Universal Health Care

"You still need to answer my question as to who determines physician salaries, etc.
And if you think one state will have problems, why not all 50??"

Who determines salaries now? Medica? I don't think so.
Because 50 states = universal. The complexities and the middleman siphoning off the money flow cannot be eliminated unless it is UNIVERSAL.

 

Can you show me how many are actually coming here?
What for?
Why?
Does their system back home, reimburse them for the costs here?

Besides that, the arguement isn't that our system has lousy care. It has great care for those that can get it. The problem is in getting that care to the people who need it.

As Darwood stated, it isn't free. The person's taxes are paying for it. I've had to use unemployment in the past. It wasn't some handout from the government. It was the return of cash I invested in the system. I didn't get something for free.
There are some things the government can do better than the private sector through its sheer size. Healthcare can be one of those things.
One of the articles I previuosly link may have covered this, but add up all your state and federal taxes, plus your health care costs. Compare that to one of those higher ranked countries tax rate, and there is a good chance you are paying the same or more than if you were under that 'socialist' tax system. And you would getting better care for essential healthcare.
Forget the rights issue for a moment, we need it to remain competative. Everyone one these boards probably heard that Toyota choose Canada over the US for a new factory, because Canada has a single payer system. Even if the cost of the actual care were same, our system cost a company more because they have to take the time to select an insurance company and then negotiate with them. They will likely have to go through that process peroidically. Large companies likely have to set up a seperate staff to handle the healthcare program.

 

<div class='quotetop'>QUOTE(ShellyT @ Aug 8 2007, 10:52 AM) [snapback]492375[/snapback]</div>

who does not get care. as a physician in manhattan i can attest to everyone that we take care of rich and poor, insured and uninsured. i am lost by this argument of people not having access to care.

how many non us citizens come here for medical treatment - tough to guess, i would say hundreds of thousands a year if you include canadians - get the point?

 

<div class='quotetop'>QUOTE(Darwood @ Aug 8 2007, 09:58 AM) [snapback]492329[/snapback]</div>

I think one question we need to ask is why did employers start offering health care to begin with? Government imposed wage controls during the 1940's carry a large part of the blame for this current state of affairs. Unable to offer competitive salaries, companies started to offer health care benefits as a way to lure prospective employees into jobs.

Times have changed. People rarely work for the same employer for more than a few years and this causes real problems because their health care plans are not portable. Everyone points to the 47 million Americans without health insurance, but they fail to point out that most are uninsured for only brief periods, mostly because they are between jobs or in a job-related waiting period for benefits to kick-in.

The real problem is that their is no competition in our current health care system. You enroll in the health care plan that your employer chooses and you visit whichever doctors participate in that plan. Most people choose their physicians based on their coverage and not by the skill or reputation of the physician. That is wrong.

Additionally, the current U.S. health care system also decreases incentives to "shop around" for the best price. If you are paying a set amount per month in premiums and your co-pay is ten dollars per office visit no matter where you go, why bother to look for a better price?

<div class='quotetop'>QUOTE(ShellyT @ Aug 8 2007, 10:52 AM) [snapback]492375[/snapback]</div>

I can give you an example. When former Italian Prime Minister Silvio Berlusconi needed heart surgery last year, he didn't go to an Italian hospital or to France, Canada or Cuba. He came to the Cleveland Clinic.

Also, you are implying that people without insurance don't get health care. In fact, most do. Hospitals are legally obliged to provide care regardless of ability to pay, and while physicians don't face the same requirements, few are willing to deny treatment because a patient lacks insurance. Treatment for the uninsured may well mean financial hardship, but by and large they do get care.

 

<div class='quotetop'>QUOTE(Swanny1172 @ 2007 Aug 7 2:58 PM) [snapback]492071[/snapback]</div>

I don't think I made your point at all, and I think you missed mine completely. I was suggesting you research the political leanings of various world governments, and see how that correlates to success in the health care department. None of the countries with high quality health care could possibly be socialist, now, could they?

<div class='quotetop'>QUOTE(Swanny1172 @ 2007 Aug 7 4:30 PM) [snapback]492113[/snapback]</div>

All corporations have the Midas touch that turns everything to gold, and all governments have the Medusa touch that turns everything to stone? Interesting theory, but totally out of touch with reality.

 

<div class='quotetop'>QUOTE(Darwood @ Aug 8 2007, 10:47 AM) [snapback]492369[/snapback]</div>

Again, how are you going to pay for this UNIVERSAL system that you are proposing? Are you going to raise taxes? That didn't work in France, where care is free to all that seek it. Their system is funded through a 13.55 percent payroll tax, a 5.25 percent income tax and other taxes on tobacco, alcohol and drug-company revenues. And the system is still running a $15.6 billion deficit.

 

Swanny's post:
"Times have changed. People rarely work for the same employer for more than a few years and this causes real problems because their health care plans are not portable. Everyone points to the 47 million Americans without health insurance, but they fail to point out that most are uninsured for only brief periods, mostly because they are between jobs or in a job-related waiting period for benefits to kick-in.

The real problem is that their is no competition in our current health care system. You enroll in the health care plan that your employer chooses and you visit whichever doctors participate in that plan. Most people choose their physicians based on their coverage and not by the skill or reputation of the physician. That is wrong.

Additionally, the current U.S. health care system also decreases incentives to "shop around" for the best price. If you are paying a set amount per month in premiums and your co-pay is ten dollars per office visit no matter where you go, why bother to look for a better price?"



I agree with a lot of that, Swanny. Portability is a huge problem. So is affordability of COBRA coverage. And if you happen to get cancer in the months between jobs and you did NOT use COBRA, you might as well off yourself, cuase you're SCREWED.


"why bother to look for a better price?" Actually, you CAN'T look for a better price. You get the plan your employer has. You go to the doctors that the plan allows. There is NO choice to make.

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 10:09 AM) [snapback]492396[/snapback]</div>

Who pays NOW? WE DO. Who will pay then? WE WILL. Why does it matter if we pay through paycheck dedcutions and less salary (to cover employer cost of insurance) or if we pay it through taxes? We still pay either way. But at least greedy insurance companies won't get their hands on it. Greedy politicians might, but that's our job as Americans to oversee our legislators. We get no oversight in the current system. Instead, we get lobbyists, back door deals, and Viagra ads every where you look.

 

<div class='quotetop'>QUOTE(Darwood @ Aug 8 2007, 11:17 AM) [snapback]492398[/snapback]</div>

Trust me, I can see some of the efficiencies that could be gained through a single-payer system, but I would only agree to one as long as the new program would not make other health care plans or operations illegal. Those that can afford to should be able to opt-out, and doctors should not be forced to work for the government. If Universal Health Care is really the proselytized silver bullet that everyone claims it to be, then the new program shouldn’t be scared of a little competition. In fact, it should benefit greatly from it. Citizens could choose to take advantage of the government program, but they should also have the choice to pay for other services.

The federal and state government would also give up most of its regulations and oversight over this new private sector of health care and focus exclusively on the new program. Government run offices, hospitals, etc., could only get increases in funding one way, and that is if they are providing better service than their private counterparts in a given region. Comparisons would be made based on total patients served, mortality rate, polls, and other similar metrics to be determined at a later date.

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 10:28 AM) [snapback]492404[/snapback]</div>

I completely agree! I would predict supplemental policies would be quite common, which we see now with Medicare. I never envisioned that doctor's would be government employees either. The bills they send out would just be paid by them.

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 8 2007, 08:26 AM) [snapback]492321[/snapback]</div>

Proof? How about that every other western country that provides universal single-payer health care to their citizens also spends inconsiderably less than we do to cover a great percentage of their population. These countries also have longer life expectancies, lower infant mortality and rank higher than the US for standard of care.

<div class='quotetop'>QUOTE(dbermanmd @ Aug 8 2007, 08:26 AM) [snapback]492321[/snapback]</div>

Wisconsin's plan is not a universal single payer system as used by European countries. It does provide for universal coverage for children but not for all citizens. The Wisconsin plan is a catastrophic reinsurance policy. The state of Wisconsin will reimburse private insurance companies for catastrophic claims. The idea is that this will allow the insurance companies to reduce premiums because the state government assumes the risk for catastrophic claims. The state will also provide tax rebates to individuals that purchase their own insurance. This is also not new, Dr. B's own state of New York has been doing this since 2001.

So regardless of what Dr. B claims this is NOT universal health care. It is a great little trick to boost private insurance companies profits by shifting risk from the companies to the state with no guaranteed return to the states citizens. Read all about it yourself if you like instead of relying of Dr. B's misrepresentations.

http://www.dhfs.state.wi.us/HealthyWiscons...df/proposal.pdf

Dr. B, why do you always misrepresent or outright lie about anything that you provide as proof of your position? Can't you just let your evidence speak for itself?

The Goals of "Healthy Wisconsin" from the State of Wisconsin's own website:
Reduce the cost of health insurance premiums by 30% for individuals and small businesses.
Reduce the uninsured rate in Wisconsin by 50%.
Increase the number of businesses that offer their employees affordable, comprehensive health insurance.

You could have simply said that Wisconsin is close to implementing a reinsurance program with the goal of reducing the cost of health insurance and decreasing the rates of the uninsured. Instead you LIED and said "the State of Wisconsin which is on the cusp on enacting socialized universal care for all its citizens". Why lie?

 

<div class='quotetop'>QUOTE(Darwood @ Aug 8 2007, 11:35 AM) [snapback]492408[/snapback]</div>

I'm not talking about supplemental plans, but rather the right to opt-out of the Universal Health Care Plan entirely and either pay directly for services or participate in a private insurance plan. Doctors could also choose to opt-out of the plan, as their license to practice medicine would not be predicated upon participation in the plan.

I guess I am a little confused? Do you see Universal Health Care as free health care coverage for everyone, or do you see it as a single-payer system? Do you see it as just extending Medicare benefits to everyone?

 

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 11:39 AM) [snapback]492411[/snapback]</div>

The limited plan of Wisconsin (for individuals, not just children) is expected to cost more in the first year than the State receives in taxes in toto - so imagine the cost if it were to cover all its citizens universally? And how are they going to pay for it? What do you think will happen to businesses in Wisconsin? What will happen to their other obligations like education?

No trick here. There is no socialized medical system that works anywhere - and those that barely survive only due so because of living off the American medical system.

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 11:41 AM) [snapback]492412[/snapback]</div>

Agree - should be voluntary - you could just expand VA care for those that want it :blink:

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 10:41 AM) [snapback]492412[/snapback]</div>

There is no proposal on the table. How can we see it as anything? I see a need for change and enjoy the discussion on how we can make it better (Barring Dr. B's constant "SHOW ME MY MONEY" crap).

I think the easiest fix is to extend medicare to everyone (and yes, increase the taxes for it). All basic procedures and the stuff medicare proides for seniors would be covered for everyone. Sort of a healthcare safety net. The existing insurance companies would only be needed as suplemental policies, thereby reducing there cost, but still providing the great care that they do to those who could afford the supplemental insurance. I don't know if this would/should be through employers still, or a private portability policy, more like life insurance policies people carry. There are obviously many more details to such a plan, but that's why we are discussing it, right? (or trying hard to prevent good discussion on it, depending on which side your bread is buttered on).

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 11:28 AM) [snapback]492404[/snapback]</div>

A Wise Swanny indeed

 

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 11:39 AM) [snapback]492411[/snapback]</div>

Most experts agree that life expectancies are a poor measure of health care, because they are affected by too many other factors like violent crime, poverty, obesity, tobacco and drug use, and other issues unrelated to a country's health system. Americans in Utah live longer than those in New York City, despite having essentially the same health care.

And what about those other countries? Let's look at the ones that are most similar to the US -- Canada and Great Britain. In Canada, nearly 800,000 are currently waiting for treatment. The Canadian Supreme Court has pointed out that many Canadians waiting for treatment suffer chronic pain and, "Patients die while on the waiting list."

Or what about Great Britain? Nearly 850,000 Britons are waiting for admission to National Health Service hospitals. Every year, shortages force the NHS to cancel as many as 50,000 operations. Roughly 40 percent of cancer patients never get to see an oncology specialist. Delays in getting treatment are often so long that nearly 20 percent of colon-cancer cases considered treatable when first diagnosed are incurable by the time treatment is finally offered.


<div class='quotetop'>QUOTE(Darwood @ Aug 8 2007, 11:53 AM) [snapback]492417[/snapback]</div>

The problem with expanding Medicare is that the plan is flawed to begin with. Medicare specifies standard rates for nearly every medical treatment. Because participating health-care providers must adhere to these rates for all patients, these policies effectively create a regulated price structure for all medical care.

 

We're not talking about other countries, we're talking about the US.

"20 percent of colon-cancer cases considered treatable when first diagnosed are incurable by the time treatment is finally offered."

Define "considered treatable" and "waiting for treatment". I have a great deal of experience with colon cancer deaths and this stat smacks of vaguery and oversimplification. My brother (considered treatable) was waiting for various treatments throughout the 6 years he fought colon cancer.

"In Canada, nearly 800,000 are currently waiting for treatment."
This doesn't mean anything. Right now there are far more than that sitting in waiting rooms accross the country "waiting for treatment". Others are at home waiting for their appointment a day, a week, or a month from now.

...waiting for the usual scare stories to be brought up AGAIN.....
As if if no healthcare injustice has EVER occurred in the US....

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 10:06 AM) [snapback]492388[/snapback]</div>

Let's see, when my brother was still a paramedic on an ambulance if you didn't have an insurance card in you wallet you went to the county hospital, it didn't matter if one of the privately run hospitals was closer.

In all the doctors offices that I visited in East TN required me to show my insurance card when I when up to the receptionist. They ran my card to see what the co-pay was for my scheduled visit and I was required to pay it before seeing the doctor. You can't pay, you don't see the doctor. It was the same thing with people without insurance except they had to pay in full before seeing the doctor. So says the giant 3'x5' sign in the reception area. That sounds like the definition of denying care to those that can't pay.

This policy pretty much requires the poor and uninsured to go to the emergency room for any care or go without. Most just go without unless they have life threatening conditions.

I've just moved to Birmingham, AL and they have a big outbreak of syphilis. Now syphilis is a STD that is easy to treat with a single shot of penicillin if you catch it early. If you ignore the first symptoms, which will go way by itself, and wait for the second round of symptoms then you need a longer penicillin regiment. It is also much harder to identify in later stages because the symptoms are more varied. If you leave syphilis untreated it can lead to cardiovascular and neurological problems that cannot be reversed.

Now the poor uninsured in Birmingham has the choice of paying $100 to $150 upfront to see a doctor or going to the emergency room and paying $500 or more but not having to pay right away. Or they can just go to the store and get some anti-itch cream for $3 and hope that it is just a rash. What do you think the average minimum wage worker does?

 

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 12:14 PM) [snapback]492434[/snapback]</div>

But, they received treatment, right?

Hospitals have to treat patients, private physicians don't. Are you saying that a doctor, in his own office, should be forced to see a patient that has no way of paying? Would you expect a mechanic to fix your car if you had no way to pay him? Of course not, so why would you expect anything different from a physician.

Again, they got treatment, right? It doesn't matter where they had to go to get it, as much as it does that treatment is available and that they were able to receive it.

<div class='quotetop'>QUOTE(Darwood @ Aug 8 2007, 12:05 PM) [snapback]492426[/snapback]</div>

Excuse me, but my post was in response to a question about how the US stacks up against other countries which have adopted universal health care programs, so we are talking about other countries.

One of the realities of universal health care are waiting lists. Access to a waiting list is should not be confused with access to health care, just as standing in line at a restaurant should not be confused with eating.

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 8 2007, 10:53 AM) [snapback]492416[/snapback]</div>

AGAIN YOU OUTRIGHT LIE! WHY? The NEW proposal has NO state supplied care for individuals. The only state supplied care for individuals are Medicaid, Medicare, BadgerCare, and Senior Care. These are all existing programs.

This is the scope of the proposal from the governor:
Governor Doyle's Healtch Care Agenda
1. Badger Care Plus - Health Insurance for all Children
2. Healthy Wisconsin - Reinsurance for Catastrophic Care
3. Family Care Statewide - Allowing seniors to Remain in the Homes
4. Access to Affordable Prescription Drugs
--Protect SeniorCare
--Canadian Drug Website
--Badger Rx
6. Increases Tax Deduction for Health Insurance Premiums for worker whose employer does not contribute to the cost of health insurance.
7. Creates a Tax Deduction for Health Insurance Premiums for individuals with no employer and are not self-employed.
8. E-Health Board- Information on Quality and Cost in Health Care, Reduce Medical Errors.
9. Permit the development of health care "co-ops" for farmers and small businesses.
( I know that 5 is missing but this is verbatim from the State of Wisconsin's website and they have a typo)
New Winsconsin Proposal: http://www.dhfs.state.wi.us/HealthyWiscons...df/proposal.pdf

Wisconsin's Existing Programs: http://www.dhfs.state.wi.us/badgercareplus...aidoverview.pdf
Note you have to be poor or old or both to qualify.

So there you have it, NOT UNIVERSAL HEALTH CARE and no "limited plan for individuals" that are not already covered by existing programs for the young, old, and poor.

SO I REPEAT, AGAIN YOU LIED! WHY? DOES YOUR CREDIBILITY NOT MATTER EVEN A LITTLE BIT TO YOU?

<div class='quotetop'>QUOTE(dbermanmd @ Aug 8 2007, 10:53 AM) [snapback]492416[/snapback]</div>

WHAT? you have already called this "Socialized Universal Healthcare". Now you say "Imagine the cost if it were to cover all its citizens universally?" Which is it? Did you LIE by calling Wisconsin's plan "Socialized Universal Healthcare" originally, or are you LYING NOW by saying that it doesn't cover every one universally? Which is it?

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 12:30 PM) [snapback]492440[/snapback]</div>

and what kind of hardship did they experience as a result? again, a single emergency would put many americans near bankruptcy.

we lived in a nice place until a few months after the medical bills started to add up. we broke our lease, our argument being that thanks to the hospital bills we would either break the lease or be evicted for non-payment of rent.

the cheaper apartment helped us to recover, but i can't say it's too comforting hearing so many gunshots, car alarms, police sirens and the like going off every night. and, we had to move all our stuff despite my husband being in serious pain. that left the majority of the move to me, and i've got my own back problems. i had to take 4 days off work to lay in bed afterward, and no we didn't have the money for me to go see a doc and maybe get a prescription. so it cost me a lot of pain too.

i'm sharing these real-life experiences in the hope that you get it. the average american is SCREWED if they need care. so that hospital visit may have saved a life, but think of the suffering that person may have gone through afterward to cope with the serious financial consequences. access to care is one thing, access to care without losing everything in your name is another.