Fuck I want "socialized medicine" and I want it now!

[catsix]

gonzomax said:
You pay more for health care in the US and get less.

I think I get a pretty good deal, actually. I’m very, very happy with the health insurance plan I chose.

Take care of yourself ,slacker. Do not get downsized or you are not a person worth considering.

It’s up to me to make sure that I am always marketable. I won’t be expecting anyone to cry for me if I fail to take care of myself.

Everything you buy in America has the health costs folded into them.

Yeah, we’re paying a fortune for the health care costs of some 8 year old in a Nike sweat shop in Taiwan.

These slackers are paying your coverage. It is wrapped in the cost of everything we buy. So why should we pay for your insurance?

Are you actually trying to claim that under socialized health care no one is forced to pay for health care for others? Oh, no, what you’re saying is that under socialized health care slackers get everything and pay nothing because the unemployed don’t pay taxes. Why is it in your mind better to take away what a person works to earn and give it to a person who does not work or earn anything? Should not people keep the rewards of their work?

Why should the consumer pay higher costs .so you can get covered ?

If they want what I have to sell, and find the price of what I’m selling is what they are willing to pay for that item, they buy it. If my widget is too expensive, because of my health insurance or my vacation to Cancun or my shiny new car, they will choose not to buy it. Maybe they’ll go to the other guy who sells it cheaper, or they’ll do without it.

Of course, don’t forget that with VAT taxes in other countries, they’re still “paying higher costs” so you can get covered. How much total tax burden do you really have?

[lalenin]

@Euphonious_Polemic

Apologies, - of course lalenin did not explicitly tout Cuba’s UHC. lalenin did contribute

I’m just saying that in a discussion about Universal Health Care in different countries, bringing up the flaws in Cuba’s medical system is probably not the best example of flaws in UHC in general.

Wait, if we are discussing UHC in different countries I think it is absolutely relevant to discuss the problems in the Cuban system, as that system is an actual implementation of UHC. It is a flawed implementation or course, but that does not make it irrelevant, unless you want to discuss only hypothetical perfect cases.

[Nava]

@Meyer6

But as a grad student I assume that *Ogre *would not be covered by an employer.

I don’t know Ogre’s situation, but when I was a graduate student in the US, we were required by the Uni to have health insurance. If we didn’t have coverage, or if said coverage wasn’t deemed adequate (1), you had to take the Uni-chosen group policy, which changed every August.

This led to situations like insurance policies refusing claims for “preexisting condition” on a pregnancy, or on things that weren’t “preexisting” when that person became a graduate student - but yes, by the last August they had already been diagnosed.

1: my Navarrese-government provided policy of “everything non-elective is covered” was deemed inadequate, as it didn’t give a loooooong list of every covered condition. The “non-elective” is defined by Spanish General SS Law, but I didn’t think to hit the school with it (hardbound copy) and anyway the policy itself didn’t mention the law by name, so the school probably would have rejected it anyway.

[Defensive_Indifference]

@Szlater

NICE develops guidelines for medical treatment. The guidelines are written by panels of healthcare experts, so the guidelines for Obstetrics care are written by senior Obstetricians.

Patients and other health professionals can get involved by joining the committees and working groups. You just apply to join if you want to be involved in the decision making process. It’s a pretty open system actually. They actually want patient input into even the technical discussions.

Wow, interesting. Let’s say NICE writes a guidline approving coverage of some new kind of treatment. The elected officials still have to write the check for it, right? Does NICE have to do constant battle with them to increase or maintain funding? Or is it more like, “Here’s the tax revenue for the year, and that’s what you have to allocate”?

[Nava]

Bayard, we’re protected by the same mechanism that protects us from, say, the President waking up one morning and deciding that all those other guys who think they’re Napoleon are wrong as, evidently, it’s him who is Napoleon and btw he’s also married to Carla Bruni, who is much better-looking than Josephine anyway. The budgets, SS Law, etc have to be prepared by the Ministers and then go through Congress and the Senate if it’s at the national level; at the regional level they have to be prepared by the Councilors and go through the Regional Parliament.

[wonky]

@catsix

Oh, no, what you’re saying is that under socialized health care slackers get everything and pay nothing because the unemployed don’t pay taxes.

Everyone pays taxes. Everyone foots the bill. You are paying my healthcare expenses. I am paying yours. And we’re paying more than we have to and get less, based on what the rest of the world has shown us.

You are already paying for healthcare for people other than yourself. If you’re content paying more than you need to, well, you’re weird.

[Defensive_Indifference]

@Nava

Bayard, we’re protected by the same mechanism that protects us from, say, the President waking up one morning and deciding that all those other guys who think they’re Napoleon are wrong as, evidently, it’s him who is Napoleon…

Alas, sometimes our protection against that has seemed a little weak, too. Seriously, though, those are all good points. Although the past eight years have scared the bejeezus out of me, I think I can see the kind of system you and Szlater describe working here. I’m sure there would be bad decisions made at times, but with enough checks and balances in place, hopefully we could avoid the really horrifying stuff.

[Szlater]

@Bayard

Wow, interesting. Let’s say NICE writes a guidline approving coverage of some new kind of treatment. The elected officials still have to write the check for it, right? Does NICE have to do constant battle with them to increase or maintain funding? Or is it more like, “Here’s the tax revenue for the year, and that’s what you have to allocate”?

The NHS funds whatever NICE guidelines tells it to fund. The funds for the NHS are set in the budget every year. The funds are dispersed to local “Primary Care Trusts” who then contract care from hospitals and GPs etc. It’s up to each PCT to balance their budget, and running a deficit may result in the board of the PCT being dismissed.

There’s no political input except that which happens when the Treasury set the budget.

What might be a problem in the US is if you have a PCT board like the Dover school board, you’d have to find someway to make them non-political.

[UnwrittenNocturne]

@catsix

I think I get a pretty good deal, actually. I’m very, very happy with the health insurance plan I chose.

It’s up to me to make sure that I am always marketable. I won’t be expecting anyone to cry for me if I fail to take care of myself.

So what happens if you lose your job and become too sick to work?

Yeah, we’re paying a fortune for the health care costs of some 8 year old in a Nike sweat shop in Taiwan.

Another issue entirely. But you paying for it anytime you buy something still made here.

[quote]
Are you actually trying to claim that under socialized health care no one is forced to pay for health care for others? /quote]

You pay for other people under the insurance scam…sorry system you have right now. Every time a premium is paid and not used to it’s fullest extent you are paying for someone who had expensive surgery. Why is that so hard to grasp.

Of course, don’t forget that with VAT taxes in other countries, they’re still “paying higher costs” so you can get covered. How much total tax burden do you really have?

Well let’s check New Zealand as an example. UHC…check. Total tax burden some 10% less than the US…check. You don’t see the hidden tax you pay here in the form of premiums for health insurance. It’s either a tax on your employers or on you. Or both. And instead of actually providing care to people it exists to provide a money for nothing to the insurance companies. Unless you want denying claims doing something. In which case perhaps they are ‘working’ for their money

[wonky]

@Bayard

Alas, sometimes our protection against that has seemed a little weak, too. Seriously, though, those are all good points. Although the past eight years have scared the bejeezus out of me, I think I can see the kind of system you and Szlater describe working here. I’m sure there would be bad decisions made at times, but with enough checks and balances in place, hopefully we could avoid the really horrifying stuff.

Funding Medicare is something of a political football, but the actual paid-for procedures/drugs/etc. don’t seem to be that politically volatile. I’ll put a big “yet” on the end of that thought.

[catsix]

jsgoddess said:
Everyone pays taxes. Everyone foots the bill. You are paying my healthcare expenses. I am paying yours. And we’re paying more than we have to and get less, based on what the rest of the world has shown us.

That’s why I asked about total tax burden, not just income tax. I may pay more income tax as a percentage than people in other countries, but I don’t pay 14% tax on everything I buy in a store. I don’t even pay half that in sales taxes.

If this is supposed to be funded entirely through income or payroll taxes, then it is not true that “everyone pays taxes”. Those who do not work, or who are making below a certain amount of money, do not pay income tax. Some of the people who are considered working poor get a “refund” from the government that is larger than their entire tax burden, meaning they pay a negative tax amount.

Now, currently, I pay a lot and I get a lot. I’m pretty happy with that. I don’t get less than my Canadian friend who has told me many times that he cannot afford his prescriptions under the Canadian system. So maybe with the socialized plan I pay higher sales tax or income tax and I get less coverage for myself so that someone who doesn’t work gets health insurance.

I’m not seeing how this is something I should want. There is no benefit in it for me.

[Defensive_Indifference]

@Szlater

The NHS funds whatever NICE guidelines tells it to fund. The funds for the NHS are set in the budget every year. The funds are dispersed to local “Primary Care Trusts” who then contract care from hospitals and GPs etc. It’s up to each PCT to balance their budget, and running a deficit may result in the board of the PCT being dismissed.

There’s no political input except that which happens when the Treasury set the budget.

What might be a problem in the US is if you have a PCT board like the Dover school board, you’d have to find someway to make them non-political.

Huh. This has been the most informative Pit thread I’ve ever been in. How is the PCT staffed? Are they part of the NICE apparatus, or are they elected?

[Antinor01]

@UnwrittenNocturne

So what happens if you lose your job and become too sick to work?

Been there, done that. Lost my job, lost my house, etc. Fortunately, I recovered from my illness and rebuilt my life. I’m still not completely sold on the UHC concept.

[wonky]

@catsix

I’m not seeing how this is something I should want. There is no benefit in it for me.

The benefits are really obvious for the economy. Keeping more people in the workforce, avoiding catastrophic disability, not hindering American business with massive insurance anchors, etc.

We funnel massive funds into overburdened ERs because that’s one of the few places uninsured people can get care. You are paying out the nose for that and it is impacting your own ability to get care in an ER. It shifts hospital resources around, overworking doctors and nurses, thus impacting your own ability to get care.

And UHC has led to better outcomes in countries where it is implemented. That means people you care about have a better chance of living to an old age with a high quality of life.

You don’t have enough money to insulate yourself from the world. Sorry.

[catsix]

UnwrittenNocturne said:
So what happens if you lose your job and become too sick to work?

Well, I pay for unemployment insurance and I also have savings for expenses such as rent, food, health insurance that will last me about six months during which I would be looking for another job. As for “too sick to work”, considering what I worked through during my last year of college, I don’t think I can imagine circumstances in which I am too sick to do something to provide for myself.

You pay for other people under the insurance scam…sorry system you have right now. Every time a premium is paid and not used to it’s fullest extent you are paying for someone who had expensive surgery. Why is that so hard to grasp.

Firstly, I have a choice in the current system. I can choose to purchase a health insurance plan that is suitable to me. There are several that my employer offers, and there is also the possibility of opting out of that and choosing my own coverage. So what I do is evaluate the plan and determine the level of service I’m buying and the price I’m paying. I make an effort to choose one that offers the best “bang for the buck” I can get.

Secondly, I also view this as somewhat similar to car insurance or renter’s insurance. I’m not out making claims against those policies every day but at the same time, I chose a level of courage that I deemed sufficient and at a price I found acceptable. Am I wasting my car insurance because I don’t crash my car? Am I wasting my renter’s insurance because I don’t get burglarized? Maybe, but what I’m paying for in part is the knowledge that the cash will be there if I need it.

Well let’s check New Zealand as an example. UHC…check. Total tax burden some 10% less than the US…check.

That was quoted as income tax. Dig a little deeper and you find out that New Zealand has a Goods and Services Tax that applies to all but a few items of 12.5%. Now I don’t know if there are any more localized taxes added to goods and services in New Zealand, but I do know that I do not pay a national Goods and Services Tax in the US at all, and that the sales tax where I live is 6% and exempts necessities such as food and clothing.

jsgoddess said:
We funnel massive funds into overburdened ERs because that’s one of the few places uninsured people can get care. You are paying out the nose for that and it is impacting your own ability to get care in an ER. It shifts hospital resources around, overworking doctors and nurses, thus impacting your own ability to get care.

Y’know, I’ve never h ad a problem actually getting health care at a doctor, ER, hospital, specialist, anything. Seems I’m very able to “get care”.

You don’t have enough money to insulate yourself from the world. Sorry.

I have enough to care for myself.

[wonky]

@catsix

As for “too sick to work”, considering what I worked through during my last year of college, I don’t think I can imagine circumstances in which I am too sick to do something to provide for myself.

I think that’s pretty illustrative. It can’t happen to you. Check.

[Szlater]

@Bayard

Huh. This has been the most informative Pit thread I’ve ever been in. How is the PCT staffed? Are they part of the NICE apparatus, or are they elected?

NICE only deals with setting guidelines and best practice with regards to treatment, they have no other role. The MHRA licences drugs (like the FDA). PCT boardmembers are employed, not elected. When there’s an opening the job is advertised and people apply. They want people with business and/or healthcare management experience. Hospitals are run the same way. No political appointments at all AFAIK.

Here’s some useful info. They system is not simple, but has various levels of control and oversight.

PCT

Strategic Health Authorities

NHS Hospital Trust

NHS Foundation Trust (a hospital with more autonomy, usually either centres of excellence or very big hospitals).

Department of Health (The Ministry involved in running the NHS and public health)

[Defensive_Indifference]

@Szlater

NICE only deals with setting guidelines and best practice with regards to treatment, they have no other role. The MHRA licences drugs (like the FDA). PCT boardmembers are employed, not elected. When there’s an opening the job is advertised and people apply. They want people with business and/or healthcare management experience. Hospitals are run the same way. No political appointments at all AFAIK.

Here’s some useful info. They system is not simple, but has various levels of control and oversight.

PCT

Strategic Health Authorities

NHS Hospital Trust

NHS Foundation Trust (a hospital with more autonomy, usually either centres of excellence or very big hospitals).

Department of Health (The Ministry involved in running the NHS and public health)

Many thanks!

[Nava]

@Bayard

Or is it more like, “Here’s the tax revenue for the year, and that’s what you have to allocate”?

That post wasn’t here when I wrote my last one, promise, and I’ve been getting some work done.
My father was one of the Founding Members of Staff for a brand new public hospital (well, it isn’t brand-new any more). There’s three kinds of medical facilities in Spain, defining it by funding type:
public (100% funded by SS),
concertado, (privately owned but they do provide SS services and get some income from SS),
private (100% funded through billing their customers).

Dad was the Purchasing Manager: the whole Purchasing Department was himself and an AA he shared with the Personnel Manager. The budget for the hospital was initially prepared looking at expected expenses for the year. So much to buy furniture, so much to buy bedclothes, so much to buy food. Of course, since the hospital’s first year didn’t involve any of those pesky patients, the budgets for consumables were very low.

On following years, the hospital got a budget which was basically created from the budget for the previous year, adding the same % to each line. So Dad would resort to some creative resource allocation (for example, bandages would be paid from the blankets budget) but, since the auditors agreed that the creative allocation meant a lower risk than trying to get the Honorable Members of our local Parliament to think too hard (we wouldn’t want to give them a migraine, and they’d be likely to cut the blankets budget without raising the bandages budget), things sailed along for the 15 years he worked there.

So, while the budget isn’t just “have a lump sum and do with it as you see fit so long as you don’t steal,” it ends up being that for practical purposes.

There are other sums for medicines, I don['t know if it’s distributed by region, province or it’s a national amount. I pay 40% of any medicine which has been ordered by an SS doc, 100% if I haven’t gotten the Rx through SS or if it’s OTC; someone retired or with a disability greater than 30% pays 0% for SS-prescribed medication.

Something that hasn’t been mentioned is the price limit on medicines. The government will set price margins for different medicines. A couple of projects ago, I worked for a Very Large Pharma which was getting set up to release a New Cancer Miracle Medication - in the US only. It wasn’t a cure: it chronified a rare type of cancer. Looking at the price tag explained why it was going to be released in the USA only: you had to have a course of the medication per year for all your life and they intended to charge 30K for it :eek:. Try charging that in Spain and the government is likely to decide that they’re going to make an exception on copyright law… (production costs were in the three-figure range per course, and yes I know the rest pays for RnD and for support folks like me, but the campaign they had going to make them look like Saviours Of The Weak made me sick, ok?)

[UnwrittenNocturne]

So, basically, you’re fine with enriching someone for not providing healthcare but not okay with paying what would probably be less to ensure that everyone gets covered. Right. Your money is more important than other people’s lives.

Furthermore yes there is a GST. But even including that (and adding say only half of the 6% sales tax in your state) it still works out as a better deal. (total tax take of around 30% compared to 33%). And everyone gets covered.

What makes you think you have no choice in a UHC system? In many ways there are more choices. Choose any doctor. Not just one in your network. Be supported indefinitely if you are unable to work due to illness or catastrophe. And have training taken care of if it necessitates a career switch. Nobody stops you buying insurance on top of the UHC system (and in fact for a while I did. It cost me a little under 100/month (covering two people) for 100% coverage of absolutely everything with no ‘co-pays’ or the like. What are the average payments here?

ETA: in response to catsix