US House Democrats Unveil a Health Care Plan 925
gollum123 sends in this piece from a political blog in the NY Times. Here is the text of the bill in question (PDF). "House Democrats on Friday answered President Obama's call for a sweeping overhaul of the health care system by putting forward [an] 852-page draft bill that would require all Americans to obtain health insurance, force employers to provide benefits or help pay for them, and create a new public insurance program to compete with private insurers — a move that Republicans will bitterly oppose. ... But the chairmen said they still did not know how much the plan would cost, even as they pledged to pay for it by cutting Medicare spending and imposing new, unspecified taxes. The three chairmen described their bill as a starting point in a weeks-long legislative endeavor that they said would dominate Congress for the summer and ultimately involve the full panorama of stakeholders in the health care industry, which accounts for about one-sixth of the nation's economy. ... House Republicans, who have had no involvement in the development of the health legislation so far, quickly denounced the Democrats' proposal as a thinly disguised plan for an eventual government takeover of the health care system. ... The House Democrats' plan is one of three distinct efforts underway on Capitol Hill to draft the health overhaul legislation. In the Senate, both the Finance Committee and the health committee have separate bills in the works, and in recent days those efforts seem to have stumbled."
Cost (Score:5, Insightful)
"But the chairmen said they still did not know how much the plan would cost..."
I'm not sure the politicians care how much it's going to cost since it's not their money.
Re:Cost (Score:5, Insightful)
Of COURSE they don't know how much a voluntary insurance plan is going to cost, since they can't FORCE you to sign up for it! Blue Cross doesn't know how much their plan costs in advance either.
Will this bill stop the pre existing condition BS? (Score:5, Interesting)
Will this bill stop the pre existing condition BS? Let you buy any plan that you want? UN tie it from your job?
How about having a Bankruptcy that is just for Health stuff and does not show up on any back round check?
Not let people ask about you medial history before offering your a job?
Make it so you can not be dropped by a insurance provider.
Holy Shit Are You A Fucking Piece Of Garbage (Score:4, Insightful)
If anyone had any questions why the US health care 'system' continues to be a complete joke compared to the rest of the Western World just read this single post from this fucked in the head wacko.
Miserable little fucks screaming about people getting a free ride while wasting their own 'precious' money on more than 50 percent extra on health care costs in the US compared to every other modern aka 'Socialized' health care system.
Democracy's fatal flaw. Too many people are just fucking stupid like jstork.
Re:Then its not insurance... (Score:4, Insightful)
The point of insurance is to keep people healthy. If society can't provide that with the current system, it has to decrease the (now exorbitant) prices until people, taken as a whole, can pay for it. Insurance is merely an intermediate in this process -- if it can't operate with a profit, make it a nonprofit
The point of insurance is to provide a way for people to manage the financial risk of catastrophic health care costs. It is up to you to keep you healthy.
I think the larger point is that health care is so expensive that we cannot afford to pay for it ourselves, and that, if an insurance company cannot operate profitably, it means probably that health care is too expensive for society as a whole. With health care costs climbing by 10% a year, it stands to reason that even if you completely wiped out private insurance, in a scant few years, those profits would be replaced by tax increases or additional borrowing as costs continued to climb.
The only sensible way to approach health care is to understand that we have created cures and treatments that we cannot afford, and the only way to have health care for everyone is to not have those treatments. That way, everyone could afford to actually pay for their own health care.
Re:Then its not insurance... (Score:4, Insightful)
Re:Uh no, let the Democrat die.!!! (Score:5, Insightful)
Re: (Score:3, Insightful)
Parent not +5 insightful (Score:5, Insightful)
Insurance (of any kind) is an exchange where you pay a higher average (i.e. expected value) in exchange for a smaller variability in the outcome (statistical variance or standard deviation).
For example, suppose that each year one out of ten people one will incur a $10000 medical expense while the others incur no expense. The average cost is $1000, but there is a wide variability ($0-$10000).
Now suppose an insurance company charges $1100. If you take the insurance your average costs would be $100 higher. However, you have also eliminated variability. You no longer have to worry about being surprised by a $10000 bill. Instead you know exactly how much you will have to pay each year.
For things that have only a small amount of variability (e.g. utilities), insurance does not make sense. However, for things (e.g. house burning down) where there is a small but very real chance (e.g. 1 in 10000) of a very high cost (e.g. $100,000), insurance decreases the risk of financial ruin in case you happen to be the unlucky 1 in 10000.
It seems obvious from this (Score:4, Insightful)
it's kinda like the game my brother and I would play as children splitting a piece of cake , one cuts - the other chooses.
Of course, what happens when there is more then two ways to look at a problem, i don't know.
Two Sides? You Can't Be Serious (Score:3, Insightful)
There are two sides:
1. The entire modern world that has low cost universal health care
2. The Democrats and Republicans on the other side with Republicans off in 'teh free market' la-la land and Democrats too fearful of the 'Insurance' company lobbying/campaign contribution dollars to propose any real long term solution
Re:It seems obvious from this (Score:5, Insightful)
Health care isn't going to be Democrats negotiating with Republicans. I doubt the Republicans are going to contribute anything constructive to health reform, and so far they haven't put anything useful on the table. I wouldn't mind being proven wrong.
The current system is great for Republican politicians -- lots of fundraising to be done among rich healthcare CEOs and rich doctors, lots of noble rhetoric about the glories of the free market, the risks of "socialism" and sober warnings about the risks of change (...to the system that every other developed country in the world currently has).
Also, if the government started providing health care as good as the VA or Medicaid, people might realize that the government can be more competent than the market (again, as it is in every other country) and Republicans would be forced to change. Instead, I expect they will try to scuttle the bill and leave us with the status quo, the world's most inefficient health care system by a factor of 2.
It'll be a negotiation like you say, but between Democrats and right-wing/corporate Democrats, or between the more populist Democrats in the House and richer corporate Democrats in the Senate.
The irony, of course... (Score:5, Insightful)
Is that the House Democrats are essentially following the blueprint for Healthcare provided by Republican Mitt Romney in Massachussetts. So far, the Massachusetts model has pretty much worked, in that, they did reduce the number of uninsured significantly. However, costs for the state provided side of the plan have come in way more than anyone either promised or expected. Quite frankly, the expansion of the health insurance pool did not increase the economies of scale and drive down costs for everyone. Now everyone just has procedures that they cannot afford done.
The other irony is that Obama's said to be considering the McCain plan's idea of taxing health care benefits and requiring employers to purchase it.
Re: (Score:3, Insightful)
Now everyone just has procedures that they cannot afford done.
Most of my friends from work go to their doctor whenever they have a cold. Its fucking ridiculous and it needs to stop, but it wont stop until people take responsibility for their own.
Nationalized coverage wont help. It will make it worse!
Re:The irony, of course... (Score:5, Insightful)
Re:The irony, of course... (Score:4, Insightful)
Re:The irony, of course... (Score:4, Interesting)
You can cut down a lot of timewasting if it's in your interest to prevent waste of resources rather than maximise profits.
e.g. I know "antibiotics don't work on colds or flu" as I heard it on an NHS "commercial" on TV.
There's a call centre full of nurses telling people with colds and flu to get some rest and drink lots of water (dial 08 45 46 47 from a UK phone). The same information is online ("NHS Direct").
Then there's things encouraging people to seek help -- e.g. there's an advert on a bus shelter by the college near me, telling teenagers about chlamydia and how they can get a confidential test (and free condoms).
There's also billboards with messages like "a chest pain is your body telling you to call 999" [for an ambulance], and offering help to quit smoking, or diet advice.
Re:The irony, of course... (Score:4, Insightful)
Most of my friends from work go to their doctor whenever they have a cold.
Then your friends are idiots.
Nationalized coverage wont help. It will make it worse!
Nothing will ever stop idiots from being idiots. But this myth that if people are able to see doctors then they will swarm to the nearest medical clinic on a daily basis needs to be addressed. Look at places like the UK or Australia - what you're describing simply doesn't happen.
Going to the doctor is not a particularly fun experience. Sensible people only go to the doctor when there's a reason to. Common cold? Don't go - the doctor can't do anything. Food poisoning? Go - antibiotics will fix you right up. As another poster has mentioned (and numerous studies have shown), easy access to frontline health care ends up creating a lot LESS of a burden on the health care system as problems are diagnosed at an earlier stage when they are more easily correctable or preventable.
Cheaper system and a higher standard of living! What are you Americans so afraid of?
PS. I have experience with both the US and Australian medical systems. The Aussie (single payer, government) system is light-years better - faster, simpler, better care, and peace of mind.
What we really need are DMV like medical centers (Score:3, Insightful)
What you really need to have is a health care center that works more like the DMV does in Delaware. Basically, everyone goes in and gets a ticket. There are separate lines for separate things. you might have some nurse look at you and determine if you are obviously dying, and have a special line for that. Then, you have a line for people with colds and coughs and stuff, and so forth. You wouldn't need to schedule an appointment, everyone could walk in, just, if you walked in for a stupid reason, you wou
Fundamental difference. (Score:5, Insightful)
The question you have to ask yourself is, do you think access to health care is a right or do you think that it is just another commodity to be bought and sold. If you say health care is a right then you have to be willing to pay for everyone to have it, it will be expensive, very expensive. If you think it's a commodity then you need to admit that poor people don't deserve to see doctors, or deserve a substantially lower quality of care from understaffed and overwhelmed free clinics.
I happen to think health care is something society needs to provide to everyone equally. I know where the money can come from without raising taxes too. I have my eye set on the bloated defense budget. Cut the military fully in half (by dollars spent) and we'd still have the best armed forces in the world for DEFENSE of the nation and we'd have the money to take care of every sick and injured man woman and child.
There are other things we can do to reduce costs as well such as approve the use of drugs that are already available in Europe and Canada and have been proven safe, and reform the liability insurance system.
Orwellian language, as usual (Score:4, Insightful)
We see what you are doing here. Government provision of services, by definition, is the exact opposite of free market competition. When you take money from people by force and give it to others, that is NOT competition. Please stop saying that it is.
Do not be afraid (Score:5, Insightful)
First, it appears to requires universal coverage. This is good. I remember a long time ago when universal coverage was not the norm for automobiles. All these irresponsible people would drive around, damage other peoples property, and then not pay. What was more they often continued to damage other peoples property with little consequence. This meant that those who were responsible had to pay higher premiums. Now everyone has to have proof of financial responsibility. One consequence of this is that I can get coverage against the irresponsible motorist for very little money. The benefit of health care should be similar. No more irresponsible people going to the hospital without health insurance. This should mean that those of us who actually pay for medical treatment, instead of expecting others to cover the bills,
Second, there will be a public option. Auto insurance in many states has the same option. Most of us do not use the public option. Most of us still pay private firms to carry our insurance. The public option is used by those those who cannot or chooses not to afford private insurance. Sure this public option costs money, but not nearly as much as having some irresponsible asshole crash into your house in his SUV, then discovering he has no insurance or assets because all his or her income went to pay the note of the truck. Every uninsured person costs us money. The public option will insure that hospitals and doctors get some money for every patient, so they do not have to gouge the rest of us.
Third, and this is what I hope, that they reform payments and set standards for care. For instance, it make no sense to pay 80% of a standard cost for a procedure, when in most cases doctors charge double the standard costs. Pay 100% of the standard cost, and don't worry about co-pays. The co-pay is built in with real and opportunity costs. Likewise, set minimum standard for diagnostics. Hospitals are spending money on proton accelerators rather than prene care. We can live without proton accelerators and other machines that go beep. What we need is care.
And this is what I think many people are afraid of. That medicine is going to go back to giving care, rather than huge returns on investments for the HMO or funding for lavish and extravagant building and equipment that rich people can then put their name on because they paid half. Or, as mentioned, we might be concerned that in the US we have a higher infant mortality rate than Cuba or Hungary, the worst in the developed world.
Hell no. (Score:3, Insightful)
I've been paying for my own medical insurance out of my own pocket since I was 23, now 36. A few months ago, my automatically deducted premiums jumped from $290ish to $530ish a month. Why?
Because Medicare sent my HMO (Group Health) a message indicating that I was on Medicare, and so they automatically combined the billing, without notifying me. I'm not even on Medicare! I may get a refund in Mid-August... meanwhile, I'm scraping by, because I saved some money for emergencies... having this happen during my regular period of unemployment (MSFT contractor 'break') makes it extra painful.
Make healthcare more affordable, so more people will choose to have it. NOT mandatory, involving buerocrats that'll screw it up even worse. Offer tax incentives, etc to businesses to cover their employees, don't cram it as another effective mandatory tax.
How about this idea (Score:5, Interesting)
Let's require that whatever bill they propose, that all of the US government, especially congress & house, have to operate under that bill for one year before it can be forced on the rest of us. Whatever plan they currently have is gone. They are not allowed to work outside of their proposed system. They have to use only what their bill contains, and the funding has to come as a deduction (tax) out of their salaries. The money used to provide their health care services must come from whatever they paid in, and if (when) it runs out, nobody gets any more services until more funding is available. Also, any government employee who goes outside the system must declare it on some specified national forum, so we can know about its deficiencies before it takes effect on the rest of us.
This will show us if it is a viable plan, and that it is has enough money coming in so that extra funding is not hidden in additional taxes. Let's see how they like their own plan before we're forced into another stupid plan.
Re: (Score:3, Insightful)
Let's require that whatever bill they propose, that all of the US government, especially congress & house, have to operate under that bill for one year before it can be forced on the rest of us.
Or how about this? The congress already has single payer health care -- they get to pick from a list of premium plans from health insurers, and taxpayers pick up the tab. Since you want the congress to live with whatever plan they foist on us, we can go ahead tomorrow with the plan that the congress currently has -- government back private health insurance.
Re: (Score:3, Insightful)
Well, considering part of the plan is to let people keep their current providers, I'm sure that'd work just fine. Nice of you to assume the plan is stupid though.
The rest of the first world has national health care. They are healthier than us, live longer than us, and pay less than us. Stop believing the FUD that the Republicans are pumping out.
public vs private health care (Score:5, Insightful)
Here are the real differences between a single payer public health care provider plan and the hodgepodge private health care/insurance system we have now:
1) under a public plan, your health care is decided by a government bureaucrat sitting in a government office. While in a private system, you health care is decided by corporate bureaucrat sitting in a corporate office.
2) under a government plan you, or your employer would send hundreds of dollars in tax money each month to the health a agency to cover care. Under private plans, you or your employer must send hundreds of dollars each month to insurance companies each month to get coverage.
3) Under a government plan you a guaranteed coverage. You are not under private plans.
4) Under a government plans you are essentially covered for life. Under private plans you are limited in the number of claims you can make.
5) From what I have seen, government plans overseas control costs by focusing on preventative care and reward doctors who get patients to quit smoking and lose weight for example. Insurance companies in the us drop patients and increase deductibles.
6) Under a government plan, you and your doctor would have to fill out government paperwork to get benefits paid. Under the private system, each insurance company has it's own form to fill out which requires staff, meaning non-medical overhead, to proper fill out and file the forms in the proper manner.
There, those are are the real differences.
Basically, there are some problems the private sector is poorly equipped to solve. Medical care is one of them. Medical care is less of a free market choice and should be thought of more as an essential public utility. Market forces do not work very well do to the complexity of medical care and the urgency of catastrophic cases making comparison shopping impossible.
Not sure the US is ready for public healthcare (Score:3, Informative)
People just assume that free healthcare means everything stays the same except it's free. That's not true.
Granted, the healthcare I receive in the UK isn't bad. My local doctor definitely has room for improvement but my previous doctor was perfect. I just hope I don't have to deal with cancer in the UK. Despite probably being in one of the better areas as far as the whole post code lottery ordeal goes, it's always a concern I'll be told "tough luck, we're low on cash".
When I was in the US, despite not being jobless, the hospital and state government (PA) was actually quite helpful and I only had to pay a tiny fraction of what it would have cost. Even for someone in a transitional job, which was low paying, it was quite easy to pay off. Certainly better than the $20,000+ I would have had to pay if I didn't seek help from the state and hospital.
My case might be slightly biased since I was in a decent area of the state and the hospital doesn't deal with a load of poor people begging for free care but even with free healthcare, being in a poorer area of the UK can mean not getting a treatment someone else would get in a better off area.
I just hope people realise that neither system is perfect and going to free healthcare will not solve everyone's problems.
Negative feedback failure (Score:4, Insightful)
The problem with the US health system is that there is no negative feedback of any sort to control costs. Places like Massachusetts actually made it worse because the state has become the policeman for the insurance industry. I have heard comparisons of health insurance and car insurance. A car is optional. Health is only optional if you are dead.
Another point people are confusing is health *care* and health insurance. They are completely different beasts (even though they overlap a bit).
I believe most people (in congress) who preach free markets have no idea that a free market system should have some negative feedback somewhere in the loop. The few proposals which have cost controls will not make it anywhere (sigh).
Pass... not that it matters. (Score:4, Insightful)
In an ideal world, I'd like to see all health care spending be tax deductible. If my employer wants to spend money on insurance for me, great. If my employer wants to put money in an interest-bearing health account, like a 401k or something similar, so much the better, provided it's portable from job to job. Heck, if my employer just pays my bills directly - sweet! Let them earn their tax credit either way, and if I choose to do the same, well, let's encourage that, too. It'll never happen, though, especially if this bill gets passed. Besides, all of the market-based innovation in payment methods in the world isn't going to change one basic, simple fact:
Health care is scarce.
There is a finite supply of people willing and capable of being doctors and, due to generational constraints (fewer people in the younger generations than during the Boomer generations), there are fewer and fewer of them than there used to be. Meanwhile, more and more people are consuming more and more health care. This isn't just a case of the Baby Boomers getting older, though that's a big part of it. The other part is that the health care industry can do far more than it could in, say, 1950. In 1930, if you had an infection, they gave you sulfates and told you to start praying. Nowadays, we have books that list nothing but types of antibiotics. We can transplant organs, cure most kinds of cancer if we catch it soon enough, cure nearly any imaginable infection, and on and on and on. If I get an ingrown toenail now, I see a doctor (possibly even a podiatrist - specialist rates!). If I got an ingrown toenail in 1930, I probably would have grabbed a bottle of whiskey and a pocketknife. Simply put, the health care industry can provide far more services than it could years ago, increasing demand, while also seeing fewer and fewer people willing to provide the services. As long as that dynamic is true, it won't matter how we pay for health care. If we try to make it cheap, there will be increased scarcity, which means longer waits for procedures. If we try to make it plentiful, such that nobody has to wait, it will be expensive. That's just the way it is.
If you really want to make health care affordable, you need to loosen up who provides non-emergency health care. This might involve getting nurses involved, but they're nearly as scarce as doctors right now. This might involve robots - heck, Japan's been playing with them in health care for years. This might involve computerized quizzes - fill in some blanks (I have the sniffles but I don't have a fever) and receive a diagnosis (You have a cold or mild allergies). In short, think of it sort of like IT. You don't need to throw a CCNA or MCITP/MCSE at every infected workstation - why should you throw a doctor at every minor ailment? Yeah, I know - when you're holding a hammer, every problem looks like a nail, but there's some wisdom here.
In the end, no matter how you shuffle the cards around, it will never change the fact that, as long as health care is as scarce as it is (and there's no reason to suggest it won't be anytime soon), it will be expensive, one way or another. There isn't a Republican or Democrat sponsored piece of legislation in the world that will ever change that.
Some people who CAN afford it, can't get it! (Score:5, Insightful)
My COBRA coverage got pulled at about the 1/2 point because my old company was small and both of the spouses had coverage, so at the annual renew time, they just stopped offering health.
After talking with an Insurance rep that I have used for company insurance at a few places, it became clear that my family and I would NEVER get personal health insurance. Currently, I suffer from chronic foot pain (for the past 6 years), my oldest son suffers from depression and bi-polar disorder (for the past 4 years), and my wife gets migraines (from childhood). You can see why an insurance company would not want to touch us, but we still need insurance.
As my COBRA ran out my agent tried to get us on a temporary plan. We know that if we claim the meds that my son and I require, $2,000 to $3000 a month, we will also not be allowed to re-up the temp plan. We decided that we would not claim any of the chronic things that we have to deal with so that we have the plan if we have a major issue, but once we do, we no for sure that we will not be allowed to re-up.
For the temp plan we went with a carrier that haven't been covered by for over 12 years. But we were denied coverage by this carrier because they had on record that...
1) My wife had been treated for headaches.
2) One of my 2 sons had been treated for a sore throat.
OVER10 YEARS AGO!!
Those 2 reasons were all that it took to deny even temporary coverage.
We had to find a carrier that had never insured me and my family before just to get temp insurance.
We are still looking for a permanent option, but as we do our savings are being drained rapidly as we try and cover our ongoing issues. We need to minimize claims to preserve our temp insurance in case of a major issue. Because of that none of us are getting any ongoing treatment, so no one is getting any better. Were stuck with little chance at improving medically, and at this point we have not found an insurer who will offer us insurance at any price.
If you have now, or have ever had anything more that a minor medical issue, your chance of getting coverage as an individual are effectively 0%
I have been looking for work for 2 years, sending out, and following up on at least a dozen job openings ever month (12 is my self imposed min). While the economy is bad I have no idea if I will be able to get a job, and while I am in this catch 22 I am spending more and more of my time trying to find coverage.
In the mean time, I have one of my cars for sale, family jewelry is listed, and while our house is not under water, real estate is not exactly booming either.
I dunno. Does my government really want me to be broke, unemployed, and perhaps homeless, before I can get health care for my family?
Or can they come up with some way for people to purchase coverage, to allow them to get healthy, before they loose everything?
Re:Stupid... (Score:4, Insightful)
So, yes, fixing health care is a plausible means to repair the economy. It is entirely possible to fix two interrelated problems at once. Whether it is an economic issue is not really in question, given the size of the healthcare industry in the US. You might dispute the efficacy of a national healthcare plan, but it'll still have an economic impact one way or another, and President Obama has made it clear in previous statements that he believes that fixing the U.S. health system will have beneficial economic effects.
Re:Stupid... (Score:4, Interesting)
They get government jobs denying or delaying medical procedures they deem unnecessary or low priority.
Re: (Score:3, Funny)
Slashdot formatting (TM)
Re:Great quote... (Score:5, Insightful)
Canada has "socialized medicine" and they spend 10% of their GDP funding it. The USA has a tangled hodgepodge of insurance companies that deny valid claims, overpay their CEOs, and refuse any coverage of any pre-existing conditions, and they spend 15% of their GDP funding it, while also bankrupting countless families without enough insurance. Great Britain has the National Health Service, and they spend 7.5% of GDP funding it.
Tell me how the US can't do better than Canada and England. No really, how could we suck badly enough to be worse than Canada at national health care?
Canada has a single payer system (Score:4, Insightful)
Re: (Score:3, Insightful)
Canada and England do not have our malpractice litigation mentality, which raises costs as doctors practice "defensive medicine". Neither has the high costs of introducing new medications associated with our FDA, which results in the same pills being substantially cheaper in Canada than in the US. Both offer lower quality service, with rationing, and less access to innovative procedures. The problem with a state run insurance plan is that that the state has never made anything more efficient. Ever. It's rea
Re: (Score:3, Interesting)
Re:Great quote... (Score:4, Insightful)
The problem with a state run insurance plan is that that the state has never made anything more efficient. Ever.
Yeah! Retirement savings were so much more efficient before Social Security! Sure, it meant lots of old people ended up begging on the streets, but those people didn't have any money by then, so they didn't count against the efficiency!
Re:Great quote... (Score:5, Insightful)
The reason pills are cheaper in countries with socialized healthcare systems is that that the power is in the hands of the very large single buyer. If a pharma wants to sell a drug in significant numbers in Britain they have to negotiate an acceptable price with the NHS. If the NHS doesn't buy, then they'll sell very few of the pills in Britain.
In America, there are countless buyers. Thus a single buyer has little price negotiation leverage.
That's easy. Health company profits are the elephantine waste in the system. The idea of charging "what the market will bear" rather than the lowest possible.
It's astounding to me that right wing Americans object to the governent taking over healthcare on cost grounds when ALL the evidence from other countries is that no one else pays as much for their healthcare than Americans do currently. You HAVE the most expensive system already, you have nothing to fear on cost grounds from learning lessons from the rest of the world.
Re:Great quote... (Score:5, Insightful)
Yes, but the reason that health care costs are so high in America is that we have the best quality of health care in the world.
You are right, King Hussein of Jordan will come to America for surgery, because we have facilities that offer among the best available care in the world, and they will be happy to take care of King Hussein.
But to say the country has the "best quality of health care" is extremely misleading; that high quality health care may be =offered= in America, but most actual American's don't actually get it when they need it.
What exactly is the value of having high quality health care that you can't actually use?
America still produces fine crafted hardwood furniture too. But most people's homes are furnished with ikea and other particle board and plastic shit. The fact that high quality furniture is available in the country doesn't mean simply being in the country will get you some. Ditto with health care.
Now, I'm not railing against the existance of private health care. If King Hussein wants surgery, he should be able to get it, and there's no reason it shouldn't be in America. But so what? We should still have socialized care too.
Why exactly should serving the worlds rich and famous the best care in the world mean that half the country has no health care at all?
Re:Great quote... (Score:5, Interesting)
Wrong. When German Railways (Deutsche Bahn) was still state owned, the trains were always on time, there were many more connections, the fares were lower and easier to understand and the trains and tracks were better in shape.
Now Deutsche Bahn is a private company. Trains run notoriously late (often because the trains are damaged or the tracks are in the sore need of repair), many connections are inoperative, the prices soar.
I never have seen a high speed train being evacuated in the middle of nowhere because of some motor damage in the early nineties. I had to live through it twice last year.
Re:Great quote... (Score:5, Insightful)
Both offer lower quality service, with rationing, and less access to innovative procedures. The problem with a state run insurance plan is that that the state has never made anything more efficient.
Bullshit. We have lower life expectancy than they do in Canada, England, France, Germany, Spain, Italy, Japan, Australia and virtually any other first world nation you care to name. We have higher infant mortality than any of those nations. And yet, we're paying twice as much.
Governments all over the world are taking much better care of their citizens than we are, and are doing it for less money. Do you really believe that we can't do the same? Do you really think that we're just worse than them?
Re:Great quote... (Score:5, Informative)
The infant mortality statistics are skewed for various reasons. They have to do with what we report as a "live birth" vs. what other nations report.
For example, in Canada, a premature baby that is delivered, and then dies, that weighs less than a half a kilogram is not counted against the live birth count.
There is also the matter of timing. In Hong Kong and Japan, a baby that dies in the first 24 hours of life is not counted against the live births. They consider it a miscarriage. In France, Belgium, and many other European countries, babies born before 26 weeks of gestation, and then die, are not counted as deaths.
In Switzerland, a baby that perishes that is also less than 30 cm in length is not counted.
Needless to say (for the illustration of my point), the U.S. does count these as live births, and the deaths in such cases count toward the relatively higher infant mortality rate. In the types of cases above, the chances of infant survival are sketchy at best. Thus, the disparity in infant mortality rates.
Re:Great quote... (Score:5, Insightful)
Re:Great quote... (Score:5, Informative)
* Anderson, Gerard F., Peter S. Hussey, Bianca K. Frogner, and Hugh R. Waters. "Health Spending In The United States And The Rest Of The Industrialized World." Health Aff 24, no. 4 (July 1, 2005): 903-914.
Re:Great quote... (Score:5, Informative)
Re:Great quote... (Score:5, Interesting)
Bad news: your 15% figure is out of date. We're now spending 17% of our GDP on health care, and if the trend of the 2000s continues, we'll be at 30% by 2020.
Unfortunately, the Republicans will oppose any type of health care legislation, because the truth is that they don't think anything's wrong. Most won't admit it, or will make the wholly unsubstantiated claim that malpractice insurance is the only thing wrong with our system. This is despite the fact that all estimates put tort at least than 0.5% of our health spending. Of course, while the effects of 'defensive medicine' are tougher to estimate, there's fortunately empirical proof showing that it makes no difference. Texas has the strictest malpractice tort limits in the country (you can get at most $250k, even in cases of gross negligence causing permanent disability or death), causing malpractice claims to plummet, yet their health spending increases have continued to outpace the rest of the country in the six years since it was passed. So much, in fact, that Texas now spends more than any other state for decidedly mediocre results. Essentially, it's a microcosm of the U.S. as a whole.
There was a great article [newyorker.com] in the New Yorker a few weeks ago wherein a reporter visited McAllen, Texas, home of the largest health care spending in the world. What he found was a perfect example of what we see across the country: when doctors treat their practice as a revenue generator, costs go way up, and quality actually suffers. The doctors think that they're doing their best for their patients, but they subconsciously make more referrals when it brings in money. It's long, but it's definitely worth the read.
Re:Great quote... (Score:5, Informative)
* Anderson, Gerard F., Peter S. Hussey, Bianca K. Frogner, and Hugh R. Waters. "Health Spending In The United States And The Rest Of The Industrialized World." Health Aff 24, no. 4 (July 1, 2005): 903-914.
Re:Great quote... (Score:4, Interesting)
As someone who knows many doctors, I will tell you flat out that if that figure includes malpractice insurance it's either a flat out lie, or product of ridiculously bad methodology.
Or maybe you shouldn't rely on the anecdotal testimony of a small group of people who make up only one part of the sizable cost structure of the whole health care system? Even if there was something wrong with the study (which you only stated, but did not demonstrate), how do you attribute the negative correlation between malpractice caps and health spending?
Re:Great quote... (Score:5, Informative)
Define "better". According to a recent Lancet Oncology study (http://www.telegraph.co.uk/news/uknews/1560849/UK-cancer-survival-rate-lowest-in-Europe.html [telegraph.co.uk]) for males the average cancer survival rate in the UK is 44.8%. Compare to 66.3% in the USA for the same period. The US has the highest cancer survival rates in the world, and by a pretty large margin. That has to be worth something in your metrics of "better". I do not go to the doctor for social justice, I go to the doctor to get medical problems, say cancer and cardiovascular disease, fixed. The US is tops for fixing medical problems even if the system surrounding that medicine is a wreck.
Discard all the policy issues and ask yourself one simple question: what country will give me the best average statistical odds of having my condition cured/fixed? The US looks very, very good by that metric, and the reason people go to the doctor is to get cures. The medical system may be a wreck, but that is a semi-separate issue and I would be reluctant to throw away stellar medical outcomes as the price for cleaning up a broken system.
One of the more interesting statistical anomalies is that if it was not for the extremely high death rates due to accidents (e.g. vehicular) and homicides, Americans would have the longest lifespans in the industrialized world instead of average ones (better medical outcomes offset high non-disease death rates). As is amusingly observed in health outcome statistics, the only demographic group that lives longer than Japanese women are Japanese women that live in the US. It is a relevant observation in this discussion, many people here are far too eager to throw out the baby with the bathwater.
Re:Great quote... (Score:5, Informative)
You are comparing a single data point...
USA has great cancer research facilities, like National Cancer Institute. Which sponsors trials of about two-thirds of all approved drugs. Oh, and it is funded by the government, not private industry.
Re:Great quote... (Score:5, Informative)
Rather than looking at a single disease statistic I think it is more instructive to look at overall average life expectancy. I let the numbers do the talking [indexmundi.com].
Re:Great quote... (Score:4, Interesting)
The US has the highest cancer survival rates in the world, and by a pretty large margin. That has to be worth something in your metrics of "better".
Well, duh! That's where the money is.
The overwhelming majority of health care expense in the USA is in the last 6 months of life, often after there is little question that no matter what is done, the patient is gonna die. Patients are typically guided into increasingly expensive treatments without any meaningful discussion about the quality of life of those final few months. It is not as bad as all the doctors consulting with each other over how to wring a few dollars more out extending Joe Smoker's life another 3 weeks. But it is much closer to that extreme than telling Joe "Hey you don't have much longer, and in 3 months your going to feel really bad no matter what we do, so now is your last good opportunity to take that Summer-long fishing vacation you've been promising yourself the last thirty years. When you get back, we'll see what we can do to make the last few weeks as comfortable as we can."
No, USA health professionals don't know how to have that conversation with a patient as a general rule. The general attitude is that it is much better for the patient to keep him hopeful that this treatment or the next can keep him going for a good long time. That this is also more lucrative for the doctors and the health care institutions is purely a side effect (according to the doctors and the health care institutions, and they do say we should trust them about this kind of thing).
Re:Great quote... (Score:5, Informative)
I am a 45 year old Canadian and no one has EVER told what doctor I may/may not see.
It has never been mentioned or hinted at by any of the doctors I have seen or by any government bureauocrat.
I call B.S. on your claim.
Re:Great quote... (Score:4, Insightful)
Re:Great quote... (Score:5, Insightful)
And if you can't afford it, you can take yourself a medical vacation to a country where you can. The important thing is that, here, we don't ration our healthcare.
Because if you can't afford healthcare, taking a flight to foreign country and taking days or weeks off your job is obviously within your means! (And I'll bet this is a *great* solution for getting preventative care too!)
Oh, crazy right wingers... One wonders if you ever even talked to someone who is a member of the working poor.
Re:Great quote... (Score:4, Insightful)
One wonders if you ever even talked to someone who is a member of the working poor.
Talked to - quite likely. Listened to - ...
Re:Great quote... (Score:4, Insightful)
RS
Re:What 'Better' Means For Right Wing People (Score:5, Informative)
If you really think most people, conservative or otherwise, actually hate people who are poor, you've been completely brainwashed.
It's the liberal equivilent of calling everyone who disagrees with you unpatriotic.
Re:Great quote... (Score:5, Funny)
The problem with Margaret Thatcher is that she is always wrong.
Re:I'll go ahead and say it (Score:5, Insightful)
I ain't registering for a goddamn thing
.
In the glorious and free country of the United States a citizen's decision to register for government-mandated healthcare is absolutely and completely voluntary.
Being forced to pay for those that do register, however, is another story.
Re:I'll go ahead and say it (Score:4, Informative)
Re:I'll go ahead and say it (Score:5, Insightful)
Any time an unpopular social program is established, the government tries to sell it under "special" tax provisions, e.g. only those that enroll have to pay.
Once the issue is mostly forgotten, the program inevitably merges with general government spending and starts drawing money from the general tax pool (e.g. your and my tax dollars).
This ALWAYS is going to happen for a simple reason: if everyone who wanted to enroll in the program could afford to pay for it, there would not be a need for a program in the first place. The sole reason for it to exist is to get those who don't use it to pay for those that do (that is the concept of welfare).
NEVER vote for a program on the basis of it having "special" tax provisions such as pay-as-you-enroll. If you are not willing to accept a government program under the understanding that it will be paid for with general tax dollar's, don't vote for it at all, since that is inevitably what is going to happen after a while.
Re:I'll go ahead and say it (Score:4, Insightful)
Re:I'll go ahead and say it (Score:4, Insightful)
Re:I'll go ahead and say it (Score:4, Informative)
Re:I'll go ahead and say it (Score:4, Insightful)
One has to wonder if Canada benefits disproportionally because the research for their healthcare (Drugs, methods, etc) is primarily bankrolled by the companies in the United States.
Re:I'll go ahead and say it (Score:4, Insightful)
USA drug companies do research to make money. They'll happily take Canadians money.
The question you should be asking is WHY the same drug can be so much cheaper in Canada vs the USA? Why are drugs so much more expensive in the that bastion of free enterprise? Why do USA drug companies spend more on marketing each year than on research? Most of this marketing is illegal in Canada so they don't waste as much money on marketing in Canada. Canada doesn't have huge private health insurance companies skimming huge profits, denying claims, and thwarting doctors from using what they feel is the best treatment. Why does virtually all health care cost more in the USA? Why does they USA spend MORE per person on healthcare yet still lag behind Canada in almost all indicators of health care like infant mortlity, and longevity?
Why do many USA citizens still want a good chunk of their health spending to be taken by private insurance companies?
Re:I'll go ahead and say it (Score:4, Interesting)
Something else that is popular in Canada is wait insurance. People are signing up by the truck load and most Canadian insurance providers offer wait coverage. In case you don't know what that is, it's where they guarantee the wait for procedures will be under a certain time or they take you to another country if necessary and have the procedure done there.
And yes, this was brought before Canada's high court because Quebec attempted to enforce it's no private insurance laws and the court said it was a fundamental human right to have the coverage because the lack of it would endanger the lives of the people it serves.
Don't sit there and sugar coat government health car as if nothing is ever wrong with it and everyone is satisfied with it's results. Obviously enough people aren't otherwise there wouldn't be a need for wait insurance and there wouldn't be a market so profitable in it that they took it all the way to the highest court in Canada or that every other insurance provider has a plan that covers wait times.
Re:I'll go ahead and say it (Score:5, Insightful)
Re:I'll go ahead and say it (Score:5, Insightful)
Re: (Score:3, Informative)
Canada has a completely-free universal national healthcare system.
It is also a country where...
The average life expectancy is two years longer than in America [unitednorthamerica.org].
maybe it is because they are poor ? (Score:4, Interesting)
and your medieval healthcare system practically KILLS poor by neglect, or treatment that arrives somehow too late ?
Re:I'll go ahead and say it (Score:5, Insightful)
Now ... repeat after me ... correlation does not equal causation.
I don't believe I said it did. However, if you're going to complain about how awful Canada's national health plan is, you had better deal with the fact that, awful health plan or no, they live two years longer than Americans do. That "rotten" health plan, which costs on the average about half what Americans pay for health care, doesn't seem to be producing worse results.
Re:I'll go ahead and say it (Score:4, Informative)
Which works well, and is thus the target of right-wing wackos bullshit-filled attacks such as this one:
Bullshit. Every procedure that is urgent is performed as fast as possible. The wait may be longer than in the US, but that’s because we do not discriminate in favour of the rich, everyone is on the same footing up here.
Bullshit again. Life-threatening conditions are treated right away. This is why the morons who come to the emergency room with a headache have to wait 15 hours: they pass the urgent cases before them.
More bullshit again. The prescription is given right away, and the pharmacist takes care of the coverage.
That troll does not clearly understands how a doctor works. And in the US, the doctors have to take as much cases as possible, thus making it much more likelier that they’ll only spend 2 minutes per patient.
This is called CIVILIZATION, as opposed to the barbarity that is so common in the US.
Re:I'll go ahead and say it (Score:5, Insightful)
Re:I'll go ahead and say it (Score:4, Insightful)
Re:I'll go ahead and say it (Score:4, Insightful)
Part of the rationale behind Social Security is that people are too stupid to voluntarily put away their money.
The number of bankruptcies and foreclosures that took place over the past year should be sufficient to confirm this.
I don't like paying for irresponsible people any more than you do. However, the societal cost of widespread poverty would be far greater than the cost of the social security tax. Once again, the current economic kerfuffle is a perfect example of how the irresponsible decisions of a few have lead to the suffering of a great many.
Re:I'll go ahead and say it (Score:4, Insightful)
It's unpopular among the younger people who can see that there likely be nothing left in the system by the time it's their turn, but among older people it is extremely popular.
The 55+ year old portion of the population is what has primarily stopped social security reform. They happen to be a very large voting block, and it is hard to get past them. The people in this block either are currently drawing social security or will be drawing it soon, so they certainly don't want to remove it. Also, people in this category tend to be more active voters than other categories, so even politicians who may otherwise be amiable to removing or revamping Social Security won't dare touch the subject.
It's a self perpetuating problem; more people are drawing social security than can be supported by the younger workforce. These people rely on it, and so will adamantly fight anything that jeopardizes that income (imagine if the government tried to slash your paycheck, and how adamantly you'd fight that, it's the same from their perspective). Combine them with idealogues who can't see past their ideology to see that the system is unsustainable and WILL crash at some point in the near future, and you've got a voting base that is nigh unsurmountable.
The fact is, there are more people who are pro Social Security, at least more people who vote anyway, than there are anti Social Security. This is pretty much the definition of Popular.
What we need is a welfare reform that fixes the problem without harming the people who currently rely on the system, or those who are currently expecting to be able to use those funds in the near future.
I believe it is doable, but a plan hasn't so far been presented in a way that it reassures the people at the highest risk.
Re:I'll go ahead and say it (Score:5, Insightful)
Re:I'll go ahead and say it (Score:4, Interesting)
Re: (Score:3)
Re: (Score:3, Insightful)
Re:give me a break (Score:5, Insightful)
Economics IS a difficult subject to understand, let alone interpret correctly. Even professional economists who do nothing but study the economy often get things wrong. Yet, everyone talks about the economy as if they are the expert and they actually know what's going on, even if they've had zero education on the subject.
Re:give me a break (Score:5, Insightful)
Re:give me a break (Score:5, Insightful)
Thus, we get grotesque situations where, in order to avoid charges of "socialism" government functions are essentially "laundered" through private sector intermediaries that take their big fat cut and, all too often, deliver seriously subpar results. We would be much better off if we abandoned that charade and, instead, let the state attend to state functions, the private sector attend to private sector functions, and avoided the incestuous interrelations of the two.
Re:give me a break (Score:5, Insightful)
It's a huge pity, really. We in the US are far better at being anti- or pro- state than we are at being anti- or pro- free market.
Thus, we get grotesque situations where, in order to avoid charges of "socialism"...
Most US Americans seem to have no clue at all about what socialism or for that matter communism actually is. Every time they start throwing those words around on Fox News, accusing their various political opponents of being "socialists", it makes me laugh.
Re:give me a break (Score:5, Insightful)
If I am sick, how is that your problem, and what right do I have to force you to pay for my doctor's bills so that I can get well?
You don't. However, most people do not know in advance if they will someday require a million dollar medical treatment. Therefore, it is to their advantage to pay a flat fee into a huge risk-amortization pool managed by US government. To avoid ethical questions about government's use of force, let people opt out of the pool and stop paying any related taxes. However, they will then have to rely on their own private hospitals for treatments, even in emergency. And organ donations made to public system will not be available for private transplants. Let them see if resources of 10 million mega-rich people can buy more MRI machines than resources of 300 million not-so-rich people. And rejoining the pool will not be easy/cheap as it's not fiscally sound to let people join the insurance pool only when they get sick.
So hard-core libertarians get to die on the road after a car accident, knowing that nobody forced them to pay taxes for a public ambulance service. And the rest of us, who think that government services are for emergencies such as fire, disaster relief or cancer and private sector is for extras like iPods, dining out or plastic surgery, get to have some peace of mind.
Canada is fine despite what you've heard. (Score:5, Insightful)
"I disagree only partially here. If you kick out private insurance entirely then you get some of the horror stories Canada grapples with. "
Oh please. I don't know what you've heard but it's probably on the order of the things we hear about the states, that is, if you walk any street at night you'll be mugged there.
I've in the states for a decade and the rest in Canada. There simply is no comparison. It's overpriced lunacy down there, the embarrasment of the world.
I'm sure you can find people that feel hard done by by the Canadian system. And for each of those there are a plethora of problems with the American system. It's so bad poeple makes movies about it.
Last year in the US the health sector spent $3.4 Billion lobbying, the only sector that spent more was the finance sector. That's 5X than defense lobbyists. They don't want to kill the gooose that lays the golden eggs.
Cite: http://www.opensecrets.org/lobby/top.php?indexType=c [opensecrets.org]
Re: (Score:3, Insightful)
Also, bear in mind that the readership of this site is heavily skewed towards males age 18-34 with a college education (or attending college now). These people will have proportionately far fewer medical issues than the population at large, esp. the poor and elderly. Many here probably take no medication at all (except perhaps recreational), and haven't been inside a hospital for years. So from their perspective, what good is government-guaranteed health care? But the perspective may change as they gro
Re: (Score:3, Informative)
well. there is one thing in economics that is rather clear. profit.
if ANY private organisation is involved in your healthcare you will pay (a lot) more than in actually costs. hospitals, insurance, medicines. you'll pay (a lot) extra to make the shareholders happy.
see. it isn't that hard to understand.
Re: (Score:3, Insightful)
Re:Socialism - Good on Paper, Not in Reality... (Score:4, Informative)
Re:Socialism - Good on Paper, Not in Reality... (Score:5, Informative)
Because under a socialist government everyone gets paid the exact same averaged dollar amount per year regardless of what job they do and how good/efficient they are at it right? No one is advocating that kind of system, not even the real socialists nutcases [cpusa.org].
What you described is not socialism or socialist policy and it's intellectually dishonest to call it so.
Re: (Score:3, Insightful)
Then he sent all of them this note: "A socialistic government will also ultimately fail - because when the reward is great, the effort to succeed is great, but when government takes all the reward away, no one will try or want to succeed."
Actually, the real lesson is that a socialist government will fail when you let a tinpot dictator practice collective punishment to advance his own political agenda as happened in the USSR under Stalin but didn't happen in Sweden under a democratic government. This is really more of a fable about college professors pushing an agenda and punishing students' grades when they disagree.
Re: (Score:3, Insightful)
Yeah, spending all the money you decry, spent in the 12 YEARS of Bush, being spent in the first three MONTHS under the current administration is however enlightened and useful.
You *really* need to get caught up.
If the congress and the PolitBureau really wanted to pay for hospital services, they would pay the "going rate" of hospitals. Instead, they pay $36 for a $500 procedure, causing hospitals to charge $8 for aspirin. Congress is WHY the system is broken, not the cure.
The plan is to crush as many indust
Re:they did not know how much the plan would cost (Score:5, Interesting)
Short answer: there's no easy fix. Medical costs are rising for several reasons:
* Rising costs and quality of medical care (30 years ago there were no MRIs, hip replacements).
* Corrupt doctors, ordering tests because they are profitable (read the article, it goes into great detail on that point)
* Corrupt insurance agencies (sometimes charging 30% overhead)
* Incompetent government (a point which you outlined)
* Clueless patients wanting every possible test (I can't blame them for this, it's not like we have medical degrees) and not taking care of themselves (Safeway for example managed to reduce health insurance costs by 40% or so by encouraging their employees to take care of themselves)
* Oh yes, and how can any such list be incomplete without including pharmaceutical companies and medical lobbies? Many problems there.
I'm sure I'm missing some. The good news is with all these problems, there is lots of room for improvement. The bad news is that these problems exist, and the path to fixing them isn't entirely clear. I am not sure that I favor this bill, but I think it is good we are having a debate about it. We should have had this debate 10, 20, or 40 years ago.
Re:they did not know how much the plan would cost (Score:4, Informative)
And also in the Wall Street Journal, here [wsj.com] is an article about Mr. Burd, of Safeway, going to Washington to lobby regarding how the market can rein in costs:
Re: (Score:3, Insightful)