Most Americans Want Universal Health Care

[kallend 1,623]

Seems to show that (1) we are NOT getting what we paid for, thanks to the stupidity of our current system, and (2) by correcting the imbalance in our military expenditures compared with other nations, we could indeed pay for a lot of healthcare, JUST AS I STATED.

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The only sure way to survive a canopy collision is not to have one.

[NCclimber 0]

The current state of VA healthcare makes a pretty compelling case against government run universal healthcare.

YIKES!

[DrewEckhardt 0]

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The US Health and Human Services Budget for 2007 is $697.95 billion, up from $639.66 billion in 2006. Of this, $627,315 billion is for mandatory outlays (Medicare $389.5 billion and Medicaid $204.69 billion). http://www.gpoaccess.gov/usbudget/fy07/pdf/budget/hhs.pdf

If we assume 45 million (42.9M estimated in 2004) enrolled in Medicaid, that's $4548 per person not including states' contributions (up to half) and hospital write-offs due to unreimbursed medicaid expenses (paid for by the rest of us with private insurance).

I've been in group plans that cost $350 a month or $4200 a year for far better coverage.

If we assume 45 million (42.5M in 2005) enrolled in Medicare that's $9164 per person not including the $226 per month premium and high deductables.

That's even worse!

[spudboy 0]

if the US spends $2548 per capita on healthcare and only a % of the citizens are getting government paid healthcare, doesnt that make our system extremely inefficiant in relationship to all those countries listed that spend a similar amount and everyone recieves government paid healthcare?

[penniless 0]

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The current state of VA healthcare makes a pretty compelling case against government run universal healthcare.

YIKES!

Don't equate the ARMY with the government. The Army treats everyone poorly (as GQ-Jumper wrote a couple fo days ago in the Walter Reed thread)www.dropzone.com/cgi-bin/forum/gforum.cgi?post=2701919#2701919

[penniless 0]

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if the US spends $2548 per capita on healthcare and only a % of the citizens are getting government paid healthcare, doesnt that make our system extremely inefficiant in relationship to all those countries listed that spend a similar amount and everyone recieves government paid healthcare?

Not to mention that our life expectancy and infant mortality rate put us in the 2nd tier of nations, despite the high cost.

[DaVinci 0]

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Not to mention that our life expectancy and infant mortality rate put us in the 2nd tier of nations, despite the high cost.

OK but since we already spend more than other countries...What is the solution? Spend even more, or fix the system?

[kelpdiver 2]

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Not to mention that our life expectancy and infant mortality rate put us in the 2nd tier of nations, despite the high cost.

Our ability and insistance on living life in excess is not the fault of the health care system.

[billvon 2,400]

>Spend even more, or fix the system?

Fix the system. Eliminate the dozens of levels of billing, insurance, collection agencies, government forms, laywers, prequalification etc for basic care.

[spudboy 0]

I believe that we should fix the system by duplicating what is working well in all the countries that have healthcare systems superior to ours

[nathaniel 0]

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Not to mention that our life expectancy and infant mortality rate put us in the 2nd tier of nations, despite the high cost.

Our population is not like Iceland and Norway and Luxembourg. In addition to having an upper and a middle class, we have a huge class of people that live in poverty. There's ample demographic data to show this. There's also ample research that demonstrates that impoverished people need different and more healthcare than the wealthy and the middle class.

For this reason, it's not appropriate to compare the US with either 1st world or 3rd world countries. We are a blend of both. Essentially the same X billions of dollars that Europe spends every year on healthcare wouldn't go as far in the US due to our demographic differences.

My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

[lawrocket 3]

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Seems to show that (1) we are NOT getting what we paid for, thanks to the stupidity of our current system,

Oh, I absolutely agree. Interestingly, the this is a common complaint among many of these countries.

And actually, I will agree with you that we are "NOT getting what we pay for." I don't get subsidized medical treatment, and I'm paying for it, while others get it and don't pay for it, "thanks to the stupidity of our system."

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and (2) by correcting the imbalance in our military expenditures compared with other nations, we could indeed pay for a lot of healthcare, JUST AS I STATED.

I agree. And, true, if we took money from defense, we could continue to get less than what we pay for.

My point was that our imbalance in military spending when compared with the rest of the world is probably only slightly less than the imbalance in healthcare spending versus the rest of the world.

It is not "imbalance" that you per se have a problem with, otherwise you'd argue to slash the healthcare budget because our govt. spends more than the next 10-20 countries put together. Rather, it is just your subjective values.

There's nothing wrong with that. Just call it what it is.

My wife is hotter than your wife.

[lawrocket 3]

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if the US spends $2548 per capita on healthcare and only a % of the citizens are getting government paid healthcare, doesnt that make our system extremely inefficiant in relationship to all those countries listed that spend a similar amount and everyone recieves government paid healthcare?

Yep. And some want it that way, like the original poster. People should pay for other people's healthcare until they cannot afford their own, in which case somebody else will pay for theirs, etc., etc.

I'll admit to being bitter about a system that provides no service for those that pay for it and only provides service for those that do not.

We should all get what we pay for.

My wife is hotter than your wife.

[kallend 1,623]

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if the US spends $2548 per capita on healthcare and only a % of the citizens are getting government paid healthcare, doesnt that make our system extremely inefficiant in relationship to all those countries listed that spend a similar amount and everyone recieves government paid healthcare?

Yep. And some want it that way, like the original poster. People should pay for other people's healthcare until they cannot afford their own, in which case somebody else will pay for theirs, etc., etc.

I'll admit to being bitter about a system that provides no service for those that pay for it and only provides service for those that do not.

We should all get what we pay for.

Sorry to be the one to break it to you, but taxes just don't work that way.

How do you feel about this proposal?

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The only sure way to survive a canopy collision is not to have one.

[nathaniel 0]

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What is the solution? Spend even more, or fix the system?

The only solution is to spend way less, and the most likely way to do that is more expensive--as in more of the costs coming out of your pocketbook-- and less (in some cases much less) healthcare for nearly everyone. Some of will be fairly painless, like reducing overhead per Billvon's and just about anyone's rational proposal, although don't count on the Capitol Building and the Whitehouse getting even this right.

But some of it will be abysmal, exposing the depths of poverty that we have in this country. People dying in droves from treatable conditions like diabetes because nobody, not least themselves nor our gov't, can afford to pay for their treatment. It'll be the best we can do to focus on contagious diseases and prevention to minimize the ripple effects of lower healthcare. Basically the safety net is going to have to get thinner, and won't cover nearly as much as it does currently.

My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

[spudboy 0]

I respect your point of view, but what exactly do you suggest we do about all of the people that cannot afford healthcare? Ive been to countries that share your beliefs, and there was lepars begging on the streets, I dont think that would be acceptable in the USA.

[nathaniel 0]

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I dont think that would be acceptable in the USA.

Acceptable is an interpretation. The economics of the situation is incontrovertible. For all the money we have in the US, we do not have enough to achieve European standards of healthcare. To vainly pursue such is to invite economic ruin, and fail at the same time.

My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

[spudboy 0]

After reading some of your posts it seems your solution to America's healthcare problem is to basicly cull the heard, is that correct?

[Lindsey 0]

...and there was lepars begging on the streets, I dont think that would be acceptable in the USA.

Maybe they're not lepars, but they're certainly begging on the streets even here in Arkansas. I don't see where healthcare is more important than housing and food, but there's a lot that people here in our country do without.

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[DrewEckhardt 0]

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Our population is not like Iceland and Norway and Luxembourg. In addition to having an upper and a middle class, we have a huge class of people that live in poverty.

99.2% of Americans have refridgerators and 98.2% color TVs. Our definition of poverty is a bit different than the rest of the world.

[spudboy 0]

I agree, there is always going to those that do without something, most of the people you see in the streets begging in America are just searching for their next nickle bag of whatever. But that doesnt change the fact that our government spends the same amount per capita as European countries on healthcare, yet we only cover a portion of our citizens with that money and they cover everyone. It seems to me that reorganizing our system as per Bill Von suggetions we could cover everyone and it wouldnt cost anymore than we spend already

[lawrocket 3]

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I believe that we should fix the system by duplicating what is working well in all the countries that have healthcare systems superior to ours

The problems with your post are twofold: 1) "working well in all other countries" is subjective. Ever notice that countries are always busy fixing problems? No system works well - even the countries with socialized medicine are facing funding problems, etc., and the lack of accessibility that comes with it.

2) "systems superior to ours" - I believe ours is superior. I believe that the quality of our care and the speedy availability of it is unmatched. Get in a major vehicle accident and where would you rather be: Baltimore, MD or Laval, Quebec?

The biggest problems that our medical system face ae: 1) people who use it without paying; 2) people who won't drop 50 bucks for a doctor's visit when they don't have to drop any money for an ER visit; and 3) the high costs of compliance.

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I'll show you that the system of government funding for healthcare (and the accompanying level of care) is the same for the US and Canada with one exception - the US healthcare system is an "opt out" for those who wish something a little better than what the government will give them.

See, no system will be free of problems - you gotta make value judgments. Nobody has figured out how the make the highest quality product or service also be the cheapest AND most plentiful. If something is great and cheap, there will be a shortage of it. If something is great and plentiful, it will be expensive. If something is plentiful and cheap, it won't be good.

So it comes down to values - you can have two of three, but not all three. Socialist countries typically are not that plentiful or not of high quality.

Now, Canada has a national health care system - a system that is too cheap to get "medically necessary" things to ensure availability.
This article - from December, 2001 issue of the University of Toronto Medical Journal, discusses one problem in Canada - the shortage of MRI's. Here are some tidbits:

"Due to the cost, limited supply, and shortage of staff to acquire, operate, and maintain these machines, waiting lists have become lengthy."

"MRI technology is an expensive imaging modality when compared to others. The cost to acquire a machine varies with field strength, but can range from 1.5 to 2.4 million dollars per machine.4 Other
costs include building an appropriate facility ($300,000 to $1,000,000), leasing a building to house the machine, and upgrading the machine to prevent it from becoming outdated ($200,000
per year).4"

"Interestingly, MRI availability varies between provinces. In Ontario, there are currently 31 machines, which translates into one for every 278,000 people."

"In Ontario, the average wait time for a non-urgent MRI is currently seven months; however, emergency studies can be done within days (http://www.ottawamri.com/thestory.htm). Although the Ontario government plans to add 11 new MRI machines by the end of next year, the waiting list is expected to grow by 12,000 over the same period.6"

And..
"With inarguably long waiting times, a number of patients have elected to go to the U.S. and pay privately for the procedure. This can cost upwards of $700, not including the non-medical costs the patient incurs such as travel and accommodation.7 The cost to perform an MRI in the public health care system is considerably less. However, due to the lack of staff and machines, the government has been sending patients south of the border for scans since 1991."

"Interestingly, there are more MRI machines in Michigan then there are in all of Canada. Canada also lags far behind other member countries of the OECD. It ranks 21st in CT scanners, 19th in MRI units and last for bone mineral densitometry machines and PET scanners.9"

"There is a great deal of controversy surrounding private MRI clinics because many consider them to be a direct violation of the Canada Health Act, which prohibits personal payment for medically necessary services."

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I think my MAIN difficulty with the system in Canada - and what differentiates it from the US - is this quote, "There is a great deal of controversy surrounding private MRI clinics because many consider them to be a direct violation of the Canada Health Act, which prohibits personal payment for medically necessary services."

The implication is absolutely mindboggling to someone like me - medically necessary procedures are not available, and it is a violation of law to provide them for pay. It means that people are not receiving "medically necessary" treatment at home, and they cannot get it unless they go elsewhere, i.e., the US. (p.s. - I understand the logic - you don't want some people getting what others don't).

What we have in America, then, is a system that addresses and fixes the horrors of the Canadian system. See, in Canada, you cannot "opt out" of the system. You get what the government gives, and that is all. America has the Canadian system with an opt-out provision - you can get sucky government-funded healthcare or you can opt out at your expense for extras you desire.

So, the bad healthcare for the poor man that people moan about is seen in Canada, where, rich or poor, you'll have to wait for a "medically necessary" procedure, unless they can afford to go to the US.

As an aside - why the hell are there 3 times as many MRI machines per capita in New Brunswick than Newfoundland? Canadians must really hate Newfies..

My wife is hotter than your wife.

[lawrocket 3]

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Sorry to be the one to break it to you, but taxes just don't work that way.

No kidding. Taxes pick winners and losers. It should be up to me whether I win or lose.

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How do you feel about this proposal?

I'm not a fan of it, but it's better than what we've got. There are definitie problems with billvon's proposal, i.e., what is elective, etc.

I'd be more along the lines of my proposal in this post. here's what I wrote:

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In my opinion, the most efficient solution would be towards a single payment system - a move towards cash-based payments. It would relieve the load of billing and compliance, and dramatically reduce administration.

By cutting the government out of it things can improve. How about this - if there IS to be some degree of socialism in this, how about providing cash payments to the population at the beginning of the year every year?

In 2007, the federal budget for Health and Human Services is $696.063 billion. Of that, 84.1 percent is Medicar and Medicaid, or $585.39 billion. With 300 million people, that's almost $2k per person for fed health care spending.

So, what can we do? Let's give debit cards with the cash on them to everybody to buy the basic health care they need. If they want to spend it on stuff they don't need, then they can, but will then pay out of their pockets for stuff they do. Want the $300 pair of glasses instead of the $80, get em! And hope that you do not break a leg this year - it'll hit you. The visits to the dermatologist are important? Cool. Spend a grand on it, but let's hope a mole check doesn't come out positive.

Let's say $3k per year for everyone under the age of 12 to cover doctor visits, shots, etc. Kids can get sicker easier and get boo boos more often.

For teenagers through age 21, get them $1k per year, which should cover most things, i.e., physicals, mild injuries, birth control. It won't cover kids being stupid, for which the parents can get them insurance. You had them, you insure them for excess.

Between 22 and 45? Hey, you are usually the healthiest and cheapest to privately insure. Plus, they are prime working years. Pay your way or get your own insurance. Health care will cost you. And your kids are covered.

46-55? Guys get $1,000 and gals get $1,500 - more things go wrong with women that age, so let's get that working.

56-65? $2,000. You've been able to save and have assets that you can use.

After age 66? $3,000 per year. Your costs are higher.

This cuts overhead dramatically because there is so little billing overhead to deal with. People don't use all of their money in a year? Roll it over to the next year.

Private insurance Go for it! Insurance will be cheaper and easier, and there for other problems such as catastrophic illness and accidents. In a sense, all health insurance will be like an umbrella policy.

Also - emergency rooms will be authorized to charge 50% higher than the average rate for all non-ambulance visits that did not result in admission to the hospital or transfer to another hospital. This will cause patients to seek help through other practitioners and keep the ER's open for true medical emergencies.

Billing problems? Let the government have an appeals board to act as an arbiter in disputes.

The most important feature is that these cards can ONLY be used for medical purposes. The transaction costs and administative costs are cut dramatically. In a sense, it's cash pay. Everyone will have the "cash on hand" to pay "cash" for regular treatments. Everyone gets the minimum care, and people may buy more coverage through insurance. Choose to go uninsured? That's fine. You'll face the consequence if you femur in while skydiving.

It's the best solution I can think of so far. While it goes against my libertarian ideals, it's a far more pragmatic solution to lowering the transaction cost for basic care.

Note that I wrote, "while it goes against my libertarian ideals." While it's a subsidy (same to everyone regardless of income - while will make some people bitch because the rich get it) it fits into billvon's two-tiered system.

Medical costs will drop a lot because overhead from billing, codes, etc., will be eliminated - probably 25% of the cost of healthcare goes kaput. Also, the rollover feature allows healthy individuals to tuck some money away. Insurance costs drop because insurance is a mere umbrella policy - cheaper and can cover more.

With cash transactions, that pediatric checkup can be done for 50 bucks, shots for another 50, etc. It is enough to provide basic healthcare, and make insurance for catastrohpic injuries much, much easier to get.

My wife is hotter than your wife.

[nanook 1]

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>Spend even more, or fix the system?

Fix the system. Eliminate the dozens of levels of billing, insurance, collection agencies, government forms, laywers, prequalification etc for basic care.

Here's where I am not getting it. If you go to a socialized health plan, how would it be cheaper than now? The new beaurocracy would consist of layers of filing, claims, processing for each city, county, state, federal sector, extra costs such as the cost of maintenance of all the buildings needed for each sections, the cost of paying people according to their GS-rating (you probably will need at least 2 to 3 million personnel overall), their insurance and full retirements with benefits that include Their TSP matching retirement programs , the cost of contracting out medical supplies, buying the supplies, and associated costs of requisitions on that side, govt vehicles that have to travel much further in fly-over states, retention programs for Doctors and Nurses (they will need them).

The lists go on. I don't know how other countrys' beaurocracy works, but I know how ours works. There is only one way to structure if a program is on a purely appropriated income, such as the govt.

Looking at your proposal, it's not a bad idea at all. The only problem I see is I think the total cost of the lower tier would be way more expensive than intended.

_____________________________

"The trouble with quotes on the internet is that you can never know if they are genuine" - Abraham Lincoln

[billvon 2,400]

>If you go to a socialized health plan, how would it be cheaper than now?

Because you eliminate several layers of bureaucracy. Insurance companies alone add about 30% to healthcare costs (and that's NOT counting the extra work done by medical personnel to fill out the sometimes dozens of forms required for reimbursement.) Going to a single payer government-covered program for basic care would eliminate those costs for most basic care. One estimate (by Harry Wachtel) claims we would reduce costs by around $160 billion by going to such a program from the reduction of paperwork alone.

>The new beaurocracy would consist of layers of filing, claims, processing for
>each city, county, state, federal sector, extra costs such as the cost of
>maintenance of all the buildings needed for each sections, the cost of
>paying people according to their GS-rating (you probably will need at least
>2 to 3 million personnel overall), their insurance and full retirements with
>benefits that include Their TSP matching retirement programs , the cost of
>contracting out medical supplies, buying the supplies, and associated costs
>of requisitions on that side, govt vehicles that have to travel much further
>?in fly-over states, retention programs for Doctors and Nurses (they will
>need them).

Of course. We have more than that now, plus profit overhead. That's why health care is so expensive. Government is not all that efficient; the only thing less efficient than a government-run medical program is what we have now.