. Just at a time when advances in genetic biology and molecular engineering are opening up entirely new possibilities of treatments far superior than what we have today. How the system for payment is changed will determine how soon those advances will be realized in actual products that can be used. In a socialist system where charges are capped by law, the incentive will be gone and if health care is rationed like it is in Britain and Russia, we will have the same inferior care they have. It's the last thing Americans want...to trade a health care payment system that's broken for a health care system that's broken. There has to be a better way.
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"I know that a wealthy person in the UK will simply get the damned pump anyway and where is the fairness in that?"
Because at least in the UK the less wealthy get treated as well.
Not that hard to figure out. Well to most of us, there are still some that say No.
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norash
"somehow I highly doubt that that is the case or even likely. I doubt that the thing that gets foreigners' blood boiling about America the most is our lack of universal health care coverage. Please explain this to me. After all, I'm just another dumb yank and as such I need things explained to me a bit more extensivly."
Because it led to a collapse in the whole economy in the world.
Like house prices when one guy paints his house Red yellow and Green , starts PUMPING
http://tr.youtube.com/watch?v=zCkNu9OxThc
From the Europeans point of view look at it like this. In the work place health and safety laws are put in place because the Gov pays the bills for those who get sick . Lets say 10 years after working in a particular field.
Boss packed up gone to bolivia , who do you sue for health care?
Tough luck.
Die.
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11 splunkt In the Uk the soldiers can at least go to the normal hospital.
Thats part of the whole point.
and I have had a gran with MS in the UK . I do know about the care. I have been under the surgeons blade twice myself.
Everyone has some horror stories. but as someone pointed out in the comments section of the piece linked , health care in the US is rationed by the fact that those that can't afford it Don't get it.
While those that can get way too much
opps NO RASH SORRY
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The fact they OB/GYN physicians in many areas of our country are quitting the field simply due to insurance costs tells you plainly something is broken. The insurers claim it is due to a lack of tort reform which causes the rates to be so high. I find that highly suspicious. I hear about 'million dollar' claims occasionally on the news. The insurance companies pocket BILLIONS of dollars annually in profits. One million is a thousandth of a billion. So you are telling us that due to a .1% of your profit lost you have to hike rates every year... that is what you are telling us? Show us the numbers... add up all medical malpractice suits in the USA over 5 years and measure it against the profits of the insurance companies. If that number shows an ongoing trend upwards and represents a significant fraction of your cost of doing business you have a case. If not, you don't... odd, maybe it's me but I have a strong suspicion that if it really were the case the insurance companies would certainly be trotting that information out at any congressional hearing, etc. Since they don't I have to assume that my supposition is correct in that the insurance companies are simply padding their profits at the expense of both the patients and the doctors. Why does it seem the insurance companies make more money than the doctors who actually provide the treatment? I think it's time to give the industry a wake up call and provide 'government health insurance'... if the critics and the insurance companies are right, then the government insurance will quickly be 'out priced' by the more efficient and effective private companies, right? Isn't that the theory that private companies can do this far better and cheaper? Well, let's find out shall we. I have a nasty suspicion that what will happen is that you will see the private insurers have to lower their prices to compete with the government plan or they will simply go out of business.
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A number of doctors are willing to cut their own salaries to reduce the cost for the patients of medical care. Perhaps this practice should be encouraged. (Incidentally, one of the doctors doing this is a OB/GYN named Ron Paul...yes, that one.)
Alternatively, the US could take a different approach to socializing or federalizing medicine... draft the doctors into the US Public Health Service. Their pay would be lessened in some cases, but pay rates would be centralized, the public health response in emergencies would be greater, and they'd get cool uniforms.
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I heard a statistic the yesterday while watching MSNBC. I don't know who quoted it though, so I can not be sure of its accurrancy. Accord to the statistic nearly 50 million Americans are currently with out health care. In a country of 300 million people, that is nearly 17 % of the population. That is a travesty. That is a crying shame, my friends.
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Or alternatively, what if the US Government purchased the health insurance companies?
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14. 'In a socialist system where charges are capped by law, the incentive will be gone and if health care is rationed like it is in Britain and Russia, we will have the same inferior care they have. It's the last thing Americans want' (Marcus)
Re: Excuse me, but our health care system is far better than yours, american. At least we have the decency to treat he poor and not turn them away just because of their bank accounts.
Saying American healthcare system better than the UK = Absolute. Total. Idiocy.
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19 that's the percentage with none whatso ever. there are way more that have some but cannot afford the co pay.
18
20 Orville3 I like that draft. no conscientious objectors either.
and the buy them all. Just take them. After the draft here will be no problem staffing them
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opps posted too soon. the article linked was good. no shop will sell just in imperial.
but choice to show weights or prices for those that wish. OK.
but go to work there.see how many use it.
Some smiths sure do, but most use metric. Why?
cause it is easier and less prone to built in conversion inaccuracies than imperial. calculators can be used directly with Pythagorus to get results that otherwise would require a computed conversion. leading to inaccuracies on the floor.as one example.
as to the pints that's easy.
1 Imperial pint = 0.568261485 litres
We Brits don't mind doing as were told but not when we get less beer.
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Justin, thank you for bringing this important issue to the attention of your listeners and readers.
Your article does contain a number of inaccuracies that need to be addressed let's start with two questions you posed in the 5th paragraph. You ask:
"How are Americans to make an informed and sensible choice?"
Answer: Like all political issues Americans will have to take an active role in their education if they ever expect to obtain a comprehensive understanding of the subject. Electronic Media are the exclusive the domain of corporate interests. Their programing is driven in the service of corporate interests as such programming is cleverly formulated with elusive and illusory messages that mislead the public. If the American Citizenry ever hopes to make an informed decision they will have to use the internet, library and attend local meetings of groups active in healthcare reform.
You then ask "In particular, how are they to get to grips with a system that seems so utterly devoid of cost controls?"
While troubling the lack of cost controls does not lie at the root of the problem with American Health. This is to no way imply that cost controls are unnecessary but will do little if anything to address the central problem. More about that later on.
You then went on to state "On the other hand, some Americans are willing to be arrested for the cause of socialised medicine."
This statement contains a glaring error that is central to the debate about health care. The Americans arrested at Senate Finance Committee Hearings on Monday and then again Wednesday were not arguing for Socialized Medicine as used in the UK, but for a Single Payer System as employed in Canada. And it is very important to parse out the difference between the two systems. Under a Socialised Medicine System. The government owns the hospitals, the government owns the clinics, the doctors are employed by the governement and the government pays for all of the health care. In a Single Payer System the government ONLY FINANCES health care. Doctors and hospitals remain in private practice in this system. This system avoids two constraints present in the Socialised Medicine System. The first is the state tells doctors where they can practice. The second and most vexing issue is the state dictates to its citizens which Physcian they will see. Many Americans have this concern about seeing the Doctor of their choice. This constraint makes Socialised Medicine a bitter pill to swallow. In a Single Payer System no such constraint exists. To be exact Socialised Medicine is a FORM OF Single Payer but Single Payer does not necessarily have to be Single Payer.
What Single Payer does is eliminate the rapacious Insurance Industry which is the driving force behind by the soaring increases the American People have seen over the last 25 Years. The organization Physcians for a National Health Program estimates that of the 400 Billion Dollars wasted in US Health Care every year 350 Billion Dollars is wasted in the administrative overhead of Insurers. This comes back to your cost question. Most of the waste in US Health Care is in the Financing System not the Delivery System. Are there savings that could be made in the delivery system ? Yes. But do those wasted expenditures amount to a significant portion of the problem ? The answer to that is no with one exception. That exception being the Pharmaceutical Industry which charges confiscatory prices for drugs which they hold monopoly patents.
The Medical Equipment Suppliers are not a major source of the problem regarding health care costs.
Your blog does fail to address the major players in this debate. They are the Insurance Industry, the Federal Government under Barack Obama, and the Grassroots Citizens Groups.
The Insurers have lobbied Washington for decades for the system that now exists and are pushing of maintenance of the status quo.
The Obama Administration has laid out their strategy to give the American People a brown paper bag filled with air and then conducting a campaign to convince us we actually received something of substance. This is what "The Public Option" is all about.
Then there are the Grassroots Citizen Groups. These include Healthcare Now, Healthcare for All, Single Payer Action, PNHP, the National Nurses Organizing Committee and Single Payer Now to name a few of the more promiment ones. These groups are pushing the unconditional implementation of a Single Payer System. A few of these groups have been around for a number of years. Some date back to the last time there was a major discussion about health care in the US in 1994. Their proposal was dismissed out of hand by the Clinton Administration whose plans went down in a ball of flames. Because of this they feel vindicated and are in little mood to compromise. There is little if any popular support for the insurance industry among the American Public.
What this struggle boils down to is whether the US Health Care System will serve the needs of the many or the greed of the few. It is class struggle in it's essence. How it turns out remains to be seen but the last time the Government decided to dictate a health program the American People did not support it went down to defeat in a ball of flames. Barack Obama best heed that less lest he doom his administration to repeat that sorry chapter.
Bob Marston
Single Payer Now
links:
http://www.singlepayernow.net
http://www.pnhp.org
http://www.calnurses.org
http://www.singlepayeraction.org
http://www.healthcare-now.org/
http://www.healthcareforall.org/
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"The healthcare battle will shape America and impact the lives of everyone here, but it will also shape world perceptions of America, which are as much affected by US domestic foibles and strengths as by foreign polic. In fact more so, I think."
I'm not clear as to why the people of other nations would be angry with Americans for not having sufficient health care available at a reasonable price.
Surely that would not be a cause for complaining about Americans? Surely that, of all things, is our own business?
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American Sports Fan:
"I heard a statistic the yesterday while watching MSNBC. I don't know who quoted it though, so I can not be sure of its accurrancy. Accord to the statistic nearly 50 million Americans are currently with out health care. In a country of 300 million people, that is nearly 17 % of the population. That is a travesty. That is a crying shame, my friends."
I agree with you.
My main concern is that this will result in tax increases that will destroy the economy and that it will be a bonanza for lawyers. But something does have to be done.
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Rocksinyourhead #21
If you are referring to the UK, the reports are that the hospitals are so filthy, the patients families have to come in and help clean the place up so their relatives in there for care don't die of infection. We have no waiting lists here. When you need medical treatment in America, you get it right away, even if it is elective surgery. Even Candians come across the border to get care immediately and pay for it when they could wait at home and get it for free. Waiting months for a hip replacement may be all right in Britain but that doesn't fly here. Unless there are complications, that's usually a matter of a few days, almost invariably less than one week.
If what you said were true, the poor would be dying like flies in the streets. Often the hospital emergency room is their primary care physician, a waste of valuable resources. That's another reason to fix it.
Guiwhiz, the reason malpractice insurance is so high is that competent doctors refuse to testify against or turn in the small percentage of them that are incompetent. As a result, the entire profession suffers and insurance costs go up. They are doing it to themselves. I don't think the HMO hospitals are bringing in inferior foreign trained doctors to work at low wages or lose their green cards if they don't cooperate the way they used to. Those doctors were often so awful, they often wouldn't have known the best available treatment for many cases even if the hospital had it avialable and was willing to pay for it.
American Sports Fan, I hope you follow your team's scores better than you follow the score on the medical cost problem. 50 million Americans are without medical insurance, not without medical care. The problem is that if they get sick and have to go to a hospital, the bill could wipe out most or all their financial assets. The best care costs the most.
happylaze, the co pay for many insurance plans runs between 10 and 30 dollars per office visit. Hospital bills are usually based on a percentage after a liability such as the first $1000 dollars. It depends on the plan. The number and variations of plans available are mind boggling. When I worked at AT&T they offered 44 different plans at the same time each employee had to choose from...and that was just for medical care.
I think what we will wind up with is some sort of hybrid where private insurance companies work with the government to assure insurance for everyone and the government may become the insurer of last resort. But it will not be free. There is no such thing as free. Everywhere, somebody has to pay for what is available one way or another no matter how miserable the serice is.
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Ref 10 Richard_SM
I guess bobmarston beat me to the punch, but in a nutshell Single Payer is where health expenses are paid by a single entity, usually under the government's aegis. However, this would mean that all current insurance companies would be driven out of business, so politically this task will be extremely difficult, if not impossible, to accomplish. Never mind that it seems to work quite well in other countries. Sometimes I think that "American Exceptionalism" means that we have to do everything our own way; never mind that Canada and New Zealand have already effectively managed this problem, we're America, we've got to come up with our own way lest we admit that someone else can do it better than us!!
Ref 14 Marcus:
Plenty of countries with universal health care have successful pharmaceutical industries. Just because their health systems are managed by the government doesn't mean that they can't earn income on their R&D. Examples are SanofiAventis (France), Novartis (Switzerland) and Bayer (Germany) to name just a few.
Ref 21 Rocking:
In America, it is illegal to deny basic health care to the poor. Granted, they might not get too much, but the little they do receive in emergency rooms costs money, which is spread out among us paying folk who have to subsidize them along with our own care.
Ref 3 Old South:
Great point on tort reform. Sadly, as a lawyer Obama probably will not address this issue. It might be a sticking point to attaining a Canadian-like system, though.
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#14. MarcusAureliusII: "the US has the finest health care available."
At a price. What good is it if the delivery system is not adequate to the need? No-one would argue against the fact that, in addition to the United States, anywhere in the world the wealthiest segment of society can receive care. It's the rest of the population which has the problem. In Britain, the better-off have private insurance to cover major medical problems but rely on the NHS for emergencies and less important procedures. Basic coverage is available to everyone regardless of the ability to pay.
"Waiting months for a hip replacement may be all right in Britain but that doesn't fly here."
I speak from the experience of my late mother; at 91, in a care home, she fell and required a hip replacement. It was done within days and would have been swifter had I not discussed the matter with the surgical team. I was concerned that it would be too much for such an old lady, but there was no problem. She was up and moving around within 72 hours and discharged within ten days. It couldn't have been quicker or more effective anywhere in the USA. The NHS is not perfect, but then not all care in the US is either. There are horror stories of neglect in American hospitals - and the problem of MRSA is not confined to Britain. Although largely contained, there are more outbreaks reported in the US. Like HIV, MRSA does not favour one group over another.
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I realise it's a cultural thing but i'm damned if i can work out why so many Americans oppose a national health system that provides free treatment at the point of need??
To me it defies basic logic?? i hope someone can explain this to someone whose mother country provides free prescriptions to all (Wales)
ta in advance???
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justanothertaff:
"I realise it's a cultural thing but i'm damned if i can work out why so many Americans oppose a national health system that provides free treatment at the point of need??
To me it defies basic logic?? i hope someone can explain this to someone whose mother country provides free prescriptions to all (Wales)
ta in advance???"
I don't even understand the question. You assume that Americans oppose health care being made available?
Most Americans are extremely concerned that a government take-over of the health care system will mean massive taxation to pay for an extremely expensive system, and government regulations that will invade our lives to an even greater extent than they do now. The result would be a dramatic drop in the quality ana availability of health care.
That is offset by great worries about the enormous costs that we already face, and the fear that a major, long term illness will destroy all our savings. I know of cases like that, as do most of us. There seems to be absolutely nothing we can do about that.
I don't know of any Americans who oppose giving free medicine to those who need it. The idea that we do is merely a crude insult.
I must admit that while I understand (to some extent) people of other nations griping, whining and complaining about Americans in relation to foreign policy or culture, it is astounding to me why you would turn Americans into villains regarding our own health care system. How on earth is it your business unless you are living here?
That is taking anti-Americanism in a different direction that really is reprehensible.
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30, justanothertaff -
So many Americans are opposed to a national health system because they hate the idea of paying for someone else's health care and are too ignorant to understand that they are already paying for everyone else's health care, but in the most expensive and inefficient way possible.
Their taxes pay for part of the health care of every federal, state, and local government employee. Part of the price they pay for all goods and services goes to pay for the health care of the employees of those companies that provide the goods and services. Every single working person pays for the health care of the elderly and indigent. People who cannot afford their own health insurance are paying for the health care of those who make more money than they do.
People with group policies are charged higher premiums if someone in their group has a major medical problem. A healthy person can find his/her premiums going up and up and up even though they never get sick.
But because they can't bear the thought that they might be paying for the health care for their neighbor's children, many Americans refuse to understand the way the whole system works.
And of course they refuse to see that a large portion of all this money they pay out goes straight into the yachts of the obscenely wealthy insurance company executives. And to all the shareholders of these companies, who scream if their portfolios don't increase.
Appalling ignorance and selfishness. That's what it boils down to.
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justanothertaff wrote: "I realise it's a cultural thing but i'm damned if i can work out why so many Americans oppose a national health system that provides free treatment at the point of need??
To me it defies basic logic?? i hope someone can explain this to someone whose mother country provides free prescriptions to all (Wales)
ta in advance???"
You really want an explanation ?
You can't imagine the drivel foisted upon the American People under the guise of political discourse. Political Chat Shows in this country be they TV or Radio have gone from the sublime to the ridiculous. Public Broadcasting is a shell of what it used to be in it's prime, which wasn't much.
Check out this cartoon caricature of one of America's most popular Poltical Talk Show Hosts. It may be a caricature but it isn't far of the mark.
http://watching-tv.ew.com/2009/04/glenn-beck-gets.html
And the only more ridiculous then the Glen Beck Show is the fact that people are actually gullible enough to believe it.
That is what gets jammed into peoples heads over here.
Does that answer your question ?
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bere54:
"So many Americans are opposed to a national health system because they hate the idea of paying for someone else's health care and are too ignorant to understand that they are already paying for everyone else's health care, but in the most expensive and inefficient way possible.
But because they can't bear the thought that they might be paying for the health care for their neighbor's children, many Americans refuse to understand the way the whole system works.
Appalling ignorance and selfishness. That's what it boils down to."
This is the most appalling bigotry a laundry of crude and ugly insults. Disgraceful even by the standards of this site - and this is supposed to be a serious discussion!
The thoughtless portrayal Americans as evil is now so out-of-control and so far from reality that it is truly frightening.
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About a week ago I was surprised to read that the US had only about twice as many cases of the swine flu as did Canada.
As it originated close to the southern border and the population of the US is so much larger, I found this to be puzzling.
Could the lack of full health coverage for so many of the population mean that some were not being tested?
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Canard, who do you think you're kidding?
"I speak from the experience of my late mother; at 91, in a care home, she fell and required a hip replacement. It was done within days and would have been swifter had I not discussed the matter with the surgical team. I was concerned that it would be too much for such an old lady, but there was no problem. She was up and moving around within 72 hours and discharged within ten days."
Both my grandparents needed hip replacements, the results of accidents in their 80s and my aunt needed one in her 90s. It doesn't work that way. Nobody gets up and about within days. Therapy takes months. After they leave the hospital they go to a nursing home where they get daily therapy and around the clock professional care. You cannot do it at home, you don't have the resources, the skills, the energy. It takes about 3 months before they can leave being able to walk with a walker. Then they get more therapy with a visiting therapist at home and in home care from a visiting nurse and a hired caregiver. You and the rest of the Brits tell more lies on these blogs than I knew existed in the world.
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#31: TimothyR444: "I don't know of any Americans who oppose giving free medicine to those who need it. The idea that we do is merely a crude insult."
Since I am in the delightful position of being ignored by this poster, I can respond without fear of a snippy, "too, too absurd" response. Tiny Tim must live in a very rarified atmosphere since universal health care has not found favour with those of the Republican Party for many years. One should not have be at or below the poverty line to be entitled to it. Ordinary, middle-income Americans cannot afford either it or the insurance policies which might cover them. If they could, and considering that health care was a major plank of both Democratic candidates, then why was the Republican candidate given the thumbs down, along with many of his Congressional colleagues?
"How on earth is it your (justanothertaff) business unless you are living here?"
The same could be asked of those American posters who admonish the United Kingdom and Europe. One could ask what business it was of the United States to interfere in the business of Iraq, since Mr Bush (and later Tony Blair) was not living there. People say and do what they think is best for somewhere else, so, sweetheart, be a little more understanding and never, but never, criticise Britain, Canada, Australia, Sweden, The Netherlands, Finland (and so on) about their policies or their health care systems.
#34. Re, bere54: "This is the most appalling bigotry a laundry of crude and ugly insults. Disgraceful even by the standards of this site - and this is supposed to be a serious discussion!"
From earlier posts, I think you'll find the bere54 is an American (note the spelling) and she is entitled to criticise her own government. The right-wing opinionator, Bill O'Reilly, asked "why should I pay for other people's health care?" He failed to consider that everyone pays for children's education. Like education, basic health care should be a right to which every American citizen should be entitled. At present, this is not the case.
"This is the most appalling bigotry a laundry of crude and ugly insults."
I do not see a list, let alone an entire laundry of crude or ugly insults. Exaggeration does not assist your arguments.
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I see that (mostly) good points have been posted in my absence.
I have a modest suggestion: since insurance companies, lawyers, and the
medical profession together consume most of the money in the system, why
don't we just get rid of the first two, and train more doctors?
That would cut our costs to a third.
I didn't mention the drug companies, but they are up to no good when
they buy off legislators to prevent us Americans from buying drugs in
Canada, where they are cheaper.
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I was billed $12 000 for a one-block ambulance ride in Philly in 2006. I rest my case. National health is the only thing I miss about living in the UK. And it's a big thing to miss, let me tell you.
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I am one of the 15% of unisured Americans. I have no insurance whatsoever, it's a horrible position to be in. I'm married, have a 5 year old son, attend college and hold down a full time job - it's because I make too much but still too little to qualify for any kind of insurance. My son and my husband; who also works full time with no benefits, are also uninsured. It's a terrible place to be, all I can hope is that once I have aquired my degree I will be able to find a job that will provide a qualaty insurance program for my family. If it's true, that only 15% of Americans are unisured, why would it be so hard to reach out and offer decent insurance to this portion of the population? It hurts and I'm not sure what the best solution would be - I would love to see something happen, I need to go to the doctor badly - it's difficult enough to pay for my son's health costs, I can't afford my own. Please let this turn out to be something for the better!
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#36. MarcusAureliusII: "Canard, who do you think you're kidding? . . . Nobody gets up and about within days."
Well she did, and was discharged shortly thereafter. Patients are not kept in bed but are up as soon as possible after surgery. It was done at The Royal Berkshire Hospital and she returned to her care home in Lower Earley, Reading. Eventually all of her long-term care was paid for by the state, but not without a fight. Such care in the UK is now almost impossible to obtain despite a ruling by the Health Service Ombudsman to which I was a party. We managed to get the government to reimburse patients who had previously been denied and which then totalled some $360 million. Budgetary constraints now influence Primary Care Trusts (which are responsible for providing NHS care) rather than medical need.
"You and the rest of the Brits tell more lies on these blogs than I knew existed in the world."
Calling me a liar would normally be a reason to complain about your post/s, but in this case I do not do so in order that your ignorance and malicious nature can be seen by all. Like King Gama, you are a thoroughly disagreeable man.
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Sorry, for sick people in Americanothing will happen with your health care system...because you have too many people that think like...
14. MarkusAureliusII :...health care is rationed like it is in Britain and Russia, we will have the same inferior care they have.
markus, markus can there be more inferior system then yours when 50 mil. are refused to be cared for because of lack of money profit is more important than healing.
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Justin - you haven't explained what a "pump" actually is. The phrase "pump night" sounds like it could be American slang. But you later mention the pump as a device. Maybe I'm just having a moment but it comes across very ambiguous.
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Ta folks, that clears it up for me (-:
32, thank you Bere, much as i believe also, still don't get the right wing denial of anything that's good though????
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Nor does the majority of our our planet methinks???
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I thought the american healthcare system was fine until I came to europe.
Even a visit to the ER was pleasant, they actually cared about me and not about my wallet. After this I will only travel back to the US if I am insured. They may have the most expensive equipment and the "best treatment" but at here I will not spend the rest of the life they saved paying them for saving me. Sometimes you have to understand that in the end you will pay for your own care in taxes or so, but it will be cheaper since we are ALL helping in.
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Ref 6. NoRashDecisions
"What? So some Frenchmen is sitting in France, and instead of lamenting over the fact that we utterly and shamelessly turned our backs on our founding principles, or volentarily got ourselves into a war that was totally unnecessary, their fretting over some person in this country, whom they can't tell apart from Atom, who are unensured and wondering if they are healthy enough to carey on without ensurance?"
To be fair, the turning your backs on the founding principles thing is pretty bad. But, to answer your question, there almost certainly are some people in Europe who care about the fact that there are US citizens who don't have healthcare insurance. We may not have met any of them, but it's basic humanity to feel for those who are suffering needlessly.
Can't say if it is worse than the founding principles thing, and I can't even say it lessens my view of America (it doesn't). But it concerns me nevertheless...
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Anyone that thinks a universal health care system similar to the NHS is perfect is sorely mistaken. However, if you compare the efficiency of the NHS to the medical systems in America and Canada, is is a vast improvement. The problem in the UK is a failure of micro-efficiency.
A problem with the NHS is that people have less incentive to keep themselves healthy. As ridiculous at it sounds, if you know that you are stuck paying a fixed tax, and that if you get ill that tax will not change, then it won't be the end of the world if you get ill. There is a big issue (pun intended ;)) with obese people, who could easily excercise, draining funds and time from hospitals. (Of course this does not apply to all overweight people).
Then there is the fact that young people end up paying alot of tax money for the elderly. I myself have no problem with that (as long as when I'm reaching that age it's available to me!) but some people might be against it.
Overall, a system like the NHS is the lesser evil. It no doubt has it flaws, but they are significantly better than any other system.
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36 - Marcass. I'm not sure what your comment says about American resilience. The Queen Mother had a total hip replacement in 1995 at age 95 and walked down the steps of the hospital unaided when she left 18 days after surgery. Maybe the Brits just do it better?!?
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#49
Maybe we are just stronger and more resiliant than the yanks?
That ought to wind him up a bit :P
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Thank you, Mr Webb, for a timely reminder that in the US, so much of the system is simply skewed in favour of affluence -- great affluence.
There are good and bad sides to such a system. In terms of the sheer numbers of people who never, throughout history, have been able to pitch themselves safely into the Affluence Zone, the obvious negative is that the enormous quantity of people who shall never meet the criterion for Privilege continues to grow.
And the blunders (and even outright crimes) of people Safely Affluent have now compounded all the problems even more.
As a father, of course your first concern is your own child; as a mother, mine is for mine.
But that is merely the immediate concern. We both peek down the road a ways and extrapolate. Where will this go next?
The US needs to do something -- only not just anything -- to make health care more manageable, and increase access to more people. Not even for complex things, even for basic things such as eyes, ears or teeth would be a start. Millions of pupils struggle in school lacking vision care, hearing poorly and with aching mouths. The neglect of the non-affluent has gotten that severe in the US.
So something must be done. My current hope is that the Obama Administration makes as few mistakes as possible. Because some mistakes are inevitable. It is important there is some effort to avoid mistakes. Not just grabbing at thoughts for ideological reasons -- from either direction.
(In fact, I have come to deplore the particularly American keenness on "brainstorming" as often the thinking ends right there, at the most incoherent and preliminary level: pick something out of the "grab bag" of ideas, including wacky ones, and go with it... This approach needs to be challenged more often, and more emphasis given to deliberate thought, to turning things over in the mind and polishing them before floating them...)
Globally, the real crux of the matter is that populations have swollen worldwide. And so, whatever the system or method used, we are straining to meet even basic obligations to substantial numbers of human organisms wherever they might be found.
At the parental level, in developed societies, we go to all kinds of lengths to do the best possible thing we can for our children and nearest loved ones. We have the education and networks and even access to money (where it helps) to negotiate the complex systems.
But the systems themselves are breaking down more and more. Technology has helped some -- but even IT cannot keep pace with the need.
What can be done at the global level to fight back the tide of illness and increasingly labyrinthine avenues for treatment before we lose even the gains we have?
Well, even if the NHS has not been very effective for many UK families, there has to be some kind of start made to at least measure the dimensions of the problem. Simply relying on private medicine to do the more polished thing it does so expensively does not actually help fight back the tide of worsening need.
As the recent & ongoing swine flu story reveals, even if it makes so many people in the public uncomfortable, organization, attack-style epidemiology, proactive prevention, even at the most seemingly infantile level ("wash your hands, wipe your nose") does indeed work.
It costs less. And it relies on enormous organizational discipline to implement. Coordination across borders, languages and creeds. And look: it happened. And the threat at least diminished... Doesn't that say something about what works in modern health care?
What was interesting about the swine flu events (ongoing) is how negatively so much of the public reacted.
That is also a clue, to what won't work: the masses continuing to expect a hazy, lazy, rosy, carefree life with no bad news.
Maybe the US TV programmers are a teensy bit at fault? All those bright bubbly ads?
Most people don't live that way.
My daughter got an MRSA in a shiny high school in California with very dirty students. There's no other way to describe them. It led to pneumonia, complications and now the 5th year literally of impaired health. She used to be the healthiest one of all of us.
Maybe because there are so many more human beings everywhere, governments will have to continue to sound strict, stern and repetitive in retraining populations to take personal hygiene more seriously -- for selfish reasons, if necessary: but seriously.
Maybe effective health care reform can include components of heightened awareness that we are all increasingly duty-bound to strive to burden others less with the personal quirks or bad habits that encroach on the health of others (smoking, carousing, drugs and alcohol, and even something as charged as promiscuity).
And I think it is also fair to say people who are bringing life into the world need to be talked to about what it means to be responsible for that Life, and to help not just the Child, but also those the child will meet in life.
Conversely, those who struggle to conceive also need therapy to help understand that really it is not by any means easy or even necessarily noble to go to great lengths to procreate.
Basically, we need a lot of public health Educators for America (at least), and a whole lot of fairly boring and droning and essential lecturing (even hectoring in some egregious cases) to get through people's layers of resistance to anything that contradicts the notion that Life is Naturally Effortless and Sunny, and Everyone is Entitled to a Good Time in whatever terms they personally define such.
Because it isn't.
In the meantime, we keep watching for new developments and discoveries that will help your son, and your family, and everyone else -- because it seems tantalizingly possible to dare to hope that Diabetes at least can be cured within the next decade perhaps.
Let us hope, and even pray, and keep on pushing for more sanity & coherence from at least those portions of the human race who understand such things exist, and are needed in policy -- as policy.
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The USA does have excellent medical care...for those who can afford it. A few months ago I had a kidney and a large malignant tumor removed. The surgeon was good, the hospital mediocre, and the nursing care was simply horrible, not only because most of the nurses did not even know how to remove an IV (I had to wait two hours until a qualified nurse came on duty), but some were more interested in watching soap operas at the nurses's station than responding to my calls. When I mentioned my displeasure to my doctor he acknowledged that the US has a nursing crisis. I was released from the hospital 3 days after having surgery, which included a hemorrage and subsequent weakness so severe my sons had to lift me from the wheelchair onto the car to take me home and later to my bed. On top of everything, and even though I am on Social Security and MEDICARE, I had to pay $150 a day to the hospital and I pay $40 a month for some of the medications I take.
When my relatives in Spain, UK, and Sweden learned what happened they all voiced astonishment and told me how different their care was when they had surgery and were hospitalized in the countries they live in. Yes, we do have wonderful doctors and medical facilities, but for the most part they are accessible to those who can afford them or who have first class insurance coverage.
I don't know if the proposed reform is going to improve the system, but what we currently have is too expensive and inadequate. I should reiterate that the problem is not limited to the 47 million Americans who are uninsured, it also include millions of under insured whose coverage only takes care of catastrophic illnesses or has prohibitive co-pays and deductions.
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I wish people writing from the UK would stop saying or implying that our health care system is free. It is not. Check out the following site for 2008, where you can see that 17.4% of all tax collected in the UK was spent on health care in 2008. This year's figures are estimated as being slightly less.
http://www.ukpublicspending.co.uk/government_expenditure.html
Now all UK residents - consider how much tax you paid last year - Income Tax, National Insurance, VAT, Captial Gains etc. etc. etc. and work out what 17.4% of that was - that is what the NHS cost you last year. A considerable amount for most people unless they are paying no tax.
Personally, I would rather have this situation where people receive treatment without receiving a bill, but unless they are unemployed, it is blatantly incorrect to say that they will not be paying for it.
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As with so many issues this one is not limited a black or white, yes or no answer.
The discussion is not about single payer socialised medicine OR private sector health insurance .... but about a mixture of both as in the UK.
In the UK there is a basic level of health insurance for everyone. The rich often buy health insrance because they have lots of spare money and choose to spend it on ensurig they have a private room, immediate treatment for non-urgent procedures etc etc.
In the US poor people have cheap insurance (or none) - cheap insurance has lots of exclusions and often has very high deductibles before the repayment kicks in. Rich Americans buy better more comprehensive insurance (and also tend to be healthier thus are a better risk for the insurers anyway!)
The difference is that in the UK no one is left out. In a compassionate society this is the most important thing.
oh and Justin .... "disbenefits" ????? You may be being moved for grammatical reasons!
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43 clueduprock
You may be on the wrong blog ..... ;-)
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34 Tim
"The thoughtless portrayal Americans as evil is now so out-of-control and so far from reality that it is truly frightening."
In your world of paranoia you seem to be confusing unpalatable realism with anti-Americanism .... even from American contributors (your response was to Bere54, who is I believe American).
The word "evil" is of your own invention in this discussion and serves to highlight only your own extreme paranoia. Evil is a word which is diminished by incorrect usage.
In fact Bere is correct that many Americans do not wish their hard-earned money to benefit others (unless they choose to give it personally and selectively) - hence the strong opposition to welfare state and socialised medecin.
IMO much of this sentiment in otherwise pleasant and normal (and often Christian) people goes back to the idea that "my grandpa came here with nothing but the shirt on his back etc ... and we made it." America may be the land of opportunity for many, but social mobility is declining and ignoring vast swathes of the population because they weren't as lucky or industrious or intelligent as you is wrong in my mind.
guns has it right at 38
more doctors, and fewer lawyers and insurance companies (whose primary aim is not patient care, but shareholder satisfaction).
Certainly run a two-tier system, where the rich can buy "improved" care ... just like they buy improved education. But don't leave anyone out.
All systems are flawed but the least flawed is the one that cares for all.
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53 cjtsmith
Does the average Ameircan pay 17% less tax than his British counterpart? I don't know, but from talking to American clients and friends it seems that $500 a month for a family buys you pretty average (maybe NHS level) insurance - thats 6000 a year (about £4000) - if you count that as your 17% it would mean total tax of over £20,000 - which in the UK takes you well out of the realms of the average anybody.
The NHS is not perfect, but it does give at least basic care for everyone. That should be a right.
The problem is that science and medical advances move very fast .... and everyone wants the best available care on the NHS. It is not economically possible, nor in my opinion should that be a right. Life is not fair - some will always be better off than others, but there is a limit below which people should not be allowed to slip.
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Ref 53, cjt
There are very few things in life that can really be considered free. In the end we must pay for the healthcare services we get either through taxes, insurance premiums, or cash.
The problem we have in the USA is that in addition to paying Federal, State, local, sales, property, and excise taxes; plus Social Security and MEDICARE, we still have to pay high insurance premiums and co-pays to receive medical care.
The bulk of our taxes go to entitlement programs that are highly ineffective and are in desperate need of reform...and to buy the most powerful and sophisticated weapons and maintain a huge military force to fight a gang of thugs hiding in caves.
Our government must become more efficient, our private sector must share responsibility for the welfare of its employees, and instead of engaging in our of control spending to fend off imaginary threats we should try to change the way we interact with the rest of the world and the way we treat our fellow citizens.
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RockingTheJoint: That is completely false that if you can't afford it they won't give you healthcare or you will be turned away. If you can't afford it they will still give you health care and you won't be turned away. Why does that myth keep going around europe and the world that hospitals turn people away if they can't afford the treatment?
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Ref 29 David_Cunard
Ref 36 MarcusAureliusII
Ref 49 Princess-on-the-pea
Re: Hip Replacement Operations
My next door neighbour told me last year she needed hip replacement last year. She's a very fussy, attractive, active 56/58 year old. Looks like Meryl Streep. When I say fussy; she's pointed out to me several times over the years that the leaves on my tree blow onto her (manicured) lawn in the Autumn! (And?) She'd never had a surgical operation in her life. No kids. Terrified at the prospect. I was surprised she even 'confessed' to needing a hip operation; she's the sort in search of eternal youth. Before the operation, she was told to expect to be off work up to 12 weeks. She worked out the dates so the end of 12 week period would coincide with Christmas; allows Christmas shopping, gave an extra 2 weeks off work.
She arranged to have the operation on a Monday. Took her first few steps on the Wednesday. She arranged for husband bring her home on the Friday afternoon. She had twice daily, then daily visits from nurse and a carer for the next week or more. But I went round to take flowers the following week, and she was walking around taking it easy. Made me fresh coffee. No problems. That was probably 10 days after operation. I don't recall exactly. Spent an hour telling me all about it (yawn). She had visiting therapy sessions for about a month after. She was taking her car out end of November time; going to therapy, going Christmas shopping etc. On full pay, she was in no rush to go back to work. OK, she was in her late fifties, in good health, fit etc. But she's also a 'serial frivolous complainer' and if there were any problems with her treatment, she'd have told them until it was rectified, and I would have been listening to a story a lot longer than an hour. She even pulled down the side of her jeans one day to show me the fine-line scar, which I took as an indication that she was fully satisfied. Any blemish on her beauty would have triggered the most vociferous complaint. I don't know where Marcus gets his dates from - maybe because of other complications. It seems a routine operation, with all possible problems anticipated, and a well established care and recovery programme that follows.
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seven839: That is absolutely false that 50 million people are refused healthcare because they can't afford it, if you can't afford treatment you are still given the treatment.
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smileytm303: No you didn't rest your case, did you actually get the bill itemized? It's a very good possibility that you were accidently billed for other things. My dad works at the HCMC in the minneapolis minnesota, there is no way an ambulance ride could cost you 12k for one block. Either you are making this up or you didn't get your bill itemized and are accidently charged for other things or you are just using hyperbole to make a point.
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# 41 David_Cunard wrote [to MarcusAureliusII]
"Calling me a liar would normally be a reason to complain about your post/s, but in this case I do not do so in order that your ignorance and malicious nature can be seen by all. Like King Gama, you are a thoroughly disagreeable man."
In the words of the UK parliamentarians that MAII claims to despise so much - along with all other residents of Europe of course - 'Hear, hear'.
I realise of course that this puts me at risk of [a] MAII thinking up one of his 'witty' insulting versions of my name and [b] another spiel from him referring to eg Guinness, Whiskey and leprechauns. Oh well - there are some people who I'm happy to be insulted by - it's only if they complimented me that I'd get worried.
One of the most sadly ironic things about MAII is that one of the reasons he's given for his relentless and tedious loathing, detestation and contempt for all Europeans, and especially the British, is - racism. Not his - theirs. So, he condemns millions of people he doesn't know and has never met - because they're 'racist'.
Which is about on the intellectual level of someone who says: "I hate racists. Racists - and blacks".....
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# 53 cjtsmith wrote:
'I wish people writing from the UK would stop saying or implying that our health care system is free. It is not. '
There is no such thing as a free lunch - or a 'free' health care system.
The NHS is free at the point of treatment; you don't have to pay for the treatment you receive [except via taxes of course.]
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Pump or not pump, the question leads me to two temporary conclusions:
- The private insurance schemes are the less likely to enable chronic diseases to be cured according to each person's needs. In France, even in the mid of the crisis, our social security system allows a patient to choose between pump and seringes or pens-injectors.
- Please, do not stick to insuline rationale, as the only possible treatment. Being insuline-oriented weakens dramatically the huge possiblities for having another definitive treatment. See the weight of the insuline market: above $10 billions, and you will understand why so few is done for not damaging such a bonanza. I read an annual report of an international lab working on monoclonal antobodies, which stated that "on diabete type one, we should earn 400millions, on digestive disease, we should earn 2 billions". Guess the investment decision?
FYI, my son, 25, was diagnosed Type 1 on April 14. From an athletic shape (he is -or was?- a scuba-diver archeologist, we are in Nice, French Riviera), he had lost 15 kilos in three weeks... He is bared from diving archeology, his only job he had been training for 5 years here in Nice...I would swim the ocean for granting him a safe exit through stem cells experiments etc...Sadly, I'll buy him a boat, for keeping sea's touch...
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canadacold: You can't be serious with that question. You honestly think the US should have a much higher number of people infected?
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# 48 SaintOne wrote:
"A problem with the NHS is that people have less incentive to keep themselves healthy. As ridiculous at it sounds, if you know that you are stuck paying a fixed tax, and that if you get ill that tax will not change, then it won't be the end of the world if you get ill. There is a big issue (pun intended ;)) with obese people, who could easily excercise, draining funds and time from hospitals. (Of course this does not apply to all overweight people)."
But surely if you apply this logically, since health care is so expensive in the US, there should be v low rates of overweight and obesity there - especially among the poor, who are least likely to have insurance? Is that really the case???
[Having said that, I would concede the point, which is often made, that eg the NHS tends to be a 'Sickness Service' rather than a 'Health Service', ie resources tend to be devoted to curing illness rather than preventing it.]
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Healthcare has always been a two tiered system, in every country. In the American system profit is the primary driver, along with corruption, this makes costs high. The price for services and equipment have no relationship to the value. Because it is healthcare the providers, profiteers, charge whatever they will. A simple foam wheelchair cushin might be billed at $400 - 600. We have had a Congress that has interfered in every aspect of services, mainly to the benefit of family and friends. Rules are written and agreements made that are not in the public interest. Fraud is a major problem. Referrals, questionable tests, high costs drugs and every expensive equipment have lead to one of the worst managed system in the country. Competition does not make healthcare better, it makes it expensive. Under Medicaid, people who do not work, receive much higher levels of servies and equipment than those on Medicare, those who have worked and paid into the insurance system. As most individual plans have consistently increased co-pays, insurance is primarily for catastrophic illness. There is no managment of emergency rooms and these are frequently used by the poor as their doctor for any illness. Most hospitals have postured as non-profits to avoid any taxes so "profits" are turned into salary increases for the administration. It is surely a broken system and the costs are not realized in benefits to citizens. No member of Congress would trade health insurance plans with the people who elect them.
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I pay $100 dollars a week in health care luckily my husband makes a weekly bonus of $100 a week for being on night shift at work it covers our health care but not including our dental.We have 3 kids,the last child we had we were both out of work when I was in my 6th month had to use State health care happy it was available but is not the same as private.And their are other ways to Reform health care. Most Hospitals are non-profit instead of giving non insurance patients lower costs they over pay Board and higher up staff members,ridiculous bonuses,some even give board members loans with forgiveness clauses if loan isn't re-payed and try to buy other hospitals.We have owe $2000 dollars on credit report,$1000 is to hospital for my son when he had severe croup and needed breathing treatment, we didn't have insurance at the time.Then Americans get over charged for medications by Pharmacutical companies and again by drug stores.When we give away drugs to 3rd world countries who do you think flips the bill from drug companies.Then Doctors themselves are greedy they are grossly over payed,it's ironic how few Doctors offer their own staff health coverage.Then Doctors malpractice insurance is very high.The ironic thing is private hospitals offer same care usually at lower cost than non-profit hospitals.Then if we do have a public health care system I don't want Government being able to borrow against it for other things like they did with Social Security.I want public health care ran by State Governments like Education.Many regions have different health issues by the climate and race.I think the Regions are better at figuring out the health needs of it States better than Federal Government which has showed bad management with S.S.,Education Reform,Military contracts,Welfare,Border Control,FDA,FEMA,EPA,Trade negotiations the list of Federal Government Blunders and over payments goes on and on and on....I really don't want to add health care to list I know it's a problem I want resolved but I really want State Governments to mandate health care.I don't trust Federal Government they are so incompetent.
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Our reluctance to adopt socialized medical care, while allowing those who can afford it to retain their private insurance coverage or pay cash, is influenced by cultural values. In our society, socialized services are considered evil and considered a demand by those who do not want to work and earn enough to pay their way.
The fact, that many people without healthcare coverage are disabled and unable to work, or that many Americans can not find full time employment with an adequate benefit package is often dismissed as preposterous or dumped on charitable institutions to deal with. In effect, poverty such as the one we all saw in New Orleans during the Katrina disaster, remains hidden and we prefer to think it only happens overseas. Out of sight out of mind.
The healthcare crisis has reached the breaking point as a result of the ongoing economic downturn, high unemployment, and the tendency of many employers to hire part-timers who because of their status are denied benefits such as healthcare insurance, paid holidays, paid sick leave, and paid vacation. Part-time work is becoming the norm in many sectors of our industry to reduce operating costs and increase profits. The losers are the workers who are often scheduled to work 39 hours a week for close to minimum wage with no benefits.
I have no problem with the well off buying whatever they wish and getting exceptional services, but I think it is very wrong to deny working families the most essential services they need to survive. As incredible as it may seem, most Americans are not rich, are struggling to make ends meet, and can not afford the wonderful goods and services that we advertise to the world. Our top priority should be to address the growing inequality that exists in our society, rather than come up with excuses to justify what only the anti-Christ would find acceptable.
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Canard, if I hadn't been through it three times directly, I might almost be tempted to believe you. But getting out of bed with three people at your side to catch you if you fall and struggling to walk four feet to a chair with a walker is not being ambulatory as your implied. It is just the very first step on what is almost invariably a very long road to partial recovery. That little bit of activity is not even therapy for walking, it is to assist in the healing of the surgery.
Seven year old, I'll repeat myself in case you didn't understand the first time I said it. Nobody is denied medical treatment in the US. If they were, millions would be incapacitated in their beds, more millions would die in the street. Even illegal aliens who have no money get medical treatment. Why do you think there were so few fatalities from swine flu in America this last month. How do you explain that when there were so many more in Mexico where poor people really don't get health care?
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I agree with 14,but i think low middle class people should be able to pay the difference for state health insurance and receive benefits.They should be able to choose to have it deducted from salary in return for state health coverage then at the least middle class who can't afford coverage at their job or have one without benefit offers can purchase them at affordable cost many choose not to purchase health coverage because they can't afford private insurance so private companies are not losing customers.The only program in my state that does that is MI CHILD which does make it so you can cover your children if you are middle class and have job without benefits.I stress the word choose because when the get a job that pays more or offers benefits then they can purchase private insurance.By the way to all the Europeans most without health care are not poor but low middle class.Poor people get State coverage funded by federal government many states add to the benefits for poor,some do not.That's the out rage,that middle class can't afford coverage while paying for many others including illegal immigrants.Some are rich people without health care who don't pay for insurance because they will pay when they get sick instead of paying weekly or monthly. I say this again most poor people have health insurance as do the elderly it's the middle class getting the screw job.
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Ref 53 cjtsmith
That's a very misleading post. I don't see any UK poster, up until yours, saying the NHS is free on this page. And only one poster could possibly be accused of implying it, but even here you're wrong because he has qualified it correctly by saying "free at the point of need." We all know it's not completely free and that direct and indirect taxes contribute to overall government expenditure. He also points out, by way of comparison to England, that prescritions are 'free' in Wales. But how would you describe healthcare at the point of need?
And in your 17.4 per cent calculation, are you forgetting tax revenues from corporation tax? From employer's national insurance contributions. Fines from offenders? Fuel duty on goods vehicles. Have you considered, a husband, for example, contributing Pds 10,000 pounds annually through tax/NI with a wife and three children at home? Even using your 'false' calculation of 17.4 per cent would mean he's paying Pds 1740 pounds for five people. A higher earner whose total tax/NI contribution is double, would be paying pds 3480 pounds for complete health care (birth, maternity, GP service, ambulances, surgical operations, check ups, childrens' inoculations, psychiatric treatment, chemotherapy, pretty much everything )for his wife and three children. Still remarkable value. Simple economics through economy of scale.
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Ref 61, Noliving
"...if you can't afford treatment you are still given the treatment."
Emergency rooms are obligated to provide emergency care regardless of whether or not the patient can afford to pay for those services, until the patient's condition has stabilized at which time he/she is unceremoneously wheeled out of the hospital. Emergency rooms and the rest of the medical industry are not obligated to provided preventive care to those who can not pay for it.
I witnessed an unfortunate incident at a medical lab when I went for blood and urine tests last year. A young woman with a toddler begged the office personnel to honor a doctor's order for a blood test that, apparently, her child desperately needed. The answer was the customary "sorry, but you must have insurance or cash to pay for the test...in advance". I have no idea what their circumstances were, but I think cases like that don't say much for our society, our values and priorities.
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This comment was removed because the moderators found it broke the House Rules.
Funny america and their version of "Watch out the reds are coming"
How about a national health service and allowing private to compete but not only against other private companies (which leads to people saying we can charge them more all the others are. We have to make MORE money or we will look like the weak company on paper and people will invest in the other health care firm)
How about a nationalised version of the Bamks while at it.
Give people the CHOICE between freedom and the yolk.
Where is the choice when the only choice is to get reamed.
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67 and to further that. Health and safety laws arise in Europe regulating what workers breath. how much they handle and all sorts.
Most of which saves the NHS more money by preventing problems occurring.
Reduce damage to backs and people will not be in for a bad back
http://www.youtube.com/watch?v=xHv7MGQRYkE&feature=related
Now Coshe is not as good as it could be but it is better than Osha.
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Doubled over in Dublin, mary ashot
Number 17 Mister Moderator
I refer the right honorable posters to the reply I gave some hours ago.
http://www.bbc.co.uk/blogs/thereporters/markmardell/2009/05/french.html#P
Read about your terminal affliction Eurosis of the Fliver in post #17. You both suffer badly from it. There is no cure or even treatment but I've suggested that a long visit to places in Africa or South America might offer some relief. It's just a guess. The disease has been around a long time only it hasn't been carefully studied as such yet. Lies, irrationality, one way thinking are all classic symptoms you both exhibit. You have my sympathies.
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In the UK, my grandmother had a hip replacement when in her late 80s. The NHS told her she had to wait a year for the operation, so she had it done privately, paid for by her sons. She was up, back home, and walking within days.
In the US, my father had a hip replacement when in his middle 60s (just a couple of years ago). He was out within days, but was in great pain and had huge difficulty walking. After a couple of months he got a pulmonary embolism that nearly killed him. It was costly and the care was appalling.
Now you cannot take one case from each country and draw any conclusions about the systems. You can however conclude that the troll is a liar.
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Princ-ass in the pee;
As usual, you are way off base, you don't know what you are talking about. How many people who needed and got hip replacements have you known closely from the time they were first injured through their therapy?
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NoRash - Our blood does not boil over the health care system. Instead as posted by SaintDominick it is our disbelief that the US is either unwilling or unable to care for the health of all its citizens.
cjtsmith - Canadians also pay through their taxes. We are willing to do so as our system covers those who are unemployed and do not contribute; children, the elderly, the disabled, students, etc.
I can only speak for the Quebec system as health care is administered by the Provinces with Federal funding. It certainly does not cover everything, but no one is denied.
Some comparisons.
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Noliving -
You keep repeating that people in the U.S. who can't afford treatment receive it for free. Well, they may receive treatment (and of course that depends on what the needed treatment is; emergency treatment, yes, non-life-threatening, quite probably no) but the bill is not written off. They are billed, hounded, sued, can lose a house if they happened to have bought one in better days, their credit rating is ruined, collections agencies even hound their neighbors in order to embarrass them (and this is not illegal, as I found out when trying to stop the calls I receive about a neighbor's debts!). They may not pay in money, but they pay all right.
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As I understand it, the main opposition to socialised healthcare in the US is that people don't want to have to pay for other people's medical treatment. Is that correct?
If so, insurance isn't a viable solution. After all, the insurance companies aren't paying for people's medical bills out of the shareholder's pockets. So if you pay insurance premiums, without making any claims, then you are still subsidising someone else who is claiming more than they are paying in premiums. And there have to be more people paying money into the system (net contributors) than people taking money out (net benefiters).
No difference when we pay our taxes in the UK (except that the taxes aren't optional). Sure, I pay taxes and never use the NHS, which makes me a net loser. But I wouldn't want to be without cover, so if there were no NHS I would have private cover. Instead of paying tax, I would then be paying insurance premiums without ever needing medical treatment, thereby still making me a net loser. Don't really see the difference...?
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61. At 1:30pm on 14 May 2009, Noliving wrote:
seven839: That is absolutely false that 50 million people are refused healthcare because they can't afford it, if you can't afford treatment you are still given the treatment.
don't you get IT.
It is useful if they can visit the doctor before the cancer has spread throughout their body so much all they can do is prescribe morphine.
peoples claims that people in the UK are dying in droves from underfunding forget the number of americans that die because they cannot get help. That statistic is not so easy to find.
Americans DO NOT live longer though. How come if it is all so hunky dory.
Just remember americans pay more in the end than the brits do.
St dominick pointed out" The problem we have in the USA is that in addition to paying Federal, State, local, sales, property, and excise taxes; plus Social Security and MEDICARE, we still have to pay high insurance premiums and co-pays to receive medical care. "
well pointed out.
Richard SM..
They won't listen . strange how now most in america are getting around slowly to the Idea(wasn't so prevalent a thought back in the summer before the crash hit;)
My aunt is on another hip operation and still owns her home.
Noliving. (no kidding, well the brain anyway) HOW do you know.
Your dad is an expert not you.How do you know they are not just reaming what they can get away with.
What do you call inaccurate billing.
30 ausie taff the reason they complain about it is they are mean spirited nasty people ;)(one the whole).. or incredibly ignorant because some from the UK pander to their frail little egos and tell them they have a good system(there is no SYSTEM).
Only when it is looking like they might get hit by a bill do they care.
Old fashioned minded people ( palinolitic people) keep complaining why do euros care.
Well I care and I;m american. It seems there are other americans that care as well. but no it is always assumed that euros are trying to pull something over them. (maybe the prozac has them all paranoid)
The best examples of why america doesn't get it is this "noliving" poster here.
exactly what you expect from a defensive undereducated american on this topic.
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Profit and medicine not be mentioned in the same sentence. Ask yourself this- Is there more money to made in treating symptoms or providing a cure? Will sombody be denied medical care because it is expensive? Happens every day.
The humanas , Aetnas, Permanentes combined with the pharmacy companies will never allow their kingdoms to be altered. They may allow the same deck of cards to be redealt, but their license to steal is secure. it is a carnival game that citizens cant win. Jim VP of med mal claims
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Perssonally I don't think you know what you are talking about. Just because you have a child with a disease in no way makes you some kind of exper on American healthcare. Much too simplistic in your approach. Stick to what you know!
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get sick eventually loose your job for having too many sick days and your health care goes. (unless you rob a bank)
statements about americans not getting health care are LIES. not inaccuracies.
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almost cost me $150
just to get the doc to say "yes you need antibiotics" because I had to go to emergency cause I have no Doc.
5 minutes $150
They got 0
I offered $50 and said "if you want more sod off."
they ended up dropping it.
I saw in order
receptionist
billing person
receptionist
triage nurse(who said "yep looks like it is red")
billing person
Doc
two more billing people.
OH and it took 3-4 hours.
Just to say "looks like the scratch is infected"
Of the 5 minutes 4 1/2 were the doc and I discussing how crap it is here.
He saying that american docs worry they will not be so rich.
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Using FOX AHHHH but it was the first link
http://www.youtube.com/watch?v=kXcQT-jgI5o
http://www.youtube.com/watch?v=VHHcx3GiXGA&feature=related
but at least he did not die for politics , right?
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MarcusAureliusII
re your comments to Canard, you might just try verifying your facts before throwing accusations of lying around.
What Canard described is verified here
http://www.nhs.uk/Conditions/Hip-replacement/Pages/Recovery.aspx
And just to add my two penny worth:
Three years ago I had what I now know was my first ever asthma attack in the middle of the night. I was in great distress and near panic, my husband drove me to our local hospital where I was seen straight away (no wait) and put on oxygen, stabilised, preliminarily diagnosed, given an inhaler and a dose of steroid tablets (no charge) and told to visit my family doctor the following day.
I rang the doctor at 8am and was given an appointment for 8.45. More tests ensued (for COPD), appointments were made for further investigations (again at the local hospital) and proper inhalers and a spacer were issued and their use shown to me.
Two days later I was back at the hospital (more like a hotel than a hospital, I thought as this time I went in through the main entrance) for more tests where I joked with the clinic receptionist that I wanted to put in a complaint - I started to read a magazine article in the waiting room but my name was called before I finished it!
I rang for the results the next day and was told that other than developing asthma, nothing more sinister had been found. I then went back to the doctor the following week for a check-up.
All done & dusted in one week at a total cost out of my pocket there and then of £14 for 2 prescriptions. No waiting around, no dirty hospitals (my local hospital is Stroud General and it's reviews are verifiable on the web if you wish to check up), just efficient, prompt and caring service. I honestly feel that I could not have been treated better or more promptly if I'd been in any country or paid any amount of money for the treatment.
The NHS does have a lot of short-comings and there are real black spots in its service and it's those that make the news - it's the same with any large 'business'. After all, 'middle aged woman in Stroud treated really well' isn't going to gain much of a readership, but don't take the headlines as the whole truth about the NHS. Us Brits are quick to complain and you could bet your own bottom dollar that we'd be making an awful lot more noise about it if it was as bad as you seem to think it is.
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While Europe has made it a felony punishable by imprisonment to be an illegal alien there, and Italy's parliament is considering a bill which if passed into law would impose a $13,000 fine for being an illegal alien in that country, this from America.
http://www.medicalnewstoday.com/articles/60323.php
That's right, our so called conservative Governator of California proposed taxpayer paid medical insurance for illegal aliens in his state. Actually, since they get free medical treatment anyway, it would simply change the burden of paying for it from the hospitals to the population at large.
I think there was a case about a year ago where an illegal alien woman was treated in a hospital in NYC where there was an instance of medical malpractice and is suing the doctors and the hospital. It wouldn't be hard to find a lawyer who would take the case on a contingency fee basis if there is legitimate grounds for a suit. One of many factors that makes American medical care superior as well as more expensive to that of all other nations' is the need to practice defensive medicine, using every available appropriate test and resource in every case to avoid a malpractice lawsuit. It's a war of the lawyers against the doctors and the lawyers so far are winning. Americans are loathe to make the choice between value of life and money. That is why cost containment schemes like HMOs practiced have been so detested. It's why the problem hasn't been solved yet. It is why NHS and other socialist schemes have so far been unacceptable. The hard economic choices reality is imposing are ones Americans have not wanted to face up to so far. Using this as a convenient platform for America bashing as has been so thinly done here is one more sign of the intensity and ferocity Eurosis of the Fliver has on its victims. Europeans should stick their noses out of complex American affairs they can't possibly understand. They'd do far better to sit back and watch and learn...but they never do. That's another sure sign of Eurosis.
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#71. "Canard, if I hadn't been through it three times directly, I might almost be tempted to believe you."
You should, but my point was not the post-surgical condition, but as an illustrative contradiction to your previous statement "Waiting months for a hip replacement may be all right in Britain but that doesn't fly here." As usual you don't argue the issue but go off at a tangent. In any case, of course there was assistance to get out of bed, as anyone who has had major surgery well knows. But perhaps my mother was more resilient than your relatives, coddled and safe as they were in WWII. Living through a war with bombs threatening every day gave my parents' generation a stiff back and a better ability to cope with the adversities of life.
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50
49 for sure it's because the americans are weak and feeble.
Maybe it is because they are also so Obese that they can't walk anyway.
Americans drive in scooters cause they are SOOOOOOOOO BIG.
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86. At 3:26pm on 14 May 2009, slammagramma wrote:
Perssonally I don't think you know what you are talking about. Just because you have a child with a disease in no way makes you some kind of exper on American healthcare. Much too simplistic in your approach. Stick to what you know!
-----
why don't you just stick to knowing nothing
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paying insurance for 20 years Paying for others treatment . then get laid off and told. No benefits for you.
Just when you need it.
Oldies have these great plans and do not get the same deals(old deals recognised people were alive not numbers).
Staff at the schools
oldies pay $90 a month health care young uns $350.
when you retire you get NONE. pay all your working life and get dropped when most likely to need it.
h medicaid or medicare picks up then. Insewerants company got a free ride and every kid in america has a set of braces.
Great stuff from the nation that wants to preach the most.
OH americans why do euros care.
cause you" " do tell them how to run their countries when you can.
All the time.
Bunch of bull.
ONE system to pay into so you can move jobs state county .
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" 79. At 3:13pm on 14 May 2009, seanspa wrote:
In the UK, my grandmother had a hip replacement when in her late 80s. The NHS told her she had to wait a year for the operation,"
This is exactly what we don't want and won't accept in America. All the European lies that this doesn't exist is a smokescreeen, this is the truth, the norm, the reality. We hear it all the time. Europeans are endemic liars. That is what Eurosis is all about. They not only lie to Americans and about Americans, they lie to each other and to themselves. They are delusional.
Case closed.
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and maybe if americans were not so SCARED because of their health care costs etc. they would be less aggressive and grabby.
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80 Gosh Marcass - I just bet you spent ages coming up with that one!
Actually I know quite a few people who have had hip replacements varying from age 62, age 58 and age 84. I just picked someone famous so that you could google it to verify the facts. My great aunt had it in London at age 84 and came out to dinner 6 weeks later without even a walking stick. So I suggest you don't know what you are talking about or else ou have particularly frail relatives.
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82 Bere and all of those effects are why americans could no longer afford to pay their mortgages , .
And used property to try to get some way of beating the ever increasing Skyrocketing health care costs.
and then when the gas went up as well. they were in deep do do.
And then we all were in great do do because the american economy went bankrupt as a result.
Now if they were all taxed and paying into the same coffers there might not be a world economic collapse because the country that CLAIMED to be the bastion of freedom and free enterprise screwed up by being Cheap selfish and unsympathetic to the poorest and the sick.
All the time claiming to be some great nation By the people for the people.
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*! Time I get angry cause I live in america and pay taxes so they can start wars bomb innocents and over arm a bunch of thugs they laughingly call the police, but i cannot get a piece of metal out of my eye when I need it cause the boss didn't pay his bills right.
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83 tansaung
"so if there were no NHS I would have private cover. Instead of paying tax, I would then be paying insurance premiums without ever needing medical treatment, thereby still making me a net loser. Don't really see the difference...?"
The difference is simple. If a tax funded helath system has a net "profit" then that money remains in the system. If an insurance company has a profit its shareholders get goood dividends and its executives get fat-cat bonuses.
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Mr. Webb;
Your son's medical condition was quickly and accurately diagnosed. You were told of all of the options so that you could make an informed decision on what course of treatment you thought best for him. All viable options were made available, the choice was yours as his legal guardian. What more do you want or have a right to expect? Insurance to pay for those options whether private or by a government is a method of spreading and sharing risk. There is no method of eliminating cost. That is an economic fact of life in any system. Do you want government paid automobile insurance too so that you can pay for the recklessness of motorcycle drivers who refuse to wear helmets or drunk drivers or those who drive without a valid driver's license? How much risk must I be forced to share?
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Jumbo53
"Will sombody be denied medical care because it is expensive? Happens every day."
In a private hospital yes. In a public hospital in the United States, no.
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saintDominick: Yes I know, my point was that people are saying that if you can't afford it you don't get any health care whatsoever, you are turned away before you even enter the building. That isn't true.
bere54: Show me where I said you can get free treatment, I never said the treatment was free, I said that if you can't afford the treatment you can still get the treatment, that doesn't mean it is free.
happylaze: Yes I do get it, people who feel that they can't afford the treatment won't even both to try and get the treatment. Interesting enough America has better cancer survival rates than europe does for the most part. So what do I call inaccurate billing? Oh I don't know one patient at the HCMC was charged for over 2000 disposable gloves, one patient was charged for a surgery they never had, a lot of mistakes are made at hospitals because a lot of it is done on paper. By law they are required to give you an itemized bill if you ask for one, but they don't do it automatically because it saves in cost in that its not as much paper they have to use.
What a lot of people don't know is that a lot of states already have programs available that help pay either all of it or parts of your medical bills if you can't afford them, some programs will make up the difference, some will pay for all of the bill, but there is a lot of paper work involved along with having to prove your financial situation. A lot of people also don't know this but hospitals are actually willing to negotiate a monthly payment plan, so if you can't afford 10k upfront you can negotiate maybe a monthly payment plan of lets say $200, now granted it is just one more monthly bill but it is a heck of a lot better then declaring bankruptcy. Also some hospitals are also willing to neogotiate the final cost, if something costs 10k and you can only afford 7k, some hospitals will take the 7k and write off the rest of the bill.
The real problem with the current system is that too many people in America are ignorant of the state and federal programs that can help pay your bills, and they don't know how to work the current system, like for example they just take the bill with out asking it to be itemized.
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Any attempt to introduce a Universal Heathcare system will be the worse thing for the US since the election of Obama,
I hope you guys that advocate such a move are prepeared for the influx of South Americans looking to benefit from the contribution made to a Health Care system by the hard working,over taxed, American people at no cost to themselves.
Universal Health care will not work, it will undermine inovation, it will be very very expensive and you will lose choice.
My Preminum for Private health in the UK is actually less than the proportion of Tax I am forced to pay towards the National Health Service in Great Britian, The service is poorer as are the standards of care. and I have no opt out
We also have THREE administrators per patient.
Only one in four of the population pay for the services used by everyone.
Why are Socialists/ Liberals so short sighted?
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After reading all the post, I have realized there is a general misconception about US health care from both the Americans and the Britons. No one would deny that the US has among the best hospitals in the world. But it would be unfair to compare the US and UK systems because Britain's health care system has many flaws. Yes, there are at least 50 million Americans who, at any one time, might not have health insurance. The number changes all the time. Of course, this is an issue that has to be addressed. Going to a single payer system is not the answer, as Americans do like choice. In fact, the Bush administration sent representatives to the Netherlands to look at their health care system, which is largely based on private insurance but assisted with federal money. Yes, the Dutch do pay about 52% of their income in taxes, but they also get a lot more in benefits, including child care allowance, money for kids' school books, vacation money, funded day care. We Americans would like to think that we pay less in taxes, but in reality we do not. Add up the federal and state income taxes, the social security taxes, and even other taxes, such as property tax, and you will find that we are approaching the 52%.
http://www.nytimes.com/2009/05/03/magazine/03european-t.html?em..
Unfortunately, even public hospitals, which have mandates to care for those who cannot pay, have seen their budgets cut, and not every public hospital has the resources to raise money to cover costs. Here in Alexandria, VA, The Twig, which is the ladies auxiliary for Alexandria Hospital, has raised more than 2.5 million dollars for the hospital, and is now raising funds to built another unit at the hospital. http://www.thetwig.org/
The Dutch health care system is highly-regarded, and it is not run by the government. The difference between the US system and the Dutch system is that the Dutch insurance companies do not have a lot of paperwork, and no company can deny patients with pre-existing conditions. Of course, there are US insurance companies that have moved away from paperwork (mine included), but in the Netherlands, all insurance companies follow the same procedures, and the Dutch government tops up the extra costs. Americans do get soaked on drug costs. This is largely due to drug companies passing costs on to the American consumer as other countries subsidize the cost of drugs. The French health care system is similiar, and also involves private insurance. All Americans can have access to the health care that most Americans have, and that is where the work needs to be done. Pass regulations for the health insurance industry, and provide the funding to top off the costs.
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badcat
The NHS posting is a fantasy especially for geriatric patients. A hip replacement is a very intrusive and traumatic operation. It takes weeks for the bones to reknit, even months for the muscles to heal up to the point where assisted walking is possible. They may be out of the hospital but they are going for long term professional institutionalized treatment and therapy. Three months, that is about what it ordinarly takes. And if there are complications such as signs of pneumonia...they go right back to the hospital immediately. And when they come home, more months of therapy with a visiting professional therapist and weekly visits by an RN. Also a visit from a nutritionist. At least in America. I've been there not all that long ago so I know first hand. If you are not getting that in the UK it doesn't surprise me one bit. Not when they'll put you on a waiting list for a year just to get the operation. How are you supposed to walk during that waiting period?
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I'm not saying the current system in america works, I don't think it does but a lot of people in america don't know how to work the system.
Ya happylaze I don't get it, right....
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Oh and also happylaze, my comments you consider to be uneducated and defensive, oh I don't know I was just defending the fact that if you uninsured and can't afford the bill you can still get healthcare, the people I was responding to were saying you don't get any treatment whatsoever, that is absolutely false. So technically I'm correct. As saintdominick pointed it, a lot of it is just ER that stabalizes you and thats it, but it is still health care and treatment, they were basically saying that as soon as you step foot into a place and say you can't afford it they turn you away with no treatment at all, and that's not true.
Next time read my posts and the people I'm responding to before you make a comment about my comments.
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Prince-ass in the pee
And when will she be running in the marathon?
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I think this clip sums up some americans learning about healthcare.
http://www.youtube.com/watch?v=328Q79GoR7g
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"Sure, I pay taxes and never use the NHS, which makes me a net loser. But I wouldn't want to be without cover, so if there were no NHS I would have private cover."
One day you will need it. I guarantee that.
what if when you went to pay you found out the private coverage is one week of pay and you still pay taxes.
what if you find you cannot afford it?
is it only the rich that get health care?
Check out what a fine for polluting the water is in the US. NOT MUCH compared to the costs of all those that get affected.
The rich make money in america by trying to ensure some of the worst health and safety at work and environmental pollutants, while denying coverage to those that make them rich.
A smart slave owner paid to keep their "investments" alive, unless they got them so cheap in some deal.
But not industry these days.
Did you ever hear of the word "revolution"
what happens when americans start figuring out they are used as disposable organic production machines. That do not need maintaining cause it is cheaper to replace them.
That's the whole american ethic of business applied to people. Sick really.
But not all americans think "small casserole when they see 4 beans"
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The issue of health care is probably the most controversial and sensitive subject in the US today. Everyone has a personal story and everyone has an opinion.
Is basic health care a right? Are we to become "socialist" if we guarantee this right to everyone? Who will pay? Are we only enabling the 'unhealthy' and those who "will not work?" And most of all Cui Bono?
We already know who has mostly benefited, the insurance and drug industries for many years as health costs have risen. Insurance companies are permitted to select whom they will cover. They want dollars and do not want to pay benefits to anyone who might actually get sick. Their motives are strictly profit and the bottom line. I choose not to even discuss drug companies here.
Many have pointed out what really cannot be disputed:
It is not people on welfare who suffer the most in our current system but it is those who are working as hard as they can who have none or inadequate health coverage. They must neglect preventive care and are often one illness away from tragic financial loss. They do not qualify for any programs that might help pay medical bills. They can donate their homes, their children's futures and all they possess to meet their medical bills.
Do I have a solution to what is wrong? I do not? I do believe that a person's medical care should be decided by the person and the doctor, not by some twit at an insurance 800#. Care should be about what is best for the patient and should not make that person choose death rather than beggarhood for whatever remains of life or the lives of their families in order to pay the bill.
This is not just about you or me. This is about all of us. Are we so selfish that we would continue to allow the abuses in our health care system to continue to punish those who get sick? Can we not take the profit out of health care and treat our sick and most vulnerable with love and compassion?
Ubuntu: What hurts you, hurts me, hurts everyone and hurts the world we live in!
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104 By law they are required not to over bill you.
"Interesting enough America has better cancer survival rates than europe does for the most part."
NO reported diagnosed cancer.
DIAGNOSED.
Now if I just die on the farm when is it DIAGNOSED?
My dad fell for that line when in the states . only to return to the UK to find Guildford Hospital carrying out more effective less intrusive treatment.
"What a lot of people don't know "" is what it is like for those with less money than them. They lack a basic gene called the "empathy gene"
a small mutation with far reaching consequences.
No viable changes just a complete ability to blinker ones self from reality.
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108 glad to see you agree it doesn't work. so are you thinking we should maybe try to fix it. Or just bitch that others are calling us silly for not doing it.
106. At 4:59pm on 14 May 2009, marlenekoenig
The Dutch mentality is akin to the US (not too much of an insult meant;)
t I do think that if they looked at various ways the Dutch have sorted out problems they would be impressed and find it fits their ideals.
But most as you know have only heard they smoke pot in Amsterdam. and have clogs over the mantle piece
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Marcus Aurelius (103). Your statement about public hospitals is incorrect. While it is true that public hospitals are largely mandated by local authorites to treat all, the opposite is actually true. Due to cuts in budgets, public hospitals are having difficulties in treating all those who come without insurance. Millions of Americans do not receive the preventive medical care that we all should enjoy. Recently, Nevada notified uninsured cancer patients, who were using the public hospitals' outpatient clincs for chemo, were no longer going to be able to use the service. The hospitals had to cut the support because the state, which is in a serious economic downturn, has cut the funds. The cancer patients have nowhere else to go. These were the only resources in Nevada available to them. These patients will die. One of the hospitals affected also closed their prenatal clinic. There is no defense for this. There is no way that the US should treat our citizens in such a dispicable way. It is certainly not the Christian way. No one should denied health care in the USA. Period. (and for our British readers .. Full Stop.)
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"I was just defending the fact that if you uninsured and can't afford the bill you can still get healthcare"
sorry but yes I do consider them undereducated.
People in america cannot afford health care.
They take half prescriptions.
they were so successful at not taking their TB drugs they managed to reduce the effectiveness of standard treatments by starting a whole new drug resistant strain.
(first noticed in NY)
BTW the real number without AFFORDABLE coverage is way higher than the number without.
that means people are eating cheap crap and that leads to more problems.
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#111, bird brain is about right.
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109 No they stop you making a mess on their floor and being an embarrasment if you die in their waiting room then rob you blind until you die of stress.
do give it up.
Turn up with a shred of steel in your eye. they will not help you. they will send yo away until your eye is swollen and going blind.
Or at least ask you to sign your first born (and theirs) to get the treatment.
Even if you paid all your taxes and just got laid off after paying for 20 years.
I just argue here I did all the research back in the summer when we had this debate.
All the figures in the US are massaged to let you folk keep living in cloud cookoo land on this debate.
We need universal healthcare. REAL SIMPLE.
If not someones going to rob you to get it.
At the moment the rich are robbing the poor.
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113
Well said AQUA.
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#90. badlydrawncat: "MarcusAureliusII: re your comments to Canard, you might just try verifying your facts before throwing accusations of lying around.
What Canard described is verified here
http://www.nhs.uk/Conditions/Hip-replacement/Pages/Recovery.aspx "
Don't confuse him with facts, they're far too awkward.
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71. markus...I understand you perfectly...you will defend your rotten health care system with technicalities and comparison to Mexico...how shallow and ridiculous your arguments are...do you realize that your companies cant compete on a world market because of your greedy health care system.
...the government of any country should be guarantor of equal rights (money neutral) for education, health and legal services, people are willing to pay taxes for this role of the government, but in your country these sectors can operate only under huge profits and illusionary market forces (there is no demand for deceases!)...the priorities are in military (stemming from paranoia of Russian invasion) and bailing out greedy corporate bums including health insurances...
...until you keep sending to Washington politicians that support the present health insurance drain and businessmen-doctors culture, nothing will change.
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I understand that it is crucial for anyone with any kind of major surgery to become mobile as soon as possible for a number of reasons.
For people with hip or knee replacements it is especially important to avoid muscle atrophy and the possibility of serious blood clots. It is not just a matter of bone healing but of strengthening the muscles that support the bone. Every person heals at their own rate and there can always be complications but being out of bed and mobile is so important to the healing of any surgery patient.
One of my closest friends had major heart surgery (a valve replacement) they had her walking on the third day. I was there. She shuffled and stumbled with staff holding her arms but she walked. They were thrilled and talked about slowly rebuilding her strength. After that short walk she had hope to regain her life and her health.
Trauma to the body is more than just physical. There is also fear of not regaining the 'self,' that essence that makes us who we are.
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113, aqua -
Very eloquently said. Truth well spoken.
114, happylaze -
Yes, it's that missing empathy gene. Perhaps someone should fund a study to find out why Canadians and Europeans have this gene and so many Americans do not. It chills my blood to hear what so many Americans don't want their fellow Americans to have lest it cost them a few more pennies. Even if it would actually cost them less than what they're paying now.
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As Americans we lived in the U.K. with its single-payer health care system for eight years and generally had very good care. We could choose any doctor who would accept us, and patient paperwork was limited to the initial notification of the local health authority of our presence and their issuance of a health care card. Prescription cost was fixed yearly with a low patient responsibility no matter how expensive the actual cost for the drugs. There were problems, but no human system is without problems. Now in the U.S., my wife pays $450 per month for subsidised coverage with a very large deductible and various deductibles also for her prescriptions, and her $450 is set to increase by at least 14%. My Medicare premium has risen every year apart from this one and the government-sponsored prescription drugs program (Medicare Part D) costs also have increased, with that program set up to benefit the insurers and pharmaceuticals makers. At the time the U.K. reportedly spent half of the national budget on health care as well as many other benefits for the public, but I would rather have that than the U.S. spending half of its normal national budget on warfare and other means of killing and wounding people rather than helping them.
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Marlene Excelent post.
When i said the two nations were similar the bit I left out is how the dutch are just that bit smarter about compassion, well the system is.
the similar bits are the dutch exemplify (these days) a system of capitalism that works and works on the whole for all.
It would be hard to argue the Netherlands as a socialist state as so many try to claim about the UK and France.
An example they can understand.
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#107. MarcusAureliusII: "badcat: The NHS posting is a fantasy especially for geriatric patients."
You really do not know what you are talking about; my mother was 91 (certainly 'geriatric') and recovered swiftly.
"And if there are complications such as signs of pneumonia...they go right back to the hospital immediately."
Why to the hospital? Pneumonia is a curable condition which does not necessarily require hospitalization.
"they'll put you on a waiting list for a year just to get the operation. How are you supposed to walk during that waiting period?"
Seanspa's grandmother may have been an anomaly; in my mother's case it was done within days of being admitted and would have been earlier had it not been for my intervention. And those requiring non-emergency hip-replacement can walk, painfully, but mostly they remain ambulatory - or how could they get to the doctor's office?
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115, happy, it might interest you to know that our Governator down here
in California is advocating legalization (and taxation) of marijuana.
No word on clogs over the mantle piece yet.
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KASrick that boldrick sketch was just right for you.
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# 96 MarcusAureliusII wrote:
"Case closed."
Really? The doctors have given up?
Well, it's a long time since I got my primary degree in psychology, and I haven't practised, but let me have a go.
Severe Asperger's Syndrome, bordering on full-blown autism, with resulting obsessiveness and complete lack of social skills.
Combined with advanced paranoia and delusions of persecution, as well as severe megalomania and delusions of grandeur.
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To#116 Marlenekoenig
We have seen this also where I live. I ask where is compassion? Where is feeling for others who suffer? Treatment of the sick should not be tied to dollars and should not be a 'for profit' industry.
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Look, everybody, I have just gotten an inspiration. We've heard about people flying
to India to have operations done. Why don't we just let the Indian doctors come
here? That way, we only have to pay for one airline ticket instead of many.
Not only that, since a lot of Indians want to come here (can't imagine why),
we should just let them bring their relatives with them if they have valuable
skills like that. So, we only have to pay for one-way tickets.
Problem solved. Dump a few ambulance chasing lawyers in the ocean, haul a few
big drug company CEOs into court, and we're done. (O.K., some lawyers are
good, but only if they're on your side.)
And, there are always Cubans and we've all heard about how good their doctors
are. Let them come here! They'll easily make a hundred times as much as they could
in Cuba. Viva La Capitalism! They can even have nice American-made Toyotas and
Hondas to drive, and get Wednesdays off.
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This comment was removed because the moderators found it broke the House Rules.
# 78 Macho Autisticus II wrote:
"Doubled over in Dublin"
Very good, Macho. Laugh, I nearly did, as they say.
"I refer the right honorable posters to the reply I gave some hours ago."
So you're not just trolling on this blog, but on one that has nothing to do with the USA?
Well, nothing if not obsessive and monomaniacal.
"Read about your terminal affliction Eurosis of the Fliver in post #17. You both suffer badly from it yada yada yada blah blah blah".
"Lies, irrationality, one way thinking are all classic symptoms you both exhibit."
Macho, if you want to see lies, irrationality, one way thinking and what we are all suffering from, might I suggest a mirror?
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TB immunity to anti-biotic was caused by many countries like Russia's prisons not just US.Doesn't UK have lice immune to head shampoo.Heard your kids have a lot of bugs in their hair.Any way immunities happen all the time their is even acne immune to tropical treatments.And stupid lives in every country not just US.
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Very good happylaze about diagnosed, guess what that is true for every medical condition that affects you.
You know why I said it was interesting? You might be interested in this example, in canada less women per capita or as a percentage have a mammogram or pap test then women in the US. More americans per capita or as a percentage get tests to see if they have cancer then europeans or canadians, which means more people per capita in the US are diagnosed with cancer then canadians and europeans and yet even with their "free" health care in canada and in europe, cancer patients, meaning those that have been diagnosed with cancer in canada or europe are less likely to survive then Americans who have cancer, the survival rate for example in the US for prostate cancer is 6 times higher then in the UK, the UK has pretty much free healthcare.
To sum it up, more americans as a total percentage or per capita are checked for cancer and cancer patients, meaning those that have been diagnosed with cancer, survival rates are higher then canadian or european cancer patients. You would think that since europe and canadians pretty much have "free" health care you would think they have a higher per capita screening or tests for cancer and that there survival rates for their cancer patients would be higher but it isn't. That is intersting. So what is your point about diagnosed vs. undiagnosed?
Of course I believe there are problems in the US health care industry that needs to be fixed, my dad is actually looking at being laid off from HCMC, hospitals around the country are looking at reducing services to help slow down or prevent loses. I'm not "bitching" those trying to fix it, what I'm trying to point out is that it is a lie to say those that can't afford health insurance or can't afford health care don't get any healthcare whatsoever and in fact are turned away by hospitals 100% of the time. You then come here and purposely insult me calling undereducated/dumb/stupid even though I'm right, and now you say they, as in me, are still undereducated because people stil can't afford health care even though that doesn't disprove what I said that those who can't afford health care can still get healthcare. You then try to disprove my cancer survival by talking about being diagnosed, but you didn't realize that a patient diagnosed with cancer is still more likely to surive/live in the american healthcare system then in the canadian or european health care system even though the american system is more expensive, nor did you know that as a per capita or total percentage more americans get themselves checked for cancer even though the american system is still more expensive to get checked for caner then canadian or the european health care systems. Yet your the one throwing out the word undereducated.
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135 yes they probably have some headlice resistance. and the first cases of drug resistant TB was in NY
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happylaze: You do realize your example of the patient dieing on the floor had nothing to do with whether or not she could pay or afford her health care, it had everything to do with the staff of the hospital.
Give what up? Have I said the US doesn't need some type of Universal health system? No I haven't. All I've been doing is pointing out that is false to say that you get zero healthcare if you can't afford healthcare which isn't true and you know it isn't true.
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136 NO more WOMEN are checked for cancer.
The same free checks available for breast cancer(which guys watch out you can get it , though more rare) are available every year here.
NONE for prostrate .
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130 John Dub.
Yea and another version of that sprung up out of nowhere on the other thread.
GnR lol I am interested. And thinking of getting down there.
;)
I like your health plan. seems OK.
And TIREDOFHOTAIR
well said.
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Happylaze: Whether you wish to accept it or not, more women are checked for cancer in the US then in canada or europe and those women who are diagnosed with cancer in the US are more likely to survive the cancer then the women cancer patients in canada or europe. That is pretty much the same story for all types of cancers. More people in the US are checked for colon cancer then in canada or europe and those diagnozed with colon cancer have a higher survival rate in the US then in canada or europe. When it comes to prostate cancer its the same thing, more men in the US are checked for prostate cancer in canada or europe and they have a higher surival rate, compared to the UK the survival rate, the US survival rate is nearly 6 times that of the UK's
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138 An I as someone without health care can tell you" you are wrong."
but enjoy your benefits and relieve your conscience if you like.
All who have said no to this debate and said why are responsible for the deaths of those that did not get treatment.
indirectly so no guilt huh?
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Here you go happylaze: http://www.manhattan-institute.org/html/miarticle.htm?id=3004
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To#132 Gunsandreligion
I enjoy your posts for they lighten the mood but I will ask:
Do we not have enough people profiting from the illness of our people? Must me ask even more to join at the trough?
Health care should not be about profit but about people. QED!!!
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UM do I bankrupt myself in order to pay bills for the last 4 months because I left it too late leaving my spouse to suffer with no money or care or do I keep quiet and say "I don't want no God damn doctors".
And let the family eat after I die.
Americans face that question. Not you obviously , you're doing OK.
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Heck happylaze, even in justinwebb link also show that european cancer rate survival is lower then america's.
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Happylaze, what state do you live in? Have you applied for your state's health care coverage plans?
Well as someone whose parents work in the industry and work in a hospital who regularily treat people who can't afford the care they are given and tell me this themselves, I can tell you that you are wrong considering it is one of the primary reason why hospitals all across the nation are running out of money as a result reducing services, which means treatments which means they might just stop treating cancer patients for example, and doing layoffs.
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Does anyone have information on the hard-core Americans who refuse to seek medical care? What percentage of people will not go to a doctor under any circumstances?
I've often wondered how many Americans fall into this category. Preventive care and even free care might not change their outcomes.
It can't be that big a group, but it might be big enough to skew outcomes.
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Also happylaze how do you think the illegals who can't afford nor have health care insurance get their health care in this country?
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Or what you could do happylaze is talk to the hospital asking them to do a monthly payment plan or showing them what you can afford ask them if they write off the rest of the bill that couldn't be paid or you could find out the services that your state government offers that could help aid you in your medical bills.
Happylaze there were days when my family back in the 80's only had $3 to spend so don't think I don't know what its like. You know how many phonecalls my dad gets per day from parents asking them for their drug test results because the government will take them away their kids for smoking pot.
happylaze, what state do you live in? Do you even know what state programs are offered by your state to help pay your medical bills?
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MarleneKoenig
The current financial disaster has turned what was a serious long term problem with financing our health care system into an acute crisis. The current situation with public hospitals does not reflect the long term situation that existed until relatively recently. Now, the Congress of the United States, the greatest deliberative body in the world will be forced to address it. It won't be able to brush it aside the way it did during the Clinton administration with Lady Hillary's flawed health care alliances plan or ignore it as it did during the Bush administration. I'm sure there will be much debate, hand wringing, heated tempers, and in the end compromise to arrive at some workable system. I expect it will not satisfy everyone at first and when problems arise after it is implimented it will be tweaked to fix them. Americans are above all a practical people. We'll learn from other people's successes but we won't copy their mistakes and we will adjust what we do for our society, not theirs.
doubled over in Dublin
""Case closed."
Really? The doctors have given up?"
Dr. Marcus Aurelius II Welby has. At least on this bunch here. As I said, Eurosis of the Fliver is an incurable untreatable disease. There is no rational argument with people who suffer from it. They are to be both pitied and ignored by any unafflicted rational person. It's also terminal.
unlucky seven
If you want to live in the USSR, you are too late. It died of just what you would inflict on America.
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Ref 132, Guns
"Why don't we just let the Indian doctors come
here?"
They already do, in very large numbers. My last three Primary Care Physicians were all from India and they are all excellent doctors.
I think the reason so many Americans are going to India and other countries to have surgery is because the hospital, lab, medication, and convalescence costs are a fraction of what they charge in the USA. All the TV programs I have seen on this subject, as well as reports from patients that have gone this route, suggest private hospitals overseas are not only inexpensive, but they are clean, have modern medical equipment, offer private rooms at no additional cost, and the competency of the staff (surgeons, nurses, anesthesiologists, lab personnel, etc) is outstanding.
I think it is worth adding that the healthcare problem in the USA includes more than emergency and preventive care, it also includes inadequate access to vision, hearing, and dental services which are out of reach for those who do not have insurance or whose insurance only covers catastrophic illnesses.
Instead of nit picking everybody else's system because of occasional errors or delays, we should be focusing on what works and make an attempt to improve our system. There is no such a thing as perfection, but what we have should be unacceptable to every citizens with an ounce of civic responsibility and compassion, and it is in urgent need of care.
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Is that statistic arrived at by examining the reason of death of all the people in the US or just those that show up at the hospital.
You are joking
Americans who are diagnosed have a better chance of survival.
"That is, the percentage of all Americans who die from prostate cancer is similar to the percentage of all Britons who do." Leave that out rather conveniently .
" But this misses the point, since a much higher percentage of Americans than Britons are diagnosed with prostate cancer in the first place. If you are a patient already diagnosed with prostate cancer, like Rudy Giuliani, your chances of survival "
Wow I could figure it out without the link. I already did.
also left out the bits about how the UK uses longer term data not the convenient "snapshot" you fellow there takes.
Plus My dad is alive and doing well. the only regret on treatment was to not go back to Guildford hospital quicker instead of one of the countries(USA) leading prostrate cancer specialist.
(like I said before "Bohemian Grove" docs are generally pretty good at what they do or they are not there.
Also look at mortality rates for babies and the general population. BRITS LIVE LONGER
And not because they still smoke 20 a day and drink 3 pints every night either.
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149 Stupid question. If they are not planning to stay why worry about the bill?
If you are off the radar why worry about the bill?
Oregon Our Oregon health care was cut when GW decided all the money was needed to fight wars and make Homeland so strong .
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We have a lottery for health care seriously Did you miss it. hit headlines in the UK as well.
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Ref 136 Noliving
Comparing just one condition in order to prove superiority of the whole system is mischievous. Care to make the same comparison for heart disease?
You have to look at the whole, not choose convenient statistics. Stats vary between countries for different conditions. It's not just treatment. Some conditions are culturally specific. Differences in data collection will also skew the figures.
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Ref 136, No living
"...meaning those that have been diagnosed with cancer in canada or europe are less likely to survive then Americans who have cancer, the survival rate for example in the US for prostate cancer is 6 times higher then in the UK, the UK has pretty much free healthcare."
This cancer patient thanks you for the reassurance, but the ultimate measure to determine the effectiveness of a healthcare system rests on things such as longevity and infant mortality. We rank quite low on the former, and unacceptably high on the latter when compared to other industrialized nations. I realize that there are many contributing factors to our early demise and our horrible infant mortality rate, but inadequate preventive care is high among them.
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Yea n adrianny I provided you with all that back before the election but you were too busy ignoring it eh.or can't you remember.
It has been done but why do it every time.
Go find the posts with the PBS reports on healthcare in the states. Go look yourself.
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Noliving -
The daughter of a friend of mine was discovered to have a brain tumor, when she was in her freshman year of college. She had no insurance, but was treated at a fine hospital in Boston. She was never able to return to college, not because of the tumor, which was successfully removed, but because she had to go to work immediately to begin paying the monstrous medical bills and because she couldn't possibly shoulder more debt.
So yes, she got treatment. At the expense of of her education, and her future job prospects. Fortunately, she happened to fall in love with a Frenchman and is now married and living in France, where she will not have to face this sort of thing again. Perhaps she will even be able to continue her education there.
In this country, if you are uninsured or underinsured, the treatment comes at the expense of your future or that of your family. What kind of choice is that? Survive cancer to live in abject poverty for the rest of your life?
Have you ever experienced serious illness without insurance coverage? If not, can you possibly look outside your own experience and have empathy for those who have and those who will in future?
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It's interesting to see some of the reactions and comments; I've experienced the NHS and the US system. I've also talked with my colleagues about their experiences - most of us are from outside the USA, so we have a lot of comparisons to make. It seems that medical care in the USA is wierdly variable - some of my colleagues have horror stories of misdiagnosis, or being given the wrong treatment, that they have subsequently had corrected by doctors in their nation of origin. Others have had nothing but superb care.
There's an odd downside to this. My doctor is excellent, which is why it can take up to three weeks to get an appointment. This means that if I'm taken ill I end up at an Urgent Care or an E.R, because I can't get to see the family doctor. In the UK, the longest I ever waited was four days.
I wonder whether capping the payout on malpractice lawsuits, and giving doctors greater protection against frivolous lawsuits, might help lower the cost long term?
I see Marcus is on form.
Hello Marcus! Did it occur to you that the reason your aged rels were kept hospitalised and tortured...sorry, aggressively interrogated...by therapy so long was that the healthcare provider was milking your insurance for every last cent? Does that ever happen in America? Has it ever happened?
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"You know how many phonecalls my dad gets per day from parents asking them for their drug test results because the government will take them away their kids for smoking pot. "
Funny I know someone that works in the drug testing industry..
Course not I have not a clue why your pop would have to deal with kids taken away for having a puff. that would be some bastion of UNFREEDOM there.
Seems ludicrous. you're not telling me that the Government of the USA kidnaps kids from pot heads?
because that is what it is.
(note all another less free aspect of the states)
what will the interest rate on that payment plan be then.
keep warm don't worry about the others.
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I would really like to see that undocumented people are not brought into this discussion. They are NOT the problem of health care in this country.
The problem with health care in the US is that it is treated as a PROFIT making industry rather than a right for which ALL people should be equally eligible.
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The only reasons that we don't have National Health in the United States are the Dixiecrats and Unionism from the top. In the 1940s after WWII President Harry S Truman want to establish National Health, but the Southern Democrats: Dixiecrats did not want Nigroes served in their hospitals. So they blocked all Truman's appropriations. Now the Republicans and the Blue Dog Democrats don't want National Health because their campaigns are financed by the Insurance Industry and For Profit Health Maintance Organizations. They and the Neoconservatives have formed a Union from the top to prevent Unions at the bottom to form and demand National Health.
These Upper Unions like to brag that American has the best health coverage. But they fail to mention that this coverage only extends to the top echelon and the rich. Politicans like John McCain who have never paid an insurance premium in his life yet has enjoyed National Hearth care at tax payer expense is against the same care for all Americans.
However as times get tougher for the rich they are slowly beginning that they themselves will soon be bankrupt paying for all the sicknesses of the rich while neglect the plight of the working-middle class and the poor because their businesses and investments are failing. Out of self presevatation some are beginning to see the light.
It may become National Health or a dead Health Insurnce Industry.
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#151. At 8:26pm on 14 May 2009, MarcusAureliusII wrote: "Now, the Congress of the United States, the greatest deliberative body in the world will be forced to address (health care)."
Give it a rest won't you? Stating opinion as fact is tiresome, not unlike other Americans who proclaim that everything American is better than anything else. It just ain't so - consider the US automobile industry or even New York City, "the greatest city in the world" as David Letterman's show is introduced. Puffery and braggadocio are some of the most unfortunate aspects of American life. Too defensive by far.
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To#152 Saintdominick
Yes!!!
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aquarizonagal - you're right about Undocumenteds. I think the impression that they're flooding the health system is created when one turns up in an ER or Urgent Care and finds the place packed with Mexicans. Generally, it turns out to be a couple of families - entire families - being there in support of one sick family member.
But it would be easy to see that someone unfamiliar with that side of the system might walk in and be shocked, shocked! that all these people apparently needed to see a doctor.
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162, aquarigal, I would submit that the profit motive is not the only
reason for escalating healthcare costs. The other side of the coin is
lack of regulation to promote competition. I have no problem with someone
competing to provide a better product or service. What I have a problem
with is someone who establishes themselves in a position so that they
do not have to compete.
The problem is lack of regulation to promote competition. When Intel or
Microsoft breaks the rules so that they can gouge the consumer, they get
their hands slapped. Not so in health care.
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To#159 Bere54
You have made some of my own points precisely. Thank you!
Why should anyone have to pay their whole life for basic treatment to save that life? There is something terribly wrong here.
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Canard, once contracted shortly after birth in Europe, Eurosis of the Fliver never goes away. You've still got a bad case of it. Sorry.
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To#166 Darksideofthegoon
You made a most excellent point. Some here who try to bring up this topic have no real data just racism to back their arguments.
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167 GnR
would a national health system mean that competition was better.
I the UK private premiums are lower cause there is a cheaper alternative.
"The problem is lack of regulation to promote competition. When Intel or
Microsoft breaks the rules so that they can gouge the consumer, they get
their hands slapped. Not so in health care."
Bit like the fraudulent billing practices mentioned earlier.
Surely if a hospital has a few of these someone gets suspicious and prosecutes them. (maybe they are covered by freedom of speech . "Well I only said the bill was that cause I could. just give us the real cost . we'll let you off")
Marygrav
again I'm in agreement.
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162 Illegal Immigrates are not the cause of our health care system nor the poor or elderly they are the cause of resentment for Middle Class Families who don't get the benefits of their taxes, health care is one piece of many like day care,Head start,Food stamps,housing,etc...Resentment also runs deep for the rich but especially for Congress who implements these arguments for their own benefits of their careers both in and out of public service.Middle class Families today make less ,owe more and have nothing to show for it.I don't resent any body but politicians.Baby Boomers used up there own S.S. now using mine and my children,ruined health care,business,welfare,and everything else.Look at when these policies have started Nixon,Carter,Reagen,Bush,Clinton,Bush again.Every one of administrations has added policies that cost more for everything with little return.Savagely ruining each other policies.These people don't care about voters look at how they talk of the next Congressional elections.What policy of the federal government can you say you like.Education,Health careReform,FEMA,FDA,EPA,Business,NAFTA,Unions,what haven't they ruined.I don't trust these people with the health of my children or my self.Our road and bridges are crumbling,our schools are falling apart,we are losing businesses to foreign governments and workers,Communities Colleges and trade schools are closing down,less police,etc.. What have they done well,War,NO any one have one policy by Federal Government you like? We would be a lot worse off if it weren't for State and Local Government and Non-Profits.
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171, happy, lack of compeition is one problem, but inefficiency is another.
I'd be interested in hearing how much of health care costs is tied up
with filling out paperwork so that doctors and staff can get paid.
We should have a web-based billing system so that administrative overhead
is reduced - I'll bet that's a bit part of the problem.
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"Eurosis of the Fliver never goes away"
Lies! As research shows, Eurosis can be counteracted by long term exposure to any other continent. The Fliver's strong connection to the body's morphogenetic field - which it is, in part, responsible for regulating - means that the continued presence of another culture gradually stimulates new growth and adaptive change.
Of course, a resident of New Jersey wouldn't have noticed this in operation since the reversal of Eurosis requires the presence of an actual culture. New Jersey was the first successful culturectomy (the spare culture was successfully implanted in a man suffering from "Keine Verfeinerung" syndrome and he went on to live a normal, if slightly boisterous, life).
You really must keep up with the literature.
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To#164 Davidcunard
I totally respect your opinions and admire your knowledge about many subjects but please do not divert the discussion. This discussion should be about health care reform in the US that is so terribly needed not about which nation has it better.
Thank you
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I am all for a revamped health system. While I do not believe in a government run, single-payer system -- this will not work well in a country as big as the US -- I do advocate a system a system of regulated private insurance with further money provided to make sure that everyone is covered. I liked the idea of adding a tax to candy, cigarettes, soda, other tobacco products to be toward the system. But our European friends must understand a few things. One is the rights of states. It will be up to each state to implement the plan. Some states, including Hawaii and Vermont, already have health coverage plans. I pay about $60 per month for my premium at my job. Plus of course a co-payment for visits and drugs. But my plan is pro-active for preventative care .. as it should be. I do not pay for my annual mammogram, for example. Or for a colonoscopy. This monthly payment includes medical, dental and eyes. No referrals. No real paperwork. The US also has among the finest hospitals in the world and the most up-to-date equipment. Technology does cost money. Thus, there has to be an element of profit somewhere in order to maintain the facilities, ditto research and development. Searching for a cure for cancer is not cheap. A study done in 2007 by the ANnals of Oncology showed that Austria, France, Switzerland and the US were the leaders in uses of new cancer drugs. Britain, despite being a center for cancer research, lagged begin other European nations in using new cancer drugs. Cancer survival rates are higher in the US largely due to earlier testing, which is a positive thing. For all the carping by our British posters, it should be noted that there are positve things about the medical system in the USA. It is difficult to find an urgent care (sort of like an emergency room -- that's what we call casualty) centers in Britain. Right before Christmas, I was not feeling well, fever, achy, and I called my doctor toward the end of the day. I could not get an appointment until the next day so the nurse recommended going to one of the two urgent care centers near my home. She said it would be a better idea to go to the smaller one because the main one is also an emergency room. I called the recommended center, and got the directions. Left work, walked in, showed them my card, paid the $25.00 co-pay, and waited about 20 minutes before I was seen by the doctor. Turns out I had bronchitis. Got a prescription and off I went. I was treated like a human being. I have no quibbles. I recently had to schedule a mammogram and a bone density test. I could not get the appointments on the same day (one day apart.) I went for my mammo. Didn't wait long. At this particular place, you are given a buzzer (just like the restaurants), which lights up when they are ready for you. After having the mammo, the nurse came in and said, I see you are scheduled tomorrow for a bone density. We can do you right now. Is that okay. Sure, I replied. And off I went.
I have been reading some nasty comments about obesity here in the USA. Yes, a percentage of the US is a bit overweight, but I've seen some porky people in the UK as well. The problems are lack of exercise and a good diet. The British would not work here. It works well in places in the UK. As I said in an earlier post, the Bush administration was looking at the Dutch system because it relies on insurance and everyone is covered. Americans have to understand that this is not socialism. We have public schools, public libraries, free highways and so on. We need to invest in ourselves, all of us. Preventive health means healthy children who want to learn. Pre-natal care means healthy babies (and we do not score well here.) Millions of Americans are very good at getting their flu shots every year. My health insurance pays for the annual shot, but the shots are inexpensive and available at pharmacies, supermarkets and lots of other places in the US during the flu season.
No American should be denied health care because he or she cannot afford insurance or is not eligible for a government program.
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71. markusaurelius...a 'profound' argument: because American health system is better than Mexican (whoopi!) therefore no need for a change...why are you polluting this site with such a nonsense...case closed
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All,
I do think this discussion is missing a couple of points.
Firstly, free markets are not the answer to everything. We do not have a free market to provide the Army (athough that was tried to a degree in iraq, and did not go well), or education, or basic infrastructure. There are some goods and services folks need but simply do not want to pay for, or not pay enough for. They have to be provided by Government. The Marine Corps is not a 'socialized' service.
Secondly, the whole idea of allowing the market to determine prices to drive efficiency. In the case of health care this has not worked. Users of these services will consume as much as they can, not necessarily what they need. The private insurance system is not a pay as you drink system, it is a mechanism that diverts money from younger healthier, busier folks to older, less firm folks with time to hang around for extra tests. Nothing wrong with that but it is not a pure market where goods and services are purchased at point of need.
Next, the true cost of healthcare is not visible to private citizens today. It is hidden in the employers contribution to plans. If the employee saw the full cost coming out of their pay check then they could decide whether the systems in Canada / Europe et al are better or not. As it is we have a hidden stealth tax on business that ultimately comes out of someones wages but they never see it. That's just communistic.
Lastly a significant cause of health costs is the lack of tort reform and number of lawyers willing to sue for a % of the award. This pushes doctors insurance premiums through the roof, and causes them to test for everything just to cover their butts.
When you add these up we end up with a system that costs more per head than any other civilized nation. The crackpots can rant and rave about extreme cases on all sides (like that Lady who crashed and bled out in the ER last year and no one helped her, I think in LA?). Suffice to say I would prefer not to be treated in St Bartholemews or Harlem Hospital Emergency rooms on a Saturday night.
So what do we have? A single payer, with beurocrats deciding if you get treatment, or HMO's with managers who need a shareholder return deciding? The HMO's should in theory pass their efficiency on to their shareholders only, no more. So how do we do that? Establishing a government scheme available to all that competes with the HMO's will force them to prove their value, reduce their margins or both. Couple that with Tort reform and we have an answer.
We need to end the communist anti business oligopolic health care system now, for the sake of our citizens and our companies.
Businessman Sam
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Let the States mandate health care not the federal government.
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Happylaze: you didn't read the article very well because it said Males in the UK have a 57% fatality rate while in the US it's less then 1/5 or 20%. You also didn't read the part of the article where it pointed out that the 5 year survival rate for prostate cancer patients in the US was 99% while in europe on average it was around 78% and those in scotland it was around 71%. So nice try but next time read the article. The illegal immigration question is dumb at all, considering how many more of them are having children in this country, called anchor babies, and considering all the movement to give them amnesty I would say they plan on staying a lot longer then a shortterm visit. One of the correct answers would have been through identity theft. My dad works at the toxicology lab at hcmc. He is technically not suppose to deal with the calls but they call him because they are desperate for the results for their upcoming courtcase, he can't tell them the results and the most of the time the results are that they failed the drug test. When it comes to the interest rate, that is up to the hospital, most of the time they don't have an interest rate because your the one negotiating with the hospital over the creation of the payment plan, they don't have fixed payment plans that you can choose from, what they want to know is your financial situation. What state do you live in? You say don't worry about others yet you complain that americans don't care enough for their fellow americans.
Richard_SM: Very good richard, now prove it where I was making the claim that the US system was better? If you had been paying attention you would know that happylaze was the one who first brought up cancer and I brought up the fact that interestingly enough the survival rates and diagnosis of cancer was higher in the US then in europe or canada even though they have free healthcare. All I was doing was proving happylaze wrong on his cancer claim, I wasn't saying the US system is better just that its ironic he would call me undereducated and claim orignally that for example Universal healthcare would be better for cancer when in fact so far the facts support that Universal health care isn't better but not necessarily worse either then the current system in the US when it comes to treating cancer.
saintDominick: Well you should have pretty good longetivity as a cancer survivor under the US system, when it comes to infant mortality, I wouldn't put too much stock in those rankings considering not every nation has the same definition of what a live birth is, for example if you look at sweden's definition and the figures they used and then take the US definition of a live birth and the figures they use you would find that if sweden was to use the same definition that America does they would actually have very similar infant mortality rates.
bere54: Atleast shes alive and they have something to show for that debt, my friends girlfriend was in a similar positions as your friends daughter, except her cancer came back 4 times and she didn't survive. You could almost say in a sense the money and all the debt was wasted because she didn't live. I agree that its a crappy choice when it comes to finances and education but the choice is really between being alive and healthy and being dead. If your friends daughter didn't make the choice to get into all that debt and instead settled for dying she wouldn't be in france now would she? I'm surprise your the one accusing me of having a lack of or incapable of being able to empathize when your the one focusing on the money and I'm the one focusing on the fact that the choice was really between being dead or alive. Maybe its because I have had to save my father twice from him chocking on food, and you know what no amount of money can save someone from chocking, it aint going to get the paramedics to your house any faster. During the time when my family was living off around 3 dollars a day to spend I was begining to develop asthma, we couldn't afford the medication considering my parents were both interns so no health insurance and crappy pay, believe or not but asthma kills quite a few people in the US even those who can afford the medication. Ever had a severe asthma attack and not have an inhaler nearby?
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Bloggers,
I would like to observe that our dear friend Marcus does seem to have a lot of personal experience with the excellent medical care available in Northern NJ. I have heard tell that the Emergency Room at Morristown Memorial are particularly skilled with the use of tongs. Who can't see Marcus sitting there late on a Saturday night telling the triage Nurse 'I was cleaning the house naked when I slipped and fell, landing on the . . .'
Tongs.
Nurse Sam
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96 Seriously Marcass, if all of everything euro is so bad why the **** are you even on this site? Fox is much more your thing - leave this to those who actually care. No doubt you are an advocate of Ayn Rand and all things selfish - they must have sites which are much more your style.
107 Actually you don't know Jack! In the UK (and note I am not British amd therefore have nothing to gain) recpvery is much faster than what you quote. Again, either resilience or better quality surgery. Either way your opinion is totally misguided by your bias.
110 She already is - she is in Iran at the moment dealing with property and family issues and at age 87 would put most people half her age to shame with her energy so go pick on someone in your own league.
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#175. aquarizonagal: Ref my post #164: "please do not divert the discussion. This discussion should be about health care reform in the US that is so terribly needed not about which nation has it better."
I agree, but MAII is insistent that everything in the USA, including health care, is better than anywhere else. Saying something just doesn't make it so, which is why I suggested that he give us a break from his sledgehammer statements.
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#174
Goon,
I do recall that if you crawl into the portal on floor 7 and a half of the Mertin Flemmer building you find yourself on the side of the New Jersey Turnpike. After a short spell as John malkovich. So they've got that going for them.
And for those who think New Jersey is a cultural desert I would strongly encourage them to visit the Grounds for Sculpture in Hamilton. It is world class and unique. Especially in summer with a nice dinner at Rats followed by a stroll through the grounds at Dusk followed by getting lucky.
Oh yeah, now we're talking.
However, the rest of the state is entirely without merit. Except perhaps the big Ikea.
Art Lover Sam
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#176.marlenekoeni: "a percentage of the US is a bit overweight"
A bit overweight? Over 60 million American adults and 9 million children are obese! There aren't even that many people in the United Kingdom.
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Ref 166, Dark Side
"I think the impression that they're flooding the health system is created when one turns up in an ER or Urgent Care and finds the place packed with Mexicans. Generally, it turns out to be a couple of families - entire families - being there in support of one sick family member."
That is, indeed, one of several reasons, but the most powerful in my opinion is the fact that white Americans tend to view all "Hispanics" as illegals. Most of the "Hispanics" you see in hospitals, schools, restaurants, and living in your neighborhood were either born in the USA or are LEGAL residents. The illegals seldom seek help for fear of being caught and deported. They live in the shadows, are abused, threatened, and persecuted like rabid animals for having the audacity of pursuing what our ancestors did when their were no entry visas or quotas.
There are many reasons for the healthcare problem we are having, illegal immigration is not one of them, although I suspect it may turn out to be the most powerful weapon by those whose only solution to their own shortcomings is to demonize and abuse the less fortunate.
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No living
Wrong I suid my father had treatment in both countries and the remission rates at the guildford hospital were better than the treatment he had received in the US at the hands of one of californias best hospitals, with one of their best docs.
I also said the life expectancy is higher in the UK.
I also refereed to the bit you keep missing which is "of those diagnosed" but keep hiding yourself from it.
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180, Noliving -
Shouldn't a person be able to choose life and health without having to sacrifice their education, their home, their children's education or their children's home? Sorry if I sound mercenary to be talking about money, but no matter how healthy you are you cannot live without money. There are families in this country who end up in homeless shelters due to medical bills for one family member. I happen to find that disgusting. But you seem to think that they should be grateful just to not be dead and the rest doesn't matter.
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So here's something that has been troubling me.
I've been busy so I only saw the video this week. When Michelle was on with Elmo last week they only showed the furry little fellow from the waist up. I think we need to know whether Elmo was moved by the experience and in the interests of full public disclosure we should see the uncropped video.
Just to stay on topic, they have drugs for that too. Though advertizing them may soon be banned.
Deviant Sam
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The only people who could possibly like this current health care system in the US are insurers and hospitals who charge as much as possible and of course the very wealthy who can afford the best insurance policies for themselves. How much of the US is that?
Single Payer Systems may have its problems such as waiting lists, but it is way better than just being outrightly rejected because you cant get insurance coverage due to some technicality like 'pre-existing' conditions.
I can guarantee you that if adequate and affordable insurance was available to most americans, their would be waiting list problems as well.
These waiting lists exists because their isnt a large enough supply of specialist doctors to address certain issues. The biggest problem with single payer is having enough personnel to support an entire country.
Proponents of the current system who brag about not having waiting problems like in Canada or the UK, forget to mention that they dont have this problem because they just outrightly tell sick people, NO and shut the door on them.
Insurance companie's goal is to make a profit, and the less they pay out the closer they are to that goal, it is not in their best interest to unload cash to their customers whenever there is an issue. If you want to place your future in the hands of an insurance company, I feel sorry for you. I hope you have good lawyers, you can bet your last dollar that they do.
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I think America could save a lot of money on its military expense that could be put to much better use in providing medical care for its own people if it pulled out of NATO and let Europeans pay for their own defense, that is if they think their society is worth defending. Otherwise Russsia could overrun it and take it over. As if things in Russia weren't bad enough already. That's been my feeling for about...hmmm...around the last 35 years since I experienced Europe first hand.
Princ-ass in the pee, you and a few others who post here make me wonder if there isn't an Iranian mutational variant of Eurosis of the Fliver, some sort of Persianosis Syndrome. There has to be some explanation for all the Iraniacs. Maybe it's exposure to some indigenous toxic mineral...Iranium? By the way Princ-ass, in the free world, you have to put up with other people expressing views including those that you don't like and may be unpopular. This is not Iran where everyone must toe the Islamic Revolutionary Party line. If you think Iran has a democracy of which free speech is one key characteristic, let's see you post something negative about your government. On second thought, maybe you'd better not. You could wind up in prison if you do.
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#182
Princess,
Because unlike his hero he doesn't have any 97 year old ladies around to get bitch slapped by.
Does have some nice tongs though. Williams Sonoma probably.
Culinary Sam
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# 151 MarcusAureliusII wrote:
""Really? The doctors have given up?"
Dr. Marcus Aurelius II Welby has. At least on this bunch here."
Really Marcus? You've given up? You'll leave us alone at long last?
Oh, if only this, or indeed anything you said, were true.
And Marcy, 2 questions before you go
1] You moan about people here lacking a sense of humour. Has it really never occurred to you that maybe you're just not funny?
2] You whine about Europeans hating Americans. Has it really never occurred to you that they only hate the rude, arrogant, hateful ones?
To find an example, I refer you to my previous suggestion regarding a mirror.
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Justin, or someone,
Could you please explain what on earth Insulin has to do with 'Pump night'? It has a completely different meaning down our way.
Rural Sam
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To#183 Davidcunard
Point made and I accept. Your posts are really not at issue and I do not suppose that much can be done about the other. I do support your good efforts.
Thank you.
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"So what do we have? A single payer, with beurocrats deciding if you get treatment, or HMO's with managers who need a shareholder return deciding? The HMO's should in theory pass their efficiency on to their shareholders only, no more. So how do we do that? Establishing a government scheme available to all that competes with the HMO's will force them to prove their value, reduce their margins or both. Couple that with Tort reform and we have an answer.
We need to end the communist anti business oligopolic health care system now, for the sake of our citizens and our companies.
Businessman Sam"
"Businessman" Sam, before arriving at ROI, you'd have to report net profit (vis-a-vis investment). To report net profit, you'd need business revenue (less expenses, tax, interst, etc.). To report business revenue, you'd need (more or less satisfied) customers.
To arrive at premiums, insurers work with mortality/morbidity stats tables that are the most accurate stats available, and with top level actuaries. Who are you to judge the result of this pretty complicated process, and the resulting profitability of insurers, pharmaceuticals, etc, which allows the system to function? Universal health care, as such, is u-n-s-u-s-t-a-i-n-a-b-l-e in the long run (see EU deficits, Canada's ballooning healthcare expenditure, or the collapse of communist healthcare).
"Communist oligopolistic" market of insurers in US? They'd be in deep (anti-trust) trouble, were that the case. There's nothing like the invisible hand, the rest is govn't boondogles, deficits and inefficiency, and subsequesnt rationing.
I am amazed by Obama's audacity to take over 17% of US GDP, when his admin cannot take over a flee market booth now - where's the money, Venezuelans? Medicare and Mediaid are already TRILLIONS of $ behind in terms of future obligations.
But hey, the guy took over Chrysler and GM with bare hands ($18 bn CAD US+Canada govn't ether/printed funds combined to pay off for $25 m electoral donations from UAW)...
An interesting comparable US-rest of the world, in terms of healthcare:
http://tinyurl.com/qol9ks
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#184 - I like a bit of sculpture, so the next time there's a chance to go to NJ I shall certainly attempt to follow your advice on Hamilton, maybe Rats. But not IKEA, which doesn't count as NJ culture because it's Swedish.
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184, SamTyler -
You want to talk about culture in New Jersey? What about all those rest stops on the Turnpike named after poets and writers? Ain't that culture? You take a dirty bathroom and a bunch of greasy fast-food outlets, stick a famous dead poet's name on it (when he's too dead to object), what more do you need?
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To#182 Princessonthepea
Please keep posting! I am busy right now and will have to leave you to it. I will try to catch up later. Illigitimus non carborundum!
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Happylaze: I already answered your "diagnosed vs undiagnosed", more people in the US per capita/total percentage get tested for cancer then those in canada and europe and they have higher survival rates. Even if you factor out the undiagnosed, which I don't see how you could really measure them unless you did an autopsy, the diagnosed survival rates are still higher in the US then in canada and europe even though canada and europe have "free" health care. You said that your father fell for the belief that the US has better cancer survivor rates and that the UK actually has better treatment and thus implying that the UK has better survival rates for their cancer patients. I proved you wrong, the US does indeed have better cancer survival rates then the UK. You never talked about a hospital vs. hospital, you said that the UK overall is better at cancer treatment/higher survivor rate then the US, which just isn't true when it comes to higher survior rates, the UK may indeed have less invasive or more comfortable treatment for cancer.
bere54: An ideal world where money doesn't exist you could do that where a person wouldn't have to sacrifice health for education and a house. As long as money exists those types of sacrifices will always exist. Maybe its the amount of death that I have seen and possibly having my father almost die on me two times in my arms when I was doing the heimlich maneuver that made me realize that money and material wealth isn't everything and that just being alive is really all that you should value, when it comes to education, go to a bookstore and read the book instead of buying it or go to a public library, which is ironically publically funded. I have met those people at homeless shelters or at foodshelters where they have either lost their jobs or a debt has wiped them out to some degree. I'm not saying the rest doesn't matter, it does but the most important one is the fact that they are alive. But you have to remember their financial situation isn't exactly permanent either, look at your daughters friend in france as an example. For example I worked at steel mill in St. Paul at gerdau ameristeel, as a c-4 bundler making $15.50 an hour,time and half for the first 4 hours of overtime and and double overtime pay for anything past 4 hours of overtime in a single day along with a profit sharing that was around an average of 33%, it was unreal, I worked about 80 hours per week making around $2,000 per week before taxes, I did that for about 6 months before I was laid off. As you can see my financial situation wasn't exactly permanent.
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189, Deviant Sam, if one were to have first and middle names of "Tickle" and "Me",
as Elmo does, then he would be likely to receive so much attention from
the fairer sex that he has little need of supplemental medication.
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Ref 189, Sam
"Just to stay on topic, they have drugs for that too. Though advertizing them may soon be banned."
Pfizer announced today that they plan to provide Viagra to the unemployed and uninsured, free of charge, for one year. I reckon the pharmaceutical industry decided the best approach to fight healthcare reform is to keep people busy and smiling...
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sam, you haven't borrowed austin powers' swedish pump, have you?
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http://news.bbc.co.uk/2/hi/middle_east/8050334.stm
seems like some of you are not alone in deliberate misunderstandings.
or the nuances of speech.
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peterbo, anyone who think the current US system works has his head up his marcass. Does this describe you, or do you have anything constructive to add?
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A lot of people talk of premature babies and infant mortality.It has been on rise since 80's because teen pregnancy,diabetes,old lady pregnancy,In Vitro over stuffing a uterus ,Physical Abuse,Obesity and stupid mothers with stupid Doctors induce babies too early for no reason but the mother wants the pregnancy over.On the rise is also multiples and birth defects because of all these reasons as well.Most of these things are preventable with good personal choices and social choices.Because if we are going to be socially responsible shouldn't we also be personally responsible.
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A friend living in London recently had a problem with her retina and was given an appointment for surgery 2 weeks later. She called my husband, who had also had retina surgery. He told her to have it done immediately. She scheduled a flight home to NY to have the surgery with my husband's surgeon; but then they found a doctor who would do it immediately.
I haven't asked my opthamologist about it, but this does not inspire confidence.
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TanSauNg:
"As I understand it, the main opposition to socialised healthcare in the US is that people don't want to have to pay for other people's medical treatment. Is that correct?"
Of course not.
But you have decided this is the case, and as this "discussion" is dedicated to carrying on and whining about those "terrible Americans", I will not attempt to interfere with your comfortable assumptions.
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bere54:
"You want to talk about culture in New Jersey? What about all those rest stops on the Turnpike named after poets and writers? Ain't that culture? You take a dirty bathroom and a bunch of greasy fast-food outlets, stick a famous dead poet's name on it (when he's too dead to object), what more do you need?"
Please - spare me the hysterics and the pronouncements of superiority from your own personal Mount Olympus.
All of your ornate, ferocious anti-American abuse goes down very well on this site, a veritable festival of anti-American insults. Your "comments" fit perfectly with what they think, and you now have a large and appreciate audience who chortle and wolf down your observations and smack their lips with self-congratulatory appreciation.
The problem is that these abusive remarks are without any content whatever. Verbal vitriol and acid are formidable weapons when it comes to insulting Americans, but is the game really worth it?
All of this carrying on is essentially worthless.
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200, Noliving-
Well, you've lost me. I don't understand what your saving your father from choking has to do with the fact that so many people in the U.S. cannot afford medical care and that the for-profit system is grossly discriminatory. I'm also astonished that you apparently believe that reading library books is all the education it takes to get a decent job these days. If you make the rounds of the tent cities cropping up in urban areas and instruct those people living in them that they should be happy because they've got their health (if they've even got that - somehow I doubt they've got medical care) you might get some strange looks. If nothing worse.
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#200. Noliving: "the US does indeed have better cancer survival rates then the UK."
How can you measure survival rates of a disease which has over two hundred different variations? Breast and prostate cancer are well documented but, for example, what about soft tissue sarcomas, which are only about 1% of the cancer diagnoses? It's impossible to generalise about cancer survival even though the rule of thumb says that if you survive for five years following treatment, then a cure has been effected. That isn't always the case since it can reappear twenty years later. Indeed, radiation treatment can actually cause cancer, so it is possible that the cure actually creates a further problem years later. Since the the tool to detect cancer, the CAT scanner (a British development by the way) was only invented in 1972 and which was not generally available until some years later, I do not see how any accurate statistics for long time survival can be quoted or even estimated.
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All this finger pointing only proves that both our systems need reform,so as citizens we should demand it from our politicians and complain to insurance corporations,Fund advocacy groups.Unite as workers so we demand as world citizens fair wages and benefits for all people in all continents and stop competing our way to the bottom.Hopefully the Greedy won't throw to many obstacles in our path like they did our great grandparents,grand parents,parents,ourselves.Bickering over who needs more reform to our systems.
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209 talking about yourself again I see.
why not go talk to MA and Q and TT . all in your own.
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"remember their financial situation isn't exactly permanent either"
Have you ever tried homelessness?
Go on give it a go.
Give all your money to charity sell you house and then try getting a criminal record for getting too angry at a cop who moves you on when you finally find a dry spot.
Go give it a go.
Most millionaires start rich but the Billionaires all start as homeless.
Did you know you can make 40 000 dollars a day from pan handling.
And I heard some drive limos after "work"
Sorry mocking you again.
of course it is not permanent. they die.
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212 faeyth
agreed
and that rush to the bottom is led by ...... drum roll....... THE USA.
who have no totally crap wages for workers with no health care .
America has led that steady decline always saying" we compete better because we have no extra cost like healthcare. and why should people get paid holiday (guaranteed).
Why them Europeans are making life for us rich, unaffordable.
we don't want none of that socialism over here"(witness some posts above).
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Tim 31, I had no intention of slurring anyone, i merely asked a question as i genuinely don't understand your mindset!!
I may be of the far left but I DO NOT hate Americans, a friend i had here has returned to the states and joined the Marines!! we disagreed on nearly everything but shared a love of our football team (our post match debates in the pub became a thing of legend)i miss the banter!!
Anyways i'm more than happy for my taxes to be used for a good public health service and anything else that is for the good of All!!!
Don't be so paranoid mate! the number of Welshman who signed the declaration of independence was in double figures and you named a state after one of us, William Penn, ring any bells???
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211 the article he quoted was pretty washy . full of excuses for the discrepancies then the guys personal opinion.
well if that's all that leads his writing. sod it I'll rely on my Mum the long time Nurse with a cynical outlook and no problems in assessing risk benefits and go with the.
"what a bunch of poppycock"
My issue which was changed a little by dead was about going to the "top" guy. In the USA.
Then finding that there was more reliable treatment available in the UK.
Prostrate cancer also attacks generally later in life.
IF you drop dead of a heart attack when reading the medical bills I suspect they call it a death by heart attack. and forget the reason you had a Heart attack.
PS good health to you.
210 bere,I suspect it could be much worse. maybe even TB
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203, seanspa, that Swedish pump thing sounds painful. Perhaps there is
someone on this blog who deserves it.
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http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
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Hi Justin,
I go through all the registration steps to tell you that you've made a right choice. I have been type one diabetic for more than 10 years and 7years with pump. Other therapies like taking shots can NEVER get "exactly the same clinical benefit" as pump.
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219, happy -
Thank you so much for posting that link. I have always had a great deal of respect for T.R. Reid. Not only is he wise, intelligent, and compassionate, he has a great sense of humor. And he has a thorough understanding of and love for other cultures. So far I just read the Q&A section but there was more information there about the other health care systems than I've seen anywhere else. Really excellent link.
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To#209 Timothyr444 and some others( Most notably the the 'MAII' person)
Why assume that many posters here are not American or hate America? Please forgive me if I say that assumption is ridiculous. Many of us are American or live here but that does not make us oblivious to problems or issues facing this country.
This is a forum to discuss openly and with courtesy those issues raised in this blog. It is not a place for racism, personal insults or presumptions about others. I believe that it is possible to debate an issue without bringing a person's patriotism and intellect into question or resorting to personal insults to make a point.
I am finished here.
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I work at a "banal" govt agency (banal meaning typical-not cia, blah blah) but I receive excellent health benefits and have used them 4 or 5 times in the last year, having had a surgery and 3 fits of bronchitis (quit smoking after second time) and have used 15000 dollars of health insurance.
The average non covered person could have died waiting for this ..never receiving the medical attention, probably because of being employed and making too much money. One has to be poverty stricken to get any care from state or city hospitals.
I know this from being that way at age 35, when I had a stroke and received "free" healthcare. (can you get money from a turnip?)
I hate (haha) to say this, but most govt employees are "democrats or independents" who voted for Obama. (some of course are republicans)
But, if I hadnt been able to access antibiotics and/or surgery, I could have been in mortal danger. Outrageous that this is debateable! Yes for health insurance for every citizen.
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#209. TimothyR444: Ref bere54 "Please - spare me the hysterics and the pronouncements of superiority from your own personal Mount Olympus . . . All of your ornate, ferocious anti-American abuse goes down very well on this site, a veritable festival of anti-American insults."
You seem to forget that the writer is American and writes from her experience.
"Verbal vitriol and acid are formidable weapons when it comes to insulting Americans, but is the game really worth it?"
I think you'll find that vitriol and acid are the same thing. If you must employ such florid language as posted here, you should go back to writing the great American novel. Or perhaps it has already been rejected on account of the stylistic flamboyance employed therein.
"All of this carrying on is essentially worthless."
As are your contributions to the discussion of health care in the USA; your primary concern (#26) is that "this will result in tax increases that will destroy the economy and that it will be a bonanza for lawyers." Considering your remark "But something does have to be done" why not provide a solution - if you can.
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Funny, Mr Cunard.
But as a liberal with a good aptitude for grammar.
I do know, myself,that you won't win any arguments correcting someones grammar--but you did do a good job of exposing his logic problems :)
Sorry, just friendly criticism. Give a better answer, rather than picking apart his own comment, please.
Im not one of the regulars here, but saying it with a smile and trying to convince is often a much more effective means of influencing someone like that person.
Also, maybe you were in debate in high school. If not, you should have been, because you probably would have done well--if picking apart opponents writing and logic is more important than universal or ethical truths.
No offense. Maybe this place could seem less like a clique of liberal/righteous people patting each other on the back....blahhhh, blah blahhhh, for instance, the European site IS more interesting when it come to ..ummm...content.
Guess I'll go there now. no offense.
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Sam has made most of the points that were missing. Still, for those who do not think America needs publicly funded universal health care, I have these questions:
1. Do you really believe that burdening the manufacturing sector with what amounts to an import subsidy is really that good an idea?
2. Do you really believe that discouraging people with infectious diseases from seeking healthcare (because they are poor, and won't spend the money) is a good way to prevent the spread of infectious diseases? Why do you think tuberculosis, for example, is making a comeback?
3. (a) If universal publicly funded healthcare is such a bad idea, why is it that we don't see millions of Europeans, Canadians, Australians, New Zealnders, etc., marching in the street demanding a return to a system of private healthcare?
3. (b) If universal, publicly funded healthcare is such a bad idea, why is it that there has not been a single poster on this blog from a country that has public healthcare demanding an end to it?
4. If universal public healthcare is such a disaster, why do the citizens of dozens of democracies regard public healthcare as sacrosanct? For example, if it is such a boondoggle, why was the founder of public healthcare in Canada, T.C. Douglas, voted the greatest Canadian of all time? Why do Canadians, for example, regard the introduction of public healthcare in the 1960's as being at least as entrenched in law as the constitution, and a darn sight more popular?
5. If universal public healthcare is such a disaster, why is there not a single credible politician in any country that has public healthcare demanding its abolition?
6. Do you really think that the job market rigidity introduced by linking health care to employment serves the economy well?
7. Do you really think that the perverse incentive that keeps spouses in abusive marriages to avoid loss of healthcare benefits for the spouse and children is in the public interest?
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There have been some amazing misconceptions, and a fair deal of fear mongering in the postings of those opposed to public health care.
Canada (like lots of other countries) has a single payer system. That does not mean that a mythical bogeyman, this time in the guise of a nameless, faceless health bureaucrat or insurance company employee makes treatment decisions. What a load of nonsense.
Treatment decisions are made by the patient in consultation with their Doctor - the very same as in a user-pay system. There is a ton of case law on the requirement for informed consent in respect of medical treatment. Anybody who pretends otherwise is merely scaremongering.
The point of a single payer system is to hold down cost by making sure that the purchaser has significant bargaining power relative to the vendor of services. This is one of the reasons why, contrary to other scaremongering on this blog, universal public health care is significantly less expensive than the badly flawed, very expensive private healthcare system found in the US. That's right, the empirical evidence is that publicly funded universal healthcare is significantly less expensive than the private system. Is it possible that is one reason why stakeholders in the US system who benefit from that vast expenditure as so unflinchingly opposed to universal public healthcare?
It is true that governments are notoriously poor at facing down public sector unions and hospital administrators, but that is not specific to healthcare, rather it is characteristic of the entrenched, jurassic era labour practices of the public sector unions. That isn't a reason for ditching public healthcare. It is a reason for addressing the problems with unions in the public sector.
It is also true that in a publicly funded system, non-essential treatment and non-urgent treatment are rationed by waiting times, rather than by price. There are many problems in this regard, but I have yet to hear anybody who would rather go back to a private fee-for-service medical system. And if you have an urgent condition, you will be moved to the head of the line and be seen very quickly by the Doctors.
There is also a hefty quotient of selfishness in some of the postings. Insurance works by spreading risk. The idea that we should insure our cars and houses, but suddenly find the idea of pooled risk for healthcare unacceptable is curious for sure. You can sniff the edge of racism in some of it too - some people just don't like the idea of having to share public resources with people who are poor, or whose skins aren't the same colour. "Why should we pay for them". Well, for the same reason that overall, they also pay for your healthcare.
And then there is the question of effectiveness in addressing widespread public healthcare issues. For example, America has an epidemic of obesity, unmatched by any other country. Obesity, and the poor diet, lifestyle habits, and lack of physical activity that are characteristic of it, are huge drivers of health care costs. Paradoxically, countries with public healthcare systems don't seem to suffer from these problems to anywhere near the same extent (with exceptions: the habits of Northern England, for example, seem to be highly resistant to treatment or modification). Why is that? Could it be that the level of public discussion on the issue is far more mature?
Its the same kind of nonsense you see with other public issues, such as abortion. Almost all of the advanced democracies solved these problems a generation ago, and yet in the US you still see the same old tired arguments, the same scaremongering, the same dis-information, the same old nonsense that was discredited half a century ago. And yet, like the anti-abortion groups, the opponents of universal public healthcare, a small, but well funded and well organized minority, fight onward in their selfish battle.
Long past time to get the job done, and move on.
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"A friend living in London recently had a problem with her retina and was given an appointment for surgery 2 weeks later. She called my husband, who had also had retina surgery. He told her to have it done immediately. She scheduled a flight home to NY to have the surgery with my husband's surgeon; but then they found a doctor who would do it immediately."
Hi Andrea.
This is something I found with the UK's healthcare - that the critical tends to be done immediately but they sometimes leave things that aren't (but that seem critical to the patient) for a while. And they're not always big on explaining things.
The level of consultation and explanation in the USA is better, although I would expect that since most of the times I've spoken to a doctor it's been because I've made the decision to do so and have arrived with questions planned. Most of my interaction with UK medics was of the unplanned variety.
I'm also interested that your friend "flew home". It must be nice to have that option. Did your friend have private medical insurance in the UK, or was he/she relying on the NHS for treatment?
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#225. stellarBeloved: "Funny, Mr Cunard . . . Give a better answer, rather than picking apart his own comment, please."
I would if there was a question to be answered. And actually, I was "in debate" in (the equivalent of) high school. Had Tiny Tim been my adversary he would have been exposed for the lack of positive ideas he provides; like another "ra-ra-ra" poster here, his only purpose is to convince others that the entire world is anti-American.
I have personal experience of health care systems on both sides of the Atlantic and for those who do have insurance coverage, I consider the American system superior. However, for those who have no such coverage, then the British and other state-funded systems are far better than what the US currently provides. The spectre of "socialized medicine" haunts voters and politicians who see it as the slippery slope to full blown Socialism. However, these same people do not consider that universal primary and secondary education is a Socialist (i.e., "far left") plot - surely good health, and preventative medicine in particular, is as important as being able to read and write? Without one's (good) health, very little can be achieved. It makes good business sense to ensure that Americans are healthy; after all, as Calvin Coolidge remarked, the chief business of the American people is business. If everyone called in sick, where would business be?
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@226 - outstanding post. Thank you!
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if, good posts. I doubt that our system will wind up looking like yours,
but we can certainly learn from it.
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At the head of this blog, Justin wrote In the UK, meanwhile, a friend writes to say that in his local health authority there is no pump night, because there are no pumps: the local decree is that children can inject themselves regularly (and cheaply) for exactly the same clinical benefit.
Like clueduprock at #43, I did not know what an insulin pump was, and Justin makes it appear as if they are not available on the NHS. From what I have read, he is incorrect, as can be seen here. In any case, it is not the local health authority which determines treatment, but the Primary Care Trust: The Secretary of State for Health expects that PCTs will pay for insulin pump therapy for all patients for whom a pump is recommended by a doctor. Justin (and his friend) appear/s to be ill-informed but, as he frequently does, believes that only in America are things done properly. Come October, when he and his family return to the UK, he will discover that the NHS isn't so bad after all.
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David # 232
"All the world's a stage,
And all the men and women merely players:
They have their exits and their entrances;
And one man in his time plays many parts...." Shakespeare.-
I sometimes wonder myself about Justin's remarks but have accepted that he is winding down his blog prior to returning to the UK playing the true blue BBC Auntie - Ada Doom style.
Cold comfort for those like yourself with relevant facts to inform other Postes on the site because there are many other core and visiting contributors who reveal that they hold long-festering emotional problem[s] caused by ignorance, hatred or fear.
Unfortunately Graceless, Aimless, Feckless and Pointless will not be put out to pasture when he departs for Sussex.
That said, I am always grateful for your own, InterestedF's, Sam's in business mode, StD's and others level-headedness applying modern common sense to the problems in an attempt to help all adapt to this twentyfirst century.
An Insurance or a sickness? The haves versus the have nots! [in both categories]
The two when viewed from both angles sit somewhere between A Comedy of Errors and As You Like It. Will Obama be the new bard to see the dream for a feasable USA health programme to it's fullfillment?.
From panto to politics you never disappoint. May I compliment you on your ever dedicated attempts as an activist in securing necessary benefits confronting the extensive range of bureaucracy against all on both sides of the water.
Regards wma.
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As we are all aware, the lack of sufficient health care is a serious issue in the United States. Although I live and work abroad currently, while I was home in the US, I was not covered by my employer and therefore paid for coverage on my own. The cost of coverage exceeded $400 a month and it did not include health checkups or sick visits. I felt I needed it because it did cover around 80% of hospital bills. Luckily, but not surprisingly as I am a healthy 25-year-old, I did not go to the hospital and was not in need of any help from the insurance company. These payments really hurt my wallet as my monthly income at that time was around $1500 to $2000. It was a sad reality to have to pay for coverage that I basically didn't need but if I didn't pay for would put me at risk of great debt if I were to be hospitalized. I currently reside in South Korea and pay about $90 a month for decent coverage. I went for a sick visit the other day and it cost under $10 to get checked out. I also got an x-ray which cost under $20. And, a week's supply of a daily regimen of 12 pills cost me around $7.50. This would have probably cost me upwards of $200 if I was home in the US and still under my old insurance. It's frustrating that we live in a great nation such as the US and have a poor health care system. In other words and to be more frank, those with money can afford great health care, while the middle and lower classes have to either spend a considerable chunk of their earnings or opt for the risky choice of no insurance because it is just too expensive.
As countries around the world look to the US for the example on many different issues, I believe it is time to look abroad at other nations' examples. A considerable amount of research can be done for minimal costs at home. Once we establish a base of knowledge and perhaps some questions and issues, then we should send a group of knowledgeable people abroad to countries such as our northern neighbor, Canada, England, France, Italy, South Korea, and several other countries. See their systems in action, listen to their advice, ask questions, talk to the citizens, and use these insights to improve our system in the States. I believe taking the best attributes of each of these systems and incorporating them into our healthcare system will prove to be successful. It's time for us to make a change in our country and get health care for each and every citizen and visitor of our nation. Therefore, we must study the health care systems of other nations and organize a sincere exploration of those systems. Use the knowledge obtained from this research and on site study to form a cooperative assessment and make a logical plan for the United States.
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Follow the money in US health care today and plug some of those leaks. Fer example, UPMC is a non-profit teaching hospital system, so how does it post 'profit'?
http://www.post-gazette.com/pg/07236/811793-28.stm
How many parasites are skimming from the health care industry food chain?
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#203
Not my bag, baby!
Austin Sam
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So, in America, hospitals leave people outside to die. In Europe, our hospitals bring those people inside, before leaving them to die. Better healthcare or better hypocrites?
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#196
Peter,
There is absolutely no link between reporting revenue and having satisfied customers. Check FASB 5 and IFRS, you'll find no mention of customer satisfaction. Rather revenue is recognized when a service or goods are provided and you have a reasonable expectation of getting paid. Just ask a local Utility if they book revenue after a rate increase. Worse, the satisfaction of the customer in healthcare has nothing to do with who the payer is.
Actuaries are no guarantee of fair price. If I tell my actuary my margin has to be 1,000% and he tells me the price should be $x, that is not a fair system. Only a free market, with no barriers to entry or exit (not the case for payers in US healthcare) and perfect information available o buyers and sellers (since buyers know not what they are really paying as premiums nor what their annual services cost this is hardly the case either).
Oligopoly does not require collusion, your reference to anti trust laws is irrelevant.
Obama isn't proposing to take over healthcare, rather the proposal is to provide a government run payer and see if it can beat the insurance companies. If they are providing real benefit to consumers by providing efficiency and competitive pricing then they will be able to beat that payer and provide their shareholders a return. If they cannot then they should be run out of business.
It is deeply ironic that when folks who claim to be free market see a market being made more free they don't like it. Introduce a little bit of competition and suddenly it's all 'Waaaah! Not fair! You're making me work and compete for my money. Waaaah! I want to be protected. I want to charge what I like and not be questioned. I want to control the available services with no customer recourse. I want to put my prices up every year regardless of quality. I want to manage the proleteriat. I don't want to compete'.
That's un-American and downright communistic.
Healthcare costs in the US are just over 15%, not 17%. A huge difference. In Europe in nations with similar life expectancy and quality of life indices they run 8-10%. 7% of GDP spent, we'd need everyone to be twice as healthy and live twice as long to justify that, economically.
I'm sure the Venezuelans are happy with the $ they pay for our healthcare. I hear the Jovians and Venuvians are happy too, along with the Nibble Pibblies.
Try some facts, Comrade. Facts are so important.
Economist Sam
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#218
Guns,
He's at Morristown memorial being extrcated from the vacuum cleaner. Again.
RN Sam
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Federal Government running health care bad idea,states running health care good idea.Each region has a different set of needs based on climate,industry,and ethnic background.Many states tried to have a state program for people to buy into the state system.Michigan tried and was tied up in court,so now we have MI CHILD.Any one with children not covered in Michigan can get health care for kids based on income,if they find that you are below poverty line you get it free, Children in Michigan not covered is because parents don't fill out paper work on state website and it is advertise in schools on Parent/Teacher days,clinics,hospitals,Dr. offices,T.V.,etc..I want that program extended to adults.State governments do better job with funding and resources,just apply federal funds and regulations.That is pretty much how Canada does it.
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Ref 234 AlexLouis
I can give you a comparison with what you would have paid in UK. Based on monthly earnings of $2000 dollars, you would have had $160 dollars per month deducted automatically. You have no choice. This gives you:
- Medical insurance - instant full cover. Includes wife/kids if applic.
- Dental care - but you make a contribution (see below)
Plus contributions to the following. (Benefit depends on number of years)
- Unemployment insurance
- Incapacity insurance
- A very basic retirement pension (currently $500 dollars/month)
- A Maternity Allowance
Most people top up their pension through employer schemes or private arrangements. You can take out additional private health insurance - but it's really not necessary. Everything is covered on NHS. Doctors 24hour cover, routine check-ups, screening, all operations, maternity, chemotherapy, emergency cover, pretty much everything. The only thing you have to pay for is medication prescriptions: for one-off course of tablets, you pay $9 dollars no matter what they are. A fixed fee for any prescription. If six months later you need another course of drugs, you pay another $9 dollars. If you are one of those unfortunate enough to be on some form of permanent medication, or several together permanently you pay an annual $100 instead. This covers you whether you take two different daily tablets, or ten different tablets. Thats the maximum you pay. The minimum can be nothing - as those on very low incomes get them free. If you are in hospital, you don't have to pay for any medication, you don't pay for food. The only thing you pay in hospitals, much to the annoyance of many Brits, is car parking. But if you're in for more than a day, most people get someone to take them to the hospital, or they go in an ambulance. Mostly, its the patient's visitors who get caught for car parking - between $2 to $4 dollars each time.
Your payments are deducted automatically if you work for a company. You have no choice. In simple terms, the first $500 is not charged, everything else is charged at 11 per cent up to about $4500 per month, when it drops right down to 1 per cent. This applies only to those working for a company. If you're self employed, the charges are different. Thats it in simple form. Like most government procedures, there are slight variations and exceptions - but not to charge you more. It's different arrangements to give you more if you're poor, like medication.
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Continued for my post # 241
I forgot to add dental treatment. It's changed in the last couple of years. Here they only provide a basic, but adequate service, and you make conributions. I confess to not fully understanding this as I haven't really needed much dental treatment. I think the check up is free. Minor treatment you pay $20, medium treatment $40, major treatment $60, but it's not like health where the range of treatment is virtually unlimited. For example, an amalgam filling, or several amalgam fillings you get within the rates I've quoted. If you want a white filling, gold filling, or any other colour for that matter you pay the extra. I don't know what the rates are - maybe an extra $20 for white fillings. There are no charges for kids, including all orthodontic work, braces, bands, impressions etc - and they can choose colours. In fact any medical, dental or eyesight treatment for under 18's is free.
There is supposed to be some sort of NHS subsidy on opticians charges, but I don't know how this works at all. Again, for kids its free, and they get a choice of some glasses for free, but the cool ones are extra. My son had several pairs of 'designer' glasses and I think I had to pay about $35 - $40 dollars for each pair. I get a pair of reading glasses every two or thre years - I normally pay $100 -$120 for each pair, designer, speacial coatings etc. But the opticians sometimes do offers, buy one pair and get second pair half price. We pay for eye check ups in theory - but most opticians give regular customers eye tests for free. If you do pay - which I never do - I think its about $30 dollars. They put you through a series of tests and machines - it takes about 30 - 60 minutes.
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Dark Side of the Goon:
"I'm also interested that your friend "flew home". It must be nice to have that option. Did your friend have private medical insurance in the UK, or was he/she relying on the NHS for treatment?"
***********************
Hi,
She did not wind up flying home because they were able to prevail upon a doctor to perform the surgery there immediately.
Yes, they have the means to not only fly home but to pay out-of-pocket to have the surgery done.
Not sure which coverage she has.
Your point is a good one that there may have been a reasonable explanation for waiting 2 weeks for her retina repair; although we acted immediately when my husband's and daughter's retinas were damaged. I'm going to ask my opthamologist about it when I go for my next appointment.
Truthfully, the "waiting" bothers me. The only thing I don't mind waiting for is elective surgery -- and even there I can't imagine waiting beyond 1-2 months. Other than that, if I'm concerned about it, as I was with my mother's cancer diagnosis, I don't want to wait and will push until I get an immediate appointment with someone reputable.
I've overseen my mother's healthcare for the last 15 years. Between us, we've had 12 surgeries. She's been disabled for almost all those years. I've spent a lot of time dealing with our healthcare system. Everything's worked out reasonably well except for her resistant cancer. Not sure even my tenacity can overcome that one.
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243 -
Is your mother on Medicare? If so, then my son has money deducted from his paycheck to help pay for those surgeries but cannot afford health insurance nor can he afford the exorbitant out-of-pocket expense of health care. I don't begrudge your mother her health care; I just think that my son should have the same benefits.
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Richard:
"There are no charges for kids, including all orthodontic work, braces, bands, impressions etc - and they can choose colours. "
Don't forget the stickers they give out :)
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On the issue of healthcare for children in the USA I think it is worth noting that one of the first bills signed by President Obama after taking office was an expansion of the State Children's Health Insurance Program (SCHIP) which provides funding for families whose income is above the poverty line and, therefore, ineligible for MEDICAID, but who do not have the financial resources needed to pay for medical insurance. A similar bill was blocked by President Bush in 2007 when he labeled it "a step toward government-run health care", and the latest passed along party lines.
In effect, the health of poor American children is of no importance when the price involves an unacceptable ideological shift in the way we live. So much for Christian values and compassion; I wish I knew what version of the Bible the far right reads.
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#233. watermanaquarius - What a delightful response to read first thing in the morning; most gracious of you and for which my thanks. A pity though that panto is generally unknown in the USA!
#207. AndreainNY: "A friend living in London recently had a problem with her retina and was given an appointment for surgery 2 weeks later. . . this does not inspire confidence."
Having read your reply to Dark Side of the Goon (#243) I wondered if your friend is in fact American? If so, then how fortunate she is to receive free care from a foreign country. A British resident (without insurance) in America would not be able do so. Since she had the means to fly back to New York (not that much further than from Los Angeles) and to pay for the procedure privately, this appears to be an example of sheer greed. It would have been more appropriate for her to have had the operation privately or to have flown back to the USA. One of the problems facing the NHS is that of foreigners milking the system. Even though I paid into the system for years when I still lived there, as a British Citizen, but resident in California, I could not automatically receive such care should I return. The problem of foreigners using the NHS is still under discussion, as this article in The Times makes clear. I hope she was billed appropriately for the procedure.
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#244. bere54: "I don't begrudge (Andrea's) mother her health care; I just think that my son should have the same benefits."
As the system is at present, he will when he gets to retirement age. Younger people will then be paying, in part, for him.
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208. At 00:43am on 15 May 2009, TimothyR444 wrote:
TanSauNg:
"As I understand it, the main opposition to socialised healthcare in the US is that people don't want to have to pay for other people's medical treatment. Is that correct?"
Of course not.
But you have decided this is the case, and as this "discussion" is dedicated to carrying on and whining about those "terrible Americans", I will not attempt to interfere with your comfortable assumptions.
-----------------------------------------------------------------------
You misunderstand. I was genuinely asking if that was correct, because I have read that on another board which seemed to imply that was the main opposition. If that's not the case, then I stand corrected.
So what is the main objection? The only other objection I seem to see is that the federal government is too inefficient and market forces control the industry better. If that's the view, then why would it necessarily fall to federal government? Why couldn't it be set up at state level? And if market forces were so good at controlling the industry, then why is it generally viewed as not working?
I only know a handful of Americans, none of whom are "terrible". Moreover, everyone I know who has been to America has remarked how wonderful the people are. No talk of "terrible" Americans. I am not prejudiced against Americans, are you prejudiced against Europeans?
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SaintOne
Yes - you're right, I forgot the stickers. I have missed out lots of things. Psychiatric care is included - all types of mental health. Psychologists. Psycho-therapy. Brain surgery (yuk). Trauma counselling. Midwives. Health visitors. Quit Smoking counselling. Contraceptive pills and other family planning aspects. I also forgot to add that our 'insurance' covers us for travel through most of the countries in Europe.
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Ref 226-227 InterestedForeigner
I had been waiting to read your input on this subject knowing that you would bring a well stated, sound perspective from Canada.
Thank you.
Ref 238 SamTyler1969
And your input at the referenced post is also well stated from someone in the U.S.
Thank you.
Our U.S. healthcare system has evolved into a money mill of self-interest and greed that is another economic bubble on the verge of bursting in much the same way as what we have seen happen in the financial markets.
Inefficiencies, mis-management, price-gouging, irresponsible and over-prescription of drugs, double billing for procedures, extraneous tests, extraneous consultation fees... The list goes on and on of how the healthcare system is heading for a train wreck.
Just like the financial sector, the health care system can stop the train from running off the tracks. Just like the financial sector, too many people, companies, and institutions are gouging deep into the money pot to care. Only interested in how much money they can stuff into their own coffers before the train leaves the track.
If the healthcare system will not fix the troubles they have made, then it will fall upon the government to do so. Who else is there?
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#209
Timmy,
How can you say that Bere's comments are:
a) Anti American
b) Lack content
All she did was comment on the fact that the service stations on the NJTP are nasty (They are. Except the ones with Starbucks, the Starbucks corner is like every other Starbucks) and named after poets (except for Grover Cleveland. And Molly Pitcher. And Alexander Hamilton. Come to think of it they couldn't even come up with 12 poets). What is really bad is they named a bridge and a service station after Walt Whitman. Couldn't even find an original name. That's all content
Anyone who drives along the NJTP knows it is horrible, especially the bits near NYC, and that the rest of the state is a cultural desert. Except the Grounds for Sculpture.
Every country has it's dumping ground. The UK has Essex, we have NJ.
Geographer Sam
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248, David:
"As the system is at present, he will when he gets to retirement age. Younger people will then be paying, in part, for him."
I am aware of that; I know how the present system works. He should have the right to health care now, so he can live so long. The young have just as much value to our society as the elderly do. It is to be hoped that we will have equity long before my son reaches retirement age; perhaps we will have it before I reach retirement age.
249, Tan -
#208 is wrong. The only reason we don't have universal coverage in the U.S. is because of greed and selfishness. Fortunately, that is changing. Recent polls indicate that around 60% of Americans favor universal coverage though they vary greatly as to the preferred method. Those who have recently lost coverage due to the economy mess are now realizing what it's like to be without. Too bad that's what it takes.
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@243 - thanks for the information.
Yeah, the waiting bothers me too. It's the feature of the NHS that I'm least happy about, and I'm only not unhappy about it because I grew up with it and sort of expect it. Maybe it's the British queue instinct. In the UK, when I was last there, there were definite signs of a two-tier system appearing: those who could afford private medical insurance had it, those who couldn't, didn't. Private medical insurance was an occasional job benefit, but by no means standard, and it's only since working in the USA that I have had to worry about being ill or - in the last three years - running out of healthcare.
I have several kids and I carry the insurance to cover them all. Last year, my youngest fell off a set of monkey bars at school and fractured her arm, and then a few months later went to the school nurse with a temp of 104 - she was rushed to hospital twice (and aged me and her mother about ten years apiece) and this ate through the insurance. It's a really unpleasant feeling, to look at a set of bills and know that if anything else happens that year, you're in real trouble.
I think that's the main reason I miss the NHS - not having to try to plan for nasty surprises. Who can forecast things like accidents or illness?
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#49. TanSauNg: Ref TimothyR444 - "I am not prejudiced against Americans, are you prejudiced against Europeans?"
Is the Pope Catholic?
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251. Publius
Thanks.
Go Wings!
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IF great posts.
244 bere Yes he should.
and the reason there is no health care in the states is simple.
they didn't think they needed it.(others did but who cared).
That may be greed stupidity or a lack of empathy.
238 Sam I've saying for sometime now that Banking healthcare and all sorts nned a nationalised version to give the USA the chance to be the profiteer .
Led Capitalism compete with communism. and see what happens.
cause it seems that the capitalism that is the USA has failed and the communism of russia failed.
now you're more knowledgeable on them financial matters . .is there such a place?
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Geographer Sam (#252), what about Princeton (the University and the Institute for Advanced Study)?
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I think we can safely determine that Americans know far more about the ins and outs, the good and the bad about our health system. It is the best in the world on many levels. It is not so good on other levels. People come from all over the world to be treated at American hospitals: Mayo Clinic, Johns Hopkins, Sloan Kettering, among many others. We do some things very well, and others not very well. The good thing is that we are moving toward achieving some goals. I am happy to see this.
But now my gloves come off. One of my very dearest friends lives in Essex. Nice family, nice home. I think the comments about Essex is a bit overrated. I was born and raised in New Jersey. Two thirds of the state is farm land. Think of Jersey tomatoes, Jersey corn, Jersey blues among many veggies that are grown each year in the state. You can thank Thomas Edison for the light in your house. You can also thank him for phonographs and motion pictures (his machine was able to show moving images before Lumiere in France.) Yes, more people live in NJ per square mile than any other state because they want to live there .. great mountains, super lakes, and the shore! Monopoly was invented in New Jersey. New Jerseyans are great shoppers as there are more malls per square mile than in any other state. After all, Paramus is Indian for Shopping center. Think of the great musicians that have come from NJ including the Boss and Frank Sinatra, among others.
More American Revolution battles were fought in NJ, which is why NJ is called the crossroads of the Revolution. The reason why we have a Senate is because NJ, as a small state, believed that all states should have equal representation.
Actually, NJ is a rather brainy state: http://www.locationnj.com/Demog_NJ_FastFact.asp
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Health care fails just as all industries do in this country because we are not Capitalist or Socialist but have both sabotaging each others plans.Corporations don't compete but price fix,And social programs aren't for everyone but are payed for by everyone.That's what is sad we are getting the worse of both taxes and high prices without the benefits.Go down the line Cable/Internet speed slow but expensive,tons of phone services for same monthly prices,Banks compete for your loan I don't think so,Media from TV to Newspapers are owned by few companies all using AP NEWS for stories,There are only a few companies making our food they just keep names of original products no competition there.Every gas station in town has the same oil price it only varies by a penny at most.Theres no Capitalism here.It died long ago with Socialism and workers rights,and an equal public education.
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on that not for profit hospital. I posted the links back when to our new hospital. all non profit.(well it will be lol) http://www.peacehealth.org/Oregon/News/Facilities/RiverBend/SHMC_RiverBend.htm
now they are having problems cause the people can't afford to pay their bills despite promising to.
(Note Ironwork made in texas cause the bidding was done out of texas.(
NON profit. but the fuss to get them to this site was a local nightmare.
Downtown emergency closed.
New site built right where the willamette is going if there is major dam breaches in the big earthquake all plan for.
Nothing smart but a lovely bright roomed hospital by the river.
all from their non profits.
Now being run by christians no one gets reamed for the money;)
Now take it that it is in one of the poorer states.
here's some links for ya'll to look at
http://www.pbs.org/moyers/journal/06272008/watch2.html
http://www.fda.gov/bbs/topics/NEWS/2008/NEW01840.html
http://www.reuters.com/article/topNews/idUSN1450916820080215
http://economistsview.typepad.com/economistsview/2007/04/health_care_the.html
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Edison was raised in Port Huron Michigan and born in Ohio.
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#253. bere54: "(My son) should have the right to health care now, so he can live so long. The young have just as much value to our society as the elderly do. It is to be hoped that we will have equity long before my son reaches retirement age; perhaps we will have it before I reach retirement age."
Had you written "we" rather than "my son" ,your comment would have been clearer. I certainly agree that everyone should be entitled to coverage. I'm not so sure though that the elderly are any less worthy of care than those younger; they did pay their taxes, fought in wars and made possible today's lifestyle. Prevention is better than cure and the younger generation could well improve themselves by eating sensibly and exercising regularly. But millions do not - obesity is a major cause of medical problems today.
#259. marlenekoenig: "You can thank Thomas Edison for the light in your house. You can also thank him for phonographs and motion pictures (his machine was able to show moving images before Lumiere in France.) "
Let's not descend into which country or state invented what. Edison is credited with all kinds of innovations, but the incandescent light bulb was invented in Britain by Joseph Swan and the flat disc phonograph record by Berliner. The history of motion pictures is too complex to give Edison sole credit. The British could point to all manner of things invented or discovered by them - especially with regard to health care. May be not in Essex, but then that's far smaller than New Jersey! Incidentally, when the British speak of Jersey tomatoes and potatoes, they mean from the original Jersey, one of the (English) Channel Islands.
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Many people cursing the universal health insurance program by comparing it to socialism/communism, I bet that they cannot even define the socialism. Assertions like paying for somebody else treatment are ridiculous wake up this is an insurance plan like for instance car insurance. More people contribute into one account the lower the rate because the probability of risk, sick people percentage, will decline due to diversity of clients. In any case, these programs always manage (or organize) the demand side i.e. clients, the supply is not affected it competes usual manner to provide the services.
I like Canadian system, it retains the competition in providing services, in other words, you can choose or fire a doctor any time or change employer. Couple of things I would change though (this is already happening to a degree) and that is I would introduce a visit fee (maybe $5.00) to discourage hypochondriac visits and I would make patient ability to seek services outside the border. This way, a patient can find cheaper treatment in other country and being reimbursed. This would break the domestic supply (doctors) monopoly and increase competition.
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263, David -
I agree that the elderly are not less worthy. In fact, I think elderly people who have worked all their lives and paid taxes and contributed in a myriad of ways to their communities should not be penalized because the houses they've lived in for 50 years have so increased in "market" value that they cannot afford the taxes; I think that if they can't afford the taxes they should be exempt or at least be taxed at a lower rate (and property taxes in Vermont are income-sensitive but this may be unique to Vermont) instead of being forced to sell their homes. But that's a whole 'nother topic altogether.
I don't think the elderly are more deserving of decent medical care than the young. Everyone deserves it.
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to 263, never argue with a reference librarian. There were about 22 attempts to produce an incandescent light bulb before Swan and Edison, but Edison gets the credit for the lightbulb, even Swan acknowledged this. See Robert Friedel and Paul Israel's biography, Edison's Electric Light: the biography of an invention (Rutgers University Press: 1987) .. which goes into great detail about how the light bulb and what led to Edison getting the nod because he invented an entire electrical system - where the incandescent material was more effective. There was also a better vaccum system and the entire process more cost effective. During the 19th century, there were various attempts at trying to invent an incandescent lightbulb - but it was Edison's procedure and bulb that made it all possible. Berliner's Gramaphone was not patented until 1887. Edison's patent was in 1877. His work was enhanced by Chichester Bell and Charles Sumner Tainter.
Incidentally, I have been to Jersey, the Channel Island -- and am about to make my 39th visit to the UK. All for pleasure.
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This comment was removed because the moderators found it broke the House Rules.
#257
Jack,
Scandinavia may be the closest. One thing we can't have though and that's communist cars. The bankruptcy courts will have to sort that out.
http://www.youtube.com/watch?v=IPd8CrhiOug
Driver Sam
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244. bere54:
"243 -
Is your mother on Medicare? If so, then my son has money deducted from his paycheck to help pay for those surgeries but cannot afford health insurance nor can he afford the exorbitant out-of-pocket expense of health care. I don't begrudge your mother her health care; I just think that my son should have the same benefits."
*******************
Yes, my mother is on Medicare. She has worked and paid taxes for over 50 years. She also pays for supplemental coverage (I think through AARP). She has been able to afford this because my husband and I subsidize her living expenses.
David_Cunard: I'm not sure what type of coverage my friends, who have been assigned to London for 2 years, receive. It's provided by his company, which I'm sure pays appropriate taxes. He is probably also paying taxes while there. My guess is someone's paying for him, whether it's he or his company.
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266 edison COMMERCIALISED the light bulb. as with many american"inventions"
americans are good at that. Eddy wanted to sell power.
Swans was using hydro from the private estate to produce power but no one else had power so he could not sell the bulb to people unless they got power to. That is what Edison did. he figured a way to make it accessible to all. just as H ford did with the motor car.
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@266 - We can also thank Edison for driving Tesla out of his way. Thanks for nothing, Edison!
It just goes to show. Communism was invented by Karl Marx, but Capitalism is clearly the work of Kaiser Soze.
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259. marlenekoenig: "great mountains, super lakes, and the shore"
**********************
New Jersey is really beautiful. It does take a drubbing, though!
Have you seen SNL's guest, "Gov. Patterson" (Fred Armisen), talk about NJ?
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As a Canadian, I enthusiastically second the remarks made by Interested Foreigner @ 227 and 228.
My own experience with our healthcare system here in Canada has been very positive. My wife was diagnosed with breast cancer last summer, and the treatment she has received has been both timely, and of the highest quality.
This is not to say that our system is perfect (we face a shortage of doctors, particularly G.P.s, as you do in the States as well). Not all prescriptions are covered (in my wife's case,for e.g., a drug for boosting white blood cell counts, costing near $3000.00 per dose, of which 8 were required, was not covered. Luckily, my wife had, through her employer, private insurance coverage which paid for 80% of the cost). There are wait lists, particularly for elective procedures. As it is provincially run, there are some big variations in coverage between the Provinces (something to consider for those advocating a State administered system ... ). And so on.
But the Canadian Health Care system is in essence good, and effective, and it is there ... come hell or high water, whether you are employed or not. Cancer happens, and I am very grateful that I will never have to choose between, say, my daughter's university education and my family's health.
Yours,
Canadian Pinko
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@269 - Andrea: if your friend is on assignment in the UK, they will be covered for their National Insurance contris via a Certificate of Coverage, otherwise they'd be contributing to US social security too. Effectively, they are paying in the same way any UK citizen would (and are therefore as entitled to NHS cover) but may also get medical benefits as part of their compensation package.
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192 Culinary Sam- Williams Sonoma is one of my favourite stores I just had some tea towels and table cloths sent to me here. Did you know that the postal service is not subject to sanctions by international law (one law that the US actually abided by even during the reign of Bush jr). Having anything in common with Marcass is a little off-putting though.
191 Marcass you been drinking kool-aid again? You just get wittier by the comment! Express away we are amused.
199 Aqua thanks for the encouragement. Sadly the time difference makes it difficult to stay on line as it gets late particularly when the mods are slow, as they were last night. I went off line at about 2 last night with a number of posts pending moderators. Now its past midnight and the end of a nice weekend here so Im calling it a night!
213 Happy do you think the UK or the US has the best treatment for multiple personality disorder?
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268 lol sam OK I just thought that a national version of most industries would add to competition.
We would still allow Big trucks so you can feed the horses.
Now on his "stress test of the skin of that vehicle looking closely I notice that the old jeremy is up to something.
that is a Thor hide hammer he is using there. Aprox 25.99quid from "messengers" in the high st in guildford. Nice hammers for smithing with.but the Vaughns does have the advantage of easily replaceable heads compared to the thor.
I'd say a 2 pounder but the picture was a bit fuzzy.
Anyway you mention communism and cars .
I'm glad to see you notice this amusing trend in American motors.
So what will america do to the Lada.
Hemi and a cup holder?
Should we start up the lada jokes
why does a lada have rear windscreen defroster............to keep your hands warm when pushing it.
what's the difference between a sheep and a lada............
269 Adrien
but those paying in now will get nothing at the rate the states is going. just the ability to pay for their folks.
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Justin,
One of the Girl Scouts in my troop wears a pump. In the beginning, there were many problems with it not reading properly. Her counts were off regularly.
Her mother's a pediatrician, yet there was still quite a learning curve that first year.
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275 Lol princess Not sure I do know that mental health is hugely overlooked in the UK. where as in the states for a while you were no one if you did not see a "shrink"(they'll make your wallet shrink).
Maybe there is no cure.
273 chrono. lol the rest of the world lacks GP because they pack up and make WAY WAY more money in the USA.
where their own would be doctors can't afford to study.(oh and law suits shut teaching hospitals.
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#272
Andrea,
Why do I feel the phrase 'Jane, you ignorant slut' winding it's way towards the blog?
SNL Sam
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#266. marlenekoenig: "never argue with a reference librarian."
I fear your library is not all-inclusive. Edison did not invent the electrical system - his was Direct Current and today we use Alternating Current. Neither did he invent the flat disc which has been in use far longer than Edison's cylinder. The fact that Edison patented something does not mean to say he actually invented it, rather like Bill Gates who is credited with first programme which ran personal computers. He purchased it from another developer.
When you're next in the Scepter'd Isle, you might ask someone who invented the light bulb - I don't think they will agree with your assertion. Before you go, you might care to read this article about Mr Edison and his contributions to electric lighting. I hope you don't hold the same fervid views about X-rays, photography, penicillin, CAT scanners and anaesthesia.
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#276
Jack,
What do you call a convertible Lada?
A dumpster.
How about we do Jersey Girl jokes next?
How do you light up a Jersey Girl's eyes?
Shine a torch in her ear
Politically incorrect Sam
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236 frayedcat
RE; the article on UPMC: I live in Western PA and get UPMC insurance through my employer (Uncle Sam.) It's pricey, yes- but it and it's hospital system far and away provides the best medical I've received in my life. In part due to their system, Pittsburgh is becoming a world-class research and treatment center. It's not just an insurer, but also a provider. After my failed Fiddler on the (Porch) Roof audition, I was lifeflighted to their trauma unit in less than an hour, and had 4 days of the best of care for my 4 broken ribs.
The answer to your question- about where the revenue (profit) dollars for a non-profit go is shown in the article. They're putting it into improvements on their existing hospitals- many over 50-75 years old- and expanding into new facilities.
All That Being Said: the cost is the rub. Even if UPMC is one of the best (which, lacking data, I won't claim,) even the best non-profits have bought into the corporate business model far too much. There comes a point where efficiency ends and profiteering begins; a system such as UPMC has probably lost a bit of focus in it's drive to expand it's "market share" and carve it's own little empire.
Re: cost, using my own example, I would have been out $60,000 if I hadn't had insurance. Or else would have suffered less thorough and caring treatment at a less expert hospital.
So the current system forces a hard choice: follow an aggressive business model, emphasizing costs and profits, or else watch the "customers" go elsewhere as your aging facilities decay, being unable to finance improvements like the competition.
As IF clearly indicates at 226 (excellent post!), it's the system that forces such Catch-22 choices that is broken.
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I wouldn't trust Barack Hussein Obama to wash my car. Obama talked down the economy for his own purposes and Rahm Emmanuel said "never waste a crisis" His stupid far left policies are going to bring down america like the state of California. He is a puppet of the ACLU. This guy wants carbon taxes in a recession and he is going to fix heathcare.
Im scared.
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Pump Night - A night where you can learn about the automated insulin pumps that are available. They look like a pager - if you can harken back to that day. The run a tube into your stomach and give you insulin automatically throughout the day. No shots to take, but they are pricey. Hope that clears things up for a couple people.
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281 what do you call a lada with twin exhausts.....a wheel barrow
Jersy Girls? here we have springfield.
but the answer to the sheep one was....... it's more embarrassing getting out of the back of a lada.
283 cool
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heres one. People without insurance pay more for the same treatment than the insurance companies pay. B
They demand lower costs so the burden is passed to those that pay out of pocket.
Go check it out. I'm going to bang on a car.
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re: 278 Happy
The economics are part of it (some Canadian trained doctors do go south), but it's more complicated than that: we scaled back med school intake in the 90's because the predictions were for an over supply of doctors. We take far too long to give accreditation to foreign trained doctors. There has been rising demand for services because of rising quality of life expectations, etc.
More here.
The US is also facing physician shortages, for similar reasons -- see
this.
Yours,
Pinko
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286, happylaze -
As someone who went without insurance for 15 years, I know you are correct about that. I always demanded the "insured" rate and told them if they wanted more than that they could damn well sue me. I never got sued. This is something few people know (and those with good insurance don't want to know), that the uninsured who are able to pay are subsidizing the insurance companies (and therefore those who have insurance).
Don't ask me how I feel about being charged more for a doctor's visit so that some obscenely wealthy insurance executive can pull in more money. My answer wouldn't pass the mods.
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@283 - "This guy wants carbon taxes in a recession and he is going to fix heathcare."
I fail to see what's bad about this. Fixing healthcare is a good thing. Asking America to polute less is also a good thing.
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283. At 9:28pm on 15 May 2009, toughdirtyjoe wrote:
"His stupid far left policies..."
As Ronald Reagan said to Jimmy Carter: "There you go again."
"Far left"? By the standards of virtually any western democracy other than America, Barack Obama is leading a very middle-of-the-road path. Maybe you need to get out more, and see the world a bit.
******
"He is a puppet of the ACLU."
This is supposed to be an insult?
Gosh. Now that's really low. Accusing the guy of standing up for civil rights. Why would anybody ever want to do that. Imagine that: A President who stands up for, and believes in, the ideals upon which America was founded. A real sicko. How un-American. Must be a communist.
It would be so much better if he were (feel free to pick more than one):
a puppet of the oil industry?
a puppet of the insurance companies?
a puppet of the electronics industry?
a puppet of the religious right?
a puppet of the mob?
a puppet of real estate industry?
a puppet of the banking industry?
a puppet of the unions?
a puppet of tort lawyers?
a puppet of [[Fill in the blank with your own choice of a suitable well funded lobby group or Political Action Committee - other readers will notice that the obvious candidates for this spot have not been named to prevent the blog from tipping into the abyss of the Levantine littoral]]?
******
"This guy wants carbon taxes in a recession..."
Now there's a huge non-sequitur. Let's follow that logic: It's okay to spew greenhouse gases into the atmoshpere because there's a recession, but not if there isn't a recession.
So global warming stops being a danger because we're in a recession?
So when the recession ends, can we expect you to be a the head of the line supporting a carbon tax?
How and why is the issue of internalizing the negative externalities of burning hydrocarbons in any way effected by whether the economy is in recession or not?
******
"... and he is going to fix heathcare."
Isn't that nice. The people at Hampstead will love him.
Must be Michelle's influence - loves gardening, loves the English so much she gives the Queen a hug. Now he's going to save the English countryside. "There'll always be an England ..."
Oh, HEALTHcare, not HEATHcare.
Well, that's different then, isn't it, Fawlty?
Yes, Major.
Again, though, the non-sequiturs just jump out at you.
Health care should only be fixed if we aren't in a recession?
Somehow the problems with US healthcare disappear because there is a recession on?
America should only adopt a less expensive, more efficient healthcare system when the economy isn't in recession?
America shouldn't fix healthcare if it attempts to introduce a carbon tax?
Or perhaps America shouldn't attempt to compel the hydrocarbon burning industries to internalize their negative externalities if it also attempts to fix health care?
Since when has there been any link between the problem of an overexpensive, underinclusive healthcare system, on the one hand, and the need to internalize the negative externalities of burning hydrocarbons, on the other?
Yet the statement implies some kind of logical nexus. Maybe its the kind of logic that you just can't argue with.
******
"Im scared."
Isn't the more appropriate adjective "scary"?
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238. At 12:59pm on 15 May 2009, SamTyler1969 wrote:
#196
Peter,
There is absolutely no link between reporting revenue and having satisfied customers. Check FASB 5 and IFRS, you'll find no mention of customer satisfaction. Rather revenue is recognized when a service or goods are provided and you have a reasonable expectation of getting paid. Just ask a local Utility if they book revenue after a rate increase. Worse, the satisfaction of the customer in healthcare has nothing to do with who the payer is."
Sammy, let's brush aside GAAP, and the accounting technicalities of when exactly business revenue is recognised as such for accounting purposes. My point is: before you satisfy equityholders (ROI), you must satisfy you customers (business revenue). This is ABC in business. So, before health insurers satisfy their shareholders, they must satisfy their clients - or lose them. This is not an oligopolistic market, rather bundling of pretty undifferentiated products/services to differentiate the bundle.
"Actuaries are no guarantee of fair price. If I tell my actuary my margin has to be 1,000% and he tells me the price should be $x, that is not a fair system. Only a free market, with no barriers to entry or exit (not the case for payers in US healthcare) and perfect information available o buyers and sellers (since buyers know not what they are really paying as premiums nor what their annual services cost this is hardly the case either).
Check my #196: I never claimed that actuaries determine the profitability in an industry. YOUR opinion on industry profitabilty is irrelevant. You'd better revisit "profit" (as defined in economics), and industry ROI/profitability, and determining factors.
"Obama isn't proposing to take over healthcare, rather the proposal is to provide a government run payer and see if it can beat the insurance companies. If they are providing real benefit to consumers by providing efficiency and competitive pricing then they will be able to beat that payer and provide their shareholders a return. If they cannot then they should be run out of business.
It is deeply ironic that when folks who claim to be free market see a market being made more free they don't like it. Introduce a little bit of competition and suddenly it's all 'Waaaah! Not fair! You're making me work and compete for my money. Waaaah! I want to be protected. I want to charge what I like and not be questioned. I want to control the available services with no customer recourse. I want to put my prices up every year regardless of quality. I want to manage the proleteriat. I don't want to compete'. "
You may not be aware, but, besides a number of interviews with Dem Congress people who openly talk of a total take over of the healthcare industry, Dem-dominated US Congress and BHO Obama admin are in a frantic search for $90 bn for this year's budget, to provide "free/cheap", heavily subsidised healcare for US' middle class, who normally can buy their own ins. Why would they do that, if a total take over and crowding out of private ins is not envisaged as the strategic goal?
So gov'ment subsidised services at the expense of the taxpayer are synonimous with competition for you? What the free riders on this forum fail to grasp is, businesses cannot operate beyond MC=MR: but gov'nts can, at the expense of said free riders.
"That's un-American and downright communistic." I agree, but only when applied to my paragraph.
"Healthcare costs in the US are just over 15%, not 17%. A huge difference. In Europe in nations with similar life expectancy and quality of life indices they run 8-10%. 7% of GDP spent, we'd need everyone to be twice as healthy and live twice as long to justify that, economically."
"Economist/Businessman Sam", it's extremely difficult to determine the true healthcare expenditure of any EU country because of the heavy subsidisation distortions. For example, a medical student in Germany pays app. EUR 200 tuition fees per semester. Is the difference between the subsidised tuition fee and the market value of the tuition included in the healthcare expenditures? Or is it fare to treat it as educational expenditures, if it impacts the future income of the medical student? Or is the much lower income of a EU doctor/nurse v. a US doctor/nurse a form of government-forced subsidy of the patients?
Care to stomach data I provided:
http://tinyurl.com/qol9ks
In terms of EXPENDITURE growth rate for health services, US is on par with the rest of the developed world: and much better in a large number of vital stats.
"Try some facts, Comrade. Facts are so important."
At your services: health care at 17% of US GDP:
http://www.nchc.org/facts/cost.shtml
"I'm sure the Venezuelans are happy with the $ they pay for our healthcare. I hear the Jovians and Venuvians are happy too, along with the Nibble Pibblies."
That's the trick - to keep the current users of the PONZI scheme happy. No politician will repeal a universal healcare system, politically it's suicidal. So the transfer of the intergenerational debt will continue until the ECONOMIC collapse of the PONZI scheme. SS, Medicaid and Medicare are almost there.
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288. Bere.
Its the same when you damage your car, and the guy at the repair shop wants to know if the bill is being paid by insurance.
If it isn't the price is magically lower,...
And if you offer to pay cash, and not ask for a receipt, the price is lower again.
Strange how that works, eh?
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288 bere - The system is appalling! The more I hear the worse it gets. Many Canadians have insurance through their employers as not everything is covered by Medicare. I went for some blood tests and was asked if I had insurance (at the time I did not). I was not required to pay more instead was told there would be no charge. (This was at a clinic, it is free for all in a hospital.)
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#226 and # 227 Interestedforeigner
A few fundamental problems with the universal healthcare system (UHS)
1) Opportunity cost
The heavy subsidising prevents any objective evaluation of the returns (financial, health, etc.) v. inputs
2) Demographics
UHS is the brainchild of 60s socialists, based on the boomer birth rates. As a pay-as-you-go system, at the current birth rates, it's a classic PONZI. I have provided earlier for this forum data for ON. Currently, 40% of all of ON tax revenue is spent on UHC (38% before five yrs), crowding out govn't expenditure for infrastructure, education, etc (another aspect of opportunity cost).
The UHS will sooner or later implode. After the SC case Chaoulli v. Quebec, it's a matter of political courage to slaugher the sacred cow of UHS, and introduce proper legislation for a two-tier system. I have already voted for such a system, purchasing heavily critical illness, disability, etc ins. It's sad when everyone knows the goodies are unsustainable, but the addiction to them forces the most irrational decisions. A truly generational theft. EU is in the same boat.
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292 Interested - I understood bere's post to say the opposite; without insurance you pay more! More cash is required. I find that hard to believe, but think that is what bere is saying. Clarification bere?
Your payment system makes perfect sense, the other is beyond me. Wonderful posts btw.
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SamTaylor: "Only a free market, with no barriers to entry or exit (not the case for payers in US healthcare) and perfect information available o buyers and sellers (since buyers know not what they are really paying as premiums nor what their annual services cost this is hardly the case either). "
Mmmm, perfect market needed? That's only in the economics textbooks, Sammy. Here's a list of US health insurers:
http://en.wikipedia.org/wiki/List_of_United_States_insurance_companies
Hardly an oligopoly. If you're looking for one, please come to Canada (telecoms, banking, airlines, etc., etc).
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Time Short answer is YES the uninsured subsidise the insured with billing to individuals being up to (and maybe over) 5 times as high than the bill sent to insewerants companies.
If I'm back later I'll try to find the NPR report on it.
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295, timewaits -
Yes, quite often those without insurance are charged more than those with insurance by hospitals and doctors' offices. The insurance companies negotiate lower rates for themselves because they have the upper hand. Basically, they decide what they will pay for any given procedure or service. So a doctor will charge the patient's insurance company what he knows the company will pay, but me he/she charges more because I have no clout, and to try to make up for what the insurance companies won't pay on behalf of his/her insured patients.
I found out about this practice 15 years ago, started doing research about the average amount billed to insurance companies (I often used the Medicare standard) for various things and then wrote up a form letter which I would then send in with a check for whatever I decided to pay of the amount billed (and I was fair). In part the letter said: "This is the amount allowed by the bere54 self-insurance company." I then went on to say that I knew of the over-billing practice and they'd better not waste their time and mine trying to get more out of me. It worked every single time.
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295 Timewaits.
My mistake. Reading too fast.
The point I was making has to do with petty corruption in the Automobile insurance racket. It comes in many forms - this week a police officer and a crown prosecutor were charged. The allegation is that they colluded to allow people charged with offenses under the Highway Traffic Act to be acquitted, presumably in return for suitable payments.
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http://www.npr.org/templates/story/story.php?storyId=101693943
here's some radio for you all listen while you type.
I know some will find that hard because it is hard to listen to calmly.
9minutes 40 seconds into the piece
and some others will hard to do because they can't handle two things at once.
14 minutes long.
Medicaid was also overcharged huge amounts for equipment that could be found elsewhere for less( though I'm not sure what the quality or build issues nay have been.
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I'm pretty sure I wrote about this on another thread but it bears repeating, as an example.
My son had to go to the emergency room for an infected finger due to an on-the-job injury. He didn't have his employer information with him at the time, so they sent a statement to our home with instructions to either forward it to the employer or send the hospital the information to have the charge paid by workmen's comp insurance. The bill was $160 and for reasons I don't need to go into, we just decided to pay it ourselves. So I sent the hospital a check for $160, with a note explaining that my son didn't want to bother with workmen's comp.
A couple of weeks later we received another bill from the hospital -- for $800! That was the charge when no insurance company would be paying! Needless to say, what they got in return was a scathing letter from me with no further payment. We never heard from them again.
Unfortunately, there are a lot of people who think they are required to pay whatever they are billed, and don't question it.
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bere & happy -
It is going to take me a while to absorb and process this information! Perhaps 24 hours! as I find it so unbelievable. There is obviously much I do not know. (Of course don't really want to know it!)
Are there not zillions of Insurance companies? How do the doctors know how much each one is willing to pay? If they agreed on a price, should that not be considered a fair price for all? If the doctors are willing to accept the amount for the insured, why not for the uninsured? How do they justify the inequality? What is going through their minds? For the insured, is this common knowledge? If yes, how do they justify it?
I have more questions, but those will do for now.
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294. Peter
First, I notice that you have not actually answered any of the questions at 226 - 227.
Second, UI may be in trouble, but it shouldn't be. When Paul Martin left office the system was running huge surplusses.
Third, there are many, many problems with universal public healthcare. The point is that the system is far better than the former private sector alternative, which is why nobody wants to go back to the way it was. Public healthcare may have limited capabilities, but it takes away the fear of catastrophic financial loss due to illness, and the fear of being too poor to be able to obtain healthcare when required.
Fourth, Chaoulli is under appeal, and rightly so.
The problem with a two tier system is that the resources will simply migrate to the fee-for-service tier for anything that is easy to provide at a profit, leving the more difficult problems to the public sector. This is a tricky problem, but not insoluble.
The classic problem of public insurance programs, whether for health care of auto insurance is abuse by people who face no marginal cost (at zero price, there is infinite demand); and abuse by groups who have situational monopolies from which they attempt to extract economic rents - the healthcare administrators, the public sector unions, the college of physicians & surgeons, the pharmaceutical companies, and probably others. There are many ways to tackle these problems, used with varying success.
Some of us believe that significant savings could be obtained by introducing far more competition in the supply of services to the single payer. It may be appropriate to set up a system that gives each person so many credits per year, to use as they please, and then to do some auditing of those who can't manage within that budget. Make the credits at least partially bankable, to reward people who take pro-active steps to stay healthy.
It is a good idea to top up with extra insurance. But that does not take away from the benefit of having universal care to at least a minimum level.
The system need not go bust, any more than a privately run system should. It does require attention, and it is highly political.
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303 Interested - I would like to hear your thoughts on this billing system information. (Perhaps you are responding in #303.) Were you aware of it?
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300, happylaze -
That link didn't work. Could you try again?
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What troubles me about this health care debate in the US is that too many people insist on applying free market principles to health care as if consuming health care is analogous to consuming ice cream. The obvious diference is that health care is a human right. Incredibly many americans still refuse to acknowledge health care as a right but the fact is if you need to see a doctor and can't afford to pay for it, most likely you'll be directed to a nearby hospital's ER and get the health care you need. No doubt it's a right.
Market principles can't apply to health care. Here's an example: If you have a car accident you have no choice but to consume health care services that your doctor chooses for you. That's not a very good negotiating position to be in. Also if you have a bad accident you don't get to pick and choose which hospital to go to based on price and quality. You just go to the nearest hospital and hope for the best. There's no choice in health care; there's necessity and that's why a pure market solution is not viable, but there's more than enough room for the private sector in health care services. It's all a matter of common sense. Single payer is not the only model. The french model looks good, and we may want to take a look at the dutch model which may be easier for most americans to digest.
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What people don't understand is that we do, indeed, have government-managed health care in this country. Employer-sponsored health insurance became the norm in the 1960s as the US government gave incentives in the form of special tax treatment to employers, and subsidized the creation of health maintenance organizations (the loathed HMOs) in a misguided effort to contain costs.
That said, for all of our system's faults, it does provide pretty good care for the serious things. We Americans have lower cancer mortality rates than our neighbors to the north, are more likely than Europeans to survive breast and prostate cancer, spend less time waiting for care than Canadians or Britons, and our companies pioneer more innovative treatments. Also consider that we indirectly subsidize the rest of the world through our pharmaceutical industry. Canadians wouldn't have as wide a selection as they do in their price-controlled system if not for our larger, less price-controlled market being nearby.
Finally, consider that our attempts at government-run health care so far have failed to cut costs. Medicare costs are rising faster than costs in the rest of the system, particularly so since the Bush administration expanded benefits. That's a big part of the reason people have been suspicious in the past. That the healthcare insurers and providers seem to be rallying around the latest attempt should be a warning, since they were also enthusiastic supporters of the expanded Medicare drug coverage.
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bere & happy -
Again, thanks. I cannot in fact listen and type, so I listened.
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303. At 04:23am on 16 May 2009, Interestedforeigner wrote:
"3. (a) If universal publicly funded healthcare is such a bad idea, why is it that we don't see millions of Europeans, Canadians, Australians, New Zealnders, etc., marching in the street demanding a return to a system of private healthcare?
3. (b) If universal, publicly funded healthcare is such a bad idea, why is it that there has not been a single poster on this blog from a country that has public healthcare demanding an end to it?
4. If universal public healthcare is such a disaster, why do the citizens of dozens of democracies regard public healthcare as sacrosanct? For example, if it is such a boondoggle, why was the founder of public healthcare in Canada, T.C. Douglas, voted the greatest Canadian of all time? Why do Canadians, for example, regard the introduction of public healthcare in the 1960's as being at least as entrenched in law as the constitution, and a darn sight more popular?
5. If universal public healthcare is such a disaster, why is there not a single credible politician in any country that has public healthcare demanding its abolition?"
Please refer to my #294 again. It pretty well answers the above questions. Some of them I find irrelevant vis-a-vis the big picture of the sustainability issue. I listed at least two fundamental reasons for the unsustainability of UHS in the long run, and yes, I personally prefer it transformed into a two-tier system, which answers some of your questions, too.
You post provides too many generalisation and opinions on the superiority of UHS, some social-justice cliches, etc., but no clue how this PONZI utopia will be sustained in the long run. It's a matter of resource allocation, efficiency, and opportunity cost. Again, my point is that the UHS efficiency cannot be evaluated because of subsidy distortions; hence, you cannot claim that it is a better social deal than a two-tier system.
Chaoulli v. Quebec is not under appeal; this is a final SC decision. In Canada, a SC decision cannot be appealed:
http://ca.vlex.com/vid/chaoulli-v-quebec-attorney-general-37672828
"The system need not go bust, any more than a privately run system should. It does require attention, and it is highly political."
As every gov'nt's resources are finite, it's bound to implode. As I wrote to Sam, govn'ts, unlike businesses, can operate beyond MR=MC on taxpayers' monies, but only for so long. It will fail in terms of economics, and politics will not save it.
"Some of us believe that significant savings could be obtained by introducing far more competition in the supply of services to the single payer. It may be appropriate to set up a system that gives each person so many credits per year, to use as they please, and then to do some auditing of those who can't manage within that budget. Make the credits at least partially bankable, to reward people who take pro-active steps to stay healthy."
Your GP/specialist/laboratory, etc. are private suppliers, and compete, even at set by the prov/fed govn't fees, for limited recources. The rest of the paragraph promotes classic rationing ideas, and tries to pool individuals with different morbidity/mortality under a common denominator. I'd go with the private insurers' actuaries and morbidity/mortality tables and stats. The facts of life are conservative, as Thatcher famously said.
Have a good long week-end.
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"Second, UI may be in trouble, but it shouldn't be. When Paul Martin left office the system was running huge surplusses."
Ooops, overlooked that one. Mr Martin's pony trick was to offload the feds' healthcare obligations to the provinces. Now that was clever, wasn't it.
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You may have noticed that Mr Chaoulli sued La Belle Province for violations of his rights under the Quebec Charter for Freedoms and Rights. I hope this irony is not lost for all the proponents of healthcare as a right (under universal healthcare).
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Thank you Richard SM for the information you provided in your comments #'s 241 and 242. Cheers!
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The facts of life are conservative, as Thatcher famously said.
An interesting notion. Probably what they told my great-grandmother in the 30's as two of her children were dying, and the family had no money for medical treatment.
The facts of life are 'conservative' in a Thatcheresque way only if you ignore your own interest in the common good. I am an individual, concerned with my own health, happiness and prosperity. I am also a citizen of a society, and I recognize than my individual aspirations can only be met if that social order is functioning. Concern with social justice 'cliches' is in fact a primary duty of citizenship.
As a liberal, I would go a step further, and state that the common good is in fact a higher good than my own health, wealth, and happiness. From the perspective of history, how small our individual aspirations appear in relation to the fortunes of the societies of which we are citizens. When we celebrate the achievements of great individuals, we celebrate their contributions to the common weal. Truly great persons sacrifice something of their own interest for the benefit of their fellow citizens.
So what has this to do with health care?
Your argument is that universal, single payer health care is unaffordable. There is no guarantee of 'value for money' in a gov't run system. Individuals should be free to choose ostensibly better (privately funded) alternatives. I would argue that this is in theory fine, so long as it is clearly demonstrable that the private tier does not erode, or in fact is able to enhance, the efficacious function and universal availability of the public service. The greater good is the maintenance of public health, that is, the health of all citizens in my community.
That this maintenance of public health is expensive is a given. But we have, over the last 40 years, decided as a society that it is a priority. Not only is it worth the cost, but it is a teleological goal of our being a society. We pay for it because we have decided that it is right and good.
This does not mean it cannot be improved, and it does not necessarily mean private forms of care are forbidden. The test will be whether such forms of care can help preserve and enhance the health of all citizens.
As you propound your 'facts of life,' you might want to consider another set of facts, as expressed by that noted radical commie Rev. Donne:
No man is a island,
entire of itself.
Each is a piece of the continent,
a part of the Main.
If a clod be washed away by the sea
Europe is the less,
as well as if a promontory were,
or a manor of thy friends,
or thine own were.
Each man's death diminishes me,
because I am involved in mankind;
therefore, never send to know
for whom the bell tolls,
it tolls
for thee.
Yours,
Pinko
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kpomo
"What people don't understand is that we do, indeed, have government-managed health care in this country. Employer-sponsored health insurance became the norm in the 1960s as the US government gave incentives in the form of special tax treatment to employers, and subsidized the creation of health maintenance organizations (the loathed HMOs) in a misguided effort to contain costs. "
government-managed health care . is this medicaid medicare?
As for you norm I haven't seen that in looking for work in the states.
I've seen where you can pay half your minimum wage and get coverage that like the NPR piece showed will be of little use when you need it.
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302
Time you ask
"Are there not zillions of Insurance companies? How do the doctors know how much each one is willing to pay? If they agreed on a price, should that not be considered a fair price for all? "
much of that money spent in the US goes to firms that work out all those prices. the HMO also have people that work out how to lower their costs(laugh is they do not really pass that on in savings).
The industry in medical billing is HUGE.
I'd say offer anyone in those jobs training to be a nurse or something useful.
just do a search on medical billing.
Immediate savings for not billing are huge.
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chrono.
nice post
"If a clod be washed away by the sea
Europe is the less," does that depend on who the clod is?
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313, chrono -
Your best post ever (or at least as long as I've been reading this blog), and that's saying a lot. Why do so many not understand what is just plain common sense?
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309. Peter.
Yes, you are right on Chaoulli. Nonetheless, there may be further developments. The Chaoulli decision is regarded by several governments in this country as being wrong. This came up in discussion recently, and I misunderstood part of the conversation to mean that the decision was being appealed. This is incorrect. Nonetheless, there may be further developments.
The scheme will not go broke. It may not survive in its current form. That wouldn't surprise me at all. There may be a reduction in benefits, There may be a reduction in which procedures are covered. Users of the system will find that they more and more ancillary items - tests, hardware, equipment rentals, and other incidentals - will be charged by the healthcare provided as the provision of goods and services not falling within the plan. You can already see this anytime you go to a clinic, or, heaven forbid, go to the hospital. There may be a greater need to investigate abuse. There may be more attention paid to lower cost solutions, and greater emphasis on preventative medicine. That is the stuff of politics. But there is simply no widespread support for abolition of publicly funded health care.
The two tier solution has many problems. Among them , it undermines the principle of universality, and, because it encourages cherry picking by service providers both in terms of the services provided and the clientele that is likely to be served (and, conversely, not served). What will happen is that the cream of the resources will be drained from the public system, leaving it as a shell.
(In a similar context, Tommy Douglas used to speak of the rich getting the cream, and everybody else being left with skim. His suggestion was that everybody should share 2% instead. It was a long time ago, and he was a brilliant speaker.)
I've seen this in other contexts in a command economy, and it really does make a mockery of a system of provision of public services. It also fosters selfishness, corruption of state employees or service providers, black market provision of goods, contempt for the institutions of the state, and sorts of other petty injustices that undermine the program. This usually happens where the state tries artificially to fix prices, for political reasons fixes those prices at too low a level, and so producers stop producing, which drives the market price up, which makes black market provision of goods more attractive, and so on. The key to avoiding this is for the single payer to use its market power to force provision of services to be made as competitive as possible, and then to price the services realistically when they are charged to the plan. Not easy.
In any case, you can see this two-tier provision of services already in larger urban centers where, for about C$ 1500/year you can participate in executive health programs, where you are given an annual physical, and then you never wait for any kind of service - public or otherwise. Just how this is arranged is a bit of a mystery, but it happens nonetheless. Which is fine if you are a well to do executive and your time is valuable. Not sure if everybody who is left waiting in the slow line would take the same view.
And then, on the other side, dental care remains largely a private sector matter, and co-exists with the medical care system generally. It isn't really two-tier, so much as a parallel system providing different services.
These are difficult issues, and the baby boomers are headed into their most expensive health services consuming years.
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313. Chrono.
That is a good post.
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Under the GW Bush administration in 2001 Paul O'Neill then Treasury Secretary and Alan Greenspan wanted to save Social Security and the Medicare Trust. In the Annual Report on Social Security and Medicare the key conclusion were that the Medicare Trust Fund will run out in 2029 and the Social Security Trust Fund will run out in 2038. Bush wasn't interested in working the problem so the two were left to ride things out. Even then these two institutions were threatened by a declining economy.
When I moved to the US and lived there, I had a constant fear at the back of my mind how tenuous my existence was. If you get very sick you can lose everything, including your apartment because spiralling health costs and blocks in the rating system hinder things. I was so glad to get out of there and reside in Canada where I appreciate a socialised healthcare system more than I ever did in the UK before I lived the American Nightmare. To 'insure' health is surely the most asinine system in a 'democracy'. Still, if that's what suits the US so shall it be. Unless there's a revolution on the subject I doubt the nuts and bolts of the system will change. By the way a flatmate of mine went in for a disc operation (which in the UK & Canada would probably have been treated by physiotherapy) in 1998 she was charged US$250 for the blue sheet that covered her during the operation and $25 for a box of kleenex by her bedside. Nice.
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Dianaatkin.
well put.
who is more free. those that live in fear or those able to get on with life.
I'd say it is a freedom issue. and the rest of the first world knows that.
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Ref 313 Chronophobe,
That post will strike a chord will all who care.
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No system can be perfect, it does seem however that the 'bang for the buck' the US gets for health spending to outcomes, is very poor.
That is, if you see outcomes as not exclusive to the better off.
GW Bush said the US had the world's best health care system, which it is, if you are from a wealthy family like him. (I never got how he fooled so many with his 'regular guy/cowboy' act, he wasn't very convincing even if you did not know his background).
Clearly a US version of the NHS is not likely or viable.
Since the NHS was formed from a standing start in 6 months in 1948.
This was due to conditions unique to post war Britain.
For all it's faults though, remember, the NHS treats or consults/interacts with, every day, a million people.
You will find cases of poor care, poor judgement, neglect, late treatment in all that.
Every health care system will have some of this too, manned as they are, by imperfect human beings.
The British can be a funny bunch, not hard to find a poll showing a majority concerned with aspects of the NHS, worse still if a bad case goes public.
Then the very same people are almost always asked about their own personal experience of the NHS, then it's very different, always massive majorities happy ,or at least satisfied, with their own interaction with the service.
Since early 2000, I've had a lot of interaction with the NHS.
It took them 3 months to finally diagnose Rheumatoid Arthritis, finally after my fingers started to swell after months of worsening pain. But I did better than actress Kathleen Turner, they took (presumably in the best the US service can provide) a year to diagnose her.
Which really means you also have to be aware that every case is different whatever the system being used.
It could say something about the respective systems, or not.
As soon as my fingers started swelling my GP booked me into a specialized clinic, he did it on a friday, I was there the next Monday, for a week of extensive tests.
Prior to that, my GP had been checking me, weekly, with the usual samples, since I had first referred to him at the start of the year. And until the fingers, found nothing. Not unusual it seems, either for little old me or a well known Hollywood actress.
Once properly diagnosed, the extensive treatment, mainly through medications, commenced.
I had been near to feeling totally crippled by March 2000, in the following weeks my condition improved dramatically.
That song by The Verve was wrong, 'The Drugs DO work!'
I was lucky in that the first round of treatments hit the target, many cases take more than one attempt to find the combination that works for them, without too many adverse side effects.
Here a NHS myth was busted in my case. I was told right from the start that they had all the range of current medications available, plus funding for emerging ones once they become approved.
(Our 'usual suspect' above stated that the NHS means no UK Pharma industry, as usual the opposite is true, it's a major world class UK industry.
There have been medication adjustments since, to adapt to changes and check against side effects, I have blood checks done every 4-5 weeks, at a time of MY choosing. Also true of annual X-Rays, bi-annual bone density checks.
I'm given CHOICE in when I see my Consultant.
I was offered CHOICE when a new specialized unit opened nearer to me. (I elected to stay where I am).
I am offered OPTIONS in drug treatment, as newer ones become available, so far I've elected to stick with what I'm taking now since it works most of the time, being incurable my condition means flare ups are inevitable, but if you met me now, you'd never know what I've got.
They have been RESPONSIVE to changes in my condition all along, increase one med, or visa versa, or start taking another to supplement.
Result, I was back at work full time within a few months of treatment starting, working and paying taxes to in part, support the NHS.
Most recently, reviewing my progress with the consultant, she remarked the most recent x-rays of my affected areas, viewed on a computerised modern file system in great detail, were 'the best I've ever seen for someone 9 years into the condition'. We also, as usual, discussed the results of the most recent few blood tests, as usual, it was a two way discussion, options discussed, as well as general impact of the condition on me now (minimal).
Hang on! According to the vested interests in the US, all this is impossible in the NHS, being the broken down, queue saturated socialist relic they claim it is.
In my case, I do not pay for perscriptions, since the several medications I take, one weekly the rest daily, are life, they are controlling not curing.
As well as something to reduce the side affect risks (9 years in, none so far).
I could also have as part of this package, dietary supplements such as calcium and cod liver oil tablets.
However, I chose to get them myself, since they are not on perscription. I can afford it.
If I was in a lesser financial situation though, I'd be glad to have them free.
Of course there will have been others not so well or timely treated, but isn't that the same everywhere?
I can only go by my own experiences and those of others close to me.
No horror stories there either.
What I think needs to be understood, is that though one is part of the founding Constitution of the USA and the other is an act of Parliament passed in 1948, the majority of the British people see the right to free treatment at the point of delivery, regardless of financial means, as much a human right as the majority of Americans see the right to bear arms.
Sure the US can learn from other first world western nations, including the NHS, but a solution for them, has to be adapted to the realities of their nation.
This does not rule out radical action, though something more incremental is more likely to succeed, but the outcome must surely be not having the US slipping further down the league tables for health outcomes, not having tens of millions uncovered, not having the majority of personal bankruptcies being tied to health care costs.
And not over relying on corporate America to fill the gap via employee programmes, we have them here too, but they can only be a supplement, look at the experience of the major (soon to be less then major in some cases) US automobile companies.
Not having UHC is not only very costly socially, it is a drag on the general competitiveness of the US economy as a whole.
This seems a high price for keeping a very few but well connected in lavish luxury, as they benefit from a system that in the end works for them and them only.
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Interestedforeigner wrote:
He is a puppet of the ACLU."
This is supposed to be an insult?
Gosh. Now that's really low. Accusing the guy of standing up for civil rights. Why would anybody ever want to do that. Imagine that: A President who stands up for, and believes in, the ideals upon which America was founded. A real sicko. How un-American. Must be a communist.
The ACLU in my city do their best to protect criminals. Our state in becoming a haven for criminals. The ACLU are worried about the terrorist more than our safety. Sometimes it feel like britains hate America.
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283 - "This guy wants carbon taxes in a recession and he is going to fix heathcare."
I fail to see what's bad about this. Fixing healthcare is a good thing. Asking America to polute less is also a good thing.
The point is that businesses cannot afford it. Barry's gonna run us into the ground.
I feel that people that are concerned with climate change must come up with cost effective ways to fight it.
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I never understood why Europeans(canadians and australians)always get hot and bothered and offended at domestic policy issues like healthcare in the USA. It seems like when they discuss this issue they find the lack of comprehensive health insurance as a way to denigrate america as a whole as you see with comments in the begining...
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#291, 296
Dear Peter,
Perfect markets exist in the US for many things, including groceries and gasoline. Long distance phone coverage, all phone coverage if you have high speed internet and so on.
The health insurance market is not competitive. Consumers buy through their employer and are offered one or two plans by one or two companies. Then told their share of the price after the rest has been taken away from them. That's communism.
There is no relationship between customer satisfaction and revenue in this case, customers do not know the price they are paying (employers pay most of the cost in a hidden stealth tax). They cannot change their providers freely, even if there are choices they can only pick once a year in open enrollment. The services they receive come through third parties, the insurance companies are simply non value adding intermediaries.
Even if they could there is no relationship between customer satisfaction and a businesses ability to survive except in a perfect market, which healthcare isn't. A business can get way beyond MC=MR if it can raise capital. In fact all start ups do, many established companies do (take GM, who have been there for a long time). Reading small pieces of the Theory of the Firm does not make you an expert, it has to be applied to the real world.
Regardless of what other Dems say, the proposal at hand is not single payer. Marcus wants nuclear war, but that does not mean Rush Limbaugh does.
All that stuff about percentages. It's real easy to get past, you use a common % calculated by an independent international body. The numbers I used come from the OECD, an independent organization using a common method. Healthcare in the US is overly expensive. You should avoid web sites from pressure groups and think tanks, they tend to say whatever is needed to support their views. For example, using a not for profit funded by the insurance companies to support the insurance companies perspective would seem to be a little biased.
Expenditure growth rate is a ridiculous statistic and it tells you nothing of any economic importance.
No business should be afraid of competition from the government. Just like communist cars any decent business person should be able to kick the governments ass in a free market. The current proposal is for a government run insurance option that folks can pick instead of their current poor choices. Consumers can look at the benefits offered and choose to stick with a their current provider or pick a new one. That's American.
Last paragraph in 291 seems to be confused. Plus irregular use of capitals. Is this ponzi scheme one run by the current insurance companies? You seem to be arguing with yourself. While it is not a sign of insanity to talk to yourself, generally when you start answering back it is an indication that you may be a hot dog short of a tailgate party.
So your proposal is to limit choice? If you are Canadian why do you care? Unless you have some pinko lefty subversive communist agenda. We don;t hold with that down here in the free world.
BTW, it is generally good manners to answer a post in a single post.
Economist Sam
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#313,
Chrono,
Nice post. One additional observation. In many of those Western democracies that are being attacked for having universal healthcare there is a private option. For example in the UK there are many private insurance schemes that allow you to cut in line for treatment by paying additional fees for you. Many businesses buy this for their key personnel.
And yet the price is still lower to society as whole than in the US and with similar results. We would deny our citizens choice and call ourselves free?
Sad Sam
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328) Absolutely spot on Sam.
Here in Oz we have the same system, private insurance charge like a wounded bull!! one example would be my partner and sister in law both pregnant within 2 months of each other,same Gyno, we went public sister in law private, the care each recieved was excellent, we paid nothing whilst sis in law (even though covered) had a $3k bill at the end of it???
Needless to say her second child was born in the same maternity ward as both my sons.
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326, might that be because in defending the status quo in the US, they all too often denigrate other nations systems?
Two can play at that game.
Also, having to listen ad-infinitum from some about the superiority of the US in just about everything, does not chime so well when clearly the US is out of step with other Western democracies on health care.
With very negative results for those not wealthy.
Not our business quite right, that changes however when you get the likes of Rudi Gulliani as part of his abortive Presidential candidate run last year, telling outright lies about the British NHS, claiming basically he'd be dead if he was British with his own medical history.
Using way out of date treatment figures, used way out of context.
If you cannot take it, don't dish it out, seems a wise thought here.
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There is an economic misunderstanding among many Americans, both constituents and politicians, driven by a fantasy. This fantasy describes a medical solution for all, filling current cracks in the floor through which many have fallen. The truth is, some cracks will remain, new cracks will form, regardless the policies, implementations, and management. Why supply and demand (revenue versus expenditure), complications due to human error/corruption, and paths founded on illogical and unethical principles (i.e. false philanthropy, transfer of wealth, legal plunder, etc). Medical care is a commodity, that is, services supplied strictly through scarce labor applied to scare resources. This is an inescapable fact that must be reconciled by proper economic policies (free or profit oriented market), not governed by bureaucrats.
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321. At 6:16pm on 16 May 2009, happylaze wrote:
Dianaatkin. (320)
well put.
who is more free. those that live in fear or those able to get on with life.
I'd say it is a freedom issue. and the rest of the first world knows that.
You're so right. This is why employees say 'sure no problem' etc, they have so much more to lose (health insurance). When I moved around in employment I selected Cal Farm health cover and simply asked my employers to pay the monthly premium. You never saw such a thing! There they were in my last job, getting the bloke in from Blue Cross. I just said, well I'm already with Cal Farm, would you make my payments, making it a portable health cover and they said yes in the end. If I had cut off my existing cover and gone with another, it's a whole new rigmarole. But it is definitely about freedom. When I lived in the UK, I know it seems an absurd example, but I noticed in meetings, or in general company business there was more constructive conflict which led to better decisions, creativity and general level of work: PR, advertising, sales promotion, Television (Thames TV). When I worked in the States this was lacking and it took me a while to analyse as to why. My conclusion was the stranglehold the health insurance benefits for employees has on the actual level of excellence that is produced there. It was, to my mind, behind the times, if you want an example simply look at the level of their TV advertising in comparison to that of Europe and you'll see a big creative different. It's also interesting because advertising is geared to a socio demographic. Now in the States & Canada the population watches more ads than TV and I look at it constantly. Dumb and dumber or what - it's a great shame that Canada in September 200 is going to change their TV mandate and allow no tme limits on the amount of ads in TV programming - we already watch enough TV ads from the States. And there are noises about 'privatising' portions of Canadian health. Heaven forbid because I've lived in the US and it is definitely not one to follow in anything I can see. In fact the world ought to sue the country for introducing junk food to the world & creating humungous health issues!
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328 LOL SAm the funny thing about "private "treatment in the UK is that most of the time they "Private patients" get the same doctor and the same surgery a little quicker (but funny enough not always), for a price."
The private Corporate queue jumpers with the 'fancy poilcies' then subsidise the cost of the next guy in line.
Or they displace them. one reason the "privates" should build more of their own hospitals in the UK. but there they are not so rich as to offer several trillion in bribes .(not that they are poor either.)
332diannaatkin.
LOL TV in the states.
They put SO many ads in I gave up watching TV.
Then they wonder why people don't watch.
"GET A TRUCK GET A TRUCK GET A TRUCK GET A TRUCK"
No subtlety no humour nothing to keep you awake even. "GET A TRUCK GET A TRUCK" then onto the medical ads for dinner time .( to keep on topic)
"Haemorrhoid creams."
"Itchy crotch," "smells not even discussed anywhere on Brit TV except some maybe medical show,"
Great struff.
just about to eat and "stool softener"" do you pee too much". " want a pee now, "
And then americans wonder why the NHS does not pay for all treatments .
Leg twitch. (every one does occasionally) FICTITIOUS restless leg syndrome "Take a drug "
Only make you puke your guts through your ears, but will stop your leg being normal.
Because they were BRAIN WASHED. with ads.
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Is it charitable for my neighbor to voluntarily provide a bandage and pain medicine when I cut my leg. Yes. Is it still charity if I insist my neighbor provide bandages and medicine, forcing him under threat of violence. No. Is it my right to use force as I insist my neighbor to provide medicine, food, clothing, or housing for myself and family. No. Is such act considered civilized? No. Is it charitable, a right, or civilized if I use a third person to insist and force my neighbor to do the same? No, it makes no difference. Is it justified if my neighbors wealth exceeds my modest means (see note). No, it still does not matter. These are natural inclinations we all understand, regardless of culture, regardless of education, yet we ignore these natural understandings when it comes to petitioning the government (the third person) to provide services. Therefore we ignore the force by violence required to generate the necessary revenue. It is not charitable, it is not a right, and it is not civilized if force is necessary for the implementation.
Note:
One of the most abominable childrens story is that of Robin Hood. The story has sentimentally duped many into the unfounded logic that thievery upon the wealthy is justified while giving the same monies to the poor is a form of benevolence. It is difficult to consider propaganda more scandalous than this one.
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334. QS
Well, the crux of your argument is that the state should not have the power to tax to provide public services.
If that is your view on heathcare, then what do you say when your neighbour says the same thing about schools, water and sewers, roads, garbage collection, the military, ... Should people who don't want to pay for those things either, if they benefit someone other than themselves, simply be allowed to pick and choose?
It's called anarchy.
Which is often followed by feudalism.
The kind of thing you want is on display today in Puntland/Somalia.
Is that what you really want?
How expensive a gated community can you afford?
Do you think that imposing that kind of a transaction cost on life is really in anybody's interest?
Most of us do not want to live in a survivalist bunker in Montana, either.
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325. At 11:12pm on 16 May 2009, toughdirtyjoe wrote:
283 - "This guy wants carbon taxes in a recession and he is going to fix heathcare."
I fail to see what's bad about this. Fixing healthcare is a good thing. Asking America to polute less is also a good thing.
Peter wrote:
"The point is that businesses cannot afford it. Barry's gonna run us into the ground.
I feel that people that are concerned with climate change must come up with cost effective ways to fight it."
-----
There you go again.
50 years ago GM screamed that the automobile industry couldn't afford to put seat belts in cars, and cusotmers wouldn't pay for them.
Is there anybody left alive who doubts that the introduction of seatbelts and air bags have not only saved lives and prevented permanently diabling injuries, but have also been a boon to the economy? I.e., seat belts and airbags have yielded vast positive externalities.
Yet here we get the same kind of tired argument. We can't "afford" to protect the environment.
What a load of horse hockey.
Economically efficient ways to protect the environment? Try pricing in the cost of the negative externalities of burning hydrocarbonds. You'll find that the economy will react amazingly efficiently. That is the magic of the price mechanism, as observed so insightfully by Adam Smith 240 years ago. America has the most creative and flexible economy on earth. It should benefit the most by unleashing those forces. Have a little more faith in the strength of your own country and its ability to adapt to changing circumstances.
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334 -
Um, those rich people who were being robbed by Robin Hood were rich because of the onerous taxes and rents they extracted from the poor, whom they drove further and further into poverty as they became richer and richer. Hmm. I think there's a moral in there somewhere. See if you can find it.
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326. At 01:49am on 17 May 2009, moionfire wrote:
"I never understood why Europeans(canadians and australians)always get hot and bothered and