You Can Have the Red States

Well, 10 doctor visits a week for four months is a lot of doctor visits. And a lot more than you would have gotten with a national health care system. And $15 a visit is pretty damn reasonable. You simply had an extremely high number of visits.

National health care systems, like those of Canada and the UK, work by rationing care.

Here's another recent article about the UK's NHS: 'Hidden' NHS waits still too long

a few choice quotes...

"Data gathered from 73 out of 153 NHS Trusts by the Liberal Democrats in 2004 shows some patients are waiting more than a year for diagnostic tests."

"His survey found patients were waiting up to six months or more in two out of five NHS Trusts for routine MRI scans."

"Similarly, about one in 10 reported waiting times for CT scans of six months or more."

"Whenever the government says it has cut waiting times, it may have cut the wait for treatment, but there are still an awful lot of people on these hidden waiting lists just waiting to get a diagnosis. For some...we may well find that the diagnosis comes too late to actually save their life."

and I just love this one:

"The government has also promised that by 2008, no one will have to wait longer than 18 weeks from being referred by their GP to being treated in hospital."

Isn't that just lovely, they're going to improve things so you don't have to wait more than 4 1/2 months for treatment.

 

Any insurance agent will tell you the best way to keep insurance costs down is to maximize the numbers of people who pay into the insurance.

Currently, business pays for health insurance for the bulk of Americans, with ever increasing employee contributions and increasing co-pays and deductibles. And this smorgasbord of plans and rules and regs costs money that has nothing to do with the clinical care provided. Indeed, the salaries of some of the CEO's of some of the major players in this field are truly astronomical.

But how about a system that is NOT paid for by business? Can you think how beneficial that would be to business in America? Many of you are probably aware that GM now owns SAAB. I've read that some of the SAAB plants in Europe have smaller profit margins on their cars, sell less cars, often pay their empoyees more, and at the same time, these plants are more profitable for GM than comparable American plants.

Why? Those SAAB plants are located in countries where health care is paid for by the government, and not the auto industry. Now wouldn't THAT be a boon to business in America.

But like I said in an earlier post, there are some major impediments to getting any kind of universal coverage in the USA and large amounts of money are spent convincing Americans that it should stay this way.

So the American way for business to save health care dollars, is to gradually take that benefit away, not to "universalize" it.

 

Wow, I'm kind of surprised to see myself referred to as a future healthcare professional... I think I should clear this up...

Although you do have it right to a degree, I'll be more of the 'behind the scenes team" if you will. Although part of my degree work is in anesthesiology (I'll describe how this plays in here in a sec), mostly I'm studying drug design and determining mechanisms for their actions...

See, my thesis is about the functional mechanism of anesthetics related to some of the nasty side effects seen in elderly cardiac and ortho patients.

The reason I'm affiliated with DUMC is twofold. First, my lab gets serum samples to test from study participants through them. Second, as a major health science, the department of pharmacology has affiliated themselves with the health system in order to expand options to their students.

But I want to point out that I'll be a PhD- a medical research scientist, not an MD and not directly involved in some of the major things you think of when you think of healthcare.

So while I'll indirectly be involved in healthcare (probably working for some biotech company somewhere testing drug compounds if I have it my way) please don't think I'm as deeply involved in this healthcare fiasco as an MD would be.

From my experience it just seems wrong the way things are going now, especially with the average person living paycheck to paycheck and one medical disaster away from bankruptcy.

 

<div class='quotetop'>QUOTE(Marlin\";p=\"105414)</div>

You are absolutely right and this is a problem and it should be corrected. I don't think you would get a disagreement on this from anyone who has posted above.

But make no mistake about it, the USA also rations health care. Canada and NK ration by creating time delays and red tape. Supposedly, "urgency" can decrease delays, but even then there are problems.

In the USA, the rationing is based upon your wealth, who you are employed by, or by how well you anticipated your insurance needs for the future. And the USA ALSO has a system to get care even if you have no insurance. But this system usually is not based upon urgency, but only EMERGENCY. An example is a patient that I have who has been denied a procedure because he has the wrong insurance. He may or may not have a very serious condition. Now if he showed up in an ER with a certain acute complaint, he probably would end up getting that procedure within 24 hours regardless of his insurance. But this is not his presentation, so the system feels he can wait until the insurance issues are clarified. Needless to say, this makes me nervous. However, the patient is too "schizophrenic" to care and he has no family to nudge the system.

I also have a patient in a similar position for a different procedure. He has been waiting 2 years for this. I'm getting real close to calling the media on this one, as all my other calls went nowhere. (Of course, if I do that, it will be the last thing I do here.)

Now, which system is more honorable and decent, particularly in a society that is the wealthiest in history?

 

I would support a system like Oregon has, where the state provides insurance for those below a certain income level. I wasn't crazy about their 9% state income tax when I lived there, but at least they didn't also have a sales tax (although they've since tried).

From what I read in the papers, that system worked fairly well, but even it had flaws. I remember once case that was in the papers about 4 years ago about a 17 year old girl with some kind of rare condition where she needed a heart and liver transplant. The Oregon insurance would pay for one or the other, but not both, even though doing both at the same time was only incrementally more expensive than doing just one. I believe that some business man eventually donated the money for the operation after all of the media attention.

Anyhow, something like the Oregon system would be acceptable to me. Those who can afford it pay for their own insurance, those who can't are subsidized.

I'm just very leary about removing market forces from it since things run by government bureaucracies generally turn into a lethargic inefficient mess. Although one could validly argue that market forces have already been removed to a large degree by the insurance companies, since the doctor is not paid by the patient, but rather by the insurance company, and in fact the patient really isn't the customer of the insurance company either, his employer is.

 

I don't know one way or the other...hate the current system, but that story from Fredatgolf about the surgeon who said there was no answer really still sums up the way I feel at this point. Sure in this country private enterprise is running the medical sciences, or trying to. The other end of the spectrum is France, England and Canada..with a government bureaucracy. This country still has the most inovative ressearch, and it is people like Galaxee, working in the industry or they will be, that make the advances. Government interference seems to remove inovation. In a straight socialized medical system, FIRST the government and bureaucracy set up a system and health care is "DOLED" out, thus waiting periods. Also don't forget, TAXES.. such a system must be paid for, from top to bottom. People have the impression the RICH can pay more, fine..currently most of the money the government gets is from the middle to lower middle class taxpayer, even if you totally eliminated everything and MADE the rich pay "their fair share"., it would in NO WAY pay for such an encompassing system. Sure it is great in Europe and the likes to not have to worry about healthcare, but the TAX burden is considerably larger, ACROSS THE BOARD. I really don't much care which way we go, a mix might work, and no system will be perfect, EVER. I do like the excellence and inovation in this country, it certainly has separated the health care industry, millions from around the world come to the US, for expert and execellent quality health care. Would this survive under a nationalized system ?

 

ps innovation has 2 n's just lazy

 

Marlin we pretty much said the same thing!!

 

To all those advocating a National health care systme paid for by the Government rember - THE GOVERNMENT DOES NOT MAKE ANY MONEY! (yes the print it)

They take it from those who work. So WE pay for our health care one way or another. Government pays for NOTHING!

Plus Government does a piss poor job at securing discounts based upon volume.

 

Saab..Sweden???...tax rates there in the 40-60% area I hear for most. All I am saying is someone will pay it, and to think that business or the rich will is a fallacy. If the American public can stand the cost in Taxes, verse passed on cost of product cost, then by all means go for it. There has not been a system where ALL can get ALL and still maintain the LOW (comparatively speaking) tax rate of Europeans and Canadians too. If such a rich country like us should have a more equitable system, I am in favor, it is just not going to be FREE.

 

Devil's Advocate>>>>Exactly what I was trying to say., it ain't going to be free., in fact in my opinion as time goes on the socialized model, will wind up costing more and providing less...but I'll go with the majorities in the country..They do need to realize however it will not be FREE, somebody is going to pay for it.

 

<div class='quotetop'>QUOTE(Devil's Advocate\";p=\"105497)</div>

This is absolutely true. But GM doesn't give health care benefits for free to their empoyees. That fee is in the price of every car we buy. And of course Government does a piss poor job of negotiating volume discounts, when the Government is practically OWNED by the industry that makes the profits for those drugs. Lets not forget that in the recent medicare drug bill that GW gave us, the government is specifically barred from negotiating volume discounts, or any other kinds of discounts, from the pharma industry.

My point is that American health care is being paid for right now out of the pockets of Americans. Either in the cars we buy, the food we eat, or the copayments we pay. And for those who have less insurance, it's being paid by increased illness and disability.

And the "uninsured" are not getting free care gratis from the health care industry. That free care is paid for by the taxpayers and by those that are insured, who must take up the slack of the uninsured or underinsured.

So either we pay in a hodge podge system that has thousands of conflicting rules and regulations with everyone paying a different amount and some paying way more than others, or we have a system that is spread out amoungst us all.

And as I said earlier, the way to have the cheapest insurance is to spread the risk as wide as possible.

 

"Universal Health" care, or "Single Payer" Health care is not "Socialized Medicine". The Veterans Administration is socialized medicine as all those who provide care are Federal Employees. And according to GW and the Pentagon, those vets get great care.

(And I know some people who work at the VA, and they say that if Bush were to fully fund the VA, the health care there really could be great.)

But Medicare and Medicaid are more accurately government "Health Insurance" programs. The doctors and hospitals that get paid by them for the medical care they provide, don't actually work for the government.

So don't automatically mix the concepts of "universal coverage" with "socialized medicine" where all the providers are government employees. There are certainly similarites, but they are not the same thing.

 

According to this CBC article, Toyota recently decided to place a car plant in Ontario because the Canadians are better educated so it will cost less to train them. They got 125 million in subsidies from the Government, rounghly 1/2 of the subsidy offered by Alabama or Mississippi.

But another reason was .... "In addition to lower training costs, Canadian workers are also $4 to $5 cheaper to employ partly thanks to the taxpayer-funded health-care system in Canada, said federal Industry Minister David Emmerson."


http://www.cbc.ca/cp/business/050630/b0630102.html

 

I'm not technically jumping into the Red State debate - to me it seems pointless and neverending - but I do take exception to your mention of the Toyota plant in Woodstock and the rationale of "cheaper" health care and better training.

First of all, the Canadian taxpayer pays a much higher proportion of the health care bite compared to employers. Large corporations in Canada can pretty much forget about paying any worrisome health care costs or pension costs, the generous taxpayer picks that one up.

And if you have been following the 4 year old Failed Health Care debate, actually it started to really go downhill back in 1994, you'll know that former Finance Minister Paul Martin, now the Prime Minister, achieved many of his hocus-pocus "savings" and budget "surplus" by a magical process called "downloading."

Rather than the Federal government paying for the many socialized programs, the Province and even the local municipality must pay a far greater share. In many cases they couldn't, so local debt loads massively increased while services were cut.

As an example, at one time the Federal government contributed around 50% of the funding, now it's less than 15%.

And of course the Canadian Socialized Medicine system has almost fallen flat on its face as a result. There are many articles that reference this.

http://www.theurc.com

http://www.theurc.com/course/fiscal_16.cfm

http://www.theurc.com/course/fiscal_10.cfm

http://www.theurc.com/course/fiscal_12.cfm

http://www.theurc.com/course/fiscal_08.cfm

http://www.taxpayer.com/main/oped.php?oped_id=316

http://www.taxpayer.com/main/news.php?news_id=125

So a lot of the health care cost and former budget deficit was translated or "downloaded" to the Provinces. This has resulted in rather drastic increases in many local taxes, something that I find ironic that only Americans think they are victim to.

For example, my parents have a rather modest 1,300 sq ft home in a senior's development. Nothing at all fancy about it, rather plain and unassuming just like they are.

According to their recently received Property Tax Notice, here is the damage:

Total assessment for taxes: $136,700.
Portion taxed: 45%, Portioned Assessment $61,520

Net City Taxes: $1,218.52
Net School Taxes: $1,399.58
Net Total Taxes: $2,618.10

Oh, and because they had to stay in Canada to ensure they continue receiving their Canadian pensions, their Social Security and American investments are counted as Canadian income. So their income level magically hits the "clawback" stage of around $50,000 and their CPP is reduced.

Friends of theirs with a far higher appraised house in Mesquite, NV, are paying total taxes of around $650. They also can claim Nevada residency so naturally no state income tax, just federal.

Toyota claims to have received only half of the "entitlement" it would have received in the United States. When you factor in all the freebies - such as "free" training courtesy of HRDC giveaways - they've received more than if they would have selected an American location.

As far as Canadians having higher education standards: maybe yes and maybe no. It is recognized that Canadians with at least high school and usually post-secondary education are chronically underemployed in Canada, creating the "brain drain" to the United States:

http://www.theurc.com/braindrain.cfm

Don't forget that there are *many* funding sources that Toyota and other car makers can easily access, and these Crown Corporations (An "arms length" publicly funded source of money, often not required to audit or disclose) are many in number, mostly secretive too:

HRDC (Human Resources Development Canada), EDC (Export Development Corporation), IC (Industry Canada), TPC (Technology Partnerships Canada), CIDA (Canadian International Development Agency) :

http://www.taxpayer.com/main/news.php?news_id=2019

http://www.probeinternational.org

Apparently, according to the same CBC article you handily provided, the Ontario Provincial government and the many different Federal acronyms have actually put $5 billion- probably far higher but that number has been confirmed - into auto industry subsidies. So whether it's GM, Ford, Toyota, Honda, whatever, they can all line up at the trough.

The lower wage rates, especially when you factor in currency conversion, is just icing on the corporate cake.

I hope you understand this was nothing personal at all, you probably were not aware of all the hidden money channels that corporations can get here in Canada.

 

Prius4 is trying to tell us, that centralized medicine, can't call it for what it is is the cure all.. Prius..can you honestly tell me that the insurance is NOT means tested? Of course it is, a Canadian citizen just gave you an example. I am not against what you propose, just the facts that you seem to think it would be superior in all cases across the board. The bottom line is IT HAS TO BE PAID FOR., and the bulk of the "income" or work is done by folks who work hard everyday. The ones un-insured would get a basically free ride, and that would be on the backs of the ones working. As for the rich, yea, its wrong..etc..they get a ride anyway cause they got the money..but bottom line even if you were 100% successful in making them PAY., it would in no means pay for the millions that have to be taken care of. Class warfare is fine, but the rich folks don't make a dent in the source of funds of this or the Canadian Government. As for collusion of the GOVT with Business., well it happens also when the GOVT runs things too, I am was (retired) in the Armed Forces..such things will happen anywhere and with ANYTHING. This government here in the U.S. is actually far less involved then say the EU and the Airbus, as an example. I think jayman gave you some food for thoughts. The medical in this country is bad in some ways, I particularly dislike drug commercials and doctor commercials, kinda like the lawyers too. But the poor in this country do get care, I notice it is the ones trying to better themselves that seem to run into walls..Like Galaxee. Can't say we have the best system, wish we could reach a middle ground, without destroying the inovation but yet being fair minded to all. You can certainly do a lot with citizen's health care...

For example..

you could deny smokers cancer treatment unless it saved their lives, AND they had a productive (ie working life) left.

same for obeisity

same for heriditary conditions

what about sexualy transmitted diseases ?

Could not the government say, you did not care about your life so why should society care about saving your life ?

It is a deep issue

 

Jayman,

There is no reason to apologize and I thank you for your detailed and well written post. But I'm not sure it contradicts my points.

You point out that the taxpayer pays a bigger bite in Canada, and I have no doubt of that. But isn't that the point. When the burden is spread out more fully, and not only to those that are employed, or have independent wealth, it should by definition lower the burden for all. This is the basis of the insurance industry.

And according to this article, that $125 million subsidy included money for training. Though I take your point that there may be more subsidies than are mentioned in this article.

As for the shift in the tax burden away from a Federal Tax and more towards the local taxes, the most infamous of all taxes for "regular" people, this is bad news. It sound like the tax shifting that GW has perpetrated on the US, has similarly been perpetrated on the Canadian people. And by a "Liberal" Government yet!

So I guess what it is to be a "liberal" in Canada is way different than in the US. I believe in progressive taxation, and the property tax is very regressive. Progressive taxation attempts to share the burden, regressive taxation shifts it to the middle class.

And I did not mean that the health care system, and the better education were the only reasons that Toyota is building this plant in Canada, but they were part of the equation.

I do find this specific quote from the article a bit telling as well:

He said Nissan and Honda have encountered difficulties getting new plants up to full production in recent years in Mississippi and Alabama due to an untrained - and often illiterate - workforce. In Alabama, trainers had to use "pictorials" to teach some illiterate workers how to use high-tech plant equipment.

"The educational level and the skill level of the people down there is so much lower than it is in Ontario," Fedchun said.

My point wasn't that Canada has a wonderful low cost health care system that every Canadian loves. Only that spreading costs over a larger group (i.e. ALL members of society), and taking that burden OFF business, might have benefits over a system that rations/ apportions health care on the basis of wealth.

And overall, polls do show that by and large, Canadians prefer their system over ours.


Another reason I kind of like this CBC article is because it supports a point I have tried to make in multiple posts on Prisuchat, and other forums. I think this article makes the point that when a society makes investments in its population, it pays off in numerous ways, and sometimes it can take decades to pay off. And I don't mean to imply that Canada, or the US has not made mistakes when we do this kind of thing.

But overall, when a society makes investments in it's people -- in the past I've used the words "empower" the masses -- you end up getting significant positive results. But when a society moves to empower it's elite, or the rich or the heads of industry, you get meager results because the "masses " of common people are the key to progress.

People might refer to "Universal" Health care as another "entitlement" program, using the word "entitlement" as some kind of dirty word.

I see those "entitlement" programs -- at least generally -- as "investment" programs. And those "investment" programs pay off in the long run. With a better educated and performing and healthy population. Good for business and good for the nation, and just by accident, good for the people. This is what set the American 20th century apart from the 19th.

This is why I rarely vote Republican.


__________________________
Empower the masses and get 20th century growth rates.
Empower the corporations and get 19th century growth rates.

 

Gonna stay out of it politically... trouble is society rarely invests in its people en masse. Don't think for one minute the majority of Canadians want what they have now. Hard and Harsh choices will always have to be made, even under "Universal" health care umbrella. All I can say is if the problem was as simple as having Democrats in, then we should ALREADY have a better system then what we have now.

 

<div class='quotetop'>QUOTE(IALTMANN\";p=\"105572)</div>

Sorry, I was busy writing my post above and did not see yours. You make some good points, but I'm not convinced that I mean Universal coverage as being a perfect solution. But it has it's advantages.

And although there are many unemployed people who are unemployed out of a lack of personal wherewithal and initiative, I think this is actually quite rare. Most people who are unemployed and therefore without coverage really want to work, they just can't find jobs that can give them a living wage.

And as for your final points, I'm a strong believer in the free market (thought not Laissez Faire -- that's why I don't vote Republican) and your points to save money would require "edicts" from Government. And I'm opposed to that. On the other hand, "charging more" for health care for the sedentary, the obese, and the smoker does have merit.

 

<div class='quotetop'>QUOTE(IALTMANN\";p=\"105578)</div>

I was going to go to bed but would like to make a point here.

IMHO, the Democrats haven't really been that effective -- in promoting a "progressive agenda", since about 1980. And I think that this country was moving forward quite significantly from about 1900 until about 1980. And those are the years when the "progressive" perspective for government was the most prevalent. And that was the period in US history when progress was the greatest.

This was not a coincidence. This is my opinion, and I believe the corporate owned media have spent millions trying to convince Americans otherwise.

Since 1980, we have been hearing about the merits of smaller government, and less taxes (though in actuality, the less taxes overall has only been for the rich), and less regulation. And don't forget less programs for the people overall as well.

The result of all this has been the empowerment of the corporations, but again IMHO, it has weakened the masses of "regular" people. And the "wealth" of common people has been somewhat stagnant over the last 20 some years, at least in comparison to the decades prior.

FDR wanted Universal Health Care. He tried, but WWII got in the way.

And did you know that the great depression of the 1930's was not an aberration? The USA had a great depression just about every 20 years or so all the way back to 1776. So why have we not had one in 70 years? The answer to that is all the (horrible) government regulation that got imposed upon business in the 1930's and 40's. Imposed mostly by Democrats.

And you may notice that I don't identify myself as a Democrat. I more accurately consider myself an "anti-Republican", though John McCain could easily still get my vote. You see, I do think the Demos have made lots of mistakes.

But this is what I believe. When the Democrats pass laws that hurt "regular" people, they do it by mistake. When Republicans pass laws that hurt "regular" people, it is on purpose.