Universal Health Care

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 6 2007, 03:02 PM) [snapback]491452[/snapback]</div>

The free market doesn't always work, as has been seen in our current system. The free market has only made healthcare worse in the last 50 years. The free market makes insurance companies have profit motives in denying coverage to those who need it and denying services to the rest. I was once a Libertarian who wished that free markets, if perfect, will always provide the best system (stupid, stupid, stupid). However, free markets are never perfect, and free markets can lie against the best interest of society as a whole due to the 'prisoner's delimma'. I am a capitalist, but certain things such as healthcare and education shouldn't be determined based on wealth and ability to pay.

 

<div class='quotetop'>QUOTE(MarkMN @ Aug 6 2007, 04:17 PM) [snapback]491466[/snapback]</div>

Excuse me, but our current health care system is anything but a free-market. What the US has is an assortment of private and public third-party payers. For the most part, we do not have a system where consumers purchase and consume their own health care coverage. In short, health care consumers in the US spend other people's money (insurance) on themselves.

For the US health care consumer, there is no incentive to cut costs or to ration one's own care. The dominant incentive in the US health care system is to consume health care without regard to the cost. Naturally, this leads both to over-utilization of health care, and the consequent price rises that follow such over-utilization. That simply isn't a rational system.

A free-market health care system would get employers out of the business of providing health insurance. Instead, each individual could choose to purchase whatever health coverage he desired. The cost of that health coverage would then be treated as a tax credit—not a deduction—so that the individual would essentially be reimbursed for the cost by the government by subtracting it from his tax bill. In cases where the amount paid for health coverage is greater than the amount of taxes owed, the government would refund the difference, just as they do with any other tax credit. For the poor, the government would simply issue vouchers to cover the cost of the health plan chosen by the individual.

It seems to me that if you're so all-fired certain that the government needs to pay for health care, a system like this would work far better than any single-payer health care system you can point to. The government would remain the "payer" of last resort, through reducing individual income taxes. The actual purchases and consumption, however, would be in the hands of the consumers.

For an example of a true free-market in US health care, you need to look to the field of cosmetic surgery. Prices for cosmetic surgery are falling even as more Americans opt for breast enlargements and tummy-tucks, because plastic surgeons compete with each other to offer better services at cheaper prices. Doctors also gravitate to cosmetic surgery because of the paucity of regulations and the fact that consumers pay directly out of pocket, allowing them to avoid insurance gatekeepers. Where the market rules, physicians and consumers are happier with the results.

 

OK.
Lets talk actual costs then.
Here is the breakdown of our small companies Medica coverage.

Employee 1- $1863.09
Employee 2- $1813.81
Employee 3- $562.78
Employee 4- $1520.32
Employee 5- $1073.13

Basically if you have a spouse and 2 kids, you're looking at $1500 per month MINIMUM. People on minimum wage cannot afford that!
As an employer, we can't really afford it either (We pay 75%). But we have no choice. No coverage=no employees.

"What the US has is an assortment of private and public third-party payers. " And that's part of the problem! It's a friggen mess. We need to take it out of the hands of employers before US companies become COMPLETELY uncompetitive in the world economy. But you can't expect the downtrodden to write checks for $1500 every month, they just can't.
But they'll still end up in the emergency room (Like illegal immigrants). And we still pay for indirectly then.

 

More and more Americans report suffering from "job lock." This means that an increasing number of people are afraid to go after better employment opportunities, for fear of losing health care coverage.

That doesn't seem right.

Also, thanks for pointing out what the *actual* cost of healthcare is.

Every proposal sounds grand in the abstract, but not when specifics are actually included.

 

<div class='quotetop'>QUOTE(Darwood @ Aug 6 2007, 04:45 PM) [snapback]491482[/snapback]</div>

Throwing out numbers without providing what kind of plan you are talking about doesn't help the issue. In most health plans, there are different levels of coverage with different monthly premiums for each. Without knowing what kind of a plan you are talking about, those numbers are meaningless.

 

This always pops in my head when I hear free-market:
It was fifty years between the invention of canned food and the can opener.

I not saying the free market is never an answer, but it isn't the right answer for all. For one thing there is no true free market in the world. If the US healthcare system was a free market, employers will no longer be paying directly for health coverage, but they likely have to increase wages to the employee to cover their new expense. With a decrease in health care prices, that pay increase may be less than paying the previous insurance. It is still more of a burden to the employer than a tax paid single payer system. The money spent may be the same, and may ultimately come from the same source, but the costs are upfront in the US to the employer. That may be counted as a disadvantage to a foreign investor.

There are some things you shouldn't leave up the individual for the public good. What if a person that uses the same route as you to commute has seizures or is bi-polar and just felt like closing his eyes for a minute while doing 65. What if your co-worker has meningitus, TB, flu, or the plague. Some people won't get the care they need regardless of the system, but why leave being cheap or broke as an excuse for basic and community relavent care.

If there was an attack with bio or chem weapons, would you let the victims pay their own way for care?

 

<div class='quotetop'>QUOTE(ShellyT @ Aug 6 2007, 04:34 PM) [snapback]491506[/snapback]</div>

Free Market is the libertarians excuse for corporations to be able to more freely exploit without regulation.Corporations literally have no other purpose than to maximize profit.
Why should the health of the members of our society depend on any profit motive?
The # of entrances to medical school is fixed by the AMA.
They control the supply in order to increase demand artificially.Wheres the free market ?
Heres an interesting article from the New England Journal of Medicine about 88 American med students being trained in Cuba for free.
http://academic.udayton.edu/health/02organ/providers01.htm
They recently graduated.
http://www.msnbc.msn.com/id/19942866/

 

<div class='quotetop'>QUOTE(ShellyT @ Aug 6 2007, 05:34 PM) [snapback]491506[/snapback]</div>

That is certainly a bit disingenuous. Do you really expect us to believe that cans weren't used during those 50 years?

In fact, British merchant Peter Durand patented the tin can in 1810. In 1813, John Hall and Bryan Dorkin opened the first commercial canning factory in England. In 1846, Henry Evans invents a machine that can manufacture tin cans at a rate of sixty per hour.

The first tin cans were so thick they had to be hammered open. As cans became thinner, it became possible to invent dedicated can openers. In 1858, Ezra Warner of Waterbury, Connecticut patented the first can opener.

So, the real issue was one of technology and not the free-market.

 

<div class='quotetop'>QUOTE(MarkMN @ Aug 6 2007, 12:25 PM) [snapback]491427[/snapback]</div>

hmm - have you tried googling "canada health care wait". You will turn up a lot of stats and even "wait list strategies". If you do not think it's so bad, go back and read the post from "hard working student" who lost a baby because his wife could not get an ultrasound for 3 weeks. when they lived in wonderful Canada. I'll take higher US prices if it means I can get the care I need, when I need it, from my physician of choice. Perhaps your idea of moving isn't so bad - then you can get the healthcare you deserve! :lol:

 

Another article
http://www.businessweek.com/technology/con...0621_716260.htm

It'll take longer in Canada, but the US takes longer than the others. So it seems paying more isn't a garranty of getting timely care.

Found this post from some guy on the internet. So it has about as much merit as anything else posted here.

I sorry to hear about the loss of a baby. It's a shame the system failed you.
But the system is failing people in the US also.

What about the risk of a contagious disease being harbored in the poor or uninsured population? Having the means of healthcare doesn't automaticly shield you from a lingering sickness in the community.

 

<div class='quotetop'>QUOTE(ShellyT @ Aug 7 2007, 10:06 AM) [snapback]491821[/snapback]</div>

My sister paid for the highest level of coverage at Kaiser California.
She had the worst headache in her life (which felt like a spike was in her head) with nausea and vomiting which lasted for many days.
She visited Kaiser and was given no treatment, but was given a neurology appointment for 3 months later.She died the next day at 44 years old.
Later I looked in the home medical guide and it took me less than a minute to find that these symptoms are for aneurysm and to seek emergency medical attention.
A UCSF neurology professor looked at her records and said it was obvious malpractice.
We looked into suing and to my surprise found that Kaiser in California has legislation limiting their malpractice liability to $100,000.No lawyer will take a case on contingency for that kind of money.
What really pissed me off is that Kaiser has financial incentive to neglect to give patients expensive MRIs .They could save millions in this manner.They also avoided paying for the subsequent surgical procedures ,again saving millions.
I wouldnt mind so much ,if this savings went to the greater good providing a universal healthcare system.But not just to enrich the medical establishment.

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 6 2007, 03:29 PM) [snapback]491475[/snapback]</div>

Ummm, no incentives to ration one's care??? If I go to the doctor's office because I am sick, I am charged about 80 dollars in an office visit fee, plus sometimes another 40$ for a lab fee, even though I have insurance. There is a disincentive for me to make sure that if I am sick for three days, that it is nothing worse than influenza. That system also makes me think how long I should walk around sick (or stay at home sick) before I decide that my illness might be due to a more serious concern. Also, there is VERY little in health insurance that comes without a copay, or is subject to the deductible. Nearly everthing costs the 'consumer' (i.e. sick patient) something in the hospital. Either you have one hell of a healthcare policy, or you have never tried using your healthcare policy.

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 6 2007, 03:29 PM) [snapback]491475[/snapback]</div>

By the way, most tax credits don't apply if it is more than the tax owed (is there any, other than the EIC).

The system you propose is flawed (if I am understanding it correctly). If the government gives me a credit for whatever health coverage I choose, why wouldn't I choose the most expensive health coverage available - the government pays for it anyways. This would just allow for government to hand over money to profit making corporations. Really, the problem with any system with tax credits and deductions is that health care is subsidized to private companies that make profit.

 

<div class='quotetop'>QUOTE(MarkMN @ Aug 7 2007, 03:12 PM) [snapback]491954[/snapback]</div>

Sorry, but your insurance stinks if you get stuck paying an $80 co-pay for an office visit.

Employees on expense accounts spend much more freely than when spending their own hard-earned money. Similarly, employees consume medical services with little regard for cost effectiveness when someone else is footing the bill. As a result, a substantial portion of employer health care dollars are used to pay for unnecessary or inefficiently-provided services, or for treatment of diseases and conditions which are preventable.

My co-pay is $25 per office visit. Having small children, I am at the doctors office frequently. Also, I know all about deductibles, as I have had to pay those as well. Of course, all of these keep me from running to the doctor at the first sign of the sniffles, something that people with "universal healthcare" would have no incentive not to do, because it wouldn't cost them a thing out of their pockets.

All you need to do is look at the people with kids on MedicAid that run to the emergency room for treatment that they should be seeing their physician for. Why should they care that emergency room visits are more expensive? After all, they aren't paying for it anyway.

Studies on cost sharing show that patients who have to pay for part of their care cut back on the use of medical services substantially, although both medically necessary and unnecessary hospital care may be reduced. This indicates that patients need to be better consumers of health care and need to educate themselves much more about their medical conditions and available options for treatment.

Consider the case of SimpleCare, which is spreading across the United States. In SimpleCare, patients agree to pay physicians in full on the spot. This cuts out the morass of administrative paperwork, allowing doctors to slash their fees by between 30 percent and 50 percent. Uninsured people can access SimpleCare physicians by paying an annual $20 fee. Since patients are paying up front for routine maintenance, they can afford to buy high-deductible catastrophic insurance policies to cover emergencies like cancer and heart attacks.

The tax credits would reduce your tax owed. If they were greater, you would get a refund.

Again, with market forces at work, the most expensive health coverage would not necessarily be the best. Competition, not regulation, would keep health-care costs and insurance premiums low. On the other hand, when a health service is transformed into a government service, add the cost of all the bureaucratic machinery required to run it — all the bureaucrats with their salaries, pensions, annual leaves, sick leaves, and Civil Service – protection making it impossible to fire incompetents — and it gets to be a very high cost operation. Not surprisingly, it all ends up with lower-quality care at a much higher cost.

From a historical perspective, it’s interesting to note that as recently as the 1960s, low-cost health insurance was available to virtually everyone in America, including people with existing medical problems. Doctors made house calls. A hospital stay cost only a few days’ pay. Drugs were relatively inexpensive. And charity hospitals were available to take care of families who couldn’t afford to pay for health care. Then the federal government moved in with Medicare, Medicaid, the HMO Act, and tens of thousands of regulations on doctors, hospitals, and health-insurance companies, inciting skyrocketing costs.

 

<div class='quotetop'>QUOTE(TimBikes @ Aug 7 2007, 01:26 AM) [snapback]491738[/snapback]</div>

I found http://www.health.gov.on.ca/transformation...public_mn.html# and did a couple of waittime searches for the Toronto area. (the wait list time is noted as the time it takes for 9 out of 10 patients to have completed surgery) Breast cancer surgery - 22 days, cataract surgery 78 days. What is so horrific at these numbers considering that anyone in the population that needs these procedures can have them despite ability to pay??

I am glad you can afford the US healthcare prices, or at least you believe you can afford them. I and most americans can't afford the healthcare in the US, so should most americans just not get the healthcare we need but can't afford so that you can have your healthcare done whenever you want it??? Also, I am glad you can get the physician of your choice; my insurance gives me a handful of providers in-network that I can choose from, which is a very narrow list despite having insurance from a very large company (and if you think going out-of-network is even feasible then you need to get out of your gated community and look around and realize that not everyone is as wealthy as you, despite working just as hard).

One last thing, It is apparent to you that people like me don't 'deserve' healthcare. Are you sure you really mean that?? Healthcare isn't a human right???

 

<div class='quotetop'>QUOTE(MarkMN @ Aug 7 2007, 03:50 PM) [snapback]491985[/snapback]</div>

Let me sidebar this for one second. As a physician who has been practicing in Manhattan for nearly 20 years what will happen to my:

1. Income. who will pay me and how will they set my salary? Are there going to be incentives for performance - number of patients seen, quality of care? Will there be yearly increases based on inflation?

2. Staff. who will pay my staff and their benefits - disability, dental, etc?

3. utilities and practice expenses like electronic record costs. who will pay those?

4. loans. who will pay those as they are related to medical education?

5. insurance. who will pay my medical malpractice insurance?

6. equipment. who will decide when i should buy new endoscopy equipment or other diagnostic equipment - and who will pay for it?

7. on-call. will i be paid extra for night-time work or weekends? And if not, who will cover those time periods?

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 7 2007, 02:36 PM) [snapback]491972[/snapback]</div>

The US spends twice the amount per capita as countries with socialized medicine.
Obviously, its your glorious corporate "free market " that is causing the gouging.
http://www.nybooks.com/images/tables/20060323img2.gif

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 7 2007, 02:36 PM) [snapback]491972[/snapback]</div>

Umm, the best health coverage would be the one that covers everything, and that is the one I and the rest of america would make the US government pay for through your tax credit/refund. There is no beef behind the claims that government would build a huge bureacracy; that is just propaganda that the taxevaders league and conversatives use to kill every government program. The advantages with a government service is that profit is no longer a motivation in denying health services to people. In any private system, a percentage of revenues, upwards of 20%, is profit that is funneled into huge bonuses for executives and dividends to shareholders (aka. people with money make money). But in your government paid for private system, the government pays people to pay corporations who then take 20% of that and give it to shareholders. So the money flows from the taxpayers to the corporation's shareholders. Also, you are being idealistic about market forces working to keep healthcare costs low. Why keep healthcare costs low when the government is going to pay your customers to buy your health coverage anyway?

The HMO Act was a horrible peice of legislation.

 

<div class='quotetop'>QUOTE(MarkMN @ Aug 7 2007, 03:50 PM) [snapback]491985[/snapback]</div>

Nope, healthcare is not a right. In fact, neither is health. It makes no more sense to claim a right to health than to claim a right to wisdom or courage. However, in an age when people are clamorous about “rights†without responsibility, they don’t want to be told that health is primarily their duty and responsibility.

So what are rights? The American concept of it is officially stated in the Declaration of Independence. It upholds man's unalienable, individual rights, which are the rights to life, liberty, property, and the pursuit of happiness. That's all. According to the Founding Fathers, we are not born with a right to a trip to Disneyland, or a meal at McDonald's, or a kidney dialysis.

Under the American system you have a right to health care if you can pay for it, i.e., if you can earn it by your own action and effort. But nobody has the right to the services of any professional individual or group simply because he wants them and desperately needs them. The very fact that he needs these services so desperately is the proof that he had better respect the freedom, the integrity, and the rights of the people who provide them.

You have a right to work, not to rob others of the fruits of their work, not to turn others into sacrificial, rightless animals laboring to fulfill your needs.

<div class='quotetop'>QUOTE(mojo @ Aug 7 2007, 04:12 PM) [snapback]491993[/snapback]</div>

Once again, we don't currently have a free-market health care system in the United States. To have a free market, you have to have choices, and most of us don't have than now. We don't have choices in terms of our insurers, which means that we don't have choices over which doctors provide our care. Instead, we are locked into whatever health care plan our employer chooses to offer. 59.5% of Americans receive their health insurance coverage through an employer, while only about 9% purchase it directly from the market.

Additionally, the health care industry is likely the most heavily regulated industry in the United States. A Cato Institute study suggests that this regulation provides benefits in the amount of $170 billion but costs the public up to $340 billion. The study found that the majority of the cost differential arises from medical malpractice, FDA regulations, and facilities regulations.

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 7 2007, 04:14 PM) [snapback]491999[/snapback]</div>

Amen Brother!

Exactly, health care is NOT a right. and universal health care or socialized medicine is all about a group of people who believe they are born with an inalienable right to live off the efforts of others. our country's success has rested on the efforts and labor of the individual, not of the government. There should be a HUGE fear of a large and all encompassing government - the same fear our founding fathers had. Socializing medicine would bring 20% of the countries GDP under govt control and give the govt control over the most important aspect of our lives - our right to determine what is the best for us for our own health.

i see nobody is touching my prior post either...

 

so the operative is to keep people from running to the doctor to ask for treatment for the common cold every 2 weeks... ok...

now tell me what you're going to do for people with *real*, you know, documented health problems... what are you going to do to keep THEM from going to the doctor? oh i know... let me quote the last surgeon's opinion we got before finally being accepted to the pain management clinic: "i suggest you suck it up and live with it."

we have been through the wringer with the current healthcare setup. we nearly lost everything we have worked so hard for after a few months worth of misfortunes that had nothing to do with our lifestyle choices or stupid decisions we've made. so don't go telling me we brought this on ourselves. you're telling me that we should leave the system that way for our own best interest?! i would guess those of you who like the system as it is either have loads of money socked away for this type of situation, are making huge profits off folks like me, or have never had a serious health problem where you really needed at least halfway decent insurance benefits.