What is even more frightening is that people are prepared to do a cost/benefit analysis with other people’s lives and wellbeing. Sickening
Every dollar the government spends on healthcare is a dollar it can’t spend on something else. If your plan is “Fuck the budget, let’s just pour it all into healthcare instead of working out how the money can do the most good because cost/benefit analyses are TEH EVOL,” then I’m thankful that you are unlikely to ever be in a position of power.
I am too - I don’t even like the idea of power over other people. But you can’t, imo, justify dollars over human lives.
Look, are you just being a prick just for the sake of it? How are you not seeing that the US already spends way more for health care than any other country on the planet no matter how you look at it? Per capita, percentage of GDP, absolute dollars–we pay MORE and we get LESS. We have the clear and concrete examples of many, many different methods of UHC worldwide, all of which are outperforming our “free market” for-profit insurance method by every conceivable metric–they’re doing it cheaper, faster, better and getting better results in improved standard of living, lower infant mortality rates and average longer lifespan than we are getting here in the US. We already said “fuck the budget,” and the results are bankrupting us. If you really cannot see that investment in the health and well-being of the citizens of this country IS the highest and best use of tax dollars then you are incredibly stupid in addition to being a huge jackass.
Argue intelligently, WITH some facts to back your assertions or go away and let the grownups talk.
To be fair, any public policy has to be subject to a cost/benefit analysis and healthcare is no exception. For example, should the NHS buy the generic breast cancer drug that gives a 75% 5-year progression-free survival and costs £300/cycle or the novel drug that gives an 80% 5-year progression-free survival and costs £3000/cycle? Buying the novel drug without regard to cost/benefit could cause shortfalls in other areas of the health budget affecting more people than the additional 5% of breast cancer patients that experience some increase in PFS. How do you balance the needs of the breast cancer patients and the needs of other patients, and do it in the fairest manner?
There are other tests that should be applied too, such as Quality of Life/Benefit analysis, which should really be taken into account with any medical intervention. For example, giving a terminal cancer patient a last-ditch course of chemotherapy may prolong their life by a couple of months, but what would their quality of life be like? Would they have to be hospitalised for the entire period, or suffer from increased pain? That’s a decision that is, in the NHS anyway, between doctor and patient.
It’s done with actuarial tables now, and whatever method UHC will use, it MUST be done. Any system that does not include a method for putting dollar amounts to human lives is destined to go broke and not function.
It’s hard to believe how naive some of you are.
To be fair, I think what UnwrittenNocturne was responding to was the rather callous assertions that seem to be flying around here that it’s really okay that a large percentage of US citizens are denied all access to health care as long as the tax bill doesn’t go up. I don’t think any reasonable person would argue that there has to be a method of assigning benefit dollars to maximize results–the simplest of these is that it’s better to pay for a million immunizations than to pay for a million courses of treatment for the disease in question. Hell, even a terminally ill person is probably pretty likely to agree that it’s better to spend money helping a whole bunch of less sick people to get well than to keep one terminal patient alive for a little while longer–and many terminally ill patients do make these determinations every day with their doctors.
I don’t think any of us have a problem with triage, and only unreasonable people have a problem with having to wait for hangnail removals in order to take heart bypass patients first. What we have now is a system wherein a few very lucky people can get anything they want whenever they want, a vast majority of people can get access but it’s going to hurt the monthly budget so they triage themselves and another large fraction that only gets access to medical care by the most expensive of means–when they’re too far gone to object any longer and they go to emergency care for high dollar remedies to illnesses that would have been much better to pay a little bit to prevent or cure before it got out of hand.
American health care is an object lesson in parallax–something that could have been fixed cheaply and easily at one end of the line becomes horrendously difficult and expensive at the other end. Penny wise, dollar foolish–it’s classic. A simple mole check/cancer screen could prevent a cripplingly expensive end stage series of cancer treatments. Early cholesterol/heart function checkups could prevent expensive bypasses and transplants. Seeing a nurse-practitioner for a flu shot staves off the epidemic. Why is this so hard for people to see?
Yes. At the time, the AFL-CIO opposed the Nixon plan, because they thought they could get a better deal.
Yeah, Nixon. Real liberal guy.
Uh-huh… some of us came to support single-payer because of sound reasoning. By declaring this irrelevant, you accomplish nothing.
I’ve been following this thread with interest, and I’m starting to think you have a reading comprehension problem. The use of actuarial tables to determine insurance rates has NOTHING to do with how money is allocated in a universal health care system. Nobody can be denied treatment, not for any reason. There is triage (a concept that seems difficult for some to grasp), but you cannot be denied care for a pre-existing condition, etc in the way you can be denied insurance. Of course budgeting must be done, but it is done by determining standards of care and by cutting out enormous amounts of redtape/paperwork (in comparison to your system), not by just offing the poor suckers who dare to be sick or born with a medical condition.
Have you ever heard that Ghandi said “a nation’s greatness can be judged by how they treat their animals”? Well, what does it say when you are willing to treat people far worse than you would treat a dog? To let them die somewhere (as long as it’s somewhere else), from something treatable, in pain - and for what? To save you a little bit of money?
I know you will say this is histrionics just as you dismissed Broomstick, but for a country that is always declaring themselves as the ‘best country on Earth’ this seems extremely striking to me. The fact that such a wealthy, successful country just doesn’t see that health care is a basic necessity is a huge black mark against your ‘great’ country in the eyes of much of the rest of the world, and no amount of hand-waving and spurious arguments is going to change that.
I think the problem is that some people just didn’t look up the word “triage”. Like me. Until now.
It means ordering people’s wait times by priority of the medical problem.
I hear it helps make your case if you yell about it.
All your arguments are best-case scenarios. I’m a little more pessimistic.
Unless the US government somehow miraculously becomes a paragon of efficiency, people WILL die on waiting lists in the this country under UHC. It WILL happen. We will NOT have the best-case scenario. The US government is the most ridiculously inefficient organization in the known universe, and you have every confidence that it will be able to cleanly handle the health care needs of 300,000,000 people spread out over 10,000,000 square kilometers? I’d love to be wrong on this, but I’m not.
And some of you want UHC administered by the states instead? So wait. Is it going to make it easier or harder for the US government to oversee 50 DIFFERENT state programs than just having the one Federal system?
As oppossed to now where some people can’t even get the preventative care they need to avoid being on the waiting list?
It’s fine to be pessimistic, but the status of the system now is little better than a total wreck. I’m having a hard time seeing how even your worst-case scenario could be worse than the current situation.
I’m failing to see your point. What do you see as the role of the federal government in dealing with the individual’s healthcare needs?
In the UK, the government has no role in deciding priorities for individuals. The doctors treating patients decide based on need/availability of local resources as to how/when a patient is treated with the most in need taking priority over the least (the patient with the broken hip gets priority over the patient with the chronic but drug-manageable arthritic hip pain).
Do you see a system where post patient-consultation a doctor calls up the federal department of healthcare and gets a priority code for each individual’s place on the waiting list?
In the UK, the government can give more funding to say, oncology, to increase available services if the waiting times monitoring (which is done by all oncology centres) detects that services are falling behind, but this isn’t triage, this is a policy decision. The government can’t tell the doctor “treat Mr Jones now, and Mr Smith in two weeks and Mr Ogre in 6 months”, for one thing there’s no system for communicating in that way and for another doctors here wouldn’t put up with the infringement on their clinical judgements.
You are a terrible arguer, you know that? I’m not yelling - I just stopped by here. You’ve been foaming at the mouth for PAGES now.
My arguments (and those of others here) are not best case scenarios:
a) they are based not on some starry-eyed dreaming, but on what actually happens in other countries. Like, hey, Canada, where I happen to live. So stop with the broad-brush ‘you’ and ‘we’ there, mister, we’re not all Americans.
Here in Canada, health care is administered by the province, and somehow we are not dying on waiting lists in droves. Yes, it can and does happen (I’m also pretty sure very ill people can die waiting for treatment in the US too), and no one is denying that, but since you are already happy with people dying all over the place you should be okay with that. No health care system can save the life of every single person, but maximizing the benefit to all is an admirable goal.
Despite what you may think there is nothing so unique or wondrous about Americans that means what works all over the world wouldn’t work for you.
b) perhaps you’ve missed where people have pointed out that UHC is not perfect. But it’s a damn sight better than what you have going on right now. Why do you think there are so many Americans who wish there was universal health care? I have never in all my life heard a Canadian say they wished we had the US system.
I wish people like you would just come out and say that it’s about money. You have it, you like it, you don’t want anyone else to have it. I also wish you would address some of my other points, such as the fact that your health care system marks your country out as a morally reprehensible place that values human life less than the average animal, rather than just accuse me of yelling and dismissing me. I know you think that’s devastating repartee, but I’m afraid it’s not.
I have. They are usually VERY rich, and are mad as hell that they cannot get a procedure done quickly for something that is making them uncomfortable. They want it done RIGHT NOW, because dammit, they have MONEY. They do not give a rat’s ass if that means that a pensioner will not get a life-saving operation. Don’t you understand? THEY HAVE MONEY!!!
I’m a poor, very liberal 36-year-old doctoral student in biology, thank you very much. Not a recipe for current (or even future) wealth.
But it’s hilarious that you guys equate “not really 100% convinced about the financial sense of UHC, especially as applied to a massive bureaucracy and population” with “ZOMG!! He sleeps on a mattress made of $100 bills pilfered from orphans. He must be rich!”
You still haven’t told us where this “massive bureaucracy” is going to spring from and for what purpose. You just seem to throw out statements as fact and then rail against some comment you take offence at, and point out that you’re a liberal and undecided on UHC (which I think marks you as “not a liberal at all”).
I hate to be the bearer of bad news, but some of you people need to look up the word “histrionics” in the dictionary, paying particular attention to its complete lack of etymological connection to the word “hysterical.”
Instead of reprising the Monty Python argument sketch (“no it isn’t. Yes it is. No it isn’t”) How about a cite about administrative costs? This is an older document, but it is from a peer reviewed journal, so Ogre may like it better than a blog!
Costs of Health Care Administration in the United States and Canada
Results of the study?