I still think the largest, single problem is that US costs are grossly inflated. Increase competition, encourage prevention. Reduce the overall costs and redistribute some of the savings. Do that, and many of the other complaints will diminish. Or do not do it, and we will continue to have some of the worst health stats of the developed world at the highest cost. Not great for that economy and deficit, either. Two cents on some of this thread:
I wish they would use competition and I mean GLOBAL competition. If we can simply take patients where treatment can be put off for a few weeks and planned send these people to the best medical tourism centers around the world.
While we are stuck with systems that make domestic procedures and overhead much greater than the same plus airfare abroad, I think this makes sense for at least some cases. I've heard that major dentistry, for example, is a fairly common impetus for foreign travel.
One thing I've noticed about the examples in europe are areas of smaller populations, less diverse ethnicities. I don't want to come off as racist folks, but different ethnic groups have a much different medical profiles.
I think you're right that it's possible to find different profiles. However, only 10% or so currently hold no insurance. If some others who can afford to pay somewhat pay the national option on a sliding scale, and assuming competition and efficiency gains reduce overall costs for most people, there could still be savings to cover for ethnic differences.
We also have to consider the economic costs of not
providing a more affordable option to people in higher-risk profiles. It is partly an issue of mobility and job opportunities (one reason so many Dollar Meals are consumed), education and other social services. However, not covering that demographic helps to drain money from the state in other ways: Lower productivity, lower quality work, lower sense of worth and increased chance of violence... And keeping health care beyond the reach of those in these groups who want it, tends to perpetuate the situation where they are at higher risk while their percentage of the population grows. Last but not least, you could disagree that all of the preceding two paragraphs are monetarily worth the cost of health care for at-risk minorities. In that case, and even if the population of besieged minorities were perpetually expendable/"renewable" through births and migration (a risky proposition at best), we'd still be taking on huge moral exposure.
One problem I see with globalized health care is that some other countries do not have the same scrutiny applied to new drugs and treatments before they are made available to the public. The FDA has certain regulations regarding what kind of trials can and should be done before a product can be determined as a safe and effective treatment... [snipped: about energy drinks] Even then, there have been notable failures, even with all those regulations in place.
The last sentence may undercut the rest. As I understand, since the push for AZT, "fast-tracking" of pharmaceuticals has resulted in many ineffective or dangerous ones being granted approval. Ruby also partly addressed foreign quality by noting that globalized care would require informed choice. I still think that if the available options are prohibitively expensive (or just significantly inflated) care in the US or similarly or marginally riskier but affordable care abroad, especially for major procedures, the only thing standing between people's needs and the airplane would be 1) will we subsidize this at all and 2) state of the overall economy (who can or cannot pay to get on the plane).
i want to see it done right..not done quick to make political payday for one group or another.
How do you propose to achieve that, and get it done at all? The Republicans shot the entire idea down for Clinton. They've had plenty of time since to return to it. If you don't want them to take the credit (although they have
taken credit for freezing the status quo), and you don't want the Democrats to take the credit, is there another alternative?
Granted, we have a legislative system (among others) that suffers from lack of transparency. The play of sound-bites usually don't do justice to the issue. It may take patching down the road. Our Constitution sometimes brings a world of trial and error (not to mention bad compromises). All the same: As much as I'd like to see some government soul-searching and better transparency, lots of suffering is happening over health care in the meantime.