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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.
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.
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.
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'
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
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
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