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Health Care Reform
It appears that today might be the end of a very long road to health care reform. There's been a lot of debate on the subject really leading back before the election. The mainstream sounds like an echo chamber, so I'm hoping you guys have better insight. Will this bill do what the administration claims to do, or is it as bad for the future of America as Fox says?
Nothing is as bad for the future of America as Fox says.
BTW, I've seen thousands of comment trolls, but I think this is the first story submission troll I've seen.
But then everyone knew that already.
I expect it will at least mitigate my issues getting health insurance after getting kicked off my parents' plan, so there's that.
As for the Republicans' complaints, I'm not really clear on what there is in this bill the Republicans didn't argue for. If the left had written the bill, it would dismantle the insurance industry and set up single payer. The only thing it's missing is tort reform, and the fact is that tort reform is a red herring. It accounts for 1-2% of healthcare expenditures, and that sounds about right. There should be a process for handling legitimate malpractice claims, and it's never going to be free.
As you might expect, this bill is heavy on the benefits and light on the necessary pain. There's virtually only one effective cost-control measure, the tax on high-cost health benefits, and that has been pushed off so far in the future that it will be killed before it sees the light of day. The bill recognizes that coverage of pre-existing conditions requires an individual mandate, but then implements it in a half-assed way that won't achieve the objective of forcing healthy people to get coverage. (It also puts a dual drag on job growth by both raising taxes on private investment and directly increasing the cost of employing people. Way to go.)
I would much prefer a bill that provided funds to the states to let them structure their own solutions to the health-care problem, as Massachusetts has done. But the top-down command-and-control midset in Washington is too strong for that.
Your supply is high. In the UK we have 1.5 doctors per 1,000 people, in the USA, 2.4. Of course, we treat our doctors like crap.
The USA spends more per head on medical care than the rest of the world but gets poorer service. Either your efficiency is really low, or too much is getting creamed off the top as profit.
Part of the efficiency problem is that due to your liability culture you throw too many tests and treatments at things.
Part of the profit problem is that your medical system is run like a business that considers 15% a low profit margin.
I do not have anything of actual use to say about this bill, other than common talking points, unsourced blather about what this bill will accomplish, and vague appeals to antiauthoritarianism. But please mod me +5 Insightful like you're doing with everyone else, just to be fair.
Libertarians somehow believe that private businesses should be stronger than governments but weaker than individuals.
Read it for yourself. What I read is a wet dream for the insurance companies and penalizes anyone who is self-reliant.
You know, you're right. And I say this as an Australian living with our wonderful (and I'm not being sarcastic) universal, single-payer health care system here.
In the past on Slashdot, when the issue of US healthcare reform has come up, you inevitably get all the Canadians/Europeans/Australians/New Zealanders on here going "OMG of course you should reform - your system sucks, and ours works pretty well". It seems like a no-brainer ... why would you not want to move to a system like ours. It's cheaper, more efficient, everyone is covered, health insurance is not tied to your employer, and the health outcomes returned are better. I was one of those people ... it seemed absolutely crazy (as in, literally mind-bendingly insane) that someone would want to oppose moving from the overpriced, inefficient and inequitable system you currently have to a system like most of the rest of the world employs.
BUT... ...now that I actually ~read~ something about the proposal itself, I see why Americans are debating it so much. It isn't really giving you guys a system like that in CA/EU/AU at all! Rather, it's just modifying the current system somewhat. It isn't really a fresh, new or particularly efficient system. It's tacking something onto what's already there ... giving it a coat of paint if you will, but not really addressing the underlying problems. It's not introducing a single payer system like in most other developed countries. And although I would personally still support it on balance, had I been an American, I would agree that it's not really a straightforward decision and it does have some significant flaws.
So to non-Americans mystified at the opposition to this, take a read of the actual proposal. It's not a stark choice between "the system they have now" and "a system like in other countries". Rather the proposal is for something kinda inbetween, which runs the risk that it may not work as well as ~either~.
You mean the one that will cost about a trillion dollars that isn't paid for:
This is typical of Republican governance, they bitch and moan all the time about fiscal responsibility, but they acted in the most inconceivably fiscally irresponsible way again and again during the decade or so they were in power. Now we the taxpayer and the democrats are at least attempting to clean up after the unmitigated spending spree that was the Bush Administration and Republican Congress (Iraq war, tax cuts for the wealthy, "free" prescriptions drugs) and are getting dinged for not being fiscally responsible? If this is a joke, it's not funny.
Gentlemen! You can't fight in here, this is the war room!
I have Australian and American citizenship, I have lived in both countries and experienced both health care systems.
The US bill is not single payer public health insurance, it would be better for the American people if it was, but the reality of the situation is that such a system cannot pass in the US as things stand. The Republicans are against anything the Democrats do, more than half the Democrats are in the pockets of big corporations and the Libertarians are always up in arms about anything at all which costs them money no matter how large a benefit it might provide society at large. That's not even taking into account the Tea Party and all the crazies that have come out of the woodwork because Dick Cheney proved to the American people that the government was out to get them and made every right wing conspiracy theorist and Militia member seem sane.
That's not even counting the Americans of all political persuasions who are irate because Obama can't magic more than 11 million jobs out of his ass to fix unemployment. I mean presuming an average salary of 40k a year that'd involve finding 440 billion dollars a year somewhere, but never mind.
Single payer health insurance cannot pass in that environment it's too radical, too different, too much like the government actually doing something useful with the tax dollars. Never mind the fact that the US pays almost twice as much in terms of percentage of GDP than any other western nation, has poorer health outcomes, and leaves more than 10% of its population uninsured, it just won't pass.
As such this bill, which is very much imperfect is the best the American people can really hope for. Yes it leaves the insurance companies intact, yes it's full of corruption, pork, and special interest anti-abortion clauses, and yes it will probably mean that individuals who believe that they can cover the couple of grand a night for a hospital bed if they get sick might have to take on some of the burden of minimizing the insurance risk pool to keep down costs.
On the other hand it will give 30 million Americans insurance, require insurance companies to insure people with preexisting illnesses, and remove the bonds forcing people to keep a job at any cost to keep their insurance when they need it. It would also save the insurance companies from their current death spirals by bringing healthy people back into the risk pool which would in turn reduce over all costs. It would do this while, at least according to projections, actually lowering the deficit.
This is an ugly bill, and there are things about it which will need to be fixed, sections which are almost unconscionable. It will also require tort reform, medical practice reform, and educational reform to along with it to give it its greatest potential. Despite all that it is miles ahead of the current situation, and the best we can hope for. If Republicans had been more willing to vote yes, or there was more cost to minority filibusters we might have had a better one, with less pork, lower costs, and better results, but that's not the reality of the situation. This bill is the best the American people are likely to get under the current circumstances, and while it doesn't affect me personally I have a lot of family and friends who would be helped out tremendously by its passage.