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Tsukasa Buddha
12th March 2009, 07:31 PM
Obama sees the current economic crisis as an opportunity. He has said so openly. And now we know what opportunity he wants to seize. Just as the Depression created the political and psychological conditions for Franklin Roosevelt's transformation of America from laissez-faireism to the beginnings of the welfare state, the current crisis gives Obama the political space to move the still (relatively) modest American welfare state toward European-style social democracy.
In the European Union, government spending has declined slightly, from 48 percent to 47 percent of GDP during the last 10 years. In the U.S., it has shot up from 34 percent to 40 percent. Part of this explosive growth in U.S. government spending reflects the emergency private-sector interventions of a Republican administration. But the clear intent was to make the massive intrusion into the private sector temporary and to retreat as quickly as possible. Obama has radically different ambitions.
The spread between Europe and America in government-controlled GDP has already shrunk from 14 percent to 7 percent. Two terms of Obamaism and the difference will be zero.
Conservatives take a dim view of the regulation-bound, economically sclerotic, socially stagnant, nanny state that is the European Union. Nonetheless, Obama is ascendant and has the personal mandate to take the country where he wishes. He has laid out boldly the Brussels-bound path he wants to take.
[Emphasis mine]
Linky. (http://www.realclearpolitics.com/articles/2009/02/obama_wants_a_european_transfo.html)

Europe — sclerotic, bureaucratized and social-democratized – has for decades enjoyed the protection, inventions and security afforded by its more laissez-fair, strapping, and exuberant cousin across the Pond, the United States. America, with its free markets, its market incentives, and its relatively large private sector, has been the engine of global growth. America’s system, based fundamentally on individual risk and responsibility, has been the great incubator of innovations that have become the staples of the modern age — from medical advances, to computers, to the internet and beyond. Around the world, people have benefited in ways beyond measure.
All that energy poured into progress is likely to fade, as America devolves into a nation of carbon-capped civil servants, tending to a much-shrunken private sector, and a growing line of people on the dole.[Emphasis mine]
Linky. (http://pajamasmedia.com/claudiarosett/if-obama-turns-america-into-europe/)

From the poorly designed stimulus bill and vague new financial rescue plan, to the enormous expansion of government spending, taxes and debt somehow permanently strengthening economic growth, the assumptions underlying the president's economic program seem bereft of rigorous analysis and a careful reading of history.
Unfortunately, our history suggests new government programs, however noble the intent, more often wind up delivering less, more slowly, at far higher cost than projected, with potentially damaging unintended consequences. The most recent case, of course, was the government's meddling in the housing market to bring home ownership to low-income families, which became a prime cause of the current economic and financial disaster.
On the growth effects of a large expansion of government, the European social welfare states present a window on our potential future: standards of living permanently 30% lower than ours. Rounding off perceived rough edges of our economic system may well be called for, but a major, perhaps irreversible, step toward a European-style social welfare state with its concomitant long-run economic stagnation is not.
[Emphasis mine]
Linky. (http://online.wsj.com/article/SB123629969453946717.html)

http://img27.imageshack.us/img27/8021/20081026werenotnumberon.th.png (http://img27.imageshack.us/my.php?image=20081026werenotnumberon.png)

Linky. (http://miscellanea.wellingtongrey.net/2008/10/26/were-not-number-one/)

In Democracy, Life Expectancy, Freedom of the Press, Smallest Prison Population, Lack of Corruption, Education, Energy Usage, Scientific Literacy, and Quality of Healthcare the United States only once enters the top twenty. The link has where the info came from.

Clearly, we need to get rid of public education, fight against universal healthcare, fight against oppressive election reform and tax systems, etc. just like all those countries above us did!

Stupid Europeans.

pipelineaudio
12th March 2009, 07:35 PM
In Democracy, Life Expectancy, Freedom of the Press, Smallest Prison Population, Lack of Corruption, Education, Energy Usage, Scientific Literacy, and Quality of Healthcare the United States only once enters the top twenty. The link has where the info came from.

errr

lol?

I'd agree with the rest, though I wouldn't necessarily say democracy as a whole is a very good thing when it turns into mob rule at the local level as has happened here

I like having democratically elected leaders bound by a constitution that they are too scared to change

dirtywick
12th March 2009, 08:11 PM
Ranking Scientific Literacy of the US by the answers to a single question sounds pretty comprehensive, although the Democracy Index is close:

As described in the report, the democracy index is a kind of weighted average (http://en.wikipedia.org/wiki/Weighted_average) based on the answers of 60 questions, each one with either two or three permitted alternative answers. Most answers are "experts' assessments"; the report does not indicate what kinds of experts, nor their number, nor whether the experts are employees of The Economist (http://en.wikipedia.org/wiki/The_Economist) or e.g. independent scholars, nor the nationalities of the experts. Some answers are provided by public opinion surveys from the respective countries. "In the case of countries for which survey results are missing, survey results for similar countries and expert assessments are used in order to fill in gaps."

Well, I'm convinced.



Cute chart though.

Thunder
12th March 2009, 08:18 PM
Europeans are not stupid

Darth Rotor
12th March 2009, 08:57 PM
Stupid Europeans.

Were you being deliberately redundant here?

Ziggurat
12th March 2009, 10:17 PM
Freedom of the Press

You're kidding me, right? How exactly did they form this ranking? Because it's nonsense. What other country in the world offers the equivalent of our 1st amendment right? I can't say categorically that there are none, but there sure as hell aren't 40 of them. Which makes me rather suspicious of the ranking mechanism for other factors (like "democracy") which are undoubtedly subjective.

Cell phone usage is an irrelevant metric, and internet speed is tied rather closely to population density, so it doesn't tell us much else. And infant mortality comparisons are deeply flawed, because different countries don't use the same definitions for counting infant mortality. Very early premies who die get counted as miscarriages in many countries when they would be counted as infant deaths in the US.

Texas
12th March 2009, 10:25 PM
I thought we, the United States, fought a revolution to be free from the "European" way of life.

KoihimeNakamura
12th March 2009, 11:20 PM
No, we didn't. (And I'm sure there's a Declaration of Human Rights.. somewhere.

Texas
12th March 2009, 11:26 PM
No, we didn't. (And I'm sure there's a Declaration of Human Rights.. somewhere.
So we didn't have a revolution?

DC
12th March 2009, 11:27 PM
I thought we, the United States, fought a revolution to be free from the "European" way of life.

from the european way of life????

Tsukasa Buddha
12th March 2009, 11:41 PM
You're kidding me, right? How exactly did they form this ranking?

Well, it says in the link, as I said.

Because it's nonsense. What other country in the world offers the equivalent of our 1st amendment right? I can't say categorically that there are none, but there sure as hell aren't 40 of them. Which makes me rather suspicious of the ranking mechanism for other factors (like "democracy") which are undoubtedly subjective.

Mmm, I'd rather disagree. With the first the actual practice matters more to me. And determining democracy is rather easy, the subjective bit, as noted above, is whether it is good to be very democratic.

Cell phone usage is an irrelevant metric, and internet speed is tied rather closely to population density, so it doesn't tell us much else. And infant mortality comparisons are deeply flawed, because different countries don't use the same definitions for counting infant mortality. Very early premies who die get counted as miscarriages in many countries when they would be counted as infant deaths in the US.

Yes, I agree, which is why I didn't bother to point them out.

KoihimeNakamura
12th March 2009, 11:46 PM
So we didn't have a revolution?

DC got to it first, but it wasn't against the european way of life. It was more because some Americans whined that all of a sudden we had taxes, leading to no taxation without representation (Becuase the Ministry in Britain was full of idiots) ... and yeah. Up to about a few years before the revolution, Americans thought of themselves as British.

Had Britian tried a reasonable policy we could possibly be a Commonwealth state today.

Tsukasa Buddha
12th March 2009, 11:46 PM
I thought we, the United States, fought a revolution to be free from the "European" way of life.

No, it was because we didn't want to pay taxes (to pay for the war that Britain waged to save us, and that everyone else had to pay for) without proper representation (Britain made the lame claim that we were "virtually represented").

And (as I think you were implying with the quotes?) there is no "European" way of life, because there are quite a few different countries there, last I checked. But it happens that quite a few are the evil social democracies that happen to outperform us.

lionking
12th March 2009, 11:46 PM
Where's Oliver? He seems to speak for Europeans here.

Tsukasa Buddha
12th March 2009, 11:49 PM
I'd agree with the rest, though I wouldn't necessarily say democracy as a whole is a very good thing when it turns into mob rule at the local level as has happened here

I like having democratically elected leaders bound by a constitution that they are too scared to change

And where are the unconstitutional democracies making reckless decisions willy nilly because the unclean commoners have had their way?

MarkCorrigan
12th March 2009, 11:55 PM
Where's Oliver? He seems to speak for Europeans here.

I do hope you mean he THINKS he does. While he occasionally has something interesting to say I'd rather he didn't speak for me.

You're kidding me, right? How exactly did they form this ranking? Because it's nonsense. What other country in the world offers the equivalent of our 1st amendment right? I can't say categorically that there are none, but there sure as hell aren't 40 of them. Which makes me rather suspicious of the ranking mechanism for other factors (like "democracy") which are undoubtedly subjective.


http://en.wikipedia.org/wiki/File:Reporters_Without_Borders_2008_Press_Freedom_ Rankings_Map.PNG

lionking
12th March 2009, 11:58 PM
I do hope you mean he THINKS he does. While he occasionally has something interesting to say I'd rather he didn't speak for me.


Yeah, that's what I meant.

He's said something interesting?

DC
13th March 2009, 12:04 AM
Yeah, that's what I meant.

He's said something interesting?

did you ever?

lionking
13th March 2009, 12:15 AM
At the expense of mod action, your negative opinion of my posts says more about you than me.

DC
13th March 2009, 12:18 AM
At the expense of mod action, your negative opinion of my posts says more about you than me.

aah, and i guess your negative oppinion about Oliver's posts tell us everything about Oliver, and not about you?

but back to topic.

Redtail
13th March 2009, 01:25 AM
I thought we, the United States, fought a revolution to be free from the "European" way of life.

Do teachers (and others) still implore kids to speak "The King's English"?

Oliver
13th March 2009, 02:21 AM
I thought we, the United States, fought a revolution to be free from the "European" way of life.


I actually thought the ones who fought during the revolution basically were Europeans themselve. :boxedin:

Anyway: That freedom of press claim is interesting, I also would like to know how they measured freedom of press if the US did rank so badly about it.

funk de fino
13th March 2009, 04:13 AM
I actually thought the ones who fought during the revolution basically were Europeans themselve. :boxedin:

Anyway: That freedom of press claim is interesting, I also would like to know how they measured freedom of press if the US did rank so badly about it.

Maybe the compleltely polarised bias channels have lowered it for them?

Perhaps Fox is seen as not free? Just a thought.

Ocelot
13th March 2009, 04:20 AM
Do teachers (and others) still implore kids to speak "The King's English"?

I've seen a teacher send a player off the rugby field for abusing the Queen's English.

ddt
13th March 2009, 05:36 AM
On the growth effects of a large expansion of government, the European social welfare states present a window on our potential future: standards of living permanently 30% lower than ours.
Linky. (http://online.wsj.com/article/SB123629969453946717.html)

"Stupid Europeans" have 25-50 days vacation a year, apart from public holidays. "Stupid Europeans" don't have to work two jobs to make ends meet.

Maybe the Bill Gateses make the US have a 30% higher pro capita income than Europe, but your average working class or middle class Joe (plumber or not) certainly doesn't see it. The real spending power of middle class Americans is lower than in 1980.


Linky. (http://miscellanea.wellingtongrey.net/2008/10/26/were-not-number-one/)

In Democracy, Life Expectancy, Freedom of the Press, Smallest Prison Population, Lack of Corruption, Education, Energy Usage, Scientific Literacy, and Quality of Healthcare the United States only once enters the top twenty. The link has where the info came from.

Clearly, we need to get rid of public education, fight against universal healthcare, fight against oppressive election reform and tax systems, etc. just like all those countries above us did!
(emphasis mine)

I'm always amazed at the cognitive dissonance so many Americans (*) display about UHC. There is a strong denial about how clearly countries with UHC outperform the US in health care. But then, these Americans value their freedoms:
- the freedom of Big Pharma to set arbitrary prices for drugs in Medicare;
- the freedom to pay exorbitant insurance premiums;
- the freedom to go broke because of your hospital bills, a phenomenon that is nearly exclusive to the US.

(*) and I don't mean you, Tsusaka; the sarcasm in your OP is appreciated.

Sefarst
13th March 2009, 05:46 AM
Hopefully, one day, we can also achieve the freedom to force other people to pay for our healthcare costs.

DC
13th March 2009, 05:50 AM
Hopefully, one day, we can also achieve the freedom to force other people to pay for our healthcare costs.

we call it solidarity.
we help eachother and try to not let eachother down.

KoihimeNakamura
13th March 2009, 05:52 AM
... yes. But Americans value indepndence on that indepdence vs collective responsiblity scale.

So they see it as being forced to pay for someone elses bad health.

(There are obviously other reasons, but just pointing out you're attempting a value argument that won't work)

Sefarst
13th March 2009, 05:54 AM
we call it solidarity.
we help eachother and try to not let eachother down.

Yes, solidarity. That's why you need laws and the police to force people to do it.

MarkCorrigan
13th March 2009, 05:55 AM
Hopefully, one day, we can also achieve the freedom to force other people to pay for our healthcare costs.
I find this attitude, among other things, repulsive. I also find it odd.

Why on earth would you NOT make sure everyone had healthcare? Would you want people dying because they couldn't afford to pay for a life saving operation? Seriously?

That is what you are advocating here. No matter how you try to spin it, that IS what will happen.

Sorry if this is a derail.

DC
13th March 2009, 05:56 AM
... yes. But Americans value indepndence on that indepdence vs collective responsiblity scale.

So they see it as being forced to pay for someone elses bad health.

(There are obviously other reasons, but just pointing out you're attempting a value argument that won't work)

i find it iresponsible for a sociaty to have a such a poor healtcare system where people go bankrupt or worse just because they have health problems.

i dont pay for others, i pay to be sure that at any point in my live i get the medical care i need, no mather how my job situation or my financial situation is.

going bankrupt for having healthproblems is not independence, its iresponsible.

my 2 rappen (cent)

DC
13th March 2009, 05:57 AM
the very same people that want bring Democracy to all the countrys of the world, wants to bring freedom to everyone in the world, even by war.
dont want to secure they fellow countrymans healthcare.

Sefarst
13th March 2009, 06:00 AM
I find this attitude, among other things, repulsive. I also find it odd.

Why on earth would you NOT make sure everyone had healthcare? Would you want people dying because they couldn't afford to pay for a life saving operation? Seriously?

That is what you are advocating here. No matter how you try to spin it, that IS what will happen.

Sorry if this is a derail.

How can you sleep at night knowing that you have a computer and a house that you could sell and donate the money to some third world country so that people there could afford food/medicine/housing/clothing/etc.? Why on earth would you NOT make sure those people have those things? How can you Europeans sleep at night knowing that there are Americans that can't afford operations because we don't have universal healthcare? Send us your money and save us.

Sefarst
13th March 2009, 06:04 AM
the very same people that want bring Democracy to all the countrys of the world, wants to bring freedom to everyone in the world, even by war.
dont want to secure they fellow countrymans healthcare.

I'm not saying I'm one of these people, but it would demonstrate consistency of principle. If the American value is freedom, we can extrapolate it to economic freedom as well, i.e. the freedom to decide how and where your money is spent. I don't see a contradiction with a country that values political and religious freedom also valuing economic freedom.

MarkCorrigan
13th March 2009, 06:07 AM
How can you sleep at night knowing that you have a computer and a house that you could sell and donate the money to some third world country so that people there could afford food/medicine/housing/clothing/etc.? Why on earth would you NOT make sure those people have those things? How can you Europeans sleep at night knowing that there are Americans that can't afford operations because we don't have universal healthcare? Send us your money and save us.

Big difference between contributing to the society I live in and selling everything I own. That's a logical fallacy you just used. Tsk tsk.

I find it abhorrent that anyone would advocate refusing to give to people within their own society. After your society is steadied, reach out to others. If I had any money (student, my computer is to enable me to work) I would gladly donate to third world charities and in fact do.

There is no point in reducing oneself to poverty to help those less well off. That isn't what I advocate. Nor is it expedient to simply throw money at something and hope that the problem magically goes away. In order for the third world to be rescued the political system needs to change, and the way aid is distributed needs to change. Donations are good, but you can't think they will stop the problem on their own.

I notice you didn't actually state that you don't advocate the poor being left to die. Hi, my name is Edward and you just killed me (http://forums.randi.org/showpost.php?p=4491005&postcount=284) (I wasn't even poor).

DC
13th March 2009, 06:10 AM
I'm not saying I'm one of these people, but it would demonstrate consistency of principle. If the American value is freedom, we can extrapolate it to economic freedom as well, i.e. the freedom to decide how and where your money is spent. I don't see a contradiction with a country that values political and religious freedom also valuing economic freedom.

i see your point.
but i think this freedom is not needed in healthcare.
Healthcare is so important and expensive we best take care of it collectively.
i am more free than you. i have the freedom to get healthcare even after loosing my job and running out of money. you dont have that freedom :)

MarkCorrigan
13th March 2009, 06:13 AM
i see your point.
but i think this freedom is not needed in healthcare.
Healthcare is so important and expensive we best take care of it collectively.
i am more free than you. i have the freedom to get healthcare even after loosing my job and running out of money. you dont have that freedom :)

Oh god. The universe is tearing apart....I agree with DC!









;)

Sefarst
13th March 2009, 06:16 AM
Big difference between contributing to the society I live in and selling everything I own. That's a logical fallacy you just used. Tsk tsk.

Wrong. Your actual words were, "Why on earth would you NOT make sure everyone had healthcare? Would you want people dying because they couldn't afford to pay for a life saving operation? Seriously?"

So, make sure everyone has healthcare. Are you NOW saying that you DO want people dying because they couldn't afford to pay for a life saving operation? Or do you only care if they live in your arbitrary geographic location? No logical fallacy necessary to cut through the illogic of your argument.

I find it abhorrent that anyone would advocate refusing to give to people within their own society. After your society is steadied, reach out to others. If I had any money (student, my computer is to enable me to work) I would gladly donate to third world charities and in fact do.

I'm a student as well and send money to the Red Cross every 6 months. Universal healthcare is not reaching out to others, it's being forced against your will to put your money into a bureaucratic leaf blower and subsidize the moral hazards of other people.

There is no point in reducing oneself to poverty to help those less well off.

Why not? Why aren't you willing to go without your luxuries if it means saving your fellow man?

hat isn't what I advocate. Nor is it expedient to simply throw money at something and hope that the problem magically goes away. In order for the third world to be rescued the political system needs to change, and the way aid is distributed needs to change. Donations are good, but you can't think they will stop the problem on their own.

It doesn't even have to be a third world country. Like I said, there are plenty of people in the US who would gladly accept your money. I can give you the names of four or five who would cash your check in a heartbeat.

I notice you didn't actually state that you don't advocate the poor being left to die.

Now I'm being judged on what I DIDN'T say? How many poor are you leaving to die around the world right now? You monster.

DC
13th March 2009, 06:28 AM
Oh god. The universe is tearing apart....I agree with DC!









;)

OMG its friday the 13th.
realised that when making a huge cross in my calendar :D

MarkCorrigan
13th March 2009, 06:30 AM
1. Wrong. Your actual words were, "Why on earth would you NOT make sure everyone had healthcare? Would you want people dying because they couldn't afford to pay for a life saving operation? Seriously?"

So, make sure everyone has healthcare. Are you NOW saying that you DO want people dying because they couldn't afford to pay for a life saving operation? Or do you only care if they live in your arbitrary geographic location? No logical fallacy necessary to cut through the illogic of your argument.



2. I'm a student as well and send money to the Red Cross every 6 months. 3. Universal healthcare is not reaching out to others, it's being forced against your will to put your money into a bureaucratic leaf blower and subsidize the moral hazards of other people.



4. Why not? Why aren't you willing to go without your luxuries if it means saving your fellow man?



It doesn't even have to be a third world country. Like I said, there are plenty of people in the US who would gladly accept your money. I can give you the names of four or five who would cash your check in a heartbeat.



5. Now I'm being judged on what I DIDN'T say? How many poor are you leaving to die around the world right now? You monster.

Good lord alive, really?

My my. Ok, I've numbered your points so I can go through them easily.

1. I was discussing Universal Healthcare. Given that this operates within arbitrary geographical locations assuming that I was referring to the entire world is either monumentally stupid or deliberately dishonest. Nice going.

2. Good for you. I really mean that.

3. Given that the US is the only modernised Western power without a Universal Healthcare system, and that your healthcare standards on the whole lag well behind all of us nations with these "leafblowers" I'd say that it isn't quite as worthless as you seem to state here.

Further, while there are certainly a number of operations and such performed on people with poor lifestyle choices, what error did I make? What did I or my parents do that resulted in me deserving to die because they wouldn't have afforded my healthcare? The link is in my last post, do you need it again?

4. It's pointless, that's why. I'm sure if I sold my computer I could feed a family in Bangladesh for a few weeks or months, or contribute towards the cost of an operation for a American without insurance or something. How does that help in the long run?

5. Nice rhetorical point there. Careful now though, that's not the best method for clear debate.

Ocelot
13th March 2009, 07:00 AM
Why don't Americans understand that public health is everybody's concern. Do they really think that if someone down the road gets cholera, or tuberculosis it won't affect them? I'm happy to pay National Insurance not only because I know that I'll get good care I couldn't otherwise afford if I fall with some non-comunicable disease like cancer, not only because they pay all my prescription costs for my diabetes care, but mainly because I know that they're ensuring that other people from whom I might catch flu or who might infect my infant son with measles, whooping cough or other infectious and potentially fatal diseases, before he completes his vacination schedule, are very few and far between.

Sefarst
13th March 2009, 07:01 AM
1. I was discussing Universal Healthcare. Given that this operates within arbitrary geographical locations assuming that I was referring to the entire world is either monumentally stupid or deliberately dishonest. Nice going.

I don't think you're use to arguing from a principle. You can't say that people shouldn't suffer from medical problems if other people can save them and then go on to say that this only applies in your geographic region because that's the way the government policy currently is. Or you CAN say it, as you obviously just did, but it would mean being logically inconsistent. I pursue this point because you called my position, the logically consistent one, repulsive and odd. But in truth, you are arguing essentially the same thing I am, you just want to expand the ring of protection to an arbitrary geographic region.

3. Given that the US is the only modernised Western power without a Universal Healthcare system, and that your healthcare standards on the whole lag well behind all of us nations with these "leafblowers" I'd say that it isn't quite as worthless as you seem to state here.

I didn't call it worthless. It's worth something because obviously more people would have healthcare.

Further, while there are certainly a number of operations and such performed on people with poor lifestyle choices, what error did I make?

By saying that it's reaching out to others when it is not. You're trying to mix moral elements of your argument with practical one and I'm trying to tease them out individually. Universal healthcare is not reaching out to others, as your moral inclination might lead you to assert, it's the masses demanding the money of a few be given to them. You're not reaching out to others by paying your taxes. You pay your taxes because you will go to jail if you don't and many people look for any deduction they can in order to pay less taxes.

What did I or my parents do that resulted in me deserving to die because they wouldn't have afforded my healthcare? The link is in my last post, do you need it again?

Again, this notion of "deserve" is useless and not what I'm arguing. What obligation do I have to you and on what grounds do I have that obligation?

4. It's pointless, that's why. I'm sure if I sold my computer I could feed a family in Bangladesh for a few weeks or months, or contribute towards the cost of an operation for a American without insurance or something. How does that help in the long run?

Saving someone's life is pointless? Or your money could go towards education that would definately help those people in the long run. Would it help YOU personally? That's hard to say. But then again, doesn't demanding that helping another person personally benefit you in the long run sound repulsive? Is that what you're arguing? I'll need some clarification.

5. Nice rhetorical point there. Careful now though, that's not the best method for clear debate.

It's the best way to make you understand the point. It's also to make you consider that maybe you don't even have the moral high ground in this one.

Sefarst
13th March 2009, 07:02 AM
Why don't Americans understand that public health is everybody's concern. Do they really think that if someone down the road gets cholera, or tuberculosis it won't affect them?

There are all ready law requiring certain vaccinations and tests.

DC
13th March 2009, 07:10 AM
I dont understand why people see it as paying for other peoples health.
With UHC you make sure YOU will get proper healthcare even when you are in financiel troubles.

the US is strange, they talk about standing united and go to war, when some atack them and 3000 people die. But when it comes to UHC they dont want to stand united.

Sefarst
13th March 2009, 07:14 AM
I dont understand why people see it as paying for other peoples health.
With UHC you make sure YOU will get proper healthcare even when you are in financiel troubles.

But what if I can all ready afford health insurance?

MarkCorrigan
13th March 2009, 07:14 AM
I was part way through a serious, in depth post, and I had to stop writing it. I am bowing out of this and all other serious threads for a while. You can say I'm a coward if you wish, but I can't deal with debate right now.

If you are in any way interested in why, the answer is in FC.

Beerina
13th March 2009, 07:15 AM
During 1999--2004, life expectancy at age 65 years increased by 1.0 year for the overall U.S. population, 1.1 years for white men, 0.8 years for white women, 0.9 years for black men, and 1.3 years for black women.

Ref (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5607a5.htm)

And why? New drugs and so on. And why are there new drugs? Because corporations dump tens of billions a year into developing them, on top of what government provides (which is semi-political at best.)

Reduce profits, that goes away.

The only reason this doesn't seem to show up with lagging European medical technology is because tech. is shared around the world. This statement alone should scare the Hell out of the honest skeptic. Where is the evidence that it's not slowing down technological development? There's several trillion tons of evidence that it does. See, oh, I don't know, let's say hundreds of economic "experiments" over a hundred+ years from 1900 through today.

The "free care" they offer was bought with the sweat and cash of other, economically superior countries.

Come, Europeans. Dump your "feel good" socialized medicine, and join the fast-advancing club so your own people can live better lives than they are now.

Damien Evans
13th March 2009, 07:18 AM
65 years? That's pathetic. We're at 80.

Sefarst
13th March 2009, 07:19 AM
I was part way through a serious, in depth post, and I had to stop writing it. I am bowing out of this and all other serious threads for a while. You can say I'm a coward if you wish, but I can't deal with debate right now.

If you are in any way interested in why, the answer is in FC.

No problem. My condolences.

Beerina
13th March 2009, 07:21 AM
Think about it: In any other realm, physics, chemistry, child rearing, if such an issue came up, you all would readily recognize the potential issue.

Here, your programmed memes tell you to downplay it and discount it. Observe your own minds in action.

DC
13th March 2009, 07:25 AM
But what if I can all ready afford health insurance?

you can atm, but what when loosing job, and have financial trobles. your nearly bankrupt, maybe not even your fault. now you get sick and need an operation, but you dont have your insurance not anymore. no money left, now?

but also solidairty with the people around you that can not afford it?

but im socialist :)

Tsukasa Buddha
13th March 2009, 07:28 AM
Ref (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5607a5.htm)

And why? New drugs and so on. And why are there new drugs? Because corporations dump tens of billions a year into developing them, on top of what government provides (which is semi-political at best.)

Reduce profits, that goes away.

The only reason this doesn't seem to show up with lagging European medical technology is because tech. is shared around the world. This statement alone should scare the Hell out of the honest skeptic. Where is the evidence that it's not slowing down technological development? There's several trillion tons of evidence that it does. See, oh, I don't know, let's say hundreds of economic "experiments" over a hundred+ years from 1900 through today.

The "free care" they offer was bought with the sweat and cash of other, economically superior countries.

Come, Europeans. Dump your "feel good" socialized medicine, and join the fast-advancing club so your own people can live better lives than they are now.

An honest skeptic would say that it is you who needs to provide evidence that universal healthcare would slow technological development.

Evidence for other assertions?

Sefarst
13th March 2009, 07:28 AM
you can atm, but what when loosing job, and have financial trobles. your nearly bankrupt, maybe not even your fault. now you get sick and need an operation, but you dont have your insurance not anymore. no money left, now?

And if I'm filthy rich and can afford anything I need?

but also solidairty with the people around you that can not afford it?

Government mandated solidarity. Mandated from the bottom up by the people who want something.

but im socialist :)

You hide it well. Don't worry, I still think you're an okay guy.

DC
13th March 2009, 07:29 AM
Ref (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5607a5.htm)

And why? New drugs and so on. And why are there new drugs? Because corporations dump tens of billions a year into developing them, on top of what government provides (which is semi-political at best.)

Reduce profits, that goes away.

The only reason this doesn't seem to show up with lagging European medical technology is because tech. is shared around the world. This statement alone should scare the Hell out of the honest skeptic. Where is the evidence that it's not slowing down technological development? There's several trillion tons of evidence that it does. See, oh, I don't know, let's say hundreds of economic "experiments" over a hundred+ years from 1900 through today.

The "free care" they offer was bought with the sweat and cash of other, economically superior countries.

Come, Europeans. Dump your "feel good" socialized medicine, and join the fast-advancing club so your own people can live better lives than they are now.

eerm Novartis is doing a pretty good job in developing medicine, especialy considering how tiny my country is. and we have such a "slavery" healthcare system.

DC
13th March 2009, 07:35 AM
And if I'm filthy rich and can afford anything I need?



Government mandated solidarity. Mandated from the bottom up by the people who want something.



You hide it well. Don't worry, I still think you're an okay guy.

if your filthy rich you can afford everythng when it is on the market / invented already. (still talking about healthcare)

in a Democracy, you are also the government, it isnt just something from and for others, your part of it. or not?

and why do i hide it well? i try not to :(

Ziggurat
13th March 2009, 07:44 AM
Well, it says in the link, as I said.

Ah, so it's essentially just an opinion poll (http://en.wikipedia.org/wiki/Worldwide_Press_Freedom_Index#Worldwide_Press_Free dom_Index).

Sefarst
13th March 2009, 07:49 AM
if your filthy rich you can afford everythng when it is on the market / invented already. (still talking about healthcare)

Yes, I don't see your point.

in a Democracy, you are also the government, it isnt just something from and for others, your part of it. or not?

No, I get one small voice in deciding who is the government.

and why do i hide it well? i try not to :(

Sorry, didn't mean to hurt your feelings.

DC
13th March 2009, 08:04 AM
Yes, I don't see your point. .
because i missread your point ^^

if you stay rich, everything is fine for you.
and if you always stay healthy you never need a health insurance.


No, I get one small voice in deciding who is the government.
sure you get only a small voice, the more people the smaller your voice.
indeed in a non direct democracy you can only elect who will manage things for you.
i am used to also have a say on decisions directly, and see later do politicans the opposite anyway :D

we the people must fight to have louder voices and decide things directly ourselfe.
We decided that a UHC system is a good thing for us. and try to keep improving it.


Sorry, didn't mean to hurt your feelings.

you didnt :) just wondered why i come across as non socialist :)

Simon39759
13th March 2009, 09:39 AM
And why? New drugs and so on. And why are there new drugs? Because corporations dump tens of billions a year into developing them, on top of what government provides (which is semi-political at best.)

Reduce profits, that goes away.

The only reason this doesn't seem to show up with lagging European medical technology is because tech. is shared around the world. This statement alone should scare the Hell out of the honest skeptic. Where is the evidence that it's not slowing down technological development? There's several trillion tons of evidence that it does. See, oh, I don't know, let's say hundreds of economic "experiments" over a hundred+ years from 1900 through today.

The "free care" they offer was bought with the sweat and cash of other, economically superior countries.

Come, Europeans. Dump your "feel good" socialized medicine, and join the fast-advancing club so your own people can live better lives than they are now.



Actually, even in the US, most of the research for new treatments is funded through public research.
Private companies try to avoid the risk associated with developing a totally new product, and focus on modifying a known compound, just tweaking enough so that they can call it new and renew their license on it.
When dealing with new molecules, they only try move in after public institutes have carried the product through the initial phases of research and trials, essentially when they are fairly confident that the research will lead to a commercialized product.

Even then, private company focus their efforts on the most economically viable products, essentially life-long treatments such as against diabetes or for heart disease and quality of life drugs people are willing to shell out a lot for (little blue pills).
Private research tend to overlook 'cures' such as antibiotics and vaccines.
They won't avoid them, of course, but they are not going to go out of their way to research these less profitable sectors.


In fact, the American system of health care is quite inefficient, the US spend most of their GDP on health care than most other nations -almost twice as much as Canada- and, not only does only a portion of its population have access to health care, but it's health care is also, for the average citizen, of lesser quality (as illustrated by the lower life expectancies).


Unfortunately, I can't yet post links... But there is a comparison of both Canadian and US health care system in Wikipedia, and this article have plenty of references...

ddt
13th March 2009, 10:27 AM
Ref (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5607a5.htm)

And why? New drugs and so on. And why are there new drugs? Because corporations dump tens of billions a year into developing them, on top of what government provides (which is semi-political at best.)

Reduce profits, that goes away.

The only reason this doesn't seem to show up with lagging European medical technology is because tech. is shared around the world. This statement alone should scare the Hell out of the honest skeptic. Where is the evidence that it's not slowing down technological development? There's several trillion tons of evidence that it does. See, oh, I don't know, let's say hundreds of economic "experiments" over a hundred+ years from 1900 through today.

The "free care" they offer was bought with the sweat and cash of other, economically superior countries.

Come, Europeans. Dump your "feel good" socialized medicine, and join the fast-advancing club so your own people can live better lives than they are now.

What an incredibly stupid argument. If Novartis, Basf, Glaxo, etc. wouldn't make a profit at all on the European markets, they wouldn't sell their drugs at all, would they?

So the real situation is: the drug companies make a modest profit on the European market, and an obscene profit on the US market. From your insurance premiums.

Did you know that in the latest change to Medicare, it was explicitly written into law that the US govt. was not allowed to negotiate over the price of drugs? Your tax monies pay for that.

Moreover, as Simon39759 rightly noted, most of the development of drugs is not done by the pharma companies themselves, but at universities, funded by public grants. From your tax monies.

So, in effect, you're paying three times for the drugs in the US. Stupid Americans.

Toke
13th March 2009, 10:58 AM
Would it help if you throught of taxasion as medical insurance?
Except it is cheaper and with full cover.

Toke
13th March 2009, 11:02 AM
There are all ready law requiring certain vaccinations and tests.

Sounds like somebody is sneaking socialism in through the back door.

And what about your medicare program, taking away the poors freedom to die in the streets, and billing the taxpayers!

You better do something about that.

Sefarst
13th March 2009, 11:07 AM
Sounds like somebody is sneaking socialism in through the back door.

And what about your medicare program, taking away the poors freedom to die in the streets, and billing the taxpayers!

You better do something about that.

It'll collapse on it's own over the next few decades.

lupus_in_fabula
13th March 2009, 11:20 AM
I must be a really stupid European. We have universal health care and I still have an insurance. Thus... I win! :D

The funny thing about my insurance is (apart from that they don't issue them anymore), that it's literally called, when translated, a "health expenditure insurance". That's something weird, at least in my country.

Toke
13th March 2009, 11:36 AM
Perhaps the tread should be renamed "Lazy Europeans"

In Denmark we work an average of 36 hours and 17 minutes a week.
38hour and 53 minuttes for men and 33 hour and 14 minuttes for women.

We have 253 workdays a year, minus our 6 weeks vacation for 223 days total.

ZirconBlue
13th March 2009, 12:58 PM
Hopefully, one day, we can also achieve the freedom to force other people to pay for our healthcare costs.

Yes, solidarity. That's why you need laws and the police to force people to do it.

I'm already "forced" to pay for others' healthcare costs. It's called Medicare and Medicaid. The main difference between that and UHC is that I can't actually use the healthcare I pay (more) for.

Bob Blaylock
13th March 2009, 01:09 PM
"Stupid Europeans" have 25-50 days vacation a year, apart from public holidays.


In other words, Europeans are not expected to be as productive as their American counterparts, but expect to be paid at least as well.

Sefarst
13th March 2009, 01:10 PM
I'm already "forced" to pay for others' healthcare costs. It's called Medicare and Medicaid. The main difference between that and UHC is that I can't actually use the healthcare I pay (more) for.

No argument from me. Ultimately they will be unsustainable in the long run.

Undesired Walrus
13th March 2009, 01:29 PM
Personally, I find this European-American animosity repugnant. Just as America is not a monolithic entity, neither is Europe. I'm looking at you Oliver, Ziggurat, funk de fino, Texas.

While Berlin may have a high life standard of living, one only needs to look at Glasgow. While Britain may silence freedom of speech from time to time, publishers in Denmark publish the Mohammed Cartoons. While the Bible belt may value a cell in a petri dish over the paralysis of a young man, there are the best scientists in the world currently working on them in the same country. For every uneducated American who doesn't know the location of Iraq, there is a Baldwin, a Sagan, a Poe.

Nationalism truly is the bane of existence.

Toke
13th March 2009, 01:42 PM
In other words, Europeans are not expected to be as productive as their American counterparts, but expect to be paid at least as well.

You got it the wrong way around.:D
Short workweeks and long vacations make people more productive while at work.

Undesired Walrus,
You have a good point, but in the wrong tread.

lupus_in_fabula
13th March 2009, 02:13 PM
In other words, Europeans are not expected to be as productive as their American counterparts, but expect to be paid at least as well.

Who would be in the position to expect more productivity?

Ziggurat
13th March 2009, 02:25 PM
Personally, I find this European-American animosity repugnant. Just as America is not a monolithic entity, neither is Europe. I'm looking at you Oliver, Ziggurat, funk de fino, Texas.

Pardon me, but I expressed no animosity towards Europe in this thread. As a matter of fact, I didn't say anything about Europe. My criticism was wholly directed at what I consider weaknesses in those "rankings" lists, which covered not just Europe and America but most of the countries on the globe. Your accusation against me is baseless, and rather ironic.

Texas
13th March 2009, 04:34 PM
Do teachers (and others) still implore kids to speak "The King's English"?
Have you heard today's kids talk?

dudalb
13th March 2009, 05:25 PM
Have you heard today's kids talk?

Henry Higgins would go crazy if he lived today.

Rolfe
13th March 2009, 06:38 PM
In other words, Europeans are not expected to be as productive as their American counterparts, but expect to be paid at least as well.


You can of course prove what you said about "productive", as opposed to simply being at work longer?

Well, good luck with that long-hours culture, and not having sick leave entitlement, and two weeks holiday a year, and "termination at will", and no security of healthcare provision.

God, I'm just gutted I don't live in America....

Rolfe.

moon1969
13th March 2009, 07:19 PM
Europeans are not stupid


No but russians sure are evil. I support America and Israel but I would never visit he Great Britain or Russia because of what these two did to my country during WW2. :mad:

moon1969
13th March 2009, 07:20 PM
Personally, I find this European-American animosity repugnant. Just as America is not a monolithic entity, neither is Europe. I'm looking at you Oliver, Ziggurat, funk de fino, Texas.

While Berlin may have a high life standard of living, one only needs to look at Glasgow. While Britain may silence freedom of speech from time to time, publishers in Denmark publish the Mohammed Cartoons. While the Bible belt may value a cell in a petri dish over the paralysis of a young man, there are the best scientists in the world currently working on them in the same country. For every uneducated American who doesn't know the location of Iraq, there is a Baldwin, a Sagan, a Poe.

Nationalism truly is the bane of existence.


So Moscow is not part of Europe? :D

Oliver
14th March 2009, 01:56 AM
... I would never visit Great Britain or Russia because of what these two did to my country during WW2. :mad:


:D

funk de fino
14th March 2009, 06:03 AM
Personally, I find this European-American animosity repugnant. Just as America is not a monolithic entity, neither is Europe. I'm looking at you Oliver, Ziggurat, funk de fino, Texas.

I guess you will have to explain why you have thrown my name into this?

I suspect you are barking up the wrong tree here mate.

funk de fino
16th March 2009, 09:37 PM
Bump for Undesired Walrus to clarify his remarks

Texas
16th March 2009, 09:53 PM
Why don't Americans understand that public health is everybody's concern. Do they really think that if someone down the road gets cholera, or tuberculosis it won't affect them? I'm happy to pay National Insurance not only because I know that I'll get good care I couldn't otherwise afford if I fall with some non-comunicable disease like cancer, not only because they pay all my prescription costs for my diabetes care, but mainly because I know that they're ensuring that other people from whom I might catch flu or who might infect my infant son with measles, whooping cough or other infectious and potentially fatal diseases, before he completes his vaccination schedule, are very few and far between.Yes we have an cholera epidemic evey week and our kids are unvaccinated Typhoid Marys. Why don't Europeans realise that Americans have a different view of the role of government in our lives than they do? From my time on this forum it is obvious that the Non-American members have an almost religious desire to convert Americans into the European model. If you are happy with your social welfare states that is great but that doesn't mean we should or want to join you.

Rolfe
17th March 2009, 05:11 AM
I think most people here are happy to go with what works. There is a wide variety of universal healthcare models around the globe, and I've never encountered anyone with a desire to "convert" other countries to their particular system.

If the US system was actually working, then these conversations wouldn't be happening. It would just be one more way of doing things. But in fact it is often the Americans themselves who start threads about the US system being "in crisis" and so on. Just about any statistics you look at indicate that health outcomes in the USA on a population basis are not good, while at the same time the country is paying out almonst twice what countries with universal systems are paying (as a % of GDP).

It's a bit difficult to look at such discussions without shouting, "well, HELLO!!"

Rolfe.

Magyar
17th March 2009, 05:28 AM
standards of living permanently 30% lower than ours

Since no one has addressed this tidbit I felt that I had to call WOO on this one!
Quantity of consumption does not equal standard of living!!!

PERHAPS, and I REALLY DOUBT IT, this may apply to the wealth of the top 5-10% or something, but then is having to down grade from Royal Beluga to Osetra really considered a standard of life issue??

health care
family/maternity leave
vacation time
access to affordable higher education
access to public transportation
and the list goes ON AND ON AND ON

If you take the average median income family in the US vs any of the western and I'd say even some eastern EU countries
HOW are their standards of living lower, MUCH LESS 30% lower?

This sounds like a Rushbo pile of dung dependant on the fact that most Americans can't find EU on a map much less actually been there or talked to anyone from there.

Rolfe
17th March 2009, 06:13 AM
Seconded.

Rolfe.

Oliver
17th March 2009, 07:55 AM
Why don't Americans understand that public health is everybody's concern.


From reading and hearing about it in the US-Media and different Fora, I assume it's because the opponents of UHC don't see any benefits of a healthy society as a whole while focusing on probable disadvantages for themselves. And of course not recognizing that Universal Healthcare doesn't mean that you cannot use a private insurance anyway if you can afford it.

Rolfe
17th March 2009, 09:23 AM
And completely ignoring the fact that they may well in the future be in a less favourable situation than they are now, and be in a position to benefit from the system they've paid in to.

Rolfe.

Oliver
17th March 2009, 09:32 AM
And completely ignoring the fact that they may well in the future be in a less favourable situation than they are now, and be in a position to benefit from the system they've paid in to.

Rolfe.


Plus: Helping other citizens by granting them the same privileges does feel good in a sense that we all make this a better and more healthy place for everyone.

Rolfe
17th March 2009, 09:37 AM
One of the things I'd hate about a system with no publicly-funded healthcare at all would be the constant moral pressure to contribute to the bottomless pit of charity need that would be there. At least, with Medicare and Medicaid, the USA isn't really in that situation - quite.

Rolfe.

Ziggurat
17th March 2009, 09:39 AM
From reading and hearing about it in the US-Media and different Fora, I assume it's because the opponents of UHC don't see any benefits of a healthy society as a whole

I'm not surprised you see it that way. It's easy to assume malice as the motive for different opinions, isn't it? Funny thing, though: I have never heard anyone actually make that argument. Which suggests that you don't actually understand what those other opinions are, or the reasons behind them.

Rolfe
17th March 2009, 09:42 AM
Well, if he's misunderstood, how about trying to explain the real opinions/reasons.

Rolfe.

Oliver
17th March 2009, 09:48 AM
I'm not surprised you see it that way. It's easy to assume malice as the motive for different opinions, isn't it? Funny thing, though: I have never heard anyone actually make that argument. Which suggests that you don't actually understand what those other opinions are, or the reasons behind them.


Well, why aren't the following views that ...

A. UHC will help lazy people to be more lazy
B. UHC will cost more money if I have to pay for others
C. UHC will lead to more waiting times
D. UHC will diminish my medical treatment
E. UHC is socialism because it cares about all but not me specifically

... about a rather selfish point of View then - if UHC indeed is meant to help the society as a whole from a medical and economic POV?

In other words: What other reasons would you like to cite to be opposed to universal healthcare if I'm wrong with my assessment about conservative egoism?

Ziggurat
17th March 2009, 10:06 AM
Well, why aren't the following views that ...

A. UHC will help lazy people to be more lazy

That argument is essentially that welfare can be detrimental to the recipient because it can encourage behavior which hurts them. Whether or not you accept that argument, it is predicated rather explicitly on the notion that we should avoid doing harm to others. Again, your failure to realize what the argument means, rather than being able to form a counter-argument, is telling.

B. UHC will cost more money if I have to pay for others

The cost argument is not simply about what it costs me, or any individual. It's also about total costs, and opportunity costs (are you familiar with the phrase?), to society as a whole. Again, whether or not you think the argument is correct, this argument is still very much concerned with the well-being (in this case, economic) of other people.

C. UHC will lead to more waiting times

That would affect lots of other people, wouldn't it?

D. UHC will diminish my medical treatment

And the treatment of many other people as well.

E. UHC is socialism because it cares about all but not me specifically

This is nonsense. It's socialism because it's government control of a major sector of our economy. The "caring" bit is irrelevant to whether or not it's socialism.

... about a rather selfish point of View then - if UHC indeed is meant to help the society as a whole from a medical and econimic POV?

This is exactly what I'm talking about. Because you've assigned benign motives to backing UHC, you assume that it can only be malicious motives which would oppose it. You don't even consider that someone could disagree about the effects of a plan. It's possible for people to have complete agreement about goals but still disagree about methods. But you won't consider that. That's why it's enough for you to argue that UHC is meant to help - anyone who opposes it must therefore not want to help, rather than think that maybe it won't help. You assign malice to your opponents, and attack those presumed motives, saving you the trouble of considering their actual arguments.

Ziggurat
17th March 2009, 10:10 AM
Well, if he's misunderstood, how about trying to explain the real opinions/reasons.

In short, because for the most part opponents don't agree with backers about what the effects will actually be. Quite simple, really. As to the arguments for why, well, those are easy enough to find, if you care to look. But Oliver doesn't. His response makes that fairly clear: he has assumed malice on the part of opponents, and as long as he operates under that assumption, he's never going to actually make any real effort to understand their position.

Toke
17th March 2009, 10:17 AM
Ziggurat,
Looks like your arguments boil down to the US goverment being less competent than any other western nation.

Can you back that up?

Ziggurat
17th March 2009, 10:32 AM
Ziggurat,
Looks like your arguments boil down to the US goverment being less competent than any other western nation.

Can you back that up?

No, it doesn't boil down to that. Part of it is a different evaluation of what the relative costs and benefits actually are (especially the long-term prospects). There simply isn't agreement that everyone else has it better off than us with universal health care - Canada and the UK being two where complaints about UHC are rather significant. Additionally, the US doesn't have the same demographics as many other western nations, so whether or not our government is equally competent, we would not get the same results if we tried doing the same thing that, say, Norway does.

I'm not demanding that you agree with the arguments against UHC, but all I'm really seeing in this thread are misrepresentations and misunderstandings of what those arguments are.

Oliver
17th March 2009, 10:42 AM
That argument is essentially that welfare can be detrimental to the recipient because it can encourage behavior which hurts them. Whether or not you accept that argument, it is predicated rather explicitly on the notion that we should avoid doing harm to others. Again, your failure to realize what the argument means, rather than being able to form a counter-argument, is telling.


Well, if you assume that Europe never faced your argumentation, then you might be right. But unfortunately, there were a lot of statistics about this issue to improve the existing UHC's. So what's your personal point here taking this into consideration?


The cost argument is not simply about what it costs me, or any individual. It's also about total costs, and opportunity costs (are you familiar with the phrase?), to society as a whole. Again, whether or not you think the argument is correct, this argument is still very much concerned with the well-being (in this case, economic) of other people.


The "total cost" of health care is much higher in the US anyway in contrast to UHC - what's your point in arguing for lower costs in here if a healthy society as a whole is good for the countries economy?

That would affect lots of other people, wouldn't it?


It would. But as I said: If you can afford it anyway, get a private insurance. You're not prohibit to do so.

And the treatment of many other people as well.


That's incorrect because the government decides what treatment works best based on independent research. So it doesn't mean that you have to pay more or that you get a worse treatment.

This is nonsense. It's socialism because it's government control of a major sector of our economy. The "caring" bit is irrelevant to whether or not it's socialism.


You know that the free-market works on behalf of maximizing profit in contrast to government trying to keep costs as low as possible. So in case of UHC, we're not talking about "making sure that you get the coolest commercial promises" but the best working medical treatment for your money. That's how UHC works in foreign countries to keep the tax-level as low as possible. It's the same in case of post offices: If you like to pay 10 times as much for a private post service, that's fine - and that's what "Private post services" are all about. But if you wan't a cheap and working solution for yourself, you will use the national service rather than the commercial alternatives.

So what's so bad about a federal solution run by the government if you're still free to switch to the commercial solution?

This is exactly what I'm talking about. Because you've assigned benign motives to backing UHC, you assume that it can only be malicious motives which would oppose it. You don't even consider that someone could disagree about the effects of a plan. It's possible for people to have complete agreement about goals but still disagree about methods. But you won't consider that. That's why it's enough for you to argue that UHC is meant to help - anyone who opposes it must therefore not want to help, rather than think that maybe it won't help. You assign malice to your opponents, and attack those presumed motives, saving you the trouble of considering their actual arguments.


I'm completely aware of the fact that UHC-solutions around the world differ quite a lot concerning how they work in detail. But I was talking about being opposed to UHC "NO MATTER WHAT!".

You know that this mindset exists in the US and it's stupid because it completely ignores the positive sides of UHC. So what points do I miss here that wasn't discussed before in other western solutions yet?

Toke
17th March 2009, 10:48 AM
I'm not demanding that you agree with the arguments against UHC, but all I'm really seeing in this thread are misrepresentations and misunderstandings of what those arguments are.

Well, I don´t agree.

The benefits of UHC are so overwhelming compared to your current system, that I find it hard to see any rational arguments against it.

The only one I have heard and not seen refused soundly is the one about the pissup in a brewery. Nobody have been able to prove it either.

Oliver
17th March 2009, 10:58 AM
It'll collapse on it's own over the next few decades.


In contrast to UHC, of course - introduced by Bismarck 46.021 days ago (http://en.wikipedia.org/wiki/Health_care_in_Germany).

Ziggurat
17th March 2009, 11:06 AM
Well, if you assume that Europe never faced your argumentation, then you might be right.

I'm not talking about Europeans, I'm talking about you.

The "total cost" of health care is much higher in the US anyway in contrast to UHC

To UHC in other countries. That doesn't necessarily mean it would be more than UHC in the US. Many opponents don't think it would be.

It would.

Well then: you've now conceeded that selfish interests aren't the only arguments in play against UHC.

But as I said: If you can afford it anyway, get a private insurance. You're not prohibit to do so.

That's incorrect because the government decides what treatment works best based on independent research. So it doesn't mean that you have to pay more or that you get a worse treatment.

Uh, no. Government will decide what treatment based partly on "independent research" (which won't really be independent if the government runs the whole industry), and partly on costs. Because every single health care plan that could ever possibly work must have some form of rationing, and in the case of UHC, the government must do that rationing. It must and it will refuse some services because they are too expensive. Don't even try to pretend that someone won't still be denying treatment based on cost. Of course they will, or the system will go bankrupt. Now, proponents can argue that government will provide more and better treatment than insurance companies, but not everyone agrees. And again: even if it does provide better treatment, it will still have to refuse some treatment because of costs. Which makes your counterargument about "independent research" completely irrelevant.

You know that the free-market works on behalf of maximizing profit in contrast to government trying to keep costs as low as possible.

And what better way to keep costs low than by denying treatment? Think it doesn't happen in UHC systems? Of course it does. In fact, it must. One way or another, it happens in every health insurance system.

So what's so bad about a federal solution run by the government if you're still free to switch to the commercial solution?

Taxes will go up. Even if they go up less than your health insurance premiums, they will still go up. Which means some people (possibly quite a few) who can currently afford their own insurance won't be able to afford private insurance on top of their government health insurance once their taxes go up.

I'm completely aware of the fact that UHC-solutions around the world differ quite a lot concerning how they work in detail. But I was talking about being opposed to UHC "NO MATTER WHAT!".

Funny: you didn't specify that at all in your earlier post.

Ziggurat
17th March 2009, 11:08 AM
The benefits of UHC are so overwhelming compared to your current system, that I find it hard to see any rational arguments against it.

You need not agree with rational arguments against it, but if you truly can't even recognize them, then that's your own shortcoming.

Oliver
17th March 2009, 11:09 AM
Perhaps the tread should be renamed "Lazy Europeans"

In Denmark we work an average of 36 hours and 17 minutes a week.
38hour and 53 minuttes for men and 33 hour and 14 minuttes for women.

We have 253 workdays a year, minus our 6 weeks vacation for 223 days total.



Well, how are Europeans be able to work such a rather short period of time during a year while being so much healthier than Americans then? Is there a relation between the two margins? :D

Oliver
17th March 2009, 11:12 AM
I'm not talking about Europeans, I'm talking about you.

To UHC in other countries. That doesn't necessarily mean it would be more than UHC in the US. Many opponents don't think it would be.

Well then: you've now conceeded that selfish interests aren't the only arguments in play against UHC.

But as I said: If you can afford it anyway, get a private insurance. You're not prohibit to do so.

Uh, no. Government will decide what treatment based partly on "independent research" (which won't really be independent if the government runs the whole industry), and partly on costs. Because every single health care plan that could ever possibly work must have some form of rationing, and in the case of UHC, the government must do that rationing. It must and it will refuse some services because they are too expensive. Don't even try to pretend that someone won't still be denying treatment based on cost. Of course they will, or the system will go bankrupt. Now, proponents can argue that government will provide more and better treatment than insurance companies, but not everyone agrees. And again: even if it does provide better treatment, it will still have to refuse some treatment because of costs. Which makes your counterargument about "independent research" completely irrelevant.

And what better way to keep costs low than by denying treatment? Think it doesn't happen in UHC systems? Of course it does. In fact, it must. One way or another, it happens in every health insurance system.
Taxes will go up. Even if they go up less than your health insurance premiums, they will still go up. Which means some people (possibly quite a few) who can currently afford their own insurance won't be able to afford private insurance on top of their government health insurance once their taxes go up.

Funny: you didn't specify that at all in your earlier post.


To find a common ground here, Ziggurat: What are your personal arguments against UHC in this thread?

And to highlight your positive conclusions: What are the advantages of UHC in contrast to the arguments against it. And why do you still think that "UHC" is worse than "no UHC"?

Toke
17th March 2009, 11:47 AM
Well, how are Europeans be able to work such a rather short period of time during a year while being so much healthier than Americans then? Is there a relation between the two margins? :D

Guess we have so bad health that we can´t work much, and just have to be that much more effective and hardworking while at work.:D

Ziggurat
17th March 2009, 11:56 AM
To find a common ground here, Ziggurat: What are your personal arguments against UHC in this thread?

First off, I don't like the idea of dramatically expanding the size and role of government on general principle. Furthermore, if the federal government tries to take over health care and screws up, everybody suffers, and I've seen enough of government to know that one should never discount the possibility that they'll screw it up. In contrast, if one health insurance company tries something risky and fails, only their customers are at risk. Hell, even if only one state tries government health care, only that state's residents are at risk.

More immediately, though, I haven't seen any specific plans proposed for the US that sound like they would actually improve things here. Problems with cost containment and quality of service are serious concerns, and without significant competition (because there wouldn't be much with UHC), healthcare service could easily end up looking like the DMV. Believe it or not, though, I'm actually willing to be convinced, but that's part of the point: because of the dangers inherent in such a change, I need to be convinced that a specific plan would be enough of an improvement to be worth the risk (because even a good plan can fail if poorly implemented). And that hasn't happened yet for me.

And to highlight your positive conclusions: What are the advantages of UHC in contrast to the arguments against it. And why do you still think that "UHC" is worse than "no UHC"?

The primary advantage of UHC is that it gets rid of the information asymmetry problem, where markets do have a hard time. Namely, because people know more about their health risks than insurers, those at low risk can opt out of the system, and so raise the costs for those who remain. That increased cost in turn provides an incentive for more low-risk people to opt out. It's a bad feedback mechanism. The current methods to try to control it (employee-sponsored programs, penalizing people who want to jump into the system once they develop a health problem to discourage people from opting out in the first place) are far from ideal.

I recognize this benefit, and it's quite significant. I just don't have enough confidence in government to do the job better. The government has little accountability in a UHC system. The primary advantage (nobody can opt out, so risk is spread more broadly) also means that we have little leverage against poor service, since they get their money regardless. I just don't think the incentive mechanisms for government to do a good job are strong enough in any of what I've seen proposed, and without strong incentives, I think poor performance is what we should reasonably expect to happen. That various forms work to many people's satisfaction elsewhere doesn't mean we would achieve the same thing in the US, because every country is different.

Klimax
17th March 2009, 02:48 PM
OK.It looks like another model of UHC could be entered.

What we (czechs) had/partially have:-private,state and regional hospitals which have contracts with insurance providers.They have fixed percentage from income or payment from state for each person.
-hospitals are of various forms(corp and nonrpofit)
-Money is put into common pool inside ins. provider and from that payment for medic care is provided.It is not classical insurance as it is percentage and no alteration is possible.
-State is guaranteeing and legislates standard healtcare,which is paid for by insurance.
-however it is possible that given hospital does not have contract with provider.
-Drugs are in three categories(cost-nnot avail.): provider coverd,partially covered and not covered.
-first and second categories are defined by state
-one of changes in last years-"regulating" fees (quite contested, not longterm); each visit, prescription,...
-ins. providers not-for-profit
-MDs are paid per patient per point(usually finding,tratment,...) by IP
-medical woo is not covered!
-first three days of ilness are not paid(originally 25% of income) then 65%
-disadvantages are iveruse of antibiotics and such;unnecessary visits ; often expensive drugs prescribed over cheap ones-connected with "bribes" by pharmas (recent case!); fakers of being ill can for a year to get paid even if fired.

Maybe I forgot something.

Ziggurat
17th March 2009, 02:59 PM
Maybe I forgot something.

Yes. You forgot that a : followed immediately by a p gives you a :p

Klimax
17th March 2009, 03:06 PM
Yes. You forgot that a : followed immediately by a p gives you a :p

Night,sleep,long day. Nice. Great. Thanks. :slp:

Rolfe
17th March 2009, 03:41 PM
That argument is essentially that welfare can be detrimental to the recipient because it can encourage behavior which hurts them. Whether or not you accept that argument, it is predicated rather explicitly on the notion that we should avoid doing harm to others. Again, your failure to realize what the argument means, rather than being able to form a counter-argument, is telling.


Now let's get this clear. We're talling about healthcare here, not social security (assistance for food, housing etc.). Do you really see that as "welfare"? Do you really think that I, for example, am receiving welfare, and this is encouraging me in behaviour which hurts me?

What harmful behaviour is encouraged by knowing that you don't have to worry about how you're going to be able to afford treatment if you are injured or fall ill? Seriously?

The fact is that most illness and injury is pretty damn random. And ability to afford expensive insurance is no guarantee of virtue - and many people who can't afford this are hadworking decent people who have been dealt a bad hand one way or another. Do you really think that the enormous benefits of universally-available healthcare to people on low incomes and people with poor health histories are more than set aside by some nebulous "dependency" issue? I just don't follow you.

The cost argument is not simply about what it costs me, or any individual. It's also about total costs, and opportunity costs (are you familiar with the phrase?), to society as a whole. Again, whether or not you think the argument is correct, this argument is still very much concerned with the well-being (in this case, economic) of other people.


All the economic evidence I've seen is that the burden of ensuring they have access to healthcare is currently enormous on many people in American society. KellyB says her family pays 50% of its income for health insurance. And this doesn't seem to be an isolated example. The USA currently spends about 15% of its GDP on supplying healthcare to less than 100% of its population, compared to 8-10% for countries with universal healthcare systems. Others have linked to articles about the detrimental effect on competitiveness that paying into health insurance has on UK businesses. We've been over the restrictions on freedom that the US healthcare system puts on employees, and much more.

Britain spends less (as % GDP) on universal healthcare than you guys spend just on Medicare and Medicaid. Where on earth are you getting this "total costs" idea?

Rolfe.

Ziggurat
17th March 2009, 05:21 PM
Now let's get this clear. We're talling about healthcare here, not social security (assistance for food, housing etc.). Do you really see that as "welfare"?

Rather generally speaking, yes. The more proper term is "entitlement program", but if the government is giving someone something that they didn't fully pay for (and there will indeed be people in that category under a UHC, which is in fact a large part of the point), then yeah, that's welfare.

Do you really think that I, for example, am receiving welfare, and this is encouraging me in behaviour which hurts me?

I wouldn't know about you personally. Note that I said "can be", not "is".

What harmful behaviour is encouraged by knowing that you don't have to worry about how you're going to be able to afford treatment if you are injured or fall ill? Seriously?

Well, drug use comes to mind as one.

And ability to afford expensive insurance is no guarantee of virtue

I never claimed it was.

and many people who can't afford this are hadworking decent people who have been dealt a bad hand one way or another.

I never claimed otherwise.

Do you really think that the enormous benefits of universally-available healthcare to people on low incomes and people with poor health histories are more than set aside by some nebulous "dependency" issue?

I never claimed it was. It is only part of the argument against UHC. And not a major part in my mind either. My point wasn't so much that this should be a determining factor, but rather that Oliver's assumption of malice is without basis. Again, this doesn't require that you agree with any of these assesments, but it does take a willingness to accept good faith on the part of those who disagree with you. Oliver was reluctant to do so. Are you?

I just don't follow you.

No, I don't think you do.

The USA currently spends about 15% of its GDP on supplying healthcare to less than 100% of its population, compared to 8-10% for countries with universal healthcare systems.

Implicit in this comparison is the assumption that UHC vs. private health care is the only important difference in the cost differential, but I don't think that's actually the case. Likewise, I don't think that if the US were to adopt UHC, it would end up looking just like one of those other countries. I think Americans would end up demanding far more services from their government health care than citizens in other countries do (particularly treatments for people near the end of their lives), and I think the costs would not end up going down.

Britain spends less (as % GDP) on universal healthcare than you guys spend just on Medicare and Medicaid.

Which kinda supports my contention: you think expanding coverage to everyone is going to decrease those costs? I just don't see that happening.

Texas
17th March 2009, 05:52 PM
And completely ignoring the fact that they may well in the future be in a less favourable situation than they are now, and be in a position to benefit from the system they've paid in to.

Rolfe.

In the United States we don't have the state rationing our health careexcept for Medicare, Medicaid and VA since they are government controlled. We also don't have to wait for months to get treatment for non-emergency procedures:

http://www.timesonline.co.uk/tol/comment/columnists/libby_purves/article4498748.ece

If you read back over ten years, especially in medical journals, the same message keeps coming through: we have rationing, but it is bad rationing because it is muddled, irrational, inconsistent, and all too often covert. Nine years ago a survey of 3,000 doctors found that one in five had known a patient die or deteriorate rapidly because treatment couldn't be afforded. A senior BMA spokesman, Dr Hamish Meldrum, said: “We have to make choices and set priorities... people have been mucking around trying to avoid the word ‘rationing' but we would like a whole public debate.” Geographical anomalies were also striking.

Two years later the British Medical Association said that the concept of the NHS as a service offering all treatments may have “outlived its usefulness” because some rationing is inevitable. Six years later, again, another survey found that it was already half of all doctors - not a fifth any more - who admitted they had patients suffering because of cost. Again, that call for open debate. “Rationing,” said Dr Michael Dixon of the NHS Alliance, “is the great unspoken reality... the only people who refuse to mention the R-word are the media and the politicians”.

http://en.wikipedia.org/wiki/Criticism_of_the_National_Health_Service

NHS access is therefore controlled by medical priority rather than price mechanism, leading to waiting lists for both consultations and surgery, up to months long, although the Labour government of 1997-onwards made it one of its key targets to reduce waiting lists. In 1997, the waiting time for a non-urgent operation could be two years, while there are ambitions to reduce it to 18 weeks - although there is oppostion from doctors.[5] It is contested that this system is fairer - if a medical complaint is acute and life threatening, a patient will reach the front of the queue quickly. In the NHS, everyone that required treatment will eventually receive it, while the same cannot be said of a free-market healthcare system.

The NHS measures medical need in terms of quality-adjusted life years (QALYs), a method of quantifying the benefit of medical intervention.[6] It is argued that this method of allocating healthcare means some patients must lose out in order for others to gain, and that QALY is a crude method of making life and death decisions

Rolfe
17th March 2009, 05:56 PM
I think Americans would end up demanding far more services from their government health care than citizens in other countries do (particularly treatments for people near the end of their lives), and I think the costs would not end up going down.

Which kinda supports my contention: you think expanding coverage to everyone is going to decrease those costs? I just don't see that happening.


So really, we're just back to, every other country that tried it has found it can manage to deliver good universally-available healthcare for less than about 12% of GDP, some for less than 8% GDP.

And yet the USA, despite being the biggest, smartest, richest and just all-round wonderfullest place on the planet, couldn't manage this. Not even with economies of scale beyond the wildest dreams of most of these other countries.

You really think that anyone coolly weighs up the availability of healthcare and then decides it's OK to take drugs, or become an alcoholic, or stuff themselves with Big Macs, or smoke 40 a day? What planet are you on? And if there was any possibility you were right, don't the statistics for drug and alcohol abuse, smoking and obesity in the USA rather argue against that?

Of course there will be people who didn't fully pay for the healthcare they are getting in a universal system. Just as in an insurance-based system. Do you actually know anyone who has been able to pay for major surgery or cancer treatment out of their own pocket? So everyone who has a big claim on their health insurance seems just as guilty of being on "welfare" as people in universal healthcare systems, by that argument. And I see no reason why they aren't in just the same hypothetical moral hazard.

Now I'm not Oliver. And I don't think I ever accused you of malice. But you're quite right that I don't understand you. For example.

I think Americans would end up demanding far more services from their government health care than citizens in other countries do (particularly treatments for people near the end of their lives), ....


This is just another slippery slope argument. The solution to every single one of these is for the initial legislation to be sensibly framed in order to set clear and strict limits on how far the universal healthcare system will cover a citizen. There is absolutely no reason why such a system has to imply a blank cheque for everyone and everything. To say, I won't go for a pleasant country walk because I might be unaccountably impelled to hike on for 100 miles and I don't want to go that far, is really a bit silly.

Which kinda supports my contention: you think expanding coverage to everyone is going to decrease those costs? I just don't see that happening.


You know, CAMRA (http://www.camra.org.uk/page.aspx?o=181254) has shown that organising alcoholic events in brewing premises is actually quite feasible.

Look, I know I've posted this before, but I'll try it again. These are just the advantages of a universal healthcare system that came to me off the top of my head. Mostly contrasting with the current US system. How about addressing these and showing why they are less important than the advantages you see in your present system (which to be honest I still totally don't follow, not even the bit about how you guys are less likely to take drugs than us).


Every citizen has access to healthcare irrespective of wealth
Nobody is contributing to the provision of a service they are not permitted to access
"Freeloading" is only possible by tax evasion
Nobody is forced to accept or remain in a job they dislike in order to secure healthcare
Nobody who is involuntarily forced from their job will lose healthcare access
Heathcare access cannot be arbitrarily terminated by an employer looking to save money
Treatment provided is not restricted by insurance loss adjusters
Choice of provider is not restricted by insurance company contracts
Previous need for healthcare provision does not affect future entitlement
No lifetime ceiling on entitlement to care
The most expert consultants can have the most serious and complicated cases referred to them without losing income, even if these patients are relatively impecunious
Entitlement to care means that anyone failed by the system (not provided with adequate care) has legal redress
Citizens freed from a potentially intolerable burden of charity if a personal acquaintance lacks entitlement to care for a serious condition
Paying for insurance, while remaining an option, is no longer compulsory
Inclusion of political decision-makers within a universal system forces these people to support the system and prevents publicly-funded care becoming "second-rate"
Elimination of stress and worry about paying for treatment
Good value for money (8% of GDP for full coverage as opposed to 15% of GDP for incomplete coverage), partly through efficiency savings and partly through economies of scale/bulk purchasing potential
More disposable income for everyone (and the absence of any need to lock money away in health savings accounts) stimulates the economy
Businesses freed from the costs of providing employee healthcare
Medical suppliers benefit by having their products purchased by/for all eligible patients, not just those who can afford them
Public health benefits of everyone being able to access preventative medicine
Larger productive workforce, as some chronic ill-health will be avoided

Compared to families like KellyB's having to pay out 50% of their monthly income for health insurance, and business groups (http://www.industryweek.com/articles/competitive_disadvantage_health_care_costs_spell_t rouble_for_u-s-_companies_18706.aspx) saying stuff like

Health care costs in the United States are putting companies and workers at a significant competitive disadvantage in the global marketplace, according to a new study released by the Business Roundtable.

The business CEO group looked at 19 internationally reported measures of health spending and workforce health, and compared U.S. data to both the G-5 group (Canada, Japan, Germany, United Kingdom and France) and the BIC group (Brazil, India and China). On a weighted scale, researchers found that U.S. workers and employers receive 23% less value from their health care system than the G-5 group and 46% less than the BIC group. [....]

The Health Care Value Comparability Study also revealed that, as a group, the G-5 countries spend approximately 63 cents for every dollar the U.S. spends on health care, yet the health of the U.S. workforce lags these countries as a whole by 10%.


The article predicts that health insurance costs for a family of four are heading for $15,000 to $18,000 a year within 5 or 6 years - and that's on top of the tax they're paying to support the publicly-funded healthcare system.

I'm not really seeing how your society as a whole is so much better off with things as they are at present.

Rolfe.

Texas
17th March 2009, 06:14 PM
Rolfe: The simple fact is that you are NOT getting better care at a cheaper price. You are just getting cheaper care. We have no rationing nor do we have months long waiting times for non urgent care. We have a better doctor to patient ratio than Europe and far better access to advanced treatment options.

Rolfe
17th March 2009, 06:20 PM
In the United States we don't have the state rationing our health careexcept for Medicare, Medicaid and VA since they are government controlled. We also don't have to wait for months to get treatment for non-emergency procedures.


Two things you're slightly missing there. First, if things were actually as bad as you're inferring from these articles, why would myself and other posters in this thread be quite so relaxed about the service we can expect? The whole waiting list topic is grossly exaggerated by opponents of universal healthcare - in fact most people are treated even for non-emergency conditions within a perfectly reasonable time scale. There have been significant improvements over the last ten years or so.

Second, the "rationing" that is being discussed concerns very expensive treatments of questionable and unproven benefit, often exactly those minimally-effective end-of-life interventions Ziggauraut was referring to.

Now consider a couple more things. For the right to access the NHS, with all the problems you seem to think it has, we pay a bit less than you currently pay to fund Medicare and Medicaid, that you can't access. So we are in effect in the position of a US citizen without health insurance - we pay only for the publicly-funded system. But we can access this system! At no more cost to us than your own current tax burden.

This still leaves us absolutely free to take out supplementary healthcare insurance if we want to. It's actually quite cheap, because the insurance companies know that their clients won't use it for ordinary everyday doctor visits, or for blue-light emergencies - both of these situations are well covered by the NHS. But if you want to insure yourself so that you can have your hip replacement a bit sooner, you're entirely at liberty to do that. (Or to pay for it up-front out of pocket.) You're just not forced to. If you choose not to, you'll still get the hip replacement, just maybe not quite so fast.

So how come the uptake is so small? Well, because people who live here and who are not judging the system by newspaper headlines or Wikipedia pages but by experience, know that the NHS is actually unlikely to let them down to the extent where it's worth spending a couple of hundred pounds a month on the off-chance.

And one more thing. Maybe the government doesn't ration your healthcare outwith Medicare and Medicaid. But there's no doubt your insurance companies do.

You know, I definitely prefer a reasonably equitable system where I know I'll get the treatment I need sooner or later, with that time being dictated by clinical need, than one where some people, perhaps not particularly urgent cases, can access immediate treatment because of their wealth, while others have a wait time of essentially infinity, because they can't get insurance cover for their illness at all.

And the fact that I'm still free to be a bloated plutocrat and pay to jump the queue if I want to is the icing on the cake.

Rolfe.

Rolfe
17th March 2009, 06:33 PM
Rolfe: The simple fact is that you are NOT getting better care at a cheaper price. You are just getting cheaper care. We have no rationing nor do we have months long waiting times for non urgent care. We have a better doctor to patient ratio than Europe and far better access to advanced treatment options.


I'll just mention this little example of the standard of care provided by the NHS. Abigail's story (http://www.theherald.co.uk/news/news/display.var.1982567.0.six_weeks_ago_she_made_histo ry_now_abigail_is_ready_to_play.php). Would you mind telling me what better care she would have got if she'd been an American child? And then would you tell me if she'd have been guaranteed that level of care as an American child, even if her parents were on the minimum wage? (Note, the reason that story is in the paper is because of the pioneering use of technology, not because the standard of care was out of the ordinary. Two other posters right here in the forum have personal experience of very similar cases, one as the actual patient.)

We have no rationing in the sense that you mean it. Now which country is it whose well-covered citizens are looking at a lifetime ceiling on expenditure of $2,000,000? Not us, anyway.

And we don't have to wait months for non-urgent care either. At the very worst, we can do exactly what you do, and pay for faster treatment. The actual difference is that we're not forced to.

And excuse me if I don't entirely buy all that "access to advanced treatment options" stuff. A few examples of procedures widely available and used in the USA which are not available in Britain would be handy. If there are any (beyond very new/experimental things that are usually available in the country of origin first - given the size of the USA it's only to be expected that there will be a few of these). I refer you back to Abigail, just as an example.

Doctor to patient ratios. Now, how about if you take every citzen as a "patient". How does it look then? because here, every citizen is a patient. Nobody is left out.

And it's not me who's saying that population health statistics in the USA are poorer than in many other developed countries. If you want to cherry-pick out the privileged elite who have good insurance cover (or at least so long as they can keep their jobs) maybe you can make your healthcare provisoin look good. But in that case I'll simply raise you my freedom to do exactly the same and purchase my own healthcare if I want to. And at the same time I know my less fortunate fellow-citizens are still getting pretty decent care, thank you very much.

Rolfe.

Texas
17th March 2009, 06:40 PM
Two things you're slightly missing there. First, if things were actually as bad as you're inferring from these articles, why would myself and other posters in this thread be quite so relaxed about the service we can expect? The whole waiting list topic is grossly exaggerated by opponents of universal healthcare - in fact most people are treated even for non-emergency conditions within a perfectly reasonable time scale. There have been significant improvements over the last ten years or so.

Second, the "rationing" that is being discussed concerns very expensive treatments of questionable and unproven benefit, often exactly those minimally-effective end-of-life interventions Ziggauraut was referring to.

Now consider a couple more things. For the right to access the NHS, with all the problems you seem to think it has, we pay a bit less than you currently pay to fund Medicare and Medicaid, that you can't access. So we are in effect in the position of a US citizen without health insurance - we pay only for the publicly-funded system. But we can access this system! At no more cost to us than your own current tax burden.

This still leaves us absolutely free to take out supplementary healthcare insurance if we want to. It's actually quite cheap, because the insurance companies know that their clients won't use it for ordinary everyday doctor visits, or for blue-light emergencies - both of these situations are well covered by the NHS. But if you want to insure yourelf so that you can have your hip replacement a bit sooner, you're entirely at liberty to do that. You're just not forced to. If you choose not to, you'll still get the hip replacement, just maybe not quite so fast.

So how come the uptake is so small? Well, because people who live here and who are not judging the system by newspaper headlines or Wikipedia pages but by experience, know that the NHS is actually unlikely to let them down to the extent where it's worth spending a couple of hundred pounds a month on the off-chance.

And one more thing. Maybe the government doesn't ration your healthcare outwith Medicare and Medicaid. But there's no doubt your insurance companies do.

You know, I definitely prefer a reasonably equitable system where I know I'll get the treatment I need sooner or later, with that time being dictated by clinical need, than one where some people, perhaps not particularly urgent cases, can access immediate treatment because of their wealth, while others have a wait time of essentially infinity, because they can't get insurance cover for their illness at all.

And the fact that I'm still free to be a bloated plutocrat and pay to jump the queue if I want to is the icing on the cake.

Rolfe.First let's make your other post a bit more honest. You did not include the following portion of the article you quoted


Seidenberg called for health care reform built on four tenets:



Create greater consumer value in the health care marketplace by using health information technology and empowering consumers with more information about quality health care.

Provide more affordable health insurance options for all Americans by creating an open, all-inclusive private market for health insurance and replacing the state-by-state market with multistate markets.

Engage all Americans to take an active part in their health care by obligating them to obtain health insurance through either their employer or the private market, and by encouraging them to participate in employer- or community-based prevention, wellness and chronic care programs.

Offer health coverage and assistance to low-income, uninsured Americans to create a stable and secure public safety net.

The last item is already provided by Medicaid.

As to this post. I have Medicare and I still have to have a private supplemental policy to cover what Medicare does not and that is substantial. I realise that you like your system since that is probably the only system you have ever lived under BUT the idea that the United States has an inferior medical system is absolutely laughable. I live in a city, Houston, Texas, that has one of the most prestigious medical centers in the modern world. We are the world leader in medical research and train more doctors both GPs and specialists than most of the world combined. We have that advantage simply because we do spend more for health care. You tell me, how many heart-lung transplants NHS performs in a year? How many have access to home dialysis machines? How may NHS patients 65 and older are given chemo and radiation treatments for cancer? Finally, what new medical advance has come out of the UK in the last 10 years?

Rolfe
17th March 2009, 07:05 PM
Well, first, there are forum rules about length of quotes. And second, anyone who seriously thinks that the remedies suggested in that article are likely to provide a solution, has to be smoking something. I merely found it interesting that even such a right-wing free-market outfit was in little doubt that there is a problem.

If you think your system is doing just peachy then that's fine. However, this conversation pretty much always seems to be started by people who beg to differ. American people. Who see the inequalities in the system, that it's not just about the people who are lucky enough to have good insurance cover (until they lose their job....), it's also about the people who fall through the cracks and find themselves with no entitlement to healthcare, the people whose only opportunity to see a doctor is to show up at A&E when their condition has reached a critical point. And who see that anyone, with the wrong sort of luck, could end up in that category.

I've never heard of anyone in Britain who needed a heart-lung transplant who didn't get it for any other reason than that a suitable donor couldn't be found in time. One of our politicians (http://en.wikipedia.org/wiki/Sam_Galbraith) is actually the world's longest surviving heart-lung transplant patient. And even though he was a consultant surgeon himself, who later went on to become a senior politician, all that was done for him on the NHS - exactly as it would have been done for him if he'd been on the minimum wage. No need to go private at all.

I don't have access to statistics about home dialysis, but hey, was my thought that I needed a big bedroom in my new house for my 90-year-old mother (who has only one kidney) in case we have to get one of these in, completely pointless? Er, no. If she needed one (and thankfully it looks as if she won't), she'd get one. One of the elders at our church recently had a kidney transplant with his wife as donor. Until that happened, he had a home dialysis setup. He's in his 70s, I think. We're not actually the third world country you seem to imagine.

How about how many NHS patients over 65 are denied chemotherapy and radiation treatments on any but strctly clinical grounds? You do know of some, do you?

And finally, medical research is not actually nationalised (http://www.wellcome.ac.uk/Achievements-and-Impact/index.htm).

The world's largest medical research charity funding research into human and animal health.


Just happens to be British. You could look at the way the human genome project was funded, just as a particularly famous example.

ETA: I forgot about the government funded bit (http://www.mrc.ac.uk/Achievementsimpact/index.htm), silly me. Last decade is here (http://www.mrc.ac.uk/Achievementsimpact/Achievements/index.htm?YR=2007).

Rolfe.

Texas
17th March 2009, 07:23 PM
Well, first, there are forum rules about length of quotes. And second, anyone who seriously thinks that the remedies suggested in that article are likely to provide a solution, has to be smoking something. I merely found it interesting that even such a right-wing free-market outfit was in little doubt that there is a problem.

If you think your system is doing just peachy then that's fine. However, this conversation pretty much always seems to be started by people who beg to differ. American people. Who see the inequalities in the system, that it's not just about the people who are lucky enough to have good insurance cover (until they lose their job....), it's also about the people who fall through the cracks and find themselves with no entitlement to healthcare, the people whose only opportunity to see a doctor is to show up at A&E when their condition has reached a critical point. And who see that anyone, with the wrong sort of luck, could end up in that category.

I've never heard of anyone in Britain who needed a heart-lung transplant who didn't get it for any other reason than that a suitable donor couldn't be found in time. One of our politicians (http://en.wikipedia.org/wiki/Sam_Galbraith) is actually the world's longest surviving heart-lung transplant patient. And even though he was a consultant surgeon himself, who later went on to become a senior politician, all that was done for him on the NHS - exactly as it would have been done for him if he'd been on the minimum wage. No need to go private at all.

I don't have access to statistics about home dialysis, but hey, was my thought that I needed a big bedroom in my new house for my 90-year-old mother (who has only one kidney) in case we have to get one of these in, completely pointless? Er, no. If she needed one (and thankfully it looks as if she won't), she'd get one. One of the elders at our church recently had a kidney transplant with his wife as donor. Until that happened, he had a home dialysis setup. He's in his 70s, I think. We're not actually the third world country you seem to imagine.

How about how many NHS patients over 65 are denied chemotherapy and radiation treatments on any but strctly clinical grounds? You do know of some, do you?

And finally, medical research is not actually nationalised (http://www.wellcome.ac.uk/Achievements-and-Impact/index.htm).




Just happens to be British. You could look at the way the human genome project was funded, just as a particularly famous example.

ETA: I forgot about the government funded bit (http://www.mrc.ac.uk/Achievementsimpact/index.htm), silly me. Last decade is here (http://www.mrc.ac.uk/Achievementsimpact/Achievements/index.htm?YR=2007).

Rolfe. Your example of the Genome project was a world wide effort so a bit dishonest. We will not agree on this. With the world economy as it is it will test both your system and ours as governments have less and less money to fund their programs. We shall see.

Rolfe
18th March 2009, 03:09 AM
Your example of the Genome project was a world wide effort so a bit dishonest. We will not agree on this. With the world economy as it is it will test both your system and ours as governments have less and less money to fund their programs. We shall see.


Is that honestly all you have to say about what I posted? I did actually try to address your points one at a time. Do you consider them addressed, or not? I mean, do you still want to imply that we don't do heart-lung transplants, or home dialysis, or cancer treatment in over 65s? Did you have any evidence that we didn't, or were you just throwing out sideways accusations in the hope that something would stick?

Oh yes, and chalk this up as anti-universal-healthcare American no. 26 who has inexplicably failed to answer my simple questions about Abigail Hall (or the same questions regarding Mark Corrigan or Professor Yaffle's niece).

Suppose I hadn't happened to mention the genome project - which I only did because I'd just read an interesting book which devoted a chapter to studying the politics of that little episode. There was an awful lot more than that on both the Wellcome Trust site and the MRC site.

Anything else to quibble about?

Oh yes, and please stop calling me dishonest whenever I happen to make an argument formulated slightly differently from the way you'd like to put it.

Rolfe.

Rolfe
18th March 2009, 06:30 AM
Just as a general point, I think most Europeans are aware of the excellent, indeed world-leading medical and surgical care to be had in the USA - so long as you can pay for it. I'm not entirely sure that most Americans are aware of the quality of care available in European countries however. (That's why I've repeatedly posted the Abigail Hall case, but I've never had an answer from anyone to the questions I asked about it.)

This rather reminds me of an American friend of mine. She's chronically ill with systemic lupus. When that struck she was only in her late 20s, and apparently healthy. She could easily have been one of those "low risk" people who had chosen to not to carry expensive health insurance. Fortunately that wasn't the case, but it's a salutory example nonetheless.

However, she had a good job as a diagnostic imaging technologist at a big hospital, and she was covered by medical insurance. She got excellent treatment. But the "co-pay" system meant that she still had to pay quite significant amounts of money herself. Fortunately she had a small private income from a family trust fund, and she was able to use that. (She used to joke about still having some money left "after I've paid for my drugs".)

Nevertheless, when I visited her at that time, I found her situation very worrying. Her health made it difficult to hold down her job without taking any time off - both for her chemotherapy appointments, and when she had a flare-up of the condition. But she only had two weeks time off per year, holiday and sick leave combined. She was struggling desperately within these constraints, terrified that if she was absent for any extra time that would be used by her employers to terminate her employment, and she'd then lose her healthcare entitlement.

She was very stressed, and I don't think it was helping her condition. She was absolutely desperate to keep that job, partly because she genuinely loved her work, but partly because without it she would lose her medical entitlement. And she couldn't even talk to her employer about moving to part-time employment, because that would have affected her healthcare coverage, and it might be seen as an admission of weakness that would count against her as regards security of employment.

But at the same time, she was extraordinarily cheerful. She kept telling me and others how glad she was to live in the USA, because she knew she wouldn't get the treatment she needed anywhere else. She was absolutely convinced that only in the USA was such advanced medical care available. (Looking back, I wonder if her repeated coming back to the subject, which nobody else ever raised, might have been a sign of some underlying insecurity about this, but I don't know.)

Well, how could I or any of the other Brits in the party shatter her illusion? I certainly wasn't going to be the one to tell her that in Britain she'd have got exactly the same treatment, free at the point of need, no "co-pay" even (or perhaps a minimal prescription charge), whether she was employed, or working shorter hours, or not. It would have been too cruel. But it was interesting. She was just so certain in her assumption that only the USA offered that standard of care. And she was flat wrong.

Rolfe.

Megalodon
18th March 2009, 07:03 AM
Quick personal anecdote:

In Portugal, in recent years my mother (in her 50s) had a surgery for cancer, radiotherapy and the subsequent treatment. My father (in his 70s) had a heart surgery, with a valve replacement.

Total money expenditure: 0€

We didn't have to sell the house, or the car. We didn't have to file for bankruptcy... Just normal treatment for normal citizens.

Megalodon
18th March 2009, 07:12 AM
Nobody is forced to accept or remain in a job they dislike in order to secure healthcare

This point is, I think, one of the most dramatic. It means that one can stay stuck in a job just because of something it would be granted in any other developed country.

I can imagine cutting the family budget for a more fulfilling professional life, but how can one gamble with the family's health? It's terrifying, and one of the reasons that kept me from taking a PhD in the US. Nice for short stays, terrific people, but weird policy priorities...

shuize
18th March 2009, 07:52 AM
This point is, I think, one of the most dramatic. It means that one can stay stuck in a job just because of something it would be granted in any other developed country.

I can imagine cutting the family budget for a more fulfilling professional life, but how can one gamble with the family's health? It's terrifying, and one of the reasons that kept me from taking a PhD in the US. Nice for short stays, terrific people, but weird policy priorities...


Yeah, too bad there's no such thing as private medical insurance in the United States.

Oh, wait ...

The fact is, I paid about the same for medical insurance in the United States as I do for contributions to the national medical system here in Japan. For minor problems, I prefer Japan. While the wait times can be a hassle, the doctor visits are cheap and save me the cost of the deductible I'd pay in the U.S.

On the other hand, if it were anything serious, I'd much prefer to use my old medical insurance back in the U.S. In my experience, there is a noticeable difference in quality. My wife, who is Japanese, feels even more strongly about it than I do and has actually traveled to the U.S. to have specific medical treatment there.

Lonewulf
18th March 2009, 08:00 AM
Yeah, too bad there's no such thing as private medical insurance in the United States.

Oh, wait ...

Good thing everyone can afford insurance at equal rates!

Oh wait ...

Megalodon
18th March 2009, 08:18 AM
Yeah, too bad there's no such thing as private medical insurance in the United States.

Oh, wait ...

I thought my point was obvious when I wrote it... I'll try again.

Hypothetically, I'm married with kids. I have a job, and it sucks, but it has nice health benefits.

I want to change my job to one lower paying but more rewarding. I can handle the budget cut, but I can't risk the loss of healthcare. I can go for a private insurance, but then we go back to the budget cut vs. insurance coverage.

What I mean is that, in the European countries I lived in, this is not a problem. I don't have to worry if my kids are going to be covered if I change jobs, or if I lose my job. Actually, I don't even have to care about saving for their University tuition, since most of the Unis are public.

I obviously don't have a say on how US citizens run their affairs, but I can intervene to defend a system that is, in my opinion, superior.

Rolfe
18th March 2009, 08:27 AM
Actually, I don't even have to care about saving for their University tuition, since most of the Unis are public.


Oooh, careful! You're getting close to the dreaded c-word (http://en.wikipedia.org/wiki/Communism)! Definitely irredeemably lost in the s-word (http://en.wikipedia.org/wiki/Socialist). And you know that nothing resembling either of these bogey-words can be allowed, even if it's cheap and effective and wildly popular. :D

Rolfe.

fishbob
18th March 2009, 08:33 AM
Hopefully, one day, we can also achieve the freedom to force other people to pay for our healthcare costs.

We in the US have had that for a long time.

Those with no money or health insurance wait until things get really bad, then drop in at hospital emergency rooms for the most expensive medical care available. And we (all us Merkins) pay for it.

shuize
18th March 2009, 08:36 AM
Good thing everyone can afford insurance at equal rates!

Oh wait ...


As I mentioned above, in my case the private coverage I had in the U.S. was about the same as what I'm paying in Japan now. And since one is going to have to either pay additional taxes or purchase private health insurance, it really doesn't seem to me that would be as terrifying a reason to avoid pursuing a Ph.d. in the United States as it was made out to be above.

I mean, hypothetically, I'd really like to pursue a Ph.d. in the United States, but, Oh. My. God. I'd have to use the money I'm not paying in health care taxes to buy private health insurance at roughly the same cost. Better just to stay home and forget the whole thing.

Incidentally, in Japan, if you do not pay into the system, you get to pay "full price" just like those without insurance in big, bad America where there are no public universities ...

Megalodon
18th March 2009, 08:41 AM
Oooh, careful! You're getting close to the dreaded c-word (http://en.wikipedia.org/wiki/Communism)! Definitely irredeemably lost in the s-word (http://en.wikipedia.org/wiki/Socialist). And you know that nothing resembling either of these bogey-words can be allowed, even if it's cheap and effective and wildly popular. :D

Well, guilty as charged... I have no problem with private enterprise. In fact, just got my PhD from a private university.

But I do want to live in a society with a strong safety net, so that everyone has access to tools that allow them to live long and prosper*.



*I can't believe I just wrote that

Rolfe
18th March 2009, 08:48 AM
Hypothetically, I'm married with kids. I have a job, and it sucks, but it has nice health benefits.

I want to change my job to one lower paying but more rewarding. I can handle the budget cut, but I can't risk the loss of healthcare. I can go for a private insurance, but then we go back to the budget cut vs. insurance coverage.

What I mean is that, in the European countries I lived in, this is not a problem. I don't have to worry if my kids are going to be covered if I change jobs, or if I lose my job.


If you go back to that "Stossel saves the world with capitalism" thread, and look at the 20/20 episode Dan was on about, you find that the very first example highlighted (and in fact the absolutely most appalling case, far far scarier than anything he tried to insinuate about Canada or Britain) was a woman in her 30s who'd got caught in exactly that.

She had a decent job, with good healthcare coverage. She decided to leave the job to set up in business. Fortunately, in the light of what happened, she didn't have any children. She decided to take out a "temporary" health insurance policy to cover her for the initial setting-up period, intending to look for the best "permanent" policy once the business was up and running.

She developed breast cancer while she was on the temporary cover.

She thought at first that this policy would see her through whatever she needed, because she'd got the cancer "on their watch", so to speak. But no. She got the initial treatment OK, but when the time period of the policy came to an end, that was that. No more. And of course no other insurance company will touch her now. An insurance executive, interviewed about the case, said that she wasn't their problem, and it would cause the premiums of their existing clients to increase if they took on that sort of no-win liability.

She spoke about the possibility of using up all her assets to pay for her follow-up treatment until she had absolutely nothing left, then trying to get on Medicaid. However, she didn't want to do that, apparently pride and self-respect were in the way.

We left her story with her skimping on follow-up treatment, and more or less avoiding doctors because she didn't want to be told she needed something expensive that she couldn't pay for.

I honestly wanted to cry.

I remember reading a novel, possibly a Danielle Steele, in which the protagonist was a businesswoman with breast cancer whose husband was being very unsympathetic to her plight. I couldn't understand why she was having to drag herself into work every day, hair falling out, weak as a kitten with chemotherapy and throwing up in the ladies. This was just completely foreign to me, living where a serious illness of that sort would automatically entitle the patient to a period of sick leave, but it was presented as the norm in the novel. I'm beginning to understand it better now. No sick leave entitlement, job security paramount if your health insurance is tied to your work, and no hope of getting alternative insurance with that sort of "prior condition" if you don't manage to keep your end up in the business rat race and are "let go".

The USA is a great place to visit but I'm very glad I don't live there.

Rolfe.

Megalodon
18th March 2009, 08:50 AM
As I mentioned above, In my case the private coverage I had in the U.S. was about the same as what I'm paying in Japan now. And since one is going to have to either pay additional taxes or purchase private health insurance, it really doesn't seem to me that would be as terrifying a reason to avoid pursuing a Ph.d. in the United States as it was made out to be above.

Actually, I believe I said it was "one of the reasons"... I have a very particular health, with several chronic conditions that, while not affecting my present standard of living, can degenerate without much warning. I can't risk needing expensive treatment and have a company claim "pre-existent conditions".

I much prefer paying into a system that will provide any treatment I need, at any time I need it, without having to check with my insurance provider for coverage. I'm weird that way...

Rolfe
18th March 2009, 08:56 AM
I remember a guy I used to work with. He had some particular reason for wanting to move to the USA, but I can't remember now what it was. Anyway, he said it was an impossible dream, as he was a type I diabetic.

Rolfe.

shuize
18th March 2009, 08:59 AM
Actually, I believe I said it was "one of the reasons"... I have a very particular health, with several chronic conditions that, while not affecting my present standard of living, can degenerate without much warning. I can't risk needing expensive treatment and have a company claim "pre-existent conditions".

I much prefer paying into a system that will provide any treatment I need, at any time I need it, without having to check with my insurance provider for coverage. I'm weird that way...


To each his own. As I mentioned above, I like the Japanese system for minor issues.

Megalodon
18th March 2009, 08:59 AM
Incidentally, in Japan, if you do not pay into the system, you get to pay "full price" just like those without insurance in big, bad America where there are no public universities ...

That's funny... in Portugal, you are prosecuted for tax evasion, but you still get your free treatment. On the other hand, we have a constitutional right to health.

And I don't remember portraying the US as big and bad. I just prefer the European system, and I think I can defend it without appeals to emotion...

Megalodon
18th March 2009, 09:11 AM
If you go back to that "Stossel saves the world with capitalism" thread, and look at the 20/20 episode Dan was on about, you find that the very first example highlighted (and in fact the absolutely most appalling case, far far scarier than anything he tried to insinuate about Canada or Britain) was a woman in her 30s who'd got caught in exactly that.

She had a decent job, with good healthcare coverage. She decided to leave the job to set up in business. Fortunately, in the light of what happened, she didn't have any children. She decided to take out a "temporary" health insurance policy to cover her for the initial setting-up period, intending to look for the best "permanent" policy once the business was up and running.

She developed breast cancer while she was on the temporary cover.

She thought at first that this policy would see her through whatever she needed, because she'd got the cancer "on their watch", so to speak. But no. She got the initial treatment OK, but when the time period of the policy came to an end, that was that. No more. And of course no other insurance company will touch her now. An insurance executive, interviewed about the case, said that she wasn't their problem, and it would cause the premiums of their existing clients to increase if they took on that sort of no-win liability.

She spoke about the possibility of using up all her assets to pay for her follow-up treatment until she had absolutely nothing left, then trying to get on Medicaid. However, she didn't want to do that, apparently pride and self-respect were in the way.

We left her story with her skimping on follow-up treatment, and more or less avoiding doctors because she didn't want to be told she needed something expensive that she couldn't pay for.

I honestly wanted to cry.

I remember reading a novel, possibly a Danielle Steele, in which the protagonist was a businesswoman with breast cancer whose husband was being very unsympathetic to her plight. I couldn't understand why she was having to drag herself into work every day, hair falling out, weak as a kitten with chemotherapy and throwing up in the ladies. This was just completely foreign to me, living where a serious illness of that sort would automatically entitle the patient to a period of sick leave, but it was presented as the norm in the novel. I'm beginning to understand it better now. No sick leave entitlement, job security paramount if your health insurance is tied to your work, and no hope of getting alternative insurance with that sort of "prior condition" if you don't manage to keep your end up in the business rat race and are "let go".

The USA is a great place to visit but I'm very glad I don't live there.

Rolfe.

I might check that thread...

I agree with you. The US have the right to gun ownership in their constitution, we have the right to education and health. Guess which one I have more chances of needing in my lifetime...

Rolfe
18th March 2009, 09:12 AM
As I mentioned above, in my case the private coverage I had in the U.S. was about the same as what I'm paying in Japan now. And since one is going to have to either pay additional taxes or purchase private health insurance, ....


Two points. First, you speak as if everyone can purchase private healthcare insurance that gives them the coverage they need, for about the same, affordable price. This is quite patently, obviously and demonstrably not true.

People with "pre-existing conditions" can't. And even healthy people who choose to accept a period of very low income (such as while studying, or in the startup phase of a new business) are unlikely to find adequate cover affordable, especially if they have a family to cover as well.

Second, not talking about Japan here, but we've mentioned innumerable times that the amount of tax that US citizens pay to fund Medicare and Medicaid is actually a little more than the amount of tax that British citizens pay to fund the NHS. So it's not always a straight choice between private insurance or more tax. We don't seem to have the "more tax" bit. The difference is that because the tax-funded system covers everybody, then private insurance becomes an optional extra rather than a necessity.

Remarkably few people bother though, as it happens.

Rolfe.

shuize
18th March 2009, 09:15 AM
That's funny... in Portugal, you are prosecuted for tax evasion, but you still get your free treatment. On the other hand, we have a constitutional right to health.


I'm not an expert on the Japanese system. I only know what I pay into it and the treatment I've received under it. I think they'll go after people for the money if they can here as well. But I've heard the number of people who aren't paying into the system has grown rather large in recent years (another aspect of the national system that is not without it's flaws).

And I don't remember portraying the US as big and bad. I just prefer the European system, and I think I can defend it without appeals to emotion...


Perhaps the thought of pursuing a Ph.d in America wasn't quite as "terrifying" as initially suggested...

shuize
18th March 2009, 09:20 AM
I remember a guy I used to work with. He had some particular reason for wanting to move to the USA, but I can't remember now what it was. Anyway, he said it was an impossible dream, as he was a type I diabetic.

Rolfe.

So a diabetic guy who'd have to pay for his own medical costs if he moved to the United States decides to stay home.

As a (part time) American taxpayer, I wonder why I'm not seeing this as the tragedy you'd like me to believe it is?



ETA: It is late here. I'm signing off for now.

Megalodon
18th March 2009, 09:22 AM
Perhaps the thought of pursuing a Ph.d in America wasn't quite as "terrifying" as initially suggested...

The terrifying is not the pursuing of the PhD. It was the idea of changing a job while gambling the health coverage of your family. I don't think it's a choice one should be subjected to.

I had several reasons stay in Europe for the PhD, and the health related ones can be found in a post above.

Megalodon
18th March 2009, 09:26 AM
So a diabetic guy who'd have to pay for his own medical costs if he moved to the United States decides to stay home.

As a (part time) American taxpayer, I wonder why I'm not seeing this as the tragedy you'd like me to believe it is?

What if it was an american citizen that was not accepted by an insurance company after losing his job? Would that be a tragedy, or just good business?

Lonewulf
18th March 2009, 09:38 AM
As I mentioned above, in my case the private coverage I had in the U.S. was about the same as what I'm paying in Japan now. And since one is going to have to either pay additional taxes or purchase private health insurance, it really doesn't seem to me that would be as terrifying a reason to avoid pursuing a Ph.d. in the United States as it was made out to be above.

I mean, hypothetically, I'd really like to pursue a Ph.d. in the United States, but, Oh. My. God. I'd have to use the money I'm not paying in health care taxes to buy private health insurance at roughly the same cost. Better just to stay home and forget the whole thing.

Incidentally, in Japan, if you do not pay into the system, you get to pay "full price" just like those without insurance in big, bad America where there are no public universities ...

Okay, I'm just going to have to come out and say this.

It's too bad Japan isn't in Europe, hmmm?

That was, after all, what the OP quoted the major criticism for.

As far as I can tell, I'm not quite sure why I should care about a direct comparison to Japan and the U.S.

Rolfe
18th March 2009, 09:40 AM
What if it was an american citizen that was not accepted by an insurance company after losing his job? Would that be a tragedy, or just good business?


The man in question was a type I diabetic, childhood onset. He'd been on insulin since he was at primary school.

This of course had never affected his employment choices, apart from blocking his desire to move to America. But I'm fairly unclear how Americans who develop an expensive chronic condition while they are children (and presumably covered by their parents' health insurance) manage when they grow up.

How do they get through college? Can they ever become musicians, or artists, or anything like that? Can they ever cut loose to set up their own businesses? Can they take a job in the 40% of businesses that don't provide healthcare cover? Do they face any sort of discrimination when trying for a job with one of the 60% that do, when the company knows they will inevitably cost its health insurance scheme money?

Rolfe.

Ziggurat
18th March 2009, 10:55 AM
How do they get through college?

Most colleges offer student health insurance at low rates (and in fact require that you have insurance), and when I was a student, there were never any questions about pre-existing conditions when signing up. As a group, students are pretty healthy, so the insurance companies don't need to screen these folks.

Can they ever become musicians, or artists, or anything like that?

Yes. They just have to be more careful about budgeting. Individual health insurance plans are generally available even for those with pre-existing conditions, and in many states, there are even state-sponsored plans specifically for these "high risk" (http://www.medhealthinsurance.com/high-risk-coverage.htm) insurees.

Can they ever cut loose to set up their own businesses?

Yes, but again, they need to be careful with budgeting. That can make it tougher to start their own business, but it's still possible.

Can they take a job in the 40% of businesses that don't provide healthcare cover?

Yes.

Do they face any sort of discrimination when trying for a job with one of the 60% that do, when the company knows they will inevitably cost its health insurance scheme money?

Companies are legally prohibited from discriminating based upon such medical conditions, or even asking about them during the interview process. So for something like diabetes, they probably won't even know, and their insurer can't even tell them after they've been hired since that information is confidential.

Furthermore, while insurance companies can exclude some coverage for pre-existing coverage, they can generally only do so for a limited time period (http://healthinsurance.about.com/od/faqs/f/preex.htm). And in many instances, if you have maintained health insurance and haven't let it lapse, your new insurer cannot deny coverage for pre-existing coverage at all (http://careerplanning.about.com/cs/legalissues/a/hipaa.htm).

Rolfe
18th March 2009, 01:18 PM
I thought there had to be some way. I mean, type I diabetes isn't exactly rare. There doesn't seem to be much option other than subsidising these people with public money, though.

In most states an insurer can turn you down for individual coverage if you have a serious pre-existing medical condition. Most states are not required to have an alternative option for medically uninsurable individuals to access coverage, but most of them do. The most common way to provide individuals access to coverage is through high-risk health insurance.

Individual states offer high risk health insurance in the form of high risk health insurance pools. As of 2007, 33 states have high risk pools. The state funds the health insurance coverage and the insured in turn will pay a premium to the state insurance entity. The premiums are usually quite expensive but it is a good way to obtain coverage for your medical conditions if you fall into the high risk category. The types of conditions and medical treatments which are covered will vary depending on the type of policy and individual insurance company. [....]

The obvious benefit of high risk health insurance is the security of knowing that you are covered even if you have a high risk medical condition. The main downfall associated with a high risk health insurance policy is higher premiums which are determined by your medical condition, age and location. Other drawbacks include the possibility of a long waiting period for coverage of your preexisting conditions and benefits or options may be limited.


Actually, not sounding like such a great deal to me, really. In fact it sounds pretty terrible.

But you indicated other options.

If you have job-based coverage, the pre-existing condition exclusion period is limited to 12 months (18 months if you are a late enrollee) and only applies to conditions for which you sought treatment in the 6 months leading up to enrollment. You may be able to apply creditable coverage to offset your pre-existing condition exclusion period.


If you have at least 12 months of continuous creditable coverage, a group health plan can't apply preexisting condition exclusions to your coverage. Creditable coverage includes most kinds of health insurance except health insurance that you had before a significant break in coverage (63 or more days in a row without health insurance coverage). During a preexisting condition exclusion period your insurer will not pay for treatment related to a preexisting condition but must pay for unrelated treatment.


So the insurance companies are legally obliged to take on people who are virtually certain to take out more than they pay in, under certain defined circumstances.

I can just hear ServiceSoon and Beerina and the others again decrying the whole idea of being forced to pay for other people's healthcare. Seems to cover this just as much as it covers any universal system.

Rolfe.