Here is my problem with our current healthcare system: If you don’t have any money, and you get sick, or get an infection, you’re going to live with it for as long as you can. Only when the problems gets too bad to live with anymore will you go to the ER. There, they have to treat you (in part, at least because of that pesky Hippocratic Oath.) If you can’t pay, then you don’t. Maybe this ruins your credit rating, maybe it doesn’t. Either way, we currently have UHC; it’s just horribly implemented. I think we can do better. We have the luxury of being able to look at all of the UHC plans of all of the other developed nations, and seeing which ones work well and which don’t; and put together a plan that incorporates the best of each.
Honestly, I haven’t done much to check out other nations’ UHC plans, but if there were a thread that compared and contrasted all of them (like an expansions of post #9), including Obama’s plan, then I would definitely read it to educate myself.
That’s a good summary. You just forgot the part that after you finally go they may not ignore the cost, but bill you for it, which might drive you to bankruptcy.
BTW, here is a page where you can find summaries for all of of Europe. For instance, in the German page, you can find that they allow private insurance, but that the cost increase for private insurers has been greater than that for the public option m(58% vs 45% increase from 1992 - 2002). (page 5 of the German pdf.)
I don’t have time to summarize, but it seems like a great resource.
Quite impossible. It is an immutable fact that government cannot deal with health care without disastrous consequences. Do these charts take into account that the greater majority of Europeans are dead? That would certainly account for the cost efficiencies which socialized medicine appears to deliver.
That’s why you see so few elderly and sick people in Europe! Socialized medicine killed them all!
I heard they save money by using the skins of old people to print their forms on. If you’re being admitted to a hospital in France, check the forms for liver spots!
It isn’t a religion you know. When someone argues with dogma, their argument fails to address the facts. We expect the government to take care of us for our national security. Perhaps you might want to allocate that job to Blackwater.
And I remember all those people who lost everthing because their insurance company didn’t come through for them.
Its government for the people, by the people isn’t it ? Damn right the government is responsible to the citizens.
Are you sure you want to dispense with search and rescue operations?
what alternative do you have? Placing the responsibility for your health care with a private insurer? If one will have you ? If you won’t be able to choose your doctor ?
The simple problem with your socialized medicine is that it isn’t universal. The taxpayer has no stake in the quality of care for veterans and those who do not have insurance.
The answer is less. When you combine all the administrations of the various private insurers into one, you are bound to save administration costs for execution and oversight.
I’m a free market guy but not a libertarian, I believe in things like natural monopolies and I believe that when they exist they should be regulated. I believe in things that are best provided as a public good. Law enforcement, armed forces, education, and I think I also believe on some levels health care should probably be in this category as well.
However that is on the abstract, and the philosophical level.
The reasons I have long opposed “public health care” in the United States is simply because every time it has come up I have genuinely believed it will make the country worse off not better off.
I think it is very important to have some degree of information about health care in the United States. For one, with the most recent figures I have, 44% of U.S. health care spending is public (i.e. government provided.) The rest is private, for most countries the percentage of public health care spending is the lion’s share of the expenditure (with a smaller portion varying from country to country being filled in by private expenditure.)
However, even though the United States only publicly funds about 44% of health care expenses–that 44% alone represents a per capita outlay of spending nearly equal to the total spending per capita of most of the rest of the industrialized world. When you then factor in the 56% of health care spending that is private you realize that we’re spending sometimes as much as 2x as much as the average OECD country.
I think that the fundamental problem with health care in the United States is cost, not coverage, not the % spent by the public or any other thing. I don’t believe the costs are going to magically be reduced just because the government will start providing “universal” coverage.
I think that we’re already seeing strong signs that anywhere the current legislation has attempted to seriously go after the root problems of excessive cost, lawmakers have bucked, backed by strong lobbies that don’t want to see the cost-reducing measures which are necessary to make things work long-term put in place.
I think the reason you can’t equate the U.S. health care system to any other health care system in the OECD countries is because of how it developed. The various parties responsible for delivering care have never had any incentive to “work together.” The people delivering the actual care, physicians, the hospitals and organizations they work for and et cetera aren’t very strongly incentivized to control how much they end up billing patients for (or more accurately–patient’s insurance.)
Kaiser Permanente is, to me, a good example of how health care should be conducted. Since KP is both insurer and primary caregiver there is an integration across the organization and a genuine desire to see cost controls and other standard and accepted business practices. It’s a lot easier, to my mind, to control costs when the people footing the bill and the people providing the care are all the same entity. Otherwise you have the providers (and I don’t really mean first-line physicians but more the people who run the facilities they work in, although in some cases they are one and the same) who will happily run up very large costs, knowing that the insurance company is legally obligated to pay due to their agreement with the insured.
However, current legislation doesn’t really show me that we’re looking at the sort of systemic overhaul that would actually move the health care system to this point of cost-control and integration. Instead I am gravely worried that the government is simply going to up its percentage of the bill, without doing anything to reduce the costs. Which means we will still be paying 2x as much per capita for health care than most of the other countries in the OECD, but through government instead of through private outlays. So to me it is mostly a “push”, although there is the very small benefit of getting coverage for the presently uninsured. Although I also strongly believe the problem of the “uninsured” has been greatly exaggerated because the numbers often overlook healthy young people that simply aren’t all that interested in having health insurance–and anytime the topic of the uninsured come up it seems like the discussion is reduced to anecdote of someone’s favorite uncle who died because he didn’t have insurance so he couldn’t get a liver transplant.
What I’m essentially advocating is more “vertical integration.” Vertical integration doesn’t always work and it isn’t always advantageous. If you look at other industries, like say, auto parts manufacturing you will see examples of this. A lot of people argue that it is better for companies like GM to buy parts from independent companies because these companies compete with one another on price, and quality. They value their contracts with GM and know if they deliver a poor product or a product whose price is not competitive that GM will move on and get other suppliers. If the parts are produced “in house” the factories have less of an incentive to deliver a quality product at a competitive price because as a part of GM itself they have a guaranteed shipment of every product they produce up to the point the plant gets closed down due to mismanagement.
However in the particular instance of health care I think you’re looking at industry that would benefit immensely from complete vertical integration. Once the entity financing and insuring individuals is, across the board, the same entity that provides care you will start to see genuine cost reductions in the U.S. health care system. Other alternatives would be more encompassing and stronger “contracts” between care providers and the insurers that essentially achieve the sort of control of cost you would see with true vertical integration while allowing the parties to remain organizationally separate.
Tell you what, drop all your health care insurance and live awhile like that and tell me it is a “very small benefit”. Better still, if you have kids, make sure they are uninsured as well and tell us about the very small benefit that is health insurance…especially if you or your children or spouse have the misfortune to actually need medical care under those circumstances. Double-down on that if you or anyone in your family suffers from a chronic condition.
People like to make things complicated because they don’t want to address the simple underlying problem. Doctors, other healtcare workers and pharmaceuticals in the US make too much goddamn money. Two or three times what they make in almost any other country.
If the doctor can charge $130 for a consultation, it makes sense for him (or her) to employ two, three, four or even five staff members making $20/hour to cut the consultation time down from 12 minutes to ten minutes, because he can see one more patient per hour. Plus he orders labs like crazy because he has a partial ownership in the lab doing the tests.
The only entities keeping the costs from getting totally out of control are the insurance companies. But of course they are always the villians of the piece. They do make money from denying care, but they make even more money from reducing the amounts that doctors charge.
Of course if you reduced the income of doctors down to 2X the median income, instead of ten times, it is going to be a lot less desirable profession to people who are brilliant and want to make a lot of money from their brilliance. In the US they can go into the corporate world and make 10X the median income, without going through the hell that is medical school and the residency. In Europe at least, it is much harder to do that. There is just not that much disparity in incomes. Maybe people who become doctors in Germany are the people who really want to be doctors, rather than millionaires.
Either in this thread or an earlier one we were discussing tort reform. The reason why there is so little support for tort reform is that if doctors are paid like gods, people expect them to be held to a divine standard.
This is a rather important point. If uninsured patients were charged fee-schedule prices instead of “full price”, the number of bankruptcies would go down immensely. Insurers pay ~1/3 of the “full price” of most procedures.
Medicare, or Medicaid? Medicaid covers certain types of preventative care- family planning, pregnancy/healthy start programs, STD testing, insulin-dependent diabetic care, etc. - but not all. You can’t go get a free annual physical if you’re a non-pregnant adult, for the most part.
That’s why emergency rooms are constantly swamped- half the people in an ER at any given time are Medicaid recipients who have the flu or somesuch and can only get covered treatment at an ER or county hospital.
A lot of those people lost everything they had, including family members. They had the shirts on their back, maybe. What did you expect them to do, review their investment portfolios? Perhaps make lemonade for a lemonade stand, if they had lemons, sugar, and drinkable water? And if anybody had any money?
What’s to “get”? People who got nothin’, got nothin’. They don’t have anything to give to their loved ones, or to themselves, or to anybody. What do you think, they drove down there in their Cadillacs to sign up for food stamps?
Contempt for the helpless is not hatred, but it might as well be. You look at a crowd of victims, and see freeloaders. And you form your judgement in pure ignorance, you know nothing about these people, but their condition of misery.
And you blame them. To paraphrase Mick Jagger, you’re working perfectly, but there is a part missing.
Yes, they took the responsibility to get themselves to a safe shelter, as they were told to do. If they had cars or the financial means to get on a Greyhound ahead of the storm, they would’ve left town entirely, like the tens of thousands of New Orleanians who went to Baton Rouge. What happened at the Superdome is a massive failure of public policy, not personal responsibility.
The ones who didn’t leave couldn’t leave. How the hell do you evacuate when you don’t own a car, don’t have the money to put your whole family on a bus – never mind that tickets were sold out and then service was suspended – and people who do have cars have filled them up with their own families and can’t take yours along?
There was a public evacuation order, but there was no public evacuation assistance in a city where the poverty rate is disproportionately high, where it was well known there were entire pockets of the city that were disproportionately impoverished and these happened to be the self-same geographical areas at the greatest risk should the levees be breached. What would you have these people do? Walk to Baton Rouge?
