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Discuss the US Presidential Election & Health Care
Yesterday we discussed the war and how foreign policy will matter in your decision next Tuesday. Today our series of election discussion pieces continues with Health Care. With an obesity epidemic, a failing economy, and ballooning health care costs, which candidate has the best answers to making sure that Americans are able to stay healthy without America being bankrupted in the process?
One of the better arguments I've seen for fixing the current health care crisis can be seen here
Of course, the insurance companies (who have very powerful lobbies) will attempt to shoot this plan down as they stand to lose. Though it really can be forcefully argued that insurance companies really do bring nothing to the table in terms of health care. Fundamentally, the idea is a good one when constrained. However, insurance companies have become too powerful and they now function as parasites on the system, making it less efficient and more expensive for the end user. Ask yourself: "what product do insurance companies offer in terms of health care?" What do they create? How do they contribute to health care? When it comes down to it, health insurance companies are not in business to provide health care or help you pay for health care. They are in business to provide insurance, collect money, minimize any payout and answer to their shareholders who expect the system to turn a healthy profit. Any reduction in what they have to pay out is money earned for them.
Which candidate will be better positioned to answer the problem? It will be the one who is able to make some hard decisions and stand up to powerful lobbyists. It will be the candidate who is able to apply creative thought and novel solutions to problems that we've been creating for ourselves for decades now. it will be the candidate who is able to rationally apply logic and recruit, retain and manage in their administration, unbiased and reasoned people who are willing to work hard on solutions that will benefit Americans and the wider global population.
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With an obesity epidemic... which candidate has the best answers?
That isn't something that the government should be dealing with, or even give a damn about. If people (and this includes me, I'm a big guy, so I'm not just picking on others here) are too damn stupid or lazy to manage their weight properly, that's their own fault. Our government has WAY more important issues to deal with than trying to coax some fat Americans into improving themselves.
"16MB (fuck off, MiB fascists)" - The Mighty Buzzard
All I can really say is the obvious: That people don't believe that government is there mostly to just protect rights anymore (if that ever was really the case), so socialized healthcare will be a reality whether we (or I) like it or not,
and that once you get government in healthcare, the incentives to cut costs in places that aren't immediately visible and to pass laws that limit what we can do (and eat, and so forth) are even more likely to go into effect to keep costs low. Expect more restrictions on things like fast food if this goes into effect. People, apparently, cannot take care of themselves, so we need "Democracy" and mass opinion to do it for us. Some people might get the shaft and lose things they love, but in a democracy you sometimes gotta break a few eggs to make an omlette, right?
Which seems to distill to "We can't risk helping people in case we accidentally help some people we don't like."
If we take a look at the costs of manufacturing in the US, there is one expense that manufacturers (such as the auto makers) pay here that they don't pay pretty much anywhere else - health insurance. For every new American-built car sold, a staggering portion of the price of the car goes to cover health insurance.
Yet our country spends more per capita on health care than just about any other country on the planet, thanks at least in part to our for-profit system. In other industrialized countries, the workers are still paying for health care, but it comes out of their paychecks in the same way taxes come out. And in the end those other countries can make similar products at a lower final manufacturing cost (even after paying to export to the US).
If people are so certain that the US system is great, then please answer one question. How can we make American manufacturing competitive on the world market again while paying the highest health care costs in the world?
If you look at our top trading partner (that would be Canada), you'll see that their workers make comparable wages for equivalent jobs to those in the US. Yet numerous auto manufacturing facilities have been moved to Canada to save money. Where is the savings if the workers make similar wages? It is in health care and pensions, both managed by the state.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
There seems to be something of a misconception amongst most Americans that I speak to, that your only options are the current system or some kind of filthy commie healthcare system where government employees carry out open heart surgery with rusty cutlery.
The current system in the UK, for example, offers both private and state healthcare, with the NHS free for all and private healthcare available if you want to pay a bit of money for a TV in your hospital room and a shorter wait for your elective surgery.
If you don't want or can't afford private healthcare then you can use the NHS, which is perfectly adequate for most people and certainly doesn't have huge waiting lists for essential treatment as some people seem to believe. Yes, there are the fringe cases, but for the mostpart the NHS is no worse than any of the private medical services when it comes to patient care.
As a result of this system, the private healthcare providers have to charge reasonable rates, because they know that people will simply abandon them for the NHS if they don't appear to be offering good value for money any more.
Americans seem to be terrfied of any kind of government provided or subsidised healthcare at any level, almost as if they see it as a "gateway drug" to communism - as comical as that appears to the rest of the world.
Disclaimer: I currently contract for the NHS, making me far more cynical about it then I might otherwise be.
Huh? Since when it it a Constitutionally delegated power of the Executive branch to "make sure" that Americans are "able to stay healthy," while also meddling in their finances?
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Walk into any Emergency Room lobby and you'll see a sign saying "you will be treated regardless of your ability to pay"
Which encourages a mentality of waiting for health problems to become emergencies and discourages any sort of preventive measures to maintain health.
Sorry, health care is not a right, keep the government out of it.
Just to make a discussion of it, why not apply the same to fire fighters? Why should the government care if your house is burning down? There's a hose over there.
Here in Aus we have both nationalised AND privatised healthcare. Yes we are the country of moderation, never going to one extreme or the other.
I've made use of our public hospitals in my life for:
1. A severely broken leg (emergency).
2. A radio frequency ablation (serious but not urgent) in and out in a day, by one of the leading heart specialists in the world.
3. My sons birth...single room for the Mrs, very quiet, great midwives and a nice experience. Funnily my other half is from the UK and MUCH prefers our system and hospitals. Though more stuff is covered over there apparently.
All of these cost me nothing up front, service in all cases was great.
That includes the midwives, the bulk billed GP visits, etc.
Now the cost. I pay ~$600 a year on the 'medicare levy', that's how much it costs me in taxes. That's full cover (except dental, public doesn't cover most of that) for $600 a year for top notch service. There's more than that, but as a tax paying citizen, I'm happy for a portion of my taxes to be alloted to public healthcare.
My mate pays a little more than that for private health insurance. He fell off his ladder a few years ago and totally mangled his wrist, nasty business, many breaks. After years of putting into his private insurance...he ends up in the public system anyway. There was nobody available to operate on him in the private hospital we took him to. Total waste of money.
My father had his ankle fused in the private system, his treatment was no better than the public system. Except he got to pay a $3000 premium for the effort.
I'm happy to pay ~600 a year to the government for 'health insurance', it's money well spent.
I hear of Americans paying in the thousands a year for cover, I have to ask...why? Surely your hospitals can't be that inefficient, or are you all just very sick?
I like our system, it works well. You can have the best of both worlds if you find the right balance point, going to one extreme or the other with total nationalisation or total privatisation seems silly.
It's possible that there are no "direct answers for simple questions"; probably because the useful questions are not simple*.
I'm going to play devil's advocate and say that I have some sympathy for the modern American politician. They appear to be stuck in a bind since any complex answer to a complex question will be chopped up into sound bites and used to attack him or her. This is especially a problem in this "Age of Outrage" where the easiest way to start a news article is to interview some screaming nincompoop who is incensed that the politicians haven't waved a magic wand to provide them with eternal happiness.
- - - - - -
Here's a complex question: should a 70 year old retired male with a history of drinking problems but is currently a non-drinker get a liver transplant covered by Medicare?
Here's another one: a different, retired 70 year old male is wealthy enough to afford a liver transplant on his own, should he be in line for the next available donor organ before or after a 40 year old working male without health insurance?
* Douglas Adams taught me this. "What is the meaning of life?" is a simple but useless question.
Waltz, nymph, for quick jigs vex Bud.
"My personal health is my responsibility. If I want to smoke, drink, and eat fatty foods until I die of a massive heart attack, that's my business. Nobody else should be concerned with it. If it can't afford to pay for the health problems I've brought on myself, nobody else should be required to pay one red cent to cover me."
I agree. But what if the heart condition is hereditary and you can't afford to pay? Then you have a serious problem.
Look, I hate the thought I my money going to people who don't want to work, who don't want to take care of themselves, etc. There will always be people gaming the system because they're deadbeats and lazy and scammers, etc.
The the reality is, if I were to become homeless, I would want food, shelter, treatment until I got back on my feet. If I were unemployed, I would want food, shelter, medical treatment until I found a job. If I got some disease and couldn't afford it, I would want treatment. Just because some people refuse to find a job, or pick themselves up by the bootstraps doesn't mean the system is completely out of the question.
That costs money. At some point, you have to suck up the fact that some people game the system and will get my something for their nothing. That's life. That's taxes. That's school levys. That's fire/police. That's Social Security. In the end, YOU will need those things.
This country, including myself, needs to change it's me me me me me me me me attitude, or we're not going to make it long term. I'm a firm believer that karma is one hateful mistress when you ignore her.
It seems to me, and I might be wrong (I'm not)....
That John Mcain, a Navy brat, turned lifetime public servant who has had "socialist" government provided healthcare for his entire 72 years on this planet. Probably doesn't know sweet FA about an the average persons health care, outside of what he reads and the health insurance lobbyists tell him.
It's kind of ironic that the guy who's suckled at the government teat for his entire life, calls other people socialists.
Has he even ever been to a job interview? Or even had to ring an insurance company to get cover?
I'm a health care provider. I've been in the field in various capacities since 1981 and as a licensed professional since 1990.
When we talk about the "health care system" in America we have to be very clear about what we are talking about. There are two halves to this system- health care providers and health care finance. The main problems in the US health care system are in health care finance, since this is what determines access to health care.
National health care insurance is an inevitability and IMHO will be driven from the Right not the Left. The driving force will be lobbying from large businesses (GM, for example) that will be rendered noncompetitive by health care costs; they will either go bust or leave the US for countries with a national health care plan. IIRC nearly $1500 of a GM auto's sticker price is health care costs for current and pensioned employees. The creation of a national health system would allow GM and other large companies to offload much of the cost of health care insurance for current employees but also for retirees. This would be a major gain in the bottom line for companies struggling under these costs and other market forces, and would put them on a more-equal footing with most European and some Asian competitors. It would also be a major gain for small businesses (like my Dad's, like the company I work for, etc.) as it would reduce payroll costs. The losers, of course, would be private insurance companies and their CEOs, employees and shareholders.
For the individual, national health care coverage would mean greater freedom to move between jobs to improve one's lot in life and greater flexibility in managing care for children or dependent adults (e.g., aging parents).
The creation of a national health care finance plan would be able to leverage economies of scale unavailable to private insurance companies. The removal of the profit motive would reduce overhead from an industry average of 10-30% to closer to Medicare's 2%- a savings of hundreds of billions of dollars per year right there. With universal coverage, every person in the US could obtain preventive, clinic based care (which is the least expensive way to receive care) rather than letting problem go unaddressed and eventually seeking care in an emergency room (the most expensive way to receive medical care). With universal coverage, health care providers would not face defaults on payments for services which would allow a reduction in the cost of care. Rationing of health care would be reduced through the elimination of provider networks and access restrictions imposed by insurance companies. And finally, authorizations for services would not be influenced by the need to protect the profit margin.
From the provider side, it costs money to get paid. Someone has to prepare a bill and send it out. For many of my patients, payment comes from two to four sources and I have to send a bill to each in turn according to an order of precedence. Each bill costs $3-5 to send, and then there are the costs of tracking reimbursement to collate all the payments, figuring out who gets money back if the bill gets overpaid (which happens frequently because the insurance companies don't understand their own systems very well). Being able to do single payer billing would save an average of $10 per patient in my clinic, which means either more profit or the ability to lower costs for services. Imagine the cumulative savings if the cost of every health care service in America could be reduced by an average of $10.
That all sounds like a panacea and of course no such thing exists. Every health care finance system would have problems. People worry about where the money would come from and the only possible answer is taxes, since that is the only source of government revenue. However, we already pay that tax and then some. Like most people, I get my insurance through my employer. I chose the cheapest plan, which is a high-deductible plan. It costs $512 per month, 50% out of my po
I point out to everyone I know that under McCain's plan, I'd still have no health insurance. Why? Because they won't sell it to me.
Plus, I'd now be out whatever percentage of my taxes went towards providing tax deductions to everyone else who bought health insurance.
If corporations are people, aren't stockholders guilty of slavery?
It seems to me, and I might be wrong (I'm not)....
That John Mcain, a Navy brat, turned lifetime public servant who has had "socialist" government provided healthcare for his entire 72 years on this planet. Probably doesn't know sweet FA about an the average persons health care, outside of what he reads and the health insurance lobbyists tell him.
It's kind of ironic that the guy who's suckled at the government teat for his entire life, calls other people socialists.
Has he even ever been to a job interview? Or even had to ring an insurance company to get cover?
After a career in the Navy and a career in the Senate, it is doubtful that Senator McCain has interviewed for a job, unless you consider reapplying for his job in the Senate every six years is an interview of sorts.
But, seriously. "Suckled at the government teat"? Really? I'm not voting for McCain, but this is just unfair. Senator McCain's father served in the Navy, thus earning his pay and his benefits (including health care). Senator McCain served in the Navy, thus earning his pay and his benefits (including health care). After serving in the Navy for decades, Senator McCain has served in the Congress, thus earning his pay and his benefits (including health care). C'mon. Suckling at the government teat? That's just not a fair assessment of what Senator McCain has been doing for 72 years. Complain about his inability to offer an coherent, consistent message. Complain about his plan to freeze government spending levels. Complain about his plan to tax health care benefits. I'll even grant you that he doesn't know much about the health care insurance of average folk. Just don't deny that the man has earned his health care for 72 years.
Life is short; think quickly.
Parent should be modded up. Many are screaming that any kind of progressive change to the health care system would be socialistic. Yet they all refuse to recognize that nearly the entire system we have is already heavily regulated and in no way represents any kind of free market. I assert that excessive regulation and the insurance companies are a huge part of the problem. Unless a new adminstration is willing and able to tackle these issues nothing will change.
One of my job responsibilities is to support a Home Health Care system's application and I have a lot of experience with supporting them. The percentage of effort and expense put into keeping up with constantly changing regulatory mandates is truly staggering. I personally don't understand why people continue to get in the business anymore because they are constantly squeezed between increasing costs, and shrinking revenues. A major portion of the cost increases are due to administrative overhead a substantial portion of which is dedicated to ensuring regulatory compliance. I'm not generally a proponent of deregulation, but in the case of health care the government and industry both have made a huge complicated mess of the entire system.
The problems with our current 'private' insurance system have already been well articulated in other posts here. There's also the topic of legal liability which I won't even start in on. Bottom line is that we all need to be willing to start rebuilding the system from the ground up if we truly want change.
What if the Hokey Pokey really is what it's all about?
This is unmitigated bullshit. I've spent a good part of my life in Northern Ontario in a tiny town far from any major population centre. I had some health challenges, including experimental reconstructive surgery. I received superb care every time and have no complaints. Similarly, my friends and family have had much better luck than yours. One friend was released, in the opinion of his family, too soon. Providing a sufficient level of care for him at home for a couple of weeks cost his son and daughter some holidays. A longer-term disability would have qualified for home care.
Anecdotal evidence, both mine and yours, count for very little in the overall scheme of things. The numbers prove, time after time, that the Canadian system works. Among other things, it puts about twice the amount of constant dollars (US or Canadian) that go into the system into doctors, nurses, equipment and facilities as the American system. In other words, it uses a lot less of the money in administration and paperwork.
If you'd like to get some idea of how it works, check out infant mortality in Canada and the United States. That's a good, objective statistic that it's hard to manipulate.
I've calculated my velocity with such exquisite precision that I have no idea where I am.