When Socialized Medicine Fails:
Printed From: Tippmann Paintball
Category: News And Views
Forum Name: Thoughts and Opinions
Forum Description: Got something you need to say?
URL: http://www.tippmannsports.com/forum/wwf77a/forum_posts.asp?TID=180663
Printed Date: 17 January 2026 at 8:01am
Software Version: Web Wiz Forums 12.04 - http://www.webwizforums.com
Topic: When Socialized Medicine Fails:
Posted By: tallen702
Subject: When Socialized Medicine Fails:
Date Posted: 05 March 2009 at 12:14pm
|
http://www.dailymail.co.uk/health/article-1159506/Life-prolonging-cancer-drugs-banned-cost-much.html - Story From the UK
In short, the NHS in the UK is banning certain top of the line cancer medications due to their cost to the National Healthcare System. In short, they're too expensive. This is the same argument that many people use about the denial of coverage under traditional private insurance policies to push for a nationalized health care system. ------------- <Removed overly wide sig. Tsk, you know better.> |
Replies:
Posted By: carl_the_sniper
Date Posted: 05 March 2009 at 12:30pm
|
What a stupid thing to do. I'd still trust the government a million times over before i'd trust a private company such as the insurance companies that you guys have in the us. ------------- <just say no to unnecessarily sexualized sigs> |
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 12:38pm
|
I think all health care decisions should be left to:  http://i307.photobucket.com/albums/nn308/oldpbnoob/magic8ball01.jpg - |
Posted By: Mack
Date Posted: 05 March 2009 at 1:01pm
|
Hey, why don't we have an NHS here in the states?
------------- 
|
Posted By: agentwhale007
Date Posted: 05 March 2009 at 1:02pm
|
And as has been brought up in the Fark thread many times, there are still private medical service providers available in the U.K. that someone in that position could have had, if they had money. This doesn't come down to private vs. national healthcare. This comes down to if you, the individual, are rich or poor. |
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 1:07pm
So.. NHS could be likened to Natural Selection? Kind of ironic that the people it would be supposedly helping, it is actually letting die........ Heeeyyyy!!
|
agentwhale007 wrote:Posted By: jmac3
Date Posted: 05 March 2009 at 1:10pm
I think it could be likened to exactly what we have now except better? Instead of only poor people getting "free" care, everyone does. Then if you have the money you can get other things like this medicine not covered by the government. ------------- Que pasa? 
|
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 1:13pm
| I like the idea of letting poor people die better. That is my stance and you wil not change it. |
Posted By: Mack
Date Posted: 05 March 2009 at 1:15pm
So basically, it's exactly like we have except that the government pays for some care for people that could afford it. Which means the poor still die and we waste government money. -------------
|
Posted By: jmac3
Date Posted: 05 March 2009 at 1:16pm
|
But poor people are like sidewalk comedy? Why would you want that to end? ------------- Que pasa?
|
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 1:17pm
And good doctors leave the profession, because they can no longer afford it.
Stop making sense, you are distracting my trolling.
|
Posted By: jmac3
Date Posted: 05 March 2009 at 1:18pm
Ummm no. What about the people that aren't poor, don't qualify for a state healthcare plan, and still can't afford it? ------------- Que pasa?
|
Posted By: Mack
Date Posted: 05 March 2009 at 1:26pm
|
I would think that not being able to afford basic medical care would be indicative of being "poor." But either way, if we had our own NHS they could get all the stuff free they wanted except the expensive stuff that they actually needed to prolong their lives so either way they die. Poor dead guys. . . . or is that dead poor guys?
Sorry. -------------
|
Posted By: jmac3
Date Posted: 05 March 2009 at 1:29pm
I was not able to afford insurance. I did not qualify for Masshealth with what I did make. I am not the only one I am sure. EDIT: this medicine is not saving lives. It is prolonging lives of terminally ill patients. There is a difference. Double EDIT: I don't agree with it not being covered. ------------- Que pasa?
|
Posted By: Mack
Date Posted: 05 March 2009 at 1:31pm
So . . . what you're telling me is that the current level of socialized/government run medical care is already cutting costs and leaving those unable to afford medical care without said care? -------------
|
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 1:32pm
|
It has been about 5 years since I had to have private health insurance. At that time though, I was able to get coverage for my wife, child and myself for around $250.00/month. Granted it was not great insurance, but would have protected us in case of something major. I don't know how much more it would have been with two more kids, but I can't imagine it would be that much more. If someone is not "poor" and can't afford $250/month for health insurance, it seems like something is wrong. Maybe people need to cancel the cable, only carry one car payment, live in a smaller house, quit smoking/drinking or eat less. I guarantee somewhere in there, they could find the money. I would venture a guess that part of the problem is so many people don't want to sacrifice to be able to have insurance. Prioritize |
Posted By: usafpilot07
Date Posted: 05 March 2009 at 1:36pm
First rule of Economics: There is no such thing as a free lunch. ------------- Buffalo buffalo Buffalo buffalo buffalo buffalo Buffalo buffalo |
Posted By: Rambino
Date Posted: 05 March 2009 at 1:40pm
|
Costs have gone up a lot in the last few years. I pay for my own health insurance. Wife and two kids. Good, but not platinum-plated health insurance. $1765/month.
I am self-employed, so I pay basically double what our employees pay, but it is still an obnoxiously large number.
More importantly, it is representative of what a self-employed person might pay. And the self-employed (aka "small businesses") are the largest groups of those that are uninsured.
Currently in the US, the truly poor are covered by Medicare or equivalent. State and federal employees are covered by state/federal plans. Most full-time employees are covered by employer-based plans.
The gap is in small businesses (owners and employees), part-time workers, and entrepreneurs. Those are the folks that are not covered. Hard-working people all, and generally doing the type of capitalistic undertaking that we want to encourage. But their employers do not provide healthcare insurance, and they cannot afford to obtain private insurance.
That is the main problem with the US system - lack of coverage. The quality of care is generally good, but there are millions of Americans with no coverage at all.
Beyond that, there are issues with transfers, gaps, existing conditions, and so forth - those are important issues as well, but not to the level of the uninsured.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: jmac3
Date Posted: 05 March 2009 at 1:40pm
|
oldpbnoob. I was making working 35 hours a week part time at my job at $10 an hour. Had I been full time(which i ended up doing and got insurance). Oh and full time wasn't a pay raise. It was just 7 more hours a week. That comes out to MAYBE $1200 a month. $200 a month=Car payment $200 a month=Insurance Rent in my town=like $800. Less with roommates and less if in a worse part of town. I do believe that equals $1200. Oh and USAF. That is why I put the quotes around free. ------------- Que pasa?
|
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 2:41pm
|
Jmac. You aren't going to like my answer. First off, I would actually consider anyone making $14,400/year poor. I also havent a clue why you would have a $200 car payment every month if you only made this much money AND were trying to live on your own. Move back in with your parents, get a cheaper car, or take the bus. Also, how can you expect to only work 35 hours per week and afford to live where you have an $800/month mortgage? Again, move back home, or get a roomate(s). You have pretty much pointed out exactly what I said, people do not want to make sacrifices in order to afford to have insurance. Get another job. When I was your age, I was working 2 jobs. I averaged 70 hours per week. And to be honest, I didn't have insurance. Truth be told, I didn't have insurance once I moved from home until I was nearly 25. And the only reason I got it was the company I began working for in my first "real job" offered it as part of my salary.
As for small busines owners, I do think it sucks for them. Perhaps some sort of National system would be good for them. I don't know to be honest, but I don't think that it makes sense to do an across the board, government subsidized healthcare system for everyone.
|
Posted By: jmac3
Date Posted: 05 March 2009 at 3:40pm
|
oldpbnoob, I have the car payment because I do live at home. I live at home because I can't afford to live on my own. I was just giving you an example of costs. Fact is I was working a full time job and going to school full time up until this school year(I quit my job in July hoping to not work at a supermarket..obvious reasons). I bought a 2006 car with like 30,000 miles because I commute an hour to school. From there(when I had the full time job) I would drive a half hour to work, but it wasn't directly en route to my house so home was yet again another hour. That is 2 1/2 hours of driving 4 days a week. The other 3 days I worked at the store location next to my house. Also, not make sacrfices? If I actually did live on my own how is that not making sacrifices? I didn't put costs of a cable bill, internet bill, phone bill, etc. EDIT: I may be a bad example because I don't live on my own, but my point stands insurance is expensive and not everyone can afford it or get it. ------------- Que pasa?
|
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 3:48pm
| ^^^ Than you weren't giving a fair example Jmac. If you are a full time student and living at home, I would think you would be covered under your parents policy. Lets compare apples to apples. I honestly don't have an issue either with some form of student healt care policy. In fact, I thought most colleges offered something like this? I never took advantage of it, but when I was in school, there was some sort of clinic that we could go to as part of our tuition. Maybe an addtional major medical policy on top of that would be a good idea and for a young single guy shouldnt cost much. |
Posted By: jmac3
Date Posted: 05 March 2009 at 4:07pm
|
What parent's policy? The one they don't have? The parents I don't live with? There was one year that I didn't go to school(therefore no school insurance). During that year I was not full time at my job. I had no insurance. This is what made me decide to become full time at my job. More money and insurance. From September-January I was part time at my job. All of January I had to wait for insurance because you have to wait like 30 days. ------------- Que pasa?
|
Posted By: Ozwarg
Date Posted: 05 March 2009 at 4:56pm
|
Well, I'm not poor and my employer will not pay for my Surgerys
Having a Grade 3 Systolic Murmur is not fun.... luckily, My father worked for the state government and Wyoming is not a "negative funded state" and I was lucky to get on his insurance and get the operations I needed. If not I'd probably be worm food right now... I've rarely seen ANY insurance that is lower then $2000 a month out here that would cover my surgeries.... My employer wont, and in the next few months I'm up for a simple heart surgery(the Balloon one) and my employer is covering that, but... after that comes the pig Valve Surgery which my employer will not cover, and since I make too much I can't get on Wyoming-medicade... so yeah... basically this situation is life or death for me.  ------------- 
|
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 5:07pm
You've totally lost me.
Regardless, I don't think you are the average example.
|
Posted By: jmac3
Date Posted: 05 March 2009 at 5:23pm
|
I don't live with my parents. Even if I did they do not have an insurance policy. ------------- Que pasa?
|
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 5:41pm
So I go back to what I said before. If you weren't in school, you would have no business living alone with an $800 rent payment, a car payment, and not even working full time. If you aren't going to school, get 2 jobs. I would find it hard to beleive that a young, single, healthy male, couldn't get a major medical insurance policy for a reasonable price. I am not talking about a policy where every time, you need to go get your sniffles checked out by a doctor, I am talking about a policy that would help pay if you broke your arm or some other major issue. And anyways, you said when you went full time, you got insurance.. Was it really that much of a risk for a healthy 21 year old to go for a short time without health insurance? I don't think I even went to the doctor more than twice between 14 and 25.
|
Posted By: Evil Elvis
Date Posted: 05 March 2009 at 6:01pm
|
My Mortgage is $800. To pay almost a grand in rent is just utter crazy. When you could be owning your own place.
I don't understand people who live in a area with high cost of living, have a crappy job and somehow stay there. Why not move elsewhere? Same with the chumps that when their factory closes down stays in the same town unemployed. Like jobs fall down from heaven. ------------- 
|
Posted By: usafpilot07
Date Posted: 05 March 2009 at 6:40pm
Sounds like a marriage right now is exactly what you need. ------------- Buffalo buffalo Buffalo buffalo buffalo buffalo Buffalo buffalo |
Posted By: jmac3
Date Posted: 05 March 2009 at 8:31pm
I was going to school full time. I took a year off. I didn't have a 2nd job because I was waiting to go full time at my current job and planned on going to school. I have never lived alone. Nor have I ever lived with my parents. I don't go to the doctor, for anything. that isn't the point. Hell, when I am sick I won't even take medicine. In fact the one time I ever actually hurt myself did happen to fall when I had no insurance.I sprained my foot pretty bad. I went home from work early every day for like 3 weeks. During week 2 I went to the doctor and incurred some medical bills. i also didn't say me not having insurance for a few months was a risk. You're just arguing the fact that I theoretically could "afford" insurance. You are not arguing the fact that some people(like myself during that time period) do not, and cannot get insurance. ------------- Que pasa?
|
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 10:24pm
|
You're right. People that only make 14k per year, pay $800 per month rent, have a $200 per month car payment and only work 35 hours per week may not be able to afford health insurance. Unfortunately, I don't feel that my tax dollars should necessarily go towards paying for one for them. |
Posted By: jmac3
Date Posted: 05 March 2009 at 10:36pm
And that's fine. You don't think there should be government healthcare. Realize this though. Your taxes are already going towards healthcare of people who don't work. It is going towards the children of people who have children even though they can't afford them (lady with 14 kids what?). So you don't want to pay for the people that actually provide for themselves...  I had more to this post, but I got sidetracked. ------------- Que pasa?
|
Posted By: Rambino
Date Posted: 05 March 2009 at 10:40pm
Random example of people that are often uninsured: Dental assistants.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: jmac3
Date Posted: 05 March 2009 at 10:43pm
|
He used that number because of my posts Rambino. I didn't qualify making that(after taxes).
------------- Que pasa?
|
Posted By: Rambino
Date Posted: 05 March 2009 at 10:55pm
Well, there is just one of you - and even then I bet you were just on the line. The threshold goes up with family size pretty rapidly.
Also medicaid, not medicare. I always brainfart on which is which.
But irrelevant. The point is that most uninsured in the country today are either currently working, small business owners or employees, people with multiple part-time jobs, or people switching jobs.
This is not about paying for health insurance for the unemployed (although we ought to be doing that as well), but about health insurance for responsible working families.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: jmac3
Date Posted: 05 March 2009 at 11:03pm
I HIGHLY doubt I am the only one. The point of me using myself as an example was not because I am the only one. It was to show it happens to people, and can happen to anyone else. I just don't understand why there is so much hate against having government healthcare. I'm sure in Canada the government isn't sending people to the poor house because taxes are so high. I come from a stupidly taxed state(mass). A State where they wanted(probably did) raise gas taxes by 19 cents a gallon to pay to fix our horrible roads. Whereas in New Hampshire the roads are fine with no income tax OR sales tax. I would have no problem paying some more taxes if everyone could go to the hospital whenever without worrying about getting a bill sent home. I for one AM against people that have a kid and just automatically get healthcare. That is ONLY because they get it for doing something stupid, and there are people who actually try to do something in life that may not get it. ------------- Que pasa?
|
Posted By: Rambino
Date Posted: 05 March 2009 at 11:15pm
|
There is indeed only one of you. I am pretty sure of that.
More specifically, your family consists of only you. Poverty thresholds are determined based on the number of people in the family. In your case you are a family of one.
As for giving healthcare "automatically" to people with young kids - that strikes me as a rather easy yes. I don't favor killing children to punish their parents.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Rambino
Date Posted: 05 March 2009 at 11:17pm
Those positions appear more than a little inconsistent.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: jmac3
Date Posted: 05 March 2009 at 11:25pm
Quite inconsistent. I agree. I think EVERYONE should get it. I do not think a few people should get it for being screw ups. EDIT: I did not know you meant that I am a family of myself when you said there is only one of me before. ------------- Que pasa?
|
Posted By: oldpbnoob
Date Posted: 05 March 2009 at 11:34pm
|
I guess it just seems that everyone wants to dip in my pockets. Feeling a bit abused these days. I pay my taxes. I pay a lot of taxes IMO. I paid more in taxes last year than a lot of people even make. I pay my reasonably modest mortgage every month. On time. I have health insurance through my wifes job. She doesn't make much money, but has full insurance. It was one of the reasons she took it. I have no need for a national healthcare system. When I switched jobs and couldn't afford Cobra, I dropped it. I went for several months without insurance until I got a private one. It wasn't great, but it was only $250 for my family. I paid most expenses out of pocket, but it was there for major things. I can't imagine it has gone up that much in 5 years. But now, I am expected to foot the bill so that everyone that needs it can go to the doctor for free everytime they have the sniffles? Really? As mentioned before, in other posts, I already pay for the welfare moms and their illegitimate spawn to live for $1 in the government sponsored housing down the road. I pay for their kids lunches. I pay for their kids school fees. I pay for their kids medical insurance. I pay for their dinner, beer and smokes as well. Might as well have them live here, at least I might be able to get them to clean a dish every once in awhile. Now I have to pay for their insurance as well as small business owners that make 2-3 times as much as I do?
I get that small business owners etc may not have insurance. I empathize. I also don't understand why they are unable to group together somehow in order to form a larger partnership in order to quality under a group plan of some sort. Seems like I have seen that somewhere. But it also seems like something that would be handled as a private entity, not subsidized by the government. If it was handled by the government, maybe there could be a small business tax that owners could pay that would go into a fund to form an insurance cooperative? If they are the ones you are concerned about, why shouldnt they pay for it? I am not a small business owner, why should I pay for small business owners insurance? It seems if they are the ones beneffiting from it they should be the ones taxed. Not me.
I am just so sick of people talking about taking more of my money for programs that don't benefit me. I really am.
I am tired and need to go to bed so I can make money tomorrow fo pay for everyone elses bills. Maybe I'll just sleep in, lose my job and live off of everyone elses hard work instead.
|
Posted By: Rambino
Date Posted: 06 March 2009 at 12:11am
Not to be snarky, but that puts you very much in the "easy for you to say" category. Of course, ironically, many of the jobs that pay little but have good insurance are state jobs, like teachers. Which, of course, means that their health insurance is paid for by taxes. You know... socialized.
Another argument for national healthcare. Jobswitchers are a large category of uninsured. Easy for you to declare that you would go without - at least until you got caught in a hit-and-run. Now your care is socialized anyway. Or until you got cancer without insurance. Sucks for you.
Less easy if you have young kids. Many people are afraid to switch jobs for fear of losing healthcare for the family, even temporarily. And that is just bad economics for the entire country.
I do believe I posted by monthly health insurance bill on the previous page (that figure doesn't include dental). Health insurance rates vary significantly based on location, health specifics, local plan availability, and so forth. But yes, rates have gone up a lot.
Actually, one of the great benefits of nationalized healthcare is exactly that. Currently we have de facto nationalized emergency care. People without insurance forego preventive care, and instead wait until they get really sick - at which point the hospitals cannot turn them away. A little penicillin is a whole lot cheaper than major surgery and long-term care. Again, our system is incredibly wasteful, strictly from an economic perspective.
That's the type of plan I am on. They are obnoxiously expensive.
It could be - that's what we have now. It's not working.
We all pay now. And with national healthcare, we all also pay. It would just be far more efficient with national healthcare. Our current system is incredibly inefficient and wasteful. Not to mention that it immorally leaves millions uncovered.
Besides, this is not just about the small business owners. As I mentioned above, another large category of uninsured are EMPLOYEES of small businesses, like dental assistants - and everybody else in a dentist office. Dental practices are generally small businesses, with one or two owners and a half-dozen employees. The employees are usually fairly modestly paid. As a result, adding a health benefit would drastically change the economics of that business, and many dentists do not offer health insurance as an employee benefit. And, of course, the dental office receptionist often cannot afford to buy her own insurance either. So she goes without.
Another large category that I mentioned are the job-switchers. COBRA only guarantees 60 days coverage. That is enough for people switching directly from one job to another, but it cuts out the more adventurous switchers - the folks who "heard there were better jobs in California" so they up and went. I routinely see people here moaning about the folks in steel town who stay put unemployed, living off their wife's waitress pay. Well, under current rules it is very difficult for that family to move to Omaha to look for work. That also is inefficient and wasteful.
Another large category are the part-timers. It used to be you worked a part-time job if you were a student or couldn't get a real job. Not true any more. It is now quite common to work multiple part-time jobs, perhaps combined with an entrepreneurial effort. Other times the part-time status is the result of employer policies (like Wal-Mart intentionally cutting hour of a bunch of employees just below the benefits threshold). More hard-working low-income people trying to keep their families going.
And another large category: children of all the above groups. This group is a little better off now with Obama's extension of SCHIPS, but there are still many children with no health insurance, just because their father is the janitor for a small office instead of a small school.
The bottom line is that our system is wasteful. Americans spend more per capita on healthcare than most other industrialized nations, and get less healthcare per capita than most industrialized nations.
Having multiple insurers is inefficient. Not having enough preventive care is inefficient. Not have good transitional care is inefficient. The whole US healthcare system is a monstrosity of inefficiency and excess bureaucracy. The idea that a proper nationalized healthcare system would somehow be "expensive" compared to what we have now is frankly laughable.
The lack of proper healthcare is one of the biggest drags on the US economy.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Rambino
Date Posted: 06 March 2009 at 12:12am
|
Hmm. That was kind of long. Sorry.
And I actually had quite a bit more to say as well. ------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Evil Elvis
Date Posted: 06 March 2009 at 12:30am
|
Rambs I though all Big Shot Fancy Fast Talking Lawyers had their health care paid by your Boss the Dark Lord of the Underworld and Prince of Lies? -------------
|
Posted By: Rambino
Date Posted: 06 March 2009 at 12:54am
That is exactly correct. Like I said, I pay my own. ------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Mack
Date Posted: 06 March 2009 at 2:19am
If there was ever a statement I disagreed with, that would be it. I spent 23 years in the military which is probably as close to national health care as you can get in the U.S. And that is why I am deadset against it. Nothing the government does is efficient. I have seen the results both personally and as they affected others when medical decisions are taken out of the hands of patients and made not by doctors, but by federal administrators whose only concern is the bottom line. They make insurance companies look like angels of mercy by comparison. /rant. -------------
|
Posted By: Kayback
Date Posted: 06 March 2009 at 3:35am
|
National Health service is always good for covering things like emergencies and when you are in transition.
I've recently changed jobs and medical aids. The medical aid said they will deny me cover for a whole list of things for the first year, until I've invested enough with them or something. Like I can plan when I'm going to get into an accident, or need my appendix out or something. |
Posted By: Frozen Balls
Date Posted: 06 March 2009 at 3:54am
|
Just don't get sick.
------------- 
|
Posted By: Darur
Date Posted: 06 March 2009 at 5:23am
But is that really a situation the government can fix? Healthcare not exactly a natural monopoly, and the free market model predicts that a large number of firms providing health care and insurance will be the most efficient, not counting market failures. The government has tried to address these market failures with healthcare programs for those in need which has resulted, ultimately, in our present situation. I think the system needs a vast overhaul, but I'm not sure more government would be the cure. ------------- Real Men play Tuba [IMG]http://img89.imageshack.us/img89/1859/newsmall6xz.jpg"> PH33R TEH 1337 Dwarf! http://www.tippmann.com/forum/wwf77a/log_off_user.asp" rel="nofollow - DONT CLICK ME!!1 |
Posted By: oldpbnoob
Date Posted: 06 March 2009 at 9:18am
|
A couple of things regarding the post. Rambino, when you are comparing the two policies that I had and what you had, I can guarantee that yours is far superior to what mine was. I am sure you are comparing Volkswagens and Bentleys. Again, I cannot imagine that basic major medical health plans have gone up that much in five years. Perhaps I need to call my insurance lady and get educated if this is the case. Secondly and this will probably sound snarky as well. How much does each lawyer in your firm on average bring into the firm and how many support personell do you have? Is it that the firm can't afford to pay for insurance or that doing so would lower their income?
As for my wifes insurance, yes she works for the school as a secretary. Her insurance is paid for by tax dollars, but so is her salary. Are you suggesting that the government should start paying our salaries as well? Perhaps, we should all just start pooling our money and the government can pay us what it thinks we are worth. Out of curiosity, does a lawyer that does the same job you do, but work for the government make as much as you do? Maybe not, and you possibly chose the specialty that you are in because it was either appealing or.. made more money. Perhaps, we should socialize all lawyers so that they work for the state?
I have always worked for small businesses, all family owned independent electronic distributors. Nearly every single one has offered some sort of health plan as a benefits package. I haven't always taken them due to price or having other options. In one case, my independent plan was cheaper than any plan they could offer me, but mainly because I was not in the same state as they were. The most previous place offered insurance that I didn't take, but one of my sales guys did and it was only about $200 or so per month and I think they were matching half. Granted, it was for a 40 year old single guy, but I don't find that unreasonable. And the company overall only had maybe 20 employees. I think I asked about my coverage one time and it wasn't too bad either for me and my family. Not sure what plan you have, but .... But again, this was not a super premium plan.
I don't know about dentists, but again, wonder is it that they can't afford to offer insurance or don't want to do so without lowering their lifestyle? I know my old dentist was making some good jack and had no problem sending all of his kids to fancy private schools, driving Caddy's and living in what I imagine was a pretty nice house. I don't begrudge him or anyone else for it. Good for him/you. But again, should I be forced to pay for his employees healthcare insurance?
I don't know the solution for part timers, but as I said, when I was younger, I went without insurance as I was young and healthy. You're right, I could have been struck down by lightening, but the odds were slim and I went without. Actually, I guess with lightening, I would have been covered as it would have been an emergency. As for Walmart employees policies, I have been **edited**ing for years that people should patronizing them for their unfair employment practices, but every has to have their $100 tv's.
And now I will go off on a totally wild rant. IMO the main reason healthcare is so expensive in this country is greatly due to lawyers and their frivilous lawsuits. Due to all of the ambulance chasing, blood sucking vampires, no offend Rambs, medical malpractice insurance is so ridiculously high that it forces insane treatment prices. These treatment prices in turn are passed onto the insurance companies that try to chisel them down. In turn, the doctors pump the prices even higher, and you end up with a game of cat and mouse. In the end the doctors do not want to make less money and the blood sucking, bottome feeding vampires, no offense again Rambs, will not quietly go into the night if they even sniff a scent of blood (money). So now, the lawyers that make 2-3 times what I do each and every year, drive nice cars, live in big houses and who are responsible for the ridiculous problem in the first place expect me to foot the bill. So not only do I have to pay the high insurance rates, I have to further pay high taxes to pay for their employees insurance, so they can continue to sue the doctors, hospitals and insurance companies further raising my rates. Sweet. Isn't that akin to making me repeatedly drop a sledge hammer on my toes in order to keep the orthopedic doctors in business?
|
Posted By: Rambino
Date Posted: 06 March 2009 at 11:07am
I should clarify my statement:
Multiple bureaucracies are less efficient than a single bureaucracy. This is true simply due to reduced duplication and reduced complexity. There are far more back office personnel in a US doctor's office working insurance than there are equivalent people in any Western European country. The savings from a single-payer system would be immediate and drastic at the individual doctor's office, and would continue up the food chain.
I have a client - a very large company - whose entire business is running insurance claims for hospitals and doctor groups. That whole industry is basically wasted overhead.
So: A single-payer system has less inherent waste than a multi-payer system.
Now, that does not mean that any given bureaucracy is efficient. Your example of the VA comes up frequently. I do not have personal experience with the VA, but if a third of the stories I hear are true, then that entire agency is very bad.
But that does not mean that government is incapable of running a reasonably efficient bureaucracy. Again, our health care costs are generally quite a bit higher than those in Western Europe.
And remember, all we need for cost-savings is that the single-payer bureaucracy is more efficient than the combined bureaucracies of the multi-payer system. And there are some things that government does better than we would expect from the private sector. Can we agree, for instance, that the Marines are a pretty efficient blowing-stuff-up organization? They certainly are more cost-effective than Blackwater.
And, of course, the single payer need not be government. National single-payer healthcare need not be a government agency.
Anyway - I will not minimize the concerns over the VA. Clearly any national effort would have to do a better job than the VA is doing. But the poor performance of the VA should not automatically deter us.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Rambino
Date Posted: 06 March 2009 at 11:16am
As in my previous post, a single-payer system need not be government-run. That is the obvious model, but not the only one.
But we are not currently in a free market for health care. Not even close. If we were, the universe would be very different. Health care and health care insurance is one of the most tightly regulated industries in the US.
And, frankly, we wouldn't like an unregulated health care market. The free market is very good at being efficient and profitable, but it will not automatically do what we want, and it will not automatically do what is best in the long term.
For instance, preventive care. A true free market model would have many healthy people foregoing preventive care, even more than now.
And coverage. A free market model would leave many uninsured, even more than now. And while lack of coverage has short-term benefits, the long-term cost to all of society is tremendous.
The free market is a powerful force, but it hardly ever results in "universal" anything. A necessary side effect of free market forces is a significant degree of inequality, even to the point of harmfulness. There are societal benefits to having certain goods and services universally available, and a fully free market will never get there.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Rambino
Date Posted: 06 March 2009 at 12:00pm
I obviously can't speak for your plan, but I can tell you that four years ago my monthly payment was around $1100. There is also a lot of variability across the country and across industries.
In terms of quality, my plan is pretty good, but not as good as the plan my wife got when working for the State.
We provide insurance for our employees. As is the normal practice, we pay half of the premiums, and the employee pays the other half.
I am not an employee, so I pay double.
No. I am snarkily pointing out that you are benefiting from socialized medicine even as you are complaining about it.
That, frankly, makes no sense. That would be functionally equivalent to socializing the CEO of Microsoft. You are leapfrogging all the way to full-on 100% state-owned society totalitarian socialism, which is a theoretical bogeyman at best.
You already are paying for it - just not very efficiently.
But my point here is that our current system punishes hard-working people. People who do play by the rules, but who happen to have landed in a place or a job that does not offer health insurance. Maybe the nurse applied for a job at all the hospitals but didn't get the job, and ends up at a small practice with no health insurance instead. She worked hard, got a difficult degree, and working to help people get well - and an accident will bankrupt her instantly.
And this is very bad. You went without preventive care. The heart murmur you got after getting insurance might have been caught earlier or prevented if you had been on insurance the whole way. This runs up the cost for all of us.
And it is very different for families. Going without healthcare insurance with kids is very, very bad. Not to mention that if you do get struck by lightning without health insurance, you are hurting not just yourself but your entire family.
Medical malpractice insurance is expensive in the states, yes. This is in part due to litigation costs, yes. On a side note, frivolous lawsuits don't run up costs, because they get dismissed. The ones that succeed are, by definition, not frivolous. Litigation costs are higher in the US not because of the plaintiff's lawyers, but because of our legal system and our healthcare system. If I suffer medical malpractice in most European countries, I will be directly compensated by the state. No need to sue, and the laws won't allow it. The only way to get compensation in the US is to sue. That's how our whole system works, and it is not limited to healthcare.
Moreover, malpractice insurance are not a prime driver for high insurance costs. Excessive backroom paperwork drives up costs. A disproportionately high rate of serious illness brought on by lack of preventive care drives up costs far more than that.
Litigation adds to the issue, but frankly that is no the real problem. The real problem is that our current system focuses on treating sick people instead of keeping people healthy, and this is a function of our spotty coverage and confusing rules.
The US has health statistics that look like Eastern Europe. Almost all the countries that we like to compete with beat us in terms of life expectancy, infant mortality, and bunch of other lifelong health stats.
Our system does not provide good healthcare. And it is among the most expensive systems in the world, all while doing a bad job. ------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Monk
Date Posted: 06 March 2009 at 12:30pm
|
Pretty sure the point of a capitalist society is that the greater need for something causes more companies offering a product (insurance) to lower their prices in competition with other companies. So now small insurance companies will go out of business because they cannot compete with the government causing people to lose their jobs? That seems highly counter-productive. I may be biased because I will soon enter the medical profession, but national healthcare lowers the amount a health professional earns, eventually leading to healthcare providers losing their jobs... again, being counter-productive. America needs to stay the course and not give in to these national plans to get out of the situation we are in. Markets go up, and they go down in laissez faire. |
Posted By: oldpbnoob
Date Posted: 06 March 2009 at 12:36pm
How do you figure it is socialized medicine? You lost me on this one.
I think in the end what it comes down to is this. I DO NOT WANT TO PAY MORE TAXES to support other people having healthcare. Especially for small business owners that can afford to pay it. When I hear talk of socializing medicine, not once do I hear the phrase after it, "and it's not going to cost you another dime" come out of anyones mouth. All I hear about is how many billions of dollars it is going to cost and that directly translates into someone having to pay for it. It isn't going to be the percentage of people that currently don't pay taxes. It isn't going to be corporations. It's going to be ME.
|
Posted By: Rambino
Date Posted: 06 March 2009 at 12:46pm
|
My point is this: A truly free market will lower the prices, but will not necessarily provide services in the fashion we, as a society, want. Easy example: Safety features in cars. The free market may have eventually gotten around to seat belts in every car, but only after loss of thousands of lives. Government regulation forced a universal change for the betterment of society. More specific example: Malpractice insurance. In a free market, some doctors would have malpractice insurance, others would not. Mostly, the doctors that need it the most will be the ones without. The wealthy get good doctors with insurance, the poor get Dr. Nick Riviera - if they are lucky. In a free market, actual medical training isn't required to be a physician.
The evidence speaks to the contrary. American doctors make more money than doctors anywhere else, yet doctors in other countries manage to provide better healthcare to more people. More importantly, remember that the US medical field is not a free market either. It is less regulated than in other countries, but it is among the most heavily regulated we have. We should not hold up the US medical system as an example of the free market at work.
Yes, and laissez-faire is a bad idea. But that is perhaps a different discussion.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Rambino
Date Posted: 06 March 2009 at 12:53pm
And you will in fact not pay more.
Well, some people will pay more, some will pay less. Which applies to you will depend on the specific implementation and what your current starting point is.
Yes, you will pay more IN TAXES - but your healthcare insurance premiums go to ZERO. There would be a total net savings, on a national level, and for many/most indivuals as well.
Heck, for a while as an employee, my healthcare premiums were exceeding my federal witholding. Yes, my healthcare insurance was costing me as much as all the federal services combined.
The US healthcare system is the most expensive in the world, on a per-capita basis, BY FAR. As in three times the average cost in industrialized nations, and almost double the next most expensive country.
Yet these other countries, manage to provide BETTER healthcare to 100% of their residents, while spending less than half of what we spend.
Unless we implemented the worst socialized medicine in the world, I can absolutely guarantee that there would be very significant savings.
So for everybody who thinks they are paying too much now (including me), you should push for European-style nationalized healthcare, because it will save you lots of money, and make you healthier. ------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: oldpbnoob
Date Posted: 06 March 2009 at 1:12pm
As mentioned, my wife has an insurance policy through the school. Our premiums are currently........ ZERO. So, as said, I get screwed.... AGAIN. I get to pay higher taxes so that you and others that make significantly more than me as small business owners get to pay less.... OH YAY! I am giddy with excitement that I can better your standard of living. JOY.
|
Posted By: Rambino
Date Posted: 06 March 2009 at 1:24pm
My tiny violin is playing for you. Basically, you support state-paid healthcare for your own benefit, but nobody else should get it?
My sympathy level is what just dropped to zero.
Moreover, you are wrong. The cost of your healthcare is on the school's budget as a compensation cost. Whether by reduced wages or increased taxes, you are in fact paying for that healthcare. You healthcare is not free now, just because it is not a line item on the paycheck.
TANSTAAFL applies, and the evidence is pretty overwhelming that the US system is the most costly and inefficient healthcare system on the planet, while also managing NOT to provide top-level care.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: oldpbnoob
Date Posted: 06 March 2009 at 1:43pm
As is mine for you. You really want to compare my wifes $18k/year job with health benefits to your situation? Really?
And the bottom line by your own description is that MY taxes would go up.
|
Posted By: jmac3
Date Posted: 06 March 2009 at 1:49pm
I think his point was that while your taxes would go up, so would your wife's wages? Maybe I missed something though. ------------- Que pasa?
|
Posted By: mbro
Date Posted: 06 March 2009 at 1:56pm
Jesus H, 18k a year? I'm in school and I made more than that last year, granted I averaged 38 hr/wk but still. If I was out of school I'd be making $2/hr more at my current job and paying only $100/mo for decent health insurance. ------------- 
Don't blame me, I voted for Kodos. |
Posted By: oldpbnoob
Date Posted: 06 March 2009 at 2:01pm
And she gets to have little autistic kids bite her as an added bonus. ------------- "When I grow up I want to marry a rich man and live in a condor next to the beach" -- My 7yr old daughter. |
Posted By: Rambino
Date Posted: 06 March 2009 at 2:20pm
I don't see why not. The same principles apply.
Employees receive remuneration from their employers. This comes in the form of salary/wages and benefits: 401k, free parking, water coolers, health insurance, company car, office space, desk, stapler, uniform, paid vacation, whatever.
All of those things get bundled up by HR into the actual cost of the employee. Which in the case of your wife is paid for by taxes.
If one of those goes down (say, for instance, the cost of health insurance goes down due to a better system), then the total cost for that employee goes down accordingly. Then, depending on budgeting and policy, either the employee gets an increase in salary or a new/improved benefit - in each case equal to the healthcare savings, or the total cost for that employee just stays lower, in which case the employer just keeps the savings. In this case that means that the government saves money, which could be used for government stuff - including a tax cut.
So, no - your taxes will not go up just because your wife's healthcare is included in her employment package. If there is a total net savings, then everybody benefits, including you. That benefit might come in the form of higher salary or better benefits for your wife, or increased military spending, or reduced taxes, but you will also benefit.
But yes - you taxes would probably go up, but your wife's benefits/salary would go up to match, more or less.
You are already paying for your wife's healthcare. That will not change, only the path the money takes.
In my case, since I am self-employed, my monthly take-home would immediately increase by $1765. Woot.
Our firm would also save millions on insurance premiums for our employees. Our profitability goes up. Then we pay higher taxes to pay for nationalized healthcare, and so do our employees. Profitability goes back to where it was, more or less. But we all benefit from the overall net savings. Then salaries move around to adapt to the change in taxes vs. insurance payments, and we all end up more or less where we were, but just a little bit better off across the board. ------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: oldpbnoob
Date Posted: 06 March 2009 at 3:31pm
|
Excellent. My taxes go up. My wifes benefits go down. And you get $1765/month more. Sweet deal. |
Posted By: Rambino
Date Posted: 06 March 2009 at 3:56pm
Read slower. That's not what I said.
What I did say was that it will be a wash, except that there will be total savings. How those total savings will manifest I cannot predict.
Let me give you the super-simple version:
You pay for healthcare now. You will pay for healthcare if it is nationalized, only less. The same goes for me.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: tallen702
Date Posted: 06 March 2009 at 4:07pm
|
Rambs, we may all pay less, but the cost to benefit ration will go right out the window as the quality of health care rapidly degrades. ------------- <Removed overly wide sig. Tsk, you know better.> |
Posted By: Rambino
Date Posted: 06 March 2009 at 4:14pm
Clearly true - IF the quality of care degrades. But why would we think that it would?
I again point to the quality of care provided by European and Canadian systems. Judging by virtually all health metrics, almost all of those nationalized health care systems provide better care than the American system.
There is an irrational fear of centralized health care in this country, based on a few scary anecdotes. At the same time we conveniently ignore equally scary anecdotes from our system. The nationwide numbers, on the other hand, tell a very compelling story.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: oldpbnoob
Date Posted: 06 March 2009 at 4:24pm
The problem with your equation is that now instead of paying taxes to support my wifes healthcare, I am paying to support a greater number than were previously paying into it. All those millions that you said were currently uninsured. Where does this money magically appear? And I am basing a lot of my arguments on the fact that I will maintain the current level of care that I currently do. I will be even more pissed if my taxes go up AND I get lesser service. I was on a HMO for a short time and that was a wonderous experience. I loved waiting in line with all the welfare moms and crack whores. Good times. It's also very doubtful that any raise my wife would be would be compenserate with what she loses.
|
Posted By: Tical3.0
Date Posted: 06 March 2009 at 4:33pm
| BAWWWWWWWWWWWW This whole thread. |
Posted By: Rambino
Date Posted: 06 March 2009 at 5:05pm
Two sources that I can name: efficiency savings, and preventive care savings. There are probably many more. Smarter people than me can no doubt give more specific explanations.
The numbers are clear. The cost PER CAPITA for healthcare in the US is three times the European average. That means they cover 100% of their population for a third of what it costs us to cover 90% of our people.
Basically, we only need a 10% savings to get 100% coverage without a cost increase.
Meanwhile, the next most expensive European country (Switzerland) only spends 60% of what we spend (per capita).
While there are many differences between the US and Europe that affect costs, I have a hard time believing that they have some secret knowledge that allows them to spend a third of our cost for better care.
And, of course, Canada spends about half of what we do, and they are still healthier than us. Are the Candians twice as smart as us?
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Rambino
Date Posted: 06 March 2009 at 5:09pm
Why would you say that?
In one scenario, for instance, her/your taxes go up by $100/month, and her salary goes up by $100/month. Her healthcare improves.
That sounds pretty good.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Mack
Date Posted: 06 March 2009 at 5:23pm
I actually wasn't referring to the VA. I was referring to the military medical system. The network of base hospitals and clinics and commissioned doctors and nurses that work in them. While I understand that the VA has problems, I have been fortunate in not having suffered from any of them in my VA-related experiences. (I have actually been quite impressed with the local VA system with the exception of the antiquated equipment and facilities; something that I think must be a symptom of "socialized" medicine as I remember the same thing about British hospitals from my experiences in the U.K.) Now for a couple of semi-related random thoughts: The first is a joke we had in the USAF; I'm certain that the other branches have their own versions of it as well: What do you call a doctor who graduates at the bottom of his med-school class, can't pass his state boards and doesn't qualify for malpractice insurance? "Captain." The second thought has to do with the points that both Rambino and Darur brought up regarding efficiency. As a reminder, I will sum up those points below: Darur: The market-place pressures make the current system more efficient than a socialized system. Rambino: How can it be, multiple providers result in resource waste from redundancy in administrative positions. (My apologies if the summation was not exactly correct; I was going for brevity.) The thought related to these two points has to do with the USAF Officer/Enlisted Club system. Several years before my retirement I turned in my club card and quit frequenting it because of continuous poor service, bad food and dealings with unprofessional employees related to these issues. This seems like a simple exercise of my free-market right to take my business to places that treat the customer properly, but there is more to it than that. The club could thrive with such poor practices because it had no competition. It had no competition in the fact that it was the only "fine dining/drinking establishment on base, but the reason it really had no competition was that membership for Senior NCOs and Officers was an expected part of being in the military. (Despite the fact that you were required to pay dues based on rank and the membership card was an extra credit card I didn't want.) It was not mandatory to be a member, but it was traditional and the tradition was enforced by the even more senior people who endorsed performance reports. The end result was, the club did not have to perform well, because there was no competiton for the actual "service" it performed. The fact that it was run by the government as part of a collection of such clubs with a certain level of centralized management didn't seem to help. Does this necessarily apply to the medical discussion we're having. Not directly, but it is an example of how removing competition can decrease the level of service. -------------
|
Posted By: tallen702
Date Posted: 06 March 2009 at 5:41pm
I point to exhibit A, the article which this thread originated with. The cost of socialization of the health care system means that the government will wind up cutting coverage compared to a private health plan. Private health plans will become even more expensive than they are now since those who would choose lower costs will pull their money out of the private system. It is exactly what happened in the UK. Everyone switched to the socialized NHS plan because they were paying for it anyway, why not save some money right? But then the strain of the load wound up costing the gov't too much. Now, the gov't is telling the people enrolled in the NHS that they can't get certain drugs, that they can't have certain surgeries, and limiting their care beyond the point that current US privatized systems do. Furthermore, the lack of private policy holders in the UK drove the rates up to the point that only the very wealthy can afford better health care than what the NHS is willing to provide. The standards by which many organizations are judging the "quality" of health care in the UK and other socialized countries are not overall standards, but rather standards of normal care. This means that they look at prescription costs, scheduled doctor's visits and the like. They do not, however, compare the costs and quality of major surgeries, oncology, nuclear medicine, and many other sectors that private health care organizations excel in. For example, in the UK, you are often only allotted ONE major surgery of a particular type. For example, my friend Alisdaire's father needed a double bypass. The NHS covered it, but only once. His bypass didn't take and the drugs that would have cut down on the risks of the surgery were not made available to him because they cost the NHS too much. He died from complications that could have been fixed either with those drugs or with another surgery just six months after his first one. This isn't an isolated case, it happens all the time. If he had been on a private plan in the vein of the US health care system, he would still be alive today. ------------- <Removed overly wide sig. Tsk, you know better.> |
Posted By: Darur
Date Posted: 06 March 2009 at 6:01pm
Ehh, you sort of missed my biggest point there, but I phrased it badly so it wasn't even remotely apparent. The notion that one nationalized health care system is more efficient then many competing systems is a pretty big assumption, with the exceptions of certain natural monopolies. Beyond a certain point, the amount of capital put into the system will yield decreasing returns diseconomies of scale occurs and efficiency drops significantly. I confess I do not know much about the healthcare system, but generally speaking, even factoring in the added costs and expenses associated with ensuring the healthcare system is efficient and of decent quality, many small firms, in theory, would provide the services more efficently then 1 large governemnt run system. ------------- Real Men play Tuba [IMG]http://img89.imageshack.us/img89/1859/newsmall6xz.jpg"> PH33R TEH 1337 Dwarf! http://www.tippmann.com/forum/wwf77a/log_off_user.asp" rel="nofollow - DONT CLICK ME!!1 |
Posted By: Mack
Date Posted: 06 March 2009 at 9:39pm
|
If Canada's (socialized) system is so great, why did http://www.gmanews.tv/story/56475/Canadian-woman-has-rare-identical-quadruplets - these folks have to go to the states? Oh, never mind, the articles says "The Jepps drove 325 miles to Great Falls for the births because hospitals in Calgary were at capacity. . . " -------------
|
Posted By: Rambino
Date Posted: 07 March 2009 at 1:10am
Hard to say what the cause is - but it is pretty clear that American hospitals/clinics generally have far more new and fancy equipment than European getups. I think there are something along the lines of three times as many MRI machines per capita in the US as in Western Europe, for instance.
This presumably plays into the cost savings as well.
This is a very legitimate point, but perhaps points out the real danger of mixing quasi-free-market with full-on nationalization side by side. Based on this story, it would be reasonable to say that part of the cause for poor military medicine is that the military has to compete with the private sector for medical talent, and it does not pay nearly as much. And if the private medical sector is 9 times the size of the military medical sector, then the military basically gets the bottom 10% of all doctors.
Thus it says less about the quality of socialized care than it says about the military's ability to compete for talent.
Now compare this to a socialized-optional system, where perhaps 90% of doctors are in the managed system and 10% are in the higher-paid private sector. Now the socialized portion of the system loses only the top 10% to the private sector, which is a whole lot different than losing the top 90%. In this system, the average socialized care would be only marginally below the total average, whereas the US military care is far, far below the total US average.
So the problem in this exercise isn't really the socialized medicine itself, but the limited application thereof.
All numbers made up and generalized, of course.
Not too far off - and Darur, you should consider this a response to your post as well.
But I would restate my position instead as: It is empirically true that universal-coverage systems cost far less than the American system, while providing similar or better levels of care. The causes for this are no doubt many and complicated, but I suspect that reduced waste and more preventive care are among the leading causes.
The key part is empirically and objectively true. It is objectively true that the US system is the most expensive on the planet. By far. It is objectively true that some of the most socialized of all systems (like Norway) are the cheapest of all (ignoring countries that don't have any of that there healthcare stuff).
That is reality. We can attempt to decipher why, but it is a waste of time to discuss what "would" happen in theory - we can look and see the actual results.
In particular, there are plenty of numbers floating around showing that the administrative cost in particular represents a significant chunk of the increased cost of the US system. There is simply more paperwork to be done here than elsewhere, and this is expensive.
Why is that? Why have market forces not put us into a super-lean health machine? Your mistake, Darur, is to assume that market forces are allowed to roam free. As I have said on numerous occasions in this thread, healthcare is incredibly regulated - and for good reason. Something as simple as HIPPAA, for instance - healthcare records are required to be maintained in a certain fashion. That is probably a good idea, but it also means that every insurer has to maintain its own entire records management system - because they are not allowed to share.
Darur posted that healthcare is not a "natural monopoly", and Mack has the analogy to the officers' club. Both of these assume market forces at work that are just not there.
The reality is that healthcare IS a natural monopoly, at least within our regulatory framework. And market forces are blunted at every step.
Another example: Employer-provided healthcare insurance is deductible to the employer. As a result of this tax rule (that McCain wanted to remove), employer-provided healthcare insurance is always cheaper than private healthcare insurance. It would take tremendous market forces to overcome this tremendous advantage. As a result most people get their insurance through their employer. This leads to job lock, which is bad for the economy. It also drives the cost of private insurance up further, making it even less affordable.
The other mistake you both make is forgetting the lessons of Adam Smith. In the Wealth of Nations, Smith calls out certain categories of services that are best provided by the government, because market forces would not be able to achieve the desired result. He names roads and education, among others, as examples of this.
The reason is that while the free market might give you the lowest cost per mile for road construction, it would also give you a random mish-mash of roads across the country. Instead, a nationalized road design would give us the Interstate system. It may cost a little more per mile to build, but we more than make that up in benefits gained for having a coherent overall plan.
The free market does not plan ahead.
I believe healthcare also fits this bill. In particular, there is tremendous value to universal coverage. In fact, this is the factor that all the cheap and effective systems have in common, whether the coverage is state-provided or state-mandated, or a combination. This is true because disease and injury is a drain on society. Preventive care saves money in the long run. Just like it is cheaper to buy good shoes for your workmen than lose them to back injuries, so it is cheaper to provide universal preventive coverage than to deal with endless emergencies. Preventing is always cheaper than curing.
And the market will never get to universal coverage on its own, thereby missing out on one of the greatest prizes and making our system more expensive.
More on market forces:
I stumbled across http://healthcare-economist.com/2008/04/23/health-care-around-the-world-switzerland/ - this nifty article about the Swiss system. Cannot speak for the source, but it is consistent with what I have read elsewhere.
Some relevant quotes:
"of all the countries with universal health care, Switzerland’s is the most market-oriented "
"Switzerland ranks second only to the U.S. in terms of the ability of patients to choose their provider"
"Switzerland ranks second only to the U.S. in terms of timely care"
But then:
"Switzerland’s health care spending as a percentage of GDP is second only behind the U.S."
Two data points isn't exactly enough data for a causal claim, but I do refer to the rollover text of today's xkcd anyway.
The far more damning observation is that 100% of the countries in the world with universal or near-universal healthcare coverage have costs far below the cost in the US. Every single one of them.
(at least that was true last time I checked)
Moreover, virtually all of those countries beat the US in terms of various health metrics. My favorite is infant mortality. CUBA has lower infant mortality than the US. CUBA! And by a lot, too. Every country we want to hang out with has infant mortality rates far lower than ours.
The life expectancy in the US is less than almost all European countries, and generally hangs out with the not-failed-state-but-not-exactly-great-either countries. We have triple the MRI machines, and we still can't stay alive a little longer?
There are certainly factors other than healthcare quality at play here, particularly with life span - no doubt. But again, the correlation is striking.
And the infant mortality in particular relates back to my point about preventive care. A major predictor of infant mortality? Lack of prenatal medical attention. That should not surprise anybody.
It's all about the preventive care. Why do we need all those MRI machines? Because Americans don't go to the doctor until they are sick, because their health insurance won't cover it.
Bottom line: we can go on all day about how the market is more efficient. That's great - I am a free-marketeer as well.
But we cannot ignore reality and observable fact.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: procarbinefreak
Date Posted: 07 March 2009 at 1:21am
| if we went to a socialized healthcare, i would definitely care less and do a crappier job at work. |
Posted By: Rambino
Date Posted: 07 March 2009 at 1:50am
That all depends on the particular type of system we are talking about- universal coverage can be accomplished by a variety of means. The Swiss, British, and Norwegian systems, for instance, are quite different from each other.
But yes - ultimately there are limits. But this is true for private healthcare as well. You think your private insurance in the US will cover everything forever? Better read your policy again. There are caps all over the place. There are excluded procedures. There are excluded medicines.
The limits and lines will be drawn in different places for different systems, but any system will have limitations.
And the original article was yet another anecdote. It isn't hard to think of those in the other direction as well.
You were on Fark today - I enjoyed reading about the woman using superglue to keep her teeth in place because the actual replacement procedure exceeded the cap on her dental insurance.
Another dental anecdote, this time mine: When I was getting my wisdom teeth out, the original plan was to just take two. Then my dentist (sorry - oral surgeon) informs me that if I elect to take all four out (which was completely unnecessary, medically speaking), then it counted as a "medical" procedure rather than a dental procedure, and my medical insurance would pay for full anesthesia, which my dental insurance would not. So I underwent elective surgery, which was both counter to medical need and significantly more expensive than what I had intended to do.
Back over on medical: I had an injury, serious enough that I was in surgery five hours later. When I got to the ambulance, the main thing the EMT wanted to know was which hospital was "in plan" - they wanted to avoid taking me to an out of plan hospital, which would cost me thousands of dollars or require me moved.
Another one of mine: I had a procedure scheduled earlier this year. When I scheduled it, I spent a couple of hours on the phone and the web, just to determine whether the procedure and the physician were covered by my insurance. Total waste of time. A week before going in, I was informed that our provider had rearranged some of their plans, including mine, and that this might result in coverage changes. I had not switched jobs or insurance, and I STILL had to repeat the entire process to make sure that the doctor and procedure were still approved. More wasted time. Had I been unlucky or less diligent, I would have discovered the hard way that I owed the doctor a few thousand dollars.
And another (I can go all day): One year ago we had our second child. I duly informed our benefits people, who told me the insurance was self-updating. No action required. Great. There were some complications, and we spent a good amount of time in and out of doctor offices and hospitals. Then we started getting bills from said doctors and hospitals, saying that coverage was denied because our daughter was not a listed beneficiary.
Turns out my benefits people were wrong, and I was supposed to tell the insurance company directly. I did that, and they declared my daughter covered. That only took another month to get straightened out. In the meantime, we have run up more than ten thousand dollars worth of medical bills. Thankfully, we could manage that. I am quite confident that most people would have suffered greatly faced with those bills.
We slowly started getting reimbursed by the provider. I got the last check right before Christmas. That's a long time to carry that much money (and did I get reimbursed for my carrying cost? Of course not). I must also admit to suspicions about whether the insurance company would have agreed to add my daughter if she had been diagnosed with cancer by then.
It is not difficult for me to recall dozens of instances where the sheer volume and complexity of the US healthcare bureacracy has cost me and mine lots of money and anxiety, and occasionally left us without coverage entirely.
And did I mention that having a baby is really really expensive? And even then they kick you out on the street the very next day? In most of the world, mothers and babies stay in the hospital stay for several days. Every non-American physician I know considers this malpractice on a national scale.
That "feature" of the US healthcare system cost us dearly with our first child, and it could have gone far worse.
Every system is different - the UK system is particularly odd. But even so - yes, there are limitations there as there are here. We can disagree about whether this or the other drug or procedure ought to be covered, but a line has to be drawn somewhere.
In the meantime, the UK system costs less than half of what the US system costs, and the UK still has longer life expectancies and lower infant mortality than the US.
As aggravating as the UK system sounds, it is still doing a better job for less money than the US system.
Even with my alledgedly super-duper plan, we spend hundreds of dollars each year on required drugs, because of cost limitations. So my $1765/month is actually too low - I forgot to add in drug costs. And copays - I forgot those too. Every system has limitations.
And this raises an important issue - how do you judge the quality of health care? Experts do not agree. There are certainly many metrics to choose from, such as the ones you list.
And that is obviously a tragedy. But healthcare is full of tragic choices. The money required to generally allow that second surgery could have (and probably did) save other lives. There are cost decisions made by doctors every day.
What does appear to be consistent, however, are observations that the US system is the best in the world at keeping people alive - just like your situation above. Heart attacks are less lethal in the states than elsewhere, advanced cancers are less lethal here, and so forth.
We are also fast - no waiting for procedures. Centralized care generally involves more waiting for scheduled procedures.
Yet despite that we STILL have lower life expectancy than our peers. And what about that embarrassingly high infant mortality?
It all comes back to preventive medicine. That's where everybody else has us beat. We are good at the heroics, but everybody else, including the CUBANS, are beating the pants off us in the basics of medical blocking and tackling.
As a result of that, they kill fewer babies, they live longer, and they do it with less money.
Oh, and in case my administrative problems were not sufficiently scary: http://online.wsj.com/article/SB123620847691933901.html - http://online.wsj.com/article/SB123620847691933901.html
It really isn't difficult to find tragic coverage limit stories.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: oldpbnoob
Date Posted: 07 March 2009 at 8:09am
|
Two questions, do the infant mortality rates include abortions? Second, how can you be certain that life expectancy etc that is higher in Europe isn't attributable to the fact that we also have the highest obesity rate? Go to Europe, look around you, if there is a fat person in the crowd, it's most likely you or another American. Will socialized medicine make us quit treating our bodies like garbage disposals? |
Posted By: Rambino
Date Posted: 07 March 2009 at 10:58am
|
Infant mortality does not include abortions.
As for life expectancy, I alluded above to the obvious fact that this is a correllation from which we should not automatically conclude causation, and there almost certainly are many non-healthcare-causes of longevity.
Obesity would certainly be one of those, along with traffic deaths, violent crime, and a myriad of other things that make us different from Europeans.
But yes, in fact, I do believe that better healthcare would help with obesity. Not make it go away, but help. It is a lot easier to pretend you are healthy if you are not getting annual physicals. It is harder to make excuses if your healthcare coverage includes paid exercise programs. Triply so if your doctor sends a trainer to your house.
I cannot prove it, but I am convinced that better healthcare would make a significant impact on obesity. (I presume there are studies out there. I haven't looked.)
But that does raise another point - simply having universal care is not enough. That is the first step but not the only step. Along with that universal coverage needs to be greater emphasis on preventive care. We need to create a culture of annual checkups, and have coverage benefits that include far more "wellness" features, such as exercise programs and physical therapists. Certainly more than the $800/year I get for wellness for my family of four (which doesn't include any anti-obesity benefits anyway).
There is a twin problem here - we have a culture of "I'll see the doctor when I am sick," which lines up nicely with the fact that our doctors generally won't get paid to see you unless you are sick.
We need to pay our doctors to see healthy people, and then encourage healthy people to see doctors.
But to me the infant mortality is the most striking, moreso than life expectancy. Our rate is 40% higher (or more) than most of Europe. This is a massive qualitative difference. There are far fewer possible confounding variables here, and there can be little doubt that lack of consistent prenatal care is a significant contributing factor.
Besides, on abortion - universal health coverage would most likely also mean universal access to contraceptives. Access to contraceptives (or lack thereof) is an excellent predictor of abortion rates. Here also there are significant cultural factors at play, but the US leads the industrialized world both in teen pregnancy and abortion rates (those two are obviously related). I cannot help but think that if contraceptives were freely available to women of all ages and marital situations (and our culture allowed them to freely use those contraceptives) that our abortion rate would drop significantly - and our infant mortality rate as well, of course, as unwanted/unexpected pregnancies do not get the prenatal care that they should.
(Small side-step on abortion: I never understood how so many people who vehemently oppose abortions have no problem allowing that same fetus to go medically unattended in the womb - and equally unattended after birth. But separate issue.)
These issues are all interrelated, of course, and depend on many other cultural issues, but I find it very difficult to argue against the societal and economic benefits of universal coverage. And I haven't even gotten to the moral issue associated with allowing 10% of our population to have no coverage - that number, by the way, would be FAR higher if we dropped what government coverage we do have.
Yes, in a universal system you and I would have to wait longer for our needed-but-not-emergency procedure. That would suck. But we also would spend less time filling out paperwork at the office. We would not be turned away from the doctor because we forgot to bring our insurance car (happened to me). We would not have to play "I wonder if this doctor is in-plan" while waiting for the bill.
Most importantly from a personal perspective, I would not have to worry what would happen to my kids if I lost my job.
A friend of mine found out last fall that he was losing his job. A week later he found out that his new wife is pregnant. His foreign wife who does not speak much English. COBRA will expire before the baby is born. Instead of being happy for his new baby, he has spent the last few months desperately trying understand what state/federal benefits he does or not qualify for. This has also distracted him from his job search and his family. That should not happen. I find it unconscionable that we allow it to happen. ------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: Rambino
Date Posted: 09 March 2009 at 1:39pm
|
I'll just throw another random factoid out.
I just got a bill from a medical lab that I do not recognize. It wants me to pay $96 for some procedure that I don't recognize, and lists a physician I do not recognize, albeit it on a day when I did visit a doctor.
So I just wasted half an hour on the phone trying to figure out what the heck this is. Now I know what it is, and will waste more time fighting with the doctors about informed consent. After I lose that fight I will waste more time arguing with the insurance company over coverage. After I lose that fight I will pay $96 for a procedure that I thought was fully covered.
Yay awesome medical insurance.
I have been with a few different carriers over the years, and without fail every time there is any actual doctorin' going on, random bills show up for the next few months, and time and money is wasted. Waste, waste, waste.
With a decent centralized system, none of this would have happened - certainly not this regularly. Sure, ther are other problems with centralized systems, but we have the worst large-scale system there is.
------------- [IMG]http://i38.tinypic.com/aag8s8.jpg"> |
Posted By: mbro
Date Posted: 09 March 2009 at 1:52pm
|
When my spleen ruptured three years ago due to mono (I still want to know who gave that to me) I was in the ICU for a week, the only actual procedures I had done was an MRI and my blood pressure was checked every three hours to make sure the bleeding didn't continue. I did not even have to have surgery since it was clotted over by the time I got to the hospital.
This one week cost almost $200,000. With no surgery. Thankfully I was under my mom's insurance (the same plan teachers in Wisconsin get) which is a very good plan and it only cost us just under 10k but we were also still receiving bills for a year afterwards. -------------
Don't blame me, I voted for Kodos. |
Posted By: scotchyscotch
Date Posted: 09 March 2009 at 4:06pm
|
I didn't realise there was an excess like that. I know alot of people who couldn't afford 10 grand. |
Posted By: oldpbnoob
Date Posted: 09 March 2009 at 4:15pm
Did you get a kiss with that bill? When my twin daughters were born, my wife had to have an emergency c-section, she spent 3 days in the hospital and the twins a full additional week in the NIC unit and the total bill was only $45K. I think you got hosed. Hard.
|
Posted By: jmac3
Date Posted: 09 March 2009 at 8:41pm
That's the point. A national healthcare plan would make people not get hosed. ------------- Que pasa?
|
Posted By: oldpbnoob
Date Posted: 09 March 2009 at 9:01pm
For once I will agree with you. I guess ff we had a NHS, the hospitals wouldn't have to triple bill to cover the cost of all the crack whores having babies with no insurance.
|