Healthcare

[TX Tiburon]

It's gonna be a complete cluster&%*$ IF (and that's a big IF) Obama can ram it through Congress.

Personally, I don't think it's gonna get done.

Harry Reid is facing issues in his home state of Nevada (i.e. reelection) due to his backing of this unpopular bill. You'll see other Dems lose face with many of their constituents over this as well as they're trying to ride a fine line.

That is a big if on the "single payer" model. But don't underestimate the politicians. Some concoction of healthcare legislation will pass. It has to in order to save face. I am concerned that even if a public option isn't passed directly, various side doors will be left wide open.

It is laughable that a public option is being trumpeted to assure that there is "competition" in the marketplace. Government only works to stifle competition be it in education or anti-microsoft legislation. They don't get it. In the case of most markets, the more it is controlled the less competition.

 

[Reidy's Bottle Of Grecian]

people usually pay for bupa treatment to avoid a waiting list, or for an insurance claim, medical report etc, some things you do have to pay the nhs for e.g when i emigrated i had to get chest x-rays and a medical by my g.p, for these i had to pay because it wasnt tretament that i required. i think you can go private to get a referral for nhs treatment, there may a long waiting list to get the initial hospital appointment so you can go private to get it quicker and get on the list for the op etc

my arl fella had a knee op last week, he went private, i think it was just so he didnt have to wait and it maybe get worse, i wouldnt imagine it was the sort of op that would be high priority so he couldve had to wait for a while. imo he shouldve looked into it on the net, find somewhere in the eu where they send you to a nice retreat for some respite after your op.

 

[toffeestillidie]

Reidy, sorry to hear about both your son and father-in-law requiring so much care. I can relate. My father-in-law has had various cancer treatments over the past 9 years. I am sure that the bills have been astronomical. But between his private insurance and the government (ie taxpayer) sponsored medicare, he has paid only a small portion.

Can you tell me a little about the market for private healthcare? Do many people choose to pursue this option? If so, why? Is the market for private healthcare an indicator of dissatisfaction or a flaw in the dispensing of the public care?

One comment about the care not costing more regardless of the amount of access. That may be, depending on the capacity of the care providers and facilities. But if everyone were to begin accessing 10% more care each year, certainly the demand would outstrip the supply causing shortages in provider time and possibly medical supplies or even budgeted GBP's of the NHS.

Tiburon i see your point about the 10% increase, but with this you can't forget the benefits of preventive care. If people see their doctors more regularly, many illnesses will be caught early on, reducing the need for more costly treatments later. remember, an ounce of prevention is worth a pound of cure.

My biggest problem with the anti-public healthcare groups is that many of them seem very uninformed about the issue. Thats not to say that the program doesn't have its flaws, and there is certainly extensive room for debate, but based on the "rabble rabbles" of people shown on the news, the prevailing though process seems to be something like this: public health care = socialism, socialism = bad / unamerican, therefore public healthcare =bad / unamerican.

what bothers me about this is that we already have many socialized institutions in america. emergency care is already socialized. security is socialied, i don't call private protection companies every time i need a police officer. Schools are socialized, I attended a public school (thats state run school, not the kind of public schools you brits would think of) and i believe i received a pretty good education. I know plenty of kids who went to private schools, but there isn't too much complaining about them having to pay for public schools that there kids don't use. For that matter, plenty of single adults pay taxes that go towards schools, even though they don't have children.

The list of examples goes on and on, but i'm personally of the opinion that i don't like arsenic in my drinking water, I like being able to take the subway into the city, i love watching public television programs, love listening to NPR, and love the fact that when i call 9-11, i don't have to go through a credit check. I owe all of these things to socialism in some way.

So I'm glad no ones really brought it up on this site, but nothing upsets me more than hearing the blanket criticism that obama is a socialist and therefore his policies are bad.

 

[Bundy]

I think it would suck to pay for your health care, but then I guess you probably pay less tax. We don't have enough doctors here, don't know if that's cause they dont get paid enough or what, but I wouldn't want to be a doctor, 10 years out of your life studying, 24 hour shifts, bleh. We have to employ doctors like Jayant Patel - Wikipedia, the free encyclopedia

 

[toffeestillidie]

I think it would suck to pay for your health care, but then I guess you probably pay less tax. We don't have enough doctors here, don't know if that's cause they dont get paid enough or what, but I wouldn't want to be a doctor, 10 years out of your life studying, 24 hour shifts, bleh. We have to employ doctors like Jayant Patel - Wikipedia, the free encyclopedia[/media]

actually Bundy, the United States government itself spends more money than most countries on healthcare, and thats without even providing public healthcare

[media]http://www.oecd.org/dataoecd/46/2/38980580.pdf[/media]

if you do the math and take 45% of the 7000 some dollars spent per capita on healthcare (45% is the share of total healthcare spending made up by the government), you'll find its still higher than most countries on there. so there really is no telling what the effects might be, some models predict a slight tax increase, others predict a slight tax decrease, and both sides site the predictions favorable to their own cause.

i'm personally of the impression that higher taxes are worth it to fix such a heavily damaged, ineffective system. I think instituting tort reforms (yes i'm a liberal, but still a big proponent of some tort reform) would dramatically reduce costs as well.

Another big problem with our system is the high cost of medical schools. Most doctors finish medical school with high student loans. To keep incentives high for people to become doctors, the AMA drastically restricts the amount of people that can become doctors, so as to drive up doctors salaries (because of the low supply), so that this will balance out the high investment in medical school. If the government helped subsidize medical school (which it might have to do given the need for many new doctors to cope with the demand of newly insured patients under a public plan), then doctors salaries wouldn't need to be so artificially inflated, thus driving down cost.

 

[chicoazul]

Tiburon i see your point about the 10% increase, but with this you can't forget the benefits of preventive care. If people see their doctors more regularly, many illnesses will be caught early on, reducing the need for more costly treatments later. remember, an ounce of prevention is worth a pound of cure.

My biggest problem with the anti-public healthcare groups is that many of them seem very uninformed about the issue. Thats not to say that the program doesn't have its flaws, and there is certainly extensive room for debate, but based on the "rabble rabbles" of people shown on the news, the prevailing though process seems to be something like this: public health care = socialism, socialism = bad / unamerican, therefore public healthcare =bad / unamerican.

what bothers me about this is that we already have many socialized institutions in america. emergency care is already socialized. security is socialied, i don't call private protection companies every time i need a police officer. Schools are socialized, I attended a public school (thats state run school, not the kind of public schools you brits would think of) and i believe i received a pretty good education. I know plenty of kids who went to private schools, but there isn't too much complaining about them having to pay for public schools that there kids don't use. For that matter, plenty of single adults pay taxes that go towards schools, even though they don't have children.

The list of examples goes on and on, but i'm personally of the opinion that i don't like arsenic in my drinking water, I like being able to take the subway into the city, i love watching public television programs, love listening to NPR, and love the fact that when i call 9/11, i don't have to go through a credit check. I owe all of these things to socialism in some way.

So I'm glad no ones really brought it up on this site, but nothing upsets me more than hearing the blanket criticism that obama is a socialist and therefore his policies are bad.

That's an outstanding post.

The word socialist I've noticed is a dirty word in the American media, probably ingrained in the psyche from Cold War days. Politicians opposed to healthcare for all just it in a snidey manner.

I think Obama will get the bill passed but to what degree no one knows as there's a lot of hurdles to cross prior.

Interesting though to see Bill and D-dog's comments and who wouldn't want the best care for their family.

Private healthcare would still exist if you wanted it, it would just weaken the monopoly the private healthcare providers, insurance companies and pharmaceutical companies have on the industry which is far from healthy (excuse the pun) and ensure a level of healthcare for ALL its citizens.

Posted via Mobile Device

 

[TX Tiburon]

I will ask though... how is American healthcare worse than other modern countries. I submit it is not. What rankles some is that not everyone is covered with some type of payment plan. But as Dylan pointed out, people can not be turned away if they do not have insurance. Not-for-profit and community hospitals must treat indigent patients in order to retain their tax exempt status.

It does seem that there is one, rather large red herring in the country's debate - that those who are not covered by private or public insurance do not have access to care. This is simply not true. The problem is, insurance is not healthcare, it is a method of payment. And even those that can not pay have access to care via Medicaid.

Also, of those that are not coverd, many have the ability to pay cash, others can afford insurance but choose to take their chances or prioritize cell phones and flat screens higher, and many other make use of the not-for-profit institutions.

ToffeestillIdie is correct in that the US gov. does spend heavily on healthcare. They pay for medicare, medicaid, and military care. However, I would suggest that those are all versions of public healthcare. The long-term fiscal strength of both medicare and medicaid are questionable without dramatic changes. Not particularly promising leading indicators of what additional public payment options will bring. I would like to see government fix those programs before grabbing still more control.

Again, I agree that there are certain services that should be monopolies and public water is the classic example. But I am not convinced that healthcare will improve with more centralized planning and a public payment plan for all.

ToffeestillIdie, you are quite passionate about the public payment plan and more government control of healthcare. Is that passion centered around covering more people or do you feel that the quality of healthcare will improve? If so, how so?

 

[toffeestillidie]

I will ask though... how is American healthcare worse than other modern countries. I submit it is not. What rankles some is that not everyone is covered with some type of payment plan. But as Dylan pointed out, people can not be turned away if they do not have insurance. Not-for-profit and community hospitals must treat indigent patients in order to retain their tax exempt status.

It does seem that there is one, rather large red herring in the country's debate - that those who are not covered by private or public insurance do not have access to care. This is simply not true. The problem is, insurance is not healthcare, it is a method of payment. And even those that can not pay have access to care via Medicaid.

Also, of those that are not coverd, many have the ability to pay cash, others can afford insurance but choose to take their chances or prioritize cell phones and flat screens higher, and many other make use of the not-for-profit institutions.

ToffeestillIdie is correct in that the US gov. does spend heavily on healthcare. They pay for medicare, medicaid, and military care. However, I would suggest that those are all versions of public healthcare. The long-term fiscal strength of both medicare and medicaid are questionable without dramatic changes. Not particularly promising leading indicators of what additional public payment options will bring. I would like to see government fix those programs before grabbing still more control.

Again, I agree that there are certain services that should be monopolies and public water is the classic example. But I am not convinced that healthcare will improve with more centralized planning and a public payment plan for all.

ToffeestillIdie, you are quite passionate about the public payment plan and more government control of healthcare. Is that passion centered around covering more people or do you feel that the quality of healthcare will improve? If so, how so?

Lets not forget one other type of healthcare the government provides. Like many employers, the government provides healthcare to government employees, pretty decent coverage i might add. Its the plan that I have the good fortune of being on (for the next year or so atleast) because my dad is a government employee, and its also the plan that all the politicians making decisions about healthcare are more than happy to accept for themselves. I don't think its a major percentage of the total government healthcare spending, but i think its worth noting that the politicians themselves literally have almost no stake in this (save for those with financial interests in pharmaceutical companies)

anyways, as for your question, you're right that my passion is based on covering more people. personally i think that things like healthcare are too important to be left up to market forces. for instance, Palin criticized Obama's plan with accusations of possibly death councils who would reject care for certain people? Aside from the fact that these claims are absurd, is such a death council of people who arbitrate who lives or dies really that much worse than allowing that decision to be made by the market?

As for the question of quality, basically my position is that i've seen universal care work acceptably in enough countries to be content with the level of quality i think will arise from a universal system. it may diminish slightly, but i really think our country can expand our medical system to meet the additional demand. The only aspect of universal care i feel positive will improve the quality of healthcare is the ready access to routine care. Like you said, if someone is in immediate need of medical attention, they cannot be turned away, but these individuals don't have access to regular checkups, during which serious medical problems are often found.

Side note: This ties into chico's points, but the US needs to get rid of direct to consumer advertising for prescription medication. The point of prescriptions is that they are supposed to be prescribed by a doctor, based on their own medical expertise. As i understand it, advertisements of prescription medications to patients aren't allowed in most countries, but in the US its nearly impossible to watch a half hour of television without seeing atleast one commercial. This system helps feed the already wealthy pharmaceutical companies, as doctors will often acquiesce a patient's request, even if the prescription isn't medically necessary. I guarantee if the US outlawed this kind of advertising, it would dramatically drive down costs and prescription medications would be in much lower demand. Besides, I wouldn't be surprised if being constantly bombarded with commercials asking us if we're sick had some sort of psychosomatic backlash on our health.

 

[Bruce Wayne]

Interesting though to see Bill and D-dog's comments and who wouldn't want the best care for their family.

This is it right here for me. The best care for their family. You are ultimately responsible for your family. As an adopted child my parents had to prove they could raise me, both financially and socially, the assumption being that a good parent would be able to do both. If that is the societal aim then surely that is what we should be aiming for, that the family can provide the health (and education) needs of their family? Direct accountability. This is my main beef with the NHS, there is no accountability, hence why costs balloon.

It was mentioned earlier about prevention. Again it would seem a societal aim that personal health be improved, yet the healthy subsidise the unhealthy. It seems a perverse incentive to me?

I'm really not sure that either Britain or America have this sorted because both are going to be bankrupted by their health systems unless things change, that's simply a demographic fact. Healthcare paid for by taxation is simply not workable in a society where the not-working population is growing massively in relation to the working population. There simply won't be enough tax to go around, regardless of the moral stance taken. The only way forward is to get people paying for their own healthcare as much as humanly possible.

 

[Reidy's Bottle Of Grecian]

so i take it you can afford private healthcare then bruce ?

This is my main beef with the NHS, there is no accountability, hence why costs balloon.

is that not the case with the majority of government/state organisations, whatever "industry" they cover ?


socialism and thatcherism within a couple of posts.
this is what has ruined our country, the i'm alright i can afford it mentality, the can't afford it then tough luck mentality, look after your own interests and stuff the rest mentality.



From the cradle to the grave................ without discrimination.

 

[Bruce Wayne]

I'm by no means a wealthy man Reidy but I believe the first responsibility for me and my families wellbeing comes from me. Everything within my own power should be done to pay for things myself before asking anyone else to put their hands in their pockets. That's just my own view on life though.

The status quo does however ignore the demographic situation. As a nation our dependants, in particular those in retirement, are growing at a much faster rate than the working population. When you consider that most healthcare spending is spent on the retired and you have a problem. You could bring in workers from abroad but that creates a difficult political situation regarding immigration. You could also raise the retirement age so that it is more in line with the life expectancy of the nation but politically this isn't going to happen either and the meagre changes that are already being suggested fall behind rises in life expectancy. So you either have to tax people even more when they're working to pay for those that aren't working or you ask people to start paying for their own healthcare at the point of 'sale'. I know which sounds fairer to me.

 

[Goat]

And what if people havent got money to afford their own healthcare?

 

[Bruce Wayne]

And what if people havent got money to afford their own healthcare?

Charities? Contrary to this vision of me as some kind of Thatcherite ogre I'm not against helping others, far from it. My only beef is that help by its very nature is something that should be offered voluntarily.

Philisophically it seems hard to argue that a taxation funded healthcare service should be provided to pay for those that can't afford it when in the same breath so many wish to restrict immigration on the basis that many come here to sponge off of this very system. If the accusation of 'I'm alright Jack...' can be labelled at me then it seems hard to deny a similar label could be tossed in that direction too.

 

[Reidy's Bottle Of Grecian]

And what if people havent got money to afford their own healthcare?

this is the point that seems to go unanswered. like i've said, you can pay for bupa or whatever, thats your own choice, but the nhs is still there for you should you need it. the country makes an enormous profit out of various taxes and if the nhs needs the funding to be 'put right' then why cant it be taken from them ?
since the 2nd world war we have been paying back the u.s. for rebuilding the infrastructure of cities that we destroyed in the war, this probably includes damage caused by others as well (america and our allies), so now that we have 'rebuilt europe' where does all that money that we were finding each year go to ? what sort of amount have we been paying back annually cos i'll reckon on it being able to sort out most of the shiz in this country.

 

[Reidy's Bottle Of Grecian]

Philisophically it seems hard to argue that a taxation funded healthcare service should be provided to pay for those that can't afford it when in the same breath so many wish to restrict immigration on the basis that many come here to sponge off of this very system. If the accusation of 'I'm alright Jack...' can be labelled at me then it seems hard to deny a similar label could be tossed in that direction too.

if they are e.u. citizens mate then there aint nothing we can do about that, mr heath set us on that road. reciprocal agreements are in place with a lot of countries, in aus we get free medicare because of it being free for them over here.