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Near-universal Mexican Healthcare Coverage Results From Science-informed Changes
ananyo writes about improvement to Mexico's healthcare system. From the article: "A revamp of Mexico's beleaguered health-care system is proving to be a runaway success and offers a model for other nations seeking to reform their own systems, according to a review published this week in The Lancet (abstract). The key to the scheme's success is the way in which it has modified its reforms in response to scientific assessments of their effectiveness, the authors say. Launched in a law in 2003, the Mexican scheme was designed to sort out widespread inefficiencies and inconsistencies in the country's health-care system. Some 50 million Mexicans — nearly half the country's population — who previously were not covered by health insurance are now enrolled, leading the scheme's architects to claim that the country has near-universal health-care coverage. As well as the increased coverage, the scheme has seen the number of conditions treated under Mexican public health insurance nearly quintuple. Admittedly, the former health minister Julio Frenk, now dean of the Harvard School of Public Health, is a co-author on the paper."
So will I have to go to Mexico for my low price drugs now? Sorry Canada
Admittedly, the former health minister Julio Frenk, now dean of the Harvard School of Public Health, is a co-author on the paper."
Will there be any death panels?
What is this "it" you're referring to here? There are plenty of non-tanking countries with very good healthcare coverage.
Translation: "We did some things we thought would work, and then later we stopped doing the things that weren't working and did more of the things that were."
In an ideal world, governments behaving sensibly wouldn't make headlines.
. . . about a year and a half ago, and while it's not all bad, it's not quite as glowing as TFA.
“You have people signed up on paper, but there are no doctors, no medicine, no hospital beds,” said Miguel Pulido, the executive director of Fundar, a Mexican watchdog group that has studied the poor southern states of Guerrero and Chiapas.
The result is that how Mexicans are treated is very much a function of where they live. Lucila Rivera Díaz, 36, comes from one of the poorest regions in Guerrero. She said doctors there told her to take her mother, who they suspected had liver cancer, for tests in the neighboring state of Morelos.
Sounds like the problems the opponents to universal health care in the States are always worried about.
My sister opened a computer store in Hawaii. She sells C shells by the seashore.
You mean, using someone who actually understands the field he's working in instead of a politician with little or no qualifications, actually gives better results? OMFG this is revolutionary!
Done: Australia (to name one, there are plenty of others)
You can learn a lot about a person if you just take the time to inject them with sodium pentathol
Yes, the claim that Mexico has near universal coverage is accurate, but Mexico's health care is not a US or Canadian (-provincial) style. This Wikipedia article is pretty accurate: http://en.wikipedia.org/wiki/Health_care_in_Mexico about how it works.
Ex-President Fox's Seguro Popular is mostly what the article talks about, and that's what (properly) gives Mexico the right to say that it has nearly 100% coverage. And it's a good program -- my mother-in-law's maid's kid received a kidney transplant under the program.
It's important to distinguish, though, that you're not forced into this system. You can still buy private insurance, or pay cash. (Last time I had to go to a hospital in Mexico, they simply wanted my credit card).
tl;dr: the Mexican government hasn't taken away choice.
--Jim (me)
Hong Kong. Universal coverage for nominal charge. (Hospitals about $12/day for any kind of treatment, waived if you really can't afford that.)
Australia (where I am)
Canada
The United Kingdom
Most of Europe, for that matter
South Africa
New Zealand
Singapore
Japan
And that's just off the top of my head, with a bit of googling to back it up. You know, basically every single first world country except the United States, who recently were in a massive recession and are looking to head that way again.
Check out my sci-fi book "Lacuna" at http://goo.gl/MVxX8
The Nordic states are doing pretty well, and they all have universal socialised healthcare. The Netherlands claims it has privatised healthcare, and the best service in the world, but in fact 75%+ of the cost is transparently covered by the taxpayer, and poor people do get free healthcare.
Julio Frenk dean of the Harvard School of Public Health, is a co-author on the paper.
He's an academic, not a medic.
Oddly enough there are people in the world who are not motivated solely by profit.
We were only discussing whether a public universal healthcare system automatically tanks the economy. Whether this system provides better or worse care, or does it for ore tax money than would otherwise be spent in private insurance is a completely separate discussion.
(but as a clue, I have seen lots of studies saying that for example the US healthcare system provides about half as much "care per dollar" than most single payer systems. A lot of this is of course due to legal and bureaucratic overhead).
You display the ignorance that indicates that you are a drone repeating the mantra instilled in you by propaganda. There are plenty of countries doing very well with universal healthcare. The majority of them also offer private health care for the rich who think they can buy their way to better health with additional insurance.
Facts are history now plebs have politics for religion on social media.
In AU everybody is covered by public health care, if you earn more than $72K Aus (current ~$75k US) you pay an extra 1% tax.
This equates to about $700 a year which (I am sure not by coincidence) is about the starting point for a single non-smoker private health cover. If you do take out private cover and earn > $72k you don't pay the extra tax.
All up I feel its a fair system
lol.. isn't Australia a duel health care country consisting of private and public system like England? I'm pretty sure I was going to have to buy insurance when I was thinking of moving there.
Is the NHS in the UK inadequate these days? I don't live there but I'm quite sure I'd be happy with "just" the NHS if I lived there. Having other insurances to cover e.g. loss of income from illness is one thing. I wouldn't have to have private insurance to cover transplants or cancer treatment, nor would be in a better situation to get such treatment than my poorer neighbor, and thats the important bit.
I don't know why people don't get it. The "free market" people out there love to say "government shouldn't mess with it" and usually, I agree except when government has no choice.
Any time there is an unlimited supply, the government needs to help. Such cases include matters like "copyright" and "patent protection." The supply is unlimited and therefore must be enforced by government to use other means to get people to pay for something with an unlimited supply.
Any time there is an unlimited demandm the government needs to help. Such cases include matters like healthcare, water and electrical service. People need what they need and it has little to do with market conditions. Often is is "use or die." Government needs to ensure that needs of the people are met before suppliers are allowed to exploit the need to gain unlimited profits.
It's interesting and amusing to me that many such free market proponents are great with government enforced or assisted items like copyright but not with health and power regulation. "Only when it serves their interests." So it's selfish humanity as usual... and in the end, that's why we have law in the first place -- to help us to act against our own nature.
Yes they say the words that make you happy... do they actually deliver?
Still trolling? Let me repeat his statements for you, in a new wording
- All of the "first world" economies, except the US, pretty much have universal socialized health care.
- The systems are popular in these countries (they are all democracies, so they would have to be quite popular to remain).
- All of these economies are of course facing more or less rough times at the moment, but their economies would still be regarded as "healthy" on a global scale or seen over a few decades.
Danmark, Sweden, Finland, Norway at least are non-tanking. Plenty more in the rest of Europe, I would reckon.
The US is unique in beeing a "western world" country without universal healthcare, btw, and while we do have a financial crisis in Europe right now, I am not sure there are any relations to the health sector.
A healthcare system coudln't tank an economy unless people were forced to pay into it.
Single payer universal health care means healthcare is a figure in the budget, just like infrastructure, defense etc. If there is a budget deficit you have to cut down on something (infrastructure, defence, healthcare, whatever). People are "forced to pay into it" no more or less they are forced to pay into defense or infrastructure. Having too large expenses for healthcare is entirely possible, reasons can be for example if you have a shift in demographics where fewer young people pays for the healthcare of a large aging population (Japan has this problem whereas the US does not). This can cause economic issues, but the same can be true if you have an aging airforce.
no, healthcare tanks the economy when hospitals are forced to provide healthcare to the uninsured. if some freeloading hick with no healthcare gets hit by a bus the local hospital will be forced to treat him even though it will cost hundreds of thousands of dollars that he will obviously never pay. the only option is either force people to contribute to healthcare through taxes or let hospitals refuse treatments...forcing hospitals to treat people who are too irresponsible to get insurance is a moral hazard and raises the cost for everyone else.
I don't know where I said that paying for public healthcare leads to a collapse.
I was thinking of this: "Like everywhere else it's been tried...let's watch the mexican economy tank in 3...2...1..."
The current method of providing healthcare is basically stealing from future generations (which will eventually lead to collapse), if you think about how it works (at least in the US) it is a big ponzi scheme. Every generation needs to convince the ones after them to buy in to the insurance/Social Security scam. Please explain how else it could work.
I don't know what you mean by "stealing from future generations". If you have a budget neutral (i.e. not deficit spending) based, tax financed, public healthcare system, how will that be problematic? Look at Sweden for example. There is a single payer universal healthcare system paid for by taxes, at the same time there is a budget surplus and the national debt has been quite rapidly reduced in the last decade. Are the current generation of swedes "stealing" from the next generation of swedes?
In UK, NZ, and I presume Australia too, the reason people pay for private health insurance is to get a bed in a private room when/if they require hospitilization, and to get on a shorter waiting list for tests and treatments for non-life-threatening conditions. If you're prepared to slum it in a shared ward with other patients and wait a few months to get surgery on that low level knee pain that's been annoying you for years, then the NHS is perfectly adequate, and will kick into action quickly and efficiently when you really need it.
http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita Simply put it is way cheaper than US system which is impressively ineffective.
If the government promised to people they better pay it. That will come out of someones paycheck.
Still the same as defense. Also comes out of someones paycheck. And what the government promises, they better deliver if they want to be reelected. You are still not making a point I feel.
... nothing. President Lawnchair signed the massive bailout for the health insurance companies (which was conveniently disguised as "health care reform") which ultimately left us with the same broken system, but with people now forced to buy into it. We still have no standard of care, and nothing that actually resembled universal coverage.
And now to further accentuate how ridiculous that is, the Mexican government just beat us to health care reform as well. A significant portion of their country is embattled in violent conflict in the drug war, yet they can pass health care reform. Up here, we can't pass it because of a collection of idiots who are afraid of (their own lack of understanding of) "socialism".
Yeah, go ahead. Mod me down. I can take it. At least I said my piece.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
When I select HEALTH index (only) the United States ranks #38. The United States is trailing the industrial powerhouses of Cuba and Costa Rica.
Build your own index using UN data:
http://hdr.undp.org/en/data/build/
You can't be ahead of the curve, if you're stuck in a loop.
The NHS probably isn't inadequate but you do hear horror stories about it from time to time. Medical tourism in former colony states seems to be a popular thing for people who have government insurance coverage that is supposed to cover everyone. The NHS has a rule or law that states they can avoid treating any illness if you attempt to get treatment outside their system and it isn't an emergency situation. So if there is rumor of some miracle treatment for your liver cancer or whatever and you fly to whatever country who is allowing it to be practiced and the treatment fails, you can be stuck flipping the bill yourself for the rest of your liver cancer treatment life.
I think there are problems with most health care systems and they all have horror stories.
The United States relies upon private health insurance to provide much of the financing for medical costs. This is unusual: in Britain, Canada, and Spain, for example, health-care costs are largely paid for by the government. In Austria, Belgium, France, Germany, and the Netherlands, medical costs are paid for by a system of "social insurance": it is compulsory for most people to buy insurance, but insurance premiums are tied by law to income rather than to the risk of a claim.
The United States system makes it voluntary to buy insurance, and premiums are linked to risk, not to income. But these market-based premiums, beloved of many Americans, do not seem to be delivering health care that makes them happy. A recent survey revealed that only 17 percent of respondents in the United States were content with the health-care system and thought no substantial reforms were necessary. Why the discontent?
The superficial reasons are simple enough to describe: the system is hugely expensive, very bureaucratic, and extremely patchy. The expense first: US health cares costs a third more, per person, than that of the closest rival, super-rich Switzerland, and twice what many European countries spend. The United States government alone spends more per person than the combination of public and private expenditure in Britain, despite the fact that the British government provides free health care for all residents, while the American government spending program covers only the elderly (Medicare) and some of the marginalized (Medicaid). Most Americans worry about health-care costs and would be stunned to discovered that the British government spends less per person than the American government but still manages to provide free health care for everyone. In fact, if you figure in the costs of providing health insurance to government employees and providing tax breaks to encourage private health care, the US government spending on health care, per person, is the highest in the world.
Bureaucracy next. Researchers at the Harvard Medical School found that the administrative costs of the US system, public and private, exceed $1,000 per persons. In other words, when you count all the taxes, premiums, and out-of-pocket expenses, the typical American spends as much on doctor's receptionists and the like as citizens of Singapore and the Czech Republic spend on their entire medical care. Both places are countries with health outcomes very similar to those in the United States: life expectancy and “healthy life” expectancy (a statistic that distinguishes a long healthy life and a long life plagued by years of severe disability) are a shade lower in the Czech Republic than in the United States; and in Singapore they are a little higher than in the United States. The costs of US bureaucracy is also more than three times the $307 cost per person for the administration of the Canadian health system, whic
By looking at basic economic figures, such as Gross National Product, National debt, poverty percentages, unemployment rates, education levels etc. And yes, get over it: almost all of the countries in question are doing much better in those areas than the USA.
But they dont have any doctors there. they all left because of the low wages.
What, you mean the Tea Party people are lying about that?
Do not look at laser with remaining good eye.
Just look at this pretty list of countries by health expenditure and note the percentage of GDP health care cost for countries that use universal health care.
For further shaming of the US system (and to the benefit of other systems) you can compare with the WHO ranking of health systems though that might be a less objective metric.
Which means nothing on its own. How should we account for the quality of care, taxes paid by each person recieving care, etc?
That's a different argument/question from the one you originally posted. As Voltaire used to say, define your terms in the discussion. Other countries whose economies are not tanking due to their health care systems: Singapore, Israel, Switzerland, Japan, Brazil, Rwanda, Chile to name a few.
These countries are either doing well as developed nations or on the verge of becoming ones. As for Japan's economic woes, they have everything to do with an aging population, lack of women's participation in the workforce, and little economic expansion due to the 90's economic crisis. But even with all that, the average Japanese's purchasing power and lifestyle have not deteriorated (compare that to us.)
So if you are going to argue that any significant woes (or even tanking) on any of these countries are predominantly a function of their health care systems, you better come up with some citations. Hand waving does not count.
Since you're the one making the argument publicly funded healthcare and a healthy economy are impossible, why don't you define "healthy" for us.
Seriously? You're seriously asking that question?
In the civilised world, we view people who refuse to help the sick and injured as evil scum. In your country you may be happy with people dying, untreated, on the streets. YMMV.
Because Reagan signed that law into being in the 80's.
Sounds like a better deal for them there than here.
I posted this elsewhere, but its entirely relevant to most discussions on here -
In 2010 (year picked because figures are unlikely to be revised), the UK spent £118.2Billion on the NHS, for a population of about 63Million persons.
Thats a per population head equivalent of £1906 or $2954.
In that same year, the US spent about $381Billion on Medicaid and about $509Billion on Medicare - both of which highly intersect with what the NHS provides, for a population of about 311.5Million persons.
Thats a per population head equivalent of $2858.
Except the US Medicare and Medicaid programmes don't cover 311.5Million persons - Medicaid covers roughly 50Million persons, and Medicare covers roughly the same number - theres about a 6Million person intersection between the two (persons that are enrolled in both), so, again roughly, the total number of beneficiaries for these federal and state programmes is around 94Million.
That makes it a per eligible head equivilent of $9469.
And you know which system I would rather have? The one I currently use - the NHS at $2954.
The US system is just very very badly run.
Sources:
http://www.gao.gov/highrisk/risks/insurance/medicaid_program.php
http://www.gao.gov/highrisk/agency/hhs/reforming-medicare-payments.php
http://www.kff.org/medicare/upload/7305-05.pdf
http://en.wikipedia.org/wiki/Medicaid
http://en.wikipedia.org/wiki/Medicare_(United_States)
Germany.
Only an American could ask that with a straight face.
"It's just that today... where do you honestly want to be treated?"
Any country that won't bankrupt me to do so. Because there's no point in being treated if you then have nowhere to live, recuperate, no life to enjoy after and have to work (while in ill health) for the next 20 years to pay it off. I would love to be treated in a perfect hospital with every medicine and treatment available and have it all done while people bring me cocktails and rub my feet. Of course. But the truth is that it's a choice being PAYING LOTS OF MONEY and being treated okay, or PAYING NOTHING and being treated when necessary.
If I cut my finger, I'll do it myself.
If I sprain my leg, I'll do it myself or walk into a hospital if it really develops complications.
If I break my leg, I have to go to hospital.
If I break my spine, I have to go to hospital.
If I get cancer, I have to go to hospital.
At no point would I ever *PAY* for those services. Think about that. I get cancer, I probably have 10-20 years at most if it's serious and will never truly rid myself of it, and I get ALL my treatment paid for me. How much would that cost on insurance, and how much would that cost if you had no insurance and had to pay cash? Now what if I'm diagnosed with, say, cerebral palsy at birth? How much is my insurance going to be then? Have you even SEEN the cost of quite basic medical treatment?
My country, the UK, is shit and wonderful at the same time but wouldn't expect a dying man to pay for his own care (maybe his car parking at the hospital, but that's a minor issue in comparison). The hospital might be crap. It might have worse care rates than private wards. The staff might be belligerent. But I'm not running up debts that I will never be able to pay while I'm laying there unconscious and can't do anything about it.
In the UK, the healthy pay for the sick.
In the US, the healthy pay (next to) nothing and the sick are left to fend for themselves.
Nice attitude to humanity, there.
I never to sit there, adding to the stress of my illness, with what might happen to my insurance payments, or my house, or my family, or anything else.
Sorry, given the choice, I'd go to a hospital where the treatment is "free" and the only cost is the queue and the waiting time. Because the simple, economic fact is that *I* cannot afford to pay for anything serious (and wouldn't go to hospital for anything that wasn't) and I already pay as-much, if-not-more tax than the US and we do just fine on "free" healthcare.
Literally - if I went on holiday to the US I have to buy a travel medical insurance that I *NEVER* have to purchase in the EU. Because if I break my leg in Spain, the treatment will be paid for by the UK. If I break my leg in the US, they won't pay (because of your ridiculous healthcare arrangements) and I have to BUDGET THAT INTO MY HOLIDAY. If I fall into a coma in the US, whether my fault or not, that's me bankrupt back in my own country trying to pay off the US medical bills. Or I can pay a fortune for insurance that NOBODY in the EU requires me to have. (And, yes, US residents are charged for the cost of their healthcare in the EU but they are used to it!). I actually have to take it into account just holidaying in the US.
Either pay for everyone's healthcare out of my taxes, or ask me to pay towards everyone's healthcare as a separate payment. Don't pay for some of it out of my taxes, then make me pay for anything above a slight cold, and then make insurances compulsory, and then let insurers set the prices how they like (the point of insurance should be to cover EVERYONE for an equal price - i.e. if you all pay $100 a month, then the guy who needs a $10 operation gets it as does the guy who needs 100 $10,000 operations - otherwise you are just paying for your own healthcare).
And, in the UK, I have the option. I have complete, free, blanket NHS protection on anything I ever do. I can also pay fo
millions of Americans are not flocking to mexico for free medical care... rather millions of mexicans come north.
But many Americans do flock south to Mexico for reduced-cost medical care. For example, my dental work will be about 10% down there what it would be up here... or 20% of what it would be if I still had dental coverage.
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
Its the first time I have a "troll" score on a post I've made. Funny how it isn't even on a troll post.
There are other reasons that health care is so much more expensive in the US, though... because they never instituted proper tort laws (in part because of the privatized medical system), doctors' malpractice and other insurance is a lot higher. This, in turn, gets passed on to the users of the system, and it becomes a vicious circle... people sue for larger and larger amounts of money because they won't be able to get insurance in the private system, and need to be able to pay the increased medical fees, but the stupidly large amounts of money they sue for (and their propensity to sue for things that they'd never get away with in the UK or Canada) are the reason that the medical fees are going up.
You are absolutely right that things are much cheaper per capita in the UK. They are in Canada and Australia, too, and pretty much everywhere else where universal health care exists, not to mention the other economic benefits of having a population with access to preventative health care. But in the absence of sane tort laws, introducing public health care in the US won't fix the problem, either.
Every generation needs to convince the ones after them to buy in to the insurance/Social Security scam. Please explain how else it could work.
Simple: the population of people requiring healthcare treatment at any given moment, even at 0 population growth, is always going to be much smaller then the population who are able-bodied and working. Across the volume of that total population, if everyone kicks in a small amount of money, then we can ensure that there's cash available for all of them when they themselves need medical treatment.
Also, since insurance gets more efficient as you dilute the risk pool, expanding it up to the size of the entire country's population has enormous benefits - as well we follow on ones such as providing for government collective bargaining on the cost and purchase volumes of pharmaceuticals (the government is the largest possible purchaser, ordering the largest possible volumes, which means it'll always be able to negotiate a good deal).
Social Security (in the US) is not a scam, incidentally. It only becomes a scam if the American populace let that happen, which will be if they allow the government (screw it - allow the current batch of GOP politicians) to reduce SS benefits to future generations. The scheme has been enormously well-funded, and is owed billions by the US government, which has avoided raising taxes by "borrowing" against SS savings. It's alleged bankruptcy is due to the fact that that money was never paid back, because it was never used for anything profit earning in the long-run: it was wasted away as tax cuts to the rich, and still is.
The evidence is that the amount of money that can be saved by various tort reform laws is approximately 2%:
http://www.nber.org/bah/2009no3/w15371.html
Now, that's not nothing, but it's not even close to explaining why US health care costs 3.5 times that of the UK. Some things that are more likely to make a difference:
1. Most health care in the US is fee-for-service, so doctors get paid more if they do more procedures, no matter how useful those procedures are. Solution: put doctors on salary.
2. The US spends a lot of money keeping people alive as basically a vegetable in a hospital during the last year of their life. Solution: end-of-life counseling and legalizing euthanasia.
3. A significant portion of health care costs are insurance companies, hospitals, individuals, and government each haggling to try to make the other parties pay for the cost of care. Solution: Single payer and single provider, so there's nobody else to haggle with.
4. Another significant problem is that people without insurance and money to pay for care tend to seek care at emergency rooms, which both makes it harder for ERs to handle real emergencies and means we spend easily 5 times what we would have spent to treat the same condition in a doctor's office. Solution: Cover everybody.
In other words, you get pretty close to what every other country in the world is doing, and it gets a lot cheaper to provide health care.
I am officially gone from
Let me put it this way, 10 years ago a little over half of the costs in my dad's practice were billing insurance. Its now over 75%. That right there should tell you a lot about how a single payer system could save money.
The next largest cost is malpractice insurance; when about half the doctor's lost their malpractice insurance so they closed up shop, the state stepped in, but its still a big problem.
Finally a single payer system consolidates information about what a doctor does. In other systems, like the VA, they're using that to shape doctor's practices. Basically they get the leaders in the field together to try and figure out an ideal process (e.g. weighing the risks and costs of a test to see when you should jump to the most accurate test vs using less accurate but less costly or more safe screening). Any doctor can go outside the reccomendation; all they need to do is basically check a box. If more than a certain percent of a doctors patients go outside the expected range, they then review the cases. There may be other mitigating circumstances, so they are reviewed by doctors and that feedback is used to refine the reccomendations or to consult with the doctor about how to be more cost-effective. This system shapes doctors behaviors toward providing proper medical care at a minimal cost, without ever preventing a patient from receiving the care their doctors feels is appropriate.
Keep in mind, for many people the government already provides care. If you don't have insurance and its life-threatening, the poor, veterans, etc. Before we were married, my wife worked as a pharmacy teach and she would see all these people getting pills on the government's dime and then selling them in the parking lot, yet the government wouldn't cover her and private insurance was more than she made, so she couldn't afford her bi-polar medicine. If she quit, the government would cover her, but she's the type of person who likes to pull her own weight so she went without. How much sense does that make?
For the same reason the police investigate crimes for people who cannot pay private investigators.
I prefer the idea of Medicare Buy in for all in the US. It's been proposed several times, and never passed. The fact is, that if Government health care is so incredibly awful, why are the for-profit insurance companies afraid of a system in which they would have to compete for it? This is the question that they avoid.
Well, I'm here in Edmonton, Canada and I just recently got back from visiting a dentist in Puerto Vallarta, Mexico. Sure glad I went! Gotta do your research though!
Alberta dentist's have raised their prices in many cases to more than triple what they were 6 years ago. I even would've saved money by going to the States!
I feel bad for families who can't fly to Mexico on short notice... or me if I get stuck timewise next incident.
Lawsuits only make up about 1-2% of the health care costs. They have made a wonderful scapegoat but that is about all they are. They play well into the 'US is such a litigious' nation trip people have been fed.. which is little more then a recast of the old American 'victims should know their place' attitude... which is always amusing since our laws were specifically written so that many laws are not enforced by the DoJ and thus a lawsuit is the only way to activate them.. thus if someone tries to actually get protection under the law they can be branded 'sue happy' and slurred for it. The handicapped are a common victim of this.
From National Geographic Magazine:
http://blogs.ngm.com/.a/6a00e0098226918833012876a6070f970c-800wi
Guess who gets the least bang for their buck in Healthcare?
Even that article doesn't quantify the costs caused by what it calls "defensive medicine". These are tests and procedures done a doctor covering his ass rather than trying to diagnose and treat evident conditions.
I suppose you consider fertility treatments to be frivolous.
I hate to say this, but they ARE frivolous, at least when compared to other things such as cancer treatment.
Not to mention, you COULD just adopt... or do as you did, and pay for private care.
-- Let us endeavor so to live that when we pass even the undertaker shall be sorry. -- M. Twain
Investors. The country with the highest tax burden in the world right now, Denmark, is at the moment loaning money at an interest of -0.25%..
YES, that means rich people, very rich people, and investors in general, believe the Danish economy is so healthy they are willing to loan them money at negative interest, just so that Denmark can protect they money for them.
Popular? In Canada any hint of weakening the public health care system is met with outrage. It's one of the few things you can guarantee will upset Canadians, and get your government booted. I suspect the same is probably true in other countries that have them.
I thought that there were states in which various flavors of tort reform were instituted, and the reform was NOT followed by interesting savings. I think Texas is one example. (I'm doing this all from memory; yeah, Wikipedia says insurance companies saved money, not sure any else did, or that it was big money. Shaving 2% off costs and dumping it entirely into the lap of the insurance companies would be a big win for them, that's for sure. http://en.wikipedia.org/wiki/Tort_reform )
Who's giving anything out for free? Public health care systems simply involve one not for profit entity, the government, paying.
Speaking as someone who actually does medical research, in Canada, drug companies do and fund plenty of research here. We have excellent, unified records for epidemiological studies and a comparatively simple, consistent system with little risk of frivolous lawsuits.
I think we do have a right to healthcare, as well as food and housing, at least as long as the country can afford it. The wealthy already get to have luxuries because they're rich, why do they also get to have the necessities, like shelter, healthcare and food as well?
I also think we should cut our military budget by at least 90% before we start saying we can't afford to provide everyone with healthcare.
-- Let us endeavor so to live that when we pass even the undertaker shall be sorry. -- M. Twain
Homework: Discuss how this contradicts your belief that the free market is always the best solution.
-- Let us endeavor so to live that when we pass even the undertaker shall be sorry. -- M. Twain
Leaving the United States as the largest third world country without universal health care.
We're getting beat by Mexico while Congress is fighting over funding for Planned Parenthood by people who want to turn Medicare into a discount coupon program.
That's our life, the big wheel of shit. - The Fat Man, Blue Tango Salvage
You seem to be confusing taxes to fund universal health care with social security, which is a large confusion. Health care insurance is pretty much pay as you go, and though there is a skew in costs to the elderly, young people are somewhat aware of reasons they might need it (pregnancy and delivery, usually routine, sometimes not; random medical horribleness, that sort of thing).
Social security is mostly a young-to-old transfer, but it is hardly a Ponzi scheme; there are projections for costs and projections for benefits, and it does not have Ponzi characteristics; people get their money out regularly (unlike a Ponzi scheme). If we accept the usually conservative projections of future SS budgets, then the money set aside in the SSTF will not be adequate starting sometime around 2035 -- but that is not an inherent Ponzi problem, that is something instituted in the 80s to help manage the retirement of the baby boom. Benefits won't stop; they'll just be smaller. We can fix that with relatively minor tweaks to funding or retirement age, and these fixes do not have the "then-another-fix, and another, and another" nature, at least not according to the usually conservative projections; you have to bring the system into demographic balance, and then you're done. The baby boom is one heck of a pig in the snake, and that's what causes a lot of the "problems" of SS.
A second important part of SS that you are ignoring is Survivor's Disability Insurance. When we went out to buy healthy insurance on our own (one of the joys of working for a startup), the initial estimates of the policy size were enormous. The sales-ish person we talked to helpfully pointing out that SDI takes care of a huge chunk of that. If it were not for the SDI part of SS, I would have been sending larger checks to the life insurance company for the last 15 years.
These neoliberal politicians seem to live in an entirely different country, and Frenk is no exception; no wonder he's now run as far away from Mexico as possible and is now teaching elsewhere, standing, no doubt, on his alleged achievements while being the secretary of public health in Mexico.
As any mexican will tell you, his boasting is far from the truth; while he may have instituted a program that supposedly provides coverage for people not otherwise under any sort of health care plan (i.e. those who are not, as workers, covered by the mexican institute of social security (IMSS), or as government workers, covered by ISSSTE), he did so without increasing health spending significantly (from 2003 to 2005 it only increased 0.2 percent and it has remained constant ever since: http://corta.me/7mz). So how can you cover 50 million more people without increasing spending? very poorly, that's how. Understaffed and underequipped hospitals, lack of medication, soul-sucking bureaucracy and hoops to jump through, I don't think that's anything to boast about; as befits his neoliberal lineage, Frenk instituted these policies for the macroeconomic "bottom line".
IMSS is supposed to provide coverage for workers and their families. However this entails people working on a stable, formally constituted company which has the obligation to cover fees for employee coverage. It's not a privilege, it's a right that companies must provide to their employees. However, since Mexico has had near zero growth in the past two decades or so (and more so since 2000, when the disastrous, conservative PAN party arrived in power), job creation has stagnated, and even receded in some cases. Millions of people have to resort to the "informal economy", since there's no company through which they can have access to IMSS, this popular insurance thing was created to give some semblance of health care coverage to the 50 million poor and underemployed in Mexico. But make no mistake; this is not the glowing achievement that Frenk would have the world believe. It's really the government hastily trying to fulfill, in a half-assed way, their constitutionally mandated obligation for health care (Mexican Constitution, 4th Article). This has been there since 1983, so actually Frenk's implementation means a 20-year lag for the government to fulfill its obligations.
If we're talking about health care, the longevity and infant mortalty are good metrics. They're not that bad as part of an overall metric for scoring a nature, either.
Socialism has been tried in many places, failed in some where it was tried to excess, but works fine in others where it has been used appropriately. The dose makes the poison. Socialized health care works well everywhere it has been tried. Most countries, including the US, have socialized transport systems (in our case, highways -- arguably, we have built too many and encourage their overuse, but they work, and are hardly bringing the country down). The trashing of various economies has not one damn thing to do with health care; we took a hit, too, with our more-private system, and some countries with UHC did quite well indeed. What did us in was excess risk-taking by under-regulated banks, combined with amnesia about what it took to get us out of the Great Depression (dropping the Gold Standard, and War-scale government spending).
Germany is an interesting example -- they've had a form of UHC pretty much like Obamacare, and they have managed to continue it through boom and bust, where "bust" includes the two World Wars that they lost.
Lawsuits only make up about 1-2% of the health care costs.
It's not the lawsuits. It's the insurance doctors (and now some nurses and PAs) are required to get to insure you against those lawsuits. This can be north of $100k/yr and in some cases (depending on the state) close to a quarter million a year for a surgeon.
The hospital I work at would probably not charge for the Q-tip itself, but add the fully burdened cost to the service provided.
Follow through, though. I'll try to make it easy for you.
The Q-tip was purchased and probably has an acquisition cost of $.01.
It was stocked by a nurse who needed to track inventory to maintain a non-profit status ($35/hr). 30 seconds to place it in the correct position and check off that it is now in inventory. ($0.50)
It was housed in a rolling cabinet that cost $2K. (assume cost is amortized over several years) The cart is cleaned once a week. The Q-tip bucket's share of this cleaning is 30 seconds @ $20/hr. let's say it's $0.01
It was requested by a care provider and took 60 seconds to log the care request into the government mandated electronic medical records used for tracking and assuring proper follow up to care. Cost of 60 seconds of care from a family practice physician (assuming $120K/year) is $1.
The request was printed out at a nurse station and picked up by charge nurse. Evaluation: 15 seconds. Delegation of the service 10 second. For a nurse making $70K/year, that is approximately $0.24.
The CNA ($25/hr) will open up the cabinet, get the Q-tip, walk the Q-tip to the patient. (2 minutes) Cost: Approximately $0.25
CNA logs the patient ID band and confirms the service will be performed: 30 seconds. (approximately $.10)
Actual use of Q-tip by CNA: 1 minute, including disposal in approved container. (approximately $0.20)
Disposal of Q-tip by janatorial staff: $0.01.
If procedure is properly performed and there are no adverse issue, you have an OCOGS of over $2. And you think it should be free?
Medicare and SS spend more money than they take in, so to finance these pyramid schemes the gov't sells bonds.
SS takes in more than they make, you fucking moron. Which is where as these IOUs come from...the rest of the government borrows from them.
Jesus Christ on pogo stick, it's completely astonishing how many people are complete and total idiots.
Here, let me explain to you: You know how you don't have a job because you're too goddamn stupid to work a cash register? (And I also think it's unfair they fired you! Does it really matter if customers pay you or you pay them? Isn't it enough that money moves?) You know how you have to keep borrowing from your parents to pay off your credit cards? You know how they don't charge you interest?
They are, this analogy, social security, and you are the rest of the budget. And you are standing there arguing that they are borrowing too much and spending too much and will collapse, because look at all those IOUs they have from you! (IOUs are bad, right? So having IOUs must be bad, right?)
Hey, dumbass, it's you who have the problem, they're the people fucking bailing you out. The government has borrowed 2.7 trillion dollars from social security.
You get rid of social security, (even if we _don't_ pay it back, aka, we steal the 2.7 trillion dollars we've already borrowed, aka we default on US government securities), and in the future the rest of the budget is in a lot more trouble and has to borrow more, resulting in more interest. We borrowed $805 billion in 2011, so basically you're saying 'I wish we had to pay interest on an extra $805 billion each year!'.
And having stole 2.7 trillion dollars from our security holders (Even if said holders were ourselves), I can only imagine at what interest rate we'd have to offer on those added bonds. And our existing ones.
TL;DR: Conservatives think a place the government can, and has, borrowed money without interest (Instead of issuing bonds which do cost interest), is somehow causing the budget issues, and the fact that it has so much money is obvious proof that it is bankrupt.
(Medicare, OTOH, hovers on the line of taking in too much and too little, but is not separated out like social security and doesn't have a trust fund, so extra money just disappears into the general budget, and comes out another year, so it's harder to see that it's revenue neutral in general. People gasp and point out that it costs X billion dollars one year, and don't notice it made X billion dollars another. Right now, in a recession, yes, it's costing us.)
If corporations are people, aren't stockholders guilty of slavery?
You fail to explain how this will reduce the cost of insurance.
If 75% of your costs are dicking around with the insurance company arguing about whether illness X or medication Y are covered on a particular plan, for a particular patient, during a particular phase of the moon, etc., then you could spend 3 times more on everything else, and still come out of it spending less, if you had a single payer system where you just send them the bill (the charges being determined by the payer), and they pay it.
Government healthcare is, economically speaking, only about killing people before they cost the system (starting with anyone over 60 years, continuing with long-term disability patients, ...). Do you really want your insurance provider to have that principle as it's sole guidance ? Do you really want an organization not bound by contracts and with it's sole incentive to kill you the moment you become unproductive be the sole administrator of your healthcare ?
HAHAHAHAHAHAHAHAHAHAHAHA.
Oh, wow, thanks I needed that laugh.
You should be comic or something: Hey, folks, would you rather have a private corporation run entirely for profit decide whether or not you get care, or would you rather have the government decide that, which has people in it who have to get elected to office?
If corporations are people, aren't stockholders guilty of slavery?
All financed by American prohibition. When you see all the cash they find in a drug lord's mansion, do you see pesos, or dollars?
“He’s not deformed, he’s just drunk!”
I think they are one of few treatments that actually have a negative cost in the system. You create a taxpayer for a few thousand bucks, remember?
Thanks. Very relevant and interesting information.
The REAL costs of government run healthcare in the USA are even higher. Medicare and Medicaid reimbursement rates are mandated by government. Everyone else then gets stuck paying higher prices so that the providers can make up for the losses they take by treating Medicare/Medicaid patients.
Then we have the ban on re-importation of drugs and medical devices so that US citizens are forced to subsidize the rest of the world's medication and medical device usage.
We've also got another wonderful Federal mandate called EMTALA so that hospitals are forced to treat everyone that shows up at the door, regardless of their willingness or ability to pay. Who eats that cost? Not the government.
IMO, our government has totally screwed up the healthcare system in the US, so there's no way I'm going to let them take over the whole thing.
Perhaps in a country where the under-five mortality rate is four? E.g., Belgium, Austria, Denmark, France, Germany, Greece, Ireland, Italy, Netherlands, or Portugal? Some countries manage three (Sweden, Norway, Finland, Japan). Even Cuba manages six. Eight's not exactly something to be proud of with our level of spending.
REAL Solution: Get the damned government and their stupid laws and stupid mandates out of the system entirely.
1. Consumers aren't stupid. If the person buying medical services had a direct relationship with the provider and complete price transparency in a competitive market, they are capable of making their own decisions. Auto mechanics and many other service providers operate on a fee per service basis
2. Good idea.
3. Get the government out of the equation. Make prices transparent and use health insurance more like auto collision insurance. Get rid of government mandates on what MUST be covered by a policy so that people can negotiate contracts for their unique situation.
4. Repeal EMTALA. Negotiate payment terms with the provider or go to a charity hospital.
In other words **** the government!
Private, for-profit businesses deliver millions of goods and services to people with high quality and at affordable prices. Competition and innovation decrease costs and increase quality. Governments never do.
I thought the Mexican healthcare system, was to come to the US illegally across the border, and get onto our welfare system...help drain Medicare, and clog up our Hospitals' Emergency Rooms....?
No, that's just a side result of the Mexican Jobs Program. The health care in Mexico is all covered, but they'd have to go home to use it.
It's easy to provide better healthcare by throwing -LESS- money at it. The secret is cost control. You have to limit the profit margins for the public good.