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US House Democrats Unveil a Health Care Plan
gollum123 sends in this piece from a political blog in the NY Times. Here is the text of the bill in question (PDF). "House Democrats on Friday answered President Obama's call for a sweeping overhaul of the health care system by putting forward [an] 852-page draft bill that would require all Americans to obtain health insurance, force employers to provide benefits or help pay for them, and create a new public insurance program to compete with private insurers — a move that Republicans will bitterly oppose. ... But the chairmen said they still did not know how much the plan would cost, even as they pledged to pay for it by cutting Medicare spending and imposing new, unspecified taxes. The three chairmen described their bill as a starting point in a weeks-long legislative endeavor that they said would dominate Congress for the summer and ultimately involve the full panorama of stakeholders in the health care industry, which accounts for about one-sixth of the nation's economy. ... House Republicans, who have had no involvement in the development of the health legislation so far, quickly denounced the Democrats' proposal as a thinly disguised plan for an eventual government takeover of the health care system. ... The House Democrats' plan is one of three distinct efforts underway on Capitol Hill to draft the health overhaul legislation. In the Senate, both the Finance Committee and the health committee have separate bills in the works, and in recent days those efforts seem to have stumbled."
"But the chairmen said they still did not know how much the plan would cost..."
I'm not sure the politicians care how much it's going to cost since it's not their money.
Slashdot formatting (TM)
Will this bill stop the pre existing condition BS? Let you buy any plan that you want? UN tie it from your job?
How about having a Bankruptcy that is just for Health stuff and does not show up on any back round check?
Not let people ask about you medial history before offering your a job?
Make it so you can not be dropped by a insurance provider.
but we're in a deep recession here and now isn't the most appropriate time to start spending billions.
Actually, during a recession is the best time for the government to increase spending. The government is the only employer/buyer/spender that can afford to run counter to economic cycles. It has the ability to lessen the boom and bust cycle of the economy by running counter to it. IF the government followed the cycle of the rest of the market, then it would make booms worse and it wake make busts worse.
It seems obvious from this look into the early stage of a house bill that 'democrats' and 'republicans' are acting as either side of a polar debate, one proposing knowing it's plan leans far too far one way, confident that the other side will try as hard as possible the other way, reaching a stalemate.
it's kinda like the game my brother and I would play as children splitting a piece of cake , one cuts - the other chooses.
Of course, what happens when there is more then two ways to look at a problem, i don't know.
CS majors know the time/space tradeoff, but they never get taught the 3rd, crucial, tradeoff of the set: comprehension!
Is that the House Democrats are essentially following the blueprint for Healthcare provided by Republican Mitt Romney in Massachussetts. So far, the Massachusetts model has pretty much worked, in that, they did reduce the number of uninsured significantly. However, costs for the state provided side of the plan have come in way more than anyone either promised or expected. Quite frankly, the expansion of the health insurance pool did not increase the economies of scale and drive down costs for everyone. Now everyone just has procedures that they cannot afford done.
The other irony is that Obama's said to be considering the McCain plan's idea of taxing health care benefits and requiring employers to purchase it.
This is my sig.
Canada has "socialized medicine" and they spend 10% of their GDP funding it. The USA has a tangled hodgepodge of insurance companies that deny valid claims, overpay their CEOs, and refuse any coverage of any pre-existing conditions, and they spend 15% of their GDP funding it, while also bankrupting countless families without enough insurance. Great Britain has the National Health Service, and they spend 7.5% of GDP funding it.
Tell me how the US can't do better than Canada and England. No really, how could we suck badly enough to be worse than Canada at national health care?
Just another "DOJ fascist authoritarian totalitarian bootlicker" -- Zeio
I suspect congress will look at all the examples of socialized medicine around the world and end up picking the worst elements from each of them.
I ain't registering for a goddamn thing
.
In the glorious and free country of the United States a citizen's decision to register for government-mandated healthcare is absolutely and completely voluntary.
Being forced to pay for those that do register, however, is another story.
Seriously. I can't understand why anyone would expect a decent economic discussion on a semi-technical website full of wild-eyed conspiracy theorists, Ron Paul anti-government Libertarians, and other zealots who interpret forceful opinion as actual fact.
Economics IS a difficult subject to understand, let alone interpret correctly. Even professional economists who do nothing but study the economy often get things wrong. Yet, everyone talks about the economy as if they are the expert and they actually know what's going on, even if they've had zero education on the subject.
"If you think health care is expensive now, just wait until it's free."
Well, that sounds good, and it will be modded way up because it strokes politically oh-so-fashionable sentiments around here. But there are plenty of countries where people pay way less for government-provided health care because there is less bureaucracy than there is here in the U.S. Of course, I'll be modded -1, Anti-'Mur'kin! for pointing that out.
The question you have to ask yourself is, do you think access to health care is a right or do you think that it is just another commodity to be bought and sold. If you say health care is a right then you have to be willing to pay for everyone to have it, it will be expensive, very expensive. If you think it's a commodity then you need to admit that poor people don't deserve to see doctors, or deserve a substantially lower quality of care from understaffed and overwhelmed free clinics.
I happen to think health care is something society needs to provide to everyone equally. I know where the money can come from without raising taxes too. I have my eye set on the bloated defense budget. Cut the military fully in half (by dollars spent) and we'd still have the best armed forces in the world for DEFENSE of the nation and we'd have the money to take care of every sick and injured man woman and child.
There are other things we can do to reduce costs as well such as approve the use of drugs that are already available in Europe and Canada and have been proven safe, and reform the liability insurance system.
which is private providers who are paid by the Canadian government out of a health tax. If the United States had a single payer system we could save $350 billion a year. It would be a huge boost for small companies.
Legend! http://www.snopes.com/college/exam/socialism.asp
The problem with Margaret Thatcher is that she is always wrong.
Contrary to the popular belief, there indeed is no God.
Because under a socialist government everyone gets paid the exact same averaged dollar amount per year regardless of what job they do and how good/efficient they are at it right? No one is advocating that kind of system, not even the real socialists nutcases.
What you described is not socialism or socialist policy and it's intellectually dishonest to call it so.
If you build it, nerds will come. Soylentnews.org
Yeah, spending all the money you decry, spent in the 12 YEARS of Bush, being spent in the first three MONTHS under the current administration is however enlightened and useful.
You *really* need to get caught up.
If the congress and the PolitBureau really wanted to pay for hospital services, they would pay the "going rate" of hospitals. Instead, they pay $36 for a $500 procedure, causing hospitals to charge $8 for aspirin. Congress is WHY the system is broken, not the cure.
The plan is to crush as many industries as possible with legislation, then arrive as if uninvolved and claim "Capitalism did this!" and "We need more regulation!
Then, the Fed, despite the strict outlines in the Constitution, controls everything in exactly the same way as Communist governments. (Where life universally SUCKS.)
This is a means to secure control. Banking, Mortgages, Car manufacturing, everything but Hollywood is getting a "bailout" and then finding themselves so bound to do the WRONG thing, they don't want it. It's instead a "BUY OUT".
These are the end-times for the America of freedom. And in the next world war, there will be no one to save France, Belgium, Luxemburg, and all the other countries we've saved twice in the last two.
The problem with Republicans is that they're not Conservative; McCain and Obama had nothing on which to disagree- both loved the idea of central control, sweeping the Constition under the rug, and consolidating power.
Sorry, but this is where we stand. Thank the media, on our way to hell.
--- For a good time mail uce@ftc.gov
Anti-government I am. Not an economist by far. But even a fucking moron can see this tripe is designed with the insurance companies profits in mind. Screw the BS. Go ahead and kick the private insurance companies to the side and make it truly government supplied health care. Single ayer with no private companies taking a cut from the pie. There will be waste and corruption no matter what, but leaving private companies involved will double waste, corruption and cost at the bare minimum.
I am a 45 year old Canadian and no one has EVER told what doctor I may/may not see.
It has never been mentioned or hinted at by any of the doctors I have seen or by any government bureauocrat.
I call B.S. on your claim.
If anyone had any questions why the US health care 'system' continues to be a complete joke compared to the rest of the Western World just read this single post from this fucked in the head wacko.
Miserable little fucks screaming about people getting a free ride while wasting their own 'precious' money on more than 50 percent extra on health care costs in the US compared to every other modern aka 'Socialized' health care system.
Democracy's fatal flaw. Too many people are just fucking stupid like jstork.
We see what you are doing here. Government provision of services, by definition, is the exact opposite of free market competition. When you take money from people by force and give it to others, that is NOT competition. Please stop saying that it is.
Um....in Massachusetts, on your state income tax return, they ask whether you are enrolled in either the state program or private insurance. If the answer is no, then your taxes go up by the cost of the state program and you are enrolled. No choice---unless you want to perjure yourself, of course.
First, it appears to requires universal coverage. This is good. I remember a long time ago when universal coverage was not the norm for automobiles. All these irresponsible people would drive around, damage other peoples property, and then not pay. What was more they often continued to damage other peoples property with little consequence. This meant that those who were responsible had to pay higher premiums. Now everyone has to have proof of financial responsibility. One consequence of this is that I can get coverage against the irresponsible motorist for very little money. The benefit of health care should be similar. No more irresponsible people going to the hospital without health insurance. This should mean that those of us who actually pay for medical treatment, instead of expecting others to cover the bills,
Second, there will be a public option. Auto insurance in many states has the same option. Most of us do not use the public option. Most of us still pay private firms to carry our insurance. The public option is used by those those who cannot or chooses not to afford private insurance. Sure this public option costs money, but not nearly as much as having some irresponsible asshole crash into your house in his SUV, then discovering he has no insurance or assets because all his or her income went to pay the note of the truck. Every uninsured person costs us money. The public option will insure that hospitals and doctors get some money for every patient, so they do not have to gouge the rest of us.
Third, and this is what I hope, that they reform payments and set standards for care. For instance, it make no sense to pay 80% of a standard cost for a procedure, when in most cases doctors charge double the standard costs. Pay 100% of the standard cost, and don't worry about co-pays. The co-pay is built in with real and opportunity costs. Likewise, set minimum standard for diagnostics. Hospitals are spending money on proton accelerators rather than prene care. We can live without proton accelerators and other machines that go beep. What we need is care.
And this is what I think many people are afraid of. That medicine is going to go back to giving care, rather than huge returns on investments for the HMO or funding for lavish and extravagant building and equipment that rich people can then put their name on because they paid half. Or, as mentioned, we might be concerned that in the US we have a higher infant mortality rate than Cuba or Hungary, the worst in the developed world.
"She's a scientist and a lesbian. She's not going to let it slide." Orphan Black
Healthcare currently is costing America approximately 15% of GDP and getting poor results. A well-implemented national plan could bring that down into line with the other developed democracies of the world such as Germany and the U.K., or about 10% (your numbers may vary depending on calculation method, etc, and may be somewhat lower, but let's go with 10% for a rough estimate). This saves 5% of the current US economy that can be put to productive uses instead of pointless quality-of-life-diminishing health insurance bureaucracy. This also means many of the paper-pushers currently drawing down salaries denying people coverage will have to go do productive work instead, further improving the economic situation. Further, US companies will no longer be at a competitive disadvantage with their foreign competitors, who do not have to shell out for their workers' health coverage.
So, yes, fixing health care is a plausible means to repair the economy. It is entirely possible to fix two interrelated problems at once. Whether it is an economic issue is not really in question, given the size of the healthcare industry in the US. You might dispute the efficacy of a national healthcare plan, but it'll still have an economic impact one way or another, and President Obama has made it clear in previous statements that he believes that fixing the U.S. health system will have beneficial economic effects.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
I've been paying for my own medical insurance out of my own pocket since I was 23, now 36. A few months ago, my automatically deducted premiums jumped from $290ish to $530ish a month. Why?
Because Medicare sent my HMO (Group Health) a message indicating that I was on Medicare, and so they automatically combined the billing, without notifying me. I'm not even on Medicare! I may get a refund in Mid-August... meanwhile, I'm scraping by, because I saved some money for emergencies... having this happen during my regular period of unemployment (MSFT contractor 'break') makes it extra painful.
Make healthcare more affordable, so more people will choose to have it. NOT mandatory, involving buerocrats that'll screw it up even worse. Offer tax incentives, etc to businesses to cover their employees, don't cram it as another effective mandatory tax.
Any time an unpopular social program is established, the government tries to sell it under "special" tax provisions, e.g. only those that enroll have to pay.
Once the issue is mostly forgotten, the program inevitably merges with general government spending and starts drawing money from the general tax pool (e.g. your and my tax dollars).
This ALWAYS is going to happen for a simple reason: if everyone who wanted to enroll in the program could afford to pay for it, there would not be a need for a program in the first place. The sole reason for it to exist is to get those who don't use it to pay for those that do (that is the concept of welfare).
NEVER vote for a program on the basis of it having "special" tax provisions such as pay-as-you-enroll. If you are not willing to accept a government program under the understanding that it will be paid for with general tax dollar's, don't vote for it at all, since that is inevitably what is going to happen after a while.
So either this took place in another developed country, where national health care kept costs down, or it took place in a developing country, where costs are lower due to lower wages and costs of living? This fails to prove the claim that high quality of life + low bureacracy = cheap healthcare, only that a tradeoff between the three is possible.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
Canada and England do not have our malpractice litigation mentality, which raises costs as doctors practice "defensive medicine". Neither has the high costs of introducing new medications associated with our FDA, which results in the same pills being substantially cheaper in Canada than in the US. Both offer lower quality service, with rationing, and less access to innovative procedures. The problem with a state run insurance plan is that that the state has never made anything more efficient. Ever. It's really astounding to me that people continually propose government takeovers of things.
The way to reduce health care costs is to find waste in the system and eliminate them through process improvement. Everything else is a shell game.
If the goal is truly to do some good for the country, then the place to start is the FDA. They need to seriously rethink their views on health and nutrition and what should be allowed in the foods sold in the U.S. There are nations with a fraction of the health issues (per capita) of the U.S. and they also have better policies regarding the contents of food. The corn syrup has GOT to go for starters and they should take with it all of the aspartame and any of the dozens of other things that do not belong in our food. And let's not get into farming, dairy and livestock practices or we'd go on for days. Monsanto has GOT to go. Hormones and antibiotics on "healthy animals" have also got to go.
There is so much wrong going on in with U.S. food system that it just makes me sick... it makes us all sick. Get rid of that stuff and we will see a LOT less need for healthcare and a lot less obesity.
It's a huge pity, really. We in the US are far better at being anti- or pro- state than we are at being anti- or pro- free market.
Thus, we get grotesque situations where, in order to avoid charges of "socialism" government functions are essentially "laundered" through private sector intermediaries that take their big fat cut and, all too often, deliver seriously subpar results. We would be much better off if we abandoned that charade and, instead, let the state attend to state functions, the private sector attend to private sector functions, and avoided the incestuous interrelations of the two.
It's so much more complicated than that. It's a debate where two sides can argue opposite points, and both be absolutely correct. Here is an article that addresses one side of it:
Short answer: there's no easy fix. Medical costs are rising for several reasons:
* Rising costs and quality of medical care (30 years ago there were no MRIs, hip replacements).
* Corrupt doctors, ordering tests because they are profitable (read the article, it goes into great detail on that point)
* Corrupt insurance agencies (sometimes charging 30% overhead)
* Incompetent government (a point which you outlined)
* Clueless patients wanting every possible test (I can't blame them for this, it's not like we have medical degrees) and not taking care of themselves (Safeway for example managed to reduce health insurance costs by 40% or so by encouraging their employees to take care of themselves)
* Oh yes, and how can any such list be incomplete without including pharmaceutical companies and medical lobbies? Many problems there.
I'm sure I'm missing some. The good news is with all these problems, there is lots of room for improvement. The bad news is that these problems exist, and the path to fixing them isn't entirely clear. I am not sure that I favor this bill, but I think it is good we are having a debate about it. We should have had this debate 10, 20, or 40 years ago.
Qxe4
The point of insurance is to keep people healthy. If society can't provide that with the current system, it has to decrease the (now exorbitant) prices until people, taken as a whole, can pay for it. Insurance is merely an intermediate in this process -- if it can't operate with a profit, make it a nonprofit
The point of insurance is to provide a way for people to manage the financial risk of catastrophic health care costs. It is up to you to keep you healthy.
I think the larger point is that health care is so expensive that we cannot afford to pay for it ourselves, and that, if an insurance company cannot operate profitably, it means probably that health care is too expensive for society as a whole. With health care costs climbing by 10% a year, it stands to reason that even if you completely wiped out private insurance, in a scant few years, those profits would be replaced by tax increases or additional borrowing as costs continued to climb.
The only sensible way to approach health care is to understand that we have created cures and treatments that we cannot afford, and the only way to have health care for everyone is to not have those treatments. That way, everyone could afford to actually pay for their own health care.
This is my sig.
Then he sent all of them this note: "A socialistic government will also ultimately fail - because when the reward is great, the effort to succeed is great, but when government takes all the reward away, no one will try or want to succeed."
Actually, the real lesson is that a socialist government will fail when you let a tinpot dictator practice collective punishment to advance his own political agenda as happened in the USSR under Stalin but didn't happen in Sweden under a democratic government. This is really more of a fable about college professors pushing an agenda and punishing students' grades when they disagree.
If it's for-profit but free, you're not the customer -- you're the product (e.g., the Slashdot Beta's "audience").
Except that national health care is highly unlikely to be unpopular. In countries that have national health care, again such as Britain and Germany, the national health care program is enormously popular. This is part of why the Republicans are fighting the idea so hard; they know that, much like Social Security, once a large national program is established to provide for everyone something that they want (cheaper health care), it will be impossible to kill again later.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
RS
Shoes for Industry. Shoes for the Dead.
Let's require that whatever bill they propose, that all of the US government, especially congress & house, have to operate under that bill for one year before it can be forced on the rest of us. Whatever plan they currently have is gone. They are not allowed to work outside of their proposed system. They have to use only what their bill contains, and the funding has to come as a deduction (tax) out of their salaries. The money used to provide their health care services must come from whatever they paid in, and if (when) it runs out, nobody gets any more services until more funding is available. Also, any government employee who goes outside the system must declare it on some specified national forum, so we can know about its deficiencies before it takes effect on the rest of us.
This will show us if it is a viable plan, and that it is has enough money coming in so that extra funding is not hidden in additional taxes. Let's see how they like their own plan before we're forced into another stupid plan.
Who would win this election: Andrew Weiner vs Andrew Weiner's weiner.
There are two sides:
1. The entire modern world that has low cost universal health care
2. The Democrats and Republicans on the other side with Republicans off in 'teh free market' la-la land and Democrats too fearful of the 'Insurance' company lobbying/campaign contribution dollars to propose any real long term solution
Except for the bit about not providing it to some people, or providing less of it. When the HMO demands that the doctor not spend the needed time with each patient, but shuttle them in and out as fast as possible - they're rationing the amount of care that doctor is allowed to provide, so that he can provide more people with less care.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
And if you can't afford it, you can take yourself a medical vacation to a country where you can. The important thing is that, here, we don't ration our healthcare.
Because if you can't afford healthcare, taking a flight to foreign country and taking days or weeks off your job is obviously within your means! (And I'll bet this is a *great* solution for getting preventative care too!)
Oh, crazy right wingers... One wonders if you ever even talked to someone who is a member of the working poor.
If it's for-profit but free, you're not the customer -- you're the product (e.g., the Slashdot Beta's "audience").
And also in the Wall Street Journal, here is an article about Mr. Burd, of Safeway, going to Washington to lobby regarding how the market can rein in costs:
The World Wide Web is dying. Soon, we shall have only the Internet.
In the US, doctors also make money based on conducting tests. You have a cough? Well, your HMO covers X-rays, so you get an X-ray, even if you don't need one, because we can get the HMO to pay for that! There was a recent article on this topic, in fact, regarding a town in Texas with one of the highest per-capita health care rates in the country. Not because they had more expensive equipment or doctors or were more accident-prone or malpractice-prone; the doctors had just found the most efficient way to make money off of the HMOs was to run plausible-sounding but unneeded tests.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
The problem with a state run insurance plan is that that the state has never made anything more efficient. Ever.
Yeah! Retirement savings were so much more efficient before Social Security! Sure, it meant lots of old people ended up begging on the streets, but those people didn't have any money by then, so they didn't count against the efficiency!
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
Also, bear in mind that the readership of this site is heavily skewed towards males age 18-34 with a college education (or attending college now). These people will have proportionately far fewer medical issues than the population at large, esp. the poor and elderly. Many here probably take no medication at all (except perhaps recreational), and haven't been inside a hospital for years. So from their perspective, what good is government-guaranteed health care? But the perspective may change as they grow older, raise a family, and have possibly ailing parents to look after, with all the visissitudes that come along the way.
Singapore uses medical savings accounts and spends less than 5% of GDP. http://econlog.econlib.org/archives/2008/01/singapores_heal.html
"I don't think it's selfish, to eat defenseless shellfish." -NOFX
They get government jobs denying or delaying medical procedures they deem unnecessary or low priority.
What you really need to have is a health care center that works more like the DMV does in Delaware. Basically, everyone goes in and gets a ticket. There are separate lines for separate things. you might have some nurse look at you and determine if you are obviously dying, and have a special line for that. Then, you have a line for people with colds and coughs and stuff, and so forth. You wouldn't need to schedule an appointment, everyone could walk in, just, if you walked in for a stupid reason, you would wait a long, long time.
This is my sig.
well. there is one thing in economics that is rather clear. profit.
if ANY private organisation is involved in your healthcare you will pay (a lot) more than in actually costs. hospitals, insurance, medicines. you'll pay (a lot) extra to make the shareholders happy.
see. it isn't that hard to understand.
Privacy is terrorism.
Bad news: your 15% figure is out of date. We're now spending 17% of our GDP on health care, and if the trend of the 2000s continues, we'll be at 30% by 2020.
Unfortunately, the Republicans will oppose any type of health care legislation, because the truth is that they don't think anything's wrong. Most won't admit it, or will make the wholly unsubstantiated claim that malpractice insurance is the only thing wrong with our system. This is despite the fact that all estimates put tort at least than 0.5% of our health spending. Of course, while the effects of 'defensive medicine' are tougher to estimate, there's fortunately empirical proof showing that it makes no difference. Texas has the strictest malpractice tort limits in the country (you can get at most $250k, even in cases of gross negligence causing permanent disability or death), causing malpractice claims to plummet, yet their health spending increases have continued to outpace the rest of the country in the six years since it was passed. So much, in fact, that Texas now spends more than any other state for decidedly mediocre results. Essentially, it's a microcosm of the U.S. as a whole.
There was a great article in the New Yorker a few weeks ago wherein a reporter visited McAllen, Texas, home of the largest health care spending in the world. What he found was a perfect example of what we see across the country: when doctors treat their practice as a revenue generator, costs go way up, and quality actually suffers. The doctors think that they're doing their best for their patients, but they subconsciously make more referrals when it brings in money. It's long, but it's definitely worth the read.
Except that national health care is highly unlikely to be unpopular. In countries that have national health care, again such as Britain and Germany, the national health care program is enormously popular. This is part of why the Republicans are fighting the idea so hard; they know that, much like Social Security, once a large national program is established to provide for everyone something that they want (cheaper health care), it will be impossible to kill again later.
Wait? People like Social Security? That pit my employer and I throw money into every month? You realize in the United States there is a huge industry to actually save for retirement because we have no illusion that social security works right? If I could opt out tomorrow I'd be waiting in the queue before dawn. 15% from me, 15% from my employer and 100% worthless.
And yet, despite the right-wing horror stories (with their purely anecdotal basis), Canada's national healthcare system remains extremely popular, with Canadians expressing high levels of satisfaction with the care they're getting. See? Only about 90% of Canadians express satisfaction with their system! There has to be something wrong with it!
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
I live in the UK and despite cleaning my teeth obsessively one developed a cavity that has been growing for years and the tooth is now rotting to hell. Unfortunately like a lost of people I can't get on the books of an NHS dentist so I'm glad we're spending 7.5% of our GDP on a load of beurocrats and absolutely no health care. I'm sure all the thousands of people dieing from desises caused by filthy NHS wards are equally glad it's costing just 7.5% of the GDP.
Before claiming how grat the NHS is why don't you try living here. What you'll find is the NHS is broken beyond repair and is no matter how much money gets thrown into it things don't improve.
The reason pills are cheaper in countries with socialized healthcare systems is that that the power is in the hands of the very large single buyer. If a pharma wants to sell a drug in significant numbers in Britain they have to negotiate an acceptable price with the NHS. If the NHS doesn't buy, then they'll sell very few of the pills in Britain.
In America, there are countless buyers. Thus a single buyer has little price negotiation leverage.
That's easy. Health company profits are the elephantine waste in the system. The idea of charging "what the market will bear" rather than the lowest possible.
It's astounding to me that right wing Americans object to the governent taking over healthcare on cost grounds when ALL the evidence from other countries is that no one else pays as much for their healthcare than Americans do currently. You HAVE the most expensive system already, you have nothing to fear on cost grounds from learning lessons from the rest of the world.
Define "better". According to a recent Lancet Oncology study (http://www.telegraph.co.uk/news/uknews/1560849/UK-cancer-survival-rate-lowest-in-Europe.html) for males the average cancer survival rate in the UK is 44.8%. Compare to 66.3% in the USA for the same period. The US has the highest cancer survival rates in the world, and by a pretty large margin. That has to be worth something in your metrics of "better". I do not go to the doctor for social justice, I go to the doctor to get medical problems, say cancer and cardiovascular disease, fixed. The US is tops for fixing medical problems even if the system surrounding that medicine is a wreck.
Discard all the policy issues and ask yourself one simple question: what country will give me the best average statistical odds of having my condition cured/fixed? The US looks very, very good by that metric, and the reason people go to the doctor is to get cures. The medical system may be a wreck, but that is a semi-separate issue and I would be reluctant to throw away stellar medical outcomes as the price for cleaning up a broken system.
One of the more interesting statistical anomalies is that if it was not for the extremely high death rates due to accidents (e.g. vehicular) and homicides, Americans would have the longest lifespans in the industrialized world instead of average ones (better medical outcomes offset high non-disease death rates). As is amusingly observed in health outcome statistics, the only demographic group that lives longer than Japanese women are Japanese women that live in the US. It is a relevant observation in this discussion, many people here are far too eager to throw out the baby with the bathwater.
It's a huge pity, really. We in the US are far better at being anti- or pro- state than we are at being anti- or pro- free market.
Thus, we get grotesque situations where, in order to avoid charges of "socialism"...
Most US Americans seem to have no clue at all about what socialism or for that matter communism actually is. Every time they start throwing those words around on Fox News, accusing their various political opponents of being "socialists", it makes me laugh.
Only to idiots, are orders laws.
-- Henning von Tresckow
Canada has a completely-free universal national healthcare system.
It is also a country where...
The average life expectancy is two years longer than in America.
http://www.geoffreylandis.com
Ron Paul has a lot of good points. He was the only 'no' vote this week on a Congressional resolution slamming Iran for its voter fraud issue - and while denouncing the fraud seems like a good idea, it really hurts the anti-theocratic movement by letting the mullahs scream that the reformists are American stooges. But economics is not one of his good points. 'Unmanaged' economies are, at best, like the Gilded Age in the US, and at worst like Somalia. The boom-and-bust cycle of the Gilded Age was catastrophic for large percentages of the American population; toning it down via regulation and trust-busting was a major breakthrough in the development of the American economy.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
Would we be better off "without expensive treatments" then "with expensive treatments that only the rich people can afford"? Is society better off with certain people less healthy? I realize that some people love to hate "the rich", but this is Slashdot. A lot of people here are highly paid computer nerds who worked their rear ends off making their money. Would depriving us (them) of higher-quality health care really render the world a better place?
The World Wide Web is dying. Soon, we shall have only the Internet.
Wrong. When German Railways (Deutsche Bahn) was still state owned, the trains were always on time, there were many more connections, the fares were lower and easier to understand and the trains and tracks were better in shape.
Now Deutsche Bahn is a private company. Trains run notoriously late (often because the trains are damaged or the tracks are in the sore need of repair), many connections are inoperative, the prices soar.
I never have seen a high speed train being evacuated in the middle of nowhere because of some motor damage in the early nineties. I had to live through it twice last year.
"It's such a fine line between stupid and clever" -- David St. Hubbins, Spinal Tap
And as a way to redistribute money, insurance is pretty lousy. If insurance was a tax, it would be a very regressive tax and burden those with lower income a lot more than those with higher incomes.
The World Wide Web is dying. Soon, we shall have only the Internet.
Here are the real differences between a single payer public health care provider plan and the hodgepodge private health care/insurance system we have now:
1) under a public plan, your health care is decided by a government bureaucrat sitting in a government office. While in a private system, you health care is decided by corporate bureaucrat sitting in a corporate office.
2) under a government plan you, or your employer would send hundreds of dollars in tax money each month to the health a agency to cover care. Under private plans, you or your employer must send hundreds of dollars each month to insurance companies each month to get coverage.
3) Under a government plan you a guaranteed coverage. You are not under private plans.
4) Under a government plans you are essentially covered for life. Under private plans you are limited in the number of claims you can make.
5) From what I have seen, government plans overseas control costs by focusing on preventative care and reward doctors who get patients to quit smoking and lose weight for example. Insurance companies in the us drop patients and increase deductibles.
6) Under a government plan, you and your doctor would have to fill out government paperwork to get benefits paid. Under the private system, each insurance company has it's own form to fill out which requires staff, meaning non-medical overhead, to proper fill out and file the forms in the proper manner.
There, those are are the real differences.
Basically, there are some problems the private sector is poorly equipped to solve. Medical care is one of them. Medical care is less of a free market choice and should be thought of more as an essential public utility. Market forces do not work very well do to the complexity of medical care and the urgency of catastrophic cases making comparison shopping impossible.
putting the 'B' in LGBTQ+
Both offer lower quality service, with rationing, and less access to innovative procedures. The problem with a state run insurance plan is that that the state has never made anything more efficient.
Bullshit. We have lower life expectancy than they do in Canada, England, France, Germany, Spain, Italy, Japan, Australia and virtually any other first world nation you care to name. We have higher infant mortality than any of those nations. And yet, we're paying twice as much.
Governments all over the world are taking much better care of their citizens than we are, and are doing it for less money. Do you really believe that we can't do the same? Do you really think that we're just worse than them?
This is the kind of right-wing idiocy that has left the Republican party in its current state. Democratic areas do have more access to abortion clinics as it stands now, and yet the demographics that associate with Democrats are growing faster than the demographics that associate with Republicans. Democrats, far from sobbing and calling it 'genocide,' actively seek to expand access to these clinics on the basis that government should not be intervening in a woman's personal medical decisions. The vast majority of pregnancies that become naturally viable are not terminated; most abortions are for cases where the fetus would not survive for one reason or another (including that the mother might not survive delivery). Most of the rest are because the prospective parent is not ready or able to provide a stable family life, but many do go on later in life to have a child when they are better able to provide for one with a decent quality of life. Republicans have a stupid idea that Democrats 'want' to have abortions. Democrats want to make it an option for people who, for whatever reason, need one.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
You don't seem to understand the word "mandated".
FanFictionRecs.net
If you really think most people, conservative or otherwise, actually hate people who are poor, you've been completely brainwashed.
It's the liberal equivilent of calling everyone who disagrees with you unpatriotic.
FanFictionRecs.net
Oh, I'm sorry. I just had poll results saying Canadians were happy with their care. You have unsupported anecdotes. Clearly I should accept your premise, Anonymous.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
I think the fear is more that, like Social Security, they don't trust that it isn't going to completely fuck us later BECAUSE we can't kill the program.
FanFictionRecs.net
Let's test the hypothesis that Social Security is popular. You would expect, therefore, that when the President of the United States proposes making adjustments to it, this would be loudly and vigorously denounced. Lo and behold, this is what happened. Yes, Social Security is very popular in the US, and only small minorities (yes, including many Libertarians) want to do away with it.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
Although, you do bring up an interesting point...
Why should you be required to support the life of someone who openly hates your culture and is trying to get rid of it? Should a Jewish person be required to pay taxes and provide health care for someone who is a member of a Neo-Nazi organization? Should a black man be required to pay health insurance for someone who is a member of the Klan? Should a member of PETA be required to pay health insurance for a hunter of baby seals? You open up quite a can of worms, indeed, when you make health care a public issue.
Yes to all of those! That that is even a question to you makes me want to put you into the self-absorbed douche-bag category.
I don't know about you, but I actually subscribe to the American ideals of letting everyone else do what they want as long as its not illegal. It's not a can of worms; it's an American ideal to be able to do what you want in America and still reap all the benefits of being in America. I actually do support other people's rights and the inherent right in America to not have them infringed by someone else trying weasel out of their civic duty to pay their part for keeping this country great just because they don't like someone.
Sheesh!!!
Right, we have forty-seven million healthy, middle-aged, rich people who are the ones not getting insurance. Working poor who, for example, don't take their kids to see the doctor until they've gotten seriously, seriously ill and in need of expensive publicly-paid treatment when cheap preventative care would have nipped the issue in the bud if they could afford it... why, they just don't want health care!
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
If it is so popular there should be no need to mandate participation, right? People will just opt in because they love it so much.
Public healthcare, while seemingly free (most people do pay for it in the end) but I'm not sure such a lawsuit friendly country can handle being told you have to wait months for treatment or that you can't have a certain treatment because it's not cost effective.
People just assume that free healthcare means everything stays the same except it's free. That's not true.
Granted, the healthcare I receive in the UK isn't bad. My local doctor definitely has room for improvement but my previous doctor was perfect. I just hope I don't have to deal with cancer in the UK. Despite probably being in one of the better areas as far as the whole post code lottery ordeal goes, it's always a concern I'll be told "tough luck, we're low on cash".
When I was in the US, despite not being jobless, the hospital and state government (PA) was actually quite helpful and I only had to pay a tiny fraction of what it would have cost. Even for someone in a transitional job, which was low paying, it was quite easy to pay off. Certainly better than the $20,000+ I would have had to pay if I didn't seek help from the state and hospital.
My case might be slightly biased since I was in a decent area of the state and the hospital doesn't deal with a load of poor people begging for free care but even with free healthcare, being in a poorer area of the UK can mean not getting a treatment someone else would get in a better off area.
I just hope people realise that neither system is perfect and going to free healthcare will not solve everyone's problems.
The 0.5% figure already includes* the cost of malpractice insurance: as you noted, the actual malpractice damages are even less. Besides, as I already pointed out, Texas has practically eliminated malpractice suits with their bogus tort laws, and yet their costs are climbing faster than anyone's. I'm just speculating, but I wonder if the Texas tort law hasn't created a perverse incentive. Namely, the doctors that are moving there to take advantage of the malpractice situation are the ones more concerned about money than patients; i.e., the type of doctor driving the cost of care up. At the same time, a doctor could accidentally cut off your genitals in Texas, for which you could get at most $250k. (Yes, this just happened to someone, though luckily not in Texas.)
* Anderson, Gerard F., Peter S. Hussey, Bianca K. Frogner, and Hugh R. Waters. "Health Spending In The United States And The Rest Of The Industrialized World." Health Aff 24, no. 4 (July 1, 2005): 903-914.
There's also many who cannot get it at any cost due to various maladies - yet make too much for current government (state or federal) insurance. My mother and sister are both in this boat.
It's unpopular among the younger people who can see that there likely be nothing left in the system by the time it's their turn, but among older people it is extremely popular.
The 55+ year old portion of the population is what has primarily stopped social security reform. They happen to be a very large voting block, and it is hard to get past them. The people in this block either are currently drawing social security or will be drawing it soon, so they certainly don't want to remove it. Also, people in this category tend to be more active voters than other categories, so even politicians who may otherwise be amiable to removing or revamping Social Security won't dare touch the subject.
It's a self perpetuating problem; more people are drawing social security than can be supported by the younger workforce. These people rely on it, and so will adamantly fight anything that jeopardizes that income (imagine if the government tried to slash your paycheck, and how adamantly you'd fight that, it's the same from their perspective). Combine them with idealogues who can't see past their ideology to see that the system is unsustainable and WILL crash at some point in the near future, and you've got a voting base that is nigh unsurmountable.
The fact is, there are more people who are pro Social Security, at least more people who vote anyway, than there are anti Social Security. This is pretty much the definition of Popular.
What we need is a welfare reform that fixes the problem without harming the people who currently rely on the system, or those who are currently expecting to be able to use those funds in the near future.
I believe it is doable, but a plan hasn't so far been presented in a way that it reassures the people at the highest risk.
Security is mostly a superstition... Avoiding danger is no safer in the long run than outright exposure. - Helen Keller
I disagree only partially here. If you kick out private insurance entirely then you get some of the horror stories Canada grapples with. Instead leave the private insurance industry legally able to operate... then compete against them with the Government. If the Government can do it cheaper and more efficiently then the private insurers will either all go out of business until the government gets bloated and slows down or (more likely) they'll all cut their massive profit margins and start actually operating efficiently.
I am not in favor of this bill of any further government regulation of health care but your statement is factually incorrect. A substantial portion of those 47 mil CANNOT get health insurance at any price, due to previous medical history. If you are not covered by a group plan (such as self employed, unemployed but not dead broke or over 60 or under whatever, and do not have a spouse or somebody to cover you) good luck getting private coverage. Even minor problems such as acid reflux are enough to make you not profitable enough for insurance companies to insure.
Negative moral value of force outweighs the positive value of good intentions.
The problem with the US health system is that there is no negative feedback of any sort to control costs. Places like Massachusetts actually made it worse because the state has become the policeman for the insurance industry. I have heard comparisons of health insurance and car insurance. A car is optional. Health is only optional if you are dead.
Another point people are confusing is health *care* and health insurance. They are completely different beasts (even though they overlap a bit).
I believe most people (in congress) who preach free markets have no idea that a free market system should have some negative feedback somewhere in the loop. The few proposals which have cost controls will not make it anywhere (sigh).
It has nothing to do with 'hating' dimwit. It has to do with The Great Chain of Being. Still very much believed in to this very day by the right wing.
http://en.wikipedia.org/wiki/Great_Chain_of_Being
'Socialized' medicine is a direct assault on The Great Chain of Being. It means nothing that other countries have universal coverage with massively cheaper costs and better care. Flattening the hierarchy so that those at the very bottom have the same access to quality health care as those on the top is a direct assault on The Great Chain of Being.
Clueless patients wanting every possible test
Not to mention:
Doctors who are forced to order every possible test because if they skip one and fail to detect a 1-in-10,000,000 condition, they're subject to a $20,000,000 lawsuit and the end of their career.
Dewey, what part of this looks like authorities should be involved?
I read a bunch of slashdot comments, and the only logical conclusion i can find is that all healthcare systems suck and don't work for shit. I wonder if this means we need a completely new healthcare model. Or slashdotters just like to argue. Either way.
You are comparing a single data point...
USA has great cancer research facilities, like National Cancer Institute. Which sponsors trials of about two-thirds of all approved drugs. Oh, and it is funded by the government, not private industry.
As someone who knows many doctors, I will tell you flat out that if that figure includes malpractice insurance it's either a flat out lie, or product of ridiculously bad methodology.
Or maybe you shouldn't rely on the anecdotal testimony of a small group of people who make up only one part of the sizable cost structure of the whole health care system? Even if there was something wrong with the study (which you only stated, but did not demonstrate), how do you attribute the negative correlation between malpractice caps and health spending?
One wonders if you ever even talked to someone who is a member of the working poor.
Talked to - quite likely. Listened to - ...
I'd rather you rationally disagree than irrationally agree.
One has to wonder if Canada benefits disproportionally because the research for their healthcare (Drugs, methods, etc) is primarily bankrolled by the companies in the United States.
"I disagree only partially here. If you kick out private insurance entirely then you get some of the horror stories Canada grapples with. "
Oh please. I don't know what you've heard but it's probably on the order of the things we hear about the states, that is, if you walk any street at night you'll be mugged there.
I've in the states for a decade and the rest in Canada. There simply is no comparison. It's overpriced lunacy down there, the embarrasment of the world.
I'm sure you can find people that feel hard done by by the Canadian system. And for each of those there are a plethora of problems with the American system. It's so bad poeple makes movies about it.
Last year in the US the health sector spent $3.4 Billion lobbying, the only sector that spent more was the finance sector. That's 5X than defense lobbyists. They don't want to kill the gooose that lays the golden eggs.
Cite: http://www.opensecrets.org/lobby/top.php?indexType=c
Need Mercedes parts ?
But you only liked to an article *about* the poll, not the actual poll itself, which reveals:
So .. the statistics you have quoted are, for the most part, almost totally irrelevant to a discussion of a healthcare industry.
I would also rate every family doctor I have ever had good, and one as 'excellent'. However, I would not rate the hospital care I receive the same way. I can usually afford the doctor bill, I can never afford the hospital bill.
I rarely read replies, it's my opinion and if you thought about your opinion a little more, I'm OK with that.
If schools are so popular, there should be no need to mandate participation, right? People will just opt in because they love it so much.
People will tend to do the default thing. Schools are mandatory so that people will send their kids and not incur the social cost of uneducated, low-value workers later in life. Social Security is mandatory so that people will defer those monies and not incur the social cost of homeless, impoverished elderly. Old poor people were a major social problem in the early 20th century. Social Security dramatically changed the face of old age for millions, and was made mandatory because the costs of those who chose to risk not saving up were higher than the benefits of those for whom the risk paid off.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
Which works well, and is thus the target of right-wing wackos bullshit-filled attacks such as this one:
Bullshit. Every procedure that is urgent is performed as fast as possible. The wait may be longer than in the US, but that’s because we do not discriminate in favour of the rich, everyone is on the same footing up here.
Bullshit again. Life-threatening conditions are treated right away. This is why the morons who come to the emergency room with a headache have to wait 15 hours: they pass the urgent cases before them.
More bullshit again. The prescription is given right away, and the pharmacist takes care of the coverage.
That troll does not clearly understands how a doctor works. And in the US, the doctors have to take as much cases as possible, thus making it much more likelier that they’ll only spend 2 minutes per patient.
This is called CIVILIZATION, as opposed to the barbarity that is so common in the US.
I posted something similar to this below, but to put it mildly, your assertion that malpractice litigation/insurance and "defensive medicine" are driving up costs simply isn't supported by the data. All the best estimates for the actual litigation and insurance put it at about 0.5% of our total costs.* As for defensive medicine, while that is undoubtedly more difficult to quantify, 22 states have some form of malpractice cap, so we can see how well medical costs and quality correlate to those caps. Unfortunately, while the numbers of doctors in those state varies in a statistically significant way, neither the quality nor the costs do. In fact, Texas spends more money than any other state, despite their ridiculously strict $250k caps. (You could literally be wrongly castrated by a doctor in Texas and get no more than $250k.) Even worse, their costs are going up faster than any other state.
* Anderson, Gerard F., Peter S. Hussey, Bianca K. Frogner, and Hugh R. Waters. "Health Spending In The United States And The Rest Of The Industrialized World." Health Aff 24, no. 4 (July 1, 2005): 903-914.
It's astounding to me that right wing Americans object to the governent taking over healthcare on cost grounds when ALL the evidence from other countries is that no one else pays as much for their healthcare than Americans do currently.
That's because right-wing Americans don't care about the American people as much as they care about American corporations.
If 25% of those who can afford to pay do not, it dumps their costs and a higher portion of the costs of those who cannot pay onto me. Why? Because in the end, you're going to get the care either way.
Your freedoms do not include the freedoms to burden others.
The only debate then, is over denying all care to those who do not pay their own way. As a society, we have long since decided that isn't acceptable. Show up at an emergency room, and you'll get care. It will be the most expensive, least long term successful kind of care, but it will be care.
Unless you plan to argue that this should also be stopped, my only response is quit whining and pay your part.
Oh -- and PLEASE don't give me the "nobody helped me, I'm a self made...." like of crap. We live in a society where it is POSSIBLE to be successful only as a result of the sacrifice of all those who came before and all those around you sharing in the building of such a society. Taxes are how you pay for the upkeep of that environment in which you excelled. Consider it greens fees.
The problem with quotes on the internet, is that nobody bothers to check their veracity. -- Abraham Lincoln
As opposed to whom? The actuaries at the insurance companies and HMO's?!? Not sure about you but I'd rather have government indifference than corporate greed deciding
There are 4 boxes to use in the defense of liberty: soap, ballot, jury, ammo. Use in that order. Starting now.
Roads - should be privatized ($x/mile driven)
Water supply - should be privatized ($x/gallon taken into the house)
Sewage treatment - should be privatized ($x/gallon taken out of the house)
Police - should be privatized ($x/call to 911 etc)
Fire department - should be privatized ($x upfront to have your fire put out, but the neighbors can chip in so their houses won't be next)
Army - should be privatized (don't want that North Korean missile landing in your backyard? I hope you have the money to pay for it)
Schools - should be privatized ($x/day of school, and of course for missing school, turning in homework, missing homework etc)
Power (including lease of the lines that feed your house) - should be privatized
Street lighting - should be privatized (why not charge neighborhoods for the privilege of light?)
Garbage collection - should be privatized ($x/lbs of garbage, extra charges if you don't sort everything perfectly)
Ambulance - should be privatized (got mugged, wallet and ID stolen, head smashed in? Too bad - if you don't have the cash or picture ID to show that you're covered, the EMTs won't help you)
I wonder what other publicly provided services I left out.
The GP seems to be suggesting a system like that in the UK (See: NHS, National Health Service, www.nhs.uk). The government directly pays for hospitals, doctors, nurses, and everything else (I think the NHS is the world's largest employer).
Private healthcare exists, but to get people to pay for it companies have to add a lot of value to compete with "free" NHS care. Things like luxurious hospitals (they're like 5* hotels), promises of shorter waiting times and easier access to specialists. About 8% of people in England have health insurance (and they won't necessarily use it -- for something minor people might choose to use the NHS, and in an emergency there's only the NHS, no private hospitals do emergency treatment).
I think this is a much better system than requiring people to buy insurance from a company.
This is what is wrong with private insurers. When everyone is insured by the one and only private State insurer, there cannot be pre-existing condition bullshit, because everyone pitches-into the system and everyone is covered the same. This, in turn, saves tremenduous amounts of paperwork and overhead, because anyone is clearly covered exactly like anyone else.
The US private health insurance overhead is 35%, while the canadian public health insurance overhead is 5%.
Rather than looking at a single disease statistic I think it is more instructive to look at overall average life expectancy. I let the numbers do the talking.
dont talk if you havent actually encountered the costs of your healthcare system yourself idiot.
one of my clients had to go see a doctor because of some pain in his back, and it took $500 for the doctor to tell him that 'he had something'. it turned out later that it was a kidney infection.
so, you get minor surgery for $1000. in which united states and in what alternate dimension ?
Read radical news here
and your medieval healthcare system practically KILLS poor by neglect, or treatment that arrives somehow too late ?
Read radical news here
How do you express dislike for the only thing you know? Its like saying to dial up customers in the '90s if they were satisfied with 56K downloads. Being as they didn't know anything else they would say sure. Today would be a different story because people have had more speed and would be appalled to go back to dial-up. Another thing is, other than protecting citizens from force and fraud what else have governments been able to do successfully? Not much. This is true for all governments throughout history.
Taxation is legalized theft, no more, no less.
...that actually sounds worse than the post-privatisation British railway system. Impressive!
A lot of the finest "government waste and corruption" stories are actually the stories of private contractors. This does suggest that the government either can't spec projects for shit, or can't keep contractors on task for shit; but it tells one little about the efficiency of direct government operation.
Stop repeatedly using his full name, as if you want to rub in how foreign it sounds. It makes YOU sound like the xenophobe. Why didn't you use Hillary Clinton's full name?
Nowhere near 95%.
Do you even lift?
These aren't the 'roids you're looking for.
Now ... repeat after me ... correlation does not equal causation.
I don't believe I said it did. However, if you're going to complain about how awful Canada's national health plan is, you had better deal with the fact that, awful health plan or no, they live two years longer than Americans do. That "rotten" health plan, which costs on the average about half what Americans pay for health care, doesn't seem to be producing worse results.
http://www.geoffreylandis.com
Wrong. Insurance helps to distribute high cost, low probability risks among a group. On average, each insurance customer is paying for themselves.
Slashdot, insightful? Really? I need to stop reading the comments.
The US has the highest cancer survival rates in the world, and by a pretty large margin. That has to be worth something in your metrics of "better".
Well, duh! That's where the money is.
The overwhelming majority of health care expense in the USA is in the last 6 months of life, often after there is little question that no matter what is done, the patient is gonna die. Patients are typically guided into increasingly expensive treatments without any meaningful discussion about the quality of life of those final few months. It is not as bad as all the doctors consulting with each other over how to wring a few dollars more out extending Joe Smoker's life another 3 weeks. But it is much closer to that extreme than telling Joe "Hey you don't have much longer, and in 3 months your going to feel really bad no matter what we do, so now is your last good opportunity to take that Summer-long fishing vacation you've been promising yourself the last thirty years. When you get back, we'll see what we can do to make the last few weeks as comfortable as we can."
No, USA health professionals don't know how to have that conversation with a patient as a general rule. The general attitude is that it is much better for the patient to keep him hopeful that this treatment or the next can keep him going for a good long time. That this is also more lucrative for the doctors and the health care institutions is purely a side effect (according to the doctors and the health care institutions, and they do say we should trust them about this kind of thing).
Will
Something else that is popular in Canada is wait insurance. People are signing up by the truck load and most Canadian insurance providers offer wait coverage. In case you don't know what that is, it's where they guarantee the wait for procedures will be under a certain time or they take you to another country if necessary and have the procedure done there.
And yes, this was brought before Canada's high court because Quebec attempted to enforce it's no private insurance laws and the court said it was a fundamental human right to have the coverage because the lack of it would endanger the lives of the people it serves.
Don't sit there and sugar coat government health car as if nothing is ever wrong with it and everyone is satisfied with it's results. Obviously enough people aren't otherwise there wouldn't be a need for wait insurance and there wouldn't be a market so profitable in it that they took it all the way to the highest court in Canada or that every other insurance provider has a plan that covers wait times.
Part of the rationale behind Social Security is that people are too stupid to voluntarily put away their money.
The number of bankruptcies and foreclosures that took place over the past year should be sufficient to confirm this.
I don't like paying for irresponsible people any more than you do. However, the societal cost of widespread poverty would be far greater than the cost of the social security tax. Once again, the current economic kerfuffle is a perfect example of how the irresponsible decisions of a few have lead to the suffering of a great many.
-- If you try to fail and succeed, which have you done? - Uli's moose
The infant mortality statistics are skewed for various reasons. They have to do with what we report as a "live birth" vs. what other nations report.
For example, in Canada, a premature baby that is delivered, and then dies, that weighs less than a half a kilogram is not counted against the live birth count.
There is also the matter of timing. In Hong Kong and Japan, a baby that dies in the first 24 hours of life is not counted against the live births. They consider it a miscarriage. In France, Belgium, and many other European countries, babies born before 26 weeks of gestation, and then die, are not counted as deaths.
In Switzerland, a baby that perishes that is also less than 30 cm in length is not counted.
Needless to say (for the illustration of my point), the U.S. does count these as live births, and the deaths in such cases count toward the relatively higher infant mortality rate. In the types of cases above, the chances of infant survival are sketchy at best. Thus, the disparity in infant mortality rates.
Dark Reflection
It doesn't need to have 'nothing ever wrong with it.' What it needs is to have a distinct improvement over the alternative. The argument is that the set of problems inherent in a national health care system is preferable to the set of problems inherent in the current mess. If a public/private mix works best, great, go with that. But rejecting the premise that a national plan could be better due to ideological rejection of government programs is no way to make policy.
Long? What do you mean the signature at the bottom of every comment I post on Slashdot is too lo
Drawing the line is indeed tricky. If you're just tuning in, political theorists have been having this discussion since the mid-1800s, while the rest of the world has been pretty much content to sit by and ignore it.
Go read up on John Stuart Mill. He started formulating his ideas around the same time as Marx and Engels, in response to the same socioeconomic crises of the era. However, his core theory of government would be considered libertarian (and surprisingly relevant) by modern ideals:
The sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of any of their number, is self-protection. That the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not sufficient warrant. He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because, in the opinion of others, to do so would be wise, or even right...The only part of the conduct of anyone, for which he is amenable to society, is that which concerns others. In the part which merely concerns him, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign.â
In my experience, this model tends to be popular with both modern conservatives and liberals. It doesn't place any explicit limits of the size of the government, but, rather places a more fundamental restriction on a government's purpose or function. In that regard, it actually allows for certain socialist ideals to exist alongside a relatively restricted government.
Healthcare often isn't an individual problem, but rather a societal one. If the state can provide a system of healthcare that serves the vast majority of the population better and more efficiently than a privatized system, the government reserves every right to implement such a system.
-- If you try to fail and succeed, which have you done? - Uli's moose
It's not that conservatives hate the poor, but, rather that they strive for a society with a rigid class structure.
Effectively, this works out to be a very bad deal for the poor, leaving them in a situation that is literally hopeless.
Also, what about the mayors (usually republican) who round up the homeless, put them on buses, and offload them in other counties?
-- If you try to fail and succeed, which have you done? - Uli's moose
Let me be clear: there hasn't been a *good* president since Regan. And there's no argument that Carter was anything but inept and worthless as a president. Especially since I was there; I remember it. We liked Bush I thinking he'd be a continuation; he wasn't. Bush II was even less. Voting for McCain required an act of discipline.
The underlying, unalterable fact is that we're so far in debt we're about to collapse, and Obama, in continuation of a Democrat plan (they were first to be seduced) they want to put in a few trillion for Healthcare.
We don't need it. No one (statistically speaking) gets turned away. And as soon as we can't borrow any more, we'll be inventing new "Depression Songs" because no one will be able to power our computers or boom boxes anymore: collapse is that way. And the only people to survive will be those with tons of power now, and government jobs.
Government never has to cut back. Never has to sacrifice; it's been that way too long.
They work for us; they're working for themselves just now, both Democrat and Republican. And surprise of surprises, it's the Conservatives that want to keep the Constitution rather than shred it. Surprise of surprises, the gunman at the holocaust memorial shooting was on Obama's side, not the Conservative side.
We've all been duped. Most on the Left, but many on the right. It's time to do something about it.
--- For a good time mail uce@ftc.gov
Why should you be required to support the life of someone who openly hates your culture and is trying to get rid of it? Should a Jewish person be required to pay taxes and provide health care for someone who is a member of a Neo-Nazi organization? Should a black man be required to pay health insurance for someone who is a member of the Klan? Should a member of PETA be required to pay health insurance for a hunter of baby seals? You open up quite a can of worms, indeed, when you make health care a public issue.
Seriously? Of course they should. You might as well ask, "Why have free speech? Why have freedom of religion? Why not incarcerate people who dissent from the government?" We live in a democracy, and part of the price of freedom is having to put up with people who disagree with you.
I mean, the Republicans are in the minority now. Do you support having the Democratic-led government deny them life-protecting services, or are you just in favor of bloody civil/holy war where each side tries to kill or forcibly convert the other? The questions you ask as if they "open up a can of worms" are incredibly bloody and short-sighted and frankly say terrible things about your commitment to the American way of life.
But here's the thing, if health care is so important, why can't people pay for it themselves?
Probably because we have to pay for food & shelter first and because protection from sickness is something that's "around the corner" instead of an ever-present need. There are a lot of people who can't afford healthcare who can still survive, but that doesn't mean that our society should tolerate that anymore than it should tolerate undernourished or uneducated children (which is why we have public schools and school lunch programs).
Do you not see the problem that we actually have? We have health care that is beyond the ability of anyone to afford it, and so foolishly people look at insurers as if they can magically make it affordable. They can't, and replacing them with government won't make it affordable either.
Actually, it can, and it does in other countries who spend far less of their GDP on healthcare and manage to have equal or better life expectancy rates. I don't think this current proposal will do that. A public-private hybrid gains all the bureaucratic inefficiency of a public system's closed market with all the profit-seeking greed of a private system. But a single-payer system has been proven in other countries. It's not merely a hypothetical.
If it's for-profit but free, you're not the customer -- you're the product (e.g., the Slashdot Beta's "audience").
I would agree, that your body is inviolate so long as you pay for its upkeep, but once you start waving the cup around for someone else's dough to take care of you, the placer of the coin in the cup has more say than you.
In other words, you only believe that people have the rights their money can buy and that once someone pays a dime to help you, that they own you. You might as well not have a right to an attorney if you're poor by that logic.
Frankly, I find this worldview abhorrent because it denies that people have any rights at all -- only that which they have the might to take for themselves. I can't think of any more anti-democratic notion than that right there.
Quite honestly, the thing that is causing abortions more than anything else is free trade and its attendant destruction of the middle class.
Actually, I'd argue that refusing to teach kids about condoms is probably causing more abortions than any other policy decision in America today.
If it's for-profit but free, you're not the customer -- you're the product (e.g., the Slashdot Beta's "audience").
Are you two douchebags sitting in red leather recliners with many a leather bound book at your backs, dressed in red smoking jackets with pipes in your mouths? If not, you should be - it would add nearly 1% to your pointless pomposity.
Well, no!
And I mean that with all due respect. The problem is that people are holding these other countries up as models as if they are flawless. The very real fact is that they all have their own unique problems that most of us find them just as unacceptable as our own current problems. Some of the problems are inherent in a government running health care instead of regulating it. Most people who are against government health car are so because the US federal government has no constitutional authority to provide medical coverage, it's stretching some authority to regulate it as it is. You can blow that off as a ideological reason but it's a pretty important reason.
This bill here is riddled with problems too. First, it sets a standard lower then current policies provide and mandates that anything extra must be billed and charged separate from it's mandate levels of coverage. Second, it kills any preventative treatments that cost over 5k a year for an individual and 10k a year for family coverage. You can be stuck paying for anything over that. It limits treatments to accepted treatments which mean that drug trials and experimental procedures and off label uses are forbidden and will have to be paid for out of your own pocket. Suppose you have cancer and there is a treatment already in use for genital warts that seems to work well on your cancer in fact, so far it had cured 9 out of 10 patients, you will have to pay out of your pocket for this less expensive treatment or suffer the kemo and so on until the treatment kills you or works. Those are just the few problems I saw before my eyes started hurting from reading the mess. The bill offers less of a quality of care/coverage then current medicaid and medicare program offers and it intends to replace that coverage. This part alone should be enough to raise some fucking flags but you want to tilt at windmills shouting idiolect injustice.
The bottom line is that the bill doesn't need to be complicated nor does it need to reduce the quality of coverage or care for people already with insurance. All they need to do is create a law that very plainly says, If you offer insurance across a state line then you need to offer a plan that has X coverage for with no lifetime max or disqualifications that can't have more then a 20% copay for procedures under $5000 or 10% copay for procedures over $5000 but less then $10,000 and not more then %5 copay for anything over that. Then make the premiums 10% or less of anyone's monthly income (household income for family coverage) for anyone making more less then the median area income and allow citizens to deduct the expenses from their income for tax purposes. You could even allow the insurance company to track any losses over this extra coverage and deduct them from their taxes owed to the government. As for mandating coverage, wait until someone needs medical treatment who is not insured and make them take this minimum coverage out for a minimum of five years from their last use of the insurance for retroactive coverage.
There you have emergency medial coverage for anyone who wants it, those who truly can't afford it will be covered by an existing medicare or medicaid program, and someone who decides to take the risk isn't left hanging but will have to commit when they become a burden. Policies that offer more coverage are covered, and a minimum standard is set.
The food quality nor life style is particular different in Canada.
The problem with a state run insurance plan is that that the state has never made anything more efficient. Ever.
Except perhaps the fire department, post office and schools. In the last two cases, we have private and semi-private solutions competing against state based solutions, which seems to work well enough. I guess that means that one solution doesn't fit all situations.
On another note, it costs 11x as much to treat a broken leg in the USA than in Canada, purely from a billing perspective. Clearly the private insurance companies don't have sufficient incentives to keep prices low - perhaps because of a conflict of interest. So it seems that once again laissez-faire economics can introduce inefficiencies.
I'm 100% pro free-market, contingent upon when it works better. The history of public and private institutions shows that private institutions work better most of the time, but not all of the time. I thus support public schools, fire departments, police, libraries and health care. It's not perfect world.
Like all pain, suffering is a signal that something isn't right
Insurance (of any kind) is an exchange where you pay a higher average (i.e. expected value) in exchange for a smaller variability in the outcome (statistical variance or standard deviation).
For example, suppose that each year one out of ten people one will incur a $10000 medical expense while the others incur no expense. The average cost is $1000, but there is a wide variability ($0-$10000).
Now suppose an insurance company charges $1100. If you take the insurance your average costs would be $100 higher. However, you have also eliminated variability. You no longer have to worry about being surprised by a $10000 bill. Instead you know exactly how much you will have to pay each year.
For things that have only a small amount of variability (e.g. utilities), insurance does not make sense. However, for things (e.g. house burning down) where there is a small but very real chance (e.g. 1 in 10000) of a very high cost (e.g. $100,000), insurance decreases the risk of financial ruin in case you happen to be the unlucky 1 in 10000.
Of course that would necessitate the typical US citizen learning how to be responsible, like we used to be a few decades ago.
no, that would require the average American to become an active consumer of health care -- something most of us simply aren't qualified for. (Quote POTUS: "We just do what you tell us to.")
The economics should align with the descion making power. I pay a set amount to a doctor or medical practice of my choice, and then they have responsibility for my health care. If it's $500 cheaper for me to have one procedure over the other, the doctor gets a goodly amount of that. (All, ideally. I already paid for it when I paid for his overall service.) Doctors would then buy insurance to cover extraordinary cases.
What is their diet and exercise habit? Where is your study that compares the same economic-socio groups.
I prefer the "u" in honour as it seems to be missing these days.
You had me until this bombshell: Healthcare often isn't an individual problem, but rather a societal one.
How do you reconcile a statement like that with the quote above? Apart from special cases, such as epidemics, I don't see how on earth can you justify interfering with the individual's liberty (i.e forcing us to pay for the healthcare of others, forcing us to take part in the government's system instead of setting up a different one or opting out altogether etc)? If I am sick, how is that your problem, and what right do I have to force you to pay for my doctor's bills so that I can get well?
Negative moral value of force outweighs the positive value of good intentions.
This is only true for management-position and high-level jobs. Most middle class folks use NHS, and while there are problems with some NHS hospitals, in general the health care system is working there. Where it has failed is in dental care, and indeed that is a widely-sought employment benefit; when I lived in England, I traveled to Hungary, of all places, for my dental care.
I do a lot of government contract work, and in my opinion the main thing driving costs is that budgets and project objectives are not cost driven. For example, we analyze all our samples on a 24-hour turn around rather than a standard turn around in order to get the results sooner because they want the projects to be completed rapidly. Once one phase is completed, they sit on the project for a couple months while they decide what to do. It costs 50% more to expedite the samples, but it would only add one or two months to a year long project at most.
Another good example is doing things out of order. If you're going to build a school, it makes sense to remove all the buildings before you do the environmental remediation. However, if they feel the budget may be time-sensitive (as in it will go away if they don't spend it right away) they will go-ahead and start the remediation before the demolition is complete, effectively doubling the price do the added difficulty. The worst part is that they expect you to eat some of the excess costs even thought you told them it would cost more.
In any case, the government essentially contracts everything, so of course any example of government waste will include a contractor.
Social Security also normalizes risk across the whole population. A system that relies totally on individuals to save and invest would have a certain percentage of people ending up with no or negative return on their investment and some who overwhelmingly exceed the average (and don't think it's because everyone at the top "deserves" it - there's an element of randomness in markets). SS trims both tails off the curve -- preventing complete devastation on the left side at the expense of the fortunate ones on the right side. For those Masters of the Universe who feel slighted because you think you should be on the right side of the curve, I wouldn't worry about it. Fire up your E*Trade account make up for it with your investing superiority.
Progressive's [sic] simply don't understand economics...
The fact is a free-market economy is the ONLY type of economy on the planet that actually works.
Your ignorance is showing. Hereis a nice starting point for you. Start with
then move on to current examples such as
These are still free markets. The difference is who controls the means of production - the people who actually make shit, or others.
I think the larger point is that health care is so expensive that we cannot afford to pay for it ourselves, and that, if an insurance company cannot operate profitably, it means probably that health care is too expensive for society as a whole.
I think it's possible that just as rising home prices were driven by rising practice of purchasing on credit, medical care costs may be getting more expensive in no small part because insurance makes them that way. It means that it's possible to charge costs higher than a market without it would bear.
Not that health care is much of a "market" really. It's darn near impossible to find out how much anything beyond an office visit and very simple procedures even cost, much less make comparisons and estimates of quality of service. I'm not sure if this is again a function of insurance, or if it's that the demand for care greatly outstrips supply, but it doesn't seem health care providers actually compete for patients.
Tweet, tweet.
I am a 45 year old Canadian and no one has EVER told what doctor I may/may not see.
It has never been mentioned or hinted at by any of the doctors I have seen or by any government bureauocrat.
Perhaps true, but completely irrelevant. Yours is not a statement about the quality of the Canadian health care system. Relevant questions would be: What is the average length of wait for any given medical treatment, how many patients die each year while on waiting lists for treatment, and how many patients are denied life-saving medical procedure or medication because those have been rationed out of the Canadian system?
Ceci n'est pas une signature.
Your whole argument that SS isn't a ponzi scheme boils down to "hey, if the government finds other sources of money to pay into it, it's still viable!" You can tweak the system all you want, all you're going to do is delay the inevitable implosion. Social Security is inherently inviable program. It depends on more and more workers every year to support an ever-growing number of retirees. At the time the program was implemented the numbers worked out fairly well, but now life expectancy is WAY higher than it was in the 30s and as a result there are far too many people drawing SS checks than the system can support. This isn't just my opinion, this is well documented and EVEN THE GOVERNMENT admits the problems:
I hear that Social Security has a big financial problem? Why?
Social Security's financing problems are long term and will not affect today's retirees and near-retirees for many years, but they are very large and serious. People are living longer, the first baby boomers are nearing retirement, and the birth rate is lower than in the past. The result is that the worker-to-beneficiary ratio has fallen from 16.5-to-1 in 1950 to 3.1-to-1 today. Within 20 years it will be 2.1-to-1. At this ratio there will not be enough workers to pay scheduled benefits at current tax rates.
That's straight from the horse's mouth, at http://www.ssa.gov/qa.htm, BTW.
Yes, but the reason that health care costs are so high in America is that we have the best quality of health care in the world.
You are right, King Hussein of Jordan will come to America for surgery, because we have facilities that offer among the best available care in the world, and they will be happy to take care of King Hussein.
But to say the country has the "best quality of health care" is extremely misleading; that high quality health care may be =offered= in America, but most actual American's don't actually get it when they need it.
What exactly is the value of having high quality health care that you can't actually use?
America still produces fine crafted hardwood furniture too. But most people's homes are furnished with ikea and other particle board and plastic shit. The fact that high quality furniture is available in the country doesn't mean simply being in the country will get you some. Ditto with health care.
Now, I'm not railing against the existance of private health care. If King Hussein wants surgery, he should be able to get it, and there's no reason it shouldn't be in America. But so what? We should still have socialized care too.
Why exactly should serving the worlds rich and famous the best care in the world mean that half the country has no health care at all?
Here here! I second bs on that claim. I live in Australia which has both private healthcare and public. If you are using only the public health insurance the only limitation is that you have to use public hospitals when hospitalisation is required. There is NO stipulation as to which GP you use, you just go to the doctor, sign a form and they get paid by the public health scheme - even if you do have private insurance. Everybody gets healthcare, not just people with money. Isn't that the way a compassionate society should behave?
"A cynic is what an idealist calls a realist" - Sir Humphrey Appleby
Stop. We know you're lying.
The Canadian system doesn't work. We know that because we've been told so by our politicians , and they should know because they get a lot of contributions from the health care system and go to a lot of cocktail parties. And we've been told it so many times that we know it's true.
The approximately 20% growth health care stocks showed for at least a decade, back when I paid attention, was because they were so amazing and efficient and wonderful, not because they were siphoning off more and more of our healthcare dollars.
The paperwork is good because it generates jobs. Jobs we NEED. The American system is the best in the world. A Canadian-style system would cost us a fortune and kill us with crappy care. You won't get to choose your own doctor. You'll wait for surgery, the hospitals will fall apart and no one will ever become a doctor again. You should know all that. Haven't you been watching TV?
You can believe in whatever you want, but don't confuse yourself by thinking that has anything to do with reality. The US dollar is the world reserve currency. We borrow at better rates than any other nation, and debt happens to be one of our biggest exports. We have that privileged status precisely because of our GDP, and it won't be changing in the near future.
And please stop with the ongoing misrepresentation of debt statistics. We're in the early stages of recovering from the worst economic crisis in 60 years. Even if the year-end debt ratio ends up at 85%, it's still a whole lot better than the depression era peak at 120%. And the fact is that deficit spending is pretty much the only way to pull the economy out of a major low like this. Fortunately, the economy is already showing signs of recovery, and that debt ratio is going to drop back down quickly. But if we don't find a way to reduce health care costs over the next decade it's going to get a whole lot worse, and stay there permanently.
So, rather than waste my time paying attention to meaningless epithets like "multi-trillion dollar spending spree," I think I'll just stick with logic and established economic theory. You're welcome to keep believing in imaginary economics if it makes you happy though. But please strop trying to drag other people into your delusions.
It's not that conservatives hate the poor, but, rather that they strive for a society with a rigid class structure. Effectively, this works out to be a very bad deal for the poor, leaving them in a situation that is literally hopeless.
I hope by your stated opinion above that you aren't implying that the rich are somehow responsible for making sure the poor aren't as poor as they could be if left to their own devices? If so, my first question is: who exactly dictated it is the rich person's responsibility to take care of everyone else who makes less than them? Secondly, it is one thing for someone to *voluntarily* give something to charity. It is another thing entirely for the government to *take* that same thing away from that person (i.e. their hard-earned money) through whatever means they think makes it look good (i.e. taxes to fund social programs) and give it to whoever the gov't sees fit (i.e. the poor) using the excuse that the gov't somehow believes they can handle a rich person's property (i.e. money) better than that rich person.
To all the rich liberals who believe the rich conservatives should be sharing the wealth, I say they should be willing to give all their salary first to be an example before they force others to follow suit. Maybe Obama should take a $1 salary and give everything else to all the people who thought that Obama was going to pay for their mortgage if elected? The U.S. already has programs for the poor that people can give voluntarily to in order to help those less fortunate. If the democrats want the same thing for healthcare then make it voluntary. I for one work hard for my money and don't want it being used without my consent for someone else's insurance.
I don't think that just because someone feels they *shouldn't* be responsible for everyone who is less fortunate it means they want a rigid class structure. For those with jobs, we all work hard at them to earn our income. Obama is basically creating a 2 class society: lower middle class and an upper middle class. He is doing this by arbitrarily stating that anyone who rakes in over $250k a year is now deemed rich by his personal standard. Who is he to say who is considered rich and is therefore responsible for others less fortunate? At least $250k includes himself unless he is exempt due to being president. That "rhich" person must now give some of his money, through taxes, to the gov't so it can be redistributed for whatever the gov't deems necessary. Currently that reason is for universal healthcare.
Why doesn't Obama propose an N class society based on various income levels just like the federal income tax brackets which already exist for purposes of determining who pays for who's healthcare? Every person in a particular bracket in effect passes their money down to people in the next lower bracket through taxes. Obviously the people in the lowest bracket get to keep all their money that others had to pay in to taxes that will eventually be used to pay for others' healthcare, plus they get free money from the people in the bracket above them. Now based on that scenario, don't you think all the people in the middle brackets would be pissed that they have to support the people in the bracket below them? That is how the rich feel now based on how they know the 2 class system will operate if implemented. In an N class society created to support universal healthcare, even some of the "poor" would complain. We don't have the luxury of them seeing the problem of having to support others with their own money in a 2 class society. In a 2 class society, you are either being supported with health insurance paid for by the rich or you are the rich having to pay for someone else's insurance. If some of the people who would normally benefit from this had to become a person who supported someone else in this manner we wouldn't have so many poor people supporting this idea.
To say the rich can afford supporting someone else is typical of a democrat who feels everything should be fair. M
this nation, under God, shall have a new birth of freedom. -- Lincoln, Gettysburg Address
If I am sick, how is that your problem, and what right do I have to force you to pay for my doctor's bills so that I can get well?
You don't. However, most people do not know in advance if they will someday require a million dollar medical treatment. Therefore, it is to their advantage to pay a flat fee into a huge risk-amortization pool managed by US government. To avoid ethical questions about government's use of force, let people opt out of the pool and stop paying any related taxes. However, they will then have to rely on their own private hospitals for treatments, even in emergency. And organ donations made to public system will not be available for private transplants. Let them see if resources of 10 million mega-rich people can buy more MRI machines than resources of 300 million not-so-rich people. And rejoining the pool will not be easy/cheap as it's not fiscally sound to let people join the insurance pool only when they get sick.
So hard-core libertarians get to die on the road after a car accident, knowing that nobody forced them to pay taxes for a public ambulance service. And the rest of us, who think that government services are for emergencies such as fire, disaster relief or cancer and private sector is for extras like iPods, dining out or plastic surgery, get to have some peace of mind.
The biggest problem that I have with nationalized health care is that it effectively guarantees that we're stuck with paying for health care using the insurance model for the rest of our days. The trouble with insurance is that, in theory, less money is supposed to be spent than is put in. This guarantees that there will always be profiteering and "waste" - that's why insurance works. If we didn't already legislate the insurance model so thoroughly already, market-based innovations like interest-bearing health savings accounts might be able to take a better hold.
In an ideal world, I'd like to see all health care spending be tax deductible. If my employer wants to spend money on insurance for me, great. If my employer wants to put money in an interest-bearing health account, like a 401k or something similar, so much the better, provided it's portable from job to job. Heck, if my employer just pays my bills directly - sweet! Let them earn their tax credit either way, and if I choose to do the same, well, let's encourage that, too. It'll never happen, though, especially if this bill gets passed. Besides, all of the market-based innovation in payment methods in the world isn't going to change one basic, simple fact:
Health care is scarce.
There is a finite supply of people willing and capable of being doctors and, due to generational constraints (fewer people in the younger generations than during the Boomer generations), there are fewer and fewer of them than there used to be. Meanwhile, more and more people are consuming more and more health care. This isn't just a case of the Baby Boomers getting older, though that's a big part of it. The other part is that the health care industry can do far more than it could in, say, 1950. In 1930, if you had an infection, they gave you sulfates and told you to start praying. Nowadays, we have books that list nothing but types of antibiotics. We can transplant organs, cure most kinds of cancer if we catch it soon enough, cure nearly any imaginable infection, and on and on and on. If I get an ingrown toenail now, I see a doctor (possibly even a podiatrist - specialist rates!). If I got an ingrown toenail in 1930, I probably would have grabbed a bottle of whiskey and a pocketknife. Simply put, the health care industry can provide far more services than it could years ago, increasing demand, while also seeing fewer and fewer people willing to provide the services. As long as that dynamic is true, it won't matter how we pay for health care. If we try to make it cheap, there will be increased scarcity, which means longer waits for procedures. If we try to make it plentiful, such that nobody has to wait, it will be expensive. That's just the way it is.
If you really want to make health care affordable, you need to loosen up who provides non-emergency health care. This might involve getting nurses involved, but they're nearly as scarce as doctors right now. This might involve robots - heck, Japan's been playing with them in health care for years. This might involve computerized quizzes - fill in some blanks (I have the sniffles but I don't have a fever) and receive a diagnosis (You have a cold or mild allergies). In short, think of it sort of like IT. You don't need to throw a CCNA or MCITP/MCSE at every infected workstation - why should you throw a doctor at every minor ailment? Yeah, I know - when you're holding a hammer, every problem looks like a nail, but there's some wisdom here.
In the end, no matter how you shuffle the cards around, it will never change the fact that, as long as health care is as scarce as it is (and there's no reason to suggest it won't be anytime soon), it will be expensive, one way or another. There isn't a Republican or Democrat sponsored piece of legislation in the world that will ever change that.
No, it is paid for by customers worldwide.
Just like the article by Dr. Linda Halderman on Pajamas Media (in more ways than one), your comment contains no facts or analysis to back up your assertions. Conveniently several countries are omitted. There is no independent corroboration of the veracity or accuracy these assertions.
:. Ultimate Control Dedicated/VM Servers
My COBRA coverage got pulled at about the 1/2 point because my old company was small and both of the spouses had coverage, so at the annual renew time, they just stopped offering health.
After talking with an Insurance rep that I have used for company insurance at a few places, it became clear that my family and I would NEVER get personal health insurance. Currently, I suffer from chronic foot pain (for the past 6 years), my oldest son suffers from depression and bi-polar disorder (for the past 4 years), and my wife gets migraines (from childhood). You can see why an insurance company would not want to touch us, but we still need insurance.
As my COBRA ran out my agent tried to get us on a temporary plan. We know that if we claim the meds that my son and I require, $2,000 to $3000 a month, we will also not be allowed to re-up the temp plan. We decided that we would not claim any of the chronic things that we have to deal with so that we have the plan if we have a major issue, but once we do, we no for sure that we will not be allowed to re-up.
For the temp plan we went with a carrier that haven't been covered by for over 12 years. But we were denied coverage by this carrier because they had on record that...
1) My wife had been treated for headaches.
2) One of my 2 sons had been treated for a sore throat.
OVER10 YEARS AGO!!
Those 2 reasons were all that it took to deny even temporary coverage.
We had to find a carrier that had never insured me and my family before just to get temp insurance.
We are still looking for a permanent option, but as we do our savings are being drained rapidly as we try and cover our ongoing issues. We need to minimize claims to preserve our temp insurance in case of a major issue. Because of that none of us are getting any ongoing treatment, so no one is getting any better. Were stuck with little chance at improving medically, and at this point we have not found an insurer who will offer us insurance at any price.
If you have now, or have ever had anything more that a minor medical issue, your chance of getting coverage as an individual are effectively 0%
I have been looking for work for 2 years, sending out, and following up on at least a dozen job openings ever month (12 is my self imposed min). While the economy is bad I have no idea if I will be able to get a job, and while I am in this catch 22 I am spending more and more of my time trying to find coverage.
In the mean time, I have one of my cars for sale, family jewelry is listed, and while our house is not under water, real estate is not exactly booming either.
I dunno. Does my government really want me to be broke, unemployed, and perhaps homeless, before I can get health care for my family?
Or can they come up with some way for people to purchase coverage, to allow them to get healthy, before they loose everything?
Eschew Obfuscation
The very idea of Marx-style socialism is that the workers, rather than owners, should get the fruits of their labour. Communal ownership only enters the picture because it is impossible to run a factory alone, so it should be owned by all the workers who'd split the profits between them.
Ironically enough, if taken to its logical conclusion, this would effectively make everyone a private entrepreneur.
Any place where you can own a factory without working there is not socialist, or at least not communistic. Or, more to the point: any place where you can get money simply by owning something is not socialistic.
Trade, or any restrictions place on it, has nothing to do with whether a system is or is not socialist.
And yet whenever there's talk of using tax money to provide some service communally, that proposal gets branded "socialist". Yet when someone points to a successful socialistic country, that country is suddenly not socialistic. It kinda makes one wonder if the word "socialism" isn't simply a right-wing boogeyman?
Forget magic. Any technology distinguishable from divine power is insufficiently advanced.
It's not that conservatives hate the poor, but, rather that they strive for a society with a rigid class structure.
Wow, that's a load of bullshit.
You're free to your beliefs, as are people who think conservatives flat out hate the poor, but I'd highly suggest reading up on conservative politics. There's no focus on class structure or rich vs. poor or anything of the like. It's about letting people be free to make their own choices in life. The whole "liberty" and "freedom" thing you keep hearing conservatives go on and on about is related to that core principle. When the federal government forcibly takes privately earned money to pay for systems and structures that are not only unconstitutional, but unwanted by the person having the money taken from them, they're robbing these people as well as the unseen vendors and merchants where the money would have be spent otherwise.
You want to talk about rigid class structure? "They're rich, they won't miss the money, let's tax them!" -- the point isn't whether or not they'll miss the money, it's whether or not we want to justify ongoing government thievery, especially to pay for things that are not perceived to be better than their private counterparts. The "their rich they can afford it" argument is nothing more than a straw man distracting from the actual issue.
1) Build most of the architecture that has lasted through time
2) Build the infrastructure in most countries
3) Manger large services
4) War
5) Maintain records to a standard that private companies haven't come remotely close to
6) Create a 500 track record of a decrease in criminal activity, which while having infrequent bumps is rapidly declining in all respects
7) Create a regulated system of tariffs and tolls which has allowed for free commerce between nearby locals to prosper.
8) Insure the safety of most consumer products
9) Spread information about agriculture to the point that hunger is essentially abolished and food prices are fairly close to transportation costs.
etc...
It is popular because of mandated participation. It isn't an individual savings system. It redistributes "retirement savings" from people who had long careers to those who got disabled and those who did very well financially to those who did not. The welfare aspects are what makes it popular.
USA drug companies do research to make money. They'll happily take Canadians money.
The question you should be asking is WHY the same drug can be so much cheaper in Canada vs the USA? Why are drugs so much more expensive in the that bastion of free enterprise? Why do USA drug companies spend more on marketing each year than on research? Most of this marketing is illegal in Canada so they don't waste as much money on marketing in Canada. Canada doesn't have huge private health insurance companies skimming huge profits, denying claims, and thwarting doctors from using what they feel is the best treatment. Why does virtually all health care cost more in the USA? Why does they USA spend MORE per person on healthcare yet still lag behind Canada in almost all indicators of health care like infant mortlity, and longevity?
Why do many USA citizens still want a good chunk of their health spending to be taken by private insurance companies?
Anarchists never rule
What, a major surgery took five weeks to go from diagnosis to recovery, and you're whining about it? Hell, it takes that long to get my insurance company to approve a required test.
Just another "DOJ fascist authoritarian totalitarian bootlicker" -- Zeio
I also saw several reasons for the lower cost of (superior) care:
Think global, act loco
here's no focus on class structure or rich vs. poor or anything of the like. It's about letting people be free to make their own choices in life.
I'll bite. Under the current system, the poor have very few opportunities to make their own choices in life. If you're born poor, odds are that you're going to stay that way.
In fact, the routine costs of living for the poor are often higher than what the rest of us pay, creating a vicious cycle from which there is little chance of escape.
-- If you try to fail and succeed, which have you done? - Uli's moose
With respect to everything everybody is saying, I'm Canadian, more of a Quebecers, but anyway. Even If sometimes you may have more specialized healthcare available to whom's willing to pay. I assure you, being 30 and have been sick like hell lately, I'm happy I didn't had to pay a Pennie for the millions bucks worth of care I received over the last 2 years. Yes some people may complaint, but most of those who complain are those who because of just a sneeze wants a doctor checking their temperature every minutes because it's free... And if you are worried about those who don't work and aren't willing to pay for them, stop worrying, it's nothing compare to the satisfaction of having nothing to care about if you are ill or not... Even better, BTW, if you score a good job, you will have insurance that will pay for private clinics so you can get your results faster, in 2 days instead of 5, or in 24hrs instead of a day. But the results will be less exhaustive than the free one!!! WOW! And your benefit, I should tell you that there's a bunch of researchers in Canada, that would disagree with you! We design a lot of pills and do a lot of research, and historically I think we have a lot of innovation on our hands, sure it's all American companies, but, It's all Canadian brain into it, yep!
-I swear by my life-and my love of it-that I'll never live for the sake of another man, nor ask another to live for mine
House Resolution 676 has more than 200 sponsors and calls for free, universal health care for Americans. It gets no press and will languish while these "reform" measures will pass with lots of media hubbub. Meanwhile, I (and 46,999,999 other Americans) won't be any closer to being treated like human beings instead of walking bags of money when we enter a medical facility.
To the libertarian f*cktard who will inevitably say "keep the government out of my medical decisions": Are you happy with bean-counters in a New York office deciding whether you qualify for coverage?
I lie awake at night, wide-eyed with fear over a slight stomachache, not from hypochondria but from the potential of financial ruin before I'm 30.
Apologies for asterisks, the slashdot post box simply will not accept proper line breaks and mangles the post regardless of what text entry mode I set it to.
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This is total bullshit. The big pharma companies have rolled this one out for years as the reason it is necessary to keep drugs expensive in the US where the same medicine in other counties cost less. It has nothing to do with research costs and everything to do with holding onto the goose that lays the golden egg: a healthcare system in a first world country that is exclusively set up to make a few people and companies rich. It has almost nothing to do with making people well, other than a side effect of making huge profits at the expense of people's health. They sell the drugs worldwide, at enormously variable prices. There is no shortage of research money at the prices and volumes sold outside the US. Also, not all drug companies are US companies.
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They'll also claim that FDA certification makes the drugs cost more in the US, which is also FUD of the highest order. If it does have an effect, it's not enough to explain the ludicrous prices. If there is anything that affects the cost of drugs, it's the money that buys senators and congressmen, though not directly passed on to the consumers as a cost of doing business, certainly affects the price of drugs with their purchased legislation.
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For a country that positions itself at the head of the world table, as a shining beacon and example to follow, the US healthcare system is a huge, nasty, malignant tumour that threatens to kill off a large portion of your population.
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There are so many things I like about the United States, but the healthcare system is most certainly not one of them - a society is judged by how it treats its poorest and most disadvantaged members, and looking after their wellbeing is extremely important. I don't think anyone could make a case that the US Social Security system should die (the people would not stand for it) - the health care system is no different. The current one has very, very limited support for the people that cannot afford to pay artificially inflated prices for insurance and drugs, and have to fight a system that employs people (who are not doctors) whose sole job it is to overrule doctors who say you need some treatment and list it as "optional" or "unnecessary" so that they don't have to pay for it with the insurance (and by the way, that'll be another $550 this month in insurance premium, pay up so you're covered!)...
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Even if you think the current US system is "fine" (which it clearly is not), there needs to be some system that runs along side it that helps the millions of Americans who simply cannot afford to sit at that table. For something like a fancy house or a fancy car it does not matter - if you can't afford one, you can go without, and perhaps envy the rich guy down the block who has a Lincoln Navigator. This is not true for healthcare though, since you simply cannot go without it, so you need to provide a system that they can take part in.
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"Get a job with good health insurance" you may say, but it's not always that easy. Remember that health insurance companies exist for one thing only, and it's not making sure people get good medical treatment. If you are in a "good" program, that is normally expensive, where they just simply cannot legally get out of paying for the treatment you are insured for then you are lucky. You may not even be able to get minimal coverage - a huge number of Americans exist in a salary range that they cannot escape from (easily) and that provides them with insufficient money to afford good treatment or insurance.