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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?
In 2006, BBC flagship news programme Newsnight featured Cuba's Healthcare system as part of a series identifying "the world's best public services". The report noted that "Thanks chiefly to the American economic blockade, but partly also to the web of strange rules and regulations that constrict Cuban life, the economy is in a terrible mess: national income per head is minuscule, and resources are amazingly tight. Healthcare, however, is a top national priority" The report stated that life expectancy and infant mortality rates are pretty much the same as the USA's. Its doctor-to-patient ratios stand comparison to any country in Western Europe. Its annual total health spend per head, however, comes in at $251; just over a tenth of the UK's. The report concluded that the population's admirable health is one of the key reasons why Castro is still in power.
"Kill 'em all and let Root sort 'em out"
I have long thought that having a national health insurance system that anyone can buy into makes a whole lot of sense, especially if you roll in medicare/medicaid and the VA program costs into it. I also wonder how much of a discount doctors would be willing to give if you provide them with free malpractice insurance for accepting patients in the national health insurance program.
I went the emergency room last week. The total bill was $5,000, and I didn't pay a dime because I have awesome (but expensive) health insurance. Anyone can buy health insurance. The only question is: how important is it to you?
I don't want to hear folks complaining about not affording health insurance when they have a 60" LCD on a payment plan, and an $80 AT&T bill every month. They didn't prioritize correctly, and it's their own fault.
For folks who truly can't afford health care, they don't have to pay, already.
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.
Where's my choice not to pay into your system, though? Or, my choice to use treatments not permitted by the government. There is no choice.
I have a friend who told me this week that when she needs to go to the doctor, she goes to the emergency room. I was stunned. She said she did it because she doesn't like to make an appointment and have to wait somewhere. She didn't seem to care about the fact that every time she does this, she's driving up my premiums.
There's this selfishness that seems apparent to me in this regard, a sort of never-ending spiral. People like this don't go to a clinic or make an appointment, those decisions drive up costs for hospitals, drive up premiums for me, rinse, repeat.
What we don't do well in this country is preventative care, which is a shame because if we did, premiums would likely fall as well. Neither candidate really addresses this. This is what I would like to see happen, who can deliver this. Doesn't seem like McCain would promote this as his only approach seems to be a tax credit...which I have always felt is a dodge.
If a candidate can show a plan to provide basic care for all Americans, a reasonable way to promote preventative care and finally classify mental illness as a medical illness, that would be a health plan I can get behind. Unfortunately, with everything else going on, there's not much focus on this issue this year.
I personally don't think our system is "great," but it sure as heck beats paying out of my own paycheck for other people who (more than likely) don't take care of themselves as well as I do.
There's a reason I put time into going to the gym, watching what I eat, taking vitamins and not gorging myself on fast food and ice cream cones. I like being healthy. Unfortunately, if we go to a nationalized system, I am forced to pay for those people whether I like it or not.
That's crap.
And, have you LIVED in Europe? The taxes are through the freaken roof.
Because the NHS is also one of the best healthcare systems in the world. There are maybe five countries in the world that can boast better healthcare, across the board. A lot of places do things better, but not many do so as consistently.
The US is most decidedly not one of the top five. I can't think of ANYTHING it does better than the UK.
Sure, you can see the top specialist in a given field within days in the US. But you can do that in the UK, as well. There's no bar to private service in the UK. In fact, the fact that the vast majority of people still rely on the NHS lightens the load for the private doctors. If you want to pay for health insurance, you can. If you want to ignore health insurance, and directly pay the doctor on the day, you can. And it will be cheaper than in the US to do so, even in this most extreme of cases.
But whatever you decide to do, a pretty large chunk of your salary will go to pay for the NHS. If you object to that, on the basis that you might not use it, or that you don't want to pay to help other people, that's your own bag. But I believe that making sure every single person in the country can be healthy (and yourself as well if you choose) is no sacrifice at all for a less than 10% stake in my pre-tax salary.
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.
Do you really believe we have a private system in the US? It was the complete lack of competition that started with the government-sponsored monopoly of Blue Cross/Blue Shield, which in turn led to the complete distortion of the structure and purpose of insurance and healthcare, that has brought about the current system.
You pay taxes, and part of your taxes go to health. Just like part of it goes to the military. If you don't like that, well maybe you should join us radical left-wing nutbags in a revolution and get rid of all government. (Not all left-wing nutbags want to do that, but I'm an anarchist.)
If you want to use treatments "not permitted by the government", well it depends on what you mean. If the government won't pay for them, but hasn't outlawed them, just pay for them yourself (you want to do that don't you?)
If the government has outlawed the treatment, well the government also outlaws using many recreational drugs, owning heavy artillery, speeding, not wearing a seatbelt in a car, and many other things. I suggest you join my revolution. Because governments outlaw things.
I wank in the shower.
Let me give you an anecdote to help to make your point and show how much of a parasite the insurance companies really are.
I took my grandfather to his general doctor the other day. On the window is a sign, "Pay in full at time of service with cash and get 30% off." So basically if you skip the whole insurance process you get 30% off on the spot at this doctor. Insurance isn't the only problem, but is a big part of why healthcare costs so much.
I dunno where you're from, but America's hat rations their healthcare. Things that are considered elective surgeries sometimes get bumped for years. When you need a knee replacement surgery, it doesn't feel elective to you, I can assure you.
Check out my lame java blog at www.javachopshop.com
Why would you want to opt out of the NHS? Remember the NHS is there for all at any time. So if you are in a traffic accident and have to be rushed to A&E (the emergency room) you will not receive a bill from the ambulance company, you will not have nurses going through your wallet looking for an insurance card before they treat you, you will not get a bill from the hospital because your insurance company didn't "pre approve" your life saving treatment...
Insurance compaines make their money by selling a service they don't intend to deliver, or deliver only part of. Banks make their money by stealing from you in small ammounts from all accounts.
Neither should be in a position to make decisions relating to the health needs of an individual.
I live in a country that has both Govt health care and private. However, the private insurers have no say in what treatment is given that is and should be the decision of the treating doctor.
It always amazes me that in the US accountants are allowed to decide a patients treatment.
I don't know if the government is in the best place to fix the issue either. One of the big problems with health insurance is that people are over insured for stuff like checkups and under insured for catastrophic illnesses.
Here comes the car analogy :p Imagine if you insured all the maintenance on your car for the life of the car. It wouldn't be cheap. Instead we insure for emergencies. Routine visits should be something you just pay for the same way you pay for oil changes in your car. Ideally, this would mean that routine visits get cheaper, but at this point it might be a chicken and the egg problem. Although, I was at the doctor not long ago and he gave 30% discounts to people who paid cash at the time of the visit and didn't use insurance.
The other problem is that the government and insurance companies are already to involved in pricing. When I had knee surgery the first bill came to 20k, then my insurance company went in and did a whole bunch of funny math to where they only paid 8k and I owed 1k. Why did I need insurance to get that price and why was the hospital so apt to lower it?
The whole system is messed up, I just don't feel that getting government even more involved is going fix anything.
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.
They sure do, yet Medicare (a federal organization) already spends the same $ per capita on health care in the US serving only some of the population as the NHS does on serving an entire country!
Americans might be scared of subsidies, yet they're already wasting as much as we do and get very little for it. At least I don't have to pay a single penny if I get injured in a road traffic accident. Sure, I'm paying in taxes, but UK taxes are barely any higher than those in the US except on VAT.
Until very recently health care costs were growing at several times the rate of inflation (inflation has increased a lot) and the US is spending much, much more per capita on health care than other western countries while covering a smaller portion of its population. The uninsured still receive care but they get emergency care and that is a very expensive way to treat most conditions. The cost of that is ultimately passed on to the insured and/or taxpayers so we're currently paying for insuring the rest of the country but at an inflated price and getting poor results now.
There are serious problems with care for the insured. Contracts and billing between hospitals and payors are a terrible mess and administrative costs are a big part of hospital bills with private insurance. Medicare and the medicaids cost a lot less to administer so more of the public health care dollar goes to care than the private counterparts.
I don't think the Canadian or British models would fit America very well but the German system with multiple non-profit payors or the Australian system with national health care and an option for a private premium insurance is something I think we should explore as they tend to keep choice in the equation.
Obama's plan seems like it would be expensive but we're already paying for everyone to get health care now in some form so for the most part this is just shifting money around in an effort to provide better care. I think a lot of the savings with this plan from increased efficiency of care and cutting some of the cost of caring for the uninsured that is currently passed on to the insured is going to be eaten up by the hospital and insurance companies. It doesn't fix problems with private insurance but that's too big of a problem to tackle now.
McCain's plan will cause some employers to drop insurance and make modest increases in cash wages for their workers because it will cost more to insure them and they can just let their employees buy insurance with a tax credit paid by other employers who provide insurance to their workers and some of their fake raise. It creates a competitive disadvantage to offer insurance because you'll be paying more to insure your employees and your competitors while they are probably paying a bit less than they were before. The insurance they'll be able to buy probably won't have group risk built into it so you'll see a lot more medical underwriting so healthy people can get good insurance cheaply and sick people will still have problems getting insurance.
If you didn't come to party don't bother knocking on my door. Prince '1999'
I'm in a Southern Bible belt state and I hear this from Christians??? Isn't one of the messages in the Bible to share? Sadness me.
Check your Bible. Nowhere does it say to "share" someone ELSE'S wealth. That's called "stealing" and is expressly forbidden in the Bible.
The only thing the Bible says about sharing is to share your OWN.
In times of universal deceit, telling the truth gets you modded -1 Troll
OK I'll bite. I'm a Canadian and back in Canada now, but I used to live in California. 5 years ago I had to have two vertebrae in my neck surgically fused together. I was self-employed and had what I thought was a reasonably good PPO (health insurance plan).
It was surgery that took two days from my visit to the doctor to being under the knife. There wasn't a lot of time to go over the fine print of details like who my anaesthesiologist was going to be and whether he was covered by my PPO. I had the surgery, and a month or two later I got a bill for something like $1700 from the anaesthesiologist.
I called the anaesthesiologist's company and they said "your PPO doesn't cover us. Pay up." I called the PPO and they said "It's the hospital's responsibility to choose a care that is covered by your policy. Don't pay this bill." I called the hospital and they said "We told you who the anaesthesiologist was going to be, it's not our problem your PPO won't pay."
This went around and around for months with everybody denying responsibility. It then went into collections, and totally messed up my credit. I finally paid it out of pocket myself but by that time I had a huge black mark on my credit and the cost had ballooned over $2200.
The total bill for the surgery was over $30k so I'm glad that's all I had to pay. Still, it's pretty clear in the end that I was the one who lost out of this. Nobody had any motivation to "be on my side", and that was pretty clear once it came down to the money.
www.clarke.ca
My uncle-in-law was diagnosed with a rare form of cancer about 10 years ago. He was in otherwise excellent health. He had a good job with good, company-provided health insurance. He played by all the rules with his doctors and insurance. Towards the end of his treatment, when he was getting better, his insurance company and employer decided that they'd had enough of him and terminated his employment and coverage. Too high of a risk. He was literally in the hospital recovering from a bone marrow transplant and they just said, "oops, sorry, your insurance isn't covering you anymore. And you're fired." I know, sounds unreal, but it happened. The hospital fought on his behalf but in the end the insurance company refused to pay more than $200,000 worth of bills. He and his family were just stuck with it. They hired a lawyer and fought the ex-employer and the insurance company and eventually got a settlement, but it was for only about half of the money. They ended up selling their meager vacation/planned retirement cabin to get the rest of the money, and now my uncle-in-law is blacklisted from ever getting private insurance because of the lawsuit.
This isn't hyperbole, this isn't fiction, it's absolutely true. And it sounds impossible. Everyone that's ever heard the story says, "That's impossible! They can't do that!" Yes, they can. They did.
And that's why the whole insurance industry needs a complete overhaul. I don't pretend to have any answers as to how to fix the problem. Handing it all over the government may not be a good idea. But insurance companies and hospitals shouldn't have the right to financially assassinate people.
But in the end, we're all going to pay for it, one way or the other. We can either agree that everyone deserves to be covered and pay taxes on it for some sort of national health-care. Or we can continue to go with the current system where only certain people should be insured (conditionally!), and that the poor/unwell/risky can just "deal with it". Fine. But a lot of those under/uninsured are just going to *not* pay that bill. Bankruptcy does not mean that the money just vanishes. It just means that some insurance company or hospital is going to make up that lost money by charging the rest of us more, which is why a Band-Aid in a hospital costs $375.
Huh? I think you need to be smacked. Would you evenly split your grocery bill evenly with someone that eats three times as much as you do? I sure as hell wouldn't.
it will be just like in holland. some hideous diseases are checked and checked and the government throws money at it, then throws some more at it. unless the little letters of the law, a contract which you did not sign, specify otherwise.
take holland again ... got cancer ... they do everything in their power. then you turn 65. then you get nothing anymore. so on that birthday your bill changes. from 0 to 2000 euros per month. oops.
but don't worry. you can file a suit for discrimination, which does stand a chance of success. in the meantime you do have to pay obviously, generally it takes 12 years. the people you're suing however, have the power to change the law ...
Everyone seems to forget why the Canadian health care system is in such a sad state of repair. Long story short, the liberals had to cut tons of spending in order to pay back some of the massive debt inherited from the conservatives. Health care was one of the biggest casualties. Many small communities lost their services. It wasn't a failure of socialized medicine, it was the result of overspending by the PC's and underspending by the Liberals.
Ingredients: Turkey, Mechanically Separated Turkey, Water, Salt, Flavour.
If you can't protect your own back yard from the Soviet Union, Communist China or local gangs, I fail to see why I should care. Let's dissolve the Union and let every man fend for himself.
No, seriously, let's do it. I want to see how all of these whining "Why should I have to care for my neighbour" libertarians do in the Darwinian jungle they apparently want to live in. I wonder how many of them would actually stick to their principles to the bitter end, and what proportion would band together and start rebuilding a Big Brother to keep them safe. Not that could, since it would be outcompeted by the governments built by people who cooperated from the start, but that's besides the point.
Nature is red in tooth and claw and yours are pathetic. A lone wolf can get a meal, but a lone human is the meal. That's why you should care about other people's health.
Forget magic. Any technology distinguishable from divine power is insufficiently advanced.
My wife and I just leased a car this summer, a 2009 Subaru Forester. Having experienced a lot of maintenance problems with the car we were replacing, we decided to pre-pay the maintenance on the Forester for the life of the lease, which is 3 years. It cost us about $1000 for the package that gets us oil changes every 3500 miles (we do a lot of city driving). When it came time for the first oil change, I drove over to the shop at the dealer (conveniently close to where we work), turned it over to them, and waited about 25 minutes for them to change the oil. Then I got in the car and drove off, no co-pay, no nothing.
Over the 45K miles of the lease, we'll probably get the oil changed twelve or thirteen times, which would cost us about $600. But there are several other maintenance items along the way that are covered under the plan, including one that costs about $700. One could argue that we could sneak by without having those maintenance items done, and the car would be just fine. But regular checkups and periodic maintenance help a vehicle run well, and help forestall any major catastrophes that cause big problems at unexpected times. So I'm planning to stay on the maintenance schedule, and I expect to turn a healthy car back into the dealership at the end of the lease.
Would you go to the doctor more if it didn't cost you anything than you do now? Probably. But you wouldn't go all the time for everything (some people would, but they're in the minority), because you have better things to do with your time than go to the doctor. Ultimately, though, you'd probably retire healthier if you had free, accessible health care that was of decent quality.
So, how do we get ourselves there? We need a better system than we have, and it probably doesn't need to (shouldn't) involve insurance companies in the capacity they are now. The other end of it is our knee-jerk reaction to sue doctors for malpractice for every little thing. If an issue is egregious, there should be punishment of some sort, and the patient should be compensated somehow. But millions of dollars for doing a complicated procedure less than perfectly is insane.
How about limiting settlements to the total value of someone's carried life insurance policies? Shouldn't the judicial system put the same value on someone's life as that person puts on their own?
The Spoon
Updated 6/28/2011
While this is a problem of individuals, the repercussions of those individuals actions spills over to the rest of the US citizenship
And THAT is precisely why Government involvement in healthcare is a supremely Bad Idea®.
ANY time someone else is paying your bills, you give that person (or Government) control of part of your life. You have thereby given zir authority to dictate to you what you will be allowed to smoke, what you will be allowed to eat, whether you will be allowed to ride a motorcycle, and an endless stream of other incursions into your personal liberty as the costs of Socialism inevitably spiral ever upward.
You think it will stop with smokers? Think again. Next they'll go after fat people, and suddenly Government will be telling YOU (yes, just like "in Soviet Russia") what you're allowed to eat. Then they'll decide for you that some other aspect of your lifestyle isn't "healthy" and you'll be forced to ride a bike to work in the rain.
Then, a Republican administration will be swept into power and they'll decide that homosexuality is "unhealthy" -- and they'll have to power to deny healthcare to every queer and suspected queer in the country.
Think long and hard before voting to take The Land of the Free down that road.
In times of universal deceit, telling the truth gets you modded -1 Troll
Government programs tend to work well in small groups. For example, Canada has about the same number of people in the whole country that the state of California does by itself. I don't have an issue with universal health care but it'd be better it if were administered by the states with minimal federal involvement. However, none of the current politicians seem to want that.
As an example, do any of our Massachusetts readers have experience with their new Commonwealth Care http://www.mahealthconnector.org/portal/site/connector/? There's about the same number of people in MA as there is in a single province in Canada so it should be a good example.
Hey, i thought it was actually the opposite. We Europeans are getting more americanized. We're getting fatter.
One of my coworkers had a common cold at one point. He called up the NHS, and they scheduled him an appointment - 9 months in the future.
I don't know if you're just mistaken, or making this up, but this makes *no sense* at all.
1/ For a common cold with no complications you should not seek medical care at all - it's a complete waste of time since there is no real treatment apart for letting it run its course and taking over-the-counter pallatives.
2/ If you did seek medical help, you wouldn't 'call the NHS' (?hospital do you mean) - you would see your GP (General Practitioner - local doctor at local surgery) and that *does not* and *never has* taken more than few days for a non-urgent appointment.
If you say it's urgent they will *always* see you the same day.
Most minor ailments (colds etc.) would be treated by the doctor (if treatment is even appropriate) with no further waiting.
Now, let's assume you've left all this out, that this person saw a GP and actually had something apparently more serious which the GP couldn't deal with but which wasn't life threatening (e.g. some sort of cold-like symptoms which just went on and on and didn't respond to the GP's treatment) and was referred to hospital, then your '9 months' might just have been true - 10 years ago or more.
Virtually no-one even with the most trivial ailments waits more than 12 weeks or so now (and I have repeated experience of this perosnally and via friends, colleagues and relatives). In my own case I've been seen in hospital with about 3-4 weeks for a couple of minor problems.
This improvement was achieved by upping the GDP spent on health care from about 6% to about 8%, still well below what the US spends for partial coverage.
The thing that most bothers me about the NHS is that it's a 9% (or is it 11%?) tax right off the top.
These figures look to me like the figures for the tax known as 'National Insurance'.
Some people mistakenly believe this pays directly for the NHS. They may have even told you this. I believe that historically National Insurance was supposed to pay for the NHS *and other benefits* such as pensions, unemployment benefit and sickness benefit.
However, that's not the case now. Effectively NI goes directly into the normal taxation pot. The only distinction between NI and income tax is that your NI contribution record entitles you to certain state benefits. It has no link with the NHS budget as such.
As I stated above, the NHS costs about 8% of GDP; for someone of average earnings it was about 6% of income the last time I calculated it (a couple of years ago) and about 7-8% of my income. It's an absolute bargain.
most higher-income people also had private health insurance so they didn't have to use the NHS hospitals. So they are forced to subsidize a failing system while they're getting better care out of pocket.
Higher income people with private medical care nearly alway use the NHS *as well* and have limited top-up cover. They always use the NHS for emergencies and nearly always for GP services (apart from the *very* richest). Typically they use the private healthcare purely for convenience (pick your own operation time), to save a few weeks wait or to go to a prettier hospital. Because of this, their private healthcare is much cheaper than it would be if the NHS did not exist.
Calling it a 'failing system' is just a joke. People grumble about the NHS a lot, but the support for it goes right across the political spectrum and across the classes. It is one of the most cost-effective health systems in the world. The conservative party (right wing) was in power for 18 years and sold off (privatised) nearly every state-owned industry in the UK. But there was one thing they never dared touch - the NHS.
And the selfishness of "it is ALL my money I don't want to share it" attitude
You need to look a little closer. The attitude is "it is ALL my money I don't want to share it WITHOUT HAVING ANY CONTROL...why the hell did I work for it otherwise."
Strangely enough, the people who claim you are being selfish for not wanting to share your money are the same people who are hoping they will be given a share of it when it's confiscated by the government.
For the record, I've had similar experiences with beggars. I've offered my freshly purchased sub sandwich to a beggar that had a sign that said "Homeless and hungry" - he asked what kind it was and then asked for money instead. Last fall I pulled up next to a guy with a sign that said "Will work for food" and told him I had a bunch of wood that needed to be split and stacked. I told him that I'd pay him $150 per chord. Now, it takes me about 4 hours to split a chord of wood, but I'm not that "physical" a guy - my neighbor can crank out a chord in just over 2 hours. I have other things I'd rather be doing anyway and figured this guy could put in an 7 or 8-hour day and have about $300 bucks. He looked at me like I was mocking him and said "Dude, split your own fucking wood". Well that's what I did. Took me two 6-hour days to do 3.5 chord and I saved myself $375 and got some good exercise in the process. He didn't want to work - he wanted my charity. I'm more than willing to help those who unable to help themselves. I won't help those who are unwilling and lazy.
One time I heard from my church about a family in a nearby neighborhood that had lost everything they owned in a fire. I had an old car that ran well but burned some oil and had some rust spots on it. I signed it over to them and threw in some extra kitchenware that I had. Now, my critics will say that I obviously didn't need the car and that the pots and pans I gave them were "extra" anyway so it was no big sacrifice. They may be right, but the family receiving it didn't see it that way. In fact I had to go out of my way to explain to them that the car and pans were just taking up space anyway just to quell the protestations and promises to pay me back.
This was a hard-working family that was unaccustomed to getting things they hadn't worked for themselves. They were proud people and were embarrassed at their helplessness and reliance on their community. In don't know about their insurance situation and didn't ask but I suspect they were under-insured if insured at all - that's a big problem in our area where many homes were owner-built or passed down to each generation with no mortgages.
I'm willing to help people of my own accord, you can check my other /. posts where I mention similar, on-going support situations which are really no one's business but mine anyway. But I resent the hell out of someone else dictating to me to whom and how much I "must" contribute - especially when the recipients are able, but unwilling to help themselves. An don't you dare call me selfish because I believe that ALL the money I earned is MINE. It's sure as hell is not yours. You didn't earn any of it and are not entitled to it. It's mine to do with as I determine is best. I worked for it and I earned it.
"terrorism" and "pedophilia" are the root passwords to the Constitution
I suggest you join my revolution. Because governments outlaw things.
I don't know...how can I be sure that you won't take away my heavy artillery when we are done?
...set of laws and programs to create this kind of scenario:
Start a federal medical training program, wherein college-age students could sign up for a federally funded medical school that would train NP/PA types... a lot like an Army medic or a lightweight DO. The student would get this training for free BUT would sign a chunk of his life away, much like joining the military. After graduation, he would be obligated to work for something like at least 5 to 8 years in a federally run Doc-in-a-Box clinic, at a fixed govt salary schedule, and be able to treat minor illnesses and injuries just like any typical Doc-in-a-Box. His medical license would not be a full-fledged M.D. or a D.O. but would bear the weight of something between NP/PA and a DO, and since it would be a federal medical license, would trump any state medical practice or medicine prescribing laws.
People could have the choice to get treated for their strep throats, minor broken bones, injuries needing stitches, hemorrhoids, whatever, for FREE at these govt-run clinics or they can choose to pay or use their privately (employer) funded healcare insurance to go to a conventional doctor's office.
The federal employee-docs-in-a-box would, after their "tour of duty" is up, be then be free and eligible to apply their training and experience towards becoming a full-fledged MD or DO in private practice.
The two primary-care healthcare systems (govt and private) would co-exist side by side in the marketplace, if you choose the free service, or cannot afford a private doc, you go to the govt free clinic. If you can afford it, you go see your private doc and pay him.
Of course, this does not address advanced healthcare needs like hospitalization for serious illnesses, etc, but would work great for the bulk of primary healthcare of minor illnesses and injuries.
You probably wouldn't argue with the fact that the vast majority of the users of such a healthcare scheme would be good, honest, deserving folks who are ill and need fixing up.
I wouldn't argue that good, honest, deserving folks who are ill need fixing up. I would argue that they need a federal bureaucrat involved in the process. I would argue that, for the most part, they already have systems in place to attend to themselves. I would argue that the main impediment to them maintaining said systems, is the ridiculous way we have tied our health maintenance programs to our jobs. I would argue that the federal involvement debases community involvement and invites corruption.
As a Christian you should thoroughly endorse a system which does so much to help the needy and those who are worse off than yourself
You sir, do not understand Christianity or charity.
It is not charity for me to take someone else's property and spread it around as I see fit. it is only charity when *I* take of my resources and give to who I see as the needy. Christianity teaches that I must spread my wealth around. *I* must do it. The benefit I receive is a spiritual reward. You may not understand, or even care to understand, the reward that I think I recieve; but, you don't have to. It was my charity to give. I take nothing from you when I give it.
And I must spread the word of Christ as I spread my wealth. That is what we Christians call Christ's Great Commission. If you reject the words I bring, then you reject Christ. I'm free to leave you to your misery and move on. Again, you may not understand, or care to understand, my viewpoint; but, again, it is my charity to give. I take nothing from you, and leave all free to do as they will.
The system that Democrats in general, and Obama in particular, like to support and call charity robs me of the benefits of my charity on one side, and emasculates my commission on the other. It may be the law. You may even call it fair. But it is not charity. It's just paying taxes. It robs me of having any say in determining if the people it goes to are deserving in any way. It forces me to contribute resources, without forcing me to contribute emotional involvement in seeing a proper outcome.
The end result is that you see a destitute on the street and in your mind you say, "Why don't they get on a government program." The people who do receive the government aid have no one to prod them to do better...no one to stand with them as they turn their lives around, become productive and no longer need the aid.
As a Christian, I argue that the government's usurpation of the church's place is a sad abomination. It robs everyone and ultimately helps no one.
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
hmm, if you are in the US(remember US centric website) and you can't feed yourself you should go apply.
I've been there when the bubble burst, It's a good investment in that I was able to use the time I would ahve spent needing to make min. wage just to feed my family to look for a higher paying job. Now the government has gotten more from me then they spent..sounds like a good investment to me.
The Kruger Dunning explains most post on
By that logic, all rights are fundamentally self-contradictory. By providing a right to your own property, you would necessarily deprive all of that right by making them pay (via taxes) for the means of providing that right (laws, police, courts, etc.).
upon the advice of my lawyer, i have no sig at this time
At least you admit to having bias,
*Some* bias? McCain has a "plan." Obama has "promises." McCain comes up with an arbitrary number and it's a good solid number, but Obama comes up with a number and he doubts its accuracy. He's made up his mind about the candidates, and that greatly interferes with his ability to evaluate anything they talk about.
The Feds cover about 1/4 of the people and pay about half of all medical expendatures. It should be the other way around. The government should be able to provide services for less, not more. But the health care industry has broken government care. Most hospitals are non-profit. Nationalize them all and get real collective barganing for services and supplies. Abolish all state laws which make it illegal for non-AMA members to practice medicine. Fund medical schools (many are government owned/run, even if that government isn't federal) to increase output by 50% to 100%. Cap doctor hours at 10 per day, 60 per week (exceptions for proceedures in progress, and mandatory breaks of at least 4 hours between shifts). Eliminate malpractice for honest mistakes (not that it would matter, as winning a claim for it would result in more treatment, which would be free anyway). Work on developing inexpensive diagnostics (one of the reason that medical expenses are so high is we test 100 times for everything to make sure nothing is missed that will be sued over later). Triage. Not just emergency, but life quality. Someone that's 80 having trouble seeing? Back of the line for a corneal transplant. Treat those that are expected to recover fully with highest priority.
There are two reasons the US has high costs, one, we test for everything all the time. Two, we go to heroic measures to save everyone, even those that don't want to be saved or can't be saved. A little more fatalism, a few less tests, no more malpractice, and the cost the government is already paying on medical care will cover 100% of the population, not just the 25% now.
Learn to love Alaska
Agreed. Those opposed to universal health care point out that "a government bureaucrat will not care about your health". But since when does a corporate bureaucrat care about one's health?
I don't want my medical claims subject to the approval of people who get paid bonuses for keeping costs down.
Adherence to the truth is a form of disloyalty.
Start a federal medical training program, wherein college-age students could sign up for a federally funded medical school that would train NP/PA types... a lot like an Army medic or a lightweight DO. The student would get this training for free BUT would sign a chunk of his life away, much like joining the military. After graduation, he would be obligated to work for something like at least 5 to 8 years in a federally run Doc-in-a-Box clinic
At least the veterans' hospital in Fort Wayne, Indiana, already does this for some medical technician positions. The student gets a loan, which the VA repays in full after the technician has worked x years for the VA.
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.
This is really the key making the system work. In a totally "free" and unregulated insurance market with today's giant companies (where, as it has been noted, payouts to customers are an expense that the companies attempt to reduce) the customer will tend to continue getting less and less for his/her dollar as each company is beholden to investors rather than customers.
The clearest solution to this is an "anchored free market". As you describe, there is a government run, nationalized competitor in the market--an elephant in the room that influences the decisions of the other companies. This helps to prevent broad price-fixing and corner-cutting by the fully private companies as the government's anchor keeps the health economy from drifting far from some set of determined standards.
Private companies are free to provide the services they desire at the costs they set, but if they continue to raise costs and cut services, customers will simply drift away from them to the anchor.
For an example of this, look at the USPS. I agree that it is not exactly in the best shape at the moment, but look what it has historically done for the light-shipping industry: The USOS has provided a low-cost, low-service option to customers and 'anchored' the industry, while still allowing private industries such as FedEx and UPS to thrive and grow as full competitors.
>> Standing on head makes smile of frown, but rest of face also upside down.
What you do NOT have a right to do is take your Bill, hand it to your neighbors, and force them to pay the bill. That's theft.
It's public good. A sick member of the community is a net drain on it. If you get sick, you're not just dropped out in the middle of the woods, you get cared for, you get medical care even if you don't have insurance. If you can't pay for it personally, they can't reposess that work, it gets paid for by the community AND you.
Even if you don't go to the hospital, your neighbors and family do take care of you, which is a drain on a smaller part of the community, but is still making others pay for your health. Plus there's the net effect on the economy of you not coming into work or failing at your other responsibilites because you were sick.
The point I'm trying to make is that with healthcare, it's ALWAYS the community supporting you. Whether you're paying through an insurance company which screws the patients over and keeps the change, or whether you pay directly to the government and deal with the inefficiencies there, you can't be self-sufficient completely.
Nor should you be. The lexus is a choice. If you can't pay for it, you don't get to keep it. Getting sick is not, you can't choose to get sick or not based on your finances.
So there's no choice, and everyone pays for it anyway. Your black and white picture of healthcare as being the same as buying a car is completely immature.
I just had a titanium disc put it my back. They said this was 'elective surgery'.
So, either I could live my days in agonizing, excruciating pain until I put a bullet in my head, or 'elect' to have back surgery.
Interestingly, the surgery that fixed me had been done in Europe 15 years before the FDA allowed US doctors to perform it.
I am. Price controls are a term more general than price caps. And, yes, I think it is a fantastic government program. Since there is an oligopoly of four between farmers and consumers, the fact that farm output prices plummitted after '96 didn't result in a huge benefit to the consumer. And now there are fewer family farms.
In addition, I think that security of food, water, electricity and healthcare are too important to trust to the vagrities of the free market. Possibly telecommunications as well (or at least heavily regulated... yay net neutrality.)
I'll avoid quoting your next spiel. Suffice it to say that I could afford better healthcare. I could, but it should be cheaper. Examine the cost structure. Or, to put it another way, let me buy into Medicare now. Oh, and I don't blow money on any of the crap you assume I do.
You then make a bunch of claims, without any evidence, that government sponsored healthcare would be inferior. Please demonstrate how?
Evidence seems to indicate that supply-side economics and deregulation fail miserably (look at Wall St.)
ANd I have nothing against the superrich, I just think they owe a debt to society.
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