A Great Article on National Healthcare

[SakiaWarner]

http://www.washingtonpost.com/wp-dyn/content/article/2009/08/21/AR2009082101778.html?sub=AR

This article is so very intelligent.
Some of the things said in here are so very freaking true and for all of those who complain about a national health care system... look at some of the facts in here and think about it.

This is the biggest indication of the issues in our country in one sentence.

The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.

Of course the problem now is how to fix a system bent on profit.. when the entire system is flawed?

This paragraph really hit home.. and is the honest to goodness truth

Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.



But still a good read.

[limondrop]

wow- GREAT read.

I needed that.

[Vekseid]

The bankruptcy counts are telling - a significant portion of hospital expenses go towards nonpayment issues. Insurers take a 30% cut while hospitals struggle to get by on 3% or less. The costs due to lost prevention can currently only be guessed at, and the same is true for the gains in productivity.

It would not surprise me to see a single payer system bring about a new economic revolution in the United States.

[The Overlord]

As Americans search for the cure to what ails our health-care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.

This is the opening phrase and probably the key point. The powers that be here in the medical sector are just plain happy with what's going on, and this is going to require some level of force to rip it down and rebuild.

1. It's all socialized medicine out there.

2. Overseas, care is rationed through limited choices or long lines.

These are standard issue and hidebound conservative arguments against health care reform. For one thing we're hard coded since the Cold War to automatically believe socialism = bad, even if there's some merits to it. A large slice of the Right is just too stupid to think for itself and just perpetuates the paranoia spewed by the most vocal among them.

3. Foreign health-care systems are inefficient, bloated bureaucracies.

This has to be my absolute favorite part. Pot calling kettle black. You've got something wrong with your head if you can't see this in the current system.

[Caeli]

I have personal experience with inefficient and bureaucracy, unfortunately.

I thought this article made a good read. :-) I enjoy the Washington Post's (and NY Times') Op-Eds.

[Revolverman]

Both Private and public health care are failures.


We need to find a system that doesn't cater to Big Pharm.

[Vekseid]

Step 1) Disallow all drug advertisements
Step 2) Mandate efficacy reviews of all treatments
Step 3) Less Pharma profit.

[Vekseid]

Also, patent busting >_>

[The Overlord]

Step 1) Disallow all drug advertisements
Step 2) Mandate efficacy reviews of all treatments
Step 3) Less Pharma profit.

Yeah you got fat cats getting fatter off this industry. Only way I see radical change here is you’re going to have to start knocking them off to drive home the message. You can’t pass legislation to control them or make them illegal, because they’ll just buy enough votes in congress to keep doing their good work.

[September]

Less pharma profit = less pharma.

[OldSchoolGamer]

Eliminating the prohibitions against Americans getting drugs from Canada would go a long way toward lowering drug prices.

One's position on this issue makes a good touchstone as to whether a person is truly a believer in free markets, or merely a believer in free markets so long as it profits the wealthy...

[Revolverman]

Personalty, I feel debating on how to pay for health care is stupid, the real issue is how do you make it cheaper.

Why is it everything falls in price, but health care continues to skyrocket?

[Vekseid]

1) Medicare underpayments. Medicare pays for a majority of health care coverage in the country, but it only pays ~75% of actual costs. So hospitals need to charge everyone 20-30% more to cover it.
2) A lack of preventative care, combined with medicare. Basically, we insure people when they are 65, guaranteed... but not before then. This means that treatments that would have cost a trivial amount if they had been caught five to ten years earlier now cost tens to hundreds of thousands... driving up costs.
3) Bankruptcy, insolvency, and other nonpayment issues. This accounts for a good 5-10% of healthcare costs alone.
4) Pharmaceutical advertising. It needs to be banned. Seriously.
5) Insurance premiums and overhead - they take an additional 30% cut.

...there are other reasons, but it is a known fact that guaranteed health care would cut costs significantly - and soon. The political will for the public option actually comes from financial institutions - healthy people are more likely to pay their debts. Guaranteed healthcare is an economic driver, not a burden.

[Pumpkin Seeds]

Less pharma profit = less pharma.

The American pharmaceutical companies that people are so quick to defend do not share the same loyalty.  Basic logic does state that if a company stands to make more money, they will produce more.  Yet this is not the case with pharmacy.  Currently the United States picks up the tab on research costs for most of the drugs produced.  Sure other countries contribute, but the United States is charged massive amounts of money to cover research.  This is because we will pay for it where as other countries say they will not. 

Canada gets the same drugs for so much cheaper that they can turn around and sell them to us at cost.  That is a ridiculous thing to have happen.  As consumers we are idiots if we do not try to take advantage of that savings.  When people did, the government suddenly claimed hazard and shut down the shipping.  Curious though that these are the same exact drugs we get, but because they went through Canada they are now dangerous.

[RubySlippers]

What about the working poor and indigent poor (homless people, people forced to work part-time or at minimum wage at say 30 hours a week which is common in my area?

Last year I worked and earned a little over $12,400 for the year before taxes, how do you expect me and I work to cover co-pays and deductibles. Last month I had for the month to spend $38 after covering rent, utilities, food, transportation ($30 bus pass) and my cheap dial-up internet. I only have cable because its given to me by my folks free off a side cable and its BASIC service only.

For people like me the only real option is to make Medicaid income only based and expand it to say 133% of the Federal Poverty line. I will be blunt if they give me any other plan odds are high I would never use it. Even a $25 office visit is insane not including the costs of treatment which would likely eat up what tiny income I have left. I could afford a dollar or two here and there for doctors care and medicines but thats it. Homeless Americans are even worse off than I amand a bigger medical concern if they don't get care they will end up in the system costing a great deal of money.

Why not start there I looked at the numbers my group is the one group that is there that must be cared for. Most of the others choose not to have health coverage or employers don't provide it they should be treated seperately.

[Mr Self Destruct]

Do we really want the government in charge of our medical rights?  Granted, if you can afford insurance, you're good to go.  You pay your copay, you see your doctor, and take your medications.  If you don't have insurance, then yeah...you're pretty much screwed.  But with things like Medicare and Medicaid, along with the various state sponsored medical coverage for children, there are options.

Take a look at the cash-for-clunkers program that the government has recently conducted...

Every person who took advantage of the government's money is going to have to pay it back at the end of the year when tax season comes.  Granted, the idea was intended to be a good one...turn in your hunks for cash, and buy yourself a decent ride.  But nothing is for free, and there's going to be a lot of pissed off people come tax season.

Another example is the recent tax leniency on federal income tax for workers making less than a certain amount (can't remember exactly, I think it's near $200 a week).  Yeah, you might have more money now, but when the government comes calling for their share of your paycheck, guess what?  You pay, or you get busted for tax fraud.

Socialism is a bad thing.  Plain and simple.  Its been tried and it has failed!  Time and again, it has never worked, and a little research on the topic will prove just that.

Do we want the government having power over the people?  Do we want our freedoms squashed in the name of government sponsored security?  Is it worth having a security blanket provided by our nation's leaders, just to have to give up our fundamental rights as Americans?

Thomas Jefferson said it best, "When the people fear their government, there is tyranny; when the government fears the people, there is liberty."

[Andy]

Do we really want the government in charge of our medical rights?  Granted, if you can afford insurance, you're good to go.  You pay your copay, you see your doctor, and take your medications.  If you don't have insurance, then yeah...you're pretty much screwed.  But with things like Medicare and Medicaid, along with the various state sponsored medical coverage for children, there are options.

Take a look at the cash-for-clunkers program that the government has recently conducted...

Every person who took advantage of the government's money is going to have to pay it back at the end of the year when tax season comes.  Granted, the idea was intended to be a good one...turn in your hunks for cash, and buy yourself a decent ride.  But nothing is for free, and there's going to be a lot of pissed off people come tax season.

Another example is the recent tax leniency on federal income tax for workers making less than a certain amount (can't remember exactly, I think it's near $200 a week).  Yeah, you might have more money now, but when the government comes calling for their share of your paycheck, guess what?  You pay, or you get busted for tax fraud.

Socialism is a bad thing.  Plain and simple.  Its been tried and it has failed!  Time and again, it has never worked, and a little research on the topic will prove just that.

Do we want the government having power over the people?  Do we want our freedoms squashed in the name of government sponsored security?  Is it worth having a security blanket provided by our nation's leaders, just to have to give up our fundamental rights as Americans?

Thomas Jefferson said it best, "When the people fear their government, there is tyranny; when the government fears the people, there is liberty."

I disagree, in Denmark, we have government ruled health care, that we pay through our taxes (mostly) i havent been hospitalized much, or have done much study on this, but so far, it works. What i can see youre pointing out is that a corroupt government cant handle social healthcare, where an un-corrupt one can.

[Mr Self Destruct]

What makes you think that American government isn't corrupt?

[Andy]

Never said it wasnt, since that has been obvious to me since Bush got elected, which is around when i started to get insterested in politics :P

[RubySlippers]

How come socialism is bad ONLY when it doesn't benefit you - seems to be the consensus.

Medicare is ok if your a senior.

The VA seems fine if your a military veteran.

Medicaid is fine if your poor.

The fire department, police, military, public libraries, free public education, loans for college ...

do I NEED to go on?

Health care especially for the low income and indigent is important as is keeping costs under control and the free market as much as I like it can't fix this without strong government oversight. People are dying from preventable illnesses, suffering without care, going bankrupt over medical bills that have insurance etc. We need health care reform.

[Oniya]

And we certainly don't need lawmakers imposing fines for people who don't have health insurance.  Right now, it's a choice between health insurance and having a roof over our heads.

[RubySlippers]

The goal is to get everyone on a health care plan one way or another. I think the fine is a bad idea but the need for universal coverage is necessary to help keep costs down. I think an easier way would be to have a BASIC pacakage at a good price everyone must take and make sure its affordable for a lower income family. All insurers must offer this at no profit but can make a profit on add-ons. Nothing fancy but a good solid basic plan.

Maybe something that would be one or two days pay for a person on minimum wage a month, more for a family but reasonable.

[Oniya]

Offer something affordable, and I'd jump on it.  Until then - I don't want to use my mandatory insurance to pay for treatment for malnutrition.

[The Overlord]

A very good follow-up to the article. If you vote against reform, then you deserve shit medical service, as you were too stupid and gullible to ignore the scare tactics.


The Truth Behind Public Option

[Marlow]

Socialism is a bad thing.  Plain and simple.  Its been tried and it has failed!  Time and again, it has never worked, and a little research on the topic will prove just that.

Uhm, no, it isn't. Yes, communism doesn't work, but when it's married with democracy, socialism works wonders. Look at Sweden. By far a very socialist nation, and it's not some evil satanic nation run by the anti-christ.

Americans need to stop looking at the past, and looking at the present. Socialism is an umbrella term for a lot of different types of government. Saying it all is bad is like saying all Americans are dumb, uneducated hicks. It just isn't true. Some Americans are, but the vast majority aren't.

[Vekseid]

Do we really want the government in charge of our medical rights?  Granted, if you can afford insurance, you're good to go.  You pay your copay, you see your doctor, and take your medications.  If you don't have insurance, then yeah...you're pretty much screwed.  But with things like Medicare and Medicaid, along with the various state sponsored medical coverage for children, ...

The possession of health insurance does not affect bankruptcy rate. The reason for this becomes obvious quickly - insurers take a ~30% cut, and effectively get you a ~30% reduction in medical fees. They are essentially just middle men who add no value to society.

there are options.

This is either a lie or willful ignorance. There are two options for the self employed in the United States.

1) Quit all revenue-generating venture - expenses are not considered by any public system currently available in the United States. Wait six months, get public health care.

2) Commit a crime, go to jail. This way you don't have to wait six months.

Socialism is a bad thing.  Plain and simple.  Its been tried and it has failed!  Time and again, it has never worked, and a little research on the topic will prove just that.

Which explains why the US is a debtor nation to say, Sweden and Japan, has a net trade deficit with them both and inferior life expectancies to both.

Which is actually rather odd - an aging populace should be less productive.

An unhealthy population is apparently even less so.

[Serephino]

Yeah um... what I'm about to say is a rant, but also pertains to this topic....

I received a letter today telling me I no longer have Medicaid.  Why you ask?  My disability income is magically too high now.  It hasn't changed when I was approved April.  But when I called my case worker she said I was approved only because I had a medical bill (a $1200 ER bill). 

Now that was paid for in April.  I continued to have Medicaid all summer, for 5 months.  So really that explanation doesn't add up.  My theory is they were getting pissy because I was getting my teeth fixed.  I still have 5 undrilled cavities, but I guess my teeth will just have to rot.

I was told by a few people that because I'm disabled they can't deny me medical coverage by federal law.  When I pointed this out to my caseworker she asked if I had a certificate of disability.  My response was that the Social Security office obviously believes I am disabled since they're sending me a DISABILITY check every month.  What more proof do they need?  Then of course she asked how much my check was and when I told her I again was told it's too much. 

I really can't stand dealing with them!  I have fantasies of blowing that office into a million fucking pieces with all of those fucking morons in it.  They will use any loophole they can to deny people who really need the help. 

It pisses me off that people with insurance are so willing to leave me here in this hole because a plan I could afford would be too socialist.  What did I ever do to deserve to have all my teeth rot out and get sick and die of something that could easily be treated?  I never asked to be bi-polar.  I tried to work damn it!  I had 7 jobs in 2 months, got fired from all of them, usually on the first day, because I kept having a nervous breakdown. 

Social Security doesn't give me enough to live on, forget paying $120 a month for health insurance.  I could get Medicare, but that would be $109/month, and they only cover 80% of approved procedures, plus a $135 yearly deductible.  That's worse than crap. 

My very good credit was destroyed when I got a gallstone.  My mom keeps telling me I might as well go ahead and declare bankruptcy because it can't hurt my credit much more.  My score went from 712 to 561.    That's what having medical bills you can't pay will do to you.  So what will happen if I get sick again?

I was sick to my stomach when I had to call and cancel my dentist appointment.  I also have TMJ syndrome, but I guess I'll just have to live with it, because treatment costs money I don't have.

[RubySlippers]

First off Medicaid in most states does restrict care in Florida you must be a pregnant woman, very poor child, unable to work at least a year after they approve the status or be unexpected to live for at least a year. Besides being poor.

This is why I support the 133% income guideline to get on Medicaid regardless of other factors, just income based. But itw odd your on Federal disability I would think you would be disabled they just don't hand out that status like candy, its alot of hoops to jump through if I'm correct on that.

[Kotah]

I am all for health care reform.

However, Obama's plan isn't the way. It really isn't going to change anything, but if you don't have insurance... You get to pay a neat little fine to the insurance companies. I don't see this as a solution.

What would be the best solution is a single payer system that can be supplemented by normal insurance. What do you get? Everyone has health care, and for the people that want a little extra they can have extra, if they pay extra.

As far as medicare is concerned. Please hope you never have to have it. This is how medicare works. Say you have a stroke. In very small small scale to keep everything simple, let's say the average recovery time for a stroke is 90 days. You spend 10 days in the hospital, and 80 days in a restorative care program. The 80 days include: 40 days of physical therapy, 80 Days of PROM and AROM therapy, yadda yadda. A bunch of therapy happening all at the same time to get you ready to go back to the world.

Day 84 you fall down, and hurt yourself. You now have a sprained wrist. You already have limited mobility because of your age. I.E. You are in a wheel chair. Medicare only pays for you to receive care for 90 days. You better hope that wrist gets better in 6 days. Cause unless you have a few thousand dollars to throw around, your ass is going home.

I have had this happen to countless patients, and I just get to sit around and wait for the time limit to be up so they can come back to us, and try to make them better again... so we can send them home to hurt themselves. We can't do anything to stop it. Why? Medicare only provides for a standardized care program.

[The Overlord]

Socialism is a bad thing.  Plain and simple.  Its been tried and it has failed!  Time and again, it has never worked, and a little research on the topic will prove just that.

Some thoughts to gnaw on here-


Socialism and communism’s main bad rap here is not their inefficiency, but because they’ve been the government of the ‘enemy’. The words invoke an automatic knee jerk reaction from many of us.


Now the reason they don’t work is the same thing that fuels capitalism; basic human avarice.


On paper, a socialist state looks pretty good, because it provides for all, and everyone gets a slice of the pie. In practice it doesn’t work, because inevitably someone who gets into a position of power, influence, or authority decides they’re not just happy with their slice of the pie…they want yours too.


To expand on what I said above; the reason they don’t work is the same thing that fuels capitalism; basic human avarice. Capitalism is fueled and oiled on greed.



…for a little while longer.




And that is what I fear we’re seeing right here, right now, with the current financial debacle, knowing how it came to be. We’re finally learning the limits of capitalism.

[Celestial Goblin]

The way the terminology gets used and abused in service of political propaganda is disgusting.

The Euro-Canadian-etc concept of society providing things like healthcare and education to everyone in need is thing A.

The totalitarian system that existed USSR and the rest of the Soviet block is thing B.

Thing A is as apart from thing B as a monarchy is from democracy.

[Kotah]

I agree with Celestial Goblin. There are different types of everything. Canada is obviously no USSR. The difference even goes deeper then socialism and communism. There are different types of communism.

In example, take Maoist China vs. Stalinist Russia. They are both types of communism. Stalinist communism is described as Proletariat Bonapartism. While Maoist China is described as peasantry Bonopartism. Cuba is a strange mixture of the two, but far more closely related to Stalinist Russia then to Maoism.

The difference between the two type of communism are as different as a non-denominational church, and a southern baptist church. They may get along from time to time, and they may agree on some things, but if you really look in to the basic doctrine they are clearly different from each other. Different means to the same end.

That is not to say, however, that Stalin and Mao were not jerks that the world is better off without.

My point is, just because certain type of socialism and communism fail, doesn't mean that everything about them is a failure. Canada, and most of Europe, have some from of national health care that far outdoes the united states. The united states at 37 in the rank for health care. With about 18 countries that have national health care ranking above us. I would also like to note that France, which has national health care, is ranked 1. This ranking is done by the World health organization.

http://www.photius.com/rankings/healthranks.html

[Oniya]

Just to make sure all the facts are on the table, that chart was produced in 2000, and the WHO no longer produces a chart like that, due to the complexity of the task.

[September]

The trouble with that WHO report is that it's not really ranking countries on "health care".  It's ranking countries on various things including "fairness of financial contribution" and "distribution of financing".

If you rank countries on things like "cancer survivability" and "waiting times" and "number of medical breakthroughs" then you would get the countries in a different order.

As with so much in politics I think that in this case you have to really do your own research and not just rely on politicians and bloggers and people on internet forums to tell you what you should think.

[Kotah]

Then to clarify my point. http://ucatlas.ucsc.edu/spend.php

Despite the wide gaps, higher spending on health care does not necessarily prolong lives. In 2000, the United States spent more on health care than any other country in the world: an average of $ 4,500 per person. Switzerland was second highest, at $3,300 or 71% of the US.

If you look at the graph for average life/ pc spending You see that France, who was ranked first, has a better life expectancy, with the universal health care. Where as, America spends the most out of any country. It ranks just above Cube, which spends the least amount in health care.

Another reason some countries achieve high life expectancy with low health spending is that clean drinking water and preventive health care can be provided with little spending. If there is near universal clean water and preventive care, life expectancy rates can be high. In the US, however, nearly 40 million Americans lack basic health insurance, and are therefore less likely to receive preventive care.  In contrast, Cuba has universal health care and one of the highest doctor-to-patient ratios in the world.

These were all made in 2000 too.

http://graphics8.nytimes.com/images/2009/02/28/business/0301-sbn-webHEALTH.gif

1960-2008 US health care spending.

As for waiting times, ect.

Preventable deaths in 2000-03
http://www.allcountries.org/ranks/preventable_deaths_country_ranks_1997-1998_2002-2003_2008.html
Healthy life expectancy
http://www.photius.com/rankings/healthy_life_table2.html

Cancer survival rates highest in France and Japan:http://www.medicinenet.com/script/main/art.asp?articlekey=91106

It's simply easier to link information then try to argue out.

[Kotah]

It posted on accident. The last link is for the 4 main common types of cancer. The highest life expectancies countries are, France, Japan, USA, Canada, and Australia. Not necessarily in that order.

[September]

Respectfully you are kind of illustrating my point by cherry picking certain statistics that support the conclusion you would like everybody else to reach.

Here's a page written by somebody who wants you to draw the opposite conclusion: http://www.ncpa.org/pub/ba649#_edn1

The writer demonstrates that:
- Americans have better survival rates than Europeans for common cancers.
- Americans have lower cancer mortality rates than Canadians.
- Americans have better access to treatment for chronic diseases than patients in other developed countries.
- Americans have better access to preventive cancer screening than Canadians.
- Lower income Americans are in better health than comparable Canadians.
- Americans spend less time waiting for care than patients in Canada and the UK.
- People in countries with more government control of health care are highly dissatisfied and believe reform is needed.
- Americans are more satisfied with the care they receive than Canadians.
- Americans have much better access to important new technologies like medical imaging than patients in Canada or the UK.
- Americans are responsible for the vast majority of all health care innovations.

This issue isn't as clear cut as some people are making it out to be.

[Vekseid]

If you really want to get into the wait time fight, look at Japan.

[RubySlippers]

I'm a lower income AMerican I have no clue what your smoking but on my income of $12,900 last year and chronic medical care is needed trust me I'm fraked in the US. Diabetes care NADDA no drugs, testing supplies or insulin. My related conditions Diabetic Retrinopothy NADDA, Diabetic Neuropothy (bleeding in the eyes) NADDA and Weakened Legs NADDA.

And lets be blunt what the hell good are all the fancy new treatments, care for cancer and other frankly rarer conditions when I and many others can't get fraking basic fraking care for common fraking conditions. Trust me if I go blind, lose my legs or get a horrible infection its going to cost alot more down the road. All PREVENTABLE if I can see a medical doctor, get basic drugs and a specialist or two now and then.

I'm blind I can't work that means social security disability, housing assistance, medicaid anyway and I'm not working and paying for housing and my other needs. Not to mention pain, suffering, losing my quality of life etc. that is right now a real worry.

Can I add one thing in Canada how many people GO FRAKING BANKRUPT over medical debts? In the UK, France, Finland, Netherlands or other nations? In the US a third of bankruptcy cases not due to stupidity (credit card debt etc.) are medical or caused do to medical bills in the main.

Sorry for all the fraking but I'm sick of writers stating numbers when I'm among the working poor and get ignored. And sick of looking at this issue from the use of rarer medical issues over day to day care.

[Kotah]

I would actually disagree. In your like it gives specific statistics that don't fully support that claim.

I'm not going through them all.

Americans have better survival rates than Europeans for common cancers

In breast cancer and prostate cancer. two of the four. Where as  France has higher survival in colon cancer, another of the four, it isn't so far behind in breast cancer either. As per my link above. France is in Europe too. :)

As far as the best innovations...
The pharmaceutical industry has a financial incentive to make sure that these people are repeat-customers, consequently there is very little research being done to find a cure. Most research done by the private sector is centered on finding new anti-retroviral drugs - drugs that patients will have to continue taking for a lifetime.

Meh. DCA has been proven to be effective against many forms of cancer, but it is not being researched as a cure for cancer because, well, DCA is not patented or patentable. It's not getting funding for clinical trials because the only places that are supporting the research are not-for-profit. The can't get enough money to possibly cure cancer.

I'm in health care. I don't have health insurance. Slightly ironic. I

[Serephino]

Lower income Americans are in better health than comparable Canadians.

Really?  Did you not read my rant?  I have TMJ, 5 cavaties, Inflamitory Bowel Disease, allergies, bi-polar disorder, bad knees, insomnia...

I could go on and on.  I am in very bad health, and so is my boyfriend.  He randomly passes out.  We have no idea what's wrong with him.  Why?  Well... One of your points was that Americans have access to better care, but that's only if you can afford it.  We can't. 

I am at very high risk for both heart disease and diabetes.  I should be getting regular screenings for both, but I can't.  Those tests cost money.  I have no idea what my cholesterol level is.  And I could have diabetes right now and not know it.  I could decide to go get an ice cream sundae one day and end up in a diabetic coma.  The last time I was tested was when I was 19 and had insurance.  A lot can change in 5 years. 

As for the wait times in other countries, if you read through this entire topic, members here who live in said countries have said the wait times really aren't all that much worse there in the US.  I think I'll take the word of someone who lives in Canada, Britain, or Australia rather than some Congressman trying to be an ass.   

[RubySlippers]

I looked up the Finance Committees Health Care Bill it also expands Medicaid to those at or under 133% of the Federal Poverty line, strictly income based. I know its not perfect but anyone either working part-time or doing seasonal work will have a chance at getting coverage. And the rest will seem to get help to get coverage based I think off your income levels as a percentage. For families of three over $55k income it would be 13% of their income a month as a target for costs. Lower for lower incomes so it seems like it can work. Combined with other reforms naturally.

[OldSchoolGamer]

Respectfully you are kind of illustrating my point by cherry picking certain statistics that support the conclusion you would like everybody else to reach.

Here's a page written by somebody who wants you to draw the opposite conclusion: http://www.ncpa.org/pub/ba649#_edn1

The writer demonstrates that:
- Americans have better survival rates than Europeans for common cancers.
- Americans have lower cancer mortality rates than Canadians.
- Americans have better access to treatment for chronic diseases than patients in other developed countries.
- Americans have better access to preventive cancer screening than Canadians.
- Lower income Americans are in better health than comparable Canadians.
- Americans spend less time waiting for care than patients in Canada and the UK.
- People in countries with more government control of health care are highly dissatisfied and believe reform is needed.
- Americans are more satisfied with the care they receive than Canadians.
- Americans have much better access to important new technologies like medical imaging than patients in Canada or the UK.
- Americans are responsible for the vast majority of all health care innovations.

This issue isn't as clear cut as some people are making it out to be.

The above may be true...but with an important qualifier:

"...for those who can AFFORD a good insurance plan, or who can pay medical expenses out of pocket."

Trouble is, we've got millions of people who can't afford decent medical coverage, and who therefore do not achieve the outcomes discussed above.

We can't do an apples-to-apples comparison of the American system versus others if we disregard the medical outcomes of those who cannot afford access to the system.  They count too.

[The Overlord]

Hmmm...

The writer demonstrates that:
- Americans have better survival rates than Europeans for common cancers.
- Americans have lower cancer mortality rates than Canadians.
- Americans have better access to treatment for chronic diseases than patients in other developed countries.
- Americans have better access to preventive cancer screening than Canadians.

Other than the claims made in the article, I have seen nothing one way or another on this.

What I can tell you is this- In less than a decade I’ve see two family members go down from cancer. If you’re paying attention at all, an alarming number of celebrities have been taken down by cancer just this year. Perhaps our numbers are better, but if you ask me, a few more statistical percent points than Europe or Canada are small consolation for those of us that have lost loved ones to this evil…cancer is still getting enough of us. >:(

- Lower income Americans are in better health than comparable Canadians.

Really? It’s news to me that any country let alone the US statistically gave a fuck enough about its poor to tally this with any degree of accuracy. ‘Mister Atlas’ will forgive me if I don’t take his word for it.

- Americans spend less time waiting for care than patients in Canada and the UK.

Maybe…maybe not. I’d like to see real stats on this. Better yet, any Canadians on the forum that can pitch their two cents?

- Americans are more satisfied with the care they receive than Canadians.

Are they? Once again…

- Americans have much better access to important new technologies like medical imaging than patients in Canada or the UK.
- Americans are responsible for the vast majority of all health care innovations.

Bear in mind that ‘access to’ and actual use of are two different animals, given the inflated medical prices here. No matter how you feel about Obama’s health care reform package, I’d bet my left nut nobody here believes US healthcare prices are sane.


Furthermore- a quick Wiki browse states “The NCPA states that its goal is to develop and promote private alternatives to government regulation and control, solving problems by relying on the strength of the competitive, entrepreneurial private sector.”


This tells me nothing, in fact if anything it makes me wary of the NCPA, because it’s the competitive, entrepreneurial private sector that gotten us to where we are. Of course they oppose meaningful health care…too many of them are getting fat like slugs off the profits. Like the NCPA, they don’t want regulation…business is good, and people are dying to make their profit.

[RubySlippers]

I don't understand the problem with the government option we have the US Postal Service and UPS and FedEx and all seem to be happy together.

As for government control we have the VA, Medicare and Medicaid and locally and state run programs all socialized in the common understanding.

As for rationing care with pencil pushers the INSURANCE COMPANIES already do that and far more cruelly than the government likely would, maybe more government oversight is necessary. Its just how its set up that matters.

[Trieste]

I don't understand the problem with the government option we have the US Postal Service and UPS and FedEx and all seem to be happy together.

That seems like it's actually a really good comparison.

[OldSchoolGamer]

I think the best approach to national health care is to utilize the Pareto Principle.

To oversimplify, the Pareto Principle holds that approximately 20% of the population of something is responsible for around 80% of the traffic.  If you have, say, 30 people on your cell phone contact list, you probably call 5 of them every day, the next 5 a few times a week, the third 5 maybe once a week, the fourth five, a couple times a month, the bottom ten, rarely or never.

In health care, there's a relatively small percentage of all the ailments out there that are the primary drivers of health care utilization.  Minor injuries.  Respiratory infections and influenza.  Management of chronic conditions like hypertension, diabetes, thyroid imbalances, pain, depression and schizophrenia.  Caries.  These are conditions that are relatively cheap and easy to treat...yet have the potential to spiral into expensive, debilitating, even (in some cases) life-threatening situations if they are not managed.

This is what a national health care system should focus on: covering everyone for this 80% or so of doctor's office visits.  This would keep the cost of the national coverage down, yet substantially improve the lives of the presently uninsured.  It would also help serve to bring costs down, as it's a lot cheaper to treat a condition with a $50 office visit and a $50 prescription than a $2,500 ER visit.

[Vekseid]

That's entirely unnecessary. We're already doing that. Government spending covers the disabled and the elderly - or tries to. The lack of preventative care is the killer, however. Literally as well as figuratively.

Right now, business self-insurance in the United States costs around $3k/person per year for large companies. Similar coverage would cost $1,500/month for me, if I bought it from an insurance company. There isn't a single situation where it makes sense for me to pay an insurance company - if I got struck with cancer, for example, they would not pay back more than I paid them. That's not insurance, that's a bank account with a negative interest rate.

[RubySlippers]

I pointed out in a Town Hall Meeting that there are ajor issues with the proposals first they are hardly keeping the entire thing simple which is turning people off to the reform bill proposals even if I want to have it happen. The second is that oddly the entire plan group is poorly thought out. There are maybe four things that have to be done:

1. Figure out how much money there really is and what people and businesses can afford to do, and I think all businesses should have to be in the system to some degree.
2. Cover the very poor the Medicaid expansion could do that.
3. Instead of a public option have a basic package that all insurance companies must offer at no propfit, that is low cost and reasonable even if it "rations" care and keep the price at say for an average full time worker earning the minimum wage no more than three days pay. More for a family but I think $150 a month split with an employer is reasonable to ask. The insurers can make money on add-on to basic packages and would have flexibility to provide treatment include exporting patents to foreign hospitals if it saves them and the patient money.
4. Serious electronic recordsreform I should be able to get one card I can take to any provider and they should get all my necessary information with one swipe, ideally. That would also cover insurance coverage and make that streamlined as well.

[Trieste]

It would take an extreme amount of work to get something like that to happen. This is why:

1. Figure out how much money there really is and what people and businesses can afford to do, and I think all businesses should have to be in the system to some degree.

The current system is murder on small businesses - and a system like this would also be murder on them. Small businesses are not expected to turn a profit for the first 2-3 years, for example. So we're talking about either adding the cost of health care for all employees onto whatever small business loan they'll have to take out - and forcing entrepreneurs to repay the cost of employee health insurance with interest when those loans come due - or having employees of small businesses in their first three years go uninsured. Neither option is viable, for various reasons. We have to stop punishing small, private businesses with the healthcare system; they are what drives the underpinnings of local economies.

2. Cover the very poor the Medicaid expansion could do that.

Medicaid is broke, on top of being broken.

3. Instead of a public option have a basic package that all insurance companies must offer at no propfit, that is low cost and reasonable even if it "rations" care and keep the price at say for an average full time worker earning the minimum wage no more than three days pay. More for a family but I think $150 a month split with an employer is reasonable to ask. The insurers can make money on add-on to basic packages and would have flexibility to provide treatment include exporting patents to foreign hospitals if it saves them and the patient money.

If we could trust insurance companies to offer what would be considered fair and affordable, we wouldn't be in this mess in the first place. On top of that, it would be foolish to expect insurance companies to accurately report expenses (and therefore profits) without a ton of oversight. Oversight is costly. If we're going to need to employ an army of healthcare officials, we might as well cut out the middleman and go for public option.

4. Serious electronic recordsreform I should be able to get one card I can take to any provider and they should get all my necessary information with one swipe, ideally. That would also cover insurance coverage and make that streamlined as well.

That way, when a laptop gets stolen from a state secretary in Oregon, the thief can have easier access to a whole lot more information. *thumbsup*

[RubySlippers]

If you look at the one group that is impossible to expect to pay for health care if its demanded its the poor, many of whome work. In my area the majority of homeless work they sell newspapers in Sunday, do day labor or in one case takes money to clean up dog shit from properties and collects cans. I have to respect those people and think if one is trying offering health care might keep costs down.

And guess what if I would get really sick and need major care your still going to pay for it just after lower cost care would have been cheaper.

As for small business one could exclude them for a period of time say until they turn a profit as determined by the IRS at a fair level. The law could define that.

[Vekseid]

...I don't think you are disagreeing with Trieste as much as you think you are >_>

[RubySlippers]

Update on PBS the News Hour it looks like everyone seems to agree on a Medicaid expansion and the unisured families earning over $88,000 a year should be paying for their own coverage. So what we have to look at is the rest of the uninsured citizens.

All I know this passes I'm going to be sure never to earn more than the poverty limit minus $1.  Working sucks anyway so working part-time would be good and let me relax I should be able to get along on 20 hours a week. No really with that health care worry gone I can make enough to cover room & board and cover my few other needs if I get that.

I'm a big fan of the Idle Foundation and the Leisure Ethic, the less I have to work the better.

[Trieste]

So that others have to work harder to support you? That's pretty ridiculous.

[Serephino]

Interesting....  In this Medicaid expansion are they making doctors take it?  Cuz um yeah... you know what I had to go through to find a dentist that took it to do really crappy work that still hurts?

[RubySlippers]

I would, just say any provider taking Medicare has to take Medicaid.

And come on why should I be forced to work more because its expected, no one is making others work 40 hours at high paying jobs I just have simpler values, assuming Medicaid passes that would take the one reason I have to work so hard.  Some nice reading on the subject: http://www.whywork.org/rethinking/leisure/easy.html But I prefer to be productive not busy I feel if I work 20 hours that leaves more time to do other things like read or volunteer or other meaningful things I want to do.

[Trieste]

[There was originally a very long post here, but I have come to the conclusion that it's just not worth the aggravation, so I deleted what I had typed.]

Ruby, I hope you come to be a woman of great means one day, and I hope you have someone with precisely the same attitude as that living under your roof. If you enjoy it, fine with me.

[Vekseid]

Interesting....  In this Medicaid expansion are they making doctors take it?  Cuz um yeah... you know what I had to go through to find a dentist that took it to do really crappy work that still hurts?

A part of the expansion does involve increased payout rates, I believe.

All I know this passes I'm going to be sure never to earn more than the poverty limit minus $1.  Working sucks anyway so working part-time would be good and let me relax I should be able to get along on 20 hours a week. No really with that health care worry gone I can make enough to cover room & board and cover my few other needs if I get that.

I'm a big fan of the Idle Foundation and the Leisure Ethic, the less I have to work the better.

You do know that if this passes, it will be a holding measure before refinement, right?

Everyone knows that the current system hemorrhages an insane amount of money each year. Since it is essentially a make work industry - that is, it actively saps productivity - allowing health insurers to remain in business actually hurts America.

[Lilias]

I follow this blog very closely; this is the latest, brand spanking new, post. Being an octogenarian in full possession of her faculties lends the author an angle we don't often see.

[Trieste]

Honestly,  if I could , I would put the entire Republic party over my knee and give them a good spanking.

Oh my god, the mental image of one of the old scooter-grannies in the banner doing this to Rush Limbaugh just slays me! *dies laughing*

[Vekseid]

That's no good, he'd probably get turned on.

[Trieste]

Noooooo I hate you...

[HairyHeretic]

You could have Dick shoot him in the face at the same time. That'd cool him down a bit.

[Trieste]

... which kind of puts a new spin on 'moneyshot'.

[Oniya]

You could have Dick shoot him in the face at the same time. That'd cool him down a bit.

*takes this the wrong way and dashes for the brain-bleach* 

[Trieste]

See? Oniya was right there with me.

[HairyHeretic]

Either would probably work.

[Hunter]

I only have this to say.

We don't need a healthcare reform.  We need an INSURANCE reform.

[MercyfulFate]

The American healthcare system is a joke, seriously.

I recently lost my job and now have to go without healthcare for weeks while waiting for a COBRA continuation. Mind you I have some prescriptions I need, and physical therapy I also need to go to.

I've had enough surgeries and issues over the years that I've seen the ugly side of our healthcare system, and it is ugly. Anyone who wants it to stay the same either:

Is Rich

or

Is perfectly healthy

[OldSchoolGamer]

[There was originally a very long post here, but I have come to the conclusion that it's just not worth the aggravation, so I deleted what I had typed.]

Ruby, I hope you come to be a woman of great means one day, and I hope you have someone with precisely the same attitude as that living under your roof. If you enjoy it, fine with me.

Let's be fair here...if such a high percentage of the fruits of our labors didn't go to idle government bureaucrats and the corporations and wealthy elite, we probably could go to a 30-hour workweek and enjoy just as high a standard of living as we do today.

I'd be all in favor of that.  Is some CEO bailing out of a failing corporation with a $50 million "golden parachute" to go play golf for the rest of his life any less a slacker than someone practicing voluntary underemployment?

[RubySlippers]

SLACKER!?!?!?  >:(

I do volunteer work both at Hospice of Florida and at my local library in the Children's Programs, educate myself and still work I just don't find slaving away just for money as worth it. And my needs are simple a bed, internet and for me high speed dial-up is perfect, food, clothing (I shop at Goodwill and theHospice Thrift Stores a great deal), transportation (half price bus passes) and my library card. And a small amount of pocket money. The one thorn in my side is fraking health care even working alot of hours I couldn't get covered so why work that much. If I earn under a certain amount and have little savings the hospitals can't bill me and most providers that give me care give me cut rates so I'm better off uninsured.

What makes me an evil one Leisure Theory makes slacking a part of evolution that we simply due to our modern advantages don't HAVE to work so much if we don't want to. Some people want more things or a higher lifestyle so that is fine, its not a big deal for me if I have my basic needs covered.

On the health care bill the doctors, insurance companies, drug companies, states, hospitals all think they are getting SHAFTED and hate the bill that came out of the Finance Committee. So I am thinking this is a good bill since everyone feels fraked, that is usually a good sign.

[September]

Obama advisor Robert Reich explains what an honest liberal Presidential candidate would say about health care reform:

I'll actually give you a speech made up entirely, almost on the spur of the moment, of what a candidate for president would say if that candidate did not care about becoming president. In other words, this is what the truth is and a candidate will never say, but what a candidate should say if we were in the kind of democracy where citizens were honored in terms of their practice of citizenship and they were educated in terms of what the issues were and they could separate myth from reality in terms of what candidates would tell them:

"Thank you so much for coming this afternoon. I'm so glad to see you and I would like to be president. Let me tell you a few things on health care. Look, we have the only health care system in the world that is designed to avoid sick people. And that's true and what I'm going to do is that I am going try to reorganize it to be more amenable to treating sick people but that means you,  particularly you young people, particularly you young healthy people...you're going to have to pay more.

"Thank you. And by the way, we're going to have to, if you're very old, we're not going to give you all that technology and all those drugs for the last couple of years of your life to keep you maybe going for another couple of months. It's too expensive...so we're going to let you die."

"Also  I'm going to use the bargaining leverage of the federal government in terms of Medicare, Medicaid---we already have a lot of bargaining leverage---to force drug companies and insurance companies and medical suppliers to reduce their costs. What that means, less innovation and that means less new products and less new drugs on the market which means you are probably not going to live much longer than your parents. Thank you."

Robert Reich: What An Honest President Would Say About Health Reform

[MercyfulFate]

I will say this about healthcare reform, if we come out of this with no public option and mandatory insurance, I might snap.

I've been through the medical ringer for years for problems, add to that I live in a state with mandatory insurance and it's aggravating to say the least. Mandatory insurance simply gives the insurance companies more money and customers, while not fixing the underlying problems. People without insurance may not have it due to cost, and forcing them to get something that could be $200 a month or thereabouts is cruel.

[Oniya]

Today in the mail, I got a flyer suggesting I might be able to get insurance for $55 a month. 

That's really nice, but I've got a family, which would push it up to around $168 a month - and as it is, we're starting to sell things around the house to make grocery money.

[Vekseid]

I will say this about healthcare reform, if we come out of this with no public option and mandatory insurance, I might snap.

I've been through the medical ringer for years for problems, add to that I live in a state with mandatory insurance and it's aggravating to say the least. Mandatory insurance simply gives the insurance companies more money and customers, while not fixing the underlying problems. People without insurance may not have it due to cost, and forcing them to get something that could be $200 a month or thereabouts is cruel.

Fortunately the mandatory insurance as proposed in the Baucus bill is a joke. Ideally, Reid will remove it entirely and AHIP can go fuck themselves sideways with a tetanus-infested rusty rake.

And deny themselves coverage over the resulting surgery and infection.

[MercyfulFate]

Today in the mail, I got a flyer suggesting I might be able to get insurance for $55 a month. 

That's really nice, but I've got a family, which would push it up to around $168 a month - and as it is, we're starting to sell things around the house to make grocery money.

Tell me about it, I got laid off and lost my insurance, now I have to or I'm going to be penalized come tax time. Add to that my prescriptions will cost a whole bunch more.

[OldSchoolGamer]

I think making insurance mandatory would be a big mistake.  It might just be enough to gin up a popular revolt.  Things are going to be getting progressively worse once this illusory, fiat-money driven "recovery" sputters, and making people send their last dollars to Big Insurance could be the spark that sets off the powder keg.

[September]

Obama speechwriter moves to state with universal health insurance; finds she can no longer afford health insurance.

What makes this a double blow is that my experience contradicts so much of what I wrote for political leaders over the last decade. That's a terrible feeling, too. I typed line after line that said everything Massachusetts did would make health insurance more affordable. If I had a dollar for every time I typed, "universal coverage will lower premiums," I could pay for my own health care at Massachusetts's rates.

If you think health care is expensive now, just wait until it's "free".

[RubySlippers]

Well I don't understand why they are trying to remake the whole system if your goal is to cover the uninsured Americans why not start there first?

I saw several pie charts and most seem to agree many people who are middle class and young are uninsured by choice so why not mandate at least a basic care package for them. Something reasonable like catastrophic coverage and a basic package for primary care. Then work on those whose incomes or pre-existing conditions make government help vital.

Market reforms and the like might help with the rest of the problems.

I have another idea allow the states take a tax hourly workers paid for by the employer and worker say $1.50 per hour, and non-hourly workers a certain amount of tax. And use that for health care mandating each state cover all its citizens. Adding in already existing funds naturally. I would not mind paying half that and paying premiums and the like based on my ability to pay. But let states decid how to do this with only certain Federal mandates on what must be covered. Just an idea after seeing San Fracisco did something like this and seems to have a good county medical program covering everyone that needs coverage.

[Transgirlenstein]

Are they still sprouting the "England has death panels and people don't get treated in England due to their health care!".  Cause honestly that is the stupidest thing I have heard yet.  From my time here in London, I have far better health care then I ever got back home.

[RubySlippers]

I looked into the Death Panels all they seem to do in England is see if a new drug, procedure or devices is worth the investment of their public dollars over older well known options that are cheaper. That is very practical. Unless I'm wrong about that.

[Transgirlenstein]

Yeah, there is no one who goes "you can't go to a doctor."  Crazy American conservatives seem to think we kick the old into the Thames or something.  I mean..giving them and everyone else free healthcare!  That's just silly!  Who would do such a thing?

[September]

16.5% of all deaths in the UK between 2007-8 (about 95,000 people) came about after medical panels withdrew food and fluids from sedated patients.  That's twice as many as in other European nations.  Like Obama advisor Robert Reich said

"if you're very old, we're not going to give you all that technology and all those drugs for the last couple of years of your life to keep you maybe going for another couple of months. It's too expensive...so we're going to let you die."

Queenie, you can stop sneering for long enough to see how all that sounds a bit like a death panel to some people, right?

[Trieste]

Queenie, you can stop sneering for long enough to see how all that sounds a bit like a death panel to some people, right?

Easy, there.

[Transgirlenstein]

I would like to point out that doctors can decide that as well in the states. 

[September]

It would be very interesting to compare the percentages.

[RubySlippers]

16.5% of all deaths in the UK between 2007-8 (about 95,000 people) came about after medical panels withdrew food and fluids from sedated patients.  That's twice as many as in other European nations.  Like Obama advisor Robert Reich said

Queenie, you can stop sneering for long enough to see how all that sounds a bit like a death panel to some people, right?

What were the reasons its odd medical people in our nation just can't accept death as part of medical care. I remember my aunt had end stage renal failure and decided not to get dialysis and they forced her into therapy, when she just accepted she is ready to die and wanted to have fun. Eat things she would not dare normally and the like since she was going out anyway.

I could say this number is just accepting that people will die and not waste resources on them which will do no good.

[Celestial Goblin]

Like Obama advisor Robert Reich said
Queenie, you can stop sneering for long enough to see how all that sounds a bit like a death panel to some people, right?

If any rationing at all is a 'death panel' then those people should be protesting the fact that USA goverment rations healthcare much tighter. Do all states have free care for seniors in the first place?

Not that, mind you, I don't agree with the people from the article. But this is a problem of NHS trying too hard to save money.

[RubySlippers]

I don't get something San Fracisco set up a universal health care option that is decent to look at and covers people of different income brackets with obligations to pay. But even at the upper end its oddly cheaper than most private insurance. Even with the wait times and limits it oddly has merit. Why can't all counties just follow this model.

Its funded by taxes in this case part of that a minimum $1.25 per work hour the employer must pay, that can be higher. But since it covers all employers I don't see the issue added to that premiums, co-pays and the like people in the program are obligated to pay.

It might be one way to go.

http://www.healthysanfrancisco.org/

[MercyfulFate]

I don't get something San Fracisco set up a universal health care option that is decent to look at and covers people of different income brackets with obligations to pay. But even at the upper end its oddly cheaper than most private insurance. Even with the wait times and limits it oddly has merit. Why can't all counties just follow this model.

Its funded by taxes in this case part of that a minimum $1.25 per work hour the employer must pay, that can be higher. But since it covers all employers I don't see the issue added to that premiums, co-pays and the like people in the program are obligated to pay.

It might be one way to go.

http://www.healthysanfrancisco.org/

Well because a case that works must be swept under the carpet, or else it lends credence to allowing it on a national level.

People do say it will cost too much nationwide, but is it worth it? I think so.