Healthcare in the US. [Archive] - Outpost Nine Forums

Sock Full of Boiled Dimes

06-30-2007, 06:31 PM

I'm in the middle of watching SiCKO.

Now I, like most people I know, really don't like Michael Moore. I think Farenhiet 9/11 was trash.

This movie, however, is genius. It pokes some holes in the American Health Care system making me just think how sucky we've got it.

Here is a breakdown of it.

US HEALTH CARE:
-We've got to get insurance.
-In our country (I knew this before the documentary) your insurance company looks for any excuse for them NOT to pay for your injury. Essentially Health Care companies will cover only for small injuries while you have to fight tooth and nail just to get treatment for something large.
-To make matters worse our pharmacy care has become more privatized making the elderly have to pay more to get pills. I remember reading on the news that they go to Canada now just because it cost way too much to get pills.

Every other Democratic Country:
-You get free Health Care...What the hell? You get free Health Care. You don't have to pay bills. The only thing you do is pay more in taxes.
-In fact in Japan they pay less in taxes then WE do and they still get free freaking health care (I think).

So there has to be a catch right? Talking to one of my more conservative friends I get a break down like this:

"You have to understand that America's doctors and surgeons are top notch compared to every other country out there. You will find no better kind of Health Care then you would than in America. We've got the best equipment, the best doctors, and everything else. Every other country is subpar compared to American doctors. In fact do you really want your health care to be muddled up under buracracy? I know that we need an overhaul in our health care, but universal health care wouldn't work in this country. We need privatized companies for these kind of things."

Is the true? Is the only reason why we have to pay insurance is because we've got the top notch doctors in the world? Is it because 1 American doctor is better than 100 Britian doctors or 100 Canadian doctors?

If we somehow get universal health care that our country's health care system would be worse?

I want to know because the WHO is telling me that we rank 27 in health care.

Shishio

06-30-2007, 06:42 PM

"You have to understand that America's doctors and surgeons are top notch compared to every other country out there. You will find no better kind of Health Care then you would than in America. We've got the best equipment, the best doctors, and everything else. Every other country is subpar compared to American doctors. In fact do you really want your health care to be muddled up under buracracy? I know that we need an overhaul in our health care, but universal health care wouldn't work in this country. We need privatized companies for these kind of things."

Is this friend of yours related to any executives? Or perhaps he has... "friends" that are executives?

Sock Full of Boiled Dimes

06-30-2007, 06:47 PM

Nope, poor ass Republican who just finished Community college. I forget what he got his associates for, but he's unemployed at the moment.

Cherub Rock

06-30-2007, 06:53 PM

If you have money then you have access to the very best healthcare in the world by a very large margin.

If you don't then you are screwed because the US does not have universal health care.

Therefore compared to countries that do have universal health care, the US ranks VERY LOW. It is mis-leading though because, as I said, if you have money then you rank #1. If you don't, then you rank much lower. That's just the way it is.

And yes, the fact that health care is privitized does play a large part in us having the best doctors. That WILL decline if we move to a universal system, though I'm not sure how much. Right now the best doctors in the world go to school in the US and they stay in the US because they can make the most money here. As it is, whenever a business is privitized the very best doctors will rise to the top and make the most money. If you force a universal healthcare system on them it will even the playing field, thus reducing the overall quality. Less incentive for excellence and all that jazz. It could be avoided by allowing privitized healthcare as well, but how many people want to pay the premium for universal healthcare AND pay for their own private coverage?

What it really comes down to is, do the people with money want to sacrifice their better healthcare so that the people without money can have it too?

RandomPasserby

06-30-2007, 06:56 PM

MEGA SATAN 3000

06-30-2007, 07:25 PM

Just a note, health care is not free, anywhere. Doctors need to be paid, equipment needs to be bought, etc. The difference is where the money comes from. In a private system, either you pay for it or you pay other people (insurance companies) ahead of time to ensure that they'll pay for it when you need it. In a socialized system, you take from others to pay for it.

Enders Shadow

06-30-2007, 08:39 PM

Is the true? Is the only reason why we have to pay insurance is because we've got the top notch doctors in the world? Is it because 1 American doctor is better than 100 Britian doctors or 100 Canadian doctors?

If we somehow get universal health care that our country's health care system would be worse?
We don't pay insurance because we have the top notch doctors in the world. We likely have many more skilled and experienced doctors than any other country (due to the "American dream") but that's not why we have insurance.

We have insurance because doctors are living the American dream. They can charge you whatever they want because health problems are something you can't (or... well, shouldn't) ignore so you're at their mercy. There are many doctors in America (though, more wouldn't hurt) so it's not like there are too few of them. It's just that it's a highly skilled profession (they have put years in school and interning as well as maybe a hundred thousand dollars into their education) so they're getting what they "deserve".

Insurance is actually similar to the middle man. Without it, you'll see how bloodsucking doctors can really be. Though, insurance companies are just that, a company... and they're looking to make profits themselves. Evading claims is one of the ways they can make profits (my mother's job is actually finding the smallest reason to not provide insurance for a certain claim). Another way to earn a profit is to have a high price for insurance :clap:.

By the way, one doctor is never better than one-hundred.

Fermented Yeast Paste

06-30-2007, 09:31 PM

Therefore compared to countries that do have universal health care, the US ranks VERY LOW. It is mis-leading though because, as I said, if you have money then you rank #1. If you don't, then you rank much lower. That's just the way it is.

And how many people have the money to afford the very best in terms of healthcare? Yes, the United States has graduates from some of the best medical schools and residencies in the world. However, I'm willing to bet that the majority of physicians practicing in the US aren't graduates of these schools and residences and aren't better than the majority of physicians in Canada, Britain, Belgium, etc. to any significant degree. Number17 your friend has some learning to do.

Physicians don't just charge a lot because they can. They go through a LOT to get to where they are-- roughly $200,000 from medical school alone, macaroni-and-cheese-style living for another number of years through residency, then they have malpractice insurance, etc. It's a big huge mess. For example, with medical school, the average tuition I believe for one year is roughly $25,000-$30,000 (Yale is more-- $39,000 and Baylor is a lot less at $10,000 roughly). The tuition for, say, medical school at McMaster University (Canadian)? $16,000 a year.

Trump

06-30-2007, 10:03 PM

I think you underestimate how much people pay in taxes in some other countries.

http://en.wikipedia.org/wiki/List_of_countries_by_tax_revenue_as_percentage_of_ GDP

The tax rates in Canada and other countries that have universal health care is MUCH higher.

So yes, while everyone has access to it, it costs people who don't use it even more under universal health care.

Cherub Rock

07-01-2007, 12:03 AM

Physicians don't just charge a lot because they can. They go through a LOT to get to where they are-- roughly $200,000 from medical school alone, macaroni-and-cheese-style living for another number of years through residency, then they have malpractice insurance, etc. It's a big huge mess. For example, with medical school, the average tuition I believe for one year is roughly $25,000-$30,000 (Yale is more-- $39,000 and Baylor is a lot less at $10,000 roughly). The tuition for, say, medical school at McMaster University (Canadian)? $16,000 a year.

They go thru a lot which is why a large portion of them who came from other countries to learn in America STAY in America. It's brain drain. I'm not knocking foreign doctors... I'm saying the US's healthcare "rank" is misleading. If you have healthcare you are not ranked 27th. It's just we have a LOT of people who don't have it...

Sock Full of Boiled Dimes

07-01-2007, 03:07 AM

Actually 250 million Americans have health insurance.

Anyway, any kind of universal social system in the US is never going to happen. We agree to Firemen, schools, and police because those are kind of needed.

However I think you'll find it very hard to convince many Americans to pay more taxes so that everyone has health care.

I'm actually pretty adament about the idea that the government should pay for colleges as well because I'm getting the fucking shaft at the moment with government financial aid and loands. Our colleges are way too expensive while other countries don't have to pay for it.

I'm pretty much a fond believer that our country is only for those who are rich. You only live well in America if you are rich.

Angelyne

07-01-2007, 03:33 AM

The US health care system is completely broken, but universal health care isn't as great as some may claim. It's good for treating minor injuries and illnesses, but if you need an operation, you get stuck on a waiting list for years. When I worked in a surgeon's office, we had a lot of foreign patients (mostly Canadians, some Europeans) for this very reason.

I don't have much faith that our government could create a successful health care delivery system, either. The numerous ways we have failed to give health care to veterans has been well-documented. If we can't even provide adequate care to a small group of people, what makes you think that they can take care of a couple hundred million Americans?

EDIT: I'm actually pretty adament about the idea that the government should pay for colleges as well because I'm getting the fucking shaft at the moment with government financial aid and loands. Our colleges are way too expensive while other countries don't have to pay for it.

Study abroad. You'd be amazed at the number of European universities who offer free education to international students.

harper

07-01-2007, 03:33 AM

I'm pretty much a fond believer that our country is only for those who are rich. You only live well in America if you are rich.

I don't consider myself rich, though I think I live pretty well. I am rich compared to residents of many third world countries, I suppose, but I have a nice job, work hard and am able to save quite a bit. I'm certainly glad I have nice health insurance through my school, though. I just got a statement from the hospital that my surgery last week cost $6825. I don't think I have to pay any of it, or if I do it will only be a token amount.

Sock Full of Boiled Dimes

07-01-2007, 03:38 AM

Study abroad. You'd be amazed at the number of European universities who offer free education to international students.

...

FRICK! I would do that if it were the U.K. and I got accepted. I mean, I'm running a 3.02 GPA at the moment as it is.

I wish we had some people from other countries to tell us how their healthcare is. I firmly believe that any other weastern country who has universal health care is on par with us with the skill in doctors and equipment.

Cherub Rock

07-01-2007, 03:47 AM

Also, many hospitals have free clinics for people without health insurance. You can't get a complicated operation or anything but if you need to see a doctor you don't actually HAVE to have health insurance. The problem is a lot of people don't take advantage of this because they don't know about it (just as many homeless people are unaware of government programs to help them). There's also the transporation issue as free clinics aren't something you find on every block or in every city. Still, it's not like people aren't doing anything to help those without the money for health care...

4letterwords

07-01-2007, 04:23 AM

I'm in the middle here. My mom had to pay 8000 dollars AFTER insurance for my surgery... but I had the surgery when I wanted, where I wanted, with the surgeon I wanted.

My moms boyfriend, ironically, needs the same surgery (he lives in canada) and he's on a 3 YEAR waiting list. He can't run until he gets the surgery.

If something else happens to my knee, I think I would prefer to have the prompt treatment. But like I said, I'm inbetween.

Psychochink

07-01-2007, 06:51 AM

U.S. doctors are better than everybody else = horseshit.

This is not to say that a significant chunk of the top 5-10% of specialists aren't in the U.S. (frankly, I don't have the figures and doubt they exist), but rather that you can get top-notch health care without having to pay through the nose for it.

Hell, having worked on the peripherals of a medical field, I know for a fact that at least a few of the very best and renowned specialists in the world in their field work in my city's public hospital (i.e. many of their patients don't pay a cent for their services).

On the cost of health care in the U.S., I think it's entirely feasible that a lot of it does have to do with:

Physicians don't just charge a lot because they can. They go through a LOT to get to where they are-- roughly $200,000 from medical school alone, macaroni-and-cheese-style living for another number of years through residency, then they have malpractice insurance, etc. It's a big huge mess. For example, with medical school, the average tuition I believe for one year is roughly $25,000-$30,000 (Yale is more-- $39,000 and Baylor is a lot less at $10,000 roughly). The tuition for, say, medical school at McMaster University (Canadian)? $16,000 a year.

To make a comparison, the entire 6-year medical degree in an Australian university will set you back about $38,000 (approx. US$32,500) - and students are bitching about that because it's higher than any other degree costs. Also, the goverment loan that amount represents has an interest rate that equals indexation, does not have to be paid off until your income reaches a certain level, and then a small amount is automatically added to your tax bill to do so (and is tax-deductible).

So our public education system backs up everything else. Of course, while this works in a country of 21 million...

Angelyne

07-01-2007, 07:33 AM

...
FRICK! I would do that if it were the U.K. and I got accepted. I mean, I'm running a 3.02 GPA at the moment as it is.

Do some research. Some universities will accept that GPA or lower. Some in non-English speaking countries will offer language classes, if it is the language barrier that you're worried about.

There are also a few Canadian universities that offer cheaper tuition than the US, and your chances of getting financial aid/scholarships are higher since you would be a foreign student (even with a 3.0 GPA).

whispering

07-01-2007, 09:20 AM

Is the true? Is the only reason why we have to pay insurance is because we've got the top notch doctors in the world? Is it because 1 American doctor is better than 100 Britian doctors or 100 Canadian doctors?
Good doctors are always good doctors, doesnt matter if they went to school in US or any other "western countrie". With very specialised doctors, US is probably has the biggest amount of the "best" doctors, as its a huge countrie. But here if someone needs a really specialized doctor that cant be found here, the next options are usually France, UK (also our crime labs use UK a lot) or Germany (though its usually only in extremely rare deseases where the treatment couldnt be provided here). Also a big part of it is, how big the disease is in the countrie. If US doesnt have many heart deseases, you most likely dont have the best doctors in that field.

Anyway, here you get free health insurence when you are born, or become a citizen. At the moment i pay ~20% in taxes (if i made more money i would have to pay a bigger prosent. If i made less, i would pay a smaller prosent), VAT is 22% here.

If something else happens to my knee, I think I would prefer to have the prompt treatment. But like I said, I'm inbetween.

In some things the wait list is big here. But you always also have the option to use private clinics. I dont think the government pays it fully, but it still pays a big part of the bill. If you have money, it doesnt mean you couldnt buy faster treatment. Free health care means, you get treatment no matter who you are and as fast as possible. I would say the only thing bad about free health care is, that people think its free. Meaning some will go to the doctor for small things that a simple visit to the pharmacy would have solved. To fix this there has been discussion that nurses should be allowed to give prescription medicine, so that the doctors wouldnt have to waist time to write prescriptions for a simple flu.

Trump

07-01-2007, 07:19 PM

I managed to get through school with no debt and very little assistance from my parents using mostly scholarships, fellowships, and an odd job here or there. That included a masters degree. Maybe it is just Florida, but post high school education was very affordable and aid was not difficult to find.

Pierrot le Fou

07-02-2007, 01:44 AM

Le sigh...

Healthcare has three primary items of importance: accessibility, cost, and quality of care.

Universal healthcare focuses on the second, and to an extent the first, but not as much the third.

A privatized system would focus on the first and third, with plans available that focus on the second and the first instead.

Unfortunately, the US isn't privatized entirely, and it's not entirely public, and it's entirely fucked.

The ideal system would have the government provide basic preventative care. You would get your teeth cleaned, vaccinated for free, flu shots and the like, all on the government's dollar. The costs of that preventative care would be distributed across the entire population, and everyone would have the very basic care provided for.

On top of that, there would be two types of policies: catastrophic insurance, and full coverage. Catastrophic insurance would cover your bills over X amount per year, where X depends on the policy. If I get cancer, and my treatment costs $10,000/year, I'd only have to pay $2000. These policies currently exist (and are pretty damned cheap), but they don't cover basic preventative care (or rather, basic preventative care never exceeds the base coverage rate, and so you pay out of pocket), making it far less appealing.

Full coverage would be more expensive, but cover EVERYTHING. Perhaps you'd have a copay system (I definitely think charging $10 every time you see a doctor prevents people from going to the doctor for a papercut, and overworking them, if you've ever been to a Japanese hospital), but otherwise fully covered.

By having the three-tiered system, people could choose what's best for them. Eliminate coverage through work, because it creates market inefficiencies (people no longer choose their healthcare, it's chosen for them, and the cost ends up higher for everyone as a result since the free market isn't really coming into play).

The problem with the US is that insurance is paid for through work, and prohibitively expensive if paid for independently. Furthermore, the lack of preventative care greatly increases emergency room costs for the uninsured, which end up getting footed by the insured yet again in higher costs for hospital visits. A vicious circle. It'd greatly reduce costs if we gave basic preventative care to reduce the long-term costs of healthcare, and so it'd make sense to provide it.

Ideally there would be things in between, where the basics were covered, and a list of 'standard' illnesses are covered, so that you're covered so long as you don't get freak illness Y or unknown condition Z, but it'd get very difficult to evaluate what type of coverage is appropriate, and what you're likely to get (but greatly increase the salary of actuaries).

At any rate, if people are in charge of their own healthcare (as they are with life insurance, home insurance, car insurance, etc.) it will allow people to evaluate their choices themselves, and create more competition for good coverage, rather than employers picking the cheapest coverage (it's absurdly expensive for employers, hence HMOs).

But this is more what things should be like. And they aren't. As is, employers need to pay for health insurance, because it's difficult to get insurance as an individual (as well as being hellishly expensive). Employers resent this, because employees are expensive even without the insurance, so they contract the insuring out to HMOs (Health Maintenance Organizations), which limit care to reduce costs, and you end up with a half-assed system that isn't full coverage, isn't really cheap, and has a whole lot of issues.

The benefit of the US system is that you get what you pay for. It may be costly, but if you can afford it you WILL get the best care in the world. People can call bullshit on this all they want, but there's a reason the entire Saudi Royal Family visits Massachusetts General Hospital, and not a Saudi clinic for their treatment. The downside is that it's expensive.

The catch to healthcare is that nobody wants to pay for it when they're healthy, and they want everything for free when they get sick. When a private insurer covers you, they can say, "Hey, look, you aren't covered for cancer of the entire body on your cheap-o plan, and we're sorry, but that's business." And you die, because you didn't/couldn't pay. When the government does it, people get in an outrage, "Why don't you pay for condition X?!" and "They won't give me the best medication for condition Y!"

The government has to say, "Sorry, if you have illnesses X, Y, or Z, you'll just have to take second-class care."

To save costs, they use old medicine, or 'generic' drugs, and they don't really fund the development of new drugs, new trials, and new developments. They get things when they're cheap, which allows for broader coverage for lower cost, but it DOES leave people behind. And that makes folks indignant.

Universal healthcare is tremendous if you don't mind waiting for knee surgery for a few years, or if you don't mind paying less knowing that if you get certain illnesses, you'll have to go abroad or die.

Private healthcare is tremendous if you have money.

But if you have all universal healthcare, medical research would drop in a hurry, and we'd see fewer drugs, and fewer developments, and the bottom would drop out of that industry. And that's fine, so long as the current level of care is fine for you.

Universal healthcare has its share of problems. In Japan, for instance, we all get 60% of our care covered. 60%. That's crap. I get $10,000 of care? I have to pay $4,000. Great if I break a bone, I suppose, absolute shit if I need serious surgery.

The problem is the lack of choice in ALL systems. We should be able to pay for health insurance like we do life or car insurance. Research, decide what policy is best, and buy it. There should be options, and we should make people understand that they can't live forever, and that they have to decide how much their life is worth.

People do it with life insurance every day, why not health as well?

Plekto

07-02-2007, 04:10 AM

Unfortunately, none of this is news at all to those who actually have been watching it all fall apart and be taken over by Big Business(yes, the real thing, TM and all).

I'd like to see him do a movie for once about how to SOLVE a problem. That would be great.

Pierrot le Fou

07-02-2007, 04:38 AM

Can't we just lock Michael Moore and GW in a cage and have them fight to the death? They're both blowhards I cannot tolerate.

whispering

07-02-2007, 07:24 AM

The benefit of the US system is that you get what you pay for. It may be costly, but if you can afford it you WILL get the best care in the world.
According to WHO, you will get the best health care from France.
http://news.bbc.co.uk/2/hi/health/799444.stm

Universal healthcare is tremendous if you don't mind waiting for knee surgery for a few years, or if you don't mind paying less knowing that if you get certain illnesses, you'll have to go abroad or die.

Private healthcare is tremendous if you have money.

But getting that certain illness is less likely then winning from the lottery. And it doesnt matter if your in the US. If the best doctor is in France, they will go there or get the doctor to US. If you cant wait 2 years (at least here i havent heard that anyone would have waited that long) you will never have to. If its medically risky to wait, you dont have to wait. If you are able to wait and dont want to, there are 2 big private clinics where you dont have to wait. Government still pays most of it. So if you can afford, you can have just as fast and good treatment here, with a universal healthcare.

But if you have all universal healthcare, medical research would drop in a hurry, and we'd see fewer drugs, and fewer developments, and the bottom would drop out of that industry. And that's fine, so long as the current level of care is fine for you.

That is just crap. Finnish pharmaceutical companys are doing well as far as i know. Do you really think that US is the only country that does medical research?
Blue ones have some type of Universal Health Care ->
http://img244.imageshack.us/img244/1161/healthau0.png

Pierrot le Fou

07-02-2007, 07:57 AM

According to WHO, you will get the best health care from France.
http://news.bbc.co.uk/2/hi/health/799444.stm
The rating is based on a comprehensive assessment of medical treatment, including factors such as availability of medical insurance and pharmacies.
Gee, really? You'll get the best health care? Because that's not what the article says.

I don't give a shit if you think universal healthcare is better. It has advantages for certain. Namely availability of fundamental care. But to suggest that the quality of care in France is better than that in the US while citing an article that doesn't even make that claim makes me think that you're being intentionally daft.

But getting that certain illness is less likely then winning from the lottery. And it doesnt matter if your in the US. If the best doctor is in France, they will go there or get the doctor to US. If you cant wait 2 years (at least here i havent heard that anyone would have waited that long) you will never have to. If its medically risky to wait, you dont have to wait. If you are able to wait and dont want to, there are 2 big private clinics where you dont have to wait. Government still pays most of it. So if you can afford, you can have just as fast and good treatment here, with a universal healthcare.
Getting surgery for a gunshot wound doesn't have a two year wait. If your appendix is going to explode, you won't have to wait two years. Want arthroscopic knee surgery? You're going to wait. Now perhaps to you it's not important that someone is less mobile for a couple years, but to people who love playing sports and being active, but are prevented from it for two years while they wait for surgery, it's NOT the same.

And what you're discussing is a two-tiered system which has even MORE problems (since good doctors will go to the private hospitals where they get paid more).

That is just crap. Finnish pharmaceutical companys are doing well as far as i know. Do you really think that US is the only country that does medical research?
Blue ones have some type of Universal Health Care ->
http://img244.imageshack.us/img244/1161/healthau0.png[/quote]
And who's buying those Finnish drugs then there chief? I was unaware that place of manufacture was part of my argument -- I was arguing for who FUNDS the production of these drugs, not which country they're eventually produced in.

Perhaps you should get off your high-horse, read what the fuck I said, and stop spewing nonsense.

RoxFontaine

07-02-2007, 08:59 AM

Trump

07-02-2007, 12:43 PM

That is just crap. Finnish pharmaceutical companys are doing well as far as i know. Do you really think that US is the only country that does medical research?
Blue ones have some type of Universal Health Care ->

Also consider an average resident/business of Finland pays almost double the taxes compared to what they would pay in the US.

All the systems have issues, but I am with PLF on this one. If I had a knee injury and had to wait 2 years for surgury I think I would go life would not be worth living.

Sock Full of Boiled Dimes

07-02-2007, 12:52 PM

Healthcare in the US trumps anywhere else in the world. Period. I don't care what it costs. I've told you all this before. I love Michael Moore's work, but I'd like to see him, with a SERIOUS health issue, in a place like Japan.

Well, its not like I'm saying that Universal Health Care would be grand for the US and in fact I doubt it would ever work for this country.

If you do see the film, however, you will notice how Michael Moore puts on a performance. I like this one because he wasn't trying to pursuade people to a point of view but rather , "Why is our health care so crappy?" This movie pokes some real holes just from the stories you hear from people. From the woman who had to pay for an ambulance ride to the hospital after a car wreck because it was not "Pre-Approved" to the 9/11 volenteer worker who has lung issues (due to the dust and smoke from ground zero) and isn't getting any help because he wasn't on the governments paylist.

What makes it even more interesting is that there was one story of a woman who had a brain tumor and her insurance company (Blue Shield) said she didn't have one and wouldn't pay for the MRI. While visiting family in Japan she got sick and went to the hospital where the doctors told her she DID have a brain tumor. She then sued Blue Shield.

It's not that the care is bad in this country. It's just the availablility of it and the health insurance that makes it so bad.

Pierrot le Fou

07-02-2007, 01:17 PM

I'm going to make a healthy bet, $100, for anyone who wants to take it, that Moore's film ends up having SERIOUS credibility issues along the lines of bowling for truth (http://www.hardylaw.net/Truth_About_Bowling.html).

Anyone who wants to take said bet, please, PM me.

If you refuse to acknowledge it, don't bother, but if you're willing to take the bet with an open mind, the bet is open.

ETA: The old 'bowling for truth' site seems to be gone. I linked to it accidentally prior to the edit. I didn't proofread the second site I added, but it seems to be along the same lines.

Knife-Fingered Sue Sanderson

07-02-2007, 01:48 PM

I was just listening to the radio this morning about how the senate democrats in the state of Wisconsin want to add a payroll tax of 15 billion dollars to create a universal health care plan. There are 5.5 million people in this state, and approximately 3 million in the labor force with 4.9% unemployed (http://www.dwd.state.wi.us/oea/cp_pdf/wicpw.pdf).

So basically, 3 million people will have to deduct $15 billion from their paychecks to pay for universal health care. That's 5,000 per person. Wisconsin is already in the top 10 of most heavily taxed states in the nation, and this could push us closer to first.

I would like to see people who can't afford health care be able to receive it, but the kind of people who need universal health care won't be able to afford much else with close to $5000 being taken from their paychecks.

Fred

07-02-2007, 06:00 PM

Reasons why the US Health Care System is expensive (not good or bad – just expensive)

1. Cost of medical technology (http://dll.umaine.edu/ble/U.S.%20HCweb.pdf)
2. Cost of prescription drugs
3. Administrative costs (estimated at 19.3-24.1% of the total dollars spent on health care in the US)
4. The growth of for-profit hospital chains
5. The high proportion of uninsured people (about 15.5%???)
6. Physician’s salaries (http://www.physicianssearch.com/physician/salary2.html; http://www.allied-physicians.com/sal...n-salaries.htm)
7. Systemic incentives to perform unnecessary tests and procedures
8. The focus on the treatment of illnesses over the prevention of illnesses
8-1. The disinclination of people, particularly men, to come in for routine checkups (http://www.ahrq.gov/news/focus/menshc.htm) (treatment is more expensive then prevention)

Evaluating Health Care in the US

1. Very good at treating acute surgical emergencies (http://www.ahrq.gov/qual/nhqr06/high...high.htm#acute)
2. Poor at treating chronic illnesses (http://content.healthaffairs.org/cgi...stract/20/6/64)
3. High rate of error (http://www.consumeraffairs.com/news0...al_errors.html)
4. Quality varies significantly (http://www.ahrq.gov/news/qualfact.htm)
5. High availability of the latest technologies and pharmaceuticals

Also, we had a discussion of the US Health Care System in a Thread titled, “Anyone else hate US healthcare?”

http://www.outpostnine.com/forum/showthread.php?t=8223

雨

07-02-2007, 06:04 PM

I just watched it... makes you appreciate the healthcare you've got and also realise the thick veil of misinformation and perhaps even propaganda some people are hidden behind.

digable

07-02-2007, 07:04 PM

As Angelyne and 4letterwords both said, one of the trade-offs for universal health care in Canada is the long wait to be treated for complex healthcare related issues. Still, my Canadian wife and I took advantage of the "free" healthcare in Canada and had both our children in Canada for free.

I put free in quotes because the Canadian healthcare system is becoming more and bankrupt each year (which was created by Donald Sutherland's father (?), as my wife reminds me every time she gets the chance). Some of the Canadians here can confirm or correct me, but there are some optometry and dental related services that were free some years ago, but are no longer free.

Also, IIRC, Canada is undergoing a brain drain right now with the healthcare system, and many doctors are going to the States to find jobs because they pay is better.

Sock Full of Boiled Dimes

07-02-2007, 07:24 PM

I'm going to make a healthy bet, $100, for anyone who wants to take it, that Moore's film ends up having SERIOUS credibility issues along the lines of bowling for truth (http://www.hardylaw.net/Truth_About_Bowling.html).

Again, I would think along the same lines. The only difference is that this is a story all about the people WITH health insurance and they are getting the shaft.

It's the story about the people and less about Moore trying to put out a message (that message is Universal Health Care, but I won't get into that).

I even wrote a scathing criticism of Michael Moore a long while back. However, I think he did this one good and it is VERY credible. If you don't want to believe me I don't blame you really. I'd understand after watching Bowling for Columbine and Farenhiet 9/11.

Decade

07-02-2007, 08:11 PM

The catch to healthcare is that nobody wants to pay for it when they're healthy, and they want everything for free when they get sick. When a private insurer covers you, they can say, "Hey, look, you aren't covered for cancer of the entire body on your cheap-o plan, and we're sorry, but that's business." And you die, because you didn't/couldn't pay. When the government does it, people get in an outrage, "Why don't you pay for condition X?!" and "They won't give me the best medication for condition Y!"

Q
F
T

:clap: :clap: :clap: :clap:

Fred

07-02-2007, 08:25 PM

The U.S. health care system is analogous to receiving an exquisite blowjob from someone with herpes. It was good while it lasted, but afterwards the price seems a little high.

Pierrot le Fou

07-02-2007, 11:44 PM

The U.S. health care system is analogous to receiving an exquisite blowjob from someone with herpes. It was good while it lasted, but afterwards the price seems a little high.
Not quite. The US healthcare system is like a gentleman's club. You pay an atrocious fee to become a member, but the blowjobs are on the cheap.

Universal healthcare is like the neighborhood slut. Sure she's 'free,' but you're paying for her anyway, you just don't know it yet.

number17, I know you say this film is different. I haven't seen it. I haven't even heard of it. I seriously doubt it however. His 'gift' is that he can tell a bald-faced lie and make it seem genuine.

erbiumfiber

07-03-2007, 12:07 AM

I read an article a LONG TIME AGO in Reader's Digest (yes, not the most scientific authority) that said something along the lines of when people stop paying for things directly, they get more expensive. People stopped paying for doctor's visits (directly- most paid through insurance) and the prices went up (this is over many decades). People stopped paying for college directly (more loans, grants, financial aid) and prices went through the roof. It was thought-provoking.

In the old days (e.g., when my parents had me- 1964) you actually PAID the hospital and doctor to have a baby. You paid for doctor's visits. You had hospitalization insurance for the big stuff (similar to catastrophic insurance). When did the tide turn and we decided that health care should be essentially free? (my employer pays for my health plan and I pay very little out-of-pocket.)

I've been using catastrophic health insurance for years. Basically, I pay for anything up to $10,000 per year ($5000 on my US plan). I am responsible for my own health care costs (incentive to stay healthy and not go to the doctor for every little thing or use specialists when a walk-in clinic will do). It's still A LOT cheaper than private insurance. If we all got paid more (the cost to the employer of health insurance) and bought catastrophic coverage and paid our own bills, I believe (absolutely no scientific proof here) that we would mostly all come out ahead. People with chronic illnesses like diabetes would always be paying that $5000 (although I got a break on drug prices- my insurance didn't pay but had negotiated a lower price with the drug companies)- so maybe the diabetes patient might not make it to $5000 every year.

I kind of agree with a system like the Japanese system where you pay for 40% (if there is going to be "universal" coverage). However, I think it should be capped at a maximum of $5000 yen (or some reasonable number based on salaray) per year. Basically, nothing else in life is free. Why should health care be free?

And I, for one, am tired of paying (through higher insurance costs) for sports injuries. These are entirely voluntary and the player should bear a higher cost. My own insurance provides NO COVERAGE WHATSOEVER for injuries from sports with high rates of injury such as skiing (so I ski on off days-weekdays- and do it very, very carefully. I can't afford to break my ankle).

Disclaimer: These are personal opinions based on little to no evidence, I don't have the time to do major research right now.

Sock Full of Boiled Dimes

07-03-2007, 12:23 AM

number17, I know you say this film is different. I haven't seen it. I haven't even heard of it. I seriously doubt it however. His 'gift' is that he can tell a bald-faced lie and make it seem genuine.

Well then I guess he gave all those people he interviewed a script and told them how to lie.

Campion

07-03-2007, 01:18 AM

Also consider an average resident/business of Finland pays almost double the taxes compared to what they would pay in the US.

All the systems have issues, but I am with PLF on this one. If I had a knee injury and had to wait 2 years for surgury I think I would go life would not be worth living.

Higher taxes don't necessarily equate to a more expensive system, in comparing the cost of the systems it is poor rhetoric to attack a nations taxes as being the basis for the charge of just one of its services. If you compare the cost per capita or by GDP, the United States has the most expensive healthcare system in the world. VOA LINK (http://www.voanews.com/english/archive/2006-02/2006-02-28-voa59.cfm?CFID=170168769&CFTOKEN=56254211)

This ability of the populace to spend their money however does have its benefits, as PLF has pointed out, the system itself provides the best quality of care as a whole system prior to the consideration of societal factors (which we in Europe consider a major issue, what with our belief in universal healthcare and all).

Factor in such things as infant mortality rate and access to care and it doesn't look so rosy from that perspective, but if you can afford to get in, yes, you are getting the best healthcare system in the world.

The English system is certainly buggered (due to political interference, our NHS now has more beurocrats than beds for fecks sake), however not all universal systems are this badgered. The assumption that you have to wait for surgery for all universal healthcare systems is a bit skewed, there are as far as I know no significant waiting times in France (nor are there in Ireland).

Campion.

雨

07-03-2007, 03:41 AM

I personally didn't experience any waiting time at all for surgery (all three times I needed it so far) and that's pretty much the way it always has been for me. And I really don't think I'm a lucky stray.

Pierrot le Fou

07-03-2007, 06:23 AM

Well then I guess he gave all those people he interviewed a script and told them how to lie.
You do realize that he tends to do crafty edits and splices to make it seem like people are saying something they aren't, right? You also do realize that he doesn't thoroughly research what he's talking about, and/or conveniently leaves out slightly contrary facts, right?

Disney's doug89

07-03-2007, 10:47 AM

2 relevant experiences I have had in Australia.

About 3 years ago I had an extremely infected ingrown toenail. I went to the doctors with my healthcare card (which all Australians receive if they have a low income), got it cut out for free, no cost at all. Because of the card I also got my Antibiotics for $4 total.

This year I started university doing Asian Studies. It costs me nothing at all except for books and transportation. All of the debt is assumed by the government until I earn 't enough (I think its about $38000 a year) then its repaid as tax. The debt doesn't have interest, and only increases at the rate of inflation.

From what I know about America this is a much better system. Could someone provide me with an appropriate comparison for different countries?

Exeter

07-03-2007, 10:50 AM

My biggest issue with US medical coverage is that doctors love to take advantage of the insurance system. I once went to the doctor after spraining my wrist and was given a splint to wear for a week. I got a bill in the mail a few weeks later. The visit was covered by my insurance, but the splint was not, for whatever reason. They wanted $120 for it.

I rose hell at the doctor's office but they refused to take the splint back, so I was forced to pay $120 for something I could've bought at Wal-Mart for eight bucks. The doctor's office had simply assumed that my insurance would cover it, and didn't even bother to let me know how much it cost.

If there were restrictions on what doctors were allowed to charge for various services I think insurance companies would be more willing to actually pay for them, and costs would be lower regardless.

Campion

07-03-2007, 12:01 PM

From what I know about America this is a much better system. Could someone provide me with an appropriate comparison for different countries?

Well, in Great Britain we apparently hire fundamentalists from the Middle East to be our doctors.. ..Yep, the NHS is really great. :eyepop: Reuters Link (http://in.today.reuters.com/news/newsArticle.aspx?type=worldNews&storyID=2007-07-03T163037Z_01_NOOTR_RTRMDNC_0_India-282961-6.xml)

Campion.

Trump

07-03-2007, 12:32 PM

japanat

07-03-2007, 01:45 PM

I had a motorcycle accident in college where I was on the receiving end of a hit-and-run. Luckily, I had purchased 'uninsured motorist insurance' in addition to my regular policy, so I didn't have to pay anything. But an open-fractured big toe, with the bone sticking out, and various road rashes (including surgery on my toe to place a permanent screw) ran my insurance company just over $6000 US. For a toe.

And even though I didn't have to pay any of it myself, there was one bill that just chapped my ass: Ambulance transport, 5 mi - $200, Gauze from ambulance to wrap my injured foot (not clean, not immobilize, just wrap) - $55!

I now have Japan's National Insurance, and let me tell you, it ain't no free ride. Rates are determined according to your salary and family circumstance. My children are covered on my wife's insurance from her pharmacy job (100%!), so I pay the rates for a single man. I won't tell the exact amount on a public forum, but it is as much as I'm paying for my damn car (and it covers 70%, I pay 30). Plus the 'graying society' has caused coverage over the last 10yrs to go from about 85% in my case to the current 70.

SlickWilly440

07-03-2007, 02:05 PM

Decade

07-03-2007, 02:43 PM

If there were restrictions on what doctors were allowed to charge for various services I think insurance companies would be more willing to actually pay for them, and costs would be lower regardless.
Is this trolling or serious?

Angelyne

07-03-2007, 06:17 PM

San Francisco starts universal health care. (http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/07/03/HEALTH.TMP&tsp=1)

If the US were ever to get universal health care, this is how it should be done: at the local and state level.

RandomPasserby

07-03-2007, 06:38 PM

Dunno if you guys have discussed for this, but one of main reasons for longer waiting lines for universal health care surgery in Finland is that lots of surgeons/doctors/nurses work two jobs, one in public health care and one in private health care (legends tell of surgeons leaving from their public sector job before 14.00 for their second private job and even telling patients that the waiting time for a UHC surgery is x years but they could do the operation "this afternoon" in their private job). So they have a bias against public health care which shows in nurse and doctor unions lobbying for a private health care system currently.

Sock Full of Boiled Dimes

07-03-2007, 07:34 PM

Exeter

07-03-2007, 09:14 PM

Is this trolling or serious?

Explain to me how that's trolling?

Fermented Yeast Paste

07-03-2007, 09:32 PM

What I think is a huge benifit for this country is that we have a State and a Federal government.

In which case I think health care should be decided and planned out on a state by state basis rather than be a federal issue. Not to mention people can vote if they want universal health care or not and I'm pretty sure that it won't increase taxes that much everywhere.

Holy hell...why hasn't anyone thought of this before.
What makes you think no one has? Massachusetts has being trying to get this working for a while and, as far as I know, has begun taking the first steps towards doing so. Other states are trying to do something like this, including my own state of California, but are probably waiting on to see how well it goes with Massachusetts. Even San Francisco is attempting to do this on a more citywide level. So, it's definitely a thought that's been going around for a while now.

Trump

07-03-2007, 09:42 PM

But really, pretty much everywhere in the US you can get emergency treatment if you need it. If you show up in a hospital gushing blood, they will see you even if you have no insurance. (At least I'm fairly sure of this, I've never really looked it up). The problem is really the other things like voluntary surgury and preventative care. These would be covered under universal health care but not in the US. Under universal health care who decides whether these treatments are to be performed? I mean, if you've torn something in your knee but the only symptom is loss of flexibility, in the US you can pay to have it treated but what happens in other countries? Do tax payers have to foot the bill for such trivial (well, almost trivial) things? For a total geek who plays video games 24/7 they might not think it was worth it to pay for it, but if it is free why not? I'm having trouble organizing my thoughts, but hopefully you see what I'm getting at. How do you keep people from abusing the system?

雨

07-03-2007, 09:52 PM

How exactly could people be abusing such a system? Getting injured on purpose?

Anders

07-03-2007, 10:02 PM

Trump, I don't think I understand your argument. Are you saying that voluntary and preventative procedures are unnecessary and shouldn't be covered?

Trump

07-03-2007, 10:30 PM

Well, people talk about the advantages and disadvantages of a universal health care system. Sure, everyone has access but waiting lists are horribly long, but what advantages really exist to giving everyone access to health care like that?

Under every system, if you are dying you'll get treatment. If blood is gushing or bones poking out or something along those lines, are the systems different?

What type of care has the long waiting lists, everything else? Treatments for chronic illnesses? Treatments for minor injuries? I guess I wonder if a universal health care system would be better if they had people more closely scrutinize the cases (like insurance companies).

Let me give you a personal example. I went to the doctor over some pain I was having in my ankle 1 year + after my injury. I ended up getting an MRI to make sure everything was OK and the doctor was able to better explain my situation and let me know things I could do about it. It turned out that after my injury the ligaments in my ankle had been inflamed and when everything healed they were thicker than they used to be. I could still run but I had lost strenght and flexibility of the ankle and I was afraid I would twist it playing sports. The doctor said I should use a brace and do flexibility and strength exercises to help. Today, I don't notice it much any more and I don't wear a brace.

If I hadn't had insurance (couldn't afford it) I wouldn't have gone to the doctor of an issue like that. What is to stop people with universal health care from clogging the system? And if these people were kept out of the system then would the waiting lists be nearly so long? Would people who really need an MRI be able to get in sooner? And who is to say what is important? Is the knee of a total couch potato less important than the knee of an athletic person?

I guess to consider my post an argument is the wrong term. These are just questions going through my mind. I'm trying to understand the situation better and get people to think about different issues relating to the original topic. I hear arguments both ways saying one system is horrible or the other system is horrible. Firstly, I feel like so many people aren't seeing all of the issues, that there is more than just one system is better than the other, and secondly, I'm trying to learn more and make my own decisions. Anyway, does that help?

雨

07-03-2007, 10:52 PM

I just don't know of any possibility of the system (here) getting clogged. How long did you have to wait?What type of care has the long waiting lists, everything else?I don't know of any treatment with a waiting list beyond the absurd stretch of 45 minutes. Except the obvious organ transplant which depends on the rate of the right people dying.

Pierrot le Fou

07-04-2007, 12:12 AM

雨

07-04-2007, 12:15 AM

A 39 degree fever would get you bumped straight to "urgent" status. That's pretty damn high, isn't it?

erbiumfiber

07-04-2007, 12:28 AM

I now have Japan's National Insurance, and let me tell you, it ain't no free ride. Rates are determined according to your salary and family circumstance. My children are covered on my wife's insurance from her pharmacy job (100%!), so I pay the rates for a single man. I won't tell the exact amount on a public forum, but it is as much as I'm paying for my damn car (and it covers 70%, I pay 30). Plus the 'graying society' has caused coverage over the last 10yrs to go from about 85% in my case to the current 70.

Can you opt out and get expatriate international insurance? I pay about $1000 per year for catastrophic coverage ($10,000 deductible). Plus, I'm pretty sure I can go back to the US for treatment (although I maintain a catastrophic policy there because I need it for my daughter so I'm sure to be covered in the US if there's any problem). I don't know how often you go to a doctor (I haven't in years except my annual free physical at work) but it might be a lot cheaper (I took my daughter once to a Japanese emergency room and, uninsured, it was only about 10,000 yen).

Pierrot le Fou

07-04-2007, 12:38 AM

But it didn't. They took my temperature, told me to sit down, and it took me 2 hours to get treated.

Period.

japanat

07-04-2007, 12:44 AM

What are some of these problems you speak of?
I think he means if Michael Moore were himself seriously ill (which he will be, if he doesn't change his lifestyle... me, too)

Re: what PLF said, it's true. For many older people, the doctor's office is their social circle. Now that rates are beginning to change (they have to pay 10% of meds, and will soon pay 10 or 15% of visit cost and 20% of meds), it will hopefully change. But my father-in-law is a Japanese doctor, and he sees lots of folks who are just looking for reassurance or even a sympathetic ear. And in many Japanese clinics, they have so many people each day (100-150 on a busy morning for my F-i-L's one-doctor clinic, another 150+ on the evening shift) that they just take them in order of arrival. They will fast-track you if you have a serious condition, but you have to tell them of that fact. After I broke my wrist a few years back and was going for therapy, I would routinely wait 60-90min before being helped.

And ambulances here are free, so many times older folks call the ambulance to take them to the ENT or skin doctor. It's funny when an ambulance comes up to the ENT in front of my house, sirens wailing, and a little old lady walks out calm as can be to the doctor... and the ambulance leaves! It's become such a problem that they are posting notices, asking old folks not to use the ambulance as a taxi. One I saw said exactly that: 救急車はタクシではありません！

cama

07-04-2007, 01:04 AM

Go to ANY hospital in Japan. 90% of the people will be old women who are there, socializing, and are there all the time. Because it's free to see a doctor (it only costs money for medication), they will go just to get checked up and have tests done for absolutely no reason at all.

That is exactly how people abuse the system. Everytime I get a cold, my mom tells me I should should go to the doctor. And for what? So that he can tell me himself that there's nothing he can do and that I should just go home and rest? This waste his and his patients' time. But the only reason my mom would ever suggest going to the doctor for such a frivolous reason is that it's free.

Even though the health care system here is still very flawed, I am still thankful it is free. Last year, I had a bad case of food poisoning which left me very dehydrated and I had to be hooked up to an IV. I had to wait several hours in the waiting area, and I never did end up getting my own room; they left me on a bed in the hallway since all the rooms were occupied. They performed many tests, including a few chest x-rays. I can't even imagine how much more stressful it would be to go through such an illness AND get billed for it too.

雨

07-04-2007, 01:22 AM

After I broke my wrist a few years back and was going for therapy, I would routinely wait 60-90min before being helped.I was lucky to be second, if not the only person, in line every time I visited the physiotherapist.

It might also be interesting to know that my local hospital has a waiting lounge where I never have been, which has two or three booths that I never have gone to. I guess this is where the elderly hospital-friendly people go to give each other accounts of their papercuts.

The problems you bring up all sound like they come from the same root or principle; first come, first serve. That could only happen in my area if there were like, one doctor in the building complex and nobody to evaluate (or simply appreciate) urgency.

Pierrot le Fou

07-04-2007, 01:25 AM

No, the problem is that there is no consequence for abusing the system. Copays, costs to see the doctor, all that nonsense would help. But they don't exist in many systems.

Decade

07-04-2007, 03:13 AM

IRT Exeter
If there were restrictions on what doctors were allowed to charge for various services I think insurance companies would be more willing to actually pay for them, and costs would be lower regardless.

First, most doctors are limited in the states as to what they can charge as the insurance companies only cover so much of the cost. Therefore, many people would actually prefer to have worse treatment for a medical problem if they go to another doctor who will do a lower cost procedure thats more likely to be covered by their insurance (or at least cost them less out of pocket).

2nd, to complain about copays and such is absurd, especially when they're typically in the area of $20. You eliminate that, you get cunts abusing the system like in PLF's case.

In short, dont blame the doctor, blame the insurance policy.

Especially malpractice insurance policies, btw, which are ridiculously out of control expensive and causes brain drains across the states.

Exeter

07-04-2007, 06:00 PM

I was more referring to situations such as the example I gave in my first post ($120 wrist splints that actually cost ten bucks), and less complicated surgeries and the like. And I have nothing against copays; as people have said, they keep people from abusing the system.

Candyvan Stan

07-04-2007, 06:03 PM

Healthcare in the US trumps anywhere else in the world. Period. I don't care what it costs. I've told you all this before. I love Michael Moore's work, but I'd like to see him, with a SERIOUS health issue, in a place like Japan.

How many other first world countries have you lived in long enough to experience their health care to warrant a bold claim with a period behind it?

Anders

07-04-2007, 09:26 PM

IRT Exeter

First, most doctors are limited in the states as to what they can charge as the insurance companies only cover so much of the cost. Therefore, many people would actually prefer to have worse treatment for a medical problem if they go to another doctor who will do a lower cost procedure thats more likely to be covered by their insurance (or at least cost them less out of pocket).

2nd, to complain about copays and such is absurd, especially when they're typically in the area of $20. You eliminate that, you get cunts abusing the system like in PLF's case.

In short, dont blame the doctor, blame the insurance policy.

Especially malpractice insurance policies, btw, which are ridiculously out of control expensive and causes brain drains across the states.

I'm not too sure about your claim that there is a limit on what doctors can charge. I looked through the library of Congress for any such law, but I couldn't find anything that supports it. The closest thing I found was for prescription drugs.
Pharmaceutical Market Access and Drug Safety Act of 2007 (Introduced in Senate) (http://thomas.loc.gov/cgi-bin/query/F?c110:2:./temp/~c110r6af0I:e1350:)

Honestly, I think it's the insurance companies and the pharmaceutical companies that are the main determining factor in how much we pay at the hospital. The medical profession shouldn't exist to make millions off of people who can't afford it, but it sure is easy to argue that insurance companies are. Co-pays are not just $20. If that's all you have to pay for your insurance than please let me and the rest of the nation know what insurance you have. I'm sure they'll put all other insurance companies out of business.

As for malpractice lawsuits, I am torn. On one side, I see the need to hold bad doctors accountable for the damage they do to people- especially if the damage leads to a life filled with pain and suffering. On the other hand, the insurance that the doctors have to hold in order to protect themselves from these lawsuits is incredible too and probably increase the cost of medical treatment. I have to think more about that.

Pierrot le Fou

07-04-2007, 11:53 PM

Weak sauce Michael. Weak weak weak.

The 'you have to have lived there' argument is specious. I can read up on government expenditures, coverage, and level of care, and get a far better view of what a system's strengths and weaknesses are than simply living in the same country.

Not that I think Rox is right in this one, he's just hollerin' U-S-A! at the top of his lungs for no rational reason methinks.

Honestly, I think it's the insurance companies and the pharmaceutical companies that are the main determining factor in how much we pay at the hospital.
It's more regulations that drive up the cost. Hospitals need to have equipment X and equipment Y, and it's ungodly amounts of expensive, and everyone who uses that hospital has to help pay for it. CT scanning equipment and the like are exceedingly expensive, but most people will never ever need to use them. However, having it covered, and need to be covered, means that your policy expenses will go up.

People don't think of the costs. They want want want demand demand demand and then complain about their insurance premiums and general costs. Same with drugs -- drug companies create a super-advanced drug that does something no previous drug would do, and everyone complains! Why? Not because the drug doesn't work, or that it has horrible side effects, but because it's too expensive!

The old adage, "The best things in life are free" seems to mean "life is free" in the minds of the whiners.

As erbium said, as costs stopped being out of pocket, people demanded more and wanted to pay less. So we've ended up with this mess. Universal healthcare isn't the solution, it's just a way to shut up a large chunk of people up until they start demanding a higher level of care for 'free' and we end up with the same problem on an even larger scale.

Anders

07-05-2007, 04:10 AM

I am kinda surprised by your response PLF. I would think that of all people you would see the need for regulation, especially when it comes to the area of medicine. Regulations make sure that dangerous drugs are kept out of hospitals- not supply and demand. Regulations make sure that doctors and nurses are skilled enough to save people's lives by requiring a license to practice medicine. Regulations make sure the equipment the hospitals use don't kill you instead of diagnosing an illness. I could go on, but you see my point. Regulations are there for a reason, leave them alone.

Yes the equipment used in hospitals may be extremely expensive and the necessity for them to be paid for means that we all must pay our share, but that's where I think we need to take a step back. Shouldn't the taxpayers help a little bit? Having the equipment is good for the community as a whole, so shouldn't the government help a little bit? Exactly how much should you pay to have a couple stitches put in your kid's chin because she fell off her bike?

Drugs are very expensive to develop and test. Nobody can argue that point, but how come drugs are so much cheaper in other countries? The answer is in the advertising. All you have to do is pay closer attention to the pens people are using and I bet you'll find more than just a couple advertisements for Prozac or some allergy drug. Pharmaceutical companies love to "wine and dine" medical professionals to promote their "revolutionary" new medicines.

As for the safety of the foreign made drugs, that bill I posted implies that there may be more than one reliable source for safe drugs outside of the US. Does everything have to be free? No. But I think we can do way better than paying through the nose for health insurance.

Pierrot le Fou

07-05-2007, 04:52 AM

I'm going to try to be calm and polite in response, but it's requiring me to bite my tongue.

I was specifically referring to the cost of equipment, like CAT scans. Most people will never need one. Most people are subsidizing them. That is absurd. Life, as much as you may not want to admit it, does have a monetary value attached to it. If we pay out of pocket, there is a limit to how much we will spend on medical care. Most of the time we'll just say, "Well, it's my time, I'm not going to burden your finances after I'm gone."

With insurance, people don't have that thought. They don't care that the CT scan they demand is going to cost others tons of money, despite the fact that most of the others will never have a use for that machine. They don't care that their demands for top-of-the-line tests and equipment are what make insurance so costly.

Why in God's name should the taxpayers pay for a share of equipment that most will never use or need? In what universe do you find this to be acceptable?

It would also be awesome if we coated the streets in major cities with heat-reflecting paint (to prevent the heat island effect and lower temperatures where there's lots of pavement). But it'd cost a whole boatload. Should someone living in Kansas pay for the paint for New York City? That's what you're proposing! The person in Kansas may visit New York City, but that's hardly reason to foot them with their 'share' of the bill for something they never asked for or needed.

You are asking people to be involuntarily burdened, and for what? Because of some misguided concept of people having to pay their 'share' in lives that are perhaps more expensive to extend than they are worth to begin with?

Don't give me sappy discourses on the 'value' of human life, and sentimental value and all that. Every life has a cost, and medical bills don't magically disappear because the whole family really wants gramma to get better and love her a lot. Keeping people alive beyond 'natural' lifespans costs lots of money. Who is going to pay the balance? You want to distribute it across everyone, I want those who care about the person's life to pay for it.

You really think yours is more fair?

And in regards to drugs, have you ever been to southeast asia? If you have been, you'd wonder, "Why are movies so cheap here?"

Actually, you wouldn't. You'd know that they were pirated movies, cds, dvds, etc. Why? Because they're so cheap! Now if we suddenly started importing these pirated movies to the US, what do you think would happen to the movie industry? Do you think it would excel, grow, and continue to develop expensive movies when they know it can just be bought on the street in a few days?

You do realize this is why there are global staggered release dates, and why DVDs/games have various regions, right?

Drugs are the same way. A company can analyze a new drug, figure out how to make it, and then start producing it semi-legally because the laws of the producing country state that it's okay due to different copyright law and the like, or legally because the patent has expired. At any rate, they are selling the same product but are doing it without any of the costs involved with production. What does this mean?

Let's assume all generic drugs are legal drugs with expired patents.

If we compare this to movies, it would mean that movies need to make all their money in the theatre, because once it gets to video, the studio no longer controls its release and sales (and is open to competition). If a movie falls flat in a theatrical release (say the Rocky Horror Picture Show), then it can't make any extra money from being a cult classic later on. Therefore companies stop producing more 'artsy' or niche films with higher budgets, as they can't hope to get long-term profits from video rentals and sales.

Instead they create blockbuster after blockbuster -- high cost high reward drugs that will sell like hotcakes to people who have money.

That's why drug companies create AIDS drugs and cancer drugs en masse. They are profitable. They are blockbusters. That's why they shelve malaria drugs -- little profit in it. There are some companies which buy those unneeded patents to try to make them a reality, but they are few and far between, and it's difficult to make those drugs profitable, or to even break even.

You're attributing the difference in advertising. Pshaw. The difference is in development costs and the short window in which to get a return on your investment. (legal) Generic drugs are available later on and for cheaper, but there are no (legal) generic drugs that are the bioequivalents of the most current medicines.

You want to sit here and tell me that we should all wait for generic drugs. Okay, swell! Who's going to be producing the generic drugs of the future when nobody's buying the current drugs of today? Will a little faerie scientist spend the billions on research and development for something that will sit on a shelf until the patent expires?

Drugs are cheaper in other countries because they regard the value of life to be lower and therefore find it more reasonable to apply a lower standard of care to more people for the same net effect, than to provide the top level of care to the few while those with nothing have no care.

It's average level versus peak level.

And it makes sense.

You just have to think about it a bit rather than doling out clichés without understanding them.

Candyvan Stan

07-05-2007, 08:18 AM

Weak sauce Michael. Weak weak weak.

The 'you have to have lived there' argument is specious. I can read up on government expenditures, coverage, and level of care, and get a far better view of what a system's strengths and weaknesses are than simply living in the same country.

Well, then. My question to RoxFontaine would be - have you read up on the statistics to prove that bold claim?

Anybody (and I assume you did, too) could see that the point I was trying to make was that it was a claim RoxFontaine likely wouldn't be able to back up. It had nothing to do with me requiring him to have lived anywhere to back up what he said, but simply expressing my doubt that he had any experience (whether personal or researched) with any other country besides the USA, Japan, and maybe a few others here and there he accidentally read up on in the past. Please don't nitpick, Pierrot. We've been doing that since '05 and we all know where it ended. Frustration, talking to brick walls and having to post endless replies with endless lists of sources simply to win an online debate nobody even remembers a week later. I'm not the schoolboy with endless amounts of spare time to think up bulletproof posts to take part in an online-prestige pissing contest. I'm a busy man now, and I'm really through with that, hence the one-liner reply to Rox. I hope you understand. Sorry if I sounded rude. I want to bury any negative past I've had here on OP9, and truly meant this in the most respectful way possible.

Pierrot le Fou

07-05-2007, 08:29 AM

We've been arguing since 2005?

Candyvan Stan

07-05-2007, 09:22 AM

I was talking about the collective 'we' of the OutpostNine General Discussion board, but I'm sure we've had our fair share of discussions since the creation of this board too. The first one I remember had to do with the US economy and the EU's status as an emerging superpower (or, some would say, lack thereof), but that was probably in '06.

RoxFontaine

07-05-2007, 11:25 AM

Well, then. My question to RoxFontaine would be - have you read up on the statistics to prove that bold claim?

Anybody (and I assume you did, too) could see that the point I was trying to make was that it was a claim RoxFontaine likely wouldn't be able to back up. It had nothing to do with me requiring him to have lived anywhere to back up what he said, but simply expressing my doubt that he had any experience (whether personal or researched) with any other country besides the USA, Japan, and maybe a few others here and there he accidentally read up on in the past. Please don't nitpick, Pierrot. We've been doing that since '05 and we all know where it ended. Frustration, talking to brick walls and having to post endless replies with endless lists of sources simply to win an online debate nobody even remembers a week later. I'm not the schoolboy with endless amounts of spare time to think up bulletproof posts to take part in an online-prestige pissing contest. I'm a busy man now, and I'm really through with that, hence the one-liner reply to Rox. I hope you understand. Sorry if I sounded rude. I want to bury any negative past I've had here on OP9, and truly meant this in the most respectful way possible.

Keep doubting. Some of you really haven't figured out that I don't give a fuck what you THINK you know.

You want dumb ass subjective rankings that don't really mean jack? Here you go....

http://www.cbsnews.com/stories/2000/06/20/world/main207853.shtml

Candyvan Stan

07-05-2007, 11:39 AM

Keep doubting. Some of you really haven't figured out that I don't give a fuck what you THINK you know.

You want dumb ass subjective rankings that don't really mean jack? Here you go....

http://www.cbsnews.com/stories/2000/06/20/world/main207853.shtml

Well on your way to attempting to prove both my earlier points (about lack of maturity during 'debates' being a source of frustration, and you confidently making up facts) in one two-sentence post.

Great job. Notice how I wasn't once disrespectful to you or to your opinion besides questioning it (literally, I asked a question twice), and even apologised in advance for seemingly sounding rude. If you can't even take the time to elaborate on why you made that bold claim in a respectful manner, what are you doing in General Discussion?

And to think I always thought you were one of the kinder debaters here back when I still visited regurlaly. Remember not to shoot yourself in the foot like you just did in any real life discussions, and try not to get so worked up. Remember, it's bad for your health.

japanat

07-05-2007, 01:40 PM

Notice how I wasn't once disrespectful to you or to your opinion besides questioning it (literally, I asked a question twice), and even apologised in advance for seemingly sounding rude. If you can't even take the time to elaborate on why you made that bold claim in a respectful manner, what are you doing in General Discussion?
Remember not to shoot yourself in the foot like you just did in any real life discussions, and try not to get so worked up. Remember, it's bad for your health.Maybe you should read some of RoxFontaine's earlier posts regarding medical care before you challenge him on this one. I would hazard that he has at least as much, if not more, experience on this one than damn near everyone on this board.

Candyvan Stan

07-05-2007, 01:50 PM

Maybe you should read some of RoxFontaine's earlier posts regarding medical care before you challenge him on this one. I would hazard that he has at least as much, if not more, experience on this one than damn near everyone on this board.

I know of his medical problems, and certainly feel a sense of compassion for him in that regard, and would never wish anything like that to even my worst enemies.

However, it must also not be used as an excuse for swearing and flaming. And no, having an extensive medical history certainly doesn't make grounds for saying your nation's health care system is undubitably the best on the planet, simply because it compares very well to another nation said person has also resided in. That said, I feel I'm now becoming the very nitpicker I was trying to avoid, so I'll leave it at this. I came back to OP9 to get to know the people in a positive way, I don't want that going down the drain simply because I decided to take part in one of the pissing contests I so very much loathe.

Anders

07-05-2007, 03:14 PM

Plf, I know that nothing I say is going to change your mind. Even if I presented irrefutable evidence to prove what I'm saying is true, your ideology and ego would prevent you from budging an inch.

Perhaps you don't know the value of life- yet. Personally, I'm still learning, but I do know that even if I couldn't afford the insurance, let alone the cost of the test, I would want a CT scan or MRI or whatever ungodly expensive test if it meant I had a better chance at living and being with the family I love. That's me. I care about not only myself, but for the people who care about me. Furthermore I would gladly pay for years after the passing of a family member if I knew we did everything possible to save them.

As for paying for equipment you never use, my argument is that it's good for the community as a whole to have that equipment available. We may never know how many lives can be saved by not requiring patients to travel 200 miles to the nearest CT scanner. Does it matter to you? Probably not, but it matters to me. I pay my taxes every year. I know that most of my tax money will be used for projects that will never directly affect me. Projects such as the repaving of roads that I never use or ever use for that matter. I pay my taxes anyway because it is for the greater good. Plus I don't want to go to jail.

I can't believe there was a connection drawn between prescription drugs and movies. Movies can't cure any serious illnesses Patch Adams, but you did make a claim that if a movie can be pirated and sold in the US, that the movie industry would collapse. Not true at all. You know people make pirated copies of movies from day 1 of their theatrical release here in the US? How many people have burned copies of movies in their possession? Yet people still go to the theater, and they buy DVDs at their local video stores.

You assumed that when I wrote about drugs being cheaper in other countries, I wasn't necessarily talking about generic copies. Viagra is sold in other countries too, and I bet it doesn't fetch nearly as much money as it does here in the US. Why would that be? If a doctor knew that a cheap but dangerous copy of a drug was available, would he/she prescribe it? Would they recommend it? I think they would rather convince the patient not to be fooled by the low price.

Decade

07-05-2007, 07:37 PM

Wow, I dont look at this thread in a few days and this cluster fuck emerged :eyepop:

Before any more flaming goes on, I just wanna say that I generally agree with PLF. He's making rather well written, elaborate posts on the subject that are essays in and that of themselves.

Any chance you guys can all take it down a notch and keep debating like we were for the first 3 pages?

....hey, at least I can say I tried to calm it back down :meh:

RoxFontaine

07-05-2007, 08:18 PM

Well on your way to attempting to prove both my earlier points (about lack of maturity during 'debates' being a source of frustration, and you confidently making up facts) in one two-sentence post.

Great job. Notice how I wasn't once disrespectful to you or to your opinion besides questioning it (literally, I asked a question twice), and even apologised in advance for seemingly sounding rude. If you can't even take the time to elaborate on why you made that bold claim in a respectful manner, what are you doing in General Discussion?

And to think I always thought you were one of the kinder debaters here back when I still visited regurlaly. Remember not to shoot yourself in the foot like you just did in any real life discussions, and try not to get so worked up. Remember, it's bad for your health.

You don't want a pissing contest? Then don't start pissing.

The pretense on this board is far beyond anything I've ever experienced in my entire life and I know PLENTY of pretentious people. Apparently everyone has a doctorate in every subject on the planet. All gained from the comforts of home and a few clicks through the internet.

What you are speculating about, I've lived. I have close friends in damn near every stretch of the world. What I haven't experienced myself, I have plenty of relevant information about.
The article I linked to is an example that what is PERCEIVED in the world is not what is STATISTICALLY true. We can all agree on that, yes? The practice of medicine is not the sole deciding factor in world health. Most people believe that the best doctors are from India. It's also no secret that there is a shortage of medical facilities in India. Know why? Most of those doctors head for the US or the UK.

The end result is that the medicine in the US is far beyond most other countries in the world. Is the end all be all of medicine? No.

I'm not going to ramble on anymore about it as I have no interest in proving myself right or proving you wrong. It is what it is.

Have a great day.

edit: I apologize for the foul language. That was uncalled for.

Pierrot le Fou

07-06-2007, 12:53 AM

Plf, I know that nothing I say is going to change your mind. Even if I presented irrefutable evidence to prove what I'm saying is true, your ideology and ego would prevent you from budging an inch.
And I was being polite. Just today I conceded that I was wrong (http://outpostnine.com/forum/showpost.php?p=375247&postcount=36) and even without abject proof.

I just provided irrefutable evidence to prove that what you're saying is false. Will your ideology and ego prevent you from budging an inch?

Perhaps you don't know the value of life- yet. Personally, I'm still learning, but I do know that even if I couldn't afford the insurance, let alone the cost of the test, I would want a CT scan or MRI or whatever ungodly expensive test if it meant I had a better chance at living and being with the family I love. That's me. I care about not only myself, but for the people who care about me. Furthermore I would gladly pay for years after the passing of a family member if I knew we did everything possible to save them.

As for paying for equipment you never use, my argument is that it's good for the community as a whole to have that equipment available. We may never know how many lives can be saved by not requiring patients to travel 200 miles to the nearest CT scanner. Does it matter to you? Probably not, but it matters to me. I pay my taxes every year. I know that most of my tax money will be used for projects that will never directly affect me. Projects such as the repaving of roads that I never use or ever use for that matter. I pay my taxes anyway because it is for the greater good. Plus I don't want to go to jail.
Did I not request for you to respond without making a sappy discourse on the 'value' of human life? Did I not ask a very succinct and direct question?

Who is going to pay for it?

See, if a human life is truly worth that much, then there will be people willing to pay it, take out loans for it, sell their souls or their bodies for it. You want to take the economics of life and death out of it. You want an army of Terry Schiavo's, lying on life support, in comas or worse, sucking tax dollars because nobody can tell those people that the life of that person isn't worth the expenditures on the care and support.

You say that's for the greater good? How? How is removing any sort of economic sense from the healthcare sector GOOD? To me it sounds expensive, inefficient, and will result in old women calling ambulances for a papercut or physical therapy, and braindead quadriplegics with a dialysis machine working overtime will be left in a hospital for 50 years because there's a chance that they may pull out of it.

You want to take the economics out of it, but somebody has to pay. And if the state is paying, then the state has to tell a family -- one who's willing to pay mind you -- that the limit for keeping braindead quadriplegics on life support is 2 years, and that they're going to have to let that child/husband/parent die, because it's just not in the budget to keep them going.

You think that's somehow more fair and respectful of life than letting families pay what they feel a life is work for an ill loved one?

Because you seem to believe that what you think is best for you is necessarily best for everyone when it is not. Sorry to say, if I knew I was going to die, and that I had a 50% chance at survival with a lot of expensive treatment that would put my family in debt for a decade after I lived/passed away, I would say no. Why? Because even if I lived, I would have to work harder just to try to pay those bills that I incurred through survival, and it's just not worth it to me.

Yes it's tough to lose a family member (and I'd wager I know this far better than you do), but you get over it. And it takes less time to get over a tragic death than it does to repay an expensive tragic death/recovery.

You want me to pay for people who think like you, whereas it means I end up having to pay more for services I don't want.

You say I don't know the value of human life? Pure whimsey. I know very well the value of a life, and I know how much I'm willing to pay. You claim you'll pay anything, yet you want everyone else to help you foot the bill.

Who's being the selfish one here? Who really knows the value of life?

You sit here and tell me that your taxes don't pay for things you use. I laugh. Those roads you 'never use' bring the food to your supermarket, the delivery trucks to your department stores, and the products produced at your factories to places they can be sold. You don't use those roads? Funny, because without them you'd suddenly be a far poorer and far worse off person.

You tell me I don't understand, yet you show a shocking degree of ignorance about the topics you feel justified in lecturing me on.

I can't believe there was a connection drawn between prescription drugs and movies. Movies can't cure any serious illnesses Patch Adams, but you did make a claim that if a movie can be pirated and sold in the US, that the movie industry would collapse. Not true at all. You know people make pirated copies of movies from day 1 of their theatrical release here in the US? How many people have burned copies of movies in their possession? Yet people still go to the theater, and they buy DVDs at their local video stores.

You assumed that when I wrote about drugs being cheaper in other countries, I wasn't necessarily talking about generic copies. Viagra is sold in other countries too, and I bet it doesn't fetch nearly as much money as it does here in the US. Why would that be? If a doctor knew that a cheap but dangerous copy of a drug was available, would he/she prescribe it? Would they recommend it? I think they would rather convince the patient not to be fooled by the low price.
Now I'm being polite, so I'll try to refrain from making a quip about being shocked that movies don't save lives.

I'll also refrain from making a quip about not having read my post.

I'll just quote myself:
If we compare this to movies, it would mean that movies need to make all their money in the theatre, because once it gets to video, the studio no longer controls its release and sales (and is open to competition). If a movie falls flat in a theatrical release (say the Rocky Horror Picture Show), then it can't make any extra money from being a cult classic later on. Therefore companies stop producing more 'artsy' or niche films with higher budgets, as they can't hope to get long-term profits from video rentals and sales.

Instead they create blockbuster after blockbuster -- high cost high reward drugs that will sell like hotcakes to people who have money.
I never said that the industry would collapse. I said that companies would reduce the scope of their operations to only those drugs which are most profitable.

But I digress.

You say that you're not discussing generic drugs, but rather 'brand name' drugs provided for cheaper in other countries. You make the assumption that because a drug can be sold more cheaply in, say, Korea instead of Japan, that it could be sold more cheaply in Japan as well. The problem is that you're thinking outside of the realm of economics.

At the price they sell it in America, people will buy it, and they will recoup part of the investment in clinical trials/R&D/patent acquisition. If they sell at the same price in Korea, far fewer people will buy it (because of the cost). If they sell it more cheaply, however, they will still make a profit (albeit a smaller one), and they will have a larger market, increasing overall revenues.

They do, however, have to balance that reduced price with the profit losses incurred by reselling to users in higher-priced countries. Unfortunately, they can't region-encode pills like they can DVDs.

Oops, there I go with movies again. Funny how that works? The same principle is in play with DVDs, and theatrical releases. It's far cheaper to see a movie in Korea ($4) than it is in Japan ($15) -- yet it's the same movie! Why don't they just allow the movie to be shown for $4 in Japan?

Perhaps, Anders, instead of insulting me, ignoring me, and at the same time accusing me of doing just that, you should listen to what I say, really think about it, and not dismiss it do to your 'ideology and ego.'

andrewt

07-06-2007, 02:02 AM

damn - this has been discussed how many times before...
I'm surprised PLF has the time and patience to respond to the same stupidity over and over again...
I guess now i see where the roughness comes from...
Do a fucking search - this is rehashing the same argument that's been argued before - until morons have finally just shut the fuck up.

雨

07-06-2007, 02:46 AM

Pierrot le Fou

07-06-2007, 03:21 AM

What I don't realise is how the reattachment of the tip of a finger can be valued at $12g. The price tags on healthcare are not realistically set. I also understand that one of those scanners can cost thousands and thousands to buy but what in the world makes the procedure that requires electricity to repeat so incredibly expensive?

The value of human life is not monetary.
The value of human life is monetary. What else can it be?

Sappy diatribes on the value of human life being something other than monetary shows a lack of understanding of what money is. Money represents human effort, production, creation, value. A human has value, yes? Then that value can be represented monetarily!

You act as if electricity is the only expense for these things. You ignore the efforts of very smart people who are putting their time into creating the machine. You ignore the efforts of very smart people who are putting their time into creating the machines to create the machine. You ignore the efforts of very smart people who are putting their time into understanding the results of the machine.

Were the machine to drop from the sky and give detailed analysis which anyone could understand, then maybe you'd have a point.

But the world doesn't work that way, the cost isn't solely electricity, and the value of the machine isn't solely in how many lives it can 'save' since lives are without value.

雨

07-06-2007, 04:00 AM

You act as if the inventor of a scanner demands a cut out of every time it is put to use. Or that the medical research should be funded exclusively by the people it is currently being put to use on.

Human life is invaluable if we're talking beyond the kind of life that requires 5-10 machines and doesn't require the subject to be conscious.

Pierrot le Fou

07-06-2007, 04:07 AM

RoxFontaine

07-06-2007, 04:21 AM

^ Word to that. This sounds like some guru shit that I need to know about.

Anders

07-06-2007, 04:39 AM

I was afraid this was going to happen. It seems that every time there is a debate Plf and I trade blows. The easiest way of course is to break down the post, sentence by sentence to contest every word and seem the better. It's difficult to resist and satisfying to believe that our words can damage each other, but in the end the only thing we accomplish is to make ourselves look stupid.
PLF, I'm sorry you don't see things the way I see them. I'm not sorry that I don't see things your way. I'm not sorry because I see the human side of the issue instead of just the financial or economical side. I am not ignorant to the fact that universal health care costs a lot of money. I hope you can realize that some people need help, and the responsible thing for people who have the ability to help to do, is to lend a hand.

You can always retreat to the same arguments- some old bat is going to call an ambulance because she has a paper cut and waste untold thousands of our tax dollars so she can socialize... but what about the people who genuinely need it? Of course to some people it doesn't matter how many people are saved not only medically but financially by a universal health care program. The only thing they care about is the old bat.

I don't have health insurance right now. If I did, my views would still be the same. Getting health care in any form is expensive, and if I (heaven forbid) do get seriously injured right now, I would be be taken care of medically, but I would be in debt well above and beyond my ability to pay. Is that right? Should people be charged so much that chances are they will be in debt until they have no life to save? I don't think so. I hope others think the same way.

Health insurance is expensive, and the programs offered through many businesses won't cover much of anything, let alone a severe injury or illness. This is one of the many reasons why we need to have a Government funded, universal health program.

雨

07-06-2007, 04:58 AM

Okay, so how exactly does this magical healthcare of yours work? Life is invaluable, creators of machines shouldn't be justly compensated, and the people funding medical research shouldn't be the people who currently need that medical technology.

Care to flesh it out a little more for me? Because I'm rather confused exactly how it's even possible.Creators of machines don't need compensation for every time their creation is used in a hospital on the other side of the fucking planet. Think of other inventions, perhaps. The inventor of the microphone is not getting a cut for every time I speak into mine. The inventor of medical equipment or perhaps even drugs probably got paid and probably didn't expect thousands USD for every time their ideas were put to use in the world. I'm expecting them to have gotten paid for their efforts already.

Research is done in all kinds of fields of interest so to avoid the wrong people being asked to pay for the advancement of drug technology - wrong because they're ordinary people who can't afford what they need to pay for - and the rest of the world idly standing by because they're not the ones in need of any treatment (atm), everybody pays a bit to cover everything. And guess what, it doesn't amount to tens of thousands of USD per citizen.

Pierrot le Fou

07-06-2007, 05:02 AM

Blah blah blah
You call this a debate? No. It was not a debate. I was polite, pertinent, and persuasive, you decided to call me names, refuse to backup your claims, and revert to clichés to make an 'argument.'

This is not a debate. It's you being a massive hypocrite.

I was polite, you were not.

You claimed that 'Even if I presented irrefutable evidence to prove what I'm saying is true, your ideology and ego would prevent you from budging an inch,' despite being guilty of the exact same thing yourself.

You claim that I keep reverting to the same old arguments, despite the fact that you continue to restate the very sappy discourses on the 'value' of human life I specifically warned against in an earlier post.

Where are your responses to the substance of my arguments? Are you reduced to arguing semantics and resorting to sympathy?

And what's worse is that you don't have the sack to admit that you were wrong on this, and instead try to dismiss it.

Pierrot le Fou

07-06-2007, 05:42 AM

Creators of machines don't need compensation for every time their creation is used in a hospital on the other side of the fucking planet. Think of other inventions, perhaps. The inventor of the microphone is not getting a cut for every time I speak into mine. The inventor of medical equipment or perhaps even drugs probably got paid and probably didn't expect thousands USD for every time their ideas were put to use in the world. I'm expecting them to have gotten paid for their efforts already.

Research is done in all kinds of fields of interest so to avoid the wrong people being asked to pay for the advancement of drug technology - wrong because they're ordinary people who can't afford what they need to pay for - and the rest of the world idly standing by because they're not the ones in need of any treatment (atm), everybody pays a bit to cover everything. And guess what, it doesn't amount to tens of thousands of USD per citizen.
It's like a one-two punch with you an Anders here flailing away.

The cost of the invention is included in the cost of buying it. The cost of buying a CT-scanner is absolutely massive. The cost of buying it is spread out over each use. The inventor gets a 'share' of the profits derived from sales, and the users recoup the costs of the machine by charging for use of the machine.

I am not suggesting that the inventor is paid in the manner of an author of a book, with royalties and the like, only that the inventor is generally paid indirectly through each use because it is part of the cost equation. Most engineers, after all, don't work for free.

Regardless, patent rights are granted to inventors who go through the patent process so that they can have exclusive rights to do anything they want with the product. Yes indeed! Whether or not this is a good system or not is beyond the scope of this discussion, but to suggest that they don't get paid/shouldn't get paid simply indicates a lack of understanding about how the patent system and intellectual property actually works.

Perhaps you should ask erbium about it, since this is her field (and it certainly is more complicated than I've indicated, but for a basic overview it's passable).

A 2003 study (http://www.cptech.org/ip/health/econ/dimasi2003.pdf) found the total pre-approval cost of new drug development to be $800,000,000 US (2000 dollars). If you read the study, you'll note that from 1990-1999, only 3.3% of patents were derived from government work, and 3.5% from academia. Almost all new drugs are developed through private industry.

And those costs are pre-approval. Once they are approved, the market needs to be established, insurance companies need to be convinced to include the new drug on their accepted treatment lists, mass production needs to be established, controlled, and started, etc. You look at it and say, "Oh, only $3 to get a new drug if each American citizen contributes?" Only it's not quite that simple. The methods they use to develop drugs are based on the economic realities of the situation.

After all, they make far more on a new AIDS drug than they do a malaria pill.

But were the government to control it, such restrictions wouldn't exist -- there's no more reason to spend $800 million on the development of an AIDS drug than there is to develop a malaria medication. The progress in the most lucrative areas would drop like a stone, instead focusing on more 'basic' illnesses which aren't as life-threatening or dangerous to people in the US with the current level of care.

And what can they do about it? Can they really say, "Sorry, your illness isn't scary enough to reasearch new drugs on."? That would be political suicide.

So we end up with an unfocused drug development program with no clear goals (no profit motives) and what will undoubtedly be far lower salaries. Many of those engineers will move to other industries, etc. and drug research will suffer as a result.

But I digress.

The basics are very very simple. When private industry creates a drug, they create a drug for which there is a real demand, and where it is fiscally responsible to produce it. For those drugs which they cannot make a profit on, they can sell the rights to someone who thinks it has potential, or put it in the public domain if they think it has benefits to, say, south asia where malaria is more prevalent.

When government demands a tithe from each citizen to develop a drug, there is no longer a profit motive, no longer necessarily a demand, and no longer tha driving force of capitalism. You may cheer at this, I'm sure, but when it's only $3/drug, who decides how many drugs a year is an 'acceptable' rate of progress?

Deferring a cost over a large group of people makes things easier to bear, for certain, but it also reduces the ability to choose where your money is directed, and to have supply be balanced with demand. Since choice in healthcare would be eliminated, what people actually felt was important would no longer be represented by what is being produced.

That's a big problem.

I mean, I suppose if people like you TRULY believe that there is no cost to human life, and TRULY believe that money has no business being mentioned when it comes to life or death, then you may not find it a problem. But to the real people in the real world who need to pay real money to get treatment, it's certainly a poor way to go about things.

And regardless, medical development will NEVER be fast enough for everyone, because by the time you learn you have a terminal illness, it's probably too late to save you. Tuberculosis, for instance, used to mean death. Now it can be treated, so if you learn you have it, you no longer worry as much. Ditto with many illnesses we don't worry about now (think about the flu and how much things have changed since the last pandemic).

But the market is far quicker to respond to questions and concerns of the time than a government body is. You really want bureaucrats deciding what will and won't be produced?

You're acting as if this situation is simpler than it is. You act as if spreading out cost won't have any impacts. You're missing the forest through the trees, and it frightens me because you TRULY believe that you're right in this. Were the US to switch to universal healthcare, you would see new drug development slow way way down. That's bad.

We have gone in this century from penicillin to open-heart surgery, chemotherapy, the polio vaccine, the elimination of smallpox, and now onto stem cell research and the possible elimination of things like cystic fibrosis.

That's incredible.

You want to say that we've gone far enough, and that we shouldn't push forward, because people now don't have enough.

People never have enough now. It's human nature.

Rather than sacrificing progress for the sake of this mythical contented stability, we should be pushing forward so that the chemotherapy of today that costs so much will be cheap and affordable 20 years down the line with a newer better cancer treatment for those who can afford it.

You act like a new cure is somehow worse when only the rich can afford it, ignoring that the 'hand-me-downs' of the pharmaceutical industries are lightyears ahead of what was available 50 years ago.

stsparky

07-06-2007, 06:09 AM

Alfred Mann (http://en.wikipedia.org/wiki/Alfred_Mann) created a reliable insulin pump. It cost major bucks to make right and earned him well-deserved wealth.

R&D costs and it is often ignored. Reminds me of the idiots who try and figure what a iPod costs and never take in account what it cost to develop.

We have a panhandler who begs for money so he can have his condition treated. I told him it would be cheaper to fly to Mexico and let their socialized medicine treat him.

japanat

07-06-2007, 06:25 AM

What I don't realise is how the reattachment of the tip of a finger can be valued at $12g. The price tags on healthcare are not realistically set. I also understand that one of those scanners can cost thousands and thousands to buy but what in the world makes the procedure that requires electricity to repeat so incredibly expensive?

The value of human life is not monetary.My friend used to sell CT scanners to hospitals. She had a base salary of $65,000 US and commission. A pretty high base, right? But she was only expected to sell 1 every 18 months to keep her job, and 1 per year would have made her bosses ecstatic. Because a CT scanner costs a minimum $1.5 million each, not a few thousands. That kind of expenditure has to be made up somehow.

I just talked to my brother-in-law, who just had his right foot surgically removed. $35,000 for the surgery and 4 days hospitalization. A tad steep, but perhaps understandable. But $11,000 for a prosthetic foot?

Japanese people who can't get an organ donation (particularly children, because Japan's program is only for adults) often die when trying to save or raise the money to travel to the US for donor surgery. Hence, it does have a value. But I think each person and their relatives will have to determine what that value is in their case...

Anders

07-06-2007, 06:25 AM

You call this a debate? No. It was not a debate. I was polite, pertinent, and persuasive, you decided to call me names, refuse to backup your claims, and revert to clichés to make an 'argument.'

This is not a debate. It's you being a massive hypocrite.

I was polite, you were not.

You claimed that 'Even if I presented irrefutable evidence to prove what I'm saying is true, your ideology and ego would prevent you from budging an inch,' despite being guilty of the exact same thing yourself.

You claim that I keep reverting to the same old arguments, despite the fact that you continue to restate the very sappy discourses on the 'value' of human life I specifically warned against in an earlier post.

Where are your responses to the substance of my arguments? Are you reduced to arguing semantics and resorting to sympathy?

And what's worse is that you don't have the sack to admit that you were wrong on this, and instead try to dismiss it.

I am about to commit the very sin I wrote against in my last post. Forgive me.

First of all, reducing my post to "blah, blah, blah" is disrespectful, so already I get the impression that you don't like what I said and disagree with it. Fine.

I am confused by the claims that you were polite, pertinent and persuasive, and that I was the direct opposite. In my second post in this thread, I cited a bill that is going through the senate right now. In the findings section of that bill, several claims are made which I feel support my opinion that something needs to be done. As for my other statements, they were merely opinions and impressions. At no time did I say "this is an irrefutable fact, ..." If you asked me to show you hard evidence to prove or disprove my opinions, I may have taken the time to provide some, but nobody asked, so my opinion remains my opinion. Take it or leave it.

I jokingly called you "Patch Adams" (which actually is a great movie if you choose to watch it) I apologize if that little joke was taken seriously and you were offended by it. Other than that, I never called you names to hurt you, but I get the impression that you intended to hurt me by calling me a hypocrite. We all tend to be hypocrites sometimes, and in fact I am being one right now by picking around like this.

Sappy discourses on the value of life? I have sympathy for anyone who thinks that the value of life can be measured by dollar signs and decimal points. I don't truly know the value or meaning of life, but perhaps since you seem to be so sure about the value of life then I guess we have nothing further to discuss.

The rest of your post was a blur of statements that were intended to be hurtful and discrediting to me. Unnecessary, impolite, nasty and above all wrong. Did I once say "you're numbers are wrong, did you graduate elementary school?" Not at all. I don't contest your figures, I contest your reasoning.

You seem to not like losing arguments, debates, whatever you would like to call them. You dislike the notion so much that you resort to name calling, and pointing out not the faults in the other poster's information and reasoning, but in the poster themselves. If that's all you really can do, then go ahead and malign anyone you see fit. After all, nobody has to point out your inadequacies. We all know them.

Pierrot le Fou

07-06-2007, 07:03 AM

Re-read the thread.

I did not insult you. I did not get upset at the Patch Adams reference. I am offended that you pissed all over my argument without addressing it, boasted that I would never change my opinion, and didn't bother to actually discuss the facts and logic I was using.

You seem to believe I was being insulting. I wasn't. Point out where I called you a name.

I'll point again to you saying:
"Plf, I know that nothing I say is going to change your mind. Even if I presented irrefutable evidence to prove what I'm saying is true, your ideology and ego would prevent you from budging an inch."
And again to my response:
"And I was being polite. Just today I conceded that I was wrong (http://outpostnine.com/forum/showpost.php?p=375247&postcount=36) and even without abject proof.

I just provided irrefutable evidence to prove that what you're saying is false. Will your ideology and ego prevent you from budging an inch?"
But you ignored it, you didn't apologize for saying that I was stubborn and incapable of listening to the arguments of others, and instead proceeded to ignore my well-thought out explanation of what exactly we're discussing.

You claim that nobody's asked you for facts or proof? What do you think my questions and responses to you are about? Do you truly think that I was just asking rhetorical questions and making rebuttals without the expectation of a defense or a response?

No, it's really quite simple. I made very well-reasoned arguments, and I did it politely. You assumed that I'd fly off the handle and start insulting you, but I didn't, and you were left without an argument and having been the one to start the petty personal character sniping.

So rather than acknowledge that you made a mistake, and to acknowledge that you haven't made an argument, you're getting defensive, being a hypocrite, and trying to act as if I'm the bully here.

You are just being pedantic at this point, and it's insulting to everyone in this thread. You spouting your opinion mixed in with shots at my character is not intellectually honest, not conducive to debate, and is NOT behavior you should perform, let alone defend.

So why don't you be an adult and own up to your mistakes, and either apologize or move on rather than taking shots at me rather than my arguments?

whispering

07-06-2007, 07:42 AM

Getting surgery for a gunshot wound doesn't have a two year wait. If your appendix is going to explode, you won't have to wait two years. Want arthroscopic knee surgery? You're going to wait. Now perhaps to you it's not important that someone is less mobile for a couple years, but to people who love playing sports and being active, but are prevented from it for two years while they wait for surgery, it's NOT the same.

The wait lines arent that long, and actually if 4LW would have thought, "hey i dont want to wait, ill go to a private clinic", government would have still automatically payd 60-70% of the bill. But if 4LW wouldnt have had the money, she would have probably had to join the 10's of thousands in US that travel to countries like India to get their surgery.

Also people complaned about the Japanese system, if any of you came here. You most likely wouldnt go to the public sector, you would be directed to the private sector. So is that 60% what the Japanese pay or what you pay?

And what you're discussing is a two-tiered system which has even MORE problems (since good doctors will go to the private hospitals where they get paid more).

Actually it was just last autumn when the private sector was having trouble getting doctors to work there. The doctors there arent any better. Often their the same ones that work in the public sector, who just want to make a little extra cash on their free time. I asked few doctors, they said the Health Centers (part of public sector) pays the most. Public sector also has the best benefits (getting a permanent job from the city here is pretty much the most secure job you can get).

And who's buying those Finnish drugs then there chief? I was unaware that place of manufacture was part of my argument -- I was arguing for who FUNDS the production of these drugs, not which country they're eventually produced in.

I was discussing about the companys that do research and developement. Funding with companys is usually done buy selling their products, i believe. As for whos buying, the export/import of drugs here is done mostly with other EU countries.

Perhaps you should get off your high-horse, read what the fuck I said, and stop spewing nonsense.

You are saying American health care is the best in the world quality wise, cause its American. And i should get of my high horse?

Also consider an average resident/business of Finland pays almost double the taxes compared to what they would pay in the US.

Yea, but we get something for the money in return. As for health care US pays almoust twice as much as we here.

Dunno if you guys have discussed for this, but one of main reasons for longer waiting lines for universal health care surgery in Finland is that lots of surgeons/doctors/nurses work two jobs, one in public health care and one in private health care (legends tell of surgeons leaving from their public sector job before 14.00 for their second private job and even telling patients that the waiting time for a UHC surgery is x years but they could do the operation "this afternoon" in their private job). So they have a bias against public health care which shows in nurse and doctor unions lobbying for a private health care system currently.

I've heard those legends too, that the share holders in the private sector would somehow on purpose make the wait lines longer or seem like their longer. Which was a major issue then, but few years ago the government made a new law, that the hospitals have to guarantee service. The wait lines now cant exceed 6 months, if that happens the hospital has to buy the service from someone else, often the private sector or work overtime to cut lines. It took little over 6 months and all the major lines were gone. Now the situation is pretty good. But even if there wasnt any, they would still create artificially short waiting lines. Cause running a hospital, paying doctors when theres no patients would be the worst situation money wise.

Pierrot le Fou

07-06-2007, 07:56 AM

The wait lines arent that long, and actually if 4LW would have thought, "hey i dont want to wait, ill go to a private clinic", government would have still automatically payd 60-70% of the bill. But if 4LW wouldnt have had the money, she would have probably had to join the 10's of thousands in US that travel to countries like India to get their surgery.

Also people complaned about the Japanese system, if any of you came here. You most likely wouldnt go to the public sector, you would be directed to the private sector. So is that 60% what the Japanese pay or what you pay?
Tens of thousands of Americans travel to countries like India to get surgery? If you had said Tijuana, I may have believed you, but India?

Proof please.

Actually it was just last autumn when the private sector was having trouble getting doctors to work there. The doctors there arent any better. Often their the same ones that work in the public sector, who just want to make a little extra cash on their free time. I asked few doctors, they said the Health Centers (part of public sector) pays the most. Public sector also has the best benefits (getting a permanent job from the city here is pretty much the most secure job you can get).
Because most private sector doctors could work in the US for a higher wage than they could get in the public sector in Canada. If you create a two-tier system and have higher salaries for the public sector work, then people won't pay to go to private clinics because the care would actually be worse than the public sector, and that would be a nightmare in itself -- pay more for worse service? Swell!

I was discussing about the companys that do research and developement. Funding with companys is usually done buy selling their products, i believe. As for whos buying, the export/import of drugs here is done mostly with other EU countries.
So they're making their profits by selling top of the line drugs to European universal healthcare systems? I don't think so. They're probably making a fair amount selling generic drugs to Europe, and making a profit on production and volume, but for new drug production and development, America is the chief market. Why? Because there's no universal healthcare which means people can choose their own medications (to an extent), including expensive new ones.

You are saying American health care is the best in the world quality wise, cause its American. And i should get of my high horse?
Way to misread there chum. American health care is the best is the world quality-wise because it has the best quality. It being America only benefits it in the sense that it's a wealthy first-world country with lots of immigration and a high population.

Where do the richest people in the world go for medical care?

It ain't Finland.

雨

07-06-2007, 08:12 AM

First of all, sorry PLF; I'm being consumed by anime a bit too much to read all of your post right now.[...] Because a CT scanner costs a minimum $1.5 million each, not a few thousands. That kind of expenditure has to be made up somehow.I was setting the theoretical price low because I couldn't grasp (and still can't) what makes the production of such technology so :fever: expensive. Hence, I also bolded two of your words there. It's all in the way we put price tags on our stuff. And when you read that, consider all the price tags along all the steps of the process. Like, the price of research.

And in the same manner as I opened this post, I will read (,elaborate) and reply later. :watson:

whispering

07-06-2007, 08:43 AM

What are some of these problems you speak of?

I've heard they have some problems with the growing need of health care for the elderly. Finnish government and companys have done some collaboration with the Japanese, e.g. theres a finnish hospital in Sendai:
http://sendai.fwbc.jp/e/index.htm

Tens of thousands of Americans travel to countries like India to get surgery? If you had said Tijuana, I may have believed you, but India?

Proof please.

http://www.time.com/time/magazine/article/0,9171,1196429,00.html

So they're making their profits by selling top of the line drugs to European universal healthcare systems? I don't think so. They're probably making a fair amount selling generic drugs to Europe, and making a profit on production and volume, but for new drug production and development, America is the chief market. Why? Because there's no universal healthcare which means people can choose their own medications (to an extent), including expensive new ones.

Yea American companys are the biggest, but when you start looking like the top 50 companys (http://en.wikipedia.org/wiki/List_of_pharmaceutical_companies) compared to population UK, France, Germany, Japan and Switzerland are pretty damn big too in the industry. And honestly, i dont think it has anything to do with the health care system. People need drugs, companys make drugs, doesnt matter what system is used. See here, the health care pays it, the doctors dont think how much money anyone makes, they dont need to. They will give what is best for the patient. Which might be the reason why we pay more for our drugs, compared to other EU countries.

Where do the richest people in the world go for medical care?

It ain't Finland.

In western countries, id take a wild guess and say the countries where they live in. The doctors here study the same things, read the same medical journals, listen to the same seminars as in e.g. US. When the information is there, it will be used in every countrie. So what makes American health care have the best quality?

Pierrot le Fou

07-06-2007, 08:43 AM

You seem to misunderstand what japanat said. He was not saying that the figure was imaginary, or a fiction, but rather that the company that buys a 1.5 million dollar machine has to charge a large amount to get a return on their investment. The cost is VERY real, that's why the price is high. Not a fiction.

雨

07-06-2007, 10:34 AM

I didn't misunderstand what he said, I think. I made the emphasis to change the meaning to explain my point of view.

雨

07-06-2007, 11:54 AM

You want to say that we've gone far enough, and that we shouldn't push forward, because people now don't have enough.Actually, no. I'm just thinking that the distribution of resources isn't worth it when a (random) select few are saved by the product of research.People never have enough now. It's human nature.Indeed. I'm perfectly aware of this and it's in nobody's best interest to settle. I would like to point out, though, that the social end of the spectrum isn't necessarily going to end the world or it's medical advances.Rather than sacrificing progress for the sake of this mythical contented stability, we should be pushing forward so that the chemotherapy of today that costs so much will be cheap and affordable 20 years down the line with a newer better cancer treatment for those who can afford it.Progress won't be halted because resources are shifted around. I see where you're coming from but frankly, the idea of this is absurd.

Yes, it's the "real world" but it can change.You act like a new cure is somehow worse when only the rich can afford it, ignoring that the 'hand-me-downs' of the pharmaceutical industries are lightyears ahead of what was available 50 years ago.Like I hope I suggested already; the advancements can still be made in a more socialist system.

And I hope to leave this conversation asap, partly because I think you have a good point and partly because I think mine is much better and I don't want to have to try to get through to anyone who won't be gotten through to (probably what you feel about me by now). :watson:

Pierrot le Fou

07-06-2007, 05:41 PM

My apologies about the outsourcing whispering -- I didn't realize there were that many (I'm pretty shocked it's cheaper with the plane ticket than getting it done in the US, and rather disturbed).

However, when it comes to drug companies, you're still misunderstanding. While there are many drug-producing companies that produce drugs for Europe, the R&D aspect is focused on the American market (for obvious reasons).

I'm on a 4-day weekend. I'll get back in more detail later.

Y.T.

07-06-2007, 10:08 PM

Hmmm .. I do recall pharma companies sink more into advertising than they spend on R&D .. and that most really long term and financially risky research is carried out in government funded labs, which can sink other people's money into it ..

Anyway, one thing is unclear to me. Do obese people and smokers pay higher health insurance in the US ? I found some recent articles implying that smokers pay more, but the disgusting blobs don't.

R&D aspect is focused on the American market (for obvious reasons).

Why? Europe is the biggest market in the world. American exports are getting cheaper by the month as the dollar plummets. Or are the 300 million Americans so sick they need more drugs than 550 million Europeans ?

Because there's no universal healthcare which means people can choose their own medications (to an extent), including expensive new ones.

... I'm quite sure we can do that here, too, We have universal health care. But that doesn't mean you can't pay extra to get more treatment.
Usually, it's not the best decision... sometimes, taking less medication is actually more healthy.

What I've heard about the US is, that the practice of defensive medicine is very much widespread... that's not good for the patients(stresses them more), and it's costly(all these procedures).

Anders

07-08-2007, 07:23 PM

http://www.nihcm.org/~nihcmor/pdf/DTCbrief2001.pdf

I'd read page 5 for some pretty interesting information on Pharmaceutical company spending. They do seem to spend much more on advertising than they do on R&D.
Rather than try to explain it in easier to read language, I'm going to be lazy and just quote the actual article.

Drug Ad Spending in Context
Pharmaceutical companies spent $2.5 billion in 2000
on mass media ads for prescription drugs. What part
of overall advertising spending is that? A small portion.
U.S. companies spent $101.6 billion advertising
consumer products in the “mainstream” U.S. mass
media in 2000. That includes internet ad spending of
$2.9 billion. Thus, DTC prescription drugs ads represent
2.5% of overall mass media ad spending.8
Even so, the most heavily advertised prescription
drugs — those with ad spending of around $60 million
and up each — were in 2000 among the consumer
products with the largest ad spending budgets.9
For example:
• PepsiCo spent $125 million advertising its premier
product, Pepsi — less than the top promoted drug Vioxx
with DTC ad spending of $160 million.
• Vioxx also beat out Budweiser beer, with an ad
spending of $146 million in 2000, and was close to
the most heavily advertised car — GM’s Saturn — with
ad spending of $169 million in 2000.
• Ad spending for Vioxx exactly matched Dell Computer
Company’s ad expenditure of $160 million for its top
brands of computer-s.
• Each of the top seven most heavily advertised drugs
(See Figure 4) beat out Nike’s ad budget of $78.2 million
for its top shoes.
• Each of the top 15 individual drugs had ad spending
that exceeded Campbell’s $58 million expenditure for
its soups.

The article shows a rather disturbing trend, that the advertising is working. Doctors are listening to and actually changing their practices based on the figures drug company reps are telling them. Patients are now being prescribed the more expensive medicines, where cheaper and perhaps just as effective medicines are being ignored.

The growth in “detailing” and “sampling” has thus grown
rapidly in recent years. This powerful form of promotion sets
up a chain reaction. Doctors are grateful to drug companies
for the thousands of dollars worth of free drugs they can
then give away to patients. They are induced to use the
samples and write prescriptions for the drug for several
reasons. First, it’s there; they have it right on hand. Second,
they know patients are more likely to take a free sample of
a drug and then fill a prescription for a sampled drug. Third,
giving out free samples endears them to patients. Free
samples are very popular with patients, who view both the
doctor and the drug favorably because it was free. The
patient benefits clinically if the drug is appropriate and works,
making them more likely to want to continue taking it.

The pharmaceutical industry also uses other means to
market their products — means not counted in the above
data. Most notably, they hold thousands of “educational”
meetings each year. Doctors are invited to attend such
meetings to listen to lectures about specific drugs and their
use. Some of these are short one to two hour sessions at
which a buffet lunch or carry out dinner may be served. (These
are often called “dine and dash” events). Other events are
more elaborate half-day or day-long seminars at premier
hotels for which doctors can qualify for continuing medical
education (CME) credits. More creative venues — such as
wine tastings, celebrity autograph signings, dinner theater
shows and even Halloween hayrides — are also used.

Drug companies hosted an estimated 314,000 such
educational events in 2000 at a cost of $1.9 billion, up from
280,000 in 1999 at a cost of $1.68 billion and 70,000 events
(at unknown cost) in 1993.6

These findings were published in 2001, though I haven't been able to find more recent data, I see no reason why the trends shown in this article should change. In other words, I fully expect that the money spent on wine and dine outings and TV advertising to increase every year as they have since the early 90's.

To me, this seems to be quite a problem for universal health care. If the program is to succeed, I feel that we would need to regulate how drug companies can advertise- perhaps to the point of the FDA regulating how much a pill can cost and reducing the patent time on newer medicines.

Angelyne

07-08-2007, 08:16 PM

When I worked in that surgeon's office, we had pharmaceutical sales reps bugging us all the damn time. It was insane how much money they spent trying to get our attention--they gave me tons of free lunches, baked goods, fruit baskets, and other junk just because I worked there. And I was only working an entry-level job! The idea was that if you suck up to the doctor's staff, then they'll be more likely to persuade the doctors to meet with the sales reps.

The_Penguin

07-09-2007, 01:28 AM

The_Penguin

07-09-2007, 01:31 AM

And yes, the fact that health care is privitized does play a large part in us having the best doctors. That WILL decline if we move to a universal system, though I'm not sure how much. Right now the best doctors in the world go to school in the US and they stay in the US because they can make the most money here. As it is, whenever a business is privitized the very best doctors will rise to the top and make the most money. If you force a universal healthcare system on them it will even the playing field, thus reducing the overall quality. Less incentive for excellence and all that jazz. It could be avoided by allowing privitized healthcare as well, but how many people want to pay the premium for universal healthcare AND pay for their own private coverage?
Bingo.

Which is why French doctors are flocking to Britain at the moment. Da benjamins are across the channel.

As for your question about whether those who have it want to share with those who don't? That can be done, but it'll require cuts in other little 'programs'.

BTW, I fucking love the song Cherub Rock by the Pumpkins. Nice nic.

The_Penguin

07-09-2007, 01:33 AM

Nah, you don't have the best doctors in everything. Finland has some "best of the world" specialist surgeons (and I mean specialist as in left big toe) and I'm pretty sure that lots of other countries have similar expert surgeons. but I won't deny that you guys probably have lured lots of great foreign surgeons and doctors with money to your country, thus giving a chance for those with money to get top notch care.
The Scandinavian countries have the private sector playing a big role in some of their programs. I don't think they 'got it right' when it comes to the social programs, but they're closer to it than the French and the Germans.

The_Penguin

07-09-2007, 01:39 AM

And how many people have the money to afford the very best in terms of healthcare? Yes, the United States has graduates from some of the best medical schools and residencies in the world. However, I'm willing to bet that the majority of physicians practicing in the US aren't graduates of these schools and residences and aren't better than the majority of physicians in Canada, Britain, Belgium, etc. to any significant degree. Number17 your friend has some learning to do.
I've studied in the US and Germany.

The quality of education and the equipment that one has to work with (the computer labs, the software, etc. I'm a coder by the way) is much better here than in Deutschland. I'm willing to bet that the same can be said about medical schools.

Even at that average state school, there are some impressive equipment and teachers to be found (at the moment universities are cut-throat in order to get students.)

So yes, on average, I'm willing to bet that our doctors are better trained and educated. Clearly, the gap is different from Canada to say Zimbabwe.
Physicians don't just charge a lot because they can. They go through a LOT to get to where they are-- roughly $200,000 from medical school alone, macaroni-and-cheese-style living for another number of years through residency, then they have malpractice insurance, etc. It's a big huge mess. For example, with medical school, the average tuition I believe for one year is roughly $25,000-$30,000 (Yale is more-- $39,000 and Baylor is a lot less at $10,000 roughly). The tuition for, say, medical school at McMaster University (Canadian)? $16,000 a year.
Yup.

Economics.

Caps on the lawsuits would help.

The_Penguin

07-09-2007, 01:40 AM

Whatever the solution to the current problem of lack of insurance for many Americans, it will have to be an incentive driven approach.

The private sector has to be involved and the companies have to kill each other just to get more patients.

A 'solution' like the one in France or Germany, is... well... crap.

To me, it's all a question of how you skin the cat.

The_Penguin

07-09-2007, 01:44 AM

The_Penguin

07-09-2007, 10:29 PM

Not peaches and cream.

http://www.nydailynews.com/opinions/2007/06/03/2007-06-03_moores_sicko_gives_all_too_pleasant_view.html
http://www.chicagotribune.com/news/opinion/chi-oped0626sickojun26,0,7075775.story?coll=chi-newsopinioncommentary-hed

Ya, I know, it's that fat bastard and his movie that's mentioned specifically, but the counter-arguments are quite accurate and illustrate the great deficiencies of 'free'/socialized healthcare.

Trump

07-10-2007, 01:01 PM

Breaking your thoughts up between 8 different posts make them even less coherent and destroys the threads. Please stop and limit yourself to one post.

stsparky

07-10-2007, 03:18 PM

NPR made a good case for adopting an Australian type system that covers the basics but makes allowances to upgrade.

Just hope your doc isn't a terrorist.

SlickWilly440

07-12-2007, 09:58 PM

If anyone wants to watch the movie Sicko here is the link (Not a camera version): http://www.jonhs.net/freemovies/sicko.htm The movie was originally uploaded to google video.

RoxFontaine

07-13-2007, 02:23 PM

http://www.jonhs.net/freemovies/sicko.htm

Anders

07-17-2007, 02:39 PM

Wow. Moore did a pretty good job with Sicko. Thanks for posting a link to the movie.

RoxFontaine

07-18-2007, 10:02 AM

Movie is crap. He fails to mention a little thing called Medicaid.

I've had it with Japanese medicine, by the way. I'm going back to America to get shit taken care of properly. My father-in-law went to the cancer center I was at and made it clear that none of us were pleased with the way they handled me. He even had the hospital's President come down. I'm certain that they were just giving us "tatemae" but at least they heard the truth, in detail, about how embarrassing their work is.

SlickWilly440

07-18-2007, 02:23 PM

^
In what way was their work embarrassing?

Anders

07-18-2007, 06:10 PM

it's true that he doesn't mention Medicaid- (health care for poor families), but the focus of the movie wasn't about the people without insurance, it was about people with insurance, but can't get necessary procedures covered.

SlickWilly440

07-18-2007, 09:33 PM

^
Oh yeah I forgot that he mentioned that at the beginning of the movie.

RoxFontaine

07-20-2007, 11:13 AM

^
In what way was their work embarrassing?

Don't really want to get into it as I'd have to get all personal about what I'm going through. Just know that I'm not making this shit up. If my VERY Japanese father-in-law went in there to kick up dust, then something was VERY wrong.

As a professional, if one cannot learn, adapt and grow, one should be embarrassed.

Fred

06-09-2009, 06:25 PM

Given the renewed discussions in the news about universal health care, I really enjoyed re-reading this thread.

In particular, I liked the very first post PLF made. (I liked my posts as well)

Fermented Yeast Paste

06-09-2009, 07:31 PM

The current political debate about healthcare reform in the US is really depressing, because the most powerful and influential in writing whatever gets passed are going about it all wrong. Instead of focusing on what would be best for Americans, they (Senator Max Baucus, Senator Ben Nelson, the GOP, etc.) are focusing on how to enact healthcare reform that would still bring a profit for the health insurance industry.

Charrington

06-09-2009, 11:53 PM

I'm not gonna bother to read this thread but the US pays the most in taxes for health care of any country.

Charrington

06-10-2009, 12:57 AM

You're a bit simple, huh?

MNJetter

06-10-2009, 05:19 AM

Charrington didn't revive the thread, FYP did. Charrington just gave his two cents on the subject. Also, I was not previously aware of that piece of "common knowledge." It's not like he said something completely Captain Obvious-y.

FYP, in general, I agree with your point, but I think it should also be important to point out that health care isn't just some big faceless money-hole into which go profits and out of which comes nothing. According to the Bureau of Labor Statistics, health care provides over 14 million jobs, with 3 million new ones (more than any other industry) coming in a ten-year span that began with their report ('06). It accounts for nearly half of the 20 fastest growing occupations in the nation. And that doesn't even include those who work in the health insurance field, which I couldn't find any stats for. So while the government may not be prioritizing the needs of the American health care recipient, they are still thinking of the needs of millions of Americans for whom the health care industry is not only their source of medical care, but of their entire livelihood.

DISCLAMER: I know that 2006 is a little dated for statistics like this, considering the recession, but I couldn't find anything better. But in all likelihood, even if the numbers are different now, the importance of the industry for its employees is the same.

Fermented Yeast Paste

06-10-2009, 05:47 AM

Fred revived it.

And MNJetter, that doesn't make much sense. Senators such as Ben Nelson and Max Baucus aren't looking out for those employed by health insurance companies. Both have said several times in the recent past that the reason they don't want to include a public option in health care reform is because then the for-profit health insurance companies wouldn't be able to compete. And frankly, that speaks worlds about how completely shitty the health care in the U.S. is right now. Why don't they want those companies run out of business by a public option? If you look at their profiles on Open Secrets they both have been financed largely from the insurance industry.

A strong public option would do wonders, and a majority of Americans are in favor of it. It'd keep the insurance companies honest and maybe medical costs would stop bankrupting so many Americans (It's the leading cause of bankruptcies for Americans). Frankly I'm in favor of single-payer but hey, I know a lot of people aren't, so a good public option would be fine.

Also I don't see why the people employed by those health insurance companies matter over the many more millions of Americans that would benefit from a good public option to help bring health care insurance and medical costs down. All it would even be is just that, an option.

stsparky

06-10-2009, 03:44 PM

Bottom line - if we're paying taxes for these benefits - is that everyone should have the same care as their senators. Fair is fair. This shouldn't be 'Animal Farm (http://en.wikipedia.org/wiki/Animal_Farm_(book))' with some being "more equal" than others.

Again Socialism works if everyone gets their dreamhouse and a Bentley for their daily toil in the fields of labor.

Fred

06-10-2009, 04:50 PM

I would like to see universal coverage for health maintenance activities (i.e. check-ups, consultations), children, and pregnancies. I would be willing to consider a number of insurance options for illness treatments.

Currently, there is a lot of money in treating long-term symptoms. I am not sure how to change that incentive, but I think we would be a healthier nation if we could.

Edit: As a side note about reviving an old thread... I think the topic is very current and this thread had some very good posts, particularly in the first three pages. Also, there are very few threads currently active and I was hoping to generate some more activity.

Charrington

06-10-2009, 07:09 PM

I would like to see universal coverage for health maintenance activities (i.e. check-ups, consultations)

So you can go to the doctor and find out you have cancer for free and then figure out how pay for treatment on your own?

MNJetter

06-10-2009, 07:48 PM

I agree. I don't think that illness treatments are any less deserving of universal health coverage than regular maintenance activities. Personally, I'm wary of single-pay or universal health care as a concept at all. Even as someone who knows very little about how the economics of the health care industry works, I still understand that a huge part of what fuels advancement in medical technology is competition between companies. While this does have its bad points as well, it certainly provides a motivator for progress that would not otherwise be there. And the bureaucracy gets ridiculous. I've heard stories about people in Canada who get diagnosed with life-threatening things, but get put on waiting lists for treatment that exceeds their expected lifespan while living with the disease, so they come to the USA for treatment instead. Expensive, but if you're dead, do you really care about having saved a few bucks?

Trump

06-10-2009, 08:08 PM

Universal healthcare is basically saying that those who pay little to no taxes deserve the same level of care as those who are paying without giving those who are paying options for better or faster care. That quite simply is not fair. Everyone should have basic healthcare and access to the treatments required to save their lives, but you have to draw the line somewhere between what everyone deserves and what people earn for themselves. I think the politicians are completely incapable of doing a good job at that.

Fermented Yeast Paste

06-10-2009, 08:39 PM

Okay, here's one thing to keep in mind: "Universal health care" means nothing more than everyone having access to health care (Implying it's affordable). That's it. It does not mean single-payer or even a public option, and could simply mean a government mandate to purchase a private plan from the for-profit companies. (Which would be absolutely terrible and is what is done in Massachusetts, and it's very unpopular)

And the bureaucracy gets ridiculous. I've heard stories about people in Canada who get diagnosed with life-threatening things, but get put on waiting lists for treatment that exceeds their expected lifespan while living with the disease, so they come to the USA for treatment instead. Expensive, but if you're dead, do you really care about having saved a few bucks?
Bureaucracy is not limited to only things government run; it's more than possible for it to turn up in private institutions as well, and its a big problem with the health insurance industry overall, especially when it comes to administrative costs. Those are a huge problem here as well. I know about wait times in Canada and I've heard of people complaining about them, but frankly I need to be shown actual stories that can be corroborated about Canadians having life-threatening diseases conditions and had to wait so long that they died. Plus, Canada isn't the only example of single-payer health care. Hell, like I said, single-payer isn't even the only solution possible: Here are five capitalist countries and how they handle health care (http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/). You could even read that and tell me which you think would work best for us.

Also, it's being really disingenuous to imply that the difference between cost in Canada and the U.S. in health care is "a few bucks."

Universal healthcare is basically saying that those who pay little to no taxes deserve the same level of care as those who are paying without giving those who are paying options for better or faster care. That quite simply is not fair. Everyone should have basic healthcare and access to the treatments required to save their lives, but you have to draw the line somewhere between what everyone deserves and what people earn for themselves. I think the politicians are completely incapable of doing a good job at that.
Everyone should have access to decent health care at a very affordable price, whether you're paying for through taxes, premiums, or a combination of the two. You would have to convince me why using someone's income--and therefore income tax--is a good way to judge how deserving someone is of good health care. Hell like I said, what's likely to happen is all we'll get is a public option, which means you can stick with your for-profit insurance company for whatever reason.

Fred

06-10-2009, 08:53 PM

Charington – I know people sometimes have the experience of going in for a check-up and finding out they have an illness that they do not have the resources to treat. However, I would not characterize most check-ups that way.

Most illnesses progress from a set of warning signs to a mild case to a severe case. If you can catch a problem during the early warning signs, it is much easier to treat it than if it is a severe case. Of course, the patient has a much better quality of life as well. So, early detection will decrease the overall cost of health care.

MNJetter – You used the term “deserving”. I don’t think of it in terms of one type of coverage being more or less deserving than the other. Rather, I understand that people like having options. Provide basic coverage and then let people choose what other coverage they want from a list of private and public options.

In regards to the financial motivation to develop medical advancements, I have mixed feelings. It is much more lucrative to develop a product that alleviates symptoms without affecting a cure than it is to either prevent or cure the illness. Moreover, the tendency is to create more powerful drugs rather than more effective drugs. I remember hearing about this issue several years ago in regards to diabetes. I did a quick goggle search for an example of this issue and came up with the following article: http://abcnews.go.com/WN/DiabetesResource/Story?id=3383539&page=1

Trump – If I understand you correctly, we more or less agree.

FYP - I did not see your post when I was making this one. (I did not hit refresh until I was ready to post.) I will check out your link and let you know what I think later.

Jetsetlemming

06-10-2009, 09:14 PM

CNagy

06-10-2009, 09:57 PM

The whole taxpayer angle is nothing more than a diversion: right now, you pay for the poor's healthcare. Emergency rooms do not turn people away and are required to treat anyone--when people do not pay their ER visit bills, they eventually get passed onto the taxpayer. So the real decision is this: do you want to pay for their healthcare when it is in the hundreds of dollars for routine checkups and preventative maintenance, or when it is in the thousands of dollars because, without insurance, they waited until it became too bad not to go to the hospital?

Everyone in the United States deserves basic coverage. When someone wants to deny that without sounding like a monster, they call it socialism, and they talk about the evils of having to wait on a list. It's all bullshit, US privatized health care is too well entrenched for that to happen. But of course, even the whisper of a possible universal health care plan drives health care providers to promise a lowering of rates--this should give you an idea of just how much they are screwing people over unopposed.

Basic coverage is yearly checkups, some prescription coverage, and access to necessary procedures. These wouldn't be free as there would be a co-pay involved, but they would be affordable. If you have the money to spend, obviously you get better treatment--it's ridiculous to believe that "deserving" even plays a part in medical treatments beyond the basic, necessary level. Alright, perhaps ridiculous is a bit harsh. It is idealistic, and idealism doesn't help the situation so much as it presents unrealistic aims.

There is a major financial crisis on the horizon, and it is health care. We spend so much on it because instead of taking a preventative approach, we are stuck footing the bill for taking care of people after they're pretty far gone. As we begin to live longer, this problem will increase at an accelerated rate. It is in the health care providers' interests for people to not take of themselves, to not prevent their health from failing, because the bill that gets passed on to the taxpayer is still paid. Socialism is just a word used to provoke an emotional response, and it is being done in an effort to continue a system that allows for nearly unchecked greed.

MNJetter

06-10-2009, 10:42 PM

Bureaucracy is not limited to only things government run; it's more than possible for it to turn up in private institutions as well, and its a big problem with the health insurance industry overall, especially when it comes to administrative costs. Those are a huge problem here as well. I know about wait times in Canada and I've heard of people complaining about them, but frankly I need to be shown actual stories that can be corroborated about Canadians having life-threatening diseases conditions and had to wait so long that they died. Plus, Canada isn't the only example of single-payer health care. Hell, like I said, single-payer isn't even the only solution possible: Here are five capitalist countries and how they handle health care. You could even read that and tell me which you think would work best for us.
I meant more in terms of a single-pay system versus a bunch of smaller, more competetive systems than a government run system specifically. I agree that bureaucracy happens in any large organization, whether it's a government or a corporation, a church or a charity, or anything else.

As for stories from Canada, I thought I'd seen it on another thread here, but maybe it was on the news instead. There was a woman who had been diagnosed with brain cancer, and told that surgical removal was an option, but that it would be a 12 month wait before space was available. The prognosis for her type of brain cancer, untreated, was anywhere between 6 and 18 months. Thus, in all likelihood, she would die before treatment was available. She traveled south to the United States, and was under the knife within three weeks.

You used the term “deserving”. I don’t think of it in terms of one type of coverage being more or less deserving than the other. Rather, I understand that people like having options. Provide basic coverage and then let people choose what other coverage they want from a list of private and public options.
You're thinking of deserving in terms of ethical worth. I'm thinking of it in terms of level of necessity. Sure, basic coverage is often thought of as routine checkups and so forth. But there are also those (including me) who would think of basic coverage as more of a safety net. Most people would be able to afford regular checkups and whatnot if insurance companies didn't pay for them and give doctors the opportunity to charge an arm and a leg for them. The "basic coverage" I can think of would be a health plan that would catch you if/when you had huge medical bills that you couldn't take care of on your own. In other words, a "just in case" type of coverage that would actually ensure (as insurance ought to) that you don't go into debt.

Charrington

06-10-2009, 10:54 PM

I personally have this condition that requires surgery about every 5 years to remove sections of my intestines. I owe about 25k in hospital bills and I don't pay taxes (I get paid off the books), which means you're getting fucked by the system and covering my bills even without UHC. So you may as well relax your anus and accept UHC, it'll make this easier for all persons involved.

japanat

06-11-2009, 12:08 AM

I'm curious about one thing: exactly why does universal coverage imply excessive wait times? Universal coverage says that everyone can get at least basic care at affordable rates. The horrendous wait-times we're hearing about in Canada aren't really due to the Universal care, but rather due to bureaucracy and doctor shortages, aren't they?

I, too, believe that checkups, preventative medicine and life-saving treatments should be on the table for universal healthcare, but that elective procedures shouldn't. And yes, I know that you have to be very careful in how you spell out elective care so that a heart transplant doesn't get labeled elective...(exaggerated for effect). In other words, if a nose job is necessary to prevent apnea, it should be covered; if you just want to look like Barbie, here's the bill.

Jetsetlemming

06-11-2009, 12:25 AM

Because the UK system sucks ass.

Fermented Yeast Paste

06-11-2009, 01:51 AM

As for stories from Canada, I thought I'd seen it on another thread here, but maybe it was on the news instead. There was a woman who had been diagnosed with brain cancer, and told that surgical removal was an option, but that it would be a 12 month wait before space was available. The prognosis for her type of brain cancer, untreated, was anywhere between 6 and 18 months. Thus, in all likelihood, she would die before treatment was available. She traveled south to the United States, and was under the knife within three weeks.
As outrageous as this is, I'm going to need a lot more information regarding this as I'm sure you can understand that I'm having a hard time believing it, or at least the whole story.

Because the UK system sucks ass.
I'd take it over ours.

Jetsetlemming

06-11-2009, 01:59 AM

I'd take it over ours.
Why would you have to choose when we can have better
Fucking Canada has better

Fermented Yeast Paste

06-11-2009, 02:10 AM

France has better than Canada and they don't even have single-payer! I was just saying, I'd even take the British NHS over our system.

Samurai_Pooh

06-11-2009, 02:38 AM

The horrendous wait-times we're hearing about in Canada aren't really due to the Universal care, but rather due to bureaucracy and doctor shortages, aren't they?

Yup. Because we live right next to the united states where doctors can earn way more, unsurprisingly there is a 'brain drain'. Doctors train here, then leave for the USA where they can price-gouge patients. I'm really grateful to the doctors who stay behind, earning less but helping everyone. these are the doctors who trained in medicine so they could help people.

and not enough money is spent on healthcare in Canada either.

MNJetter

06-11-2009, 07:23 AM

As outrageous as this is, I'm going to need a lot more information regarding this as I'm sure you can understand that I'm having a hard time believing it, or at least the whole story.

You need me to google it for you?

Like I said, I don't remember where I got the story from. I could have sworn it was here on OP9. I did manage to find a very similar story (link (http://www.mayoclinic.org/patientstories/story-339.html)) on a Mayo Clinic website, though the details are a bit different. For all I know, the story I read before was this one, and the person who told me exaggerated a bit. But at least this goes to show that cases like it exist.

japanat - I agree, bureaucracy and doctor shortage are the direct cause of excessive wait time. That's why I was trying to illustrate my belief that universal health care is a big part of what causes the bureaucracy that gives rise to the wait times. The doctor shortage is being experienced worldwide, so that wouldn't be a great reason for a big difference between the US and Canada. Except that maybe doctors tend to flock to countries that has the best pay for doctors, and government-run universal health care doesn't cut the mustard there either.

jariten

06-11-2009, 07:28 AM

Not having read the thread...

I've had the following:
Whatever my parents had
No healthcare
Crappy HMO
College based pseudo state care
Decent HMO
Military Health
VA (Continues to today...but I don't use it anymore)
Civil blue cross (AWFUL)
Awesome PPO (Great West upper tier)

In that order.

Pretty big spread.

Assuming universal health would end up like the other govt run health services I've had (va/mil) ... forget about it. Service is slow and inadequate. The loss of doctor choice and the difficulty of obtaining a covered second or further opinion makes it...imo...vastly inferior to even the crappiest of HMO.

I could write a dissertation here on why I hate public healthcare...but I don't have the time. It seriously comes down to this: You get what you pay for. If a small section of the populous is forced to pay the bill for the general population then everyone will get crappy care.

I'd be willing to entertain a program which provides services to people who literally cannot pay for it (ie document every dollar they earn and spend none on luxuries) but in my experience most people who don't have health care choose things like owning a car, having the internet, having a cell phone, eating in restaurants, etc etc etc INSTEAD of choosing to pay for their health.

Charrington

06-11-2009, 07:53 AM

You need me to google it for you?

Like I said, I don't remember where I got the story from. I could have sworn it was here on OP9. I did manage to find a very similar story (link (http://www.mayoclinic.org/patientstories/story-339.html)) on a Mayo Clinic website, though the details are a bit different. For all I know, the story I read before was this one, and the person who told me exaggerated a bit. But at least this goes to show that cases like it exist.

That's really more of an argument against the Canadian execution of the system than the system itself. For example, people from all over south America go to Cuba for operations because it's free, fast and very well performed (even though they have 80s era equipment because of the embargo). Also, Cuba has such an amount of doctors that they send them to Venezuela in exchange for oil. I would imagine Cuba has avoided the doctor shortage because they have free secondary education and their systems design allows poor children to study and attend school and eventually become doctors instead of dropping out to help support their families and things like that.

I think the US would benefit greatly from a completely free college in at least each state.

CNagy

06-11-2009, 11:06 AM

Assuming universal health would end up like the other govt run health services I've had (va/mil) ... forget about it. Service is slow and inadequate. The loss of doctor choice and the difficulty of obtaining a covered second or further opinion makes it...imo...vastly inferior to even the crappiest of HMO.

I could write a dissertation here on why I hate public healthcare...but I don't have the time. It seriously comes down to this: You get what you pay for. If a small section of the populous is forced to pay the bill for the general population then everyone will get crappy care.

Actually, that's less an indictment of government run health services (from what I've heard the health care plan for civil servants is actually quite good) and more about how this country is really shitty to its veterans. The percentage of veterans that make up the homeless population (which I cannot exactly recall at this time Edit: looked it up, 23%) is appalling, as an example.

As for getting what we pay for, we already pay for people who can't afford their emergency room visits--and emergency room visits are ridiculously expensive. The first time I had kidney stones, it happened suddenly and I felt as though I were dying. I had a friend drive me to the ER, where I spent 8 hours (4 of which were me lying in a room, in pain, before a doctor came in and said "we should probably get you some pain medication"), then a short series of x-rays, a few more hours spent sleeping in room full of patients, and then home. The bill came out to roughly $6,000. If I didn't have insurance and refused to pay the bill? You would have paid it, along with everyone else. Now, kidney stones aren't exactly something a checkup will catch beforehand, but I'd rather help pay for a guy to see a doctor who advises him to take some aspirin every day and change his lifestyle (or even puts him on more serious medication), than pay for when that guy up and has a heart attack and ends up in the ER. The cost difference (start to finish, a heart attack patient is looking at a bill upwards of $50,000) makes this sort of plan common sense to everyone who isn't a health care provider.

bluestars87

06-11-2009, 11:30 AM

I'd rather take my chances with other countries' policies. I mean the United States may have some of the best doctors and medical care/facilities are around, but what is the point of that if you can't even afford it? A decent doctor is still a decent doctor and is better than nothing at all. My goodness the medical system here is terrible. Makes me so angry at times.

Fermented Yeast Paste

06-11-2009, 01:39 PM

Trump

06-11-2009, 05:18 PM

Everyone uses the term "basic healthcare" freely in this thread, yet I bet no one can come to an agreement about what that really is. Checkups? Stitches? Allergies, major or minor? Chronic pain? Tonsilitis? Arthritis? Chiropractors? Dentistry? Seriously, how much of that is really required for life at all , let alone a happy life?

And this just occurred to me, so pardon me if it isn't worded perfectly.

I think people underestimate how much healthcare really is optional (especially for younger people). Think about it. Healthcare is designed to improve quality of life. But wait, isn't that what money is used for? But magically, healthcare is different... We should give healthcare to everyone but you should have to work an extra job for a car so you can get to work an hour faster? To me getting back two hours of your life every day because you don't have to spend it waiting on a bus is pretty damn big improvement in your quality of life. Maybe I should start a universal free car movement...

I know I exagerate, but I hope you get my point. (if you quote line by line you obviously missed the point)

Fermented Yeast Paste

06-11-2009, 05:44 PM

I consider health care to be a right and not a privilege so everything from preventative care to broken legs to surgeries should be funded ideally through taxes and if necessary through premiums that don't break the bank and don't charge more because of some disease or disorder you have through no fault of your own. Also chiropractic is pseudoscience in my eyes so that wouldn't be covered.

I don't see how it can be compared to having a car or not because having a car is a privilege, not a right. It is a convenience.

Fred

06-11-2009, 06:22 PM

Trump – perhaps we can use the outline Obama provided during the election campaign as a definition of universal health care: http://www.barackobama.com/pdf/issues/HealthCareFullPlan.pdf

In regards to your second point, I think what you are saying is we should consider whether or not the resources spent on universal health care could be better spent on some other public project.

This is a hard question to answer without becoming too abstract. As a general rule, I would prefer to have the government say, “Here is a list of our priorities, here is what we expect them to cost, here is how we will allocate/generate our resources to cover them.” As opposed to saying, “Here are our resources. How can be best spend them?”

I would place universal health care as a pretty high priority. Although our health care system has definite strengths, particularly around treating acute surgical emergencies, our overall health statistics are dismal. I don’t mean dismal relative to “x”, I mean dismal. If you want to consider lost opportunity costs, think about the loss of productivity due to illness and pre-mature death.

Samurai_Pooh

06-11-2009, 08:10 PM

Whether you like universal healthcare or not does not really matter at this point. The US system cannot be sustained, universal health care is inevitable, you will be assimilated. resistance is futile.

whispering

06-11-2009, 08:14 PM

particularly around treating acute surgical emergencies
This isnt really a strong point. Go into pretty much any western country with universal healthcare, and thats not really a problem. The main thing about waiting in lines that people dont understand is that, if there isnt a line, they will create one. The worst situation is when you have a bunch of doctors but no patients. But when someone gets an emergency, you dont wait for anything else then the ambulance/chopper to arive at the hospital.

Another point people dont understand is that if you're rich or just middle class, you can still go to private health care, with no lines etc. At least here the government pays the vast majority of the bill and you (or your insurance company) pay the rest. Though private sector is worse then public. People somehow believe they get better care cause they pay more. Truth is, in private clinics (here) most surgeries are done with minimum staff and minimum equipment that the law allowes. Because thats how capitalism works. I personally wouldnt want a doctor to treat me that is thinking about money at the same time.

Also free health care isnt really 100% free. At least not here. Small checkups, lab tests etc cost a small fee (after a sertain amount the rest are free), to prevent people from abusing the system, as it does cost tax money to run the system. If you make it free, you'll get an overloaded system. Where people go to a hospital for the smallest things.

Fred

06-11-2009, 09:06 PM

The agency for Healthcare Research and Quality, which is a part of the US Department of Health and Human Services, rated the US high in the treatment of acute surgical emergencies. I had a link to this report on page 2 of this thread, but the link is no longer active.

Trump

06-12-2009, 09:21 PM

Universal Health Care? Obama? Don't make me laugh....

I will just say this. That propoganda from Obama is retarded. My main issue, is that they want health insurance to cost less so everyone can get it. First, that doesn't mean anyone will get better health care, and second that isn't how insurance works. Insurance is a balance of risk and payout. What they describe simply destroys health insurance (as an idea) for everyone and taxes everyone for it. No thanks.

Obama's plan focuses on buzz words and political agendas that have NOTHING to do with health care. He paints insurance companies out to be villainous organizations, drug companies to be power hungry dictators, and employers to be greedy bastards. What does that have to do with health care? NOTHING!

You know what? I couldn't give a crap about health insurance. I only care about the health care people actually receive. Obama's plan practically ignores that. When Obama actually talks about providing free clinics and or covering people's surgury with tax money, at least then he's speaking something real. As of now, he's just grabbing control in another industry. I do NOT trust politicians to decide this issue.

Samurai_Pooh

06-12-2009, 09:54 PM

Maybe if the private health care industry didn't have the ears of so many politicians in washington it would be easier for Obama to make a transition from private to public health care (and if knee-jerk reactionaries weren't so opposed to socialized health care in the first place).

I agree with you Trump, a compromise solution is a weaker one, better to go whole-hog on the issue than half-ass it.

MNJetter

06-13-2009, 05:12 AM

Actually, yes, I need you to google it for me because the burden is not on me to find evidence to corroborate your anecdote, the burden is on you.
No, you want me to google it for you. This isn't a courtroom or an officially designated public debate board. There's no "burden." LDD rules don't apply. It's just a bunch of people typing out their opinions on stuff, essentially in a social situation. I don't get into a discussion at a friend's BBQ and ask them to provide evidence to back up the claims they make. And, you haven't asked anyone else on this thread to provide evidence either. Why take their claims at face value and not mine?

Not that I'm really put out by you spending your typographical effort here instead of on google. I just think it's laughable when people get too serious on this forum and treat it as if the discussion has rules or protocol.

*****

Definitely agree with Trump on that one. Fixing health insurance isn't going to improve health care or make it more affordable.

stsparky

06-13-2009, 05:42 AM

I'd like to know why everyone in the country can't get the same coverage as our congresspeople.

CNagy

06-13-2009, 09:14 AM

Definitely agree with Trump on that one. Fixing health insurance isn't going to improve health care or make it more affordable.

Going to have to disagree here, completely. If you have insurance and ever have to go to the hospital for something, get a line by line summary of what you are being charged and compare it to the total that your insurance covers from it (and what you pay out of pocket). In one of my previous posts, I mentioned going into the ER and being charged $6,000 for my time there. What I didn't mention was that once my insurance got involved, they first negotiated the price down to about $3,200 and then proceeded from there.

If you make health insurance easier to obtain for the millions who do not have it, then you are going to make their health care more affordable simply because they now have someone who is going to get that initial bill cut down significantly.

Now, I would prefer Universal Health Care, but reform is necessary too. Reform has been necessary in quite a few industries because, as we're becoming all too aware of, capitalism doesn't police itself and greed certainly doesn't impose any sort of moral compass on how far is too far when screwing over the common guy to meet the bottom line.

Fermented Yeast Paste

06-13-2009, 04:16 PM

No, you want me to google it for you. This isn't a courtroom or an officially designated public debate board. There's no "burden." LDD rules don't apply. It's just a bunch of people typing out their opinions on stuff, essentially in a social situation. I don't get into a discussion at a friend's BBQ and ask them to provide evidence to back up the claims they make. And, you haven't asked anyone else on this thread to provide evidence either. Why take their claims at face value and not mine?

What am I supposed to deny? Of course I want you to google it for me, that's what I said. I could always just say that you're full of shit and leave it at that but I wanted to see if your story had any legitimacy and asked you to give me more evidence. If you want to trounce in here giving dubious anecdotes about Canadian health care without giving any citation that's fine, but then I'm not going to pay attention to whatever you have to say. I was giving you the chance to back up what you said to give it more legitimacy, which you managed to do while also getting smart for whatever reason.

Not that I'm really put out by you spending your typographical effort here instead of on google. I just think it's laughable when people get too serious on this forum and treat it as if the discussion has rules or protocol.
You seem to be taking this more seriously than I am.

Now, I would prefer Universal Health Care, but reform is necessary too. Reform has been necessary in quite a few industries because, as we're becoming all too aware of, capitalism doesn't police itself and greed certainly doesn't impose any sort of moral compass on how far is too far when screwing over the common guy to meet the bottom line.
The reform that we need isn't just in the health insurance industry but also in the way campaigns are financed, as the debate over health care reform is one of the things that has made obvious just how easy it is to buy out a senator. I think it'd be easier to just get a strong public option out there but the insurance industry doesn't want that, so it's currently not on the table. I've heard the idea of Medicare being legislated to become open for all (Which Ted Kennedy supported at one time), which I wouldn't have much of a problem with. Polling I've seen shows Medicare beneficiaries by and large prefer it over any private plans that they can get, and I think it's a better comparison than bringing up the VA health care system.

MNJetter

06-14-2009, 04:22 AM

If you have insurance and ever have to go to the hospital for something, get a line by line summary of what you are being charged and compare it to the total that your insurance covers from it (and what you pay out of pocket). In one of my previous posts, I mentioned going into the ER and being charged $6,000 for my time there. What I didn't mention was that once my insurance got involved, they first negotiated the price down to about $3,200 and then proceeded from there.
That's exactly why we shouldn't make an effort to increase our dependency on health insurance. I would much rather see the government try and find a way to have you be charged $3,200 in the first place without relying on an insurance company to negotiate it for you.

Of course I want you to google it for me, that's what I said. I could always just say that you're full of shit and leave it at that but I wanted to see if your story had any legitimacy and asked you to give me more evidence. If you want to trounce in here giving dubious anecdotes about Canadian health care without giving any citation that's fine, but then I'm not going to pay attention to whatever you have to say. I was giving you the chance to back up what you said to give it more legitimacy, which you managed to do while also getting smart for whatever reason.
You said need, not want. And you did say I was full of shit, though without such colorful language, when you chose to find my story (and nobody else's) dubious. Is anybody else giving citation? Only on firsthand anecdotes. Is anybody else an expert on health care? No.
I wasn't intending on "getting smart" or sounding offended or anything. I was confused as to why you were singling me out for having to prove my argument above and beyond what everybody else was expected to do.

And I believe that the word you were looking for was "flounce," not "trounce," unless you actually believe that I won the thread with my offhand anecdotal post. :) ...though I can't really flounce either unless I'm wearing a dress, which I wasn't.

Fermented Yeast Paste

06-14-2009, 08:18 PM

You said need, not want. And you did say I was full of shit, though without such colorful language, when you chose to find my story (and nobody else's) dubious. Is anybody else giving citation? Only on firsthand anecdotes. Is anybody else an expert on health care? No.
I wasn't intending on "getting smart" or sounding offended or anything. I was confused as to why you were singling me out for having to prove my argument above and beyond what everybody else was expected to do.
Who else am I going to call out? PLF doesn't post his rhetoric here anymore, and I largely agree with CNagy, stsparky and whispering. There's also Trump but he never cites anything and just comes in to spout whatever the hell his opinion is without really acknowledging anyone else's posts and then leaves the discussion only to do the same thing 5 posts later.

And I believe that the word you were looking for was "flounce," not "trounce," unless you actually believe that I won the thread with my offhand anecdotal post. :) ...though I can't really flounce either unless I'm wearing a dress, which I wasn't.
The word I meant was actually "traipse", as in walking into the discussion.

Trump

06-15-2009, 05:37 PM

I'd like to know why everyone in the country can't get the same coverage as our congresspeople.

Because most people in the country do not make $174,000 + benefits per year. I guarantee that everyone who makes that much can easily get the same coverage. It isn't special to them simply because they work for the government, it is simply that people think their skills are valuable enough to be paid that well. (This is in no way my agreement of that)

Going to have to disagree here, completely. If you have insurance and ever have to go to the hospital for something, get a line by line summary of what you are being charged and compare it to the total that your insurance covers from it (and what you pay out of pocket). In one of my previous posts, I mentioned going into the ER and being charged $6,000 for my time there. What I didn't mention was that once my insurance got involved, they first negotiated the price down to about $3,200 and then proceeded from there.

If you make health insurance easier to obtain for the millions who do not have it, then you are going to make their health care more affordable simply because they now have someone who is going to get that initial bill cut down significantly.

No, you have that ALL wrong. If everyone is on health insurance, hospitals have no reason to negotiate lower prices with them. Why would they? Insurance companies bringing health care a lot of business. If everyone has health insurance, the insurance companies are no longer responsible for bringing more business, so could no longer get lower prices. It's the same with ladies night at a club, it brings them more business. If only ladies showed up it would get cancelled in a heartbeat. So no, making insurance cheaper would fix NOTHING. It would simply tax us more, drive insurance companies out of business, and leave no one to stop the government from screwing everything up even further.

This sort of fix is just as short-sighted as many of the other things the administration has done. Car manufacturer bailouts? Goodbye tax-payer money. Or the things the administration has recanted. Gitmo closing? Releasing photos? We know how well those things have worked, and I only expect worse from the health insurance "fixes".

MNJetter

06-15-2009, 07:35 PM

Heh, I like your ladies night analogy.

CNagy

06-15-2009, 10:39 PM

No, you have that ALL wrong. If everyone is on health insurance, hospitals have no reason to negotiate lower prices with them. Why would they? Insurance companies bringing health care a lot of business. If everyone has health insurance, the insurance companies are no longer responsible for bringing more business, so could no longer get lower prices. It's the same with ladies night at a club, it brings them more business. If only ladies showed up it would get cancelled in a heartbeat. So no, making insurance cheaper would fix NOTHING. It would simply tax us more, drive insurance companies out of business, and leave no one to stop the government from screwing everything up even further.

15-18% of Americans do not have healthcare. Of those numbers, the amount who will find themselves in the hospital is obviously not going to be a high percentage. To think that a fraction of society gaining health insurance is going to change the way hospitals and health insurance interact is ridiculous. To think that the vast majority of people who currently have health insurance would accept a near doubling in their hospital bills because a fraction of society that was without health insurance is now insured is completely insane. Did you seriously think that through before you typed it?

Charrington

06-16-2009, 12:54 PM

Trump

06-16-2009, 04:40 PM

15-18% of Americans do not have healthcare. Of those numbers, the amount who will find themselves in the hospital is obviously not going to be a high percentage. To think that a fraction of society gaining health insurance is going to change the way hospitals and health insurance interact is ridiculous. To think that the vast majority of people who currently have health insurance would accept a near doubling in their hospital bills because a fraction of society that was without health insurance is now insured is completely insane. Did you seriously think that through before you typed it?

Wrong, 15-18% do not have health insurance. That's all it is, a promise by someone else to help pay for some specific health care costs. Please, do NOT confuse the two. Because the insurance companies have the power to deny coverage in many cases, they have a bargaining chip with the hospitals. They can choose not to cover a procedure which means the procedure never happens. That's why hospitals offer a reduce rate, because it gets them a lot more business. Under the new government plans they supposedly will not be able to deny coverage, so where is this bargaining chip? Gone. So all procedures cost more to the insurance companies. Now you also pay less for insurance (somehow?). All in all, you bankrupt the insurance companies and are left with the government controlling all health care (because you are required to be provided health care under the new plan).

I really don't see the benefit of screwing the "82-85%" to help the others. There has to be a way of helping those who need without screwing everyone else. I do not think the idea behind health insurance is a bad idea, but the way insurance is implemented now is a flawed concept. Please, do not perpetuate problems because you are too shortsighted to see the overall effects.

Fermented Yeast Paste

06-16-2009, 05:20 PM

Trump you're throwing out a lot of weird economics lessons without really anything to substantiate them and I call into question why you believe them. Health systems where the insurance organizations can't deny coverage work wither fewer problems than the US in other nations that aren't single-payer (e.g. Germany, Switzerland). I also don't see why I should care about bankrupting the companies and letting the government pay for health insurance (Which is different than having the government own the hospitals); if the option of Medicare was opened to let every American be eligible for it, why would that be a bad thing? Medicare benificiaries are generally happier with their health care than those with employer-based private plans anyway.

CNagy

06-16-2009, 05:45 PM

Wrong, 15-18% do not have health insurance. That's all it is, a promise by someone else to help pay for some specific health care costs. Please, do NOT confuse the two. Because the insurance companies have the power to deny coverage in many cases, they have a bargaining chip with the hospitals. They can choose not to cover a procedure which means the procedure never happens. That's why hospitals offer a reduce rate, because it gets them a lot more business. Under the new government plans they supposedly will not be able to deny coverage, so where is this bargaining chip? Gone. So all procedures cost more to the insurance companies. Now you also pay less for insurance (somehow?). All in all, you bankrupt the insurance companies and are left with the government controlling all health care (because you are required to be provided health care under the new plan).

I really don't see the benefit of screwing the "82-85%" to help the others. There has to be a way of helping those who need without screwing everyone else. I do not think the idea behind health insurance is a bad idea, but the way insurance is implemented now is a flawed concept. Please, do not perpetuate problems because you are too shortsighted to see the overall effects.

Accidentally said care once, rest of the post pretty pointedly uses the word insurance. Hell, even from the context, it's pretty obvious that I'm talking about insurance. And frankly, what you're saying at this point is so convoluted and so radically different from anything I've read on the subject that I have a hard time even taking your points into consideration.

If I'm reading your interpretation of what would happen correctly, a public option for insurance would cause hospitals to no longer see the need to offer reduced rates (which do not simply cover procedures--the entire reason I said get a line by line summary of a medical bill is because everything from procedures to time to disposables are reduced), and so health insurance providers will have to pay more. I assume this leads into premiums going up, people abandoning ship for the public option, and private health care going belly up. So, if I am understanding what you are saying about this doom scenario--then I still disagree.

The above seems to assume that the change essentially happens in an oversight vacuum absent of any other changes. The very first bullet point on reducing cost: "Reduce waste and fraud that comes from high administrative costs and unnecessary services that drive up costs with no added health benefits." This pretty much implies a system-wide change in how health care is managed. In that sort of overhaul, the outcome that I think you are putting forth does not seem feasible.

stsparky

06-17-2009, 03:44 AM

Trump

06-17-2009, 06:24 PM

Medicare benificiaries are generally happier with their health care than those with employer-based private plans anyway.

So... if they are "generally happier" and are still rating their service as 4 out of 6, (where 6 is completely satisfied) that means everyone else must completely hate their health insurance provider? And they never ask "if you had the money, would you stay with medicare?" because I guarantee most would say no. It's amazing how people seem to like things when they are free even if they are total crap.

Reference for above:
http://www.cms.hhs.gov/MCPSS/downloads/MCPSS_Report.pdf

Anyway, I have no problem reducing waste and fraud. The effort to digitize records seems reasonable. Working with school, ok, seems reasonable. I just don't see how the other topics help that. They are more "let's try and change reality!" goals that will never work. Make drugs cheaper! Make insurance cheaper! Just snap your fingers and make it happen. The big push seems to be to create a "public option" for health insurance. How the hell does creating another government entity reduce waste and fraud? They are usually the most wasteful, the most fraudulent, and most abused systems anywhere. How can you support that? And you trust lawmakers and their oversight? These are the same lawmakers that recently raised unemployment benefits but, the increase pushed people over the limit for food stamps and now many people are ineligible for food stamps. I know they didn't do it on purpose, but they are totally clueless about how their decisions and reality interact.

japanat

06-18-2009, 12:15 AM

The Japanese Junior Ambassador was here to do an event at the Japanese American Museum in Los Angeles. He wsa quizzed regarding Japan's more sucessful Health Care program.

I'd like to hear any of our Senators explain why we Taxpayers aren't in the same program they're in.While I think the US system definitely needs upgrading and like the idea of universal health, I'm not sure the Japanese system is the best example.

I have the Japanese National Health Insurance. This insurance is affordable, if you have low income, because rates are set according to your previous year's reported income. It's also adjustable by the size of the family.

That's my problem. My wife has a wonderful 100%-pay private insurance through her father's clinic, which my children are also covered on. And while I'm not driving a Jag, I'm not poor, either. So only I am on the National plan, and my monthly rates are horrendous. I pay ~$575/month for a plan which has dropped from a 90/10 copay 10 years ago to a 70/30 copay today. So if I get bronchitis, say, with clinic visits, lab work, and meds, I'll pay about $100 more in any given month; and hospitalization, which is on average about 3-4 times longer than the States for any given condition, would bankrupt me.

There are news stories on the TV and in the paper all the time which talk about the "ailing National Insurance system" which is "overburdened by the growing numbers of the aged and infirm".

I'm not saying that the US can't learn some things from the Japanese, British, Canadian, Swedish or other systems. What I am saying is to make sure to look carefully and consider such factors as the imminent retirement of the Baby Boomers, monthly rates and copay ratios, current US medical costs (which are some of the highest in the world), even whether to cover alternative treatments such as acupuncture or Chinese traditional medicines.

Fermented Yeast Paste

06-18-2009, 04:27 AM

So... if they are "generally happier" and are still rating their service as 4 out of 6, (where 6 is completely satisfied) that means everyone else must completely hate their health insurance provider? And they never ask "if you had the money, would you stay with medicare?" because I guarantee most would say no. It's amazing how people seem to like things when they are free even if they are total crap.

Reference for above:
http://www.cms.hhs.gov/MCPSS/downloads/MCPSS_Report.pdf
Okay, let's go over this. First some background, courtesy of Wikipedia (And cited):
Since the beginning of the Medicare program, CMS has contracted with private companies to operate as intermediaries between the government and medical providers.[5] These contractors are commonly already in the insurance or health care area. Contracted processes include claims and payment processing, call center services, clinician enrollment, and fraud investigation.
So, the satisfaction survey that you link to is essentially seeing how well Medicare beneficiaries rank the services given by these intermediaries, as stated on their website:
The Medicare Contractor Provider Satisfaction Survey (MCPSS) is designed to garner quantifiable data on provider satisfaction with the performance of Medicare fee-for-service contractors. The MCPSS is one of the tools CMS will use to measure provider satisfaction levels, a requirement of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA). The survey will enable CMS to gauge provider satisfaction with key services performed by the contractors that process and pay the more than $280 billion in Medicare claims each year.
Now, nitpicking quotes out of a 33 page study would be annoying, so the CMS website conveniently has a PDF that gives the results as a summary to the study that you posted for 2008, right here. (http://www.cms.hhs.gov/MCPSS/downloads/providerfactsheet.pdf) Basically, that the average score given by those surveyed for all contractors was 4.61 out of 6. However, it varied by contractor, with 2/3 of them scoring higher than the average, with a high of 5.25 (See page 15). At least, for Medicare Part A contracting; for Medicare Part B it was a bit lower. The average for all contractors was 4.51 out of 6. You can decide for yourself how good this is, but since it'd be about 75%, I'd say it's decent. I see nothing that says Medicare is only ranked a solid 4 out of 6, and these are all contractors anyway.

So, it's not perfect, but the job done by the contractors seems decent, and I'm not really seeing how you're drawing the conclusion you said from it. Now, as for my citation that I mentioned earlier, here is this from Health Affairs (http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.4.w521v1):

One key issue in health reform concerns the relative roles of coverage offered through private insurance and public programs. This paper compares the experiences of aged Medicare beneficiaries with those of people under age sixty-five who have private employer coverage. Compared with the employer-coverage group, people in the Medicare group report fewer problems obtaining medical care, less financial hardship due to medical bills, and higher overall satisfaction with their coverage. Although access and bill payment problems increased across the board from 2001 to 2007, the gap between Medicare and private employer coverage widened. [Health Affairs 28, no. 4 (2009): w521-w532 (published online 12 May 2009; 10.1377/hlthaff.28.4.w521)]

Anyway, I have no problem reducing waste and fraud. The effort to digitize records seems reasonable. Working with school, ok, seems reasonable. I just don't see how the other topics help that. They are more "let's try and change reality!" goals that will never work. Make drugs cheaper! Make insurance cheaper! Just snap your fingers and make it happen. The big push seems to be to create a "public option" for health insurance. How the hell does creating another government entity reduce waste and fraud? They are usually the most wasteful, the most fraudulent, and most abused systems anywhere. How can you support that? And you trust lawmakers and their oversight? These are the same lawmakers that recently raised unemployment benefits but, the increase pushed people over the limit for food stamps and now many people are ineligible for food stamps. I know they didn't do it on purpose, but they are totally clueless about how their decisions and reality interact.
And this is just more nonsense.

Trump

06-18-2009, 04:44 PM

All medicare is run by contractors, so how does that change anything about the results? Under the public system, it would be exactly the same way. The government would contract out to people to run it for them like they do for everything from port security to air traffic controllers. Or did you not consider that? The questions they asked were dealing with how well their claims were serviced, covered, how their appeals were handled, and everything you'd ask about under insurance. So it doesn't matter if it is private contractor or Obama himself running it. I didn't nit-pick numbers; I just glanced through the graphs and saw an average of mostly in the 4 range. A 4 on a scale of 1-6 is barely above half.
1= Completely unsatisified
2= Somewhat unsatisfied
3= Barely unsatisfied
4= Barely satisfied
5= Somewhat satisfied
6= Completely satisfied

All I'm saying is that between a 4 and 5 isn't saying great things. Sure, they didn't hate it, but I wouldn't say there was a lot of love.

So.... you are saying the people with free health insurance reported having less hardship from medical bills? Genius .... I'm not sure what else I can say about that except it is a completely flawed comparison. Completely different age groups? I'd be interested to see a comparison of those aged 65+ who have insurance through private means (union or retirement benefits, those still working, etc). Last I checked, those over 65 have completely different health concerns than those in their 40s, let alone 30s and 20s. So I question the validity of the results.

Overall, I have seen no evidence anywhere that the government could provide a means to better health care for less money.

Fermented Yeast Paste

06-18-2009, 05:37 PM

I didn't nit-pick numbers; I just glanced through the graphs and saw an average of mostly in the 4 range. A 4 on a scale of 1-6 is barely above half.
And yet... that isn't the case. You said 4 out of 6, and you were wrong.
1= Completely unsatisified
2= Somewhat unsatisfied
3= Barely unsatisfied
4= Barely satisfied
5= Somewhat satisfied
6= Completely satisfied
From what I read, only descriptions for 1 and 6 were given, and the person going over the study has to infer for themselves what other scores would mean, so your breakdown is just your opinion of out to interpret the results, not what the study gives. Suffice to say I wouldn't say the average score would be considered "barely satisfied".

So.... you are saying the people with free health insurance reported having less hardship from medical bills? Genius .... I'm not sure what else I can say about that except it is a completely flawed comparison.
Yeah, because cost of medical bills was the only thing mentioned in the abstract. Also, Medicare isn't free.
Completely different age groups? I'd be interested to see a comparison of those aged 65+ who have insurance through private means (union or retirement benefits, those still working, etc). Last I checked, those over 65 have completely different health concerns than those in their 40s, let alone 30s and 20s. So I question the validity of the results.
Why would completely different age groups matter? Hell, if they do, then you'd think the younger age groups that would have private health insurance would be more likely to have fewer problems with their service because they're less likely to have medical issues, yet that isn't the case. Also it was a study published to a peer-reviewed academic journal, so if you have a problem with the methodology why don't you contact the people who did the research?

Overall, I have seen no evidence anywhere that the government could provide a means to better health care for less money.
I just gave you evidence. You are just trying your damndest to ignore it.

Jetsetlemming

06-19-2009, 02:07 PM

http://www.motherjones.com/kevin-drum/2009/06/healthcare-ceos-shoot-themselves-foot
Yesterday the House Subcommittee on Oversight and Investigations decided to investigate the practice of recission. This is when you pay your premiums for years to a healthcare insurer, then get sick, and then have your insurance cancelled. The insurance industry executives at the hearing did not exactly cover themselves with glory:

A Texas nurse said she lost her coverage, after she was diagnosed with aggressive breast cancer, for failing to disclose a visit to a dermatologist for acne.

The sister of an Illinois man who died of lymphoma said his policy was rescinded for the failure to report a possible aneurysm and gallstones that his physician noted in his chart but did not discuss with him.

....Late in the hearing, [Bart] Stupak, the committee chairman, put the executives on the spot. Stupak asked each of them whether he would at least commit his company to immediately stop rescissions except where they could show "intentional fraud."

The answer from all three executives: "No."

Rep. John Dingell (D-Mich.) said that a public insurance plan should be a part of any overhaul because it would force private companies to treat consumers fairly or risk losing them. "This is precisely why we need a public option," Dingell said.

Matt W

06-21-2009, 05:57 AM

There was an interesting discussion on healthcare on the most recent Real Time with Bill Maher, takes about 30 seconds for the discussion to move to health care.

http://www.youtube.com/watch?v=SMqG_fGgVI8

silverwolf0

07-03-2009, 01:30 PM

I think health insurance is too complicated in the states.I have health insurance and I don't even know what I'm covered for. I remember something about the health industry reps telling congress that if they government didn't intervene, the health industry could reform itself and save a trillion dollars over a decade. So they shot themselves in the foot from how I see it. Now they decide to reform? Like highway robbery with the robber getting off scott free if they pretend to "reform". I don't trust doctors, especially the older ones who are looking out for their nest egg. Money isn't an incentive to be a better healthcare provider; it has the opposite effect.

Swede

08-13-2009, 03:27 AM

Holy shit, have you guys seen what's been going on recently? It's driving me nuts.

So there's a lot of town hall meetings going on right now. That's great I think. What's not so great, is that they're all just being interrupted by people who literally sound like they're insane, screaming about how Obama is socialist and wants to kill off people's grandparents. It's absolute lunacy.

Now, I honestly would LOVE to hear more actual debate going on. I'm not for a second going to try and argue for what the government's proposing, as frankly there hasn't actually been a plan presented yet to be for or against. I'd like to see the possible options discussed, but it's not happening right now and it's insanely frustrating.

Anyone else have thoughts on the current political climate, particularly with regards to health care?

Roxie

08-13-2009, 04:05 AM

I'm pretty much having the same experience/reaction as you Swede

Samurai_Pooh

08-13-2009, 04:55 AM

It seems the right-wing lunatics are really coming out of the woodwork for this issue.

CNagy

08-13-2009, 10:17 AM

It's not really fair to blame it on the actions of a few people on the extreme right. In my opinion, the GOP has gotten so desperate since their defeat across the board in elections that they have abandoned any pretense of civil discourse.

You have Sarah Palin (love her or hate her, she is influential) warning people about death panels. You have Newt Gingrich backing her up and talking about "communal standards." Not only are these blatant falsehoods, but even a few moments of sustained logical thought prove them to be ridiculous.

Are we to believe that the Congress, who wouldn't reinstate a draft (which is the equivalent to political suicide), is going to create panels condemning peoples' parents and children? Few are the voters without aging parents and, even setting that aside, the sort of callous disregard for human life that the GOP insists is coming down the pike cannot logically co-exist with an America that has many, many firearms. It sounds crazy to use our right to bear arms in this manner, but I imagine a father whose child has just been denied life-saving care would not be in the most solid frame of mind.

The behavior of people who believe that their image of America--their ideal of America--is inherently correct, who feel that the majority has stolen their America, is appalling. The nutjobs have taken over my party, and they are whipping into a frenzy the ignorant, God-fearing folk who look to them for guidance. It's a betrayal of the system, and I've half a mind to call it treason.

darighaz

08-13-2009, 01:48 PM

Quick prediction - In a few years there will no longer be a republican party. There will be a new party that is what the repubs used to be, and the current repubs will be like the Whigs or some shit.

Fred

08-13-2009, 04:25 PM

I think it is clear that the Republican Party leadership is focused on defeating any Obama initiative regardless of what it is and regardless of what it costs.

In regards to health care, our national health statistics indicate there is significant room for improvement. I would love to hear different strategies for improving those statistics while decreasing the cost of health care. The idea I like best so far is to simply open Medicare to everyone.

darighaz

08-14-2009, 12:11 AM

Remove the ability to sue for monetary malpractice rewards. You can only go after license suspensions/revokations. Say good bye to defensive medicine + stupid malpractice insurance costs.

Matt W

08-15-2009, 02:09 AM

I too am disgusted by the health care "debate" that has been going on. The wingnuts are really out in full force. That guy at the townhall who told his congressman to keep his damn government hands off my Medicare is indicative of how little people in this country understand the issues. I really hope Obama and the Dems show some backbone and don't cave in to pressure to be moderate and bipartisan, and thus weaken the bill too much. A strong public option is necessary for this to be a success. It's times like these I wish we had someone like Lyndon Johnson leading Congress. Someone needs to tell Reid you don't need 60 votes to get something passed in the Senate.

qwert

08-15-2009, 04:17 AM

I am biased for the current system. One day in the next 3-4 weeks I am going to update myself on the current health care situation. My experience talking to doctors is that they hate the new health care plan. In addition, I go to the doctor very frequently. So, I really like health insurance. You can't beat $5 an Rx. May not be the latest and greatest, but doctors write the cheapest med for me whenever possible. I'm not sure it would be possible to get an appointment with a cardiologist the very next morning after being told there was no available date until the next week under the new plan.*

*I told them my doctor wanted me to see the cardiologist as soon as they could take me. My doctor told me to call him back and tell him the date they gave me. He didn't like it, so he told me to call them back and say it needs to be asap as according to him. I got a spot for the next morning. I got a very thorough interview from a nurse who gave me an EKG. Then a very awesome PA continued the interview and answered all my questions. Moments later I got an echocardiogram. Finally the big guy came and saw me after looking at all my stuff and gave me the lay down. All of this happened in the course of 1 hour, including the initial waiting time in the waiting room.

Roxie

08-15-2009, 04:46 AM

Fermented Yeast Paste

08-15-2009, 05:31 AM

I really want a public or close to NHS option as we can get.

I would also like the ppl who have the actual details on what's in the bill to take control of the conversation. This past week I've heard:

Obama thinks white people are terrorists
This bill will force women to have abortions
This bill will force hospitals to hire more gays & transsexuals
Death panels

Everyday it something more ridiculous & disheartening
There are like 5 different proposals for reform floating about in different committees (Or were, but Congress is now in recess). The general opinion is that all have pretty big concessions to health insurance companies, it just depends on to what extent. The Finance Committee's bill, for example, as either an extremely weak public option or none at all. The Finance Committee chair, Senator Baucus, is also one of the biggest recipients of money from insurance companies.

Not really any of the proposals have actually anything hopeful unless some serious overhauls take place at this point. The public option we'll get is likely to be weak or open only to very few, which kind of negates the idea of a public 'option'. Subsidies sponsored by the government for lower-income families are likely to phase out early on, and from what I know, a proposed cap on out of pocket expenses per year ($5000) doesn't include the cost of premiums or some nonsense like that.

For what it's worth, apparently HR 676 (Medicare for All) will be voted on in September, so you can call your Rep to voice your support for it, I guess. Personally I'd prefer something like Canada's system. NHS wouldn't be bad either, but I don't see the point in making all hospital workers government employees.

qwert

08-15-2009, 07:09 AM

http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.676:

You can look up whatever you need to know.

May be helpful: http://www.opencongress.org/bill/111-h3200/show

Motivation for opencongress...I have no idea. I wouldn't trust anyone who summarizes things for you. Just get it from the primary source. Having someone else explain it to you defeats objectivity.

CSPAN sometimes has interesting talks going on.

http://www.c-span.org/

=-=-=

Reading the news is wasted time. Just read the actual stuff for yourself. There is no point musing over media drivel.

Fermented Yeast Paste

08-16-2009, 04:33 PM

I really want a public or close to NHS option as we can get.

Just adding to my previous post. Probably the most likely way that this would ever happen would be for something like single-payer to pass in a few big states and have others eventually do the same thing. The state most likely to pass something like that at this point is probably California, which has passed single-payer legislation in the past but it was vetoed by Schwarzenegger. The bill (SB 810) will be heard again in the CA State Senate in January 2010.

And an amendment by Kucinich was voted on and passed in one of the House committees covering health care reform that made it easier, through federal funding I believe, for states to pass their own single-payer plans. There isn't some law saying that states can't at the moment, it'd just make it easier for them.

EDIT: It was the House Education and Labor Committee.

darighaz

08-17-2009, 05:57 PM

I still like my idea.

Public health care will suck because our govt is terrible at running.... everything. I agree w/ healthcare for all, but the way to do that is make the insurance market easier to break into. Enhance competition in the market, and prices will come down, while quality will go up. And it wont be on our dime.

Roxie

08-17-2009, 07:35 PM

I wouldn't mind paying for it to increase the quality of life.

Trump

08-17-2009, 09:42 PM

Does that include decreasing the quality of life for others?

Everything has draw backs, a public health insurance option costs everyone (except those who do not pay taxes...) more money to fund it. In the long run it is likely to reduce services currently offered by insurance companies to compete on price. The government will not do anything efficiently, and there will be hundreds of crazy groups and boards set up in some crazy bureaucratic nightmare. Seriously, this is not the right solution.

I'd be more supportive of the government setting up a public / free hospital in cities, and smaller clinics in the country. Then you have an option whether to go to these or pay for private care. If wait times are too long, people will spring for the private care or wait until they can set up more facilities. Simple. You go there and have a doctor's appointment like today. No crap about public insurance, no crap about forcing public options, nothing. Why is nothing like this even considered? Why is it always focused on insurance instead of care? Why does everyone miss the point that this is simply a crazy political power grab into another market and most of the democrats in power couldn't give a rats ass about our actual health. Remember, these people have the best plans in the nation and won't be affected one way or the other.

darighaz

08-17-2009, 11:48 PM

I agree w/ part of trumps point.

Giving away insurance isn't the answer.

Reducing the base cost of care is.

Any doctor will tell you malpractice insurance is hugely expensive. This drives up the price of care. Remove the ability to sue malpractice, and defensive medicine goes away, along w/ a HUGE chunk of the costs. The cost of defensive medicine is in the hundreds of billions.

CNagy

08-18-2009, 04:34 AM

I don't recall any of the plans talking about "giving away" health care. These plans are not free, and lower income families would be subsidized by a tax on families making (last I heard) over $350,000. Additionally, the part of paying for the plan comes from reducing inefficient spending.

This idea that the government can't run anything is baffling. On any given day (and most likely any given hour of the day), you make use of or interact with some system or structure put in place and maintained by the government (be it local or federal.) Of course it isn't perfect. These systems are run by people, and people can be lazy, unhelpful, and (god forbid) incompetent--this can make part of the system break down. But that is a failure on behalf of the cogs, and does not invalidate the machine itself. This is how we can have a very good medical plan for the military (government run mandatory health care) and have medical horror stories of the same.

It sums up the insincerity of conservative opposition that they can talk about how government can't run a health care system out of one side of their mouth, and talk about how our troops get the best medical care out of the other side.

Fermented Yeast Paste

08-18-2009, 05:08 AM

It sums up the insincerity of conservative opposition that they can talk about how government can't run a health care system out of one side of their mouth, and talk about how our troops get the best medical care out of the other side.

Haha I'm reminded of this interview from the Daily Show:

http://www.thedailyshow.com/watch/mon-july-27-2009/bill-kristol

Roxie

08-18-2009, 05:18 AM

Does that include decreasing the quality of life for others?
I thought I was clear. YES
edit: I misread you. I thought that was increasing.
A rising tide lifts all boats

Plekto

08-18-2009, 03:54 PM

Just remember one thing:

This only covers people who don't have *any* insurance currently or who work for very small companies. Something is better than nothing.

Trump

08-18-2009, 05:07 PM

I can think of 536 broken cogs right now (435 + 100 + 1). I do believe it is possible to set up a working, effective system. This isn't it. This is exactly like what happened with the banks and car manufacturers. The US government now owns 80% of AIG. The US government was instrumental in the dismantling of the car manufacturers who needed money. This is simply an attempt at another market. These politicians obviously thrive on control of power and money, not the best interests of the country.

And do you really see this government managing money effectively? I've seen them throw away billions and billions of dollars on stupid crap in the last couple years. Has it helped the economy? Not one bit. Every job they help create has come from a job they cut in another industry. Help the autoworkers by screwing the aerospace. Build roads and screw teachers. I don't even think we have a space program any more. So has this government improved the country at all? Not really.

So while it is possible to set up a viable system, I do not believe our current federal government has the capability nor cares enough to do it right.

CNagy

08-18-2009, 07:31 PM

You go to <reform> with the <government> you have, not the <government> you wish you had.

We've waited too long to reform health care as it is. Unfortunately, the senators and representatives have no real vested interest in reforming health care and some vested interests in not reforming it, so the plan is probably going to come out pretty weak.

mawande

08-20-2009, 04:49 AM

I don't know if Ebert's blog on the subject has been mentioned yet, but here it is. And I'm sticking with my President.

http://blogs.suntimes.com/ebert/2009/08/death_panels_an_excellent_phra.html

Trump

08-20-2009, 06:02 PM

Have you actually read the bill? I understand you are bashing people that have never read the bill, but you seem to be supporting it just as blindly as they are bashing it.

To find the bill:
http://thomas.loc.gov/home/c111query.html
In the very first choice, change it from "Word/Phrase" to "Bill Number" and type in "H.R.3200"
I tried a direct link but it didn't work right, so this is how you find it from the government website.

Read it over, then decide whether you want to support it.

Roxie

08-20-2009, 10:27 PM

Folks in the White House Answer Your Healthcare Reform Questions, No Matter How Dumb
(http://www.jackandjillpolitics.com/2009/08/folks-in-the-white-house-answer-your-healthcare-reform-questions-no-matter-how-dumb/)

Plekto

08-21-2009, 04:53 PM

Very nice site. The problem is that the RNC essentially has a standing order that their goal is to hinder and disable *any* legislation from Congress no matter what it is. It's simply that they don't want the Democrats to be seen as successful and to get any credit at all for anything.

A lot of people as a result are calling for the Democrats to pull out their pimp hand(as it were) and call their bluff. Force them to filibuster until they literally give up or collapse. Over and over again until the media and public realize that they are just being obstructionist spoilsports. I'm sure that the Senators will love having to actually get up and talk against supporting our troops or health care or retirement funding or whatever else that they are against. I'm sure their opponents in the next elections will have more than enough media coverage to pummel them silly.

Because playing along nicely and wanting everyone to be friends isn't working. They have the 51+ votes so get on with it. (and the bitter old fools won't actually risk being in the media spotlight for days at the risk of votes so it's not really a real threat)

P.S. I'd replace Pelosi with the most aggressive and mean person you could find. No more being friends. We hate you and we are taking names and kicking down your doors type.

Matt W

08-22-2009, 03:08 AM

Dem. Rep. Anthony Weiner very persuasively (in my view) makes the case for the public option, and government involvement in health care in general. I wish more people would so clearly lay out the benefits of this, and point out how useless health insurance companies are.

http://www.youtube.com/watch?v=MIF_dWwxAHE

BTW Plekto, I don't think the House and Pelosi are the problem, it's the Senate and Senate Majority Reid that need to learn how to play hardball. Reid is so ineffectual and has so little backbone, it infuriates me. I agree that they should just make the Republicans filibuster.

Plekto

08-22-2009, 11:44 AM

Yes, but he's not going to move without the House also taking a hard line on this. Or Obama. Someone needs to get the message out. Because it's like trying to be friends with a shark. You either fight back or you get mauled.

Trump

08-24-2009, 05:59 PM

Roxie

08-24-2009, 08:01 PM

There is absoluately no accountability there, and the president has shown he is adept at that (1 year later and still almost 100 positions have not been filled).
Huh? One year later with what/who?

Matt W

08-24-2009, 11:16 PM

My take on the bill...

It really changes very little. The public option seems like it is going to be run almost exactly the same way as any other insurance plan/company. People still have to pay premiums and deductables like current plans. If there were any real differences, can you please point them out? So is it really all bad? No. But if nothing is changing, why are we going through all this trouble?

My problems with the house bill as I've seen it.

1) Apparently, to congress, "make health care affordable" really means "limit profit to insurance comapanies". So there is wording there about the medical loss ratio. On a good year, they'd have to give rebates back to their customers to limit the amount of profit they can make. In a bad year where they have higher than average medical costs? I guess they are screwed. I think that in itself would make me want to close down my insurance business.

2) I do not agree with the fact that at least 13 new positions are created and every single one of them is appointed directly by the president or another person who was appointed directly by the president. There is absoluately no accountability there, and the president has shown he is adept at that (1 year later and still almost 100 positions have not been filled).

3) "Premium Credits" are only available to those who make 400% below the poverty line. So yeah.... this doesn't really change anything.

So really, this bill creates a new insurnace company, except this one has absolutely no accountability to its shareholders (the tax payers instead of investors). There are no efforts at all to make health care actually affordable at all, and not many people will see advantages from it. Why would anyone vote for this bill if they knew what was really in it?

You seem to just have a deep distrust of government. There are many important reforms that need to be made, and will likely be made whenever we see the final bills.
From Obama's recent NYT OP-ED:

There are four main ways the reform we’re proposing will provide more stability and security to every American.

First, if you don’t have health insurance, you will have a choice of high-quality, affordable coverage for yourself and your family — coverage that will stay with you whether you move, change your job or lose your job.

Second, reform will finally bring skyrocketing health care costs under control, which will mean real savings for families, businesses and our government. We’ll cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies that do nothing to improve care and everything to improve their profits.

Third, by making Medicare more efficient, we’ll be able to ensure that more tax dollars go directly to caring for seniors instead of enriching insurance companies. This will not only help provide today’s seniors with the benefits they’ve been promised; it will also ensure the long-term health of Medicare for tomorrow’s seniors. And our reforms will also reduce the amount our seniors pay for their prescription drugs.

Lastly, reform will provide every American with some basic consumer protections that will finally hold insurance companies accountable. A 2007 national survey actually shows that insurance companies discriminated against more than 12 million Americans in the previous three years because they had a pre-existing illness or condition. The companies either refused to cover the person, refused to cover a specific illness or condition or charged a higher premium.

We will put an end to these practices. Our reform will prohibit insurance companies from denying coverage because of your medical history. Nor will they be allowed to drop your coverage if you get sick. They will not be able to water down your coverage when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime. And we will place a limit on how much you can be charged for out-of-pocket expenses. No one in America should go broke because they get sick.

Most important, we will require insurance companies to cover routine checkups, preventive care and screening tests like mammograms and colonoscopies. There’s no reason that we shouldn’t be catching diseases like breast cancer and prostate cancer on the front end. It makes sense, it saves lives and it can also save money.

This is what reform is about. If you don’t have health insurance, you will finally have quality, affordable options once we pass reform. If you have health insurance, we will make sure that no insurance company or government bureaucrat gets between you and the care you need. If you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan. You will not be waiting in any lines. This is not about putting the government in charge of your health insurance. I don’t believe anyone should be in charge of your health care decisions but you and your doctor — not government bureaucrats, not insurance companies.

Trump

08-25-2009, 04:50 PM

Huh? One year later with what/who?

When a new president is elected, he appoints a ton of people to his cabinet and other governmental offices. There are something on the order of 400 positions. Most have to be confirmed by the senate.

I saw an article last week stating there are still almost 100 positions unfilled. I am no commenting on the reasons, but simply stating that since he is almost 25% of the way through his term and still has that many open positions, adding even more to the list of people he needs to come up with seems like a dumb idea.

Roxie

08-25-2009, 05:15 PM

Yeah, it hasn't been a whole year yet.

Trump

08-25-2009, 05:21 PM

You seem to just have a deep distrust of government. There are many important reforms that need to be made, and will likely be made whenever we see the final bills.
From Obama's recent NYT OP-ED:

There are four main ways the reform we’re proposing will provide more stability and security to every American.

First, if you don’t have health insurance, you will have a choice of high-quality, affordable coverage for yourself and your family — coverage that will stay with you whether you move, change your job or lose your job.

Second, reform will finally bring skyrocketing health care costs under control, which will mean real savings for families, businesses and our government. We’ll cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies that do nothing to improve care and everything to improve their profits.

Third, by making Medicare more efficient, we’ll be able to ensure that more tax dollars go directly to caring for seniors instead of enriching insurance companies. This will not only help provide today’s seniors with the benefits they’ve been promised; it will also ensure the long-term health of Medicare for tomorrow’s seniors. And our reforms will also reduce the amount our seniors pay for their prescription drugs.

Lastly, reform will provide every American with some basic consumer protections that will finally hold insurance companies accountable. A 2007 national survey actually shows that insurance companies discriminated against more than 12 million Americans in the previous three years because they had a pre-existing illness or condition. The companies either refused to cover the person, refused to cover a specific illness or condition or charged a higher premium.

We will put an end to these practices. Our reform will prohibit insurance companies from denying coverage because of your medical history. Nor will they be allowed to drop your coverage if you get sick. They will not be able to water down your coverage when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime. And we will place a limit on how much you can be charged for out-of-pocket expenses. No one in America should go broke because they get sick.

Most important, we will require insurance companies to cover routine checkups, preventive care and screening tests like mammograms and colonoscopies. There’s no reason that we shouldn’t be catching diseases like breast cancer and prostate cancer on the front end. It makes sense, it saves lives and it can also save money.

This is what reform is about. If you don’t have health insurance, you will finally have quality, affordable options once we pass reform. If you have health insurance, we will make sure that no insurance company or government bureaucrat gets between you and the care you need. If you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan. You will not be waiting in any lines. This is not about putting the government in charge of your health insurance. I don’t believe anyone should be in charge of your health care decisions but you and your doctor — not government bureaucrats, not insurance companies.

Are you done spouting that propoganda BS? Have you actually looked at the proposed bill???? WTF

First, you currently have a choice of insurance. I don't understand how a public option will be magically affordable. It isn't going to be financed by tax dollars, it is going to be run very similarly to current systems with premiums you pay based on risk.

Second, how the hell does fixing insurance change the cost of medical procedures? It doesn't. The only provision for making anything cost less is them waving a finger at the insurance companies and saying "don't make too much profit!!!" On top of that, the people deciding how much profit the insurance companies make are all politicians and likely to be in the pocket anyway. That affects affordability? Last I checked it doesn't change much at all.

Third, did I mention medicare? I'm confused here... (oh right, you don't actually respond to comments, you just spout what other people have told you to say) I have no problem with medicare reform, if done right. I haven't been paying attention to that as I'm not knowledgeable enough about the subject to make informed decisions.

Lastly, it is apparently not fair to charge someone more money when they are very likely to require expensive medical treatments? Holy crap... I would have never thought that in a business based around charging people on risk assessment that might happen. There are a couple options here. A) Charge those people more to cover them. B) Charge everyone else more to cover them. C) Don't charge anyone more and go out of business. The government apparently feels that A) is not fair, so they will force either B) or C). Wow... this is a great and free country we live in.

I'm sorry if I come across as abrasive. I'm trying very hard not to cuss. I'm tired of people spouting crap from corrupt and greedy politicians mouths. All I have to go on is the house version of the bill that Obama himself was trying to push through the system as fast as he could. I looked at the bill and didn't see 2/3 of what mentioned in your New York Times article. Remember, if Obama had his way, that was going to be the final version of the bill! Don't you see the priorities of these... <insert multiple cuss words here> people running our government? I don't know their final goals, but I can tell you the interests of most American citizens are not their concern.

The inability of people to think for themselves is going to be the end of this country.

Fermented Yeast Paste

08-25-2009, 07:05 PM

For what it's worth I'm pretty liberal and I'm pretty heavily against the current bill in the House as it is. The only thing I'm being optimistic about is keeping the single-payer amendment in, but that will probably get thrown out in conference.

Matt W

08-25-2009, 11:47 PM

Are you done spouting that propoganda BS? Have you actually looked at the proposed bill???? WTF

First, you currently have a choice of insurance. I don't understand how a public option will be magically affordable. It isn't going to be financed by tax dollars, it is going to be run very similarly to current systems with premiums you pay based on risk.

Actually, like millions of Americans, I don't really have a choice of insurance. Tried to get it, they denied me because I had a prescription for sleeping pills and have scoliosis. I would have to pay insane amounts to get even shitty coverage.

Second, how the hell does fixing insurance change the cost of medical procedures? It doesn't. The only provision for making anything cost less is them waving a finger at the insurance companies and saying "don't make too much profit!!!" On top of that, the people deciding how much profit the insurance companies make are all politicians and likely to be in the pocket anyway. That affects affordability? Last I checked it doesn't change much at all.

Third, did I mention medicare? I'm confused here... (oh right, you don't actually respond to comments, you just spout what other people have told you to say) I have no problem with medicare reform, if done right. I haven't been paying attention to that as I'm not knowledgeable enough about the subject to make informed decisions.

Lastly, it is apparently not fair to charge someone more money when they are very likely to require expensive medical treatments? Holy crap... I would have never thought that in a business based around charging people on risk assessment that might happen. There are a couple options here. A) Charge those people more to cover them. B) Charge everyone else more to cover them. C) Don't charge anyone more and go out of business. The government apparently feels that A) is not fair, so they will force either B) or C). Wow... this is a great and free country we live in.

First of all, I didn't write my previous post, as I said at the top of it, it is from Obama's NYT OP-ED. I was only giving a quick (you could say lazy) answer to the last question of your previous post about why someone would support Obama's plan.

Why do you think private health insurance companies are better than government providing the insurance? Health insurance premiums have nearly doubled in the past decade, and it's just going to get worse. They do their very best to deny coverage to anyone that might actually need to use what they are selling. When people get sick, they do everything they can to not pay for what you need. Why does health insurance need to be for profit, how does that make it better??? It's not a commodity, it's just the payment mechanism.

Americans pay way more for their health insurance then people in other industrialized countries, and polls show they aren't as happy with what they get, nor are we the healthiest country. Health insurance companies spend between 20-30 cents of every dollar on administrative costs and overhead, Medicare spends 4 cents of every dollar. A good portion of the health insurance admin costs are paid to deny people coverage!! A public option wouldn't have to pay employees to weed out who they think will be expensive to cover, it wouldn't have to pay for advertising, etc...It would also be cheaper because it's basically one big group policy, rather than an individual having to buy an individual policy. Also, local and state governments especially are paying massive amounts for uninsured people (who can't afford to pay) that go to the ER instead of a regular doctor because they don't have insurance. Also, since they don't have insurance, they often wait until problems are much worse, when they could've caught the problem early on when it would be much easier (and cheaper) to fix, if they had had insurance.

The reforms he has proposed include the following objectives:

1.Elimination of pre-existing condition criteria for insurance denial (12 million people in the last three years were denied insurance or coverage due to pre-existing conditions)
2.Maintenance of coverage during time of unemployment (the precise time when insurance is crucial but it is the time when most Americans lose coverage)
3.Limit on out of pocket expenditures
4.Minimum standard of care (required coverage for certain tests and procedures-preventative medicine)
5.Increased competition (preferably with the public option) and
6.Cost control

At a minimum, the impact would be:

1.Insurance companies held accountable
2.Security and stability: seeking health care will no longer be something to avoid and will no longer lead to possible financial ruin
3.A healthier populace
4.People's health rather then private insurance companies profits are the priority

This not a radical notion but rather a reality in all industrialized countries. In Switzerland, Germany, the UK, Canada, Japan, Taiwan, Australia, Italy,. . . people do not go bankrupt due to the cost of health care because they are sick but rather generally live longer and healthier lives then Americans.

The reality is that the current system in the US is a mixed system: employer based coverage, private insurance purchased by an individual or family and government coverage. Medicare has given a future to seniors across the country (the least cost effective and bureaucratic element is the medicare Advantage program which was a gift to private insurance companies to use taxpayers money to supply services at a higher cost then traditional Medicare), the VA medical system is a blessing to our veterans, Medicaid has given a lifeline to many of the poorest citizens in our country and the SCHIP program is successfully giving millions of children a prospect for a healthy future. All of these are government run programs helping the sickest and most vulnerable in society. Private insurance companies are in the business to make a profit and therefore prefer to insure the healthy and young-it is only due to government regulations that group insurance plans (employer based plans) cannot discriminate due to pre-existing conditions.

When it comes down to it, I don't really trust government either, but I sure as hell trust government more than I trust health insurance companies. I don't have the attitude that what is important is the free market and profits when it comes to health. I think health care should be a basic human right in the country with the largest economy in the world. Again, the rest of the developed world already has it.

stsparky

08-26-2009, 03:16 AM

Just make sure whatever plan we end up with - our legislature has to use it as well.

darighaz

08-26-2009, 03:59 AM

I maintain. Fuck making a new plan, or any plan. Remove malpractice. THAT will bring the cost of care down. and THAT is the only real solution.

stsparky

08-26-2009, 04:24 AM

Malpractice is needed. I say nationalize the insurance companies.

Fermented Yeast Paste

08-26-2009, 04:30 AM

I maintain. Fuck making a new plan, or any plan. Remove malpractice. THAT will bring the cost of care down. and THAT is the only real solution.
Says who?

So you think removing the freedom to file a lawsuit for something like wrongful death is more important than fixing things like rescission; pre-existing conditions; high co-pays, premiums and deductibles; for-profit schemes; high administrative costs; lifetime maximums, and the like? Even after watching these two programs: Sick Around America (http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/) and an interview with a former Vice President at CIGNA (http://www.pbs.org/moyers/journal/07102009/watch2.html). Ending all malpractice is still more important than that?

That absolutely makes no sense unless you tell me you're a shareholder for Blue Cross or something.

We do not live in a bubble of American exceptionalism. There are plenty of solutions shown in other industrialized nations at reforming health care that don't involve removing malpractice.

Trump

08-26-2009, 05:18 PM

Answer me this: If Medicare and Medicaid and the Veteran's care system all work so well why aren't we expanding those instead of the current plan?

The current "new" insurance group plan or whatever it is will be run just like an insurance company. They will decide premiums based on expected costs. If they add in ---

1.Elimination of pre-existing condition criteria for insurance denial (12 million people in the last three years were denied insurance or coverage due to pre-existing conditions)
2.Maintenance of coverage during time of unemployment (the precise time when insurance is crucial but it is the time when most Americans lose coverage)
3.Limit on out of pocket expenditures
4.Minimum standard of care (required coverage for certain tests and procedures-preventative medicine)

--- then how the hell is it going to be cheaper? It won't. You say private companies have 20-30% overhead, so reduce the cost by 20-30% and then add 50% for increasing services. I believe many people will be surprised how much it costs.

Overall, the insurance system is broken, completely. I do not agree that private insurance is a good thing at all. I just simply believe that adding a broken concept to a broken system only breaks things worse.

darighaz

08-26-2009, 06:10 PM

Says who?

So you think removing the freedom to file a lawsuit for something like wrongful death is more important than fixing things like rescission; pre-existing conditions; high co-pays, premiums and deductibles; for-profit schemes; high administrative costs; lifetime maximums, and the like? Even after watching these two programs: Sick Around America (http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/) and an interview with a former Vice President at CIGNA (http://www.pbs.org/moyers/journal/07102009/watch2.html). Ending all malpractice is still more important than that?

That absolutely makes no sense unless you tell me you're a shareholder for Blue Cross or something.

We do not live in a bubble of American exceptionalism. There are plenty of solutions shown in other industrialized nations at reforming health care that don't involve removing malpractice.

Sue them for a license. Remove the monetary gain from the equation and get them where it actually matters. If someone is a bad doctor they shouldn't be paying a fine, they shouldn't be allowed to practice.

Getting everyone insured is great for insurance companies but does very little for the problem in health care costs. The cost of health care. Ask any doctor and they will tell you that malpractice insurance reams them, and they do tons of needless costly tests in order to try and not get sued for malpractice.

Dont think of it as removing the ability to get justice, think of it as changing how that justice is dispensed

Roxie

08-26-2009, 06:20 PM

If someone is a bad doctor they shouldn't be paying a fine, they shouldn't be allowed to practice.
they should do both.

Fermented Yeast Paste

08-26-2009, 06:22 PM

Answer me this: If Medicare and Medicaid and the Veteran's care system all work so well why aren't we expanding those instead of the current plan?

Before I answer this, tell me this Trump. Do you think people like me are currently advocating the current proposed plan as actual reform? Because I'm not. As to why we don't expand Medicare to all because it works so well? It'd hurt the insurance companies, and those same insurance companies have bought off both Democrats (Kent Conrad, Max Baucus, etc.) and Republicans alike, both in the House and Senate. That is why simply expanding Medicare to include everyone isn't being considered. The legislation that would do this, HR 676, has been introduced and has a handful of cosponsors but no one else really wants it to pass.

Getting everyone insured is great for insurance companies but does very little for the problem in health care costs. The cost of health care. Ask any doctor and they will tell you that malpractice insurance reams them, and they do tons of needless costly tests in order to try and not get sued for malpractice.

So then introduce a strong, non-profit insurance option through the government to compete with health insurance companies, which is barely being considered at this point on Capitol Hill.

darighaz

08-26-2009, 07:10 PM

The fines on malpractice suits ARE abused. People sue exorbitant costs on EVERYTHING, and at this point you could more or less say, They've ruined it for the rest of us.

FYP - You keep missing the point. How you get your insurance isn't the problem. How much you pay for insurance isn't the problem. The problem is that the cost of that which you are insuring against is stupidly huge, and needs to drop. THAT is what we need to reform. HEALTH CARE reform, not insurance company reform, or insurance company competition improvement.

Making health care affordable IS NOT the same thing as making insurance affordable. The cost of care itself needs to come down. Eliminating defensive medicine and huge costs to the doctors themselves will bring the COST OF CARE down.

Bad doctors need to be punished, but the way to do that SHOULD NOT be take insurance against everyone suing you for tons of stupid shit. Having an intelligent penalty system should be the solution.

CNagy

08-26-2009, 08:50 PM

You lost me at the idea that making health care affordable does not go hand in hand with making insurance affordable. I'm curious to see any sort of data that supports that assertion.

darighaz

08-26-2009, 09:26 PM

Making insurance affordable, w/out changing how much the care costs, just means that the insurance company has to pay more, and we have to pay less.

Making health care availiable means that for those that cannot afford health insurance, they're not neccesarily totally screwed if they get a bill.

Making the cost of care reasonable != making insurance cheap.

Insurance is not the answer to all questions.

CNagy

08-26-2009, 09:59 PM

Ignoring insurance practices and abuses as a major factor in the cost of health care is simply disregarding whatever you feel like.

The topic is Health Care Reform--not Health Insurance Reform. There is a significant difference, because the latter is a subset of the former. Health Care and Insurance are so completely intertwined that the idea that you can fix one without taking the other into account is absurd.

darighaz

08-26-2009, 11:32 PM

Wouldn't insurance be irrelevent if health care was cheap.

Why not make it the goal that insurance isn't needed, because health care doesn't cost so damn much.

CNagy

08-27-2009, 12:21 AM

That might be a good mental exercise, akin to constructing utopias and the like. Back in reality, though, the idea of eliminating the need for insurance through somehow just making it health care cost less--in effect, removing the market for health insurance--is one that simply no one will endorse. It moves a dozen steps past "give the insurance companies competition to keep them honest" and goes straight to "let's put them out of business by making healthcare cost dimes on the dollar." It's not even worth serious consideration.

darighaz

08-27-2009, 12:27 AM

CNagy

08-27-2009, 02:44 AM

Agreed, health care will never be super free.

However more effort DOES need to go into figuring out how to REDUCE the cost. This will in turn cost the insurance less. Which should in theroy make them charge YOU less, or at least allow you to get a cheaper plan. Eliminating the circus of malpractice cash-suits helps.

Work on the heart of the problem rather than its symptoms.

Edit : Why is it bad to put them out of buisness? People living should trump keeping insurance comps going.

Emphasis mine, and really one of the major reasons your proposal falls flat. Health Insurance Providers have a laundry list of abuses and examples of greed--many of which have nothing to do with providing doctors malpractice insurance. You propose removing malpractice lawsuits, which negate the need for malpractice insurance. If that happens, insurance companies lose a portion of their profits, because the malpractice policies they used to make money off of no longer exist. And you think that would give them an incentive to lower their prices elsewhere? Seriously?

And what reason does a hospital have, really, to lower their prices by the same measure? When you are a company that suddenly has one of a reduction in cost, do you see a chance to pass the savings on to your customers or a chance to make a very profitable quarter? Realistically, it would be a bit of both, but let's try and stay realistic when we imagine which of the two choices is the more heavily chosen.

And your idea of suing to remove a doctor's license to practice is inherently flawed. Exactly how attractive is a job as a doctor going to be (Pre-Med, Med school, time spend in residence... 10 years or so of education at least?) when you can lose it because you had a bad day, or made a mistake? Let's go to theory: your proposed plan will decrease the supply of licensed doctors. A decrease in supply increases demand and thus the amount that doctors are paid. Paying doctors more raises costs, as does a relative scarcity of doctors which leads to fewer procedures.

Effort does need to go into reducing the cost--except that's one of the goals of health care reform. And Insurance Companies will, in theory, be made to charge less--not because of some reduction in their cost, but rather a public option that forces them to trim down obscene profit margins to stay competitive.

Is it going to be perfect? Of course not, but I'll settle for it becoming less awful than it is now. Your plan, at best, seems to change nothing and, at worst, simply creates a whole new batch of problems while doing little or nothing to address the current problems.

Edit: False dichotomy. You propose an either-or (people live or insurance companies stay in business) when no such choice is necessary. There is a workable solution that results in insuring the uninsured, reducing cost, and keeping the market competitive (the proper sort of reform).

Plekto

08-27-2009, 06:44 AM

A very good synopsis there.

Remember - the first thing that you have to do with all plans and theories is to ask yourself "how easy to abuse and take advantage of is this?"

The problem is that the insurance companies hold almost all of the cards and absolutely will lie, cheat, steal, and even let people die to make a profit. Unless there is either another option or the Government comes down on them with a two ton hammer, they will suck and bleed every last dime that they can before they are finally brought down kicking and screaming.

Trump

08-27-2009, 04:51 PM

The same can be said about the 20 politicians playing doctor that get appointed to important positions under the new plan. They will do everything they can to obtain and maintain their power. I'm really not arguing against anything except the current health care reform bill. It is stupid and should not be passed.

Matt W

09-10-2009, 01:32 PM

Anyone else watch Obama's health care speech to Congress? I thought it was a great speech, though I wish he took a firmer stance in support of a public option. However, I think he laid out the case for his reforms in a way that will speak to moderates and people who don't know much and had been scared by the Republican lies and demagoguery of the past couple months.

Roxie

09-10-2009, 02:39 PM

I pretty much agree with everything you said there Matt W. I wish he'd had a firmer stance, but he's always been moderate. I do not like that abortions won't be covered as they are medical procedures!

Also, Joe Wilson is catching so much hell!

Fred

09-10-2009, 04:19 PM

Wilson should catch hell

Trump

09-10-2009, 06:38 PM

I think the outburst was unprofessional. Was he right? It doesn't even matter. I believe it was calculated to cause a stir and make people really think about whether the President is speaking the truth. In that I believe he accomplished his goals nicely. The only thing I wonder about is whether it was a party plan or just his personal agenda.

The speech itself? Obama is a great speaker, of that there is no doubt. He brings a lot of emotion and passion to the table. However, the content of the speech stunk. The aroma reminded me dog diarrhea inside a rotting skunk corpse. I seriously wanted to puke a few times during the speech. But then again, I look past the emotion to the words he is actually saying and what they mean. Here is why we should not listen to him.

He throws the words "affordable" and "low cost" around like they are corporate donations to politicians. What the hell does affordable mean? Well, I guarantee affordable means something different to the man signing on the line for $5 billion purchases than it means to the man paying $1 for a bus ticket. It isn't just scattered about in his speech, it is all over the legislation too! Come on, anyone who knows anything about defining requirements knows you can't use words like that. That was why the government has to spend millions redoing an Air Force competition for aerial refueling tankers: the requirements were improperly defined. I promise you, follow his grand words of affordability and it can only end up similarly.

He claims there will be choice!! Glorious choice. There will be compeition! Fantasic! But wait, he also says he will create a group that makes all the rules. This "Exchange" is run on the recommendataions of 1 commissioner and 12 appointees. So every company will have to follow the same rules. Hmm... wait, so what is the difference? Why bother with choice if all your choices are the same except for the name on the letterhead and the "pay to" field of your bill? How is that competition. I guess we'll have to pick our health insurance provider based on how much we think their operator smiles over the phone? Wait, here's more choice for you. He says no one will be able to opt out of health insurance. So to add insult to injury, he'll force a choice on people. All of the sudden his choice looks like a new tax. I understand he'll let small businesses off the hook, but every family in the US will now have to pay regardless of what they want to do.

He won't add to the deficit! But it will cost 900 billion dollars. We'll save money by spending more! When asked how that works, all he can say is "there remain some signficant details to be worked out..." Everyone listening laughed at that. Why is that funny??? (except that it is terribly true)

Can't people see how he distracts them with flashy moves while picking their pockets? Look at his comparison to public education. He said public schools didn't hurt competition with private schools. Yet he didn't point out that private schools can compete while charging more by hiring better professors. Last I checked, that didn't work in health care. You'll mostly likely get the same doctor no matter which insurance company you are paying. It's all a beautifully run scam and it makes me sad so many people fall for it. Please, think for yourself, look at what the con man is actually saying before you hand him a blank check.

Plekto

09-10-2009, 07:40 PM

Here is the simple analysis, and how it works:

1:Obama met with the insurance companies and worked out a deal.
a:Insurance companies can't drop or deny you coverage or play similar games.
b:Insurance coverage is mandatory in exchange.
c:You will be fined if you don't comply.
d:There is no public option, so rates won't actually go down.

2:The way they pay for this is smart, sunning, devious, and blatantly immoral, yet nobody has figured it out, because it requires thinking about what happens next when it comes to tax time.

a: There is a tax burden on people making over the poverty limit that scales upwards if they do not "contribute"/get coverage. This much is understood by many.

b: The poorer working classes and middle class, though, routinely get money and refunds from the Government. They get child tax credits, investment credits, tax shelters, education credits, and on and on. The poorer also get earned income credit. Faced with a fine several hundred dollars per person in a familly versus $1200 a month for a family of three(bare minimum coverage, no less), they will take the less costly tax burden every time.

c: The net effect is that this plan will erase over half of the tax refunds for the poor and middle class. They will pay in and get nothing at all back come tax time. This normally is about 110 million payments or $91.834 billion in 2008. (roughly 30 billion in EIC alone)

That's how they plan to pay for it. By charging the companies and the public who buys into the plans and by effectively erasing earned income credit and most refunds.

CNagy

09-10-2009, 08:57 PM

Warning: Long post.

‘(a) Tax Imposed- In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of--CommentsClose CommentsPermalink

‘(1) the taxpayer’s modified adjusted gross income for the taxable year, overCommentsClose CommentsPermalink

‘(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.

Alright, so the penalty for not having adequate coverage is 2.5% of your gross income after deductions. Up to a limit.

‘(A) IN GENERAL- The tax imposed under subsection (a) with respect to any taxpayer for any taxable year shall not exceed the applicable national average premium for such taxable year.CommentsClose CommentsPermalink

‘(B) APPLICABLE NATIONAL AVERAGE PREMIUM-CommentsClose CommentsPermalink

‘(i) IN GENERAL- For purposes of subparagraph (A), the ‘applicable national average premium’ means, with respect to any taxable year, the average premium (as determined by the Secretary, in coordination with the Health Choices Commissioner) for self-only coverage under a basic plan which is offered in a Health Insurance Exchange for the calendar year in which such taxable year begins.

So, first off, getting coverage will never be cheaper than the fines. Average monthly premiums for an individual aged 25-34 (which makes up the highest percentage of the uninsured) is $130, or $1560/year. The poverty threshold for 1 person is $10,830. So, at $11,000 (with deductions already figured in), they pay $275 dollars as a fine. To hit a fine that matches the current average monthly premium, the individual would have to be making in excess of $62,400.

Now, we look at families. As of 2008, the average yearly premium for families was $12,680 for a family of 4. The poverty line for a family of 4 is $22,050. Thus, a family making $22,500 (again, deductions already figured in) would be fined $562.50, and it would take a household income of $507,200 to reach the cap.

This is neither devious nor immoral. The quoted portions come from House Bill H.R.3200, which assumes a public option. In that assumption, the public option has a plan that is the basic acceptable level of health care. And because of that, the penalty becomes more of a way to keep people from coasting along without contributing until they need health insurance, and opt for the public plan. Without a public option, you won't see House Bill level tax penalties in the eventual Health Care reform bill. It is a case of taking the information out of context.

House Majority Leader Harry Reid thinks that a public option could pass in the Senate, so there is a possibility of there being a public option in the final bill. Regardless of whether or not a public option passes, the addition of millions of Americans into the health care system will conceivably lower the cost of premiums, since not being in the system is part of what drives the cost up.

As for Trump, vis a vis "affordable:" health insurance is currently "unaffordable" for millions of Americans, and much of the middle class are one health crisis away from bankruptcy. I assume "affordable", in relation to "unaffordable", is less than what is payed now; lower premiums, better coverage--how much lower and how much better is anyone's guess until we see what the Senate comes up with. And that stays a guess until the House and Senate agree on one form of the bill, etc, etc. I'm sure you already know all this.

Edit: President Obama has met with Insurance providers, but President Obama does not have his own version of the bill. All of the Doomsday scenarios and teeth-gnashing are baseless until we see something tangible from the Senate. President Obama's health care plan is a list of bullet points that he would like to see in the reform. Aside from his veto power, he can only really set the agenda (at the deference of his party.)

Plekto

09-10-2009, 11:54 PM

So basically, all we have is a verbal promise from everyone that the rates won't go up? Well they certainly won't go *down*. Not unless it's written in stone.

1: As near as anyone can tell the outcome of the meeting if you read between the lines between what was being proposed before and after the meeting is exactly what I said. Coverage is more secure. But everyone has to buy it.

The problem, of course, is that penalty. That effectively obliterates the refunds from the poor who still can't afford health coverage(I was quoted $1100 a month for myself, recently, for instance!). Your data on the average payment per year is woefully off compared to what you pay if you are in a major urban area(which is most of the U.S. now). Prices have gone up by insane amounts in the last year. I'm single, healthy, have zero prior conditions at all, and 39. $1100 a month from Blue Cross. I'm sure NOT paying $13,000 a year for coverage. But that's what the prices now are. Go check them out for yourself. It's just insane now. My son was quoted $169 and is 10, perfectly healthy as well. I don't know where that data came from, but it's at least several years old or just cooked.

EDIT - this is for normal coverage. $200 a month coverage that forces you to pay the first $5,000 out of your pocket isn't realistic for the working poor, either. Quoting the cheapest most worthless coverage on the market that's really just money flushed down the drain isn't really fair(though our government loves to do this)

2: They pay the fine rather than pay for the insurance that they can't afford, even though they make more than the nationwide poverty level(note you can't rent a shoebox in Los Angeles making 20K a year...).

This makes them actually poorer since the penalty comes right out of their earned income credit, refunds, welfare, or whatever else that the government is giving them back. It's effectively a 2.5% tax increase on the poor and middle classes. If they don't pay, since it's handled via the IRS, all of the hell that happens when you don't pay your taxes gets unleashed upon them.

So they HAVE to pay the fine. And they STILL don't have coverage, so they burden the rest of us just the same.

Let's use your data above but adjust it to reflect reality.
***
Now, we look at families. As of 2008, the average yearly premium for families was $12,680 for a family of 4. The poverty line for a family of 4 is $22,050. Thus, a family making $46,000 (again, deductions already figured in) would be fined $1125. Post tax, since it's a fine via the IRS.
***

A family of four who is squeaking by on $46,000 a year in Los Angeles or any other major city cannot possibly afford $12,680 out of that amount. They'll have about $33K after taxes to spend, and then pay $12,680 out of that.(! ouch !) Leaving them a bit over 20K for the four of them to live on. There's just no way that anyone can do that, as that's about exactly $1700 a month for 4 people to live on in this case.

So they pay a LOT more in tax($1687.50 in the example above), which obliterates their entire credits and deductions at best, and at worst, forces them to actually PAY out of pocket. And still have no coverage since they are too "wealthy" to get in on the low-cost "below the poverty limit" coverage. (effectively it adds enough tax burden in this case to lower their exemptions on four people to one). Unless the parent(s) claim zero deductions and eat about a 24% tax rate, they'll never see a dime of money back after taxes.

And that's the real goal as I said. To rake in more tax money and give a LOT less of it back.

P.S. when Obama says only 5% will elect to use the plan, that's legal-speak for only 5% will be ABLE to use the plan. The rest of the uninsured in the U.S. will just be SOL and have to cough up the fines or get coverage at full market rates. This happened in California about a decade or so ago - and the rates didn't go down at all. Driving became hugely expensive. But at least you could opt out and take public transportation or a bicycle or just walk.

Matt W

09-11-2009, 02:59 AM

CNagy is right. We live in a society, and just like everyone has to pay into social security to make it work, and everyone pays for public schools so that every child can go to, everyone needs to have health insurance. There is nothing immoral about that, it's what's done in every other rich society. What I believe is immoral is the current system where people who get seriously ill go bankrupt (around 700,000 a year) and whole families are destroyed monetarily and emotionally from the insane stress involved. Many people get sicker and live less full lives than they would have if they could have afforded to go to the doctor when a problem first emerged, or prevented before the patient knew of the problem. Where insurance companies reward employees for finding ways to drop coverage for sick people, talk about a death panel!! I believe that in a rich society like ours, being able to get help when you are sick should be a basic right. Every other developed, capitalist democracy has some sort of system that covers essentially everyone, and health care costs in those countries are much lower than here, the care is high quality and accessible to all, the populations are healthier, and polls show citizens in those countries are more satisfied with their system than Americans. There is nothing radical or immoral about this, it's the free market ideologues that hate government involvement that are against this.

I would point everyone to a great PBS Frontline special called Sick Around the World. It examines the health care systems of five different capitalist democracies (Great Britain, Japan, Taiwan, Switzerland, and Germany.) Switzerland's case is probably the most relevant to the debate here. Before reforming their system in 1994, their system was similar to the current U.S. system(health insurance voluntary, usually linked to employment), and costs were spiraling out of control just like here. They changed it so that everyone was mandated to buy health insurance, with the government paying for the poor, and the government tightly regulates the (still private) insurance companies and health care and drug costs. This has made the insurance companies MUCH more efficient, brought costs down dramatically, and went from being very controversial when first implemented to being broadly accepted among Swiss on both the left and the right of the political spectrum. Now, the Swiss system is still the second most expensive (U.S. being the most expensive) The average monthly premium for a Swiss family is $750 (this doc was made in 2008.) Significantly cheaper than the U.S.!!! Seems to me that government involvement works pretty well in health care systems around the world (just like it does in the U.S. for Veterans and Medicare.) No system is perfect, but our current system is about as imperfect as it gets.

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/