Except that it doesn’t really work that way since if you pay the fine you can still get sick or hurt and be in serious financial trouble. People like to press their luck on those things, but I think the system is ultimately going to work.
So the website was built by perhaps a contractor who overpromised and underdelivered. That can be corrected. If we have to delay the mandate for a few months because of it, fine. Republicans who carp about the system being a failure because it can’t handle the demand sound like Yogi Berra’s restaurant review (“Nobody goes there, it’s too crowded”).
Yes, but that’s always been the case. Always. And yet many, many young (18-30) people never ever got health care, before. Why would this suddenly jump up and make them pay attention to their health care now? And you will still have ER care write-offs. Don’t think that ER-as-primary-care use will magically go away.
I don’t think this system is going to work. Even if all of the healthy people step up and do their civic duty and don’t cop out on health care, we are only forcing people to buy into a fundamentally flawed system. American health care is all about profit instead of about making people healthy.
For-profit insurance and an ever-growing segment of for-profit hospitals (especially in dense population areas) is driving costs up in a spiral of greed. This isn’t going to fix that. We will still have the most expensive health care in the world, but now it’ll be mandated that you participate in the flawed system.
The ACA doesn’t address any of this. It simply forces you into the market to make insurers happy but at the detriment of people who have issues making ends meet already.
I can think of several reasons.
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The cost of government programs is not as apparent as the cost of private plans. People know in a general sense that their taxes pay for government programs, but the tie-in is not as direct as it is for fee-for-service exchanges, and many people tend to regard government services as “free” or “the government” paying for it. People complain about taxes, but tend to view these as unconnected to the services, which they want more of. The idea that you might have to pay for things that you’ve been getting “for free” is always going to engender a certain amount of fear and loathing.
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There are some people who actually are making out well, mostly at the lower tax brackets. So there’s always a core of support for that system.
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Some people are are getting the best of both worlds by relying on the Canadian system for some things and traveling to the US for others. (I have Canadian relatives who live in the US and do the opposite - they go without insurance and pay out of pocket for minor unscheduled services in the US. For medical necessities for which they have advance notice, they schedule a long time in advance for when they visit family back in Canada, and also rely on the Canadian system for the possibility that they might have some sudden catastrophy.)
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Same reason the single-payer system is unpopular in the US. There are advantages and disadvantages of each system, and while people like to complain about the downsides, they tend to be reluctant to give up the upside. Especially as a single payer system tends to displace any alternatives, so that people would be contemplating an undown as-yet-to-be-developed alternative. That’s one reason it’s very difficult to close down major government programs, whether good or bad.
This is true, but the demand is not genuinely reflective of individual enthusiasm or interest. For instance. in Wisconsin the state is phasing out “BadgerCare”, and sent out letters to more than 100,000 people in the program and another hundred thousand to people on the waiting list for it, that they would no longer be covered or that the waiting list was being tossed. The letter referred them to the Federal website as the place to go for an alternative.
So that’s 200,000 people in one state who were steered there because their “regular” option was pulled out from under them. I was one of them as I was on the waiting list, though luckily I found a job after getting on the list so I now have insurance through my employer.
That’s true. However, over the past 4 years we’ve heard a lot about the online exchanges, and I for one don’t recall hearing anything about buying insurance by mail or any other way. The insurance exchanges were clearly intended to be the heart of the marketplace.
The whole goal of the exchanges was to provide a user-friendly, fast experience for those shopping for health insurance. Online, in theory, it’s easy to see all of the options in detail along with prices. Over the phone, it’s not so easy. Online, you can see all the details about the plan you’re considering. Over the phone, not so much.
I wasn’t talking about the mail. I was talking about the exchange sites run by the states.
I’ll just throw this in the mix. An account of how Republican opposition to Obamacare (after it was signed into law) was a significant factor in the problems we’re seeing today. Delays in beginning the programming due to legal battles, refusals to fund additional resources to implement, long delays in deciding on state exchanges, etc.
Republicans feel that the government can’t do anything right, and are doing everything they can to prove it.
All of that seems very weak to me.
You can’t blame Republicans because you passed a law and underestimated (and/or undersold) how much it would cost to implement it in your own law.
The idea that they couldn’t move ahead before getting the Supreme Court ruling - or the results of the 2012 election - is completely ridiculous. Nobody even thought there was much chance of any of the legal challenges succeeding until the oral arguments. And in general, if the government wouldn’t move ahead on implementation of laws as long as there are still outstanding legal challenges or people running for office pledged to oppose them, then nothing at all would get done. I have a very very hard time imagining that these were really factors.
Republicans did their best to implement Medicare Part D, while Democrats went about talking down the program as being too confusing.
It depends on the specific program.
Well, for that matter, I can offer any number of conjectures from my fertile and active imagination. But I was thinking more along the lines of the arguments being made by the very active and growing movement in Canada to repeal all of that socialist nonsense and return to a reasonable and rational approach like we have here in the USA.
Since it is already well understood that socialized medicine is the Devil’s spawn, there must perforce be a massive movement in Canada to displace it. What are their actual talking points, what is their data and citations, that sort of thing. Given the hugely popular and growing discontent in Canada with LeninCare, that should be pretty easy.
If the project managers felt that the project couldn’t be completed on time due to external factors (in this case, political horseshit and legal challenges), that should have been communicated up the chain of command so that the roll-out could be pushed to the right. Yeah, that might mean the Republicans would have “won,” but better that than for regular Americans to be stuck in this crappy situation where they were told a product would be ready on 1 October and it’s not.
Are you responding to an actual claim that such a movement or discontent exists, or is this just a rhetorical device to promote Canada-style Medicare?
What he’s saying is, if socialized health care was such a disaster, where are the movements to repeal it in places that have it now and have for a long time? Where are the Canadian Tea Partiers, or the French ones, or British? If socialized health care is really the horrible nightmare that you guys claim it is, then why hasn’t it happened in these other countries that way, and where are their movements to repeal it if its so godawful and disastrous?
One thing that might be making elucidator’s post a bit confusing is that it came in response to a post which directly answered the questions that he proceeded to ask. Something like this:
elucidator: if Canadian-style heath insurance is so bad, why aren’t people clamoring to end it?
Fotheringay-Phipps: well here are 4 possible reasons for that …
elucidator: yeah yeah, but why isn’t there a whole movement clamoring to end it?
What confused me was post #34:
Which had been directly preceeded by this:
So, it seemed that elucidator was treating Bryan Ekers’s post as some kind of anti-Medicare screed, which it obviously wasn’t.
Assuming you’re right, and thus addressing this argument: it can be intelligently argued that socialized medicine systems aren’t fungible. Just because some nations with certain characteristics have had success with their systems, it doesn’t automatically follow that a different, and perhaps flawed, system in this nation (that doesn’t necessarily share those characteristics) will be a success. The devil is often in the details.
I traveled to the U.S. by car a little while ago, and one of the things I was shocked by was that as soon as I crossed the border into the U.S. the highway had regular billboards along it advertising medical services like knee and hip replacements. These had to be aimed at Canadians.
We’re taking our kid to the U.S. in a few months to get elective surgery. It’s going to cost us about $10,000. The procedure is covered here, but the waiting list is currently over 3 years.
Canada’s dirty secret is that we severely cut back on ‘quality of life’ elective surgery, especially for the elderly. Things like hip and knee replacements generally have long waiting lists. My grandmother had to walk with a cane for several years while on a waiting list in Saskatchewan for a knee replacement.
I just looked up some of the data for the current state. The Canadian benchmark wait time for a knee replacement is 270 days. It’s considered a ‘success’ if someone gets a knee replacement within that time frame. Currently, only 59% of Saskatchewan patients receive a knee replacement within the benchmark time. In Manitoba it’s 46%. In PEI it’s only 35%. The best province, Ontario, manages 84%.
And bear in mind that we have the advantage of being able to offload demand to the United States, and that we benefit from a lot of U.S. R&D spending, a lot of which is made possible because wealthy ‘early adopters’ will pay big money for new procedures. If the U.S. went to single-payer, that form of R&D funding will vanish, and we won’t be able to offload patients to the U.S., which will probably make our system worse.
Also bear in mind that Canada isn’t truly ‘single payer’, in the sense that we have an awful lot of private health care. In fact, our government pays less per individual on health care both in terms of percentage of overall health care costs and absolute dollars than does the U.S. In Canada people are largely responsible for their own dentistry, prescription drugs, mental health care, and other non-surgical procedures. And some provinces are starting to de-list some surgical procedures as well to save costs.
From here, about 5,000 Canadians per year travel to the U.S. for health care procedures. That’s a pretty big number considering that we’re talking about a population of 30 million, and this is only that subset of the population that has a medical condition that needs treatment AND that treatment is either not available in Canada or the waiting list is too long. I think that number must be a fairly significant percentage of all the people looking for whatever those procedures are.
That depends on what you’re looking at.
For purposes of this discussion, the relevant question is itself: “what percentage of treatments are either not available in Canada or the waiting lists are too long?”
The question is not (as you imply): “what percentage of people who have medical conditions for which the treatment is not available or has too long of a waiting list travel to the US?”
Because we’re discussing (for whatever reason) the Canadian healthcare system. What’s relevant is how successful it is. How people cope with its failures is not what’s relevant.
Well, yeah, the “shortcomings” of the system are relevant if the government agency running it has planned for them. No doubt the annual number of Canadians their system doesn’t have to treat for certain conditions is fairly predictable.
Missing something here, Sam. That number, “5,000” does not seem to appear anywhere within the cited report. Nor can I see anything that supports “…this is only that subset of the population that has a medical condition that needs treatment AND that treatment is either not available in Canada or the waiting list is too long…”
Can you clarify?