How would GOP fix health care? [Archive]

Beerina

17th September 2009, 09:55 AM

I'm curious to hear what suggestions the GOP has for fixing health care in the U.S. AFAIK they agree with the Dems that it's problematic, but I haven't heard their policy ideas (sincere, not rhetorical question).

I was unaware it was busted.

More and more tech is developed means more and more things to buy. It ain't like a car, it's more like general consumer electronics.

You spend a lot more today because of DVD players and CD players and multiple, large, flat-screen TVs per home and cable and Internet and DirecTV and a satellite dish on your roof and a 6-disc DVD changer with two back seat independent screens for the kids and a jack they plug their X-Box 360 in to play on the road when they're not T9'ing their friends on their cell phones, then when you just bought a B&W TV and, maybe, a portable AM radio.

This is a good thing, not a bad. And anything that slows it down (anyone up for single-payer consumer electronics development and sales?) even just a little bit, kills. End of story.

David Wong

17th September 2009, 09:58 AM

I was unaware it was busted.

More and more tech is developed means more and more things to buy. It ain't like a car, it's more like general consumer electronics.

You spend a lot more today because of DVD players and CD players and multiple, large, flat-screen TVs per home and cable and Internet and DirecTV and a satellite dish on your roof and a 6-disc DVD changer with two back seat independent screens for the kids and a jack they plug their X-Box 360 in to play on the road when they're not T9'ing their friends on their cell phones, then when you just bought a B&W TV and, maybe, a portable AM radio.

This is a good thing, not a bad. And anything that slows it down (anyone up for single-payer consumer electronics development and sales?) even just a little bit, kills. End of story.

Ha! A great parody of the ridiculous Republican position!

"If millions of people can't afford care, too bad! They're just slowing the rest of us down! The reason our system costs twice what singler payer systems cost is because our technology is twice as advanced!!!! This is a good thing!"

Great satire, you captured the voice really well!

oldhat

17th September 2009, 10:02 AM

This is a good thing, not a bad. And anything that slows it down (anyone up for single-payer consumer electronics development and sales?) even just a little bit, kills. End of story.

Yes, health care is exactly like people buying consumer electronics! Good analogy!

jnelso99

17th September 2009, 12:18 PM

GOP plan to fix health care? Tax cuts for the rich. Duh.

ponderingturtle

17th September 2009, 01:17 PM

This page lets you see a side-by-side comparison of the various proposals (including the Republican ones) on specific topics:

http://www.kff.org/healthreform/sidebyside.cfm

Overall, my impression is that the Republican plans are more concerned with reducing costs and not with extending coverage to more people. (In fact, I think some of them would further restrict access to healthcare.)

Changed so much from their Terri Schiavo position I see.

ponderingturtle

17th September 2009, 01:20 PM

I was unaware it was busted.

So this is what is supposted to happen

T.R. Reid tells of a dramatic case in his book The Healing of America. Nikki White lost her job and health insurance as a result of having a type of lupus. Because of her pre-existing condition, she could not get new health insurance. Eventually, she collapsed and was taken to the emergency room. Three doctors undertook to treat her until her condition stabilized — that involved six months in critical care and 25 surgical operations. She went home, still without insurance, and died at the age of 32.

NPR link (http://www.npr.org/templates/story/story.php?storyId=112892744)

We got to deny her care and kill her and have individuals make lots of money from her, the best of both worlds.

ponderingturtle

17th September 2009, 01:21 PM

GOP plan to fix health care? Tax cuts for the rich. Duh.

Hey you forgot about high priced defense programs. I see space based MRI's in our future.

Rolfe

17th September 2009, 01:52 PM

So this is what is supposted to happen

NPR link (http://www.npr.org/templates/story/story.php?storyId=112892744)

We got to deny her care and kill her and have individuals make lots of money from her, the best of both worlds.

That's one of the cases shown in Sick Around America. Tragic. The pivotal role of a republican resolution to cut back on Medicaid expenditure in Tennessee was noted. The reason for the cutbacks, apparently, was to encourage sick people to take more responsibility for themselves. The effect was to stop the funding for the drugs Nikki needed.

When she was finally hospitalised, $600,000 was spent on her. To no avail, because what she needed was maintenance treatment, which would have cost far less, but wasn't avaliable for her. So she died.

Rolfe.

Sporanox

17th September 2009, 02:04 PM

I don't know much about the current GOP plans, but this article has a lot of ideas that I'd like to see in practice:

http://online.wsj.com/article/SB10001424052970204251404574342170072865070.html (John Mackey's ideas for reform)

Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs).

Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.

Repeal all state laws which prevent insurance companies from competing across state lines.

Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.

Enact Medicare reform.

I'm not completely behind the idea of tort reform - not because I dispute the problem with malpractice premiums, but because it might not work - but his ideas seem fairly reasonable to me in general.

sugarb

17th September 2009, 02:15 PM

That's one of the cases shown in Sick Around America. Tragic. The pivotal role of a republican resolution to cut back on Medicaid expenditure in Tennessee was noted. The reason for the cutbacks, apparently, was to encourage sick people to take more responsibility for themselves. The effect was to stop the funding for the drugs Nikki needed.

When she was finally hospitalised, $600,000 was spent on her. To no avail, because what she needed was maintenance treatment, which would have cost far less, but wasn't avaliable for her. So she died.

Rolfe.

Cutbacks in medicaid are problematic. More problematic are the differing ways each state handles medicaid. Sadly, this leaves a lot of folks in a bad position, one we're struggling with at the moment. In our state, we've been having a year long battle to get medicaid "approval" for a family member. We have "eligibility", but...the "approval" process takes so long (thirteen months now, to be exact) that the "patient" can not get in to see specialists or get tests until facilities know they'll get paid. In a nursing home setting, this means basic care, bills piling up with uncertainty as to who will be responsible, and no definite determiniation of diagnosis or treatment. In our family, it is very possible that we've reached the point of there being no window for treatment achieving improvement. In other words, we're left having to watch a drastic decline that *was* potentially reversible (in these particular circumstances) but now most likely is not.

This leaves us with really no options aside from two: continue to wait for our state to give us that elusive "approval", or...and this is what we are strongly considering within a very few weeks...take our relative from the nursing home straight to an ER in another state that has a quicker approval time, more efficient funding, and better patient advocacy.

I don't know what the GOP plan is. From what I'm hearing from either side, no plan with a chance of passing will take care of situations like we're dealing with. Great. I won't have caps on what my insurance pays for me in my lifetime...but...what will it do for people already dependent on the states? What will it do?

If the GOP had any sense whatsoever, they'd drop the party politics and come up with a more daring, broader plan that even the Democrats might squirm at. A plan that helps EVERYONE being pushed through the cracks and hidden away. If the Dems had any sense, so would they. Instead, they're putting bandaids on a gaping wound, and yes, people are dying. Maybe not enough people to garner everyone's interest...but...what does that say about us?

Rolfe

17th September 2009, 02:44 PM

In our state, we've been having a year long battle to get medicaid "approval" for a family member. We have "eligibility", but...the "approval" process takes so long (thirteen months now, to be exact) that the "patient" can not get in to see specialists or get tests until facilities know they'll get paid. In a nursing home setting, this means basic care, bills piling up with uncertainty as to who will be responsible, and no definite determiniation of diagnosis or treatment. In our family, it is very possible that we've reached the point of there being no window for treatment achieving improvement. In other words, we're left having to watch a drastic decline that *was* potentially reversible (in these particular circumstances) but now most likely is not.

That's just appalling. I'm not saying similar things couldn't happen in the NHS, but when they do, we have right-wing Americans screaming hate about the "evils of socialist medicine". And yet, it's happening in the USA, and there doesn't seem to be an avenue to rectify the problem.

Bizarrely, it seems easier to get problems like that fixed in the NHS, because it's supposed to be run for our benefit, so when stuff goes wrong in a systematic way, there are ways to change the system.

Rolfe.

sugarb

17th September 2009, 02:59 PM

That's just appalling. I'm not saying similar things couldn't happen in the NHS, but when they do, we have right-wing Americans screaming hate about the "evils of socialist medicine". And yet, it's happening in the USA, and there doesn't seem to be an avenue to rectify the problem.

Bizarrely, it seems easier to get problems like that fixed in the NHS, because it's supposed to be run for our benefit, so when stuff goes wrong in a systematic way, there are ways to change the system.

Rolfe.

Yes, it is appalling. Just a few years ago, I was one of those Americans screaming "evil socialist medicine"...not anymore. It is one thing to assume one understands how "the system" works, another entirely to have to actually work within it. As I've said before, it's been an eye-opener.

Funny thing is, if the leadership of the GOP would just take a serious look at it, and realize that just because THEY have never had to deal with medicaid or medicare in the same way average or poorer Americans have had to, or an insurance company that drops them...but...then I'm assuming that "politics" has a heart, and it doesn't.

I don't know what to do. I have started writing those letters to representatives, and I think it would be fantastic if Republicans not blind to the problems would do the same. I don't know how to get our voices out there. No one is interested, really, in hearing what Republicans have to say, unless they are the Republicans regurgitating the same old tired stuff that can be mocked. It is frustrating, to say the least.

JoeTheJuggler

17th September 2009, 03:01 PM

Changed so much from their Terri Schiavo position I see.
Completely irrelevant to my post. Or do you think their summary of the various plans is slanted or something?

(I'm not even aware of the Kaiser Family Foundation's position on Terri Schiavo.)

jimtron

17th September 2009, 04:09 PM

There's two problems with the OP question. First of all, there is no one GOP position on health care. Second, various pols and pundits have proposed various approaches to the problem.

I didn't say, and didn't mean to imply, that the GOP had only one position, nor did I state or mean to imply that those on the right haven't proposed solutions. Here's what I said: "I'm curious to hear what suggestions the GOP has for fixing health care in the U.S. AFAIK they agree with the Dems that it's problematic, but I haven't heard their policy ideas (sincere, not rhetorical question)." When I said I haven't heard their ideas, I meant that I haven't heard them--not that they haven't been voiced.

jimtron

17th September 2009, 04:10 PM

jimtron

17th September 2009, 04:12 PM

I was unaware it was busted.

45 million uninsured, and a great many with insurance being denied coverage due to pre-existing conditions=busted IMHO.

Rolfe

17th September 2009, 05:05 PM

I've just seen a TV segment explaining that in the USA, amputations secondary to complications of diabetes mellitus are considered to be due to a pre-existing condition, and so insurance companies do not fund prosthetic limbs. Or they limit the patient to one prosthetic device for his entire life. The report said that as a result, many diabetic amputees are virtually housebound.

That isn't "broken"?

Rolfe.

elbe

17th September 2009, 07:54 PM

This is a good thing, not a bad. And anything that slows it down (anyone up for single-payer consumer electronics development and sales?) even just a little bit, kills. End of story.

Isn't that basically the plot of 50's monster movies?

"Doctor! Why are you putting the brain of that serial killer in that unstoppable killing machine?!"
"For science!"

MattusMaximus

17th September 2009, 08:37 PM

The GOP solution to this mess is simple: ABO/D...

Anything But Obama/Democrats

Because they're playing politics, pure and simple. They aren't concerned one wit about actually fixing anything, they're just looking to make at least some political headway in 2010. And they think this is the way to do it, by slash & burn politics.

It is apparent to me now that the vast majority of the Republican lawmakers won't vote for an Obama/Democratic bill under any circumstances. No matter how much the goalposts get moved, it simply won't be enough - the reaction to Sen. Baucus's bill should be evidence enough of that.

And they're scared to death that if the Dems pass a bill without them, they'll look like obstructionists (and rightly so). But they're equally scared that if they even give a hint of going along with health care reform, then they'll piss off the wingnut base they've been cultivating for months.

The GOP has stuck themselves in a bad spot, most especially by courting the Glenn Beck / Tea Party crowd so heavily. They may pick up a few seats in Congress in 2010, but in the long term I think they're in trouble.

Skeptic Ginger

18th September 2009, 01:09 PM

I was unaware it was busted.

More and more tech is developed means more and more things to buy. It ain't like a car, it's more like general consumer electronics.

You spend a lot more today because of DVD players and CD players and multiple, large, flat-screen TVs per home and cable and Internet and DirecTV and a satellite dish on your roof and a 6-disc DVD changer with two back seat independent screens for the kids and a jack they plug their X-Box 360 in to play on the road when they're not T9'ing their friends on their cell phones, then when you just bought a B&W TV and, maybe, a portable AM radio.

This is a good thing, not a bad. And anything that slows it down (anyone up for single-payer consumer electronics development and sales?) even just a little bit, kills. End of story.Funny thing about that stereotypical assumption, it may not be consistent with the evidence. I read a study last week that documented as much innovation in health care coming out of the UK as in the US. I'll see if I can find it.

Praktik

18th September 2009, 01:10 PM

And they're scared to death that if the Dems pass a bill without them, they'll look like obstructionists (and rightly so). But they're equally scared that if they even give a hint of going along with health care reform, then they'll piss off the wingnut base they've been cultivating for months decades.

small correction, otherwise good post..;)

Skeptic Ginger

18th September 2009, 01:12 PM

GOP plan to fix health care? Tax cuts for the rich. Duh.Nominated for pith. :D

Lurker

18th September 2009, 01:21 PM

I have heard conservative talking heads proposing tax deductible health savings accounts. So we can put money aside that is not taxed and use it to pay our health care.

Health Savings Accounts.

I doubt it would have any impact at all, but that is just my opinion. Oh, and they decry govt invovlement as just an impediment to the free market system. I guess if we abolish Medicare then prices would magically come down.

Safe-Keeper

18th September 2009, 01:50 PM

Changed so much from their Terri Schiavo position I see.The GOP has a God-given, sacred mission to protect the sanctity of life. Unless it's unemployed. Or foreigners. Or does something very bad. Like trying to drive away in your automobile. Or... :cue long list:

You spend a lot more today because of DVD players and CD players and multiple, large, flat-screen TVs per home and cable and Internet and DirecTV and a satellite dish on your roof and a 6-disc DVD changer with two back seat independent screens for the kids and a jack they plug their X-Box 360 in to play on the road when they're not T9'ing their friends on their cell phones, then when you just bought a B&W TV and, maybe, a portable AM radio.I'm a student looking for a 25m2 apartment for 3000 NOK (510 USD) a month. I can't afford a tenth of that, and neither can a lot of people. Which is fine with me, because -and listen closely, Beerina, because this is important- I don't need an X-Box to live*.

You, apparently, find it totally acceptable that a significant portion of the population goes without health care and dies, because it means the privileged, lucky few that can afford health insurance (from a company that won't opt dump them for some trivial reason, see Sick Around the World) get the latest of the latest in treatment.

It's like saying the fire department should stop covering the slums of your city, because then they'd be able to buy shining new fire trucks for your district.

To turn the argument around: Beerina, do you want the fire department and police privatized?

Random

18th September 2009, 01:51 PM

Health care costs in the US are going up faster than wages, and have done so for over a decade. That’s the real problem, and that’s what we have to stop at least, if not reverse.

Heath savings accounts don’t even pretend to do that, so they are not going to solve the problem. They might give some people some breathing room, but long term they will be useless.

ProbeX

18th September 2009, 01:53 PM

And there would be no firefighters to protect us when your mountain of straw catches fire, because that would be socialism too.

... Nor "socialist" law enforcement, the "socialist" post office ...

headscratcher4

18th September 2009, 02:02 PM

Some lefty thoughts...

Maddow on that Bastion of the GOP and how it handles health care (women's health care in particular):

http://www.huffingtonpost.com/2009/09/18/rachel-maddow-nails-south_n_291337.html

Bill Moyers noting how that stalwart of keeping government out of health care...Dick Army...has had government health insurance or government financed health insurance most of his professional life.

http://www.huffingtonpost.com/2009/09/18/bill-moyers-tea-party-org_n_291625.html

Safe-Keeper

18th September 2009, 02:05 PM

Funny thing about that stereotypical assumption, it may not be consistent with the evidence. I read a study last week that documented as much innovation in health care coming out of the UK as in the US. I'll see if I can find it.I love how she uses the X-Box as an example. That thing is notorious for its lack of stability. Early models could even destroy your disks.

sugarb

18th September 2009, 02:34 PM

The GOP has a God-given, sacred mission to protect the sanctity of life. Unless it's unemployed. Or foreigners. Or does something very bad. Like trying to drive away in your automobile. Or... :cue long list:

I'm a student looking for a 25m2 apartment for 3000 NOK (510 USD) a month. I can't afford a tenth of that, and neither can a lot of people. Which is fine with me, because -and listen closely, Beerina, because this is important- I don't need an X-Box to live*.

You, apparently, find it totally acceptable that a significant portion of the population goes without health care and dies, because it means the privileged, lucky few that can afford health insurance (from a company that won't opt dump them for some trivial reason, see Sick Around the World) get the latest of the latest in treatment.

It's like saying the fire department should stop covering the slums of your city, because then they'd be able to buy shining new fire trucks for your district.

To turn the argument around: Beerina, do you want the fire department and police privatized?

I used to say that the reason so many people didn't have health insurance was probably because of their cell phones, video games, and other items that have seemed to become "necessary" for modern living. Sometimes that is probably true. Sadly, health insurance is on the list of discretionary spending, and I myself lived without it for a while.

However, when I lived without it, I didn't have cable television, didn't have a cell phone, didn't have video games (I don't play them anyway), couldn't afford to eat out, and was struggling to pay off debt.

Now that I *do* have health insurance? I still don't have cable, still no high speed internet, still no fancy television, still no new car, still no eating out much...basically, no "luxuries" (though I consider my dialup internet and my cell phone luxuries I could live without). Why? Because of health care bills.

I'm "lucky" because my bills are so low due to health insurance coverage, though, right? Funny thing, though. If I dropped my insurance coverage, I could pay those bills off within a year...but I can't do that or I'll not get coverage again for the health care issues I already have.

I'm not complaining, because we made a choice a long time ago to live as simply as possible anyway...but...the point is, what I used to think was wrong, at least in many cases. I didn't KNOW that having health insurance still meant having lots of health care bills. I didn't KNOW that they could force me to come up with the money to pay out of pocket for my care until they "investigated" pre-existing conditions. I didn't KNOW.

Now I do know. And I know how it is sometimes a choice to go without care until their "investigations" are over or beg, borrow and steal (no, we didn't steal or beg, but I can see situations that would lead people to do so) to pay for care in the meantime in hopes of getting reimbursed.

Us? We're lucky. I don't work, and that is a choice we made. I *could* work, and all of our money issues would be resolved. We also don't have children. For the life of me, I can't see how people with children manage if they fall into the median income range. We have health insurance, life insurance, all the insurances we could ever need aside from long term care insurance...those expenses alone take a huge part of our income. We even have private unem insurance. All of that is only possible because we do live simply and we don't have children, and I don't have to work (which would add some more expenses).

I remember being a student. I remember how hard it was to work full time and go to school full time. I remember how tight money was (especially when it came time to buy textbooks). Looking back, I don't see how full time working students manage.

All I do know is that my attitude, that discretionary spending was wrongly prioritized, was wrong. Like I said, maybe sometimes that's the problem, but I don't think that is the major problem.

The Painter

18th September 2009, 05:59 PM

MattusMaximus

18th September 2009, 06:36 PM

Lets see, a plan. Oh I know, lets help the 10% to 15% that need help and leave the rest alone. Wow that's great. it really is simple when you think about it. Why would you destroy the entire system to help a small minority ??? Keep the system, help the few. Yes that's it.

Fail. Next straw man, please.

You need to stop getting your talking points from Glenn Beck :rolleyes:

Sporanox

18th September 2009, 08:22 PM

Nobody responded to my proposal?

Dr Adequate

19th September 2009, 01:50 AM

Travis

19th September 2009, 03:03 AM

They wouldn't. They think those that can't get healthcare insurance aren't worthy of life. See my thread (http://forums.randi.org/showthread.php?t=153323) where they admit they'd let me die because it might inconvenience them to help other people.

ponderingturtle

19th September 2009, 05:40 AM

ponderingturtle

19th September 2009, 05:42 AM

I'm not completely behind the idea of tort reform - not because I dispute the problem with malpractice premiums, but because it might not work - but his ideas seem fairly reasonable to me in general.

Yea that 1% is killing us.

You forgot McCain's favorite, let insurance companies be regulated in what ever state of their choice, so that they can pick one states regulation and apply it to all states.

ponderingturtle

19th September 2009, 05:46 AM

ponderingturtle

19th September 2009, 05:48 AM

45 million uninsured, and a great many with insurance being denied coverage due to pre-existing conditions=busted IMHO.
But you have to only care about those who can afford coverage, not those irresponcible enough to be poor or middle class.

ponderingturtle

19th September 2009, 05:56 AM

Lets see, a plan. Oh I know, lets help the 10% to 15% that need help and leave the rest alone. Wow that's great. it really is simple when you think about it. Why would you destroy the entire system to help a small minority ??? Keep the system, help the few. Yes that's it.

It is way more than that. Why do you think that so many middle class people with health insurance lose everything they own because they get sick. I guess this is a good thing, making them responsible for their diseases right?

Cynic

19th September 2009, 10:33 PM

For what it's worth, here's my impression:

I don't know much about the current GOP plans, but this article has a lot of ideas that I'd like to see in practice:

Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs).

Anyone with high-deductable car insurance understands why this is a bad idea. And it's backwards. High-deductable health insurance only "helps" people in their 20s, who will by and large get away with ignoring their health until their 30s. After that, people with, say a $1000 deductable likely have crappy jobs, and thus probably don't make that much. So when the inevitable problem pops up, the thought of having to take a $1000 is going to prevent them from doing anything about it. Or, if it can't be ignored, it's going to hurt, and bad. Plans like that are going to cause otherwise treatable problems to be ignored until after it's too late. A healthcare plan should promote healthcare.

As for health savings accounts, that sounds like something people with excess cash and discipline have. Sure, people should be responsible, but you know as well as me that they generally aren't. When they need it, it won't be there. Then what?

Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.

I don't know enough about this to comment.

Repeal all state laws which prevent insurance companies from competing across state lines.

Overriding state laws doesn't sound like a very GOP thing to do, but don't they already do this, in general? Other sorts of insurance is, at least. I'm not sure what effect this would have, but I guess competition can be good. I'm not sure I'm looking forward to the 1-800-SAFE-DCTR ads though.

Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.

Better yet, stop doctors from bringing those lawsuits on. Anyone want to take odds on how many deserving lawsuits aren't even launched for every supposedly bad one that wins? I like to think that the industry gets what it has coming to it, one way or another.

Enact Medicare reform.

I'm not sure what this would entail, but from what I've heard from various representatives of the GOP so far, the problem is the number of people recieving it.

That generally seems to be the reply from the GOP in general on this -- there are too many people that have healthcare coverage, too many people using the doctors and hospitals. Clinics and practices are overwhelmed and we'd all(!) be better off if fewer people attempted to tend to their ailments. Somehow that doesn't seem like an entirely moral "solution" to me. Reducing costs are a good way to start, but I think the proposition begins with the assumption that things cost what they do currently for no good reason. But of course the reason is that rule changes favor those making the money from it and backing off on that threatens those industries. I don't expect the GOP to suddenly stop making their decisions based on what benefits business over what benefits people.

Sporanox

20th September 2009, 12:56 AM

High-deductable health insurance only "helps" people in their 20s, who will by and large get away with ignoring their health until their 30s. After that, people with, say a $1000 deductable likely have crappy jobs, and thus probably don't make that much. So when the inevitable problem pops up, the thought of having to take a $1000 is going to prevent them from doing anything about it. Or, if it can't be ignored, it's going to hurt, and bad. Plans like that are going to cause otherwise treatable problems to be ignored until after it's too late. A healthcare plan should promote healthcare.

Do you have any evidence for that? I could take the same slippery slope to mandated cadillac plans, as well, which would arguably enable many individuals to go beserk on unnecessary health care spending.

Overriding state laws doesn't sound like a very GOP thing to do, but don't they already do this, in general?

No, they do not.

I'm not sure what effect this would have, but I guess competition can be good. I'm not sure I'm looking forward to the 1-800-SAFE-DCTR ads though.

Competition is the only thing, besides state control of the economy, that keeps costs down. Unfortunately, we keep being told that the only thing that will create "competition" is a public option sure to be hyper-tweaked with tax money for the purpose of creating a single-payer system.

Better yet, stop doctors from bringing those lawsuits on. Anyone want to take odds on how many deserving lawsuits aren't even launched for every supposedly bad one that wins? I like to think that the industry gets what it has coming to it, one way or another.

Do you have any clue what you're talking about? Start with the disaster that was John Edwards' courtroom victories, for one - star lawyer steals millions of dollars on the basis of bad science.

Also, do you know what defensive medicine is?

That generally seems to be the reply from the GOP in general on this -- there are too many people that have healthcare coverage, too many people using the doctors and hospitals. Clinics and practices are overwhelmed and we'd all(!) be better off if fewer people attempted to tend to their ailments. Somehow that doesn't seem like an entirely moral "solution" to me.

How is this the mainline Republican position?

Reducing costs are a good way to start, but I think the proposition begins with the assumption that things cost what they do currently for no good reason. But of course the reason is that rule changes favor those making the money from it and backing off on that threatens those industries. I don't expect the GOP to suddenly stop making their decisions based on what benefits business over what benefits people.

Strawman. I could say the same thing about any Democratic proposal that includes a health insurance mandate - which would create a permanent, dependable consumer base for insurance companies.

Competition is the key to cutting down health care costs. THAT is the key to a GOP proposal.

Elf Grinder 3000

20th September 2009, 07:58 PM

The costs of medicare/healthcare are increasing and our system is usustainable. You can do one of two things - increase taxes or reduce benefits.

I think the Obama administration is guilty of lying/exaggerating cost savings in healthcare they need to just level with us.

It is time to suck it up and face reality. We need to figure out how to more efficiently allocate the resources we have.

Maybe we should stop giving tax breaks to people who need lazic surgery or old people who get to ride around on motorized scooters. This seems like a scam and means we have less money to spend on someone's heart transplant or cancer research.

not_so_new

20th September 2009, 08:26 PM

Darth Rotor

21st September 2009, 07:37 AM

Lurker

21st September 2009, 08:00 AM

The costs of medicare/healthcare are increasing and our system is usustainable. You can do one of two things - increase taxes or reduce benefits.

False dichotomy. Are you aware that other developed nations spend less than half of what we do on health care with similar outcomes? Some spend less than a third!

DDWW

21st September 2009, 08:07 AM

Has there been a thread appertaining to if it is even constitutional to “fix healthcare?”

DDWW

headscratcher4

21st September 2009, 08:09 AM

Wrong question, IMO.

How would GOP fix health care?

IMO, a better question is

Would GOP fix health care?

Since GOP had six years of House, Senate, and White House all in their box, and ... as far as I can tell ... didn't make fixing that thing a priority, other than to shower money all over pharmaceutical manufacturers, I wonder at that question's answer. My tenative answer is "not by much."

It is more than six years...they essentially had controll of the House since 1994. The GOP House leadership could have taken the initative, proposed and passed insurance reforms, tort reforms, tax breaks, FDA de-regulation and any number of "conservative" reforms designed to free up the market and increase the competition they see as necessary for improving the "best health care system" in the world (as they call it so often). They could have than dared the President to veto their reforms...or worked with Bush for the six years that it was a GOP House and Executive to construct reform and figure out how to do so without huge deficiet increases. They did not. The only thing they did was pass the Medicare drug benefit which has turned out to be a pretty good deal for seniors, it never the less was unfunded and is contributing to both the deficiet and to the eventual inbalance that could cause Medicare's collapse.

The hipocracy of the GOP on this matter is vast. Their sudden concern for the deficient is beyond belief -- because it is a position they only seem to take when they are out of power.

headscratcher4

21st September 2009, 08:15 AM

Has there been a thread appertaining to if it is even constitutional to “fix healthcare?”

DDWW

Seems to me this isn't really in much doubt...unless you're going to throw out over a hundred years of federal jurisprudence and interpretation of the powers of Congress:

"Section 8 - Powers of Congress

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States..."

Providing for the common...general welfare of the United States has long been interpreted as underlying Congress' power to regulate commerce and other issues affecting the "welfare" of the American people.

This "tenther" movement that is trying to re-write American history and that is suddenly so interested in the literal interpretation of the Constitution has about as much intelectual credibilty, IMO, as those still trying to figure out why they don't have to pay income taxes because the income tax is unconstitutional.

DDWW

21st September 2009, 08:58 AM

"

Providing for the common...general welfare of the United States has long been interpreted as underlying Congress' power to regulate commerce and other issues affecting the "welfare" of the American people.

Why did not the framers say "welfare of the American People" instead of "welfare of the United States"?

What is the purpose of the Tenth Amendment then?

DD (and yes I think paying taxes is constitutional)WW

The Painter

21st September 2009, 02:56 PM

Fail. Next straw man, please.

You need to stop getting your talking points from Glenn Beck :rolleyes:

Who's Glenn Beck??

It is way more than that. Why do you think that so many middle class people with health insurance lose everything they own because they get sick. I guess this is a good thing, making them responsible for their diseases right?

Evidence???

I have a very rare disease called Langerhans cell histiocytosis. I'm covered 100%. Am I responsible for my condition? I don't believe most people are shut out of their coverage. Show me evidence of a majority not being covered by their insurance carriers.

Ziggurat

21st September 2009, 03:12 PM

Bill Moyers noting how that stalwart of keeping government out of health care...Dick Army...has had government health insurance or government financed health insurance most of his professional life.

Yeah, um... I worked for the federal government for a few years, and while the health care plan is pretty nice, it's PRIVATE. Yes, that's right: federal civilian employees get private health care plans. In fact, one of the nice features of it was that I could choose from a fairly wide variety of plans offered by different providers. That it's paid for with taxpayer money doesn't make it "government health insurance". It isn't. And the plans currently on offer wouldn't extend such coverage to the population at large either. They can't, because such plans are too expensive.

JoeTheJuggler

21st September 2009, 03:43 PM

Nobody responded to my proposal?

I'll give my 2 cents worth:

Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs).
I disagree with this--in fact I think insurance reform should probably go the other direction. As it is now, about the only plans whose premiums I could afford (self-employed and relatively low income) have deductibles about as high as my annual income, meaning they'd essentially be like not having insurance. (I'd have to pay as I go anyway.) For young people, I suspect these plans would be about the same.

Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.
This is a laudable goal, but exactly how you achieve this isn't a simple problem.

Repeal all state laws which prevent insurance companies from competing across state lines.
I agree with this.

Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.
I'm in favor of "tort reform" that would discourage frivolous suits (and discourage indemnifiers from settling frivolous suits then passing that cost along by charging doctors and hospitals higher premiums). I'm not sure how you do that. (I had one idea--require any suits that are decided in court in favor of the defendant to go through a quick second determination by the fact finder. The fact finder who finds in favor of the defendant must answer the question, "Was this suit frivolous?" If so, the plaintiff must pay all the costs incurred by the defendant.)

I'm opposed to "tort reform" that caps damages in awards. These caps only apply to suits that have merit. If insurers are settling meritless cases, then passing the costs on to doctors and hospitals who pass the costs on to the consumer (and I'm not sure this is factually so), then that is a problem distinct from large damages awarded to plaintiffs who have legitimate cases.

Enact Medicare reform.

Again, this is a fine goal, but what specifically does it mean?
Obama's proposal calls for a reduction in Medicare funding (but not on benefits paid out) due to removing inefficiencies in administration.

Sporanox

21st September 2009, 03:48 PM

It is more than six years...they essentially had controll of the House since 1994.

No, I believe you are forgetting 2006.

(which only slightly undermines your point. The GOP legislative leadership was rather incompetent in the 21st century)

Sporanox

21st September 2009, 03:58 PM

I disagree with this--in fact I think insurance reform should probably go the other direction. As it is now, about the only plans whose premiums I could afford (self-employed and relatively low income) have deductibles about as high as my annual income, meaning they'd essentially be like not having insurance. (I'd have to pay as I go anyway.) For young people, I suspect these plans would be about the same.

As high as your annual income? That doesn't sound like the high-deductible plan offered by Whole Foods. The article has more details.

We also provide up to $1,800 per year in additional health-care dollars through deposits into employees' Personal Wellness Accounts to spend as they choose on their own health and wellness.

Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan's costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction.

This is a laudable goal, but exactly how you achieve this isn't a simple problem.

Even taking you at your word, nothing is simple in reforming health care.

I'm in favor of "tort reform" that would discourage frivolous suits (and discourage indemnifiers from settling frivolous suits then passing that cost along by charging doctors and hospitals higher premiums).

Your proposal is quite interesting - I'd like to research that a little more. A second determination would have destroyed the unscientific conclusions of the Edwards cases. Of course, the idea could have some critical cons I'm unaware of.

Again, this is a fine goal, but what specifically does it mean?
Obama's proposal calls for a reduction in Medicare funding (but not on benefits paid out) due to removing inefficiencies in administration.

I wasn't sure about that either. Medicare is a confusing system. What's clear is that something has to be done about it.

Ziggurat

21st September 2009, 04:11 PM

I disagree with this--in fact I think insurance reform should probably go the other direction. As it is now, about the only plans whose premiums I could afford (self-employed and relatively low income) have deductibles about as high as my annual income, meaning they'd essentially be like not having insurance.

Forcing deductibles down won't make the plans with lower deductibles any more affordable, all it will do is remove those high-deductible plans from the market completely. So I'm not sure why you think going in the reverse direction would help you, all it would do is make insurance completely unaffordable for you.

For young people, I suspect these plans would be about the same.

The problem actually isn't so much getting insurance plans with high deductibles, it's the savings plan side that's lacking. Right now, I've got a health savings account which I use in addition to my health insurance. But it's quite problematic: I need to commit to payroll deductions for an entire calendar year and cannot change them partway through, and any money which doesn't get spent by the end of the year will disappear. I can't roll anything over, and I can't adjust my contributions, so I basically have to low-ball my expected medical expenses or risk losing money on the whole thing. Which is, frankly, stupid. If I could do just those two things (adjust contributions and roll over my balance), I could build up a big chunk of change in that account and opt into a higher deductible, lower premium plan than I currently have.

This is a laudable goal, but exactly how you achieve this isn't a simple problem.

It's far simpler than establishing a public option.

I'm opposed to "tort reform" that caps damages in awards.

Most caps don't apply to damages in general, only to punitive damages. Perhaps there are better options than simple caps, but excessive punitive damages are a real problem, and they should be reduced somehow.

JoeTheJuggler

21st September 2009, 04:14 PM

Evidence???

http://energycommerce.house.gov/Press_111/20090616/rescission_supplemental.pdf

Snipped for brevity (mostly removed examples and citation of sources for these findings):
In the United States, people who do not have health insurance through their employers and do not qualify for government programs such as Medicare or Medicaiq.must attempt to obtain coverage in the individual health insurance market. In most states, however, insurance companies that sell policies to individuals are allowed to deny coverage based on preexisting health conditions, leaving a significant portion of the population uninsured.

The current regulatory framework governing this market is a haphazard collection of inconsistent state and federal laws. Protections for consumers and enforcement actions by regulators vary widely depending on where individuals live. The documents produced to the Committee indicate that insurance companies take advantage of these inconsistent laws to engage in a series of controversial practices...
<snip>
[Description of "post-claims underwriting" where medical histories are not reviewed when applications are submitted, but only when a claim is filed. Then, "If the insurance companies find discrepancies, omissions, or misrepresentations, they can retroactively cancel policies, return premiums, and refuse payment for medical services."]
<snip>

The documents produced to the Committee also include other examples of controversial practices, including the following:
• Insurance companies rescind coverage even when discrepancies are unintentional or caused by others. <snip>
• Insurance companies rescind coverage for conditions that are unknown to policyholders. <snip>
• Insurance companies rescind coverage for discrepancies unrelated to the medical conditions for which patients seek medical care. <snip>
• Insurance companies rescind coverage for family members who were not involved in misrepresentations. <snip>
• Insurance companies automatically investigate medical histories for all policyholders with certain conditions. <snip>
• Insurance companies have evaluated employee performance based on the amount of money their employees saved the company through rescissions.<snip>

I don't believe most people are shut out of their coverage. Show me evidence of a majority not being covered by their insurance carriers.
I don't think anyone has ever claimed that this happens to "most people" or even "a majority". In fact, it doesn't apply to most people who get their insurance through their employer.

The problem is that it happens at all.

The point of universal health insurance of one form or another is that access to health care for "most people" or "a majority" isn't good enough.

JoeTheJuggler

21st September 2009, 04:34 PM

Most caps don't apply to damages in general, only to punitive damages. Perhaps there are better options than simple caps, but excessive punitive damages are a real problem, and they should be reduced somehow.
I disagree. Punitive damages also only apply to cases where the plaintiff wins. That means these suits have merit. Again, caps don't apply to frivolous lawsuits.

Ziggurat

21st September 2009, 04:42 PM

I disagree. Punitive damages also only apply to cases where the plaintiff wins. That means these suits have merit. Again, caps don't apply to frivolous lawsuits.

That argument makes sense if damages for a case with merit can never be too large. But it should be obvious that that simply isn't the case: damages CAN be too large, even when the plaintiff rightly wins a suit. And that's most likely to happen in the case of punitive damages, which are assessed quite subjectively compared to other forms of damage. So I don't know why you're dismissing the issue so trivially.

JoeTheJuggler

21st September 2009, 04:44 PM

As high as your annual income? That doesn't sound like the high-deductible plan offered by Whole Foods.
I don't work for Whole Foods.

In my case, the plans I could get with a premium of $100 or less had deductibles starting at $14,000. That is essentially being uninsured for all practical purposes. What that means is with such a plan, I'd still be reluctant to go to the doctor for routine check-ups or minor problems since I'd have to pay out of pocket.

Even taking you at your word, nothing is simple in reforming health care.
I agree. My point is that saying "Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits" is more a statement of a goal than an actual reform that will achieve that goal.

If there's anything less simple than health care, it's the tax code.

I wasn't sure about that either. Medicare is a confusing system. What's clear is that something has to be done about it.
But not just anything. We've seen the label "Medicare Reform" used in 2003 (http://www.cbsnews.com/stories/2003/11/20/opinion/main584722.shtml)for very industry friendly legislation. I would not support that brand of "Medicare Reform".

Sporanox

21st September 2009, 05:17 PM

I don't work for Whole Foods.

In my case, the plans I could get with a premium of $100 or less had deductibles starting at $14,000. That is essentially being uninsured for all practical purposes. What that means is with such a plan, I'd still be reluctant to go to the doctor for routine check-ups or minor problems since I'd have to pay out of pocket.

Indeed. The point is, better plans exist. What keeps them from existing across the country is arcane barriers to competition.

If there's anything less simple than health care, it's the tax code.

Either way, it will be meddled with. The oft-mentioned mandate gives the IRS the power to decide if your health insurance qualifies.

But not just anything. We've seen the label "Medicare Reform" used in 2003 for very industry friendly legislation. I would not support that brand of "Medicare Reform".

Yes, very true.

eeyore1954

21st September 2009, 06:01 PM

I don't work for Whole Foods.

In my case, the plans I could get with a premium of $100 or less had deductibles starting at $14,000. That is essentially being uninsured for all practical purposes. What that means is with such a plan, I'd still be reluctant to go to the doctor for routine check-ups or minor problems since I'd have to pay out of pocket.

It is not the same as being uninsured. Do you have any assets to protect. That is what high deductible insurance is for. To keep from bankrupting someone in case of a catastrophic illness. I think that is what insurance should be for. I would think for 100 a month you got a pretty good plan (assuming it will pay if you run up a 100,000 bill) Which is not hard when someone has too spend a couple of weeks in the hospital. By the same token if you are young and healthy you will probably never need it, How else do you think the insurance company can afford it. How many people need to never use it in order to cover the occasional 200,000 claim.

WildCat

21st September 2009, 07:39 PM

Strawman. I could say the same thing about any Democratic proposal that includes a health insurance mandate - which would create a permanent, dependable consumer base for insurance companies.
How can you possibly hope to make headway on the problem without mandating coverage?

Competition is the key to cutting down health care costs. THAT is the key to a GOP proposal.
I agree there needs to be more competition.

There also needs to be severe curbs on the "health care as a business" model of hospitals where the goal is to sell you tests, procedures, and medicines you don't need in order to boost profits like a car salesman selling rust proofing and an upgraded stereo.

WildCat

21st September 2009, 07:57 PM

I agree. My point is that saying "Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits" is more a statement of a goal than an actual reform that will achieve that goal.
IMHO they should not be treated equally, but should be reversed. Tax employer-provided benefits and allow individuals to deduct their premiums. Force insurance companies to end medical underwriting (they cannot refuse due to prexisting conditions), meaning they would have to consider everyone as being in the same pool and everyone would have to be charged the same. Mandate that everyone buy health insurance, subsidize those who can't afford it to varying degrees. Allow insurance companies to sell insurance in any state.

This ends the problem of health insurance being tied to employment, creates competition, and guarantees coverage.

You'd think the GOP would like such a plan (no public option), but alas they're too busy playing politics. The Dems are just as bad, protecting their own special interests as well.

I wish both parties would actually represent the American people, instead of their big-donor special interests.

Skeptic Ginger

21st September 2009, 08:09 PM

I'm curious if any of the anti-government option folks here can explain why it is they want to DENY ME THE RIGHT TO CHOOSE the government option.

WildCat

21st September 2009, 08:16 PM

I'm curious if any of the anti-government option folks here can explain why it is they want to DENY ME THE RIGHT TO CHOOSE the government option.
It's because people are suspicious of the government keeping its promise of it being funded entirely wth user fees.

The Netherlands went from an NHS-style health care system to a 100% private one in 2006 because of increasing costs and bureaucracy in the government system.

fullflavormenthol

21st September 2009, 08:28 PM

There also needs to be severe curbs on the "health care as a business" model of hospitals where the goal is to sell you tests, procedures, and medicines you don't need in order to boost profits like a car salesman selling rust proofing and an upgraded stereo.

Yep, yep, and yep! My father-in-law was a doctor at a small town hospital in Kansas. I say he was because he was recently fired from his position. The reason the hospital let him go? Because he wasn't pushing enough tests for his patients, and he made the mistake of transferring patients to hospitals nearby that had facilities better suited for their problems. Oh, and my personal favorite, he got in trouble for helping his next door neighbor with a minor medical issue and not charging him for it; even though it was in his spare time, outside the hospital, and they literally live in the same building.

So when there is actually a doctor who cares, takes an interest in the general welfare of his patients, and refuses to rip them off; our system rewards that effort by getting rid of him.

Greatest....Healthcare...in...the...whole... :talk034: ...world!

tyr_13

21st September 2009, 09:29 PM

It is not the same as being uninsured. Do you have any assets to protect. That is what high deductible insurance is for. To keep from bankrupting someone in case of a catastrophic illness. I think that is what insurance should be for. I would think for 100 a month you got a pretty good plan (assuming it will pay if you run up a 100,000 bill) Which is not hard when someone has too spend a couple of weeks in the hospital. By the same token if you are young and healthy you will probably never need it, How else do you think the insurance company can afford it. How many people need to never use it in order to cover the occasional 200,000 claim.

It is the same to me, and a lot of low income people. Having to pay $16,000 would bankrupt me. I have similar 'insurance' and all it does is take me from 'royally **********' down to 'totally screwed' if I get sick. It wouldn't even have to get sick for this to happen.

Recently I've gone through a testicular cancer scare. The tests alone have the possibility of bankrupting me.

And please, don't come back, like others on these boards have in the past with, 'you could afford better but you choose not too'. It's absolute ********.

thaiboxerken

21st September 2009, 09:39 PM

Well, first they'd abolish Medicare, because that's socialism, and then they'd abolish the VHA, because that's socialism, and then basically we'd live in Paradise forever because there'll be no socialism to threaten our health and eat our babies.

It'll be kind of awkward if we ever get sick, but fortunately that only happens in socialist countries.

C'mon. You're assuming they'd actually be consistent in their logic. They are not.

Skeptic Ginger

22nd September 2009, 12:41 AM

It's because people are suspicious of the government keeping its promise of it being funded entirely wth user fees.

The Netherlands went from an NHS-style health care system to a 100% private one in 2006 because of increasing costs and bureaucracy in the government system.And yet people who pay for health care are already paying for the uninsured who don't pay their medical debts. The cost is passed on to people who do pay.

So are the people opposed to the government option ignorant of that fact? Or do they just prefer to force everyone to do what they choose to do?

ponderingturtle

22nd September 2009, 03:27 AM

Evidence???

Look at the percentage of people who declare bankruptcy because of medical bills how have insurance.
Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period, from 46 percent in 2001 to 62 percent in 2007, and most of those who filed for bankruptcy were middle-class, well-educated homeowners, according to a report that will be published in the August issue of The American Journal of Medicine.
...
Overall, three-quarters of the people with a medically-related bankruptcy had health insurance, they say.

"That was actually the predominant problem in patients in our study -- 78 percent of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services," says Woolhandler. "Other people had private insurance but got so sick that they lost their job and lost their insurance." Health.com: Where the money goes -- A breast cancer donation guide

link (http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/)

ponderingturtle

22nd September 2009, 03:29 AM

Yeah, um... I worked for the federal government for a few years, and while the health care plan is pretty nice, it's PRIVATE. Yes, that's right: federal civilian employees get private health care plans. In fact, one of the nice features of it was that I could choose from a fairly wide variety of plans offered by different providers. That it's paid for with taxpayer money doesn't make it "government health insurance". It isn't. And the plans currently on offer wouldn't extend such coverage to the population at large either. They can't, because such plans are too expensive.

Of course they are, just look at how much higher private sector overhead is.

ponderingturtle

22nd September 2009, 03:31 AM

I'm in favor of "tort reform" that would discourage frivolous suits (and discourage indemnifiers from settling frivolous suits then passing that cost along by charging doctors and hospitals higher premiums). I'm not sure how you do that. (I had one idea--require any suits that are decided in court in favor of the defendant to go through a quick second determination by the fact finder. The fact finder who finds in favor of the defendant must answer the question, "Was this suit frivolous?" If so, the plaintiff must pay all the costs incurred by the defendant.)

Yep we have to save that killer less than 2% of medical bills. That is what is bankrupting everyone after all, not the 98+%

ponderingturtle

22nd September 2009, 03:35 AM

Indeed. The point is, better plans exist. What keeps them from existing across the country is arcane barriers to competition.

And they have premiums less than $100? Not employee contributions but actual premiums?

ponderingturtle

22nd September 2009, 03:38 AM

Fishstick

22nd September 2009, 03:39 AM

Look at the percentage of people who declare bankruptcy because of medical bills how have insurance.

link (http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/)

I think you just set yourself up for another 7-page semantic game on what constitutes a medical bankruptcy and what doesn't.

ponderingturtle

22nd September 2009, 03:40 AM

Yep, yep, and yep! My father-in-law was a doctor at a small town hospital in Kansas. I say he was because he was recently fired from his position. The reason the hospital let him go? Because he wasn't pushing enough tests for his patients, and he made the mistake of transferring patients to hospitals nearby that had facilities better suited for their problems. Oh, and my personal favorite, he got in trouble for helping his next door neighbor with a minor medical issue and not charging him for it; even though it was in his spare time, outside the hospital, and they literally live in the same building.

This seems perfectly resonable, after all how does any of that make money for his employer? In any other industry if you sent customers to other stores because they have better services you would be sacked as well. This is a victory of the free market.

ponderingturtle

22nd September 2009, 03:42 AM

fullflavormenthol

22nd September 2009, 04:55 AM

This seems perfectly resonable, after all how does any of that make money for his employer? In any other industry if you sent customers to other stores because they have better services you would be sacked as well. This is a victory of the free market.
I would assume you are being sarcastic here. There is an actual ethical component to a hospital wishing to retain a patient in its facilities when it is very obvious the facility isn't equiped to deal with the medical problems that led him to refer them to another hospital.

Cynic

22nd September 2009, 05:20 AM

Ethical component? Who needs ethics when we have economics?

WildCat

22nd September 2009, 05:22 AM

And yet people who pay for health care are already paying for the uninsured who don't pay their medical debts. The cost is passed on to people who do pay.

So are the people opposed to the government option ignorant of that fact? Or do they just prefer to force everyone to do what they choose to do?
The Netherlands has universal coverage. As does Germany and Switzerland, none has a "government option". You don't need a government option to achieve universal coverage.

In fact, those countries don't even have the equivalent of Medicare, Medicaid, VA, SCHIP, or any other of the government run programs the US does. They have less "socialized medicine" than the US does today!

There's no reason you can't have universal coverage without a government option. By insisting on this the Dems are playing right into the GOP claims of "socialized medicine" that scares so many here.

And frankly, the Baucas plan is terrible even if it included a government option.

WildCat

22nd September 2009, 05:25 AM

Yep we have to save that killer less than 2% of medical bills. That is what is bankrupting everyone after all, not the 98+%
If you want to argue that figure out what percentage $100 billion is of $2 trillion. That's what you'd save by eliminating all administrative costs from private health insurance.

Administrative costs of health insurance isn't where the big money is to be saved, it's not even low-hanging fruit.

WildCat

22nd September 2009, 05:26 AM

An in the US that is means going from 5% overhead to 25% overhead. But the 25% is at least ideologicaly lower.
Would you like to compare/contrast their costs per person to the cost per person in the US?

The reason overhead is so high is staff has to be hired to determine if claims include a pre-existing condition, what diseases are covered, what treatments are covered, what hospital stays are covered, etc etc. A regulated universal syatem mandating the purchase of private insurance, disallowing medical underwriting, and regulating coverage eliminates the need for most of that overhead.

ponderingturtle

22nd September 2009, 07:08 AM

I would assume you are being sarcastic here. There is an actual ethical component to a hospital wishing to retain a patient in its facilities when it is very obvious the facility isn't equiped to deal with the medical problems that led him to refer them to another hospital.

But you are looking at the hospital as something other than a profit seeking company.

ponderingturtle

22nd September 2009, 07:10 AM

If you want to argue that figure out what percentage $100 billion is of $2 trillion. That's what you'd save by eliminating all administrative costs from private health insurance.

Administrative costs of health insurance isn't where the big money is to be saved, it's not even low-hanging fruit.

Not by every analysis that I have heard, it is 20-30%. Of course this is total admisitrative costs, so it includes the cost in administration that hospitals and doctors need to deal with all the administrators at the insurance companies.

ponderingturtle

22nd September 2009, 07:12 AM

Would you like to compare/contrast their costs per person to the cost per person in the US?

Those numbers are for when Medicare is administered by the goverment vs private insurance companies. I know that we need to massively subsidse the profits of insurance companies but there has to be a limit.

Ziggurat

22nd September 2009, 08:08 AM

I'm curious if any of the anti-government option folks here can explain why it is they want to DENY ME THE RIGHT TO CHOOSE the government option.

What government option? The option that federal employees get? Well, for the most part you've already got that option, as a matter of fact. You just need to pay for it yourself. Nobody is denying you anything, except THE RIGHT TO TAKE THEIR MONEY TO PAY FOR WHAT YOU WANT. Yup, using all caps makes you sound smarter, doesn't it?

Ziggurat

22nd September 2009, 08:11 AM

Of course they are, just look at how much higher private sector overhead is.

Yeah, um... no. They're expensive because they offer a lot of services. Getting rid of the overhead won't change that, and in fact you could raise costs by doing that since much of the administrative burden exists to prevent fraud and misuse of resources. Insurance companies don't spend money on those administrative costs because they like shoveling money into a hole.

Ziggurat

22nd September 2009, 08:16 AM

Those numbers are for when Medicare is administered by the goverment vs private insurance companies.

And what do you get for Medicare's minor administrative costs? Why, exactly what you would expect (http://www.usatoday.com/news/health/2009-03-12-healthfraud12_N.htm).

fullflavormenthol

22nd September 2009, 01:16 PM

But you are looking at the hospital as something other than a profit seeking company.

Yeah...for profit.:rolleyes:

GREATEST HEALTHCARE ON EARTH!

Beerina

22nd September 2009, 02:14 PM

Yes, health care is exactly like people buying consumer electronics! Good analogy!

Exactly! Except it's far more important because your life depends on that newer, larger flat screen coming out next year.

So yes, you are correct, except that advancing tech is infinitely more important than consumer electronics.

Anything that reduced costs or "gave" it to "everybody", that, coincidentally, happened to slow this rate of consumer electronic medical tech development, would end up killing more than it saved.

Thanks for asking.

volatile

22nd September 2009, 02:19 PM

Exactly! Except it's far more important because your life depends on that newer, larger flat screen coming out next year.

So yes, you are correct, except that advancing tech is infinitely more important than consumer electronics.

Anything that reduced costs or "gave" it to "everybody", that, coincidentally, happened to slow this rate of consumer electronic medical tech development, would end up killing more than it saved.

Thanks for asking.

And how would it slow the rate of development, exactly? I think you've been asked that before...

ETA: Seriously. What the hell are you talking about? HOW would it slow the rate? On what do you base this LUDICROUS argument?

Skeptic Ginger

22nd September 2009, 02:21 PM

The Netherlands has universal coverage. As does Germany and Switzerland, none has a "government option". You don't need a government option to achieve universal coverage.

In fact, those countries don't even have the equivalent of Medicare, Medicaid, VA, SCHIP, or any other of the government run programs the US does. They have less "socialized medicine" than the US does today!

There's no reason you can't have universal coverage without a government option. By insisting on this the Dems are playing right into the GOP claims of "socialized medicine" that scares so many here.

And frankly, the Baucas plan is terrible even if it included a government option.Did I ask about universal coverage?????????

I asked about my right to have a government run health insurance option just as the naysayers have a right to have privately run health insurance options. How does my choice infringe on those who want to deny me that option?

Sporanox

22nd September 2009, 02:22 PM

I agree there needs to be more competition.

There also needs to be severe curbs on the "health care as a business" model of hospitals where the goal is to sell you tests, procedures, and medicines you don't need in order to boost profits like a car salesman selling rust proofing and an upgraded stereo.
The ills you describe do exist...I know quite a few doctors (not to mention the local hospital...) who have skated around some egregious sins. Keep in mind, though, that defensive medicine also plays a huge part.

I am curious as to how exactly you propose to reform the health care "business model."

Sporanox

22nd September 2009, 02:23 PM

Random

22nd September 2009, 02:24 PM

Exactly! Except it's far more important because your life depends on that newer, larger flat screen coming out next year.

So yes, you are correct, except that advancing tech is infinitely more important than consumer electronics.

Anything that reduced costs or "gave" it to "everybody", that, coincidentally, happened to slow this rate of consumer electronic medical tech development, would end up killing more than it saved.

Thanks for asking.

If your goal is to maximize healthcare outcomes, you have to look at issues of access. A magic pill that can cure all of my ills but which I could never afford is useless to me.

Which is better? Everyone gets medical technology from the year 2000, or ten percent get medical tech from the year 2100 and the rest get nothing. Which leads to better overall outcomes?

lomiller

22nd September 2009, 02:46 PM

It's because people are suspicious of the government keeping its promise of it being funded entirely wth user fees.

The Netherlands went from an NHS-style health care system to a 100% private one in 2006 because of increasing costs and bureaucracy in the government system.

And from the personal accounts of people I know there it’s been a disaster. Health insurance costs have tripled over what they paid under the previous system

Skeptic Ginger

22nd September 2009, 02:48 PM

....

Administrative costs of health insurance isn't where the big money is to be saved, it's not even low-hanging fruit.There are many more problems with the for profit model of health insurance than just the total dollars lost in the system to third party profits.

Skeptic Ginger

22nd September 2009, 02:53 PM

Taxes. ;)But this is a myth. We are currently paying for the uninsured via our current health care dollars spent. Bad debt of the health care industry comes out of paying clients' dollars.

If there is mandatory universal insurance coverage, more people will be paying premiums. Why force people to pay a private insurer when some of them would prefer to pay into a public run insurance plan?

Forcing people to pay private insurers or subsidizing the poor to pay private insurers means a big windfall for the insurance companies including giving them billions in our tax dollars. We'd be rewarding their bad business behavior of making profits by denying coverage.

Sporanox

22nd September 2009, 02:59 PM

But this is a myth.

Taxes are now a myth? Ever take a look at the mandate, there? Or project forward a few years when our $9 trillion deficit makes taxes unavoidable?

If there is mandatory universal insurance coverage, more people will be paying premiums. Why force people to pay a private insurer when some of them would prefer to pay into a public run insurance plan?

Because the public option is merely a lead in to single payer, which is the death of private competition. Also, if it goes in the red (which it will - see DirigoCare), I don't trust the government not to raise it as an undead public option with our tax dollars.

Forcing people to pay private insurers or subsidizing the poor to pay private insurers means a big windfall for the insurance companies including giving them billions in our tax dollars. We'd be rewarding their bad business behavior of making profits by denying coverage.

That is why true health insurance reform should not have a mandate, should open up national competition, and should introduce laws about frivolous dropped coverage.

volatile

22nd September 2009, 03:05 PM

Because the public option is merely a lead in to single payer, which is the death of private competition.

No, it isn't.

MarkCorrigan

22nd September 2009, 03:18 PM

No, it isn't.

Yes it is! There are no medical (http://www.axappphealthcare.co.uk/) insurance (http://www.bupa.co.uk/) companies (http://www.pruhealth.co.uk/) in the UK! (http://www.groupama.co.uk/business/health-insurance/)

Ziggurat

22nd September 2009, 03:19 PM

No, it isn't.

Really? (http://www.youtube.com/watch?v=zZ-6ebku3_E)

Someone once said to me this is a Trojan horse for single payer, and I said, "Well it's not a Trojan horse, right? It's just right there!" I'm telling you, we're going to get there, over time, slowly, but we'll move away from reliance on employment-based health insurance, as we should, but we'll do it in a way that we're not going to frighten people into thinking they are going to lose their private insurance. We're going to give them a choice of public and private insurance when they're in the pool and we're going to let them keep their private employment-based insurance if their employer continues to provide it.
- Jacob Hacker

volatile

22nd September 2009, 03:22 PM

Really? (http://www.youtube.com/watch?v=zZ-6ebku3_E)

Yes, really. There are dozens of private healthcare providers and private healthcare insurers in the UK, for example, and private healthcare is reguarly offered as an employee benefit by larger employers. The facts prove you stunningly and incompetently wrong. You've had this expained to you, more than once. That you continue to make statements that are egregiously, provably incorrect does not speak volumes to the veracity or merit of your arguments. I don't know why you think this Jacob Hacker guy is convincing, either, given that he's tilting at the same windmills you are.

Do you have anything to support your position other than mendacious, snarky YouTube videos and ill-informed, illogical and poorly thought out quotes from talking-head propagandists? If so, I invite you to post in the other thread, created pretty much entirely for the purpose of giving you a platform to spell out your position in your own words.

Sporanox

22nd September 2009, 03:23 PM

Yes it is! There are no medical (http://www.axappphealthcare.co.uk/) insurance (http://www.bupa.co.uk/) companies (http://www.pruhealth.co.uk/) in the UK! (http://www.groupama.co.uk/business/health-insurance/)

Yes, we know. Which is why I said "virtually all" earlier.

EDIT: volatile has picked up on that line too, I see...unfortunately, the NHS still dominates the lion's share of Britain's health care and it is still below US standards as a result.

MarkCorrigan

22nd September 2009, 03:26 PM

Yes, we know. Which is why I said "virtually all" earlier.

EDIT: volatile has picked up on that line too, I see...unfortunately, the NHS still dominates the lion's share of Britain's health care and it is still below US standards as a result.

Ok....examples of sub-standard healthcare for the average UK citizen compared to the average US one please.

Then explain why you want people to go without healthcare.

Ziggurat

22nd September 2009, 03:33 PM

Yes, really. There are dozens of private healthcare providers and private healtcare insurers in the UK, for example, and private healthcare is reguarly offered as an employee benefit by larger employers.

So you think it's wrong to call the NHS a single-payer system? Well, I suppose you could form a definition of the term under which that's true, but such a definition would be at odds with general useage.

The facts prove you stunningly and incompetently wrong.

So what's it like to be competently wrong?

You've had this expained to you, more than once. That you continue to make statements that are egregiously, provably incorrect does not speak volumes to the veracity or merit of your arguments.

In the post you are responding to, I didn't make any statements. I posted a quote, and I asked a question.

I don't know why you think this Jacob Hacker guy is convincing, either, given that he's tilting at the same windmills you are.

Bwahahahahaha! Do you even know who Jacob Hacker is? Let me guess: you think he's some right-wing talking head, trying to badmouth health care reform. Is that what you think?

Sporanox

22nd September 2009, 03:36 PM

Ok....examples of sub-standard healthcare for the average UK citizen compared to the average US one please.

Then explain why you want people to go without healthcare.

Ah, yes, appeal to misery. For all the people who choose not to buy health insurance and would vehemently fight a mandate that requires them to do so.

Here's something to chew on in addition to Ziggurat's study:

http://politicalcalculations.blogspot.com/2007/09/surviving-cancer-us-vs-europe.html

Sporanox

22nd September 2009, 03:37 PM

Bwahahahahaha! Do you even know who Jacob Hacker is? Let me guess: you think he's some right-wing talking head, trying to badmouth health care reform. Is that what you think?

I LOLed. :D

volatile

22nd September 2009, 03:41 PM

So you think it's wrong to call the NHS a single-payer system? Well, I suppose you could form a definition of the term under which that's true, but such a definition would be at odds with general useage.

What's your point? I don't really care if you call the NHS "single-payer" or not - but the fact is that public healthcare, particuarly universal healthcare, most resolutely does not mean "the death of private competition". If you think it does - as Sporanox seems to - then you're flat-out, 100%, ignorantly wrong.

So what's it like to be competently wrong?

You tell me. You seem to have deveopled quite a talent for it recently.

In the post you are responding to, I didn't make any statements. I posted a quote, and I asked a question.

A rhetorical question, linking to a YouTube video.

Bwahahahahaha! Do you even know who Jacob Hacker is? Let me guess: you think he's some right-wing talking head, trying to badmouth health care reform. Is that what you think?

I don't know or care who he is. The quote you posted is neither convincing, nor correct. He could be my mother's uncle and those two facts would not change.

The question still stands, Zig: will you make your case clearly and concisely in the thread opened for that very purpose, or will you continue to cite people who are wrong, and ink to YouTube videos which are mendacious propaganda?

WildCat

22nd September 2009, 03:42 PM

Not by every analysis that I have heard, it is 20-30%. Of course this is total admisitrative costs, so it includes the cost in administration that hospitals and doctors need to deal with all the administrators at the insurance companies.
The total dollar amount of all health insurance premiums in the US per year is ~$400 billion. Eliminate 20-30% and you save is $80-120 billion. Out of over $2 trillion in health care expenses.

I have no idea why you think hospital administrative costs would go down if you eliminated private insurance entirely.

Those numbers are for when Medicare is administered by the goverment vs private insurance companies. I know that we need to massively subsidse the profits of insurance companies but there has to be a limit.
Compare total per capita health care expenses, public and private. You'll find that the Netherlands, Germany, and Switzerland are far below the US. And they have universal coverage with no government option.

Your insistence on a government option seems based entirely on ideological, rather than pragmatic, considerations.

WildCat

22nd September 2009, 03:45 PM

Did I ask about universal coverage?????????

I asked about my right to have a government run health insurance option just as the naysayers have a right to have privately run health insurance options. How does my choice infringe on those who want to deny me that option?
What's so special about a government option? Do you also want a government option for groceries? Refrigerators? Televisions?

I have no idea why the government option is some sort of holy grail to you.

volatile

22nd September 2009, 03:47 PM

Oh, wait. Hold on. I need to read more carefully - because I assumed YOU had read what I posted correctly. Sheesh.

When I said "No it isn't", I meant not that it's not a "lead-in" to single-payer, but that it's not the death of private competition. So apologies: Hacker's not wrong - the public option may indeed lead to single payer. This is not even a bad thing. It's certainly not the "death of private competition", which is the position I'd assumed you'd posted the quote in support of (which was the topic of discussion)!

Allen773

22nd September 2009, 03:48 PM

What's so special about a government option? Do you also want a government option for groceries? Refrigerators? Televisions?

I have no idea why the government option is some sort of holy grail to you.

Yeah, what's so special about the Post Office, or public education, or highways, or police, or firefighters, or the military, or the National Guard? :rolleyes:

Ziggurat

22nd September 2009, 03:48 PM

You tell me. You seem to have deveopled quite a talent for it recently.

Not so. I'm incompetently wrong. Did you forget what you just wrote?

A rhetorical question

Which is not a statement.

linking to a YouTube video.

Which I'm guessing you didn't watch.

I don't know or care who he is.

He's one of the primary authors of Obama's '08 health care reform plan. Oops.

WildCat

22nd September 2009, 03:52 PM

The ills you describe do exist...I know quite a few doctors (not to mention the local hospital...) who have skated around some egregious sins. Keep in mind, though, that defensive medicine also plays a huge part.

I am curious as to how exactly you propose to reform the health care "business model."
More hospitals run like the Mayo Clinic, less like the ones you see advertised in your local area.

Frankly, I have no problem taxing or regulating them out of existence. Patient health should be the #1 priority of hospitals, not maximizing profits for shareholders.

And note I didn't say profits are bad, they are obviously necessary. It's when the priority is maximizing profits that spiraling out of control costs are incurred, with no measurable benefit to patients.

volatile

22nd September 2009, 03:53 PM

He's one of the primary authors of Obama's '08 health care reform plan. Oops.

See above. As you seem singularly unable to follow a train of thought, you shifted the discussion in your mind onto whether or not the public option would lead to a single-payer system (and not, as the rest of us were discussing, whether or not single-payer systems were the "death of private competition").

I was too hasty in assuming the "trojan Horse" to which you had Hacker referring was aiming for the "death of private competition", the topic we were actually talking about. I made a mistake, and I apologise. Guess I shouldn't have assumed you had the ability to make a coherent argument. I shan't make that error again; don't worry.

WildCat

22nd September 2009, 03:53 PM

Yeah, what's so special about the Post Office, or public education, or highways, or police, or firefighters, or the military, or the National Guard? :rolleyes:
Not even comparable. And frankly the Post Office is all but obsolete.

Sporanox

22nd September 2009, 03:54 PM

but the fact is that public healthcare, particuarly universal healthcare, most resolutely does not mean "the death of private competition". If you think it does - as Sporanox seems to - then you're flat-out, 100%, ignorantly wrong.

Almost all of the current choices in the market would be outcompeted due to taxpayer dollars - and this is if the government doesn't simply monopolize the system as they have done with 1st Class Mail in the US.

I'll admit it's not the total death of the private market, but it would put it in the ICU.

Sporanox

22nd September 2009, 03:55 PM

Yeah, what's so special about the Post Office, or public education, or highways, or police, or firefighters, or the military, or the National Guard? :rolleyes:

I bet that straw mountain wasn't cheap.

WildCat

22nd September 2009, 03:56 PM

And from the personal accounts of people I know there it’s been a disaster. Health insurance costs have tripled over what they paid under the previous system
I note your post is evidence-free. It should be quite simple for you to find what per-capita health care costs are from 2005 to 2007.

volatile

22nd September 2009, 03:59 PM

Almost all of the current choices in the market would be outcompeted due to taxpayer dollars - and this is if the government doesn't simply monopolize the system as they have done with 1st Class Mail in the US.

I'll admit it's not the total death of the private market, but it would put it in the ICU.

Not true. Bupa and others are doing just fine - indeed, given that their premiums are lower than their US equivalents (because they don't need to cover primary or emergency care), the pool of customers may even increase.

Even a cursory glance at countries which have UHC systems show that private healtcare does not "die" or even really splutter.

Yours is another example, it seems to me, of "I'm OK, screw the rest of ya!". Even after reform, you can keep your insurance, and it will probably (indeed, almost certainly) be cheaper. Those of your fellow countrymen who do not have insurance at all will no longer be forced into debilitating illness and bankruptcy. Who loses? None of us outside the USA can see the answer to that. Not one poster on this board from outside America that I've seen has said they'd rather not have universal care. Why do you think that might be?

elbe

22nd September 2009, 04:01 PM

Allen773

22nd September 2009, 04:03 PM

If they are being outcompeted shouldn't they die? Isn't that one of the basic premises of the free market?

See, that's the thing. The opponents of universal health care don't really care about a "free market." The people behind these arguments want to protect current market shares for corporations.

WildCat

22nd September 2009, 04:03 PM

If they are being outcompeted shouldn't they die? Isn't that one of the basic premises of the free market?
If the government option is subsidized by tax dollars it's not exactly a case of being outcompeted, is it?

Allen773

22nd September 2009, 04:06 PM

If the government option is subsidized by tax dollars it's not exactly a case of being outcompeted, is it?

It's a case of people seeing the better, more convenient option and going for it.

WildCat

22nd September 2009, 04:10 PM

It's a case of people seeing the better, more convenient option and going for it.
You dodged the question. Would you care to actually answer it?

elbe

22nd September 2009, 04:10 PM

If the government option is subsidized by tax dollars it's not exactly a case of being outcompeted, is it?

Outcompeted is outcompeted no matter where it's funding comes from. If this hypothetical public option does what Sporanox suggests and actually outcompetes the existing insurers (which are doing a mightily poor job, in my opinion) then why can't the better system win?

Sporanox

22nd September 2009, 04:12 PM

Not true. Bupa and others are doing just fine - indeed, given that their premiums are lower than their US equivalents (because they don't need to cover primary or emergency care), the pool of customers may even increase.

I never said they were on the verge of extinction. But it is an irrefutable fact that the NHS is the supermajority of all health care in Britain, hence the single-payer moniker.

Incidentally, what you mentioned about premiums ties into elbe's post:

If they are being outcompeted shouldn't they die? Isn't that one of the basic premises of the free market?

The reason all of these wonderful things would happen is because the government pays for more, and more, and more. When bureaucratic inefficiencies, thieving politicians, and the lack of serious competition push federal agencies to ruin, they then can either raise taxes (the death option for any politician in office) or ration (because they don't want to admit that their bureaucracy isn't all that it's cracked up to be). Either way is fairly terrible.

Again, the track record of key governmental agencies here is not too sterling:

Social Security: going into the red perhaps as soon as next year, robbed by politicians

The Post Office: flailing despite a government-ordained monopoly on 1st class mail

Medicare: Fraught with waste and abuse, also running out of money (the Baucus plan desires to cut it at this point)

ETA: I need to make myself more clear.

The reason the government would be able to outcompete the other insurers is because it will give itself an unfair advantage - infusing the program with tons of taxpayer dollars. Obviously, this is hardly free; also, it sets the stage for future abuses and citizen-funded resurrections. And thus it will cost tons of money.

If the government really holds its nose and delivers a "self-sufficient" public option, then what happened in Maine - DirigoCare - happens and the public option dies. (not that anybody would let it die in that case, though; again, see Maine...)

elbe

22nd September 2009, 04:14 PM

So because the US government is completely incompetent a single payer system wouldn't outcompete the existing insurers. Good to know. So there is nothing to worry about.

Allen773

22nd September 2009, 04:15 PM

You dodged the question. Would you care to actually answer it?

In other words, no, it would not be a case of being out competed.

The difference is, I'm under no illusion about the dangers and failures of free-market capitalism.

WildCat

22nd September 2009, 04:16 PM

Outcompeted is outcompeted no matter where it's funding comes from. If this hypothetical public option does what Sporanox suggests and actually outcompetes the existing insurers (which are doing a mightily poor job, in my opinion) then why can't the better system win?
No, it's not. If it only costs you $100/month as opposed to an identical plan from a private insure costing $300/month but it is also subsidized to the tune of $250 then it's not a better deal or a better system. It is in fact costing more and is less efficient.

elbe

22nd September 2009, 04:19 PM

No, it's not. If it only costs you $100/month as opposed to an identical plan from a private insure costing $300/month but it is also subsidized to the tune of $250 then it's not a better deal or a better system. It is in fact costing more and is less efficient.

And what if, in this hypothetical system, it actually costs less and provided a better service? Wouldn't that be outcompeting?

volatile

22nd September 2009, 04:19 PM

I never said they were on the verge of extinction. But it is an irrefutable fact that the NHS is the supermajority of all health care in Britain, hence the single-payer moniker.

Sure. So what? If you want private healthcare, you can get private healthcare, and at cheaper costs than can Americans.

The reason all of these wonderful things would happen is because the government pays for more, and more, and more. When bureaucratic inefficiencies, thieving politicians, and the lack of serious competition push federal agencies to ruin, they then can either raise taxes (the death option for any politician in office) or ration (because they don't want to admit that their bureaucracy isn't all that it's cracked up to be).

If it needs repeating - you pay more in taxes than we do; and if there's any textbook examples of healthcare rationing to be brought to the table, it's the US private insurers, who emply teams of people do do just that.

Al the flaws you think would happen under universal care happen already in the current, busted American system, but to a greater degree and even systematically. The rationing you so fear, for example, is a desgned-in part of private provision - and the CEOs of a number of providers testified as much to a Senate committee! If you don't want rationing; if you want cheaper healthcare - universal provision is the way to go.

Again, the track record of key governmental agencies here is not too sterling:

The piss-up in the brewery argument? Again? There's enough of that silliness in this thread (http://forums.randi.org/showthread.php?p=5132135)...

WildCat

22nd September 2009, 04:19 PM

So because the US government is completely incompetent a single payer system wouldn't outcompete the existing insurers. Good to know. So there is nothing to worry about.
If you are incapable if understanding the arguments being made perhaps this thread isn't for you. Likewise if you're being deliberately obtuse.

Sporanox

22nd September 2009, 04:19 PM

Link:

http://online.wsj.com/article/SB10001424052970204619004574322401816501182.html

Then the state created a "public option" known as DirigoChoice. (Dirigo is the state motto, meaning "I Lead.") This plan would compete with private plans such as Blue Cross. To entice lower income Mainers to enroll, it offered taxpayer-subsidized premiums.

Why did this happen? Among the biggest reasons is a severe adverse selection problem: The sickest, most expensive patients crowded into DirigoChoice, unbalancing its insurance pool and raising costs. That made it unattractive for healthier and lower-risk enrollees. And as a result, few low-income Mainers have been able to afford the premiums, even at subsidized rates.

Needless to say, that's far from the only cause.

elbe

22nd September 2009, 04:21 PM

If you are incapable if understanding the arguments being made perhaps this thread isn't for you. Likewise if you're being deliberately obtuse.

Yes, I was being deliberately obtuse, mostly because Sporanox arguments were just silly.

WildCat

22nd September 2009, 04:23 PM

And what if, in this hypothetical system, it actually costs less and provided a better service? Wouldn't that be outcompeting?
Yes, but the government has never been able to do that before. Compare/contrast the rates of FedEx and UPS with the Post Office. If it wasn't for laws making it illegal* to send the equivalent of first class mail through those carriers could the Post Office still exist?

*actually it's not illegal but the law requires their rates to be at least 3 times the Post Office rate.

Sporanox

22nd September 2009, 04:25 PM

If it needs repeating - you pay more in taxes than we do

Correlation is not causation. If that is indeed true (source?) then what the mandate plus further excesses would do would be terrifying.

Al the flaws you think would happen under universal care happen already in the current, busted American system, but to a greater degree and even systematically. The rationing you so fear, for example, is a desgned-in part of private provision - and the CEOs of a number of providers testified as much to a Senate committee! If you don't want rationing; if you want cheaper healthcare - universal provision is the way to go.

Your last sentence is a complete non-sequitur. Our system has problems, so another radically different system is the only fix? How about fixing those problems through smarter insurance legislation, perhaps?

elbe

22nd September 2009, 04:26 PM

Yes, but the government has never been able to do that before. Compare/contrast the rates of FedEx and UPS with the Post Office. If it wasn't for laws making it illegal* to send the equivalent of first class mail through those carriers could the Post Office still exist?

*actually it's not illegal but the law requires their rates to be at least 3 times the Post Office rate.

I don't think that actually helps your argument. For this, the PO succeeded because it's illegal to compete (sort of), I don't see anyone suggesting making it illegal to compete with a hypothetical public option. Insurance companies would still exist, they can offer the same services, or better services, for a better price. If the competition is still there why would the free market not offer a better solution?

volatile

22nd September 2009, 04:32 PM

Correlation is not causation. If that is indeed true (source?) then what the mandate plus further excesses would do would be terrifying.

You're posting on this forum about healhcare and you haven't seen those statistics? Seriously? They are everywhere.

http://spreadsheets.google.com/pub?key=pqVgDLeO6WJ1Epmhi4w3rXg
http://content.healthaffairs.org/cgi/content/full/23/3/10
http://en.wikipedia.org/wiki/Health_care_in_the_United_States#Health_care_spend ing
http://www.nationmaster.com/graph/hea_hea_car_fun_pub_per_cap-care-funding-public-per-capita

You pay more per capita in total (pubic + private spending), and, crucially, you pay more per capita in tax to cover a tiny percentage of your population (and pay, might I add, for services you cannot access) than we in the UK pay to cover everyone. Our healthcare metrics are broadly comparable.

Are those figures really surprising to you? Had you not encountered them before?

Your last sentence is a complete non-sequitur. Our system has problems, so another radically different system is the only fix? How about fixing those problems through smarter insurance legislation, perhaps?

Because the experiments have been done. Every other country in the Western world has universal healthcare, and the problems you fear have not materialised. You're acting as if the USA would be heading into a greta unknown. It's not a non-sequitor at all - in fact, it's entirely logical and backed up by all the evidence available. Your current system has problems; dozens of other countries have implemented systems based on universal provision which eliminates (or mitigates) them. The things you fear - rationing, high costs, bureaucracy - are endemic in what you have now. The solutions have been tested, over and over again. The experiments have been done.

WildCat

22nd September 2009, 04:33 PM

I don't think that actually helps your argument. For this, the PO succeeded because it's illegal to compete (sort of), I don't see anyone suggesting making it illegal to compete with a hypothetical public option. Insurance companies would still exist, they can offer the same services, or better services, for a better price. If the competition is still there why would the free market not offer a better solution?
I'd be OK with it if there is an iron-clad guarantee that it would be 100% funded by premiums, but I really doubt that's the case.

Besides, administrative costs and profits of private insurers comprises only $100 billion of the over $2 trillion in health care costs in the US. That's less than 5%.

This is all a diversion from the real issue - high costs with no patient benefit. And these high costs mostly originate in hospitals/clinics and the pharmaceutical industry. If we don't rein in those costs any reform will be a collossal failure.

Skeptic Ginger

22nd September 2009, 04:34 PM

What's so special about a government option? Do you also want a government option for groceries? Refrigerators? Televisions?

I have no idea why the government option is some sort of holy grail to you.Round and round the mulberry bush, WildCat ignores the question...

WildCat

22nd September 2009, 04:34 PM

Round and round the mulberry bush, WildCat ignores the question...
"I want a government option" is a question? :boggled:

Skeptic Ginger

22nd September 2009, 04:35 PM

....
And note I didn't say profits are bad, they are obviously necessary. It's when the priority is maximizing profits that spiraling out of control costs are incurred, with no measurable benefit to patients.And private health insurance companies are not subject to this problem, why?

Skeptic Ginger

22nd September 2009, 04:37 PM

"I want a government option" is a question? :boggled:And around he goes again.

Skeptic Ginger

22nd September 2009, 04:42 PM

For the record, WC, this was the exchange:
I'm curious if any of the anti-government option folks here can explain why it is they want to DENY ME THE RIGHT TO CHOOSE the government option.

It's because people are suspicious of the government keeping its promise of it being funded entirely wth user fees.

And yet people who pay for health care are already paying for the uninsured who don't pay their medical debts. The cost is passed on to people who do pay.

So are the people opposed to the government option ignorant of that fact? Or do they just prefer to force everyone to do what they choose to do?

From there you got sidetracked.

Sporanox

22nd September 2009, 04:44 PM

Are those figures really surprising to you? Had you not encountered them before?

Again, the correlation of higher health care costs with higher taxes is not causation. For one, much of our system is unfunded by the government and allows for much more spending on the part of individuals who desire it. Two, our taxes go to funding more than health care.

Because the experiments have been done. Every other country in the Western world has universal healthcare, and the problems you fear have not materialised. You're acting as if the USA would be heading into a greta unknown. It's not a non-sequitor at all - in fact, it's entirely logical and backed up by all the evidence available. Your current system has problems; dozens of other countries have implemented systems based on universal provision which eliminates (or mitigates) them. The things you fear - rationing, high costs, bureaucracy - are endemic in what you have now. The solutions have been tested, over and over again. The experiments have been done.

Have you seen the links posted in regards to the comparison of health care outcomes across countries? It seems that the US, despite having a rather unhealthy population, comes out ahead in that measure.

Also, I quoted this part of your post:

If you don't want rationing; if you want cheaper healthcare - universal provision is the way to go.

Without even tackling the rationing question (which is demonstrably false - Canada and Britain, for starters, use rationing all the time), this is a false dilemma between the current US system and single payer. There may be better ways of reforming our health care system than installing a brand new bureaucracy, such as removing state-line barriers to competition and better regulating insurance companies.

Non-sequitur wasn't the type of fallacy I should have cited (it would actually apply to your taxation argument above), but as it means "does not follow" it was somewhat appropriate.

elbe

22nd September 2009, 04:47 PM

A(which is demonstrably false - Canada and Britain, for starters, use rationing all the time)

So does the US.

Sporanox

22nd September 2009, 04:47 PM

And yet people who pay for health care are already paying for the uninsured who don't pay their medical debts. The cost is passed on to people who do pay.

It's time you cited this with some statistics, or at least an explanation of why EMTALA's current costs equal or exceed the cost of a new bureaucracy.

Sporanox

22nd September 2009, 04:49 PM

So does the US.

Tu quoque fallacy.

WildCat

22nd September 2009, 04:52 PM

And private health insurance companies are not subject to this problem, why?
Health insurance companies have very low profit margins, and they have little control over the costs of health care. There simply isn't much they can do to maximize profits, unlike hospitals. They also have at least a modicum of competition, though that could be greatly improved if they could sell scross state lines.

elbe

22nd September 2009, 04:54 PM

Tu quoque fallacy.

No it isn't. I wasn't trying to dismiss or counter your statement, just expand upon it.

Rolfe

22nd September 2009, 04:54 PM

This is all a diversion from the real issue - high costs with no patient benefit. And these high costs mostly originate in hospitals/clinics and the pharmaceutical industry. If we don't rein in those costs any reform will be a collossal failure.

No, no, you have to realise. These costs are essential to the wellbeing of humanity. If you rein in these costs, you will slow the development of medical technology, and MILLIONS WILL DIE!!!

[/Beerina]

Rolfe.

Magyar

22nd September 2009, 04:55 PM

Yeah, what's so special about the Post Office, or public education, or highways, or police, or firefighters, or the military, or the National Guard? :rolleyes:

Add the Library system, National parks and NOAA

Sporanox

22nd September 2009, 04:57 PM

No it isn't. I wasn't trying to dismiss or counter your statement, just expand upon it.

All right, then.

WildCat

22nd September 2009, 05:05 PM

For the record, WC, this was the exchange:

From there you got sidetracked.
Let's recap what actually happened, as opposed to your fantasy:

And yet people who pay for health care are already paying for the uninsured who don't pay their medical debts. The cost is passed on to people who do pay.

So are the people opposed to the government option ignorant of that fact? Or do they just prefer to force everyone to do what they choose to do?
Clearly implying that no government option means "paying for the uninsured who don't pay their medical debts". So I thought I'd point out to skeptigirl that you can have universal coverage without a government option, and thus no you are not "paying for the uninsured who don't pay their medical debts":
The Netherlands has universal coverage. As does Germany and Switzerland, none has a "government option". You don't need a government option to achieve universal coverage.

In fact, those countries don't even have the equivalent of Medicare, Medicaid, VA, SCHIP, or any other of the government run programs the US does. They have less "socialized medicine" than the US does today!

There's no reason you can't have universal coverage without a government option. By insisting on this the Dems are playing right into the GOP claims of "socialized medicine" that scares so many here.

And frankly, the Baucas plan is terrible even if it included a government option.

From there, skeptigirl stamps her feet and demands a government option for no stated reason other than wanting a government option:
Did I ask about universal coverage?????????

I asked about my right to have a government run health insurance option just as the naysayers have a right to have privately run health insurance options. How does my choice infringe on those who want to deny me that option?
What's so special about a government option? Do you also want a government option for groceries? Refrigerators? Televisions?

I have no idea why the government option is some sort of holy grail to you.
Round and round the mulberry bush, WildCat ignores the question...
"I want a government option" is a question? :boggled:

Now skeptigirl, I showed that your "question" was actually a false dichotomy. You assumed that no government option means no universal coverage, clearly this is not the case.

If you are unable to understand this it's really not my problem, but yours alone.

volatile

22nd September 2009, 05:10 PM

Again, the correlation of higher health care costs with higher taxes is not causation. For one, much of our system is unfunded by the government and allows for much more spending on the part of individuals who desire it. Two, our taxes go to funding more than health care.

Let me spell this out, as you're surprisingly unversed in this debate. The amount you pay in tax, per capita, for healthcare is less than British citizens pay. Additionally, your tax pays for healthcare you cannot access (Medicare, Medicaid, VA), whereas I can access the NHS. These figures are not controversial.

Without even tackling the rationing question (which is demonstrably false - Canada and Britain, for starters, use rationing all the time),

We have no rationing save for expensive and ineffective drugs. Compare this to US insurance companies, who not only have year and lifetime provision caps, but systematic policies of denying even straightforward care.They even employ armies of staff simply for this purpose. Rationing is what you have NOW; nothing comparable happens under the NHS.

As for the rest of your post, it never ceases to baffle me that people are happy to jettison evidence and experience simply because it does not accord with their ideologial presuppositions. Universal healthcare has been proven, wherever it has been tried, to give you exactly what youre asking for. It baffles the rest of the world why you keep resisting it.

Sporanox

22nd September 2009, 05:27 PM

Let me spell this out, as you're surprisingly unversed in this debate. The amount you pay in tax, per capita, for healthcare is less than British citizens pay. Additionally, your tax pays for healthcare you cannot access (Medicare, Medicaid, VA), whereas I can access the NHS. These figures are not controversial.

That is true, as per your last link. Sorry for misunderstanding.

We have no rationing save for expensive and ineffective drugs.
http://hotair.com/archives/2009/08/26/hospital-bed-shortage-shuts-4000-pregnant-british-women-out-of-maternity-wards/
http://www.telegraph.co.uk/health/healthnews/5955840/Patients-forced-to-live-in-agony-after-NHS-refuses-to-pay-for-painkilling-injections.html
The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

Instead the National Institute of Health and Clinical Excellence (NICE) is ordering doctors to offer patients remedies like acupuncture and osteopathy.
Acupuncture.
And of course your great wait times - no, there's no rationing there!

As for the rest of your post, it never ceases to baffle me that people are happy to jettison evidence and experience simply because it does not accord with their ideologial presuppositions. Universal healthcare has been proven, wherever it has been tried, to give you exactly what youre asking for. It baffles the rest of the world why you keep resisting it.

There is no false dilemma. We don't have to embrace a single-payer system with endemic problems just because we have our own set. Remember the links about comparative treatment outcomes across nations?

I should also note that even if single-payer was all it was cracked up to be, there is not much to suggest it would work the same way in the US, considering all our dissimilar characteristics.

elbe

22nd September 2009, 06:22 PM

Acupuncture.
And of course your great wait times - no, there's no rationing there!

The UK certainly has problems with "alternative" medicines.

And I seem to recall it being said that steroid injections haven't been shown to be a good treatment for lower back pain so they encourage doctors not to use it as such. But I could be misremembering.

eeyore1954

22nd September 2009, 06:31 PM

And what if, in this hypothetical system, it actually costs less and provided a better service? Wouldn't that be outcompeting?
how can it be out competing when it isn't a level playing field. If one chess grandmaster plays another one but the second one starts with an extra queen. Is it out competing when he wins.

elbe

22nd September 2009, 06:33 PM

how can it be out competing when it isn't a level playing field. If one chess grandmaster plays another one but the second one starts with an extra queen. Is it out competing when he wins.

So the results don't matter? Better service for a lower price, as I hypothetically put in that post you quoted, is a worse option just because it's provided by the government? That's some interesting blinders you're wearing.

Skeptic Ginger

22nd September 2009, 07:59 PM

It's time you cited this with some statistics, or at least an explanation of why EMTALA's current costs equal or exceed the cost of a new bureaucracy.Regardless of adding people to the insurance rolls in private or public agencies, you have the same increases in administration costs.

Several people in this thread arguing for all private administration claim it only amounts to 1-2% of health care costs.

We already have a public agency in place, so expanding it, even as a separate agency because the polices and structure can just be copied, shouldn't be any more expensive than subsidizing the poor so they can pay into private insurance coffers.

ED care is extremely expensive and inefficient for providing primary care.

WildCat

22nd September 2009, 08:35 PM

ED care is extremely expensive and inefficient for providing primary care.
Can't they buy their own Viagra?

:golf:

Skeptic Ginger

22nd September 2009, 10:49 PM

....
Now skeptigirl, I showed that your "question" was actually a false dichotomy. You assumed that no government option means no universal coverage, clearly this is not the case....
The question was, why should you tell people who want a public option they can't because you don't like it.

Your answer so far is, people can get care the way you want so you don't have to answer my question.

Your first answer that you are afraid a public option means more taxes for you failed. It's a lie. So how about living up to that right wing claim people should make their own decisions and butt out of my choice to have a public insurance option?

Fishstick

23rd September 2009, 12:10 AM

That is true, as per your last link. Sorry for misunderstanding.

http://hotair.com/archives/2009/08/26/hospital-bed-shortage-shuts-4000-pregnant-british-women-out-of-maternity-wards/
http://www.telegraph.co.uk/health/healthnews/5955840/Patients-forced-to-live-in-agony-after-NHS-refuses-to-pay-for-painkilling-injections.html

Acupuncture.
And of course your great wait times - no, there's no rationing there!

People love pullin' out that article as if it's proof that the NHS is oh so horrible, but like to skip over:

A spokesman for NICE said its guidance did not recommend that injections were stopped for all patients, but only for those who had been in pain for less than a year, where the cause was not known.
That means that any of the people mentioned, with chronic back problems that have been receiving injections WILL STILL BE RECEIVING INJECTIONS. it just also means that your doctor needs to take at least a year to figure out WHY your back hurts and try and solve it, as opposed to instantly giving you a shot and treating the symptoms, and NOT the cause. Those animals!

Also: do you consider triage rationing? After all, you're "withholding" care from someone and putting them in a waiting line!

Fishstick

23rd September 2009, 12:20 AM

So the results don't matter? Better service for a lower price, as I hypothetically put in that post you quoted, is a worse option just because it's provided by the government? That's some interesting blinders you're wearing.

No, you see, the government can't do anything right and it will also outcompete all private insurer's because it's great at providing insurance if a government option was provided.

Rolfe

23rd September 2009, 01:50 AM

http://hotair.com/archives/2009/08/26/hospital-bed-shortage-shuts-4000-pregnant-british-women-out-of-maternity-wards/
http://www.telegraph.co.uk/health/healthnews/5955840/Patients-forced-to-live-in-agony-after-NHS-refuses-to-pay-for-painkilling-injections.html

Sorry, but there have been threads in the Science and Medicine forum section trashing both these slanted stories.

When challenged, even BaC was unable to find a single instance of a British woman told to go away and give birth unassisted because of a bed shortage. The best he could do was a woman who was sent home after a thorough examination because the midwife thought she wasn't that close to delivering.

It does happen that women are occasionally sent to different hospitals because the one they were expecting to give birth in has a bed shortage at the crucial moment. What sort of mediaeval society do you think we are?

And the Telegraph article is a lot more compicated than it appears. It's the result of a journalist listening only to one side of a furious bust-up within a pain management group. As I said, there's a whole thread in the other forum discussing all the ins and outs.

The NHS is not "refusing to pay for pain-killing injections" thus forcing patients to live in agony. Those who set standards in the NHS recognised that simply giving steroid injections to alleviate the symptoms in undiagnosed back pain is a thoroughly bad idea. This is supported by the top specialists in the field. The journalist was simply stirring up trouble for a headline, basing his article on the assertions of the losing side in the argument.

Rolfe.

volatile

23rd September 2009, 02:32 AM

volatile

23rd September 2009, 03:57 AM

Sporanox - the tax-take figures were obviously new to you. Can I ask - what are your thoughts on the facts they belie? Has finding out that universal healthcare is cheaper than the quasi-socialised system you currently have changed your opinions at all?

ponderingturtle

23rd September 2009, 04:32 AM

The total dollar amount of all health insurance premiums in the US per year is ~$400 billion. Eliminate 20-30% and you save is $80-120 billion. Out of over $2 trillion in health care expenses.

I have no idea why you think hospital administrative costs would go down if you eliminated private insurance entirely.

Yep because they need all of those administrators to check and fire doctors who do not preform enough unnessacary but proffitable tests.

Compare total per capita health care expenses, public and private. You'll find that the Netherlands, Germany, and Switzerland are far below the US. And they have universal coverage with no government option.

They also do things like prevent companies from making a profit on basic health insurance. That is even more unamerican than a public option.

ponderingturtle

23rd September 2009, 04:33 AM

What's so special about a government option? Do you also want a government option for groceries? Refrigerators? Televisions?

Or interstate policing? The Pinkertons worked fine for decades, but no we need some fancy FBI now.

ponderingturtle

23rd September 2009, 04:38 AM

If the government option is subsidized by tax dollars it's not exactly a case of being outcompeted, is it?

It is simple we will pay the top administrators of the public option hundreds of millions of dollars too. That should level the playing feild.

ponderingturtle

23rd September 2009, 04:41 AM

ponderingturtle

23rd September 2009, 04:43 AM

I'd be OK with it if there is an iron-clad guarantee that it would be 100% funded by premiums, but I really doubt that's the case.

The thing is, if it is targeted to provide coverage to the poor and they can't afford a system that is 100% funded by premiums, what do you do then? The current solution is wait for them to start to die then spend massive ammounts of money to save them, that must get passed on to everyone in an almost risk pooled sense.

ponderingturtle

23rd September 2009, 04:46 AM

The UK certainly has problems with "alternative" medicines.

And I seem to recall it being said that steroid injections haven't been shown to be a good treatment for lower back pain so they encourage doctors not to use it as such. But I could be misremembering.

But look at how horrible it is, they are preventing doctors from using ineffective medicine to increase their paychecks. That is down right unamerican.

ponderingturtle

23rd September 2009, 04:47 AM

WildCat

23rd September 2009, 05:14 AM

The question was, why should you tell people who want a public option they can't because you don't like it.

Your answer so far is, people can get care the way you want so you don't have to answer my question.

Your first answer that you are afraid a public option means more taxes for you failed. It's a lie. So how about living up to that right wing claim people should make their own decisions and butt out of my choice to have a public insurance option?
And thus you prove my point: You want a public option because you want a public option.

Which brings me to the question you ran away from: Do you want a public option for refrigerators? Groceries? Paint? If not, why not?

Oh, and show me the law preventing any tax dollars at all from being used to prop up the public option.

WildCat

23rd September 2009, 05:21 AM

The thing is, if it is targeted to provide coverage to the poor and they can't afford a system that is 100% funded by premiums, what do you do then? The current solution is wait for them to start to die then spend massive ammounts of money to save them, that must get passed on to everyone in an almost risk pooled sense.
Those other countries I mentioned subsidize the premiums of the poor as well as lower-income people. You don't need a public option to do this.

And if you had read any of my posts on this subject you'd know I have always advocated mandatory insurance with sliding-scale subsidies based on income.

a_unique_person

23rd September 2009, 05:22 AM

I'm curious to hear what suggestions the GOP has for fixing health care in the U.S. AFAIK they agree with the Dems that it's problematic, but I haven't heard their policy ideas (sincere, not rhetorical question).

They'll make everyone rich, and then we'll all be able to afford health care. Except that in a free market, you charge what the market will bear. So the that means you'll end up exactly where you started.

WildCat

23rd September 2009, 05:22 AM

Or interstate policing? The Pinkertons worked fine for decades, but no we need some fancy FBI now.
A ridiculous comparison. There are things only the government can do well. Selling insurance isn't one of them.

WildCat

23rd September 2009, 05:24 AM

It is simple we will pay the top administrators of the public option hundreds of millions of dollars too. That should level the playing feild.
I have no problems with regulating the health care industry, including executive compensation.

WildCat

23rd September 2009, 05:29 AM

They also do things like prevent companies from making a profit on basic health insurance. That is even more unamerican than a public option.
So eliminate the 3-4% profits health insurance companies make and you chop $140 million or so off the $2 trillion in health care costs, a whopping 0.7%.

David Wong

23rd September 2009, 09:34 AM

This is what rationing looks like:

http://blogs.moneycentral.msn.com/smartspending/archive/2009/09/21/got-bunions-no-insurance-for-you.aspx

And America does it more than any developed country. No industrialized nation rations health care more than we do.

Let's fix it.

Sporanox

23rd September 2009, 03:03 PM

...and in any case, the point remains: Googling "NHS rationing" or similar does not address the fundamental point I was making, which was the American system you have now certainly has rationing, at a much lower and much more systematic level, and for more basic forms of provision.

If you're against rationing, you should logically be against yearly and lifetime provision caps, against refusals for pre-existing conditions, against retrospective withdrawal of coverage - all things, as I understand it, that the Obama plan covers. Riposte-by-google is so... inelegant. It doesn't get to the root of exactly where the disgareement lies.

Well, I was going to toss some more inelegant articles out into the street, but seeing as the Telegraph and Daily Mail have a severe bias, I'll save that for...er, five minutes later or so. Let's address approval.

I often hear Brits and overseas supporters of the NHS talk about how favorably it is viewed in their country. So let's see what Americans think of the system under discussion:

http://www.gallup.com/poll/123149/Cost-Is-Foremost-Healthcare-Issue-for-Americans.aspx

Key takeaway:

85% of Americans with health insurance coverage are broadly satisfied with the quality of medical care they receive and with their healthcare costs.

Now somebody will probably direct me to this line:

The 15% who are uninsured are far less satisfied with the quality of their medical care (50% are satisfied), and only 27% are satisfied with their healthcare costs. (Sixty-nine percent are dissatisfied with their costs.)

But this does not take away from the fact that the overwhelming majority are satisfied with the current state of health care. It is blindingly obvious, from this point, that any drastic changes would upset the apple cart. Why fix something that isn't working too badly? Again - apparently (I've never seen the polls, but surely somebody has the links) you like your health care, and we like ours.

Sporanox - the tax-take figures were obviously new to you. Can I ask - what are your thoughts on the facts they belie? Has finding out that universal healthcare is cheaper than the quasi-socialised system you currently have changed your opinions at all?

Hold up. The government costs are by and large for the government programs, of course. What we have in part, due to whatever machinations of bureaucracy or GDP size are involved behind the scenes (or any other cause you may substitute) costs more than what you have in whole. Thus, if we expanded our governmental initiative to include the vast majority of all health care services, exactly what would happen to the costs?

They would go down? Oh boy. :rolleyes:

Now, if I'm not mistaken, you have called this a poisoning of the well fallacy (if I read you correctly). I disagree. We can look at analogous initiatives and the past and use them to project the results of today's proposals. This is hardly off the beaten path of logic, especially when single payer is commonly referred to as "Medicare for all."

volatile

23rd September 2009, 03:14 PM

Why are you talking about approval? We're talking about rationing. You brough it up. Do you accept that the system you have now has more rationing than a universal system, necesarily and by design?

And Rofle's posted a link more than once to a page called "Where the extra money in US healthcare goes" or similar. See her recent posts and you'll find it easily. Yes, the costs would likely go down; it is a proven fact on the ground that other countries provide a better (as efficacious, more people covered) service for cheaper. Why wouldn't the same be true in the US? Do you have some quasi-magical impediment that stops the laws of economics working?

Seriously - did those figure surprise you? Can I ask, perhaps, why you think the figure is higher in the US? Why do you pay more for a partial service you can't access than I pay for a comprehensive system free at the point of use?

Sporanox

23rd September 2009, 03:16 PM

Sorry, but there have been threads in the Science and Medicine forum section trashing both these slanted stories.

Slanted they are, and I had it in the back of my head that both had already been brought up ages ago. :( I'm hunting for the thread now.

volatile

23rd September 2009, 03:19 PM

And... what do you mean by "not working too badly"? You have pretty much the most expensive healthcare system in the Western world, millions of people without coverage, millions of people WITH coverage going bankrupt due to healthcare costs, people queueing as if in the Third World when ad-hoc screening centres show up in their towns; a system where people are unable to move jobs due to fear of losing healthcare provision...

Exactly what is "working" about the current system? Perhaps you could ask someone
like Ducky that question?

Do you have health insurance? What's yur co-pay? What's your premium? What's your maximum cap? How much would you need to pay (on top of your tax) to get a level of service equivalent to that which I recieve already?

Sporanox

23rd September 2009, 03:21 PM

Why are you talking about approval? We're talking about rationing. You brough it up. Do you accept that the system you have now has more rationing than a universal system, necesarily and by design?

There is absolutely no evidence to suggest that. Besides, approval of the NHS is an oft-cited statistic.

Yes, the costs would likely go down; it is a proven fact on the ground that other countries provide a better (as efficacious, more people covered) service for cheaper. Why wouldn't the same be true in the US? Do you have some quasi-magical impediment that stops the laws of economics working?

We have a history of government programs; I suggest you read some of it.

Seriously - did those figure surprise you? Can I ask, perhaps, why you think the figure is higher in the US? Why do you pay more for a partial service you can't access than I pay for a comprehensive system free at the point of use?

Ziggurat has already discussed, in an earlier post, several factors that increase per capita costs in a larger economy like the US.

Of course, there may be other reasons. What they are, precisely, would depend on the British government's attitude towards funding and the incidence of practices such as defensive medicine.

Cynic

23rd September 2009, 03:26 PM

We're talking about rationing. You brough it up. Do you accept that the system you have now has more rationing than a universal system, necesarily and by design?

There is absolutely no evidence to suggest that.

Currently the entirety of the US healthcare system is being rationed from 15% of the population. How's that?

Sporanox

23rd September 2009, 03:35 PM

You have pretty much the most expensive healthcare system in the Western world

It gets better results than yours does for cancer, even though the US population is infamously unhealthy.

http://politicalcalculations.blogspot.com/2007/09/surviving-cancer-us-vs-europe.html

Ziggurat has posted another study that testifies to the outcomes of the US system.

millions of people without coverage, millions of people WITH coverage going bankrupt due to healthcare costs

Many of the uninsured are that way by choice; see the breakdown of DirigoChoice's results posted earlier. And your bankruptcy point is unfortunate, but again, I must dangle the 85% approval rate. Clearly, the system is working for the vast majority of people - and there are other ways to fix it that don't involve capsizing it for everyone else.

Do you have health insurance?

Yes, I do, and it's fairly good. The co-pay is about $200 max with a 40-visit limit in a year.

volatile

23rd September 2009, 03:38 PM

There is absolutely no evidence to suggest that. Besides, approval of the NHS is an oft-cited statistic.

I've not mentioned approval once.

On rationing: of course there's evidence. For sarters, all private premiums have lifetime and annual caps; that's rationing. Private premiums deny or ramp up the cost for pre-existing conditions. That's rationing; that's rationing designed in to the private-payer system. Further: insurance companies, all insurance companies, pay vast armies of people to restrospectively refuse coverage, and reward with bonuses the people that refuse the most coverage retrospectively. That, too, is rationing. None of that happens in the NHS. Companies list approve hospitals. They can also refuse to pay for tratements or tests your doctor deemed necessary. That's rationing.

You have rationing now. There are bureaucrats sitting in the office of whichever comapny administers your plan, deciding which procedures, drugs and facilities are covered, and which aren't. When you make a claim, people are emplyed specifically to see if there is any way they can avoid paying you. These things simply do not happen in universal systems. The "rationing" that happens in the NHS is for very expensive, very novel and marginally-effective drugs; drugs, I guess, would often also be denied under private plans in the US. Further - if you are denied a drug by NICE, you can appeal, and take this all the way to judicial review. No such recourse is available for provision by private companies.

There is abundant evidnence - right there in the policy documents for whatever plan you're with, as it happens - that your healthcare is rationed. And not only that, it's rationed despite you paying vastly more up-front and more as a "co-pay" than I do.

We have a history of government programs; I suggest you read some of it.

I've read it. The reason your government plans don't work is because they are DESIGNED not to work. See all the responses to Whipash in another concurrent thread. When you have a system that is designed to exclude people, designed to force people into poverty before they are able to access it, and designed to take people only when they are so ill and so desperate they have no other recourse, it's no wonder it struggles. The problems with Medicare and Medicaid is not that they are run by the goverment, but because zealots like you put ideological impediments in the way of them functioning properly!

Sporanox

23rd September 2009, 03:39 PM

Currently the entirety of the US healthcare system is being rationed from 15% of the population. How's that?

http://hotair.com/archives/2009/09/11/who-are-the-uninsured-2009-edition/

volatile

23rd September 2009, 03:52 PM

http://hotair.com/archives/2009/09/11/who-are-the-uninsured-2009-edition/

Just why these figures are nonsense is right there in the comments: "In Texas, it would cost about $2600/month for a family of four to buy insurance in the high risk pool if anyone had any pre-existing conditions (such as moderately high blood pressure). That’s over $30,000 a year. A family making $50,000 can’t just skip buying something else to buy that insurance, unless you want them to skip having a home."

Travis, of this parish, is testament to the same problem. Why on earth are you so wedded to a worse, more expensive system? It honestly makes no sense. You've been duped by special interests into a supporting a system that screws you over! How does that not piss you off?

What's the annual / lifetime dollar maximum on your policy? And what provisions have you made should you get ill enough to exceed it?

Sporanox

23rd September 2009, 03:55 PM

On rationing: of course there's evidence. For sarters, all private premiums have lifetime and annual caps; that's rationing. Private premiums deny or ramp up the cost for pre-existing conditions. That's rationing; that's rationing designed in to the private-payer system. Further: insurance companies, all insurance companies, pay vast armies of people to restrospectively refuse coverage, and reward with bonuses the people that refuse the most coverage retrospectively. That, too, is rationing. None of that happens in the NHS. Companies list approve hospitals. They can also refuse to pay for tratements or tests your doctor deemed necessary. That's rationing.

Most of these things are simple facts of the nature of insurance. If a minority runs up costs for everyone else (DirigoChoice), premiums skyrocket tremendously and the whole group suffers.

Now the idea is that health insurance should be more affordable than it is now. That's why we need to pull down barriers for competition so that basic principle of economics can keep costs down.

By the way, something else that happens in the NHS:

http://www.manchestereveningnews.co.uk/news/health/s/163/163813_hundreds_queue_for_dentist.html

The "rationing" that happens in the NHS is for very expensive, very novel and marginally-effective drugs; drugs, I guess, would often also be denied under private plans in the US.

http://news.bbc.co.uk/2/hi/3749801.stm
http://www.dailymail.co.uk/health/article-525748/Average-NHS-waiting-times-RISEN-Labour--despite-90bn-investment.html

I've read it. The reason your government plans don't work is because they are DESIGNED not to work.

Gee, that's marvelous. If only you had been around to tell Johnson and all our other liberals to not purposely cripple their systems.

Sporanox

23rd September 2009, 03:59 PM

Just why these figures are nonsense is right there in the comments: "In Texas, it would cost about $2600/month for a family of four to buy insurance in the high risk pool if anyone had any pre-existing conditions (such as moderately high blood pressure). That’s over $30,000 a year. A family making $50,000 can’t just skip buying something else to buy that insurance, unless you want them to skip having a home."

http://www.txhealthpool.com/rates.html

The plan is government-run. Oops.

By the way, it might be a better idea to skip buying a house; we all saw what that did to the economy in the past few years.

Ziggurat

23rd September 2009, 04:01 PM

millions of people WITH coverage going bankrupt due to healthcare costs

Source? I ask because the most commonly used source for medical bankruptcy is absolute crap.

Sporanox

23rd September 2009, 04:02 PM

Travis, of this parish, is testament to the same problem. Why on earth are you so wedded to a worse, more expensive system? It honestly makes no sense. You've been duped by special interests into a supporting a system that screws you over! How does that not piss you off?

Maybe because the system works pretty good for the vast majority of the people in it? Maybe because the system consistently returns better results for actual TREATMENT of illness (the whole point of having health insurance, natch) than yours?

Not that it couldn't get better, but we would like it to get better without dumping most of the 85% who are currently satisfied. Is that so horrible?

volatile

23rd September 2009, 04:08 PM

Most of these things are simple facts of the nature of insurance.

YES! Exactly! That's the point I'm making. The system you have is designed to have rationing. If you don't want rationing (you said you didn't), then advocate for a system that doesn't have rationing as a necessary condition.

By the way, something else that happens in the NHS:

http://www.manchestereveningnews.co.uk/news/health/s/163/163813_hundreds_queue_for_dentist.html

http://news.bbc.co.uk/2/hi/3749801.stm
http://www.dailymail.co.uk/health/article-525748/Average-NHS-waiting-times-RISEN-Labour--despite-90bn-investment.html

So rather than focus on the issue at hand - rationing - you'd like to change the subject? A quick "Rebuttal by Google" again?

If we're talking about waiting times - exaclt how long does someone with no insurance have to wait to get treatment? Isn't their "waiting list" efectively "Infinity"? Are these infinite waits factored in to the comparative statistics?

What you're arguing by effectively saying "I don't want a universal healthcare system because I might have to WAIT!" is "I don't care if some people suffer, as long as I get seen quicker". Do you think that's appropriate? Sure, the NHS isn't perfect. But it's far, far better than the broken, bankrupt, immoral system you have at the moment.

What those articles don't explain, of course, is the fact that people get seen on a priority according to need. If you need to get seen NOW, you get seen NOW. If your need is not as urgent, wait in line. If you don't like that - well, pay Bupa. Which, incidentally, costs less than you currently pay.

Please take some time to read some of the other healthcare threads before moving on to more ham-fisted Googling. All these points have been rebutted dozens of times. They're simply irrelevant, untrue, exaggerated or ill-considered.

Gee, that's marvelous. If only you had been around to tell Johnson and all our other liberals to not purposely cripple their systems.[/quote]

Skeptic Ginger

23rd September 2009, 04:13 PM

And thus you prove my point: You want a public option because you want a public option.Round and round the mulberry bush,
WC continues running.
Place your bets he'll ever answer
I bet we'll hear nothing stunning.

Which brings me to the question you ran away from: Do you want a public option for refrigerators? Groceries? Paint? If not, why not?The question I ran away from????????

Oh, and show me the law preventing any tax dollars at all from being used to prop up the public option.Again you try to twist the discussion in order to avoid addressing a question you apparently cannot answer.

Question: Why deny people who want public run health insurance that option?
Answer: Worried about paying for it.
Reply: A) you already pay in the form of higher health costs as bad debt is passed on to paying clients;
B) Health care reform is going to include tax paid for subsidies anyway. Those tax dollars are going to go right into the private insurance company coffers
IE) there's no evidence a public option will cost anyone any more public tax dollars than any other version of health care reform.

Perhaps you don't like the outcome of this exchange. All your answers from here on give excuses why you want to deny people their choice of public insurance.

volatile

23rd September 2009, 04:15 PM

Maybe because the system works pretty good for the vast majority of the people in it?

Except... umm... it doesn't. And even if it did - is this reason enough to deliberately, purposively exclude people, rather than move to a system prven to work just as well, that's cheaper and which covers everyone? Honestly, this question baffles us Europeans.

You have a limit on how many times you can see the doctor! And you pay $200 per visit! And you are SUPPORTING this system? You think this is "working pretty good"? I don't understand.

Maybe because the system consistently returns better results for actual TREATMENT of illness (the whole point of having health insurance, natch) than yours?

You can cherry-pick cancer stats (which are time from diagnosis, of course, not actual life-expectancy of cancer vicitms), but there are plenty of other metrics in which the NHS does better - overall mortality, child mortality and some other diseases. Overall, the systems are broadly comparable - and there is no reason, of course, why switching to a UHC system would negatively impact your cancer survival rates, is there?

Not that it couldn't get better, but we would like it to get better without dumping most of the 85% who are currently satisfied. Is that so horrible?

Why would you be dumping anyone? As we've seen in every other country that's tried it, it is possible to cover everyone, just as well as the USA does, for less money. This experiment has been repeated over and over and over again.

A good system for 85% of people and no system at all for 15% does actually sound pretty horrible, especially when the line between the two groups is 40 hospital visits! What if you were diagnosed tomorrow with a really serious disease, which required more than 40 visits? Would you be singing the same tune?

Ziggurat

23rd September 2009, 04:17 PM

A good system for 85% of people and no system at all for 15% does actually sound pretty horrible

Darned good thing that's not what we have, then.

Sporanox

23rd September 2009, 04:18 PM

YES! Exactly! That's the point I'm making. The system you have is designed to have rationing. If you don't want rationing (you said you didn't), then advocate for a system that doesn't have rationing as a necessary condition.

It is kind of obvious that tremendous wait times are evidence of rationing.

If we're talking about waiting times - exaclt how long does someone with no insurance have to wait to get treatment? Isn't their "waiting list" efectively "Infinity"?

It's called EMTALA.

Again, there are other, better solutions to high premiums. Exactly what did you think would happen if you gave each small set of corporations a playground beholden to themselves?

What you're arguing by effectively saying "I don't want a universal healthcare system because I might have to WAIT!"

Because everybody would have to wait. Those waiting times were the national average.

But it's far, far better than the broken, bankrupt, immoral system you have at the moment.

It would be rather immoral to upend a good portion of the population into substandard care, would it not?

What those articles don't explain, of course, is the fact that people get seen on a priority according to need. If you need to get seen NOW, you get seen NOW. If your need is not as urgent, wait in line.

Unfortunately, the government determines that. If they don't like it, then your recourse is those immoral private insurance demon-wagons you have skewered, who will probably reject you due to having a threatening condition.

http://reason.com/news/show/134553.html

Shirley Healy, like many sick Canadians, came to America for surgery. Her doctor in British Columbia told her she had only a few weeks to live because a blocked artery kept her from digesting food. Yet Canadian officials called her surgery "elective."

As you can see, the government likes to determine matters of life and death as well. Problem is, single-payer narrows down your choices a heck of a lot.

Sporanox

23rd September 2009, 04:24 PM

Except... umm... it doesn't.

85% of those in the system would disagree with you.

You have a limit on how many times you can see the doctor! And you pay $200 per visit! And you are SUPPORTING this system? You think this is "working pretty good"? I don't understand.

I wouldn't have to wait. That's my choice.

You can cherry-pick cancer stats (which are time from diagnosis, of course, not actual life-expectancy of cancer vicitms)

U.S. females have a 63% of living five years or more after a cancer diagnosis versus 56% of European women. Men have a larger advantage: 66% to 47%.

Does that not sound like a fair measurement to you?

Skeptic Ginger

23rd September 2009, 04:31 PM

Source? I ask because the most commonly used source for medical bankruptcy is absolute crap.Which source is that and how do you know?

BankruptcyAction.com - US Bankruptcies 1980-2008 (http://www.bankruptcyaction.com/USbankstats.htm)Two out of three have lost a job;
Half have experienced a serious health problem;
Fewer than 9% have not suffered a job loss, medical event or divorce;

Bankruptcy Facts (found in USA Today, Wall Street Journal, CNN-Financial, and The Gallop Poll) (http://www.bankruptcylawinformation.com/index.cfm?event=dspStats)63% of filers blamed credit card bills. 50% blamed mismanagement. 37% blamed pay cuts or job loss, and 28% blamed medical bills

volatile

23rd September 2009, 04:34 PM

It is kind of obvious that tremendous wait times are evidence of rationing.

Errm... no, it isn't. Rationing means "some people don't get care". Even if you have to wait in the NHS, you WILL get seen eventually (and your care will be prioritised according to need, and decided entirely by your physician). Unlike the American system - the system you pay however much a month for, plus $200 a time - which limits the amount of care you can get and where you can get it, based on acturial tables and bureaucrats paid to try and screw you. You said you don't want rationing - so why are you supporting a system which, by your own admission, has rationing as a necessary and integral part of it?!

I don't understand your logic. You're essentially saying that you'd rather have a system where all care is rationed for all but the mega-rich (who can afford to pay out-of-pocket once their caps have been exceeded) and where bureaucrats are employed to systematically deny care that people have paid for, than one in which you can get all and any care your doctor thinks you need, with no lifetime cap, no annual cap, no chance of retrospective recinding, no bureaucratic control of your healthcare but where you might need to wait a bnt longer than you do now for a non-urgent intervention. You're saying you'd rather have rationing - systematic rationing - than having to wait for non-urgent treatment. That makes NO sense, especially given your vehement rejection of rationing earlier!

Because everybody would have to wait. Those waiting times were the national average.

Did they include the people whose waitswere "infinity"? At the moment, you have "Some people get seen quickly, some people don't get seen at all". What we have, which strikes me as a much better system, is "Everyone gets seen, based on clinical priority not ability to pay". What do you have against such a system, exactly?

It would be rather immoral to upend a good portion of the population into substandard care, would it not?

Yep. Good job no-one's proposing that!

Unfortunately, the government determines that.

Errm... no, they don't. The doctors do. The government PAY for the healthcare, but they have no say in what you get, or when you get it. This is, of course, precisely the opposite of how your system works, where your insurance company can mandate what treatment you can receive (even if your physician disagrees) and which hospitals you can get treated at.

As you can see, the government likes to determine matters of life and death as well. Problem is, single-payer narrows down your choices a heck of a lot.

No, it doesn't. What are you talking about?

volatile

23rd September 2009, 04:41 PM

85% of those in the system would disagree with you.

The line between you - in that 85% - and the 15% is 40 visits per year. You feeling lucky this year?

I wouldn't have to wait. That's my choice.

So you'd seriously would rather pay $200 a time, plus your premiums, plus take the risk of limits, just to get seen marginally quicker than even your doctor thinks you need to be? Does that sound rational to you? Especially as by supporting the current system, you're also excluding a large number of people from getting any care at all? You're esentially saying that as long as you get seen quickly (quicker than your doctor thinks is strictly necessary), you're cool with 15% of your fellow Americans waiting forever.

Can you stand behind that, in good conscience?

(ETA: Don't forget, of course, nothing is stopping you in a UHC system from paying for private insurance, which is cheaper than it would be for you now!)

Does that not sound like a fair measurement to you?

Aside from the cherry-picking (what are the rates for heart disease? Diabetes? &c.?), that's the date from diagnosis, not the overall survivability. What are the life expectancy figures for cancer patients? And anyway, even if we take the figures at face value, why do you expect they'd get worse with the introduction of universal care?

Ziggurat

23rd September 2009, 04:42 PM

Which source is that and how do you know?

Most claims I've seen come from news reports which try to summarize this report (http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf). And I know it's crap because I've read it. But maybe volatile has some other source.

volatile

23rd September 2009, 04:48 PM

Most claims I've seen come from news reports which try to summarize this report (http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf). And I know it's crap because I've read it. But maybe volatile has some other source.

You "know it's crap" because you simply pretend that the stats don't mean what they mean. You do that time and time again - simply baulk at the conclusions of experts who do not agree with your pre-conceptions.

By the way - what's the moral hazard of universal healthcare, Ziggurat? If you were interested in legitimate debate, I'd have thought you'd have posted in that thread by now. Rather than simply gainsaying awkward statistics because they utterly expose the moral bankruptcy of your position, perhaps you'd care to take the time in the thread provided to make a clear and concise presentation in support of your increasingly tenuous position?

Cynic

23rd September 2009, 04:49 PM

http://hotair.com/archives/2009/09/11/who-are-the-uninsured-2009-edition/

http://www.nchc.org/facts/coverage.shtml

Here, let's use these. I don't get my facts from "hot air". You'll note that this data was compiled from 2007, during the reign of Bush and before the economy collapsed. I'm sure these statistics have improved immesurably since then.

Regardless of how correct these statistics are, the point is that there is more than one way to look at rationing. There's rationing from the institution level, where the hospitals decide or declare that they can't do everything they should. There's rationing from the insurance level, where the company decides or declares that it won't pay for everything they should.

And then there's what has certainly been a major GOP message (complete with "I'm a doctor and this is what I think" adspace taken out on TV) in which it is declared that if all those people that don't currently have insurance are suddenly dumped into the system that the system will get crushed. That the system is already buckling at the seams. That the people currently in the system will see their levels of healthcare suffer. (Incidentally, if the GOP genuinely believed the number of uninsured was trivial, this would not concern them, would it?) So what is this argument of theirs getting at? It's rationing to prevent rationing -- currently the status quo, built right into the system.

It's being treated like a zero sum game. There is X amount of healthcare to go around, Y number of people currently receiving it, and Z number of people who need it still. If X is a constant, increasing Y decreases the quality and amount of care available for Y (rationing). Conversely, to increase the amount of care available, you can decrease Y. Regardless of how you deal with the numbers, if X is constant, the only way to manipulate amount and quality of care to the average case of Y is to manage levels of Y and Z accordingly. Which is also rationing, but in a more ugly way.

The answer of course is to increase X. The GOP would have us believe they can accomplish that, as evidenced by their time-honored habits of skyrocketing the national debt, lowering taxes, and creating laws that protect companies from their unruly customers. I dunno -- I'm skeptical.

Sporanox

23rd September 2009, 05:04 PM

Errm... no, it isn't. Rationing means "some people don't get care".

That is a rather narrow definition. Obviously, nobody is suggesting that there are some people who will NEVER get any sort of care. Take your statement and extend it to "some people don't get care in a reasonable time frame," since the care at that moment is, well, rationed.

http://dictionary.reference.com/browse/rationing

6. to restrict the consumption of (a commodity, food, etc.): to ration meat during war.

That should put to bed your notion that the NHS is free of rationing. Now, the question is, do I want a system where I can go right away if I need to or a system where I'm forced into waiting for an average of 49 days? Wouldn't that discourage early detection of diseases? (perhaps that has something to do with the lower cancer survival rate)

Now, here is the problem.

Errm... no, they don't. The doctors do. The government PAY for the healthcare, but they have no say in what you get, or when you get it.

No. There is ample evidence that rejects that notion. First: you say that your wait times depend on the prioritization of your health complaint, then you say the government has no say in when you get treated?? That makes no sense.

As for what you get, something to note is the citation of the rejecting of cortisone steroids for acupuncture earlier in this thread. Whatever you think about the legitimacy of that action, it shows that the government actually does have the final word.

It would be rather immoral to upend a good portion of the population into substandard care, would it not?
Yep. Good job no-one's proposing that!

Do you ever wonder why lots of people prefer private insurance to Medicare/Medicaid? Well, universal Medicare is pretty much the goal of the pro-single payer people here. There is a reason behind the political revolt in the US - people don't want to get dumped out of private insurance.

As you can see, the government likes to determine matters of life and death as well. Problem is, single-payer narrows down your choices a heck of a lot.
No, it doesn't. What are you talking about?

It would drive a lot of private health insurance companies out of business. That of course narrows down the field.

that's the date from diagnosis, not the overall survivability. What are the life expectancy figures for cancer patients?

Isn't it pretty clear that if you have a lower chance of living past the first five years you're in an inferior situation? What is so unfair about that stat?

Sporanox

23rd September 2009, 05:09 PM

Here, let's use these. I don't get my facts from "hot air".

One must note that HotAir is analyzing the 2009 US census statistics. Do you dispute the accuracy of that? It's more current than the report you're using.

It's being treated like a zero sum game. There is X amount of healthcare to go around, Y number of people currently receiving it, and Z number of people who need it still. If X is a constant, increasing Y decreases the quality and amount of care available for Y (rationing). Conversely, to increase the amount of care available, you can decrease Y. Regardless of how you deal with the numbers, if X is constant, the only way to manipulate amount and quality of care to the average case of Y is to manage levels of Y and Z accordingly. Which is also rationing, but in a more ugly way.

The answer of course is to increase X. The GOP would have us believe they can accomplish that, as evidenced by their time-honored habits of skyrocketing the national debt, lowering taxes, and creating laws that protect companies from their unruly customers. I dunno -- I'm skeptical.

So do you buy the zero-sum argument or no? If you do not, then it seems you support a new bureaucracy to address the shortage/cost of X. What about opening up the field to more competition so we don't have gerrymandered corporate playgrounds?

Ziggurat

23rd September 2009, 05:11 PM

You "know it's crap" because you simply pretend that the stats don't mean what they mean.

No. I know it's crap because I read the study so I DO know what the stats mean. Go on, read the report, you clearly haven't done so yet. Look up their definition of what they count as a "medical bankruptcy". You will find that what they measured is NOT the number of people declaring bankruptcy whose primary debt is medical expenses, or even the number of people who would not have gone bankrupt without medical expenses.

By the way - what's the moral hazard of universal healthcare, Ziggurat?

I've already told you. I don't care if you're unsatisfied with my answer.

Rolfe

23rd September 2009, 05:13 PM

Just reading this and wondering about that happy 85%. I wonder how many of them have never needed any major healthcare intervention?

Easy enough to be satisfied if you think you have good coverage, though you've never needed to test it much. It was fine when you sprained your ankle last year after all!

Ask Sugarb about how this perspective can change.

Rolfe.

Rolfe

23rd September 2009, 05:14 PM

I've already told you. I don't care if you're unsatisfied with my answer.

Would you mind linking to the post where you explained this? I must have missed it.

Rolfe.

elbe

23rd September 2009, 05:16 PM

First: you say that your wait times depend on the prioritization of your health complaint, then you say the government has no say in when you get treated?? That makes no sense.

You aren't really thinking this through, are you? I should imagine that the wait times in the UK are just like the wait times in the US. If the doctor or facility you want or need to go to is busy you're put on a waiting list, unless it's more of an emergency then you're pushed higher.

And for the record, I've had to wait over a month to visit my GP before when they were busy.

volatile

23rd September 2009, 05:19 PM

That should put to bed your notion that the NHS is free of rationing.

Errrm... not at all. The NHS does not restrict care like meat in wartime. What are you talking about? There are NO LIMITS to the amout of care one can get per week, per month or per lifetime (the "meat in war" analogy). This is demonstrably not the case for the system you currently find yourself in.

So, you dislike rationing, but you are advocating for a system in which rationing is a necessary part. Why are you doing that? :confused:

Now, the question is, do I want a system where I can go right away if I need to or a system where I'm forced into waiting for an average of 49 days? Wouldn't that discourage early detection of diseases? (perhaps that has something to do with the lower cancer survival rate)

Do you want a system where you can go quicker than your physician thinks is necessary but where your neighbour cannot go at all, or do you and your neighbour want one where you will get seen as quickly as your physician thinks is reasonable? Do you also want to pay through the nose for the first system, whose only noticable benefit is that you'll get seen a little bit quicker?

Personally, I think supporting the first system is both irrational and immoral - it costs you vastly more money for very little benefit, increases your risk potential massively (you're 40 visits away from bankruptcy) and deliberately excludes the most vulnerableof your neighbours to boot. Wouldn't you agree that supporting a system that is much more expensive, much riskier and also designed such that people suffer is not necessarily one that you can stand behind in good conscience?

No. There is ample evidence that rejects that notion. First: you say that your wait times depend on the prioritization of your health complaint, then you say the government has no say in when you get treated?? That makes no sense.

The DOCTOR decides on your priority, based on clinical need. The government just pays the bills. How does that not make sense? It's not complicated. In fact, it's entirely uncomplicated.

This is entirely opposite to the insurance system, where the person aying the bills also has a direct say over what treatments you can and can't get.

As for what you get, something to note is the citation of the rejecting of cortisone steroids for acupuncture earlier in this thread. Whatever you think about the legitimacy of that action, it shows that the government actually does have the final word.

Errm.... NICE is not the government. NICE is run by DOCTORS, who limit the unnecessary use of expensive, ineffective treatments. The NHS does not have an infinite budget, but then again, neither do your insurance company. NICE do this far less frequently than the pen-pushers at your insurance company do - pen-pushers, I might add, who can overrule your physician. This has been explained to you. You're still advocating for a system which does all the things you claim not to like about UHC systems! Why would you do that?

Do you ever wonder why lots of people prefer private insurance to Medicare/Medicaid?

Well, I do wonder that. And then I remember that people go on TV and lie about what public care entails, and it ceases to be a mystery. Special interests have a large stakeholding in stopping you getting the care that us in the civilised world get.

Isn't it pretty clear that if you have a lower chance of living past the first five years you're in an inferior situation? What is so unfair about that stat?

Five years from diagnosis, not in toto. Let's see the total mortality rates from cancer. Let's also see heart disease, diabetes and other conditions. You do have those figures, right? You weren't just cherry picking cancer? And you can also explain how a public option would make the cancer numbers worse, of course?

volatile

23rd September 2009, 05:21 PM

Would you mind linking to the post where you explained this? I must have missed it.

Rolfe.

I missed it too. I know he said something tangentially and in passing about "jobs", but I've never seen him spell it out directly. In fact, I distinctly remember him saying he wouldn't spell it out, just to annoy me.

I also don't think he responded to the post that pointed out that perhaps a system that only gave healthcare to those on the poverty line might actually be more of a disincentive to working a job, but again, maybe I missed it.

Skeptic Ginger

23rd September 2009, 05:23 PM

Most claims I've seen come from news reports which try to summarize this report (http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf). And I know it's crap because I've read it. But maybe volatile has some other source.Because you read it? You expect that answer to convince anyone?

ABSTRACT
BACKGROUND: Our 2001 study in 5 states found that medical problems contributed to at least 46.2% of all bankruptcies. Since then, health costs and the numbers of un- and underinsured have increased, and bankruptcy laws have tightened.
METHODS: We surveyed a random national sample of 2314 bankruptcy filers in 2007, abstracted their court records, and interviewed 1032 of them. We designated bankruptcies as “medical” based on debtors’ stated reasons for filing, income loss due to illness, and the magnitude of their medical debts.
RESULTS: Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001.
CONCLUSIONS: Illness and medical bills contribute to a large and increasing share of US bankruptcies.Care to make your criticisms more specific? This looks like a pretty good study from the abstract.

I do agree, however, this and the sources I looked at are being cited as all medical debt related when in half of those cases, loss of work for medical reasons is combined in the stats. Still, there are millions of bankruptcies from medical expenses in the last decade alone. And that represents an awful lot of bad debt passed on in medical charges to those who do pay.

Ambrosia

23rd September 2009, 05:25 PM

we need to pull down barriers for competition so that basic principle of economics can keep costs down.

I seem to recall them pulling down barriers for competition in the banking industry not all that long ago...

Quite apart from the problems the US health system has, the way that it exists at present is putting UP barriers to competition.

This is exactly the opposite of the GOPs stated ideals, as far as I understand them.

There is a huge difference between what employees of large comapnies that have good health care plans pay for their premiums and what the average Joe pays for that very same coverage if they are self employed.

Lets say I want to start my own business making widgets, and I have come up with an ingenious widget. In order to get my business off the ground I need skilled employees. Down the street there's a company called ACMEwidgetsTM and they are a huge corporation that by virtue of being the size they are can negotiate great health care for their employees.

I am in competition with ACMEwidgets for skilled workers and because of the huge advantage they have with health care plans it makes it much harder for me to establish my own small business, that dreams of one day also being a large corporation. A year or so later I get driven out of business because I cannot source or retain the skilled workers I need.

Competition in the widget market is reduced and ultimately the consumer pays more for their widgets which are not quite as good as the ones I could have supplied.

What about the hundreds of people each year that are bankrupted over medical bills, how many of those people could today be making positive contributions to your free market economy, but are prevented from doing just that because they had the misfortune to get ill? People that today are now a drain on the economy instead.

Isn't health care a fundamental basic need that any civilised government ought to provide for it's people nobody excluded?

volatile

23rd September 2009, 05:27 PM

No. I know it's crap because I read the study so I DO know what the stats mean. Go on, read the report, you clearly haven't done so yet. Look up their definition of what they count as a "medical bankruptcy". You will find that what they measured is NOT the number of people declaring bankruptcy whose primary debt is medical expenses, or even the number of people who would not have gone bankrupt without medical expenses.

I read the report a while back. They count the number of people who can't pay their medical bills. You seem to think that because these people have other debts too, their bankruptcy can't be medical - if only they'd not bought so many shoes!

You handwaved the poverty statistics in a similarly mendacious way. Reality is just so damn inconvenient to your wordview, ain't it?

elbe

23rd September 2009, 05:32 PM

Most of these things are simple facts of the nature of insurance. If a minority runs up costs for everyone else (DirigoChoice), premiums skyrocket tremendously and the whole group suffers.

Just curious, but how is dropped claims part of the nature of insurance? If I have insurance I would fully expect to be allowed to use my insurance, not for them to just drop me because they don't want to pay for something.

Sporanox

23rd September 2009, 05:36 PM

Errrm... not at all. The NHS does not restrict care like meat in wartime. What are you talking about? There are NO LIMITS to the amout of care one can get per week, per month or per lifetime (the "meat in war" analogy).

Except for the whole prioritization of care thing, remember? That sure seems to restrict consumption. Oh, and for elbe's benefit, from the Telegraph article:

But doctors said patients with serious illnesses were among those still waiting too long, while those with comparatively minor problems were being fast-tracked to meet the Government's 18-week target.

Obviously, the prioritization is the government's prerogative.

Do you want a system where you can go quicker than your physician thinks is necessary but where your neighbour cannot go at all, or do you and your neighbour want one where you will get seen as quickly as your physician thinks is reasonable? Do you also want to pay through the nose for the first system, whose only noticable benefit is that you'll get seen a little bit quicker?

The solution? The breakup of state barriers to competition and other fixes so everyone can afford insurance (or, perhaps, subsidies). Not the solution? Breaking up 85% of my neighbors' adequate care so 6% of my other neighbors can get some and we can all wait an average of 49 days or up to 18 weeks to 18 months.

Errm.... NICE is not the government. NICE is run by DOCTORS, who limit the unnecessary use of expensive, ineffective treatments.
The National Institute for Health and Clinical Excellence or NICE is a special health authority of the National Health Service (NHS) in England and Wales.

You've got to be kidding me. It's a government agency but it's not the government? You have officially jumped the shark.

By the way, here in the US, medical health care professionals also staff some of our bureaucracies, notably the OPMC in New York (RNs). Unfortunately, the OPMC is a terribly-run organization.

Well, I do wonder that. And then I remember that people go on TV and lie about what public care entails, and it ceases to be a mystery.

Maybe Americans are smart enough to know what's good for them based on their neighbors' experiences in Medicare?

Sorry, but this argument essentials boils down to "Americans are stupid and easily influenced by mind-control TV." In fact, it doesn't even hold water when you realize the staggering amount of prime-time TV given to President Obama to repeatedly broadcast talking points for reform.

Five years from diagnosis, not in [total].

Well, if you don't make it through the first five years, how are you going to live longer than that??

I will look for the other comparisons.

Ambrosia

23rd September 2009, 05:37 PM

It would drive a lot of private health insurance companies out of business.

Really?

Whats stopping the private health care insurance firms from diversifying into other types of insurance?

Assuming that lots of private health insurers did go to the wall, then how many people will lose their jobs, or go bankrupt?

How does that figure compare with how many people lose their jobs and go bankrupt as a result of being unable to pay medical expenses year on year, as a result of the present system?

Sporanox

23rd September 2009, 05:38 PM

Just curious, but how is dropped claims part of the nature of insurance? If I have insurance I would fully expect to be allowed to use my insurance, not for them to just drop me because they don't want to pay for something.

Not to say all dropped claims are valid, but fraud and abuse is a legitimate reason to stop somebody sucking up cash from the pool.

EDIT:

Isn't health care a fundamental basic need that any civilised government ought to provide for it's people nobody excluded?

Yes, let's pay for everybody's food and shelter too. After all, they are basic rights.

volatile

23rd September 2009, 05:48 PM

Except for the whole prioritization of care thing, remember? That sure seems to restrict consumption.

No, it doesn't. Everyone gets treated. That certainly isn't "restrciting" consumption. Because the system (no system) can see every single person as soon as any possible ailment arises, there will be some waiting. I'm sure this is equally true in the USA. Sure, some wait times are longer than we'd like, ideally. But would I trade quicker hip operations for the fetid hole that is the system you seem to be gleefully pissing your hard-earned cash into every moth? Not on your life, mate.

And even if we want to use your strained and spurious definition, care is still more restrcited in the system you are supporting; something which you again refuse to address. If you are concerned about rationing, why are you supporting a system which has rationinig as a necessarily inherent condition?

Obviously, the prioritization is the government's prerogative.

How many times do we need to explain that, no, it's not. The government are the customer, not the provider, and they have a target they expect healthcare trusts to meet - just like any person paying for a service, they have expected service levels.

You've got to be kidding me. It's a government agency but it's not the government? You have officially jumped the shark.

NICE is run BY DOCTORS, who assess the efficacy of expensive and novel treatments based on the best scientific evidence available. It is PAID FOR by the government, but civil servants (your feared "bureaucrats") are not involved. The NHS are the PROVIDERS, the government are the CUSTOMERS. This is, as I keep pointing out, the exact opposite to how healthcare is rationed by the insurance companies you're supporting. You are supporting a system which does everything you claim to be against. Why would you do that?

Sorry, but this argument essentials boils down to "Americans are stupid and easily influenced by mind-control TV." In fact, it doesn't even hold water when you realize the staggering amount of prime-time TV given to President Obama to repeatedly broadcast talking points for reform.

No, it boils down to "Insurance companies spend millions of dollars paying politicians to lie for them".

Well, if you don't make it through the first five years, how are you going to live longer than that??

Five years AFTER DIAGNOSIS. What are the total mortality rates per incidence?

In any case, you may be right. Cancer treatment might be better in America. How would this get worse if UHC was introduced?

I will look for the other comparisons.

I'd love to see them.

volatile

23rd September 2009, 05:50 PM

Yes, let's pay for everybody's food and shelter too. After all, they are basic rights.

Does no-one round here not have an argument we've debunked a trillion times?

We'll not spell this out for you. Instead, perhaps you can figure it out with a hint: What is the difference between an individual's healthcare need and their need for food?

Here's another hint: have you heard of "food stamps", "housing benefit" and "social security"?

elbe

23rd September 2009, 05:53 PM

In any case, you may be right. Cancer treatment might be better in America. How would this get worse if UHC was introduced?

What, didn't you know that if the government had their way we'd all be getting treated with blood-letting and trepanation?

Sporanox

23rd September 2009, 05:57 PM

We'll not spell this out for you. Instead, perhaps you can figure it out with a hint: What is the difference between an individual's healthcare need and their need for food?

Here's another hint: have you heard of "food stamps", "housing benefit" and "social security"?

That's a debunking? Comparing food stamps and housing benefits to single payer?

volatile

23rd September 2009, 06:05 PM

I can cherry pick a single data-point too! Look, Mom - America kills babies!

http://www.medicalnewstoday.com/articles/43094.php

volatile

23rd September 2009, 06:10 PM

That's a debunking? Comparing food stamps and housing benefits to single payer?

Oh, OK, maybe I do need to spell it out....

1) We do pay for food and housing where people are unable to do so for themselves

2) We only do this for a means-tested proportion of the population because food and shelter needs are consistent and predictable between human beings. There is a predictable and consistent level of income below which one's food and housing needs cannot be met. It costs the same £ amout to give someone 2,000 calories per day whoever that person is, and it is therefore simple to see who can, and who cannot afford the food they need. Healthcare, on the other hand, is not consistent and predictable. Whilst one person can earn £12,000 and not get ill at all, another could be earning £35,000 a year and be struck down with a condition requiring expensive and novel treatments. There is not a set level at which means-testing for healthcare makes any sense at all. In other words - it is very easy to see when someone cannot afford the food they need to survive. It is impossible to see when someone cannot afford the healthcare they may eventually need to survive. Food is not healthcare.

Please, read some of the older threads?

Ambrosia

23rd September 2009, 06:10 PM

That's a debunking? Comparing food stamps and housing benefits to single payer?

I think it was more in the question you ignored in that post.

Here it is again.

Whats the difference between an individuals need for food, or shelter, and an individuals need for healthcare?

volatile

23rd September 2009, 06:18 PM

Oooh! More cherry picking!

"The highest survival rates were found in the U.S. for breast and prostate cancer (http://www.webmd.com/prostate-cancer/default.htm), in Japan for colon and rectal cancers in men, and in France for colon and rectal cancers in women, Coleman's team reports. In Canada and Australia, survival was also high for most cancers."

Guess what type of healthcare systems France and Japan have?

By your own logic, Sporanox, you should be lobbying for the French system. After all, it's cancer survivability that matters, right?

Darth Rotor

23rd September 2009, 06:24 PM

It is more than six years...they essentially had controll of the House since 1994. .
Both irrelevant and false, in terms of impact on legislation.

The system is by nature adversarial.

The combination of the House, Senate, and White House in one's camp for six years gives one a lot of opportunity to get X, Y or Z passed, as one can presume quite a bit about using loyalty to get some votes. (Hell, Cheney took arm twisting to new levels).

As far as priorities go, that six year period is illustrative of where on the pecking order the GOP, as it stood then and apparently now, stood collectively on reform/improvement of the system as it operates here.

DR

Sporanox

23rd September 2009, 06:24 PM

No, it doesn't. Everyone gets treated. That certainly isn't "restrciting" consumption.

Let's put this back to the meat rations analogy: everyone got food...they just didn't necessarily get it when they wanted or in the quantity desired. How you cannot see this is rationing is beyond me.

And even if we want to use your strained and spurious definition, care is still more restrcited in the system you are supporting; something which you again refuse to address.

Why is care more restricted?

1) Wait times? Clearly not; the NHS trumps us

2) Denying based on condition? As we have seen, that happens under single-payer as well. (to what degree is somewhat hard to measure, given the number and difference of choices in our system) Good thing is, when it happens under a free-market system, there are a lot more potential choices to switch to. Unfortunately, this number is substantially reduced under a government-run system.

3) Ability to pay. Here is where the NHS has the advantage. As previously noted, of course, there is no such thing as "free" health care and the inevitably burgeoning cost overruns will inevitably result in an even greater tax burden. Fortunately, according to volatile, as long as Congress doesn't design the program to go into the red on purpose (like they did with all the other ones), this can be avoided. :)

Obviously, the prioritization is the government's prerogative.
How many times do we need to explain that, no, it's not.

Then how do you explain this quote?

But doctors said patients with serious illnesses were among those still waiting too long, while those with comparatively minor problems were being fast-tracked to meet the Government's 18-week target.

I might as well talk about NICE here too. You seem to think that just because it's staffed by doctors means that it's not a government agency or capable of being politically influenced. That's a riot. The point is, it is the only choice for most people, due to private insurance being marginalized, and if and when it screws up most affected people have no choice.

http://www.telegraph.co.uk/comment/letters/6133157/Dying-patients.html

Clearly, it is capable of doing so.

In any case, you may be right. Cancer treatment might be better in America. How would this get worse if UHC was introduced?

Because having an advisory board to determine which treatments are cost-effective across the board runs the risk of stifling medical innovation; and also because of the wait times impacting proper response time.

Now, here is a highlight from your post:

The NHS are the PROVIDERS, the government are the CUSTOMERS.

The NHS is the government. That's the reason for the "National" bit.

Five years AFTER DIAGNOSIS. What are the total mortality rates per incidence?

volatile

23rd September 2009, 06:25 PM

More cherry picking:

"For instance, 30-day acute myocardial infarction case-fatality rates are below 7% in Denmark, Iceland, and Switzerland, compared with almost 15% in the United States. Incidence of major amputations among diabetic patients in Finland, Australia, and Canada is less than 10 per 10 000 compared with 56 per 10 000 in the United States. And Australia, Canada, England, and New Zealand all have a better 5-year kidney transplantation survival."

So, you win some, you lose some. I heartily suggest that perhaps the fact that a system is socialised or not has little impact on specific disease survivability, and that we all agree to never mention such statistics again, Deal?

Sporanox

23rd September 2009, 06:28 PM

By your own logic, Sporanox, you should be lobbying for the French system. After all, it's cancer survivability that matters, right?

My link summarized the survivability of all cancers. You should have looked at it a little more carefully.

volatile

23rd September 2009, 06:42 PM

Let's put this back to the meat rations analogy: everyone got food...they just didn't necessarily get it when they wanted or in the quantity desired. How you cannot see this is rationing is beyond me.

To explain this again: meat rationing limited the amount of meat someone got. There is no such limit on the amount of healthcare provision in the NHS. You are, in other words, talking abject nonsense.

IF you are against such limits though, you shoud probably be against the current US system. You have a limit of 40 visits per year, right? That, unlike the strange and inaccurate comparison you are trying to make with the NHS, is rationing.

Will you agree that the current system - the one you are supporting - incudes precisely the rationing you claim to be vehemently against?

Why is care more restricted?

1) Wait times? Clearly not; the NHS trumps us

Can you get seen more quickly than your physician thinks is strictly necessary? Sure. Why is that important? Who knows!

2) Denying based on condition? As we have seen, that happens under single-payer as well.

Errrm. No. We have not "seen" this at all, because it doesn't happen. What are you talking about? The whole point of a universal system is that no-one is denied the care they need, no matter what their condition is. (The only exception is novel and demonstrably ineffective drugs.)

3) Ability to pay. Here is where the NHS has the advantage. As previously noted, of course, there is no such thing as "free" health care and the inevitably burgeoning cost overruns will inevitably result in an even greater tax burden.

Except, of course, as has been poihted out to you - we pay less than you do already. Quite a lot less, as it happens. You pay more in tax for the services you cannot access than I do for the services I can, plus you pay vast premiums on top, for rationed care!

Then how do you explain this quote?

The quote that explains that the government, who are paying for a service, are demanding better bang for their buck? What confuses you about that quote, and what do you think it demonstrates?

I might as well talk about NICE here too. You seem to think that just because it's staffed by doctors means that it's not a government agency or capable of being politically influenced. That's a riot. The point is, it is the only choice for most people, due to private insurance being marginalized, and if and when it screws up most affected people have no choice.

This is a strange paragraph, featuring two sentences that seem to have litte to do with each other. I suggest you investigate what NICE is, how it is funded, how its decisions are made (and by whom), what their relationship is to government and how oversight works. I'd also suggest you compare them with the bodies that fufill the exact same functions at your insurance company, and then come back to us if you have any further questions. Suffice to say, NICE will never, and indeed cannot, deny a patient treatment that his or her doctor thinks is necessary unless said treatment is a novel and inefficacious drug.

How is the NICE system - in which teams of experts rate the value for money of certan very expensive and inefficacious drugs, with juducial review and appeal - worse than the unilateral behavious of insurance companies and their policies of retroactively withdrawing cover, over-ruling physicians etc. etc.?

If we're talking about screw-ups,you might also like to consider something Rolfe often points out. Whilst we can find horror-stories about both the US and the UK systems, the UK systems are failures of entitlement whereas the US failures are failures of provision. In other words - the British system should give everyone the care they need, and if it fails, those affected have proper recourse and the right to be aggrieved. If someone is left without care in the American system, it is because the system is designed this way, and these people have no appeal or even right to complain.

Because having an advisory board to determine which treatments are cost-effective across the board runs the risk of stifling medical innovation; and also because of the wait times impacting proper response time.

Wrong and... errrr... wrong.

Also: would your insurance cover an expensive, unproven and inefficacious treatment?

The NHS is the government. That's the reason for the "National" bit.

No. The National just means it covers the nation. The government PAY FOR the NHS. They are the NHS' customers. I suggest you investiate, once you're done with NICE, how the NHS is actually run. At this point in time I'm inclined to think you're just hit-and-run googling to find quotes you don't really understand to underpin your increasingly untenable position.

You really are woefully uniformed of even the basics of this debate. Take time to learn just how screwed over you are right now by the very system you're supporting.

Sporanox

23rd September 2009, 06:42 PM

Among those reporting high blood pressure in HRS and SHARE, the proportions
reporting taking medication for the condition are similar in the US (88.0%) and Europe (88.9%)
(Thorpe et al. 2007a). However, when actual measures of blood pressure are used rather than self
reports, the position of the US improves. Wolf-Maier et al. (2004) employ regional or national
samples in the US, Canada, and five European countries. Hypertension is defined as the
population of persons who have systolic blood pressure of 160+ or diastolic blood pressure of
95+ or who are using antihypertensive medication. Of persons aged 35-64 with hypertension,
77.9% were being treated in the US, compared to a range of 41.0% - 62.4% in the other six
countries. Among those with hypertension, 65.5% were being successfully treated in the US (i.e.,
their levels were reduced below the hypertension-defining threshold), compared to 24.8% to
49.1% in the other countries.
Survival data for cardiovascular disease start not from the point of diagnosis but from an
acute event of heart attack or stroke. An OECD study, following up on a study by the TECH
network, computed one-year case fatality rates for people hospitalized for acute myocardial
infarction (AMI) in Australia, Canada, Denmark, Finland, Sweden, Great Britain, and the US.
The samples were sometimes regionally rather than nationally representative. Among the seven
countries in 1996, the US had the third lowest case-fatality rate for males aged 40-64 and the
second-lowest rate for men aged 85-89. For women at these ages, the US ranked fourth and first
(Moise 2003). Part of the explanation of the better performance of the US may be related to its
unusually aggressive treatment regime.
http://repository.upenn.edu/cgi/viewcontent.cgi?article=1012&context=psc_working_papers (Link)

Borrowing liberally from a link posted earlier by Ziggurat.