Universal Health Care

<div class='quotetop'>QUOTE(galaxee @ Aug 8 2007, 12:54 PM) [snapback]492458[/snapback]</div>

We may all wish that someone else would provide us with all of the health care we desire. But no employer, no insurance company, and no government can afford to do that. Each individual and each family must place a priority on providing themselves with the highest quality health care they can afford. (What, after all, should have a higher priority?)

Nobody ever said that health care was cheap. But, a large portion of the reason that it is so expensive is due to the costs of administration. A couple of years ago, ABC News reported that the Duke University hospital system had more employees in their billing department than they had doctors and nurses. If your hospital bill includes a charge of $25.00 for an aspirin, it’s not because they have to pay that to a drug company. Nor does your doctor get a commission on aspirin sales. It’s because of the system’s administrative costs, which exist as a vain effort to control costs.

When government intervenes in health care it makes the problem much worse. Medicare regulations currently exceed 130,000 pages. No hospital, physician, or patient can read or understand them. It is probably impossible for any health care provider to comply with some provisions of these regulations without violating other provisions. And people wonder why the increase in health care costs in the last forty years is in direct proportion to increased government intervention in health care. The government now uses your money to pay for 50 percent of health care. That is up from less than 10 percent, forty years ago.

The "crisis" was created by government, not just through its own reckless spending, but through the consequent destruction of much of the free market. In a free market, if you did not have much to spend on insurance premiums, you could buy a policy that simply covers you for a major illness or a severe injury. Many people worry about the financial ruin that might result from such misfortune and want coverage only for that. They are willing to take their own risk for routine medical expenses if they have reasonable coverage for emergencies.

Such policies are often forbidden by state governments. In California, for example, such policies are not available. Legislators and regulators have imposed 49 specific coverage requirements on all insurance companies. Many states have such requirements. It does not matter if you do not want coverage for chiropractic, or in vitro fertilization, or electronic shock or hypnotherapy for mental illness—you may still have to pay for it. That is, providers in the insurance business are not allowed to offer a policy that you might want and that they would like to offer—they are forbidden. If those restrictions drive the cost of insurance up to more than you can pay, you can thank the government. Insurance policies will get even more expensive in California if the recent proposal of the Governor to require coverage of such "wellness" care as gym and Weight Watcher memberships becomes law.

 

to insure myself and my husband would cost me over 25% of my take-home pay per month. (we have separate policies, cheaper that way.) if we had one or more children? over 34% of my take home pay. our rent costs 45% of my take home pay, for comparison. and i'm the major breadwinner right now, despite being a grad student on a meager stipend.

yes, having health insurance has priority but so does having a roof over my head and food on my table. people out there make far less than we do, and still have to make ends meet somehow. how do they do that? by skipping on insurance so they have the above-mentioned priorities instead, and hoping like hell that nobody gets sick.

 

<div class='quotetop'>QUOTE(galaxee @ Aug 8 2007, 01:22 PM) [snapback]492481[/snapback]</div>

I understand what you are saying, but don't see how Universal Health Care would make a difference. Instead of paying 25% of your take-home pay in premiums, you would just pay that 25% in taxes.

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 11:30 AM) [snapback]492440[/snapback]</div>

Unless they died on the way. I bet your family would be pissed if you died in route because the paramedic didn't find your insurance card and diverted you 30 minutes to the county hospital.

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 11:30 AM) [snapback]492440[/snapback]</div>

That's a completely different issue because no one claims that mechanics don't turn away customers that can't pay. The claim in the US is that the poor are not denied care due to the inability to pay. I gave a personal example of a portion of the US health care system that does deny care to those that can't pay.

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 11:30 AM) [snapback]492440[/snapback]</div>

Did they get care or did they forgo care because they couldn't pay? If they did forgo care did this cause they condition to worsen until it became life threatening and very expensive to care for instead of benign and incredibly inexpensive to treat? Who then pays for this difference in cost of care due to the delay if the patent cannot?


<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 11:30 AM) [snapback]492440[/snapback]</div>

If your intent was to compare the US system to universal health care programs used in other countries than you have failed. You also failed to prove that the US system is better. All you have done is show that people in the UK and Canada have a waiting period for care. What is the waiting period in the US?

In order to prove that the US system is better you must supply data from both systems that shows that the US system is better. In this case that US patients wait fewer days for care than UK patients.

It seems that opponents of universal health care can never show this data to support their case. For example, Dr. B has posted his article for The Daily Record on avoidable deaths in the Scottish healthcare system before and again in this thread. Then he throws out the scare tactic that if we had a similar rate of deaths in the US as Scotland does than 1 million Americans would die per year. However, it doesn't have any information comparing the rate of deaths in Scotland to the US. The the US rate better or worse than the rate in Scotland? I don't know and Dr. B apparently doesn't have that data or doesn't share it because it doesn't support his point.

All the article from The Daily Record does is compares the rate of deaths in Scotland to Portugal, Austria, and Italy.

The rates per 100,000 are:
Scotland - 176
Portugal - 159
Austria - 129
Italy - 100

The WHO ranks the country's health care systems as follows:
Scotland (UK) - 18
Portugal - 12
Austria - 9
Italy - 2

So there seems to be a direct correlation between the rate of avoidable deaths and WHO ranking. This is all well and good but how does this do anything to prove that the US system is better? It would seem not since the US is ranked down at 37th.

 

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 12:49 PM) [snapback]492451[/snapback]</div>

Since you know so much about this plan, what are the projected first year costs for this limited plan?

 

i'm not saying universal health care is the best solution. but to say that

is pretty indicative that you don't have to choose between food and rent vs health insurance. also, what one can afford is quite the relative term, given that some people in this country don't exactly make a lot of money.

in your free-market philosophy, placing the responsibility of procuring insurance on individuals would be fine in a perfect world, where people's priorities weren't all screwed up with things like food and rent and transportation. i'm all for personal accountability, trust me. and smaller government too, which is why i have hang-ups about universal coverage.

but again, this is the real world. people screw up all the time on things like this, and yes i believe they should have to account for their mistakes- but a $150,000 hospital bill that forever removes their chances of buying a car, a home, putting their children through college, etc harms far more than the individual for that mistake and also seems like pretty severe punishment.

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 8 2007, 07:58 AM) [snapback]492381[/snapback]</div>

Do you provide care for the poor and the uninsured in non emergency situations? Does that care extend to preventive healthcare and annual well being physical exams so that conditions can be diagnosed and treated before they become life threatening?

 

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 01:57 PM) [snapback]492506[/snapback]</div>

BS. Emergency rooms must treat patients regardless of their ability to pay. The only time patients get diverted is if emergency rooms fill up.

That is because the liberals aren't screaming over a right to free automotive care --- yet.

They are denied by doctors, not by hospitals.

Again, they are denied by doctors, not by hospitals.

What about charity? That always worked in the past. There are plenty of free clinics around in most major cities.

Why? Because I don't agree with you?

I never said it is better. I think our system is flawed and needs to be fixed. I don't, however, think that more government regulation is the answer.

I don't know, because I can call my doctor first thing in the morning and get an appointment the same day. Not too much of a wait there, is it?

Again, I never said our system it is better. It is flawed and it needs fixed. However, I find it interesting that the wealthy and powerful people from all the countries you mentioned come to the US for treatment. I also find it interesting that as government intervention has increased in the US, our quality of care has gone down and our costs have gone up. Knowing that, how could anyone possibly think that more government controls would make things better?

 

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 01:57 PM) [snapback]492506[/snapback]</div>

Here is a study for you:
http://www.dailyrecord.co.uk/news/news/tm_...-name_page.html

"The study revealed that avoidable deaths among men in Scotland over the time period was 176 for every 100,000 people."

"Doctors at Glasgow University found that between 1974 and 2003, a total of 462,000 people died in Scotland as a result of health service failings"

 

Why does it not surprise me, Doctor, that you're against such a proposal?

I can't imagine that many physicians, despite their contributions to the public good, would take kindly to a significant decrease in compensation.

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 8 2007, 01:03 PM) [snapback]492511[/snapback]</div>

Avoidance, I love it. :lol: No, I don't know how much the projected cost is and I don't care. I never took issue with your claim that it would be expensive. I took issue with your LIE that Wisconsin was going to offer universal health care.

 

<div class='quotetop'>QUOTE(Pinto Girl @ Aug 8 2007, 01:31 PM) [snapback]492537[/snapback]</div>

Why would doctors necesarily see a decrease in compensation? It's the insurance companies that stand to lose. At most they'd probably have their wages stagnate, but in exchange for malpractice protection.

"I also find it interesting that as government intervention has increased in the US, our quality of care has gone down and our costs have gone up"
-as a means to provide MORE care to MORE people, rather than exemplory care to the wealthy few.

It wasn't that long ago that small town communities would pay someone to ge through med school, so that they could act as "town doctor" for a period of time, ala: northern exposure. Not sure what that has to do with the discussion, other than look how much things have changed. It's inevitable that things will continue to change, which is why we need to keep our eye on the ball here.

 

<div class='quotetop'>QUOTE(galaxee @ Aug 8 2007, 02:14 PM) [snapback]492523[/snapback]</div>

You are missing my point entirely, which is that you should have a choice in what level of insurance you want to purchase. Back in the days of a free-market health system in this country, you had that choice. Now, most of use are forced to either participate in the plan our employer offers, or go uninsured.

I know all about making sacrifices to be able to afford insurance. Years ago, as a grad student, I was no longer covered under my parent's health plan. Instead of forgoing any coverage, I bought a major medical plan that would insure me against catastrophic losses. It didn't cover doctor's visits, emergency room visits or anything like that, but it would have insured me against a serious illness. My friends used to laugh at me for spending the $100 or so a month on that plan, but I saw it as an absolute necessity.

The problem is, there just aren't many plans like that around anymore. It isn't because there isn't a demand for them, but because such policies are often forbidden by state governments. That is, providers in the insurance business are not allowed to offer a policy that you might want and that they would like to offer—they are forbidden. If those restrictions drive the cost of insurance up to more than you can pay, you can thank the government.

There are those in the insurance business in other states who could help you with a policy that meets your needs at a cost you can afford. But they cannot, because policies from out-of-state providers are outlawed by your state government. When bills were proposed in Congress to allow for a national market for health insurance, insurance commissioners and other state officials around the country rallied in opposition, because consumers in each state would lose the protection of their state's regulations.

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 8 2007, 01:24 PM) [snapback]492530[/snapback]</div>

1) That is not a study, it is a NEWSPAPER STORY about a study.

2) You have already posted that NEWSPAPER STORY once already in this thread and other times in other threads.

3) As I pointed out in the message you replied to, that NEWSPAPER STORY about the study does nothing to prove anything about the US system. All it shows is the Italians, Austrians, and Portuguese have fewer avoidable deaths than the Scottish. As I also pointed out, that is to be expected since all the countries mentions rank higher on the WHO's health care ranking. The UK is the worst of the 4 mentioned at 18th but is still ranked 2x better than the US at 37th.

4) If you want to post some meaningful data, post the number of avoidable deaths per 100,000 in the US. Then we can compare that number to the number in Scotland, Portugal, Austria, and Italy and see if the US really comes out better than universal health care systems in preventing avoidable deaths.

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 01:48 PM) [snapback]492547[/snapback]</div>

Gee, placing my trust in a for-profit insurance company, or the federal government.

Is there a "none of the above"?

Your catastrophic coverage was fine, when you were young, and not likely to get sick at all.

As we age, though, preventative care becomes crucial to trimming health care costs.

The median age of Americans is climbing yearly. We, as a country, are getting *older.*

I'd suggest that it's actually penny wise but pound foolish to think that catastrophic coverage is really the answer to lowering the cost of health care.

By denying preventative visits, we'll end up with lots more serious cases. These will require complex, costly, and potentially long term care, and (I'd assert) will actually*increase* the overall cost of healthcare in the long term.

Not to mention the increased number of sick days taken by employees who are afflicted with conditions that were not diagnosed early.

-----

Would you rather change the oil regularly, or drop in a new engine every 40,000 miles? Hey, if insurance pays for it, why not just wait and drop in a new engine?

That way you can avoid all of those time consuming visits to the dealer for periodic maintenance...


This is bad jazz, and a panacea.

 

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 02:41 PM) [snapback]492543[/snapback]</div>

The only avoidance is by you - how much will this "limited" plan cost the taxpayers of Wisconsin? And since you seem to be an expert at this, what would you project the costs to be for "universal" health care for the citizens of Wisconsin. Seems to me that universal care is impossible just from a financial point of view and would entail rationing of services on a massive scale.

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 02:53 PM) [snapback]492549[/snapback]</div>

Again, as the local expert, this study that shows the US in 37th place seems funny to me. Could you tell me the parameters that were used to judge a countries performance? Where some of them subjective? Did they take into account the wide variety of genotypes we here take care of and the scale of our system? Did they take into account innovation and technological advances?

Thank you in advance for your help.

I just cant see us being 37th in health care.

<div class='quotetop'>QUOTE(Pinto Girl @ Aug 8 2007, 02:31 PM) [snapback]492537[/snapback]</div>

Why should we?

 

So you try to make a point about socialized health care by pointing to a study with statistics about avoidable deaths. Then you say you disagree with the study, because they rank the US so low. Oh! quick, change the topic! Go back to your scare story of Joe Canadian waiting months for a hangnail removal! (we'll disprove it and you can jump right back to the above mentioned study!)

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 8 2007, 02:08 PM) [snapback]492557[/snapback]</div>

I don't honestly know, or have an answer...or, for that matter, even think you should, personally.

I was simply suggesting that a plan like this *might* (or, as was suggested, actually might *not*) have such an effect, and that your opinions about it could be colored by the former potentiality.

 

<div class='quotetop'>QUOTE(Pinto Girl @ Aug 8 2007, 03:01 PM) [snapback]492555[/snapback]</div>

I agree. However, under a system that allows for more choices in insurance, I simply would have added on additional insurance as my income increased as I got older. I did that with my homeowners insurance over the years by adding various riders as my need to insure increased. Why shouldn't I be able to do the same with my health insurance?

Great analogy, although it is somewhat flawed. You shouldn't expect a manufacturer's warranty to pay for a new engine if you haven't taken care of the car per the manufacturer's recommendations. In the same vein, why should anyone expect a free heart transplant when they smoked, drank and ate fatty foods for years? There is some level of personal responsibility that needs to be exercised in both cases. You can't make bad decisions and expect to be bailed out.

 

I'm going to throw this little tidbit of information into the fray and see what happens. Just so you know, I pay medical premiums of $108 per month for a family of four. That's it. Everything is covered, other than prescriptions, dentistry and eyecare, which I can deduct on my tax return. I don't get charged extra to see the doctor, and whatever tests, procedures and operations they deem necessary are covered. I'm not saying it's the greatest health system in the world, and it clearly isn't at 30th on the list, but not being bankrupted by a medical condition would seem to be a distinct advantage.