Universal Health Care Reform in the United States [Archive]

Mark in Oshawa

13th August 2009, 06:46

Steve, the bill is over a 1000 pages long. No one has read the damned thing, and like all the legislation Obama has tried to bring in, they wont give the general public any time to figure it out either.

Furthermore, Obama in his speech before a friendly audience in Boston asked why people were so scared of government agencies? He said the private sector will still compete, just like the Post Office competes with UPS and FEDEX. Now think of just how STUPID the man is for saying that. The US Postal Service is infamously inefficient and loses money while not delivering packages and mail as fast. So if the new reformed government healthcare system is the post office, is he saying this new Government supported healthscheme is going to be that badly run???

The rage you guys are seeing is being framed by a media very eager to portray these people as dupes. They are not, no more than the anti-war people protesting Bush were dupes. They have legitimate concerns. 50% of the American people have no faith in any government healthcare. Those polls are not lies, watch the news and then watch the spin.

The US healthcare system is a mess, and I do agree that many people may not be really grasping the holes in the system, but what the people protesting don't want is rationed healthcare and they don't want to pay for illegals to get healthcare (funny how the government is going to deny that one when you know they have been dying to screw the legal citizens with all the costs of illegal immigration).

Furthermore, the people wanting this besides the Dem's and Obama are the big pharmaceutical firms, the tort lawyers, the AARP (they would be able to sell their drug plans to the 50 million people not covered and get the money FROM the gov't.)and all those people believing government knows best how to ration out healthcare. None of these people are on anyone's top 10 list of groups of people trusted by the general public.

Americans are not stupid. They know Canadian Cancer death rates are up because we have to wait longer for access to the testing to discover the cancers. They know that most of the people not covered currently either are young and choose NOT to pay, or people who would just as soon have the government give them care. Most of the truly poor get healthcare coverage in the US now. Mass has it, and is going broke. Ditto with NY. The US Economy is Broke and now this guy wants to spend a trillion?

Even if you think some form of socialized healthcare is required, can you see how the US gov't and economy can absorb the cost of it? No...so why is there a sudden rush and the general public is being left in the dark?

You try to bully people and ignore their concerns, you create the feeling you ARE hiding something. If Obama cant figure this out, than too bad, because the rate he and that idiot Pelosi are going, the Republicans will be running the show in 4 years....

Brown, Jon Brow

13th August 2009, 13:29

What is your point?

My point is, do Americans really believe that a reform to their health care system is really going to turn the nation into a socialist one?

Brown, Jon Brow

13th August 2009, 13:43

This made be giggle.

http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877

“People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless,”

What are they on about? Steven Hawking is British! And has said the if it wasn't for the NHS he wouldn't be alive. (The article now has been corrected as the editor realised that they couldn't tell lies and get away with it.)

steve_spackman

13th August 2009, 17:11

steve_spackman

13th August 2009, 17:15

Americans are not stupid. They know Canadian Cancer death rates are up because we have to wait longer for access to the testing to discover the cancers.

Americans are stupid to make the Canadian system the best example of socialised healthcare..

BTCC Fan#1

13th August 2009, 18:31

My point is, do Americans really believe that a reform to their health care system is really going to turn the nation into a socialist one?
I've just watched a video of a grown woman crying at one of these 'Town Hall Meetings' because she "doesn't want America to turn into Russia".. The sheer amount of ignorance, intolerance, and general misinformation flying around about this issue is incredible.

Wade91

13th August 2009, 18:43

having health innsurance is of cource a very smart choice, but people shouldn't be forced to have

schmenke

13th August 2009, 19:26

DexDexter

13th August 2009, 21:09

So if no one has read the bill, then where are they getting all this nonsense from??

As for killing off the old.

My grandmother is in her 80s. She was diagnosed with lung cancer last year. She saw her doctor..then was sent to a specialist..(didnt have to wait by the way) and got all her treatment and medication all at no cost to her....

So much for the NHS killing off the elderly...

Free government-provided health care for all can work, at least in small countries. We here in Finland have it and we have, for example, one of the lowest infant mortality rates in the world. I couldn't imagine people here accepting a situation where somebody would not get treated because he/she didn't have an insurance. But the US is so huge, can they afford free health care for everybody?

janvanvurpa

13th August 2009, 21:49

Free government-provided health care for all can work, at least in small countries. We here in Finland have it and we have, for example, one of the lowest infant mortality rates in the world. I couldn't imagine people here accepting a situation where somebody would not get treated because he/she didn't have an insurance. But the US is so huge, can they afford free health care for everybody?

The question is rather "can we afford not to?"

The cost of insuring just the choicest, those generally young who need generally less, and the elderly and premature babies is already twice as expensive as most of the civilized world.

The opponents repeat their cliches "I don't trust the gubbymint.....' but that implies they have faith that the for-profit corporations who hire low wage minions in some warehouse reviewing and approving or disapproving procedures, or worse, a computer program, will do a better job.

It is folly here.

Via motorsport, I have had a chance to be treated for identical injuries in Sweden, France, UK, California and Washington State.
I have just had----after 12 years of fighting---2 spine operations related to the stresses from racing from 40-30 years ago.
12 years of dead ends, can't do it, "take it easy" , "try asprin" "try physical therapy.
None of that helps crushed discs and smashed nerves.
12 years of "the Best health care in the World" according to the armchair/keyboard experts.

What was the cost of lost production for 12 years?
Near disability for 12 years?

The difference between systems is one thing, the randomness of treatment is another.

ALL the systems depend on somebody listening.

When was the last time a Corporation listened to a complaint and did something that costs them money?

Drew

13th August 2009, 21:55

It's incredible to think that judged by how much is spent by the federal government each year doesn't give everybody in the USA universal health care.

steve_spackman

13th August 2009, 21:56

Well said janvanverpa couldnt of said it better myself

steve_spackman

13th August 2009, 21:59

http://news.bbc.co.uk/2/hi/americas/8198084.stm

http://twitter.com/#search?q=nhs

Tomi

13th August 2009, 22:24

But the US is so huge, can they afford free health care for everybody?
Dont see why the countrys size should matter, there is much bigger population who would pay it aswell.

schmenke

13th August 2009, 22:25

I know it's a simplistic argument but I can't help but think that if the U.S. would divert only 1% of their annual ~$1 trillion in military spending to national healthcare, that would provide $10B :mark:

BDunnell

13th August 2009, 22:29

You're obviously baiting the question. Few have had the opportunity to read the entire bill (1200 plus pages, when was the last time you read 'War and Peace' and then had to give a detailed report on the contents?). Though as more time goes by, more will have that opportunity and more truth will be available for people to consider. This bill was attempted to be pushed through the Congress before the summer break when few if any of the legislators had any opportunity to read it --- much less time to consider and debate the ramifications of each part of that 1200 pages. That is NOT good governance no matter what system you're working under.

Maybe not, but neither is making spectacularly ignorant comments about the nature of state healthcare in those countries that have it, and I feel that more vitriol deserves to be directed at them. Some of the remarks I have read and heard are simply unbelievable in their crass stupidity.

A.F.F.

13th August 2009, 23:00

Free government-provided health care for all can work, at least in small countries. We here in Finland have it and we have, for example, one of the lowest infant mortality rates in the world. I couldn't imagine people here accepting a situation where somebody would not get treated because he/she didn't have an insurance. But the US is so huge, can they afford free health care for everybody?

On paper, it's just like that. Seems good but reality is a bit different. Why else they call them "arvauskeskus" ? In capital area of Finland, health centers are reducing their services. The payments for doctors are so low that many native doctors choose the private factor so who work at health centers, immigrants and students. The services are not top quality, the waiting lines for doctor's appointment are getting longer and longer. So no wonder that all the filthy rich ones, like me, are choosing private services which are more expensive or if your work provides it, occupational health care.

I'm not ass-kissing the US but I don't want the foreign to get too rosy picture about what we have. It's going to be a difficult task for US goverment and even they'd succeeded, I fear it might be very vulnerable of any economical and political changes.. at least for starters.

Rollo

14th August 2009, 00:19

You're obviously baiting the question. Few have had the opportunity to read the entire bill (1200 plus pages, when was the last time you read 'War and Peace' and then had to give a detailed report on the contents?). Though as more time goes by, more will have that opportunity and more truth will be available for people to consider. This bill was attempted to be pushed through the Congress before the summer break when few if any of the legislators had any opportunity to read it --- much less time to consider and debate the ramifications of each part of that 1200 pages. That is NOT good governance no matter what system you're working under.

Then debate the bloody thing. That is why you pay legislators and politicians isn't it? Just because something is big and hard to read doesn't mean that it isn't useful and/or valuable.
Title 26, better off known as the Internal Revenue Code of 1986, is just on 16,000 pages long, but without that piece of legislation the country would be unworkable.
Most people have little to no idea how the components of their car works either, but under the logic you've just imposed, then no-one would ever drive anywhere.

What the heck are the House of Representatives and Senate for anyway?

anthonyvop

14th August 2009, 00:55

Rollo

14th August 2009, 01:31

The USA has the best healthcare on the planet.....bar none.

In 2004 (the latest year that data are available for all countries), the United States ranked 29th in the world in infant mortality, tied with Poland and Slovakia.
http://www.cdc.gov/nchs/data/databriefs/db09.pdf
- US Dept of Health and Human Services
This is the worst in the OECD.

http://www.washingtonpost.com/wp-srv/politics/documents/american_journal_of_medicine_09.pdf
imedical problems contributed to at least 46.2% of all bankruptcies

http://www.bmj.com/cgi/content/extract/337/jul21_1/a889
The United States ranked last across a range of measures of health care in a comparison of 19 industrialised countries, despite spending more than twice as much per person on health as any other of the countries, says a report published last week.
- British Medical Journal, 21 July 2008

The USA has the best healthcare on the planet.....bar none.

anthonyvop

14th August 2009, 03:27

In 2004 (the latest year that data are available for all countries), the United States ranked 29th in the world in infant mortality, tied with Poland and Slovakia.
http://www.cdc.gov/nchs/data/databriefs/db09.pdf
- US Dept of Health and Human Services
This is the worst in the OECD.
So? What does that have to do with healthcare. All it means is that we have some stupid mothers.

http://www.washingtonpost.com/wp-srv/politics/documents/american_journal_of_medicine_09.pdf
imedical problems contributed to at least 46.2% of all bankruptcies
So? Like I said......Everybody get essential medical care by law.

http://www.bmj.com/cgi/content/extract/337/jul21_1/a889
The United States ranked last across a range of measures of health care in a comparison of 19 industrialised countries, despite spending more than twice as much per person on health as any other of the countries, says a report published last week.
- British Medical Journal, 21 July 2008
The best costs money.

The USA HAS THE BEST HEALTCARE BAR NONE!

Mark in Oshawa

14th August 2009, 03:33

I think the real issue is the people know that unless the Gov't in Washington stops spending money like they can just print more, they know they cant afford this type of reform. Furthermore, they know countries like Canada who have nothing BUT gov't healthcare have many citizens come south for private care in the US if the lineup is getting longer than they would like.

I have lived in nothing BUT Socialized healthcare, and I wouldn't say it was bad, but too many Americans don't understand it isn't "Free". Obama isn't telling THAT side of things. There hasn't been an honest debate ANYWHERE o what this bill is about near as I can tell. I think this is just a pretext for a elite few liberals in America trying to ram through their utopia, and getting mad because people aren't buying it.

They need reform in the US, NOT wholescale socialization of the US healthcare system.

janvanvurpa

14th August 2009, 06:02

When you, and others, took your business down the road to someone else.

I can't speak for other countries, I don't live there. My experience with the US government is that it rarely does the right thing and never does it economically. Those faceless people in a warehouse somewhere? What exactly will you get with a (US) government run system? Faceless. overpaid federal employees with tenure and no accountability.

Well I live in the real world, and in the real world there is sweet fawk all difference between one insurance company and the next, one gas station and the next and one phone company and the next or bank or chain store etc.

In the real world nearly every consumer product and service are de facto
oligopolies all watching each other like hawks for a 2 cent advantage or worried they'll loose business if they're 2 cents over.
My experience with the US and multi-national corporations is that they rarely do the right thing and never does it economically for anybody but themselves.

So aside form the once theoretical ability, in a simpler time maybe 150 years ago, to walk down the road and take your business elsewhere--and theoretically, by not spending you $1.50 for some nails or paint or molasses, register you unhappiness, there is no accountability, even the threat of no money for even huge corporations run by $25,000,000 a year (salary plus options) executives doesn't scare the big Multi-nationals.

In the real world which has evolved while you and millions like you have been repeating old storybook tales long since discredited, maybe you didn't notice but even if they (those $25m exec) can't make money, they just stick out their hands and we give them money. Over a trillion dollars all told now...

You really think they care if you take your business elsewhere?

Grow up.
Get real.
Obama's plans don't go far enough, it's like he said in a different context: You can put lipstick on a pig, and it's still a pig.

I will give one example for all you Americans who keep repeating this tired bullsh!t about Government inefficiency. And I want you to explain to me something.

Seattle Washington and Vancouver Canada only 200kms apart. Very very similar ethnic and socio economic factors, similarly both very healthy and outdoorsy, similar Metropolitan area, similar diet (except those Commie socialist Red bastids have yummy HP Sauce on the table at eating establishments, and we have watery ketchup. And they are all Sossi commies, why ever notice what color the leaf is in their flag? Explain that!), and the University of Washington Hospital---where I have received several times both good and at another time indifferent treatment---and University of British Colombia Hospital are roughly equal size, see very similar numbers of patients getting very similar treatments---which one would reasonably expect with all the similar demographics.
In 199~~whatever toward the end, UW Hospital had a billing staff of 47 or 50 something AND some slimey Director of Billing or some such poof thing "earning" over 150-160,000 p.a.

UBC Hospital had a billing Department total of 2.

So you loyal freedom™ loving Americans who ENDLESSLY SAY how inefficient the Government always is, 'splain that

Dirty filthy Commie Red Canadian Socialists being suppressed by the burden of their inefficient Stalinist Government with 2 average salaries to pay, versus
the lean and mean Super efficient, Best Health care in the World, and certainly 2 times as expensive as the next,

with around 50 salaries to pay PLUS the parasite Director making 6-7 times the average wage: How is America's business model more efficient?

Maybe "Freedom isn't Free"? fawk yeah!

steve_spackman

14th August 2009, 07:32

Wow.

So much ignorance.

All these people from countries that have socialized medicine criticizing us in the US who don't want it and yet every day 1000's of people hop on planes around the world to come to the US for healthcare.

Yeah so much ignorance...

All the Americans whom go abroad for healthcare, because its cheaper and they get the same if not better treatment and care...

Its called medical tourism..check it out....

DexDexter

14th August 2009, 08:46

On paper, it's just like that. Seems good but reality is a bit different. Why else they call them "arvauskeskus" ? In capital area of Finland, health centers are reducing their services. The payments for doctors are so low that many native doctors choose the private factor so who work at health centers, immigrants and students. The services are not top quality, the waiting lines for doctor's appointment are getting longer and longer. So no wonder that all the filthy rich ones, like me, are choosing private services which are more expensive or if your work provides it, occupational health care.

I'm not ass-kissing the US but I don't want the foreign to get too rosy picture about what we have. It's going to be a difficult task for US goverment and even they'd succeeded, I fear it might be very vulnerable of any economical and political changes.. at least for starters.
That's true up to a point, it's not perfect but the level of health care for even the poorest is still relatively high. It's all relative. I've got experience of NHS back when I was working in the UK and we certainly have it better here.

Mark

14th August 2009, 08:48

DexDexter

14th August 2009, 08:53

The USA has the best

No offence but why do you guys always fulfill the stereotype we have of you?

Mark

14th August 2009, 08:55

The NHS in the UK is a puzzle sometimes. During the mid-90's especially it was chronically underfunded and was falling apart.

Since Labour came in 1997 funding has increased massively, however while we have seen improvements, we haven't seen the corresponding increase in the quality of car the funding improvements would suggest.

BDunnell

14th August 2009, 10:01

All these people from countries that have socialized medicine criticizing us in the US who don't want it and yet every day 1000's of people hop on planes around the world to come to the US for healthcare.

I don't see all that much criticism of healthcare in the US. What I do see criticism of are some of the absurd attitudes expressed in the US about state health services, which are, I have to tell you, wrong.

The USA has the best healthcare on the planet.....bar none.

I am aware that you feel that anyone suggesting that the US doesn't have the best (insert anything here) on the planet is a dangerous saboteur who should be locked up at once, but it would be nice occasionally to read a post from you in which you don't feel the need to assert some form of national superiority.

BDunnell

14th August 2009, 10:02

I have lived in nothing BUT Socialized healthcare, and I wouldn't say it was bad, but too many Americans don't understand it isn't "Free".

Now this is a very good point.

Mark

14th August 2009, 10:44

The US does often lead the way in pioneering and expensive experiemental surgery. But for 99.999% of cases, that's not what they need.

A.F.F.

14th August 2009, 12:02

That's true up to a point, it's not perfect but the level of health care for even the poorest is still relatively high. It's all relative. I've got experience of NHS back when I was working in the UK and we certainly have it better here.

:up:

Brown, Jon Brow

14th August 2009, 12:10

Quite appropriate that this page is being advertised by BUPA health insurance. :laugh:

Mark

14th August 2009, 13:51

The USA is spending 12% GDP on healthcare and the UK 9%. So who has the worst system here?!

Hondo

14th August 2009, 14:42

Personal update: In order to keep the thyroid medicine a'coming and the dossage checked for correction I called my doctor's office last Thursday to set up an appointment, the first since no longer having medical insurance. The girl on the phone told me that without insurance, I would have to use another clinic. Same doctor, different staff and physical location. I told her that didn't sound right and asked her to have somebody higher in the food chain call me. Within 15 minutes the doctor's nurse called me back and explained that although the girl was new in the clinic, the policy was correct only for those who would require more than 90 days to pay their bill due to their bookkeeping setups being different between the two locations. I told Mary I'd be paying cash in full at the time of the visit and she informed me that would get me a 35% discount.

End result, she scheduled a doctor's appointment on Monday at 2:15 pm and said if I could swing by anytime before 5:00pm Friday to leave a blood sample, that would speed things along on Monday. I dropped off some blood on Friday, was visiting with the doctor by 2:30pm on Monday and on my way to the pharmacy to pick up my new dosage by 3:00pm.

It still works ok for me.

Brown, Jon Brow

14th August 2009, 18:49

Wow.

So much ignorance.

All these people from countries that have socialized medicine criticizing us in the US who don't want it and yet every day 1000's of people hop on planes around the world to come to the US for healthcare.

The USA has the best healthcare on the planet.....bar none.

out of the 40 million in the US(estimate) without health insurance about 14 million are Illegals. They can go back from where they came from which in all probability has Universal healhcare.

Another 15-20 million choose not to have Health Insurance by choice. They would rather make payments on a BMW I guess.

The rest still get medical care by law. They just have to pay for it later.

So what is the problem?

So you have experienced health care in every single country in the world to make the statement that the USA has the best health care in the world?

The USA clearly doesn't have the best education system in the world because I don't think you know the meaning of the word "ignorance" . (Assuming you were educated in the US)

BDunnell

14th August 2009, 19:41

The USA clearly doesn't have the best education system in the world because I don't think you know the meaning of the word "ignorance" .

And have you seen the YouTube version of Tony's South Florida Motorsports Report?

Brown, Jon Brow

14th August 2009, 22:05

And have you seen the YouTube version of Tony's South Florida Motorsports Report?

No I haven't. What's it all aboot?

anthonyvop

15th August 2009, 02:13

The USA is spending 12% GDP on healthcare and the UK 9%. So who has the worst system here?!
Using those numbers it is obvious....The US.

JoCoLo

15th August 2009, 11:16

I work in the NHS, it isn't perfect but I can't imagine anything that would work much better.

I love the NHS!

Mark in Oshawa

15th August 2009, 17:27

I will give one example for all you Americans who keep repeating this tired bullsh!t about Government inefficiency. And I want you to explain to me something.

Seattle Washington and Vancouver Canada only 200kms apart. Very very similar ethnic and socio economic factors, similarly both very healthy and outdoorsy, similar Metropolitan area, similar diet (except those Commie socialist Red bastids have yummy HP Sauce on the table at eating establishments, and we have watery ketchup. And they are all Sossi commies, why ever notice what color the leaf is in their flag? Explain that!), and the University of Washington Hospital---where I have received several times both good and at another time indifferent treatment---and University of British Colombia Hospital are roughly equal size, see very similar numbers of patients getting very similar treatments---which one would reasonably expect with all the similar demographics.
In 199~~whatever toward the end, UW Hospital had a billing staff of 47 or 50 something AND some slimey Director of Billing or some such poof thing "earning" over 150-160,000 p.a.

UBC Hospital had a billing Department total of 2.

So you loyal freedom™ loving Americans who ENDLESSLY SAY how inefficient the Government always is, 'splain that

Dirty filthy Commie Red Canadian Socialists being suppressed by the burden of their inefficient Stalinist Government with 2 average salaries to pay, versus
the lean and mean Super efficient, Best Health care in the World, and certainly 2 times as expensive as the next,

with around 50 salaries to pay PLUS the parasite Director making 6-7 times the average wage: How is America's business model more efficient?

Maybe "Freedom isn't Free"? fawk yeah!

Us Red Commies don't have that big billing staff in the hospital, but the State Government doens't have about 400 drones doing the leg work on charging the government for all this stuff either. The staffing for keeping track of the bills isn't in the hospital, it is in a government building in Victoria BC where I have no doubt there is more than enough government featherbedding to give you the ineffieciencies you so desire.

Furthermore, in my previous working life (or about 3 working lives ago) I worked in a hospital. The admin of the hospital there (Oshawa General then, now Lakeridge Health Centre) was/is making a HUGE salary to justify his existence. My mother, who was a RN there part time made great money but was always having her hours cut back and nurses per floor has been dropping steady since she retired.

What the US critics of this version of healthcare keep pointing out that is there will be rationing of healthcare, or higher taxes to justify this plan. Many who are covered through their employer, or like Fiero paying their own way do NOT want Obama dictating their choices or taking money from their pocket to pay for the illegal immigrant to have healthcare. Believe me it isn't that they are cold or heartless, or love their HMO. They probably hate them about one erg less than the government is all.

What Brits keep buying into is this notion there IS no other way to provide healthcare. The US has and does, and while I wouldn't say it was the best system in the world like Tony does, it is pretty darn good in terms of providing very excellent top drawer service to those who have good coverage, which is a significant number. The people in the US who don't have private healthcare can pay cash or go through the government medicaid/medicare systems which ARE Government health care. And they are going broke...so why would anyone want to "Reform" and expand them and then tell anyone with a straight face taxes are not going to go up?

Mark in Oshawa

15th August 2009, 17:34

Using those numbers it is obvious....The US.
You are spending the most, but that isn't a measure of performance. Can you statistically prove you are getting your money's worth?

Mark in Oshawa

15th August 2009, 17:45

So you have experienced health care in every single country in the world to make the statement that the USA has the best health care in the world?

The USA clearly doesn't have the best education system in the world because I don't think you know the meaning of the word "ignorance" . (Assuming you were educated in the US)

One doesn't have to go to every country in the world. However, Tony's one sided view aside, the point is there is more than one way for a nation's healthcare system to operate, and the US isn't a third world nation in terms of healthcare. A great number of top notch doctors and research hospitals in the US are doing great work, and the majority of the US population not only has adequate healthcare, they have great healthcare. The issue that skews the stats is the uninsured.

The Uninsured are either the working young or working poor who wing it hoping they dont' get sick, or the illegals, or genuinuely poor. The young and working poor are making a choice (Americans and that right to choose, to succeed or fail). Many will think nothing of spending 100 a month for a big screen for 2 years and then NOT want to pay for health insurance.
Then you have the illegals. Well they are there illegally, so why should the legal citizens pay for their healthcare needs, which are often paying for the birth of the baby (who then is a "legal" citizen with illegal parents. You ever wonder why mothers to be come in 8 months preggers from Mexico?). The taxpayer is paying for this, and they don't like it. Then you have the geninuely poor and working poor. I suspect this is a VERY small number.

Medicare/medicaid exists in various forms in every state to cover most or not all of these people. Some may be in debt to pay for their care if they had jobs or chose NOT to get insurance, but that again was their CHOICE. The illegals and poor are covered and I am still scratching my head trying to figure how what Obama is offering that isn't offered already unless he is going to take AWAY something from those who have to give to those who don't. The hallmark of his presidency. HE is a socialist of sorts after all.

15th August 2009, 18:11

The NHS has saved the lives of both my parents, and is currently doing a brilliant job with a friend of mine who has a very rare form of cancer.

The NHS is the single greatest achievement the British nation has ever had.

As my Grandfather used to say, it made fighting two world wars worthwhile.

DexDexter

15th August 2009, 20:50

The young and working poor are making a choice (Americans and that right to choose, to succeed or fail). Many will think nothing of spending 100 a month for a big screen for 2 years and then NOT want to pay for health insurance.

Having the freedom of not having a health insurance could potentially lead to very dangerous situations, if for example a more severe swine influenza was to occur. Some people would not seek treatment until very late for costs reasons and lives would be lost. IMO certain things should not be a matter of choice, because people are stupid. Then again, arranging a working healthcare for 200+ million people of which many are illegals is a huge task.It's sometimes puzzling to me how you guys (Americans, don't know about Canadians) over there have very different views on some things even though many of you hail from this continent.

BeansBeansBeans

15th August 2009, 22:47

I'm in favour of the NHS in principle, but it has become a lumbering, inefficient monolith. The USA should be wary of adopting any system that resembles the NHS in its current state.

Camelopard

15th August 2009, 23:37

Having the freedom of not having a health insurance could potentially lead to very dangerous situations, if for example a more severe swine influenza was to occur. Some people would not seek treatment until very late for costs reasons and lives would be lost. IMO certain things should not be a matter of choice, because people are stupid. Then again, arranging a working healthcare for 200+ million people of which many are illegals is a huge task.It's sometimes puzzling to me how you guys (Americans, don't know about Canadians) over there have very different views on some things even though many of you hail from this continent.

Because they don't like being told what to do even if it's for their own good, for example, not wearing seatbelts, it's a choice you make and in some cases make for others (eg, children) and therefore it's up to you to wear the consequences of that decision.

Darwin's theory at work!

anthonyvop

16th August 2009, 01:56

Mark in Oshawa

16th August 2009, 05:02

Because they don't like being told what to do even if it's for their own good, for example, not wearing seatbelts, it's a choice you make and in some cases make for others (eg, children) and therefore it's up to you to wear the consequences of that decision.

Darwin's theory at work!

It isn't that simple Camel. I think the point Anthony would beat us to death on is personal responsiblity, and while we could joke about Darwin, it is common to all young people in their 20's. They would do without health insurance so they could afford a new car or a nicer apartment, and most of them would get away with it.

Where people in the UK and other nations with a national health care system are not grasping is Americans have good healthcare. It is not a third world nation in any stretch, and those who are not "covered" are still able to get treatment, just they have to figure out later how to pay. In Canada or the UK, we pay a much higher level of taxes to have our "universal" care, and that would be likely something some Americans may consider except for the fact that the nanny state healthcare system ina lot of nations in the name of "cutting costs" is talking about cost benefit analysis on who gets WHAT care, and THAT is a decision Americans in the majority do NOT want the government taking. Example? Having them tell you that you cant have a life saving operation because you are too old. Or having the healthcare system deny your application for a new hip because you are 70 and in theory you will be dead in 4 years. There was an element to this kind of analysis in the original bill in the US Senate and it has been removed in light of the uproar.

All the arguements for and against healthcare aside, Obama is burning all his political capital up on this, while not having fixed the economy or putting anyone really back to work. From what I have seen on the news, just about every other western nation is starting to show signs of growth while the elevator is still plunging down in the US. Is this really a time to be trying to spend money like crazy putting public input to 1/6th of the US economy?

DexDexter

16th August 2009, 09:15

It is called freedom and personal responsibility. The work hand in hand. Sometimes it goes bad for certain people. Look at the U.K. for example. What was once a proud and powerful nation is now a shinning example of the dangers of the "Nanny State."

Is freedom and personal responsibility acceptable in situations where for example a pandemic spreads into the insured population because the uninsured have not sought treatment?

BDunnell

16th August 2009, 10:56

It is called freedom and personal responsibility. The work hand in hand. Sometimes it goes bad for certain people. Look at the U.K. for example. What was once a proud and powerful nation is now a shinning example of the dangers of the "Nanny State."

Do you realise you are posting in public here? You have literally no idea what you are talking about.

BDunnell

16th August 2009, 10:58

Where people in the UK and other nations with a national health care system are not grasping is Americans have good healthcare. It is not a third world nation in any stretch, and those who are not "covered" are still able to get treatment, just they have to figure out later how to pay.

I'm not sure anyone in the UK assumes that because the US doesn't have an NHS it must have a 'third world' healthcare system. This is as incorrect a generalisation as the US right is making about state healthcare.

Mark in Oshawa

16th August 2009, 17:14

I'm not sure anyone in the UK assumes that because the US doesn't have an NHS it must have a 'third world' healthcare system. This is as incorrect a generalisation as the US right is making about state healthcare.

Well Ben, they know about the NHS in the UK and my healthcare system up here rationing out certain tests and procedures, and the majority of Americans do not have to wait for this stuff. If you think you may have a cancer lump, you don't want to be told by the "system" that you cant have that biopsy for 3 months because you are low priority on the list or they are short operating theatres. In America, the tests are done within HOURS. In Canada, and I suspect in the NHS, it isn't always that quick. The effort may be there, but the reality is you wait for things up here. My mother waited a year for a knee transplant. A YEAR. THAT is what the Americans want no part of, and you and I both know that the US Governnment taking over most of the healthcare system will result in crap like this.

janvanvurpa

16th August 2009, 17:36

Well Ben, they know about the NHS in the UK and my healthcare system up here rationing out certain tests and procedures, and the majority of Americans do not have to wait for this stuff. If you think you may have a cancer lump, you don't want to be told by the "system" that you cant have that biopsy for 3 months because you are low priority on the list or they are short operating theatres. In America, the tests are done within HOURS. In Canada, and I suspect in the NHS, it isn't always that quick. The effort may be there, but the reality is you wait for things up here. My mother waited a year for a knee transplant. A YEAR. THAT is what the Americans want no part of, and you and I both know that the US Governnment taking over most of the healthcare system will result in crap like this.

Mark, quit writing crap.
The crap that you are writing as generalisations verge on outright fantasy fabrications,
Hours my ass.
NOTHING down here is done in HOURS.
Even with full insurance --- a well respected plan via my wife's job it was still over 2 months for the first spine operation.

Hours! My gawd where do you get this crap from...?

You seem to be compelled to write even though you know full well your knowledge of the details of things here is EXTREMELY INCIDENTAL.
IS THERE ANYTHING in AMERICA you're NOT an EXPERT IN?

Just shut up for fawks sake rather that just writing writing writing fabrications.

Mark in Oshawa

16th August 2009, 21:39

Mark, quit writing crap.
The crap that you are writing as generalisations verge on outright fantasy fabrications,
Hours my ass.
NOTHING down here is done in HOURS.
Even with full insurance --- a well respected plan via my wife's job it was still over 2 months for the first spine operation.

Hours! My gawd where do you get this crap from...?

You seem to be compelled to write even though you know full well your knowledge of the details of things here is EXTREMELY INCIDENTAL.
IS THERE ANYTHING in AMERICA you're NOT an EXPERT IN?

Just shut up for fawks sake rather that just writing writing writing fabrications.

Jan...I would be insulted if it was anyone else but you, but you never seem to accept someone just might have an opinion you don't like. So in short, bite me...

One of my best friends from my timing and scoring days lives in Scottsville NY and he and I have always talked on and off about the differences in coverage. I do know also many Canadians drive to Buffalo (and PAY CASH)for MRI scans and other routine tests they have to WAIT for in Canada. When people are willing to drive and PAY for a routine "Free" test, doesn't that tell you something?
Since when did you become an expert on the Canadian Healthcare system? I have an OHIP card in my wallet and KNOW the pluses and minuses of my healthcare system.

It is funny, you have no problem spreading your opinion and passing it off as fact but you get offended when you see someone else doing it. My opinions on what is going on in the US may be ancedotal but my opinion on what is going on with our system I can back up. Read any Toronto paper talking about healthcare over a year and the talk of wait times for procedures is often....

GridGirl

16th August 2009, 22:22

Camelopard

16th August 2009, 22:29

edit...... Is it similar to car insurance where you make a claim your premium goes up and if for example you got cancer one year your health insurance would go up the next?.......

There have been publicised cases of people being refused continued cover after they developed a serious problem, even if they had been paying premiums for years, even decades......

Most health insurance funds are in it to make MONEY, they don't want sick people on their books. :)

Mark in Oshawa

16th August 2009, 23:05

There have been publicised cases of people being refused continued cover after they developed a serious problem, even if they had been paying premiums for years, even decades......

Most health insurance funds are in it to make MONEY, they don't want sick people on their books. :)

That's true too, but I think if the law was changed to respect people's right to actually get sick once in a while..lol...then maybe nationalizing half of the medical community of the US might not be necessary.

I just watch what is going on in the US, and I know while a reform of the medical system may be needed, what is being offered is a dog's breakfast of bad ideas. What they could end up with is probably more confusing and worse than Canada's or the UK.

jeff8407

16th August 2009, 23:31

Mark in Oshawa

16th August 2009, 23:58

For those that don't realize it healthcare is rationed in the US. Try and get approval for a name brand drug when your plan wants generic: or, try and go to an out of network provider or hospital for care....

How many of us have had to get pre-approved for some type of test or treatment--that is rationing? US providers ration care to benefit the bottom line, not because of better health outcomes.

That may all be true, but trust me, in Canada, more than a name brand vs generic rationing is at work. I don't think there is a good choice for a version of healthcare systems, they all seem to have warts.

anthonyvop

17th August 2009, 00:57

For those that don't realize it healthcare is rationed in the US. Try and get approval for a name brand drug when your plan wants generic: or, try and go to an out of network provider or hospital for care....

How many of us have had to get pre-approved for some type of test or treatment--that is rationing? US providers ration care to benefit the bottom line, not because of better health outcomes.
You get what you pay for. if you signed up for a cheap HMO then don't be surprised if they want to give you generics.
BTW what is so bad about generics? It is just a chemical compound. Both are FDA approved and are identical.
That is like people who spend $6 for a bottle of Tylenol when that $3 bottle of Acetaminophen is the exact same thing.

Rollo

17th August 2009, 01:07

I have no real problems with the NHS although I do think that there are far too many layers of middle management that dont achieve anything and need to be removed. My parents (before my dad took early retirment) had both worked over 60 years in the NHS between them.

People complain about the levels of inefficiency of the NHS but when you consider that it costs £94bn to run as opposed to the US$2.26 trillion the U.S. spent on health care in 2007*, it means that on a per capita basis the NHS is 2.898 times more efficient than the health care system in the US, and certainly more equitable because the level of service afforded to patients is not determined by incomes.

Having been in hospitals in both the USA and the UK I can tell you from personal experience, that in the real world I don't see the level of service provided to patients by at least the hospital I was in, being 2.898 times better than an NHS hospital.

That's the rub as far as I'm concerned. The ultimate purpose of the health care system as the Rt Hon James Hacker MP said was "for healing the sick", whereas there seem to be a lot of monies in the US system flowing into private pockets.

Still, that is the consequence of a private system - private profiteering. And I suppose that if people virulently defend it, then they are by inference condoning it.

*http://www.cms.hhs.gov/NationalHealthExpendData/Downloads/proj2007.pdf

Mark in Oshawa

17th August 2009, 01:24

People complain about the levels of inefficiency of the NHS but when you consider that it costs £94bn to run as opposed to the US$2.26 trillion the U.S. spent on health care in 2007*, it means that on a per capita basis the NHS is 2.898 times more efficient than the health care system in the US, and certainly more equitable because the level of service afforded to patients is not determined by incomes.

Having been in hospitals in both the USA and the UK I can tell you from personal experience, that in the real world I don't see the level of service provided to patients by at least the hospital I was in, being 2.898 times better than an NHS hospital.

That's the rub as far as I'm concerned. The ultimate purpose of the health care system as the Rt Hon James Hacker MP said was "for healing the sick", whereas there seem to be a lot of monies in the US system flowing into private pockets.

Still, that is the consequence of a private system - private profiteering. And I suppose that if people virulently defend it, then they are by inference condoning it.

*http://www.cms.hhs.gov/NationalHealthExpendData/Downloads/proj2007.pdf

Well there is the issue I suppose. I have not much time for a private corporation making money off of me, but I know the government often pays lip service to being for my welfare while rationing out my healthcare also. A pox on both of them.

For the Yanks tho Rollo, the right of the individual to pay his way is what they are concerned about. They want that right to not have some gov't agency be in charge of what doctor they see, or what care they get. In Canada, that option is gone unless we drive south over the border. IN the UK, you guys have a private component to the system, and I suspect most Americans would accept something similar IF all the details were engraved in stone about protecting an individual's right to determine his own care. The problem is, Obama hasn't given them that choice, he is giving them a lot of non-specific generalities that will inevitablly cost everyone more ( he hasn't really rebutted that) in a time when the economy is knackered. Attacking the rich to pay for it, or attacking those joe citizens who oppose this is just digging him into an ideological hole.

I don't think the current US system is perfect, but what they are being told is their future isn't anything better. They wont get the NHS or Canada's system, they will get a mishmash of ideas with higher tax requirements and rationing of care. If they are not getting that on paper, that will be their reality.

Tomi

17th August 2009, 01:26

BTW what is so bad about generics? It is just a chemical compound. Both are FDA approved and are identical.
That is like people who spend $6 for a bottle of Tylenol when that $3 bottle of Acetaminophen is the exact same thing.

I agree, generics should be used if available, I think here nowdays, even if the doctor writes in the prescripion the original medicine, the farmacy is obligated to tell about generics if such excist.

Mark in Oshawa

17th August 2009, 01:35

I agree, generics should be used if available, I think here nowdays, even if the doctor writes in the prescripion the original medicine, the farmacy is obligated to tell about generics if such excist.

The problem is some generics just aren't as good. My wife takes losec for her acid reflux. The generic that the doctors keep trying to make her accept doesn't seem to work as well as the original Losec. The pharmaceutical industry is the biggest profitteering crooks in the whole medical system, and their manipulation of formulas for various drugs and the generic market is riddled with issues....

For the most part generics do the job, but there are issues....

Rollo

17th August 2009, 01:45

For the Yanks tho Rollo, the right of the individual to pay his way is what they are concerned about. They want that right to not have some gov't agency be in charge of what doctor they see, or what care they get.

Most Americans will tell you that "healthcare is not a right". Bear in mind that the United Nations Universal Declaration of Human Rights was never ratified by the USA so legally Article 25 does not apply:
Article 25.1
Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

But when you bear in mind that under the US Constitution, that the Government has the responsibility through the preamble to "establish Justice, ensure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity", I wonder what the "Founding Fathers" meant.

Legally what promoting the General Welfare actually is has never been addressed, and this is what a lot of the arguments in the US Senate have actually been of of late.

I do admit to being sick or hearing Ron Paul's voice in podcasts. I don't mind actual debate but his voice in the chamber is most vociferous and possibly constitutes filibustering to a degree. Certainly if he spoke with a more measured tone he'd be more bearable, but I find myself going "shut up" a deal of the time.

Tomi

17th August 2009, 01:49

The problem is some generics just aren't as good. My wife takes losec for her acid reflux. The generic that the doctors keep trying to make her accept doesn't seem to work as well as the original Losec. The pharmaceutical industry is the biggest profitteering crooks in the whole medical system, and their manipulation of formulas for various drugs and the generic market is riddled with issues....

For the most part generics do the job, but there are issues....

That is true offcourse, but there is normally several different manufacturers of the generic medicines, maybe its worth to try some other brand, if it does not work, then its offcourse better to stick to the one that works.
Agree about the pharmaceutical industry 100%, also the way they advertise new medicines is a bit questionable, take for instance this Tamiflu, now it does not seem to be so good as told.

Mark in Oshawa

17th August 2009, 02:16

That is true offcourse, but there is normally several different manufacturers of the generic medicines, maybe its worth to try some other brand, if it does not work, then its offcourse better to stick to the one that works.
Agree about the pharmaceutical industry 100%, also the way they advertise new medicines is a bit questionable, take for instance this Tamiflu, now it does not seem to be so good as told.

To be fair in the case of Tamiflu, a one size fits all antiviral drug is pretty hard to develop that will be a knockout punch. Nature and virus mutation being what they are, I suspect Tamiflu will help but isnt a panacea.

Alexamateo

17th August 2009, 02:35

.......To be honest I know nothing of the US medical system apart from that you need to get health insurance. What exactly do you get if you have full health insurance and roughly how much does it cost? Is it similar to car insurance where you make a claim your premium goes up and if for example you got cancer one year your health insurance would go up the next?...............

I'll give some recent personal history. I recently went the self-employed route and was very apprehensive about it, fearing the worst when it came to buying my own insurance. I was very pleasantly surprised to get complete family insurance for $3504 a year. This covers all medical/dental/vision with $25 office visit co-pays. There is a $1500 per member deductable, before co-insurance kicks in at a standard 80% coverage up to calendar year out-of-pocket maximum of $7500 per individual and $15,000 per family. I keep a six-month emergency fund of $18,000 so the deductibles etc are no problem for me.

To put it in perspective, At my previous employer, I had "great" insurance. My co-pay was $0, all deductibles were covered by a employer provided HRA (Health reimbursement account) The only thing I ever paid in the three years we had this plan were prescriptions, and I would recieve a check payable to me for the exact same amount three weeks later, and that was only at first, later we just picked up the prescriptions and we didn't owe a dime.

But, for this great insurance, $6000 was taken out of my paycheck over the course of a year. Using last year as a barometer, I can expect to pay out an additional $1500 this year in co-pays, deductables etc, so In a standard year with no major problems I'll actually be $1000 to the good over my previous insurance.

I was also apprehensive about dreaded pre-existing conditions. My 5 year old daughter was born with a congenital heart defect (coarctation of the aorta) and had heart surgery at 4 days old. Now, as one nurse put it, "it's a plumbing problem", and repairable, there is a chance she will have to have heart surgery again at age 15-18. They did ask for all of her records (she has an Echo done every year) , but they didn't attach any riders related to her. They won't however provide any psychological/behavioral coverage for my wife for seven years. :confused: My wife's doctor gave her a Zoloft prescription to help her deal with toddlers, but that's it as far as anything psychological. I told my wife she can't go crazy for at least 7 years :p : The only other conditions are a six month waiting period for dental and vision coverage, and a nine month waiting period for maternity benefits. In other words, you can't already be pregnant and sign up for insurance. I think those conditions are reasonable.

No, health insurance is not like car insurance, a claim alone won't raise premiums, although if I or someone in my family were do develop a chronic condition such as diabetes, the premiums would go up.

Another way it's not like car insurance is that it's not really treated like insurance, i. e. only used in catostrophic situations. I don't expect to go to the mechanic and pay the same $25 co-pay regardless of whether they are changing the oil, or overhauling the transmission. In someways there is an extreme disconnect with costs associated in medical care.

Something else I don't like is this: You get a bill for an office visit, and it says $109. Then the insurance pays $65 and the remaining $44 is automatically discounted. This is done because one insurance company pays $65 for a visit or procedure, another pays $75, or even $85, so they charge high to make sure they maximize their revenue. This hurts those without insurance because many times they refuse to negotiate with you and give you the discounted price even though you are paying cash today and there is no paperwork to file :angryfire . Did I mention this has happened to me? ;)

A couple of other thoughts on health care reform:

Any reform bill that does not include tort reform is incomplete on it's face.

There's a problem because there's five different versions of the bill and nobody know's what's in it and the populace in general doesn't really trust the government because of an annoying tendency to insert items for favored groups (like trial lawyer lobbyists), not debate them and then ram the deals through. Nothing this important should be treated that way.

I think politicians have misinterpreted people's complaints about insurance companies as a call to action. When it comes to change, there's the devil you know and the devil you don't. We may complain and hate certain things about our health insurance, but when push comes to shove, it is preferable to the alternative for many.

Mark in Oshawa

17th August 2009, 04:01

I'll give some recent personal history. I recently went the self-employed route and was very apprehensive about it, fearing the worst when it came to buying my own insurance. I was very pleasantly surprised to get complete family insurance for $3504 a year. This covers all medical/dental/vision with $25 office visit co-pays. There is a $1500 per member deductable, before co-insurance kicks in at a standard 80% coverage up to calendar year out-of-pocket maximum of $7500 per individual and $15,000 per family. I keep a six-month emergency fund of $18,000 so the deductibles etc are no problem for me.

To put it in perspective, At my previous employer, I had "great" insurance. My co-pay was $0, all deductibles were covered by a employer provided HRA (Health reimbursement account) The only thing I ever paid in the three years we had this plan were prescriptions, and I would recieve a check payable to me for the exact same amount three weeks later, and that was only at first, later we just picked up the prescriptions and we didn't owe a dime.

But, for this great insurance, $6000 was taken out of my paycheck over the course of a year. Using last year as a barometer, I can expect to pay out an additional $1500 this year in co-pays, deductables etc, so In a standard year with no major problems I'll actually be $1000 to the good over my previous insurance.

I was also apprehensive about dreaded pre-existing conditions. My 5 year old daughter was born with a congenital heart defect (coarctation of the aorta) and had heart surgery at 4 days old. Now, as one nurse put it, "it's a plumbing problem", and repairable, there is a chance she will have to have heart surgery again at age 15-18. They did ask for all of her records (she has an Echo done every year) , but they didn't attach any riders related to her. They won't however provide any psychological/behavioral coverage for my wife for seven years. :confused: My wife's doctor gave her a Zoloft prescription to help her deal with toddlers, but that's it as far as anything psychological. I told my wife she can't go crazy for at least 7 years :p : The only other conditions are a six month waiting period for dental and vision coverage, and a nine month waiting period for maternity benefits. In other words, you can't already be pregnant and sign up for insurance. I think those conditions are reasonable.

No, health insurance is not like car insurance, a claim alone won't raise premiums, although if I or someone in my family were do develop a chronic condition such as diabetes, the premiums would go up.

Another way it's not like car insurance is that it's not really treated like insurance, i. e. only used in catostrophic situations. I don't expect to go to the mechanic and pay the same $25 co-pay regardless of whether they are changing the oil, or overhauling the transmission. In someways there is an extreme disconnect with costs associated in medical care.

Something else I don't like is this: You get a bill for an office visit, and it says $109. Then the insurance pays $65 and the remaining $44 is automatically discounted. This is done because one insurance company pays $65 for a visit or procedure, another pays $75, or even $85, so they charge high to make sure they maximize their revenue. This hurts those without insurance because many times they refuse to negotiate with you and give you the discounted price even though you are paying cash today and there is no paperwork to file :angryfire . Did I mention this has happened to me? ;)

A couple of other thoughts on health care reform:

Any reform bill that does not include tort reform is incomplete on it's face.

There's a problem because there's five different versions of the bill and nobody know's what's in it and the populace in general doesn't really trust the government because of an annoying tendency to insert items for favored groups (like trial lawyer lobbyists), not debate them and then ram the deals through. Nothing this important should be treated that way.

I think politicians have misinterpreted people's complaints about insurance companies as a call to action. When it comes to change, there's the devil you know and the devil you don't. We may complain and hate certain things about our health insurance, but when push comes to shove, it is preferable to the alternative for many.

Question, do you think if you had a gov't system you would pay MORE in taxes than you do in insurance? Second, would you accept a gov't plan if it was a simple bill with easy to understand objectives? Tort Reform isn't in the new bills anywhere and THAT is the biggest anchor on the medical system....

Alexamateo

17th August 2009, 04:37

Question, do you think if you had a gov't system you would pay MORE in taxes than you do in insurance? Second, would you accept a gov't plan if it was a simple bill with easy to understand objectives? Tort Reform isn't in the new bills anywhere and THAT is the biggest anchor on the medical system....

For me personally, yes, I would probably pay more in taxes than premiums. I went out on my own March 1, and at the risk of sounding immodest, I have met spectacular success and am moving into higher tax brackets (and during a recession to boot).

As far as the second, I don't know, I just think it's not the role of government to provide us with healthcare. Provide the laws and framework within which it exists, yes, but to actually pay for it, no.

Alexamateo

17th August 2009, 04:41

Actually the best situation is to probably be a Canadian living near the US border. A nice government provided system at low cost to the consumer, and the US, just a short drive away should a little more be desired ;) :p : :D

Mark in Oshawa

17th August 2009, 05:45

Tomi

17th August 2009, 06:11

Its common known that every day buss loads of us people goes to canada and buy their medicine from there, it was a program in tv here about it not so long time ago.

janvanvurpa

17th August 2009, 06:31

Jan...I would be insulted if it was anyone else but you, but you never seem to accept someone just might have an opinion you don't like. So in short, bite me...

One of my best friends from my timing and scoring days lives in Scottsville NY and he and I have always talked on and off about the differences in coverage. I do know also many Canadians drive to Buffalo (and PAY CASH)for MRI scans and other routine tests they have to WAIT for in Canada. When people are willing to drive and PAY for a routine "Free" test, doesn't that tell you something?
Since when did you become an expert on the Canadian Healthcare system? I have an OHIP card in my wallet and KNOW the pluses and minuses of my healthcare system.

It is funny, you have no problem spreading your opinion and passing it off as fact but you get offended when you see someone else doing it. My opinions on what is going on in the US may be ancedotal but my opinion on what is going on with our system I can back up. Read any Toronto paper talking about healthcare over a year and the talk of wait times for procedures is often....

******** you write FLAT statements which very often are complete boolock and then when you're caslled out for writing your NARROW opinion with no qualifiers ie "There's no waiting", then you whine piteously that it's merely your opinion and I can't accept anybody else's opinions
Bullsheet,
I can't stand people writing OPINION as FACTS.

You can have your voluminous and verbose opinions but OCCASIONALLY ADD A "In my opinion" or "It seems to me" or "Somebody I was talking to said, but I HAVE NO PERSONAL EXPERIENCE....".

And I don't doubt you keep abreast of Canajian Health care developments, but don't write crap about this *****up system here when your experience is SO MASSIVELY LIMITED to anecdotal contacts with a few people.

Your ranting about me "since when did I become an expert on the Canadian system?" is flat bizarre, I never claimed to be an expert any ANY, although I did say I have been treated for motorsport related serious injuries in a number of different countries over several decades.
That's limited experience but my 30 year informal poll shows most people have NEVER been treated for injuries, had an operation, or been hospitalised.
So I guess i have a LOT MORE actual experience than average TO BASE AN OPINION ON.

That's the real rub: opinions are one thing but are they based on actual personal experience, or second, third, 15th hand re-telling?
Informed opinions or just talk.

Or opinion with no qualifying phrases presented indistinguishable from a "fact'.

Mark in Oshawa

17th August 2009, 07:14

********, you write FLAT statements which very often are complete boolock and then when you're caslled out for writing your NARROW opinion with no qualifiers ie "There's no waiting", then you whine piteously that it's merely your opinion and I can't accept anybody else's opinions
Bullsheet,
I can't stand people writing OPINION as FACTS.

You can have your voluminous and verbose opinions but OCCASIONALLY ADD A "In my opinion" or "It seems to me" or "Somebody I was talking to said, but I HAVE NO PERSONAL EXPERIENCE....".

And I don't doubt you keep abreast of Canajian Health care developments, but don't write crap about this ***** up system here when your experience is SO MASSIVELY LIMITED to anecdotal contacts with a few people.

Your ranting about me "since when did I become an expert on the Canadian system?" is flat bizarre, I never claimed to be an expert any ANY, although I did say I have been treated for motorsport related serious injuries in a number of different countries over several decades.
That's limited experience but my 30 year informal poll shows most people have NEVER been treated for injuries, had an operation, or been hospitalised.
So I guess i have a LOT MORE actual experience than average TO BASE AN OPINION ON.

That's the real rub: opinions are one thing but are they based on actual personal experience, or second, third, 15th hand re-telling?
Informed opinions or just talk.

Or opinion with no qualifying phrases presented indistinguishable from a "fact'.

I just do what you do John...except you have a hate on for me while I find your complaints a little hypocritical. You make assumptions about the Canadian system based on what I cant discern, while I have many friends in the US who have told me their experiences and opinions. Some want a Canadian style system, some don't. My point in this whole thread is maybe those against what Obama is proposing may have a pretty good reason to not like this particular version of socialized medicine. You I know seem to think the US is overeacting and is going to hell in a handbasket if they don't accept the Obama plan or not....I find I haven't found your clear opinion on much of anything except a dislike of my thoughts.

Actually...not sure what your EXACT thoughts are. As for calling me a post whore, thanks...its a hobby. When Ia m gone for 5 or 6 days you can post away and spew YOUR opinion and I am not going to complain. I used to find you annoying, now I find you just amusing....

Mark in Oshawa

17th August 2009, 07:18

Its common known that every day buss loads of us people goes to canada and buy their medicine from there, it was a program in tv here about it not so long time ago.

That was a seniors tour from the US getting generic brand drugs in Canada that were way more in the US because Canada has lower cost drugs through a legal requirement in Canada that all drug patents are only good for 5 years on certain drugs, and then the copycat or generics can make the market. US patents on drugs last a lot longer, so it means certain drugs are a lot cheaper in Canada.

Mark

17th August 2009, 12:04

It's impossible to compare really. The amounts you are paying for insurance in the USA seem mind bendingly huge, but if you compare it to the tax burden in the UK, I wonder if they really are.

GridGirl

17th August 2009, 13:22

Plus we don't actually know how much of our national insurance contribution actually goes towards the NHS but we do stop paying national insurance when women reach 60 and men 65 (although this will change) in the UK. Assuming you live long enough, you will be the biggest burden on the NHS when your not actually paying anything towards it. I dont think I'd still like to be paying for and worrying about health insurance when I'm 90 years old.

Rollo

17th August 2009, 13:52

It's impossible to compare really. The amounts you are paying for insurance in the USA seem mind bendingly huge, but if you compare it to the tax burden in the UK, I wonder if they really are.

Yes, and already stated as such in this thread.

The NHS costs £94bn to run as opposed to the US$2.26 trillion the U.S. spent on health care in 2007*, it means that on a per capita basis the NHS is 2.898 times more efficient than the health care system in the US.

Unless you could prove that the level of healthcare provided in the US was 2.898 times better, then the people of America are being taken for a ride.

Mark

17th August 2009, 13:54

Mark in Oshawa

17th August 2009, 14:55

Well notionally national insurance is mostly for your pension, with a bit for the NHS, but of course it just goes into the giant goverment black hole never to be seen again.

It's that sort of statement that makes Americans nervous. They had a revolution to stop paying what they thought was unfair taxes. The gov't black hole is a large gaping hole right now too.....

Malbec

17th August 2009, 19:39

The problem is some generics just aren't as good. My wife takes losec for her acid reflux. The generic that the doctors keep trying to make her accept doesn't seem to work as well as the original Losec. The pharmaceutical industry is the biggest profitteering crooks in the whole medical system, and their manipulation of formulas for various drugs and the generic market is riddled with issues....

For the most part generics do the job, but there are issues....

On this point Antonyvop is actually correct, there is nothing wrong with generics unless you have an obsessional need to spend unnecessary money. If the generic your wife takes is not as effective then it is probably worth raising it with your doctor, there are feedback mechanisms present in any country to ensure problems with drugs get fed back to the regulatory board. If there are enough complaints, that generic drug you have a problem with ought to be looked into.

Generics have to be identical to the drug they are a copy of. Even the inactive parts of the drug such as the solution its dissolved in or the tablet or capsule its provided in has to be 100% identical to the original. If its not, its not licenced.

Malbec

17th August 2009, 19:56

Example? Having them tell you that you cant have a life saving operation because you are too old. Or having the healthcare system deny your application for a new hip because you are 70 and in theory you will be dead in 4 years.

The problem with these worries is that they are false, as false as the idea that an uninsured American hit by a car will be left to bleed on the road when the ambulance crew fail to find his insurance card.

In the NHS decisions such as those you brought up are made not on cost grounds but on humanitarian ones. Is it better to have a risky life saving op and potentially live for a few more years in pain, crippled if it goes wrong or is it better to stay lucid for just a few more hours, not have the operation and die? Those are not easy questions to ask but in my experience the patient makes the choice with advice from the medical/surgical team. The cost does not enter into the equation at all.

There is also this odd notion that socialising healthcare will result in rationing. I'm afraid that the US system does indeed ration already, in fact it rations more than most other systems by limiting healthcare to the uninsured. The various grades of insurance on offer also limit healthcare, with the companies demanding that you only see approved doctors or healthcare centres that are not necessarily the best capable of treating the problem you have.

The problem is that people seem to identify with particular healthcare systems more than they do with any other branch of government, except perhaps the military. You would not get arguments as passionate over social security or even education but healthcare is totally different, and this IMO is also why the US reforms are doomed to failure. Because its such an emotive topic and its in the public arena, there will be no rational debate and decision making, merely kneejerk reactions to scaremongering on both sides.

Mark in Oshawa

17th August 2009, 19:59

The problem with these worries is that they are false, as false as the idea that an uninsured American hit by a car will be left to bleed on the road when the ambulance crew fail to find his insurance card.

In the NHS decisions such as those you brought up are made not on cost grounds but on humanitarian ones. Is it better to have a risky life saving op and potentially live for a few more years in pain, crippled if it goes wrong or is it better to stay lucid for just a few more hours, not have the operation and die? Those are not easy questions to ask but in my experience the patient makes the choice with advice from the medical/surgical team. The cost does not enter into the equation at all.

There is also this odd notion that socialising healthcare will result in rationing. I'm afraid that the US system does indeed ration already, in fact it rations more than most other systems by limiting healthcare to the uninsured. The various grades of insurance on offer also limit healthcare, with the companies demanding that you only see approved doctors or healthcare centres that are not necessarily the best capable of treating the problem you have.

The problem is that people seem to identify with particular healthcare systems more than they do with any other branch of government, except perhaps the military. You would not get arguments as passionate over social security or even education but healthcare is totally different, and this IMO is also why the US reforms are doomed to failure. Because its such an emotive topic and its in the public arena, there will be no rational debate and decision making, merely kneejerk reactions to scaremongering on both sides.

Dylan, there is not much I can really disagree with in your statements except Americans with good insurance are NOT rationed and have options. THey do not want the Canadian experience where your only option for quicker or more "appropriate" treatment is to leave the country and PAY.

BDunnell

17th August 2009, 21:59

steve_spackman

17th August 2009, 22:51

Well Ben, they know about the NHS in the UK and my healthcare system up here rationing out certain tests and procedures, and the majority of Americans do not have to wait for this stuff. If you think you may have a cancer lump, you don't want to be told by the "system" that you cant have that biopsy for 3 months because you are low priority on the list or they are short operating theatres.

That is utter nonsense Mark about the NHS rationing out certain tests and procedures.

In Their Own Words: The NHS Rebuttal to the Associated Press (AP)

http://blog.hishamrana.com/2009/08/13/in-their-own-words-defending-the-nhs

“The NHS sees one million people every 36 hours and 93 percent of patients rate their care as good or excellent. In recent years patients have benefited from record levels of investment and more lives have been saved through better prevention and treatment – waiting lists are at their lowest ever levels, there has been a 44 percent reduction in the mortality rate from cardiovascular disease and 50,000 more lives have been saved through better cancer services.”

steve_spackman

17th August 2009, 22:55

They came in their thousands, queuing through the night to secure one of the coveted wristbands offering entry into a strange parallel universe where medical care is a free and basic right and not an expensive luxury. Some of these Americans had walked miles simply to have their blood pressure checked, some had slept in their cars in the hope of getting an eye-test or a mammogram, others had brought their children for immunisations that could end up saving their life.

In the week that Britain's National Health Service was held aloft by Republicans as an "evil and Orwellian" example of everything that is wrong with free healthcare, these extraordinary scenes in Inglewood, California yesterday provided a sobering reminder of exactly why President Barack Obama is trying to reform the US system.

Read the entire report and just open your eyes as to how bad things really are.

http://www.truthout.org/081609A

Mark in Oshawa

17th August 2009, 23:58

That is utter nonsense Mark about the NHS rationing out certain tests and procedures.

In Their Own Words: The NHS Rebuttal to the Associated Press (AP)

http://blog.hishamrana.com/2009/08/13/in-their-own-words-defending-the-nhs

“The NHS sees one million people every 36 hours and 93 percent of patients rate their care as good or excellent. In recent years patients have benefited from record levels of investment and more lives have been saved through better prevention and treatment – waiting lists are at their lowest ever levels, there has been a 44 percent reduction in the mortality rate from cardiovascular disease and 50,000 more lives have been saved through better cancer services.”

That nice...the NHS has someone saying they do a great job. What Obama is offering is NOT the US answer to the NHS. He hasn't defined what exactly anyone is getting but a clause on rationing and evaluation was pulled out of the bill presented to the Senate.

You have not heard me say I am 100% against some form of government run insurance but I think people need the right to opt out of the system and they reserve the right to not be taxed out the wazoo. In the US, none of these promises are being engraved in stone from what I have seen. People protesting this bill are just slagged as reactionaries and unpatriotic. I keep waiting for Obama to read out the clause being voted on that guarntees certain provisions that would put the skeptics at ease. This says to me a 1000 page bill that many are scramblling to read must be debated and amended a lot before passing. Obama wanted it rammed through in 2 weeks .....

steve_spackman

18th August 2009, 00:20

That nice...the NHS has someone saying they do a great job. What Obama is offering is NOT the US answer to the NHS. He hasn't defined what exactly anyone is getting but a clause on rationing and evaluation was pulled out of the bill presented to the Senate.

You have not heard me say I am 100% against some form of government run insurance but I think people need the right to opt out of the system and they reserve the right to not be taxed out the wazoo. In the US, none of these promises are being engraved in stone from what I have seen. People protesting this bill are just slagged as reactionaries and unpatriotic. I keep waiting for Obama to read out the clause being voted on that guarntees certain provisions that would put the skeptics at ease. This says to me a 1000 page bill that many are scramblling to read must be debated and amended a lot before passing. Obama wanted it rammed through in 2 weeks .....

Yet the very same people who are against the bill are the ones whom have not even read it themselves, yet take what the likes of Fox News, S Palin and co say and believe that to be the truth...

Its a government option, not a bill to have everyone put on the government plan. They have said if you want to keep your HMO then thats fine. Its for the people who cannot get covered by the greedy selfish companies whom put profit before life

quote "The health care debate is more like a spoiled brat kicking and screaming because he doesn't want to share his toys, all the while his well meaning parents (the Dems) try to reason with him:
GOP: "Mine! Mine!
Dems:" Now Billy that's not nice, you have lots of toys, you can share with the rest of the children."
GOP: "No, I hate you! You're mean!"
Dems: "Now how would you like it if someone did that to you?"
GOP: I don't care, mine!"
Dems: "How about if you just share this toy?"
GOP:" I want em all!"

chuck34

18th August 2009, 01:57

This really is a fairly simple thing to fix. And I think that everyone on every side of the issue will agree that the US healthcare system could be better. No one needs to even bring up Nationalizing Health Care. That is if they really want to fix the system, not just take it over.

#1) Looser pays lawsuits. That fixes way more than just healthcare.

#2) Tort reform. Why is it that no one is talking about this? The amount of money spent by doctors (and passed on to the consumers) for mal-practice insurance is staggering. Simply capping the amount of money that can be won in lawsuits would be a good start. Then follow that up with other rules, see #1 for a starting point.

#3) Give individuals an insentive to buy their own insurance, and allow them to buy coverage across state lines. The Dems keep saying that the "Public Option" is mearly there to provide "competition". Well a whole boat load of INDIVIDUALS suddenly buying their own healtcare (instead of the relatively low number of employers) sure would add competition into the market. I just about break even when I compare the insurance premiums I pay through my company to what I would pay privately. However, when I factor in the tax break I get for paying through my employer, it doesn't work economically. But if I could get that same tax break that would give me a better insentive to go private. If a lot of people did that, then things may work a bit more like auto insurance. For example, if I have a sore throat, I may just tell my doctor to bill me, and not report it to the insurance because it will be less than the deductable anyway. Much like a minor scratch on your car. That way the doc. gets his money faster (and may knock off a bit, I know people who do this currently), and the insurance company doesn't have to deal with anything, thus lowering the beaurocratic costs for them.

The fact that these ideas, or ones like them, have not been seriously discused leads me to believe that this is not about "fixing healthcare". This is a government take-over of the Medical System. Don't take my word for it, listen to what Obama himself said a few years back. HE WANTS SINGLE PAYER HEALTHCARE. This is NOT a public "option", this is the first step to single payer.

chuck34

18th August 2009, 02:03

Its a government option, not a bill to have everyone put on the government plan. They have said if you want to keep your HMO then thats fine. Its for the people who cannot get covered by the greedy selfish companies whom put profit before lifel

That is the whole mis-direction of this bill. If there is a "Public Option" many, if not most, companies will drop their insurance plans (my company has already said so). Then it becomes difficult/prohibativly expensive for me to buy my own private insurance. And I make fairly good money, others in the company make quite a bit less than I. There is no way they will be able to afford anything other than the "Public Option".

It is not an option.

Alexamateo

18th August 2009, 04:30

......

#1) Looser pays lawsuits. That fixes way more than just healthcare.

#2) Tort reform. Why is it that no one is talking about this? The amount of money spent by doctors (and passed on to the consumers) for mal-practice insurance is staggering. Simply capping the amount of money that can be won in lawsuits would be a good start. Then follow that up with other rules, see #1 for a starting point.

...........

I would generally agree, but some research may indicate it's not the panacea some might hope it to be.

Malpractice: Do other countries hold the key?
Jul 25, 2003
By: Robert Lowes
Medical Economics
Senior Editor

Driven to despair by skyrocketing insurance premiums and malpractice woes, US physicians are marching in the streets for tort reform. They're demanding federal legislation that, for starters, would limit noneconomic damages in malpractice suits to $250,000.

What reform would you most like to see the US malpractice system adopt?

Some legal experts, however, say America should look beyond its borders for a more drastic solution. So what can we learn from how the rest of the world handles malpractice cases?

Stunned by huge awards handed out by juries? In Canada, judges try the vast majority of malpractice cases.

Outraged by the contingency fees of plaintiffs' attorneys that gobble up one-third or more of court-awarded damages? Germany bans them, while the United Kingdom limits a victorious plaintiff's attorney to twice his customary fee.

Skeptical of dueling expert witnesses? German judges appoint their own neutral experts.

Sick and tired of litigation, period? In New Zealand, malpractice cases bypass the courthouse. They're adjudicated through a no-fault system run by the government.

To be sure, foreign legal systems may not hold the key to resolving the US malpractice insurance crisis. Some experts argue that steep premiums stem more from the business cycles of malpractice carriers and the financial fallout of the Sept. 11 terrorist attacks than from frivolous suits and swollen jury verdicts. And the approaches that other countries take don't always produce the results you'd expect. Nevertheless, the way the rest of the world treats malpractice claims challenges long-held assumptions about the American justice system.

Here's a quick look at a few key features of other legal systems, particularly those in the United Kingdom, Germany, Canada, and New Zealand.

..........snip.....................

The loser-pay rule: a judicial speed bump?

One gripe about American justice is that even if you triumph over a plaintiff, you (or your insurer) still have to shell out big bucks to defense attorneys. In Germany, the UK, and other Commonwealth countries, the loser pays the winner's legal bill.

"This rule would dampen our fervor for speculative suits," says law professor David Bernstein. "And it would discourage plaintiffs from trying to wear out the other side with excessive discovery."

Opponents of the loser-pay rule, of course, challenge the assumption that doctors are beset by a tidal wave of flimsy lawsuits. Ken Suggs says the loser-pay rule would discourage plaintiffs with legitimate claims. However, there's a way to make the rule less risky for plaintiffs. In the UK and Germany, they can buy special insurance that will cover what they'll owe a defendant if their suit fails.

Alaska is the only state that observes the loser-pay rule in some form. Florida tried it out with malpractice litigation during the early 1980s, but dropped the rule after doctors there were disappointed with the results. They found that while their costs went up when they lost a case, they often couldn't collect from insolvent plaintiffs when they won. So much for deterrence.

Florida's experience mirrors that of Canada, where the loser-pay rule is on the books. "We seldom attempt to collect costs from plaintiffs when we win," says John Gray. "Frequently, the families who sue aren't well off to begin with, and they're attempting to care for someone who is severely injured."

The no-fault approach: End the blame game

Several countries, Sweden and New Zealand among them, have a no-fault system of evaluating and paying medical malpractice claims, similar to the way car accidents and workplace injuries are handled. If someone is injured by medical treatment and meets certain criteria, the government cuts a check.

The word "no-fault" is a bit misleading, though. In Sweden, an injury must be deemed "avoidable" to merit compensation. In New Zealand, about 10 to 15 percent of compensated injuries are each year classified as medical errors. The rest are "mishaps," or very bad outcomes. The physician didn't make a mistake, but the bad outcome is severe enough and rare enough to warrant compensation (there are criteria for severity and rarity). But whether an injury is considered avoidable, the result of error, or just bum luck, the no-fault approach spares physicians the ordeal of litigation.

Meanwhile, injured patients reap significant benefits. The streamlined nature of no-fault translates into speedy decisions and payments within months. In contrast, plaintiffs in a malpractice suit might have to wait years for their money. In addition, the ease of no-fault systems encourages small claims that might otherwise be shunned by plaintiffs' attorneys. That's an important consideration to legal experts who say that contrary to conventional wisdom, the US tort system doesn't do enough for victims of malpractice. Only one in eight actually files a claim and only one in 15 receives any money, according to a landmark study of hospital patients in New York published by Harvard University researchers in 1990.

A mandatory no-fault system for medical malpractice in the United States probably would meet tremendous resistance from trial lawyers who'd see it as an infringement on the public's right to file suit and their ability to earn a living. Some scholars question whether it would adequately deter medical negligence, given that nobody's taking the rap for mistakes. And it's not clear whether the United States could afford no-fault.

However, a 1997 study published in Law & Contemporary Problems suggests that a no-fault system in the US is within our economic reach. The study concluded that no-fault could compensate two to three times more victims than the court system, while costing the same or less than what doctors and hospitals pay in malpractice premiums. The researchers came to this conclusion by hypothetically applying the Swedish avoidability test to Colorado and Utah patients injured by medical care in 1992.

Affordability, though, is a real-life issue for New Zealand's no-fault system. Outlays for patients injured by medical errors and mishaps rose 82 percent from 1997-'98 to 2001-'02. The cost per claim has been rising dramatically, and the system piles on new claims even while it continues to pay on old ones. Some New Zealanders are so concerned about the level of spending that they've proposed having physicians reimburse the government for what it pays injured patients.

New Zealand's situation doesn't surprise health care economist Patricia Danzon, a professor at The Wharton School of the University of Pennsylvania. "I don't think there's an advantage in moving away from a fault-based system," she says. "It's hard to define a compensable injury if you eliminate the idea of error. You don't want to pay for all bad outcomes, but where do you draw the line? The cost can go through the roof."

..............snip............

"Americans may believe that tort reform and reducing the cost of insurance will fix their problems," says Gray, "but I worry that it might not happen."

http://medicaleconomics.modernmedicine.com/memag/article/articleDetail.jsp?id=111474

A very interesting article if you get a chance to read it.

Alexamateo

18th August 2009, 04:50

Something else too, I would like to see health insurance de-coupled from employment. How often do you hear of someone wanting to change jobs, but feeling trapped into staying because the insurance is so good? I believe John McCain was actually on the right track when he mentioned taxing employer provided health benefits while at the same time providing tax credits so people could buy their own.

The way I understand it, employer provided insurance was an unintended consequence of government intrusion into the market. Wages and salaries were frozen for a period of time, so employers used a loophole to provide extra benefits to attract the best and brightest workers, and it just grew from there.

In short that's the problem of government, there's always a loophole or an unintended consequence, and government cannot or will not react fast enough to correct it. It's almost impossible to kill a program or beureaucracy once it's started, even if it's clear you started going in the wrong direction. There's always someone gaming the system, and picking the winners and losers, and unlike the private sector you can't just go somewhere else or start your own. There's nothing like being able to outlaw your competition.

In the long run, the aggregate of decisions of individual businessmen,
exercising individual judgment in a free economy, even if often mistaken,
is less likely to do harm than the centralised decisions of a government,
and certainly the harm is likely to be counteracted faster.

Rollo

18th August 2009, 07:45

In short that's the problem of government, there's always a loophole or an unintended consequence, and government cannot or will not react fast enough to correct it.

Yes, but the problem with the private sector is that if there isn't a profit to be made with a particular good or service, then it simply won't be provided. The market never decides what is good or bad, nor does it describe or ascribe the social consequences of something, it merely affixes a price for something.

The same arguments could also equally be applied to the police and fire departments, the military, public education and the arts. If you turned all of those over to the private sector, then you'll end up with an entirely different set of unintended consequences.

Mark

18th August 2009, 08:06

BeansBeansBeans

18th August 2009, 08:44

The only real complaint I have about the NHS is not with the actue care, but the out-patient stuff. There appears to be no regard that you might actually work for a living. It's greeted with shock and amazement that, no, I can't come along to an appointment at 2 in the afternoon, as I'm at work. Can't I have an appointment at 5.30pm or on Saturday? No :|

Anything outside of 9-5 Mon-Fri is out of the question it seems.

I completely agree.

I agreed to undertake a course of CBT for an anxiety problem, which involved a weekly appointment, but they could only ever give me 1pm or 2pm slots, which was utterly unworkable. I had to knock it on the head and go down the self-help route.

I must say though, that I'm under a specialist at the RVI for a long-standing genetic health problem (nowt too serious) and the care is absolutely brilliant. I still can't get an appointment at a convenient time, but as it's only twice a year it's okay.

Malbec

18th August 2009, 09:46

Socialized healthcare (where practised) is pretty much available to everyone. And everyone who is gainfully employed pays for it through taxes. They pay for everybody who receives any benefits. In some places this means that people who have never contributed to the system at all receive all the care they need. That's true some places in the US too - see California. The drawback here is when those who don't pay and get care reach a certain percentage of those who do pay. The system becomes unstable then and costs go up, a lot. There is also no incentive for living a healthier life style if you're riding the gravy train provided by Joe or Helmut or Carlos who actually does work for a living.

The US system expects YOU to be responsible for your own healthcare - as in YOU pay for it. It's called personal responsibility. You pay either directly or as part of a group. The groups are mostly benefit packages of employers and it is part of your compensation package just like your salary, vacation, etc. Insurance companies do make nice profits. That's what much of the US is about. It's still a capitalist system (mostly) and not a socialist one. We like it just fine that way. I for one don't mind them making a profit. I expect to make a profit in my own line of work, else why would I do it? There are mechanisms for the truly poor here, so you can let that one alone. There are few here who can't get any care at all.

Socialism sounds like a wonderfull idea until you factor human nature into the equation. Communism sounds even better - on paper. It's been put into practice before...and we all know how that little experiment turned out.

Of course the US has a different mindset to Europe and it is inevitable that healthcare provision will differ too, reform or no reform to reflect that. This is how it should be.

However the points you raise don't really make sense to me. You say that the system gets unstable when there are more non-payers, I presume you mean unemployed or other people who do not contribute significantly to tax. I suspect what you mean is that government provided healthcare is dependent on tax revenue which is correct, however in line with other types of government spending, the government simply borrows in the lean years and uses excess revenue during productive years whilst healthcare spending stays relatively stable.

As for improving lifestyle, as you say there's a difference between reality and what things look like on paper. The US population has one of the highest rates of cardiac disease and obesity in the world, more so than Europe and thats down to two simple lifestyle factors, unhealthy overeating and lack of exercise. In reality the US health insurance system has done little to encourage its users to improve their lifestyle has it? In fact the healthiest lifestyles and diets are found in areas which happen to have socialised medicine in place, Scandinavia, Japan and the Mediterranean states. There's no point in claiming a link between the fact that they have socialised medicine and that they live healthy lifestyles, thats just a coincidence.

Malbec

18th August 2009, 09:54

Yet the very same people who are against the bill are the ones whom have not even read it themselves, yet take what the likes of Fox News, S Palin and co say and believe that to be the truth...

Its a government option, not a bill to have everyone put on the government plan. They have said if you want to keep your HMO then thats fine. Its for the people who cannot get covered by the greedy selfish companies whom put profit before life

I think we need to discriminate between the extreme right wing propaganda rubbish thrown out by the likes of Fox news and look at the genuine concerns about the healthcare reforms Obama is suggesting.

The fact is that these reforms are going to be staggeringly important and there is a need in such circumstances to have serious open debate. Whatever reform he enacts will likely take the rest of Obama's tenure to put in place (regardless of whether he's a two term President) so will likely dictate the tone of his Presidency in a similar way that Bush's response to 9/11 did.

I don't think its clear to the public and even to many politicians exactly what the proposals are and how they are to be executed, let alone the myriad side effects that can't be predicted. It isn't helped that Obama didn't say much beyond 'I'm going to reform healthcare' before he got on the case.

Still, I prefer the way Obama is going about reforming US healthcare than the way its been done in the UK where major changes have been made without any public debate whatsoever.

chuck34

18th August 2009, 12:40

Still, I prefer the way Obama is going about reforming US healthcare than the way its been done in the UK where major changes have been made without any public debate whatsoever.

See that's the problem, Obama (and Congress) tried to ram this down our throats "by the August recess". It was only on the massive outcry of the public that slowed it down. Now they are wanting to do it (have the vote) in the first two weeks of September. Do you really think that two weeks is enough time for debating the actual language of the bill?

chuck34

18th August 2009, 12:43

I would generally agree, but some research may indicate it's not the panacea some might hope it to be.

http://medicaleconomics.modernmedicine.com/memag/article/articleDetail.jsp?id=111474

A very interesting article if you get a chance to read it.

Alex, the clip from the article is totally un-readable (too many "color" texts). I don't know if it's a problem with my computer or something. I'll follow the link though and see if it's better.

But anyway, I'm not proposing tort reform will solve all the problems, it won't. But it will go quite a ways to reducing costs, and isn't that the whole point?

Brown, Jon Brow

18th August 2009, 13:11

chuck34

18th August 2009, 13:12

I would generally agree, but some research may indicate it's not the panacea some might hope it to be.

http://medicaleconomics.modernmedicine.com/memag/article/articleDetail.jsp?id=111474

A very interesting article if you get a chance to read it.

Ok went to the link and read most of it, skimed some. It sounds pretty much like what I'm saying. Fixing lawsuits will do a lot to help lowering costs. It won't solve everything, but it will help. So why not do it?

chuck34

18th August 2009, 13:21

It just seems strange that pretty much every industrialised country has 'socialised' health care apart from the US. They can't all be wrong can they? Especially when the W H O ranks American health care down in 37th place in the world, below countries like Morocco and Columbia.

As I mentioned in my opening post, most of the arguments against a health reform seem to just play on a hostility to any form of socialism in America, rather than actually debating health care.

Like it or not, for better or worse, Americans (for the most part) do not like government control over any part of our lives. That has served us fairly well throughout our history.

I don't get this argument about how every other country does it so why not the US. Didn't your mother ever tell you that "just because everyone else is jumping off a bridge doesn't mean you have to"? Perhaps we wish to do things our way.

And which WHO report are you speaking of? I saw one that ranked us, I think it was 37th so maybe the same report, but that was for mortality. Mortality does not necessarily relate to healthcare because it factors in things like murder, car crashes, and the like. Those factors are more related to culture than healthcare.

You want to debate healthcare, lets debate healthcare IN THIS COUNTRY, not the rest of the world. Most people here are at least somewhat satisfied with their coverage. They may not think it's awesome or anything, but it's good enough. I'm one of those people. Sure things could be better, but I don't believe what they have proposed will be any better.

Why would anyone believe anything that comes from the government will be better? This is the same government that said Medicare/Medicaid would be funded ... now broke. This is the same government that said Social Security would be fully funded ... now broke. This is the same government that said $1billion would be enough to last "Cash for Clunkers" for 3 months ... it lasted 4 days. Why do you believe that "Healthcare reform" will only cost $1trillion and improve the quality of care? This is just completely illogical to me.

Brown, Jon Brow

18th August 2009, 13:51

Like it or not, for better or worse, Americans (for the most part) do not like government control over any part of our lives. That has served us fairly well throughout our history.

I don't get this argument about how every other country does it so why not the US. Didn't your mother ever tell you that "just because everyone else is jumping off a bridge doesn't mean you have to"? Perhaps we wish to do things our way.

It seems to me that America would still be the only kid jumping off the bridge because they don't like being told what to what to do from above. :p

Mark in Oshawa

18th August 2009, 14:30

It just seems strange that pretty much every industrialised country has 'socialised' health care apart from the US. They can't all be wrong can they? Especially when the W H O ranks American health care down in 37th place in the world, below countries like Morocco and Columbia.

As I mentioned in my opening post, most of the arguments against a health reform seem to just play on a hostility to any form of socialism in America, rather than actually debating health care.

Jon, Americans just love to live the good life. No medical system saves you from THAT. Fatty foods and the like are a staple for too many. Go into a US grocery store and you realized processed crap fills the shelves. There isn't enough of a market for whole foods and simpler fare. You end up with a population always fighting its weight. THAT has nothing to do with the quality of doctors and healthcare system.

The Reform debate I have said a million times is more about Obama playing a socialist play for healthcare rather than any honest debate on making things better. There hasn't been any debate to the questions of the opponents. It has been just one big denial while trying to ram through the bill. I think there is some room for a properly funded and run government run healthcare system in the US, but they have that. There is state run Medicare/Medicaid programs in most states, and it is quite extensive in places like Mass or NY. What's the common problem? Both programs are going broke. Now in the middle of the recession Obama wants to create a national version of this.

Damn right this is a contentious issue about the evils of socialism because only a socialist would be so dogmatic in the face of a reality that the US is BROKE. B R O K E. There...spelled it out for you. THis like saying we need a new car in the family but Dad just lost his job and Mom had to take a job in the coffee shop. Lets go to the BMW dealer and check out an M5. What Americans want is reform they can afford.

Obama promised the American public not to raise their taxes unless they made over 225000 dollars. A lot of Americans would like to make that much and they wont pay extra taxes to pay for a healthcare system that wont help them any more than the current one. Furthermore, they are not getting any one representing them explaining exactly what they are getting.

We have beat this to death but the simple fact is while the US may need some reform for the public healthcare system to exist, what they are being asked to do is give blind trust in Obama to get it right. I don't think that blind trust is there for any American President.

Obama is going to waste all his political capital on a project that will require a lot of public dollars at a time when the economy is still broke and the government is broke. It is just silly.

Brown, Jon Brow

18th August 2009, 15:05

Jon, Americans just love to live the good life. No medical system saves you from THAT. Fatty foods and the like are a staple for too many. Go into a US grocery store and you realized processed crap fills the shelves. There isn't enough of a market for whole foods and simpler fare. You end up with a population always fighting its weight. THAT has nothing to do with the quality of doctors and healthcare system.

You're talking about life expectancy. The report I found measured countries on a range of criteria.

The World Health Organization has carried out the first ever analysis of the world’s health systems. Using five performance indicators to measure health systems in 191 member states, it finds that France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan.

The U. S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of gross domestic product (GDP) on health services, ranks 18th . Several small countries – San Marino, Andorra, Malta and Singapore are rated close behind second- placed Italy.

The impact of failures in health systems is most severe on the poor everywhere, who are driven deeper into poverty by lack of financial protection against ill- health, the report says.

"The poor are treated with less respect, given less choice of service providers and offered lower- quality amenities," says Dr Brundtland. "In trying to buy health from their own pockets, they pay and become poorer."

One key recommendation from the report is for countries to extend health insurance to as large a percentage of the population as possible. WHO says that it is better to make "pre-payments" on health care as much as possible, whether in the form of insurance, taxes or social security.

While private health expenses in industrial countries now average only some 25 percent because of universal health coverage (except in the United States, where it is 56%), in India, families typically pay 80 percent of their health care costs as "out-of- pocket" expenses when they receive health care.

"It is especially beneficial to make sure that as large a percentage as possible of the poorest people in each country can get insurance," says Dr Frenk. "Insurance protects people against the catastrophic effects of poor health. What we are seeing is that in many countries, the poor pay a higher percentage of their income on health care than the rich."

"In many countries without a health insurance safety net, many families have to pay more than 100 percent of their income for health care when hit with sudden emergencies. In other words, illness forces them into debt."

WHO’s assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system’s financial burden within the population (who pays the costs).

http://www.photius.com/rankings/who_world_health_ranks.html

chuck34

18th August 2009, 15:15

Obama promised the American public not to raise their taxes unless they made over 225000 dollars.

You can tax those people at 100% and not be able to pay for this. THAT is the dirty little secret here that no one wants to admit. Taxes WILL go up with the plan in it's current state. And that's if you believe the numbers comming out of the CBO.

Mark in Oshawa

18th August 2009, 15:17

Jon...I wont go into a lot of that article. There is a lot that makes sense there for sure. Just have to point out a few facts.

It states that "Insurance protects people against the catastrophic effects of poor health. What we are seeing is that in many countries, the poor pay a higher percentage of their income on health care than the rich." Gee...there is an OBVIOUS statement. Of course the Rich pay less of their income for healthcare. They also pay less of their income for cars, food, housing and a few other things. They also do pay more than the poor in TAXES. MAybe not as much as some would like but they do pay more in places like the UK and the US. Still doesn't justify taking away their right to private care.

Another thing that must be pointed out tho is that the poor will always need a government alternative for health care. In the US they have it. It works poorly and the system is broke. Obama wants to expand this system into the healthcare providers of the middle class and get them to pay for the shortfalls. Still haven't figured out how the government run medicare system will provide better care without taking it from someone with adequate care.

You can have a state run medicare system, and a nation should have one, but when you force or jeopardise the rights of people paying their own way with a system that works for them to take a cut in service and an increase in taxes to pay for someone else to get health care, then you will find a debate. Not just in the US, but anywhere.

The tone of the debate on this board is the Brits keep trying to tell the Yanks they are idiots because they wont allow a massive state run health care system, and the Yanks have very much pointed out they don't want THIS one. Meanwhile, I am the guy who never has a choice. I could make 2 million a week, and still have to go through the Canadian healthcare system, which has wait times, and which rations care. Americans don't want our model, yet many on Obama's side look at Canada as the way to go. Gee...cant see why any right wing Republican types wouldn't want to go along with THAT.....lol

Mark in Oshawa

18th August 2009, 15:22

What it always comes back to, what is a RIGHT? Is Healthcare a RIGHT? Is housing a RIGHT? Is food a RIGHT? In theory, yes they are, but I still go to work every week because I pay for my housing, I pay for my food, and through the big chunk missing from my pay every two weeks, I pay for my healthcare. If I sat at home and let the gov't give me all of this, Who pays? The guy working.... Enough guys take "gov't gives it to me, why work?" tack and society is screwed. So it would really be incumbent of Government to be real careful with making the people working and paying taxes pay for services for those who don't pay. In the US, there is legititmate poor who need this, and there is 15 million illegals who shouldn't be in the US who will get healthcare coverage in a country they are not legally supposed to BE IN. Gee....the "gov't gives it to me, this is great crowd" just got a point for their side....

chuck34

18th August 2009, 15:26

WHO’s assessment system was based on five indicators:

1) overall level of population health;

2) health inequalities (or disparities) within the population;

3) overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts);

4) distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system);

5) and the distribution of the health system’s financial burden within the population (who pays the costs).

1) Does that factor in things like murder, car crashes, and the like. The reports I've seen do. And again that isn't healthcare related, but lifestyle.

2) While I don't want the poorest to be left out in the streets (and they aren't currently), who will pay for the poor to get the higest level of care that I can afford, thanks to my hard work. The math doesn't work out in any system that I've seen. Therefore, if we impliment these plans, care will necessarily go down. So by this metric, if everyone has the same crappy care, you score higher?

3) How is the level of system "acting" measured?

4) So presumably we (the US) are rated low on this one because the poor are not treated "responsively". Well the poor are taken care of by a GOVERNMENT run system currently. That doesn't bode well for more government run systems does it?

5) Who do you think is going to pay the costs? If the "rich" pay more does that mean you score better? What a load of crap. Why should I keep paying more and more to get less and less? And I'm by no means "rich", but I do pay taxes.

Brown, Jon Brow

18th August 2009, 15:33

2) While I don't want the poorest to be left out in the streets (and they aren't currently), who will pay for the poor to get the higest level of care that I can afford, thanks to my hard work. The math doesn't work out in any system that I've seen. Therefore, if we impliment these plans, care will necessarily go down. So by this metric, if everyone has the same crappy care, you score higher?

This.

I don't see the point of having great health care if it doesn't fully include 50 million+ of the population.

People have already said that the best place to be would be a Canadian living on the border. So you get a good standard health care system that covers everyone and the option of paying for more across the border if you need it.

What would be the situation with private health care in the US under Obama's plans?

chuck34

18th August 2009, 15:36

I forget where I heard this, but I think it's a pretty good illustration of the system.

If you go to lunch and have $10 to spend you can get $10 worth of food. Now you have a friend that also wants to eat, but he forgot his wallet. You're a nice guy and tell him you'll pick up his lunch. Now you have two choices. 1) Use your original $10 and only get $5 worth of food for the two of you. 2) Double your $10 to $20 in order to pay for $10 worth of food for the both of you.

This is the same with healthcare. There is X amount of money out there to pay for this. Obama has said that no one that makes under $250,000 will pay any more in taxes. From what I understand, even if you tax everyone that makes over this at 100%, you still will not be able to pay for it. Therefore we end up with two options, either we all get less healthcare, or Obama breaks his tax promise. Which will it be?

chuck34

18th August 2009, 15:40

This.

I don't see the point of having great health care if it doesn't fully include 50 million+ of the population.

BS!!!! I can't say this any stronger without being censored. BS!!!!!!!

10-15 million of those are ILLEGAL. Why do we have to pay for someone that is here illegally? BS!!!!!

A few more million, about 10 or so, are under 25 and/or make over $50,000 a year (plenty enough to afford insurance) and just plain choose not to. I'm not one to force anyone to do what they do not choose to do on their own.

That leaves the truly poor. They are taken care of by Medicare/Medicaid. So if you really want to improve their coverage, let's fix those GOVERNMENT run programs. And do it before you screw up the 85-90% of the US population that currently has health insurance.

chuck34

18th August 2009, 15:43

What would be the situation with private health care in the US under Obama's plans?

I responded too fast, and you added this last bit. Obama claims that nothing would change. But that's a lie. I've already been told that if there is a "Public Option", my company will drop their insurance. I'm sure my company isn't the only one that will do this.

That is the plan. Obama has said so previously, but is now denying it. He said that it may take 10/15/20 years, but by providing a "Public Option", that is the best way to transition into a single payer system. And he's right, that's what will happen.

Brown, Jon Brow

18th August 2009, 16:15

I responded too fast, and you added this last bit. Obama claims that nothing would change. But that's a lie. I've already been told that if there is a "Public Option", my company will drop their insurance. I'm sure my company isn't the only one that will do this.

That is the plan. Obama has said so previously, but is now denying it. He said that it may take 10/15/20 years, but by providing a "Public Option", that is the best way to transition into a single payer system. And he's right, that's what will happen.

Lets put some economic theory into this. If you have a public option then demand for private health insurance will go down. Usually when demand falls for a product/service the price falls too. So wouldn't private health insurance become cheaper?

chuck34

18th August 2009, 16:19

Lets put some economic theory into this. If you have a public option then demand for private health insurance will go down. Usually when demand falls for a product/service the price falls too. So wouldn't private health insurance become cheaper?

That could be, but I doubt it. Because the price of the treatments will stay the same. So the payments that the insurance company are paying out won't drop much, if at all. Their administrative costs should go down though. But that won't be immediate either. Therefore people will be in the "Public Option" and I'm going to guess that there will be restrictions put in place that will make it hard to extract yourself from that system, once you're in.

Malbec

18th August 2009, 16:45

the Canadian healthcare system, which has wait times, and which rations care. Americans don't want our model, yet many on Obama's side look at Canada as the way to go.

At the risk of repeating myself again and again, ALL countries ration healthcare. Canada or other socialised systems do, America does and will do whatever reforms come in. Anyone who thinks a particular system doesn't ration is simply wrong. AFAIA Canada though is unique in banning 'private' healthcare, ie the state is the one and only provider. This doesn't happen anywhere else and therefore Canada isn't a good model for those wanting to see how socialised healthcare systems can and do work.

Malbec

18th August 2009, 16:55

Lets put some economic theory into this. If you have a public option then demand for private health insurance will go down. Usually when demand falls for a product/service the price falls too. So wouldn't private health insurance become cheaper?

Its not that simple. In the UK private healthcare is considerably cheaper than it is in the US because its effectively state subsidised. Private hospitals do not treat emergencies, and if operations go wrong patients are transferred to the NHS for intensive care. Therefore private hospitals don't have to invest in the most expensive parts of healthcare, have lower running costs and can charge less. Also, private healthcare does not need to invest in training staff, the state university system and the NHS do that for them. The private system in the UK is an option to the state funded default option NHS.

In the US, its the private system thats the default and the state funded system that is the 'option' if you're too poor or qualify for medicaid/care. Cutting demand for private care is fine by boosting state services but this may have unforeseen results. Having said that, my belief is that the US health insurers are pretty bloated as they effectively operate in a cartel, all using the same model as each other. A properly executed state funded option as proposed by Obama may well run on considerably less money and may well bring down costs across the board as the private companies have to compete.

Malbec

18th August 2009, 17:00

That could be, but I doubt it. Because the price of the treatments will stay the same. So the payments that the insurance company are paying out won't drop much, if at all. Their administrative costs should go down though. But that won't be immediate either. Therefore people will be in the "Public Option" and I'm going to guess that there will be restrictions put in place that will make it hard to extract yourself from that system, once you're in.

The NHS pays considerably less for its drugs than the US does because it has far greater negotiating power than any individual US healthcare provider. In fact its cut its pharm costs by about 5% per year over the past few years due to an agreement with the pharm companies. It does help that some of the biggest pharm companies are in fact British. If the US government were to negotiate directly with the pharm companies there will be discounts to be had. When companies bid for contracts to supply drugs for 50 million people at a time you'd be surprised how far costs can drop.

Another thing that doesn't help is the fact that pharm companies advertise directly to the consumer in the US, and they also pay off doctors and hospitals to prescribe their medication when far cheaper alternatives would suffice, inflating costs again. This is a serious problem that needs to be looked at and the current reforms don't appear to mention anything about them.

chuck34

18th August 2009, 17:43

The NHS pays considerably less for its drugs than the US does because it has far greater negotiating power than any individual US healthcare provider. In fact its cut its pharm costs by about 5% per year over the past few years due to an agreement with the pharm companies. It does help that some of the biggest pharm companies are in fact British. If the US government were to negotiate directly with the pharm companies there will be discounts to be had. When companies bid for contracts to supply drugs for 50 million people at a time you'd be surprised how far costs can drop.

Another thing that doesn't help is the fact that pharm companies advertise directly to the consumer in the US, and they also pay off doctors and hospitals to prescribe their medication when far cheaper alternatives would suffice, inflating costs again. This is a serious problem that needs to be looked at and the current reforms don't appear to mention anything about them.

I agree that drug costs should and could come down. However, I don't think the government is the one to do it. I think that if people had more input into their own health choices they would have more insentive to ask for the cheaper drugs. That is why I think getting away from the employer based system and switching to an individual system works better in most cases.

Malbec

18th August 2009, 17:53

I agree that drug costs should and could come down. However, I don't think the government is the one to do it. I think that if people had more input into their own health choices they would have more insentive to ask for the cheaper drugs. That is why I think getting away from the employer based system and switching to an individual system works better in most cases.

What input do you mean? You mean choice or paying more?

That assumes that each and every patient will be educated about the effects of those drugs whether the more expensive one will be of benefit or is even appropriate. In my experience that isn't the case, people often assume newer is better like with cars or computers and demand the latest regardless of its use.

The easy way would be to break the links between the pharm companies and the medical establishment, making it illegal to offer financial incentives to prescribe a particular drug. That way medical staff will prescribe with clinical efficacy in mind only, not what cut they can take home with them.

As for the block negotiations, alternatively the government could negotiate directly with the drug companies allowing for bulk discounts as in the UK, these drugs could then be sold onto the private insurers or hospitals on a no-profit basis. Just like any other business the more you buy at one time the more money you get off.

Alexamateo

18th August 2009, 18:12

Ok went to the link and read most of it, skimed some. It sounds pretty much like what I'm saying. Fixing lawsuits will do a lot to help lowering costs. It won't solve everything, but it will help. So why not do it?

Oh I agree, like I said, anything that does not include tort reform is incomplete. It's just that some states that have tried "Loser pays" have not had the results they would have hoped for enacting it.

That is one thing though, with 50 states, why not try out all of these ideas in test markets so to speak for a couple of years before they force us into a huge bureaucracy that will never be killed. We can then choose what works, kick out what doesn't and tweak the unintended consequences to get what we as a nation want, whatever that is.

chuck34

18th August 2009, 18:14

What input do you mean? You mean choice or paying more?

I mean choice between generic or not, or even having the drug. Look at it this way. There's this new drug out there, lets call it Fucitall. Fucitall will make you feel better no matter why you feel like crap. But Fucitall costs $100 a pill. Right now, as a consumer, I don't care because my insurance will pay all but say $20 for the script. So I go to my doctor and tell him that I have symptoms that will be cured by Fucitall. Now if I am paying for my own insurance and have to absorb the increased premiums that come with getting this expensive drug, perhaps I will think twice about asking for it.

That assumes that each and every patient will be educated about the effects of those drugs whether the more expensive one will be of benefit or is even appropriate. In my experience that isn't the case, people often assume newer is better like with cars or computers and demand the latest regardless of its use.

Yes, people are rarely educated on drugs and their benefits. However, I believe this would change if the consumer would have a vested interest in their costs increasing. And thus would be more likely (perhaps not much more) to educate themselves.

The easy way would be to break the links between the pharm companies and the medical establishment, making it illegal to offer financial incentives to prescribe a particular drug. That way medical staff will prescribe with clinical efficacy in mind only, not what cut they can take home with them.

I would agree with that. How do you go about doing that?

As for the block negotiations, alternatively the government could negotiate directly with the drug companies allowing for bulk discounts as in the UK, these drugs could then be sold onto the private insurers or hospitals on a no-profit basis. Just like any other business the more you buy at one time the more money you get off.

That may work in the UK, but I have very little faith in the US government being able to negotiate "good" deals and pass the savings on. Everything our government does is so tied up in red tape and beurocratic BS that I doubt we'd see much savings.

chuck34

18th August 2009, 18:16

Oh I agree, like I said, anything that does not include tort reform is incomplete. It's just that some states that have tried "Loser pays" have not had the results they would have hoped for enacting it.

That is one thing though, with 50 states, why not try out all of these ideas in test markets so to speak for a couple of years before they force us into a huge bureaucracy that will never be killed. We can then choose what works, kick out what doesn't and tweak the unintended consequences to get what we as a nation want, whatever that is.

That makes WAAAAAAAY too much sence, it'll never happen. ;-)

Malbec

18th August 2009, 18:44

I mean choice between generic or not, or even having the drug. Look at it this way. There's this new drug out there, lets call it Fucitall. Fucitall will make you feel better no matter why you feel like crap. But Fucitall costs $100 a pill. Right now, as a consumer, I don't care because my insurance will pay all but say $20 for the script. So I go to my doctor and tell him that I have symptoms that will be cured by Fucitall. Now if I am paying for my own insurance and have to absorb the increased premiums that come with getting this expensive drug, perhaps I will think twice about asking for it.

Its never that easy is it. What if you have to remain on fucitall for the rest of your life? What if there are no competitors or generics? Are you going to remain objective when you're ill, or are you simply going to want to do whatever you think will make you better? My experience suggests the latter.

Yes, people are rarely educated on drugs and their benefits. However, I believe this would change if the consumer would have a vested interest in their costs increasing. And thus would be more likely (perhaps not much more) to educate themselves.

In theory thats true but in practice people don't make rational decisions when their health is at stake even when knowledgeable. People don't choose a cancer drug using the same thought processes as they do when choosing between a Merc or Beemer. Thats why doctors are advised to see another doctor when they are ill, to retain objectivity that is easily lost when you're ill.

I would agree with that. How do you go about doing that?

Simple, transactions between pharm companies and the medical establishment need to be audited and offenders prosecuted. Doctors need to be named and shamed and prosecuted where required.

In the UK its always been illegal (and nearly impossible) for pharm companies to pay off individual doctors or hospitals to prescribe their drugs. All they can do is work out a special discount for individual hospital groups on top of what they've worked out with the NHS.

To get around this drug companies used to do what car companies still do with journos, invite top doctors to a launch event somewhere nice, followed by a weekend of golf or sightseeing. The hope was that those doctors would pressurise the hospital into buying that drug, or perhaps choose that drug over a competitor when prescribing. That was made illegal by limiting the amount of money drug companies could spend on events.

That way, drugs are purely prescribed on clinical grounds. Obviously reality is slightly different but cash incentives to prescribe are unheard of.

That may work in the UK, but I have very little faith in the US government being able to negotiate "good" deals and pass the savings on. Everything our government does is so tied up in red tape and beurocratic BS that I doubt we'd see much savings.

And the British government is better? I doubt that very much.

chuck34

18th August 2009, 18:57

Its never that easy is it. What if you have to remain on fucitall for the rest of your life? What if there are no competitors or generics? Are you going to remain objective when you're ill, or are you simply going to want to do whatever you think will make you better? My experience suggests the latter.

Perhaps healthcare shouldn't always be objective and rational. Objectivism and rationalism in healthcare lead to things like Logan's Run and Soylent Green. Obviously those are extreem examples, but if you follow things logically that's pretty much where you're led to. So you need some compassion, hope, and yes non-objective optimism sometimes.

In theory thats true but in practice people don't make rational decisions when their health is at stake even when knowledgeable. People don't choose a cancer drug using the same thought processes as they do when choosing between a Merc or Beemer. Thats why doctors are advised to see another doctor when they are ill, to retain objectivity that is easily lost when you're ill.

You need a doctor to help guide you with or without Nationalising the whole system. That doesn't change anything.

Simple, transactions between pharm companies and the medical establishment need to be audited and offenders prosecuted. Doctors need to be named and shamed and prosecuted where required.

In the UK its always been illegal (and nearly impossible) for pharm companies to pay off individual doctors or hospitals to prescribe their drugs. All they can do is work out a special discount for individual hospital groups on top of what they've worked out with the NHS.

To get around this drug companies used to do what car companies still do with journos, invite top doctors to a launch event somewhere nice, followed by a weekend of golf or sightseeing. The hope was that those doctors would pressurise the hospital into buying that drug, or perhaps choose that drug over a competitor when prescribing. That was made illegal by limiting the amount of money drug companies could spend on events.

That way, drugs are purely prescribed on clinical grounds. Obviously reality is slightly different but cash incentives to prescribe are unheard of.

As you just pointed out, there are always loopholes and work arounds. That's why I'm not sure how you could ever really stop any of this.

And the British government is better? I doubt that very much.

As do I. You seem to be saying that the UK system is good, not me.

Malbec

18th August 2009, 19:07

Perhaps healthcare shouldn't always be objective and rational. Objectivism and rationalism in healthcare lead to things like Logan's Run and Soylent Green. Obviously those are extreem examples, but if you follow things logically that's pretty much where you're led to. So you need some compassion, hope, and yes non-objective optimism sometimes.

You need a doctor to help guide you with or without Nationalising the whole system. That doesn't change anything.

Non-objective optimism? Thats what an economist would call a waste of money. If there isn't evidence or logic to back up a treatment, don't do it. Non-objective optimism isn't just a waste of money and resources, its also cruel to the patient by raising hopes that can't be delivered upon more often than not. I thought wasting money was precisely what you were against?

As you just pointed out, there are always loopholes and work arounds. That's why I'm not sure how you could ever really stop any of this.

You can't stop it but you can minimise it as I've suggested. The US is one of the few countries where such backhanders aren't even illegal and hasn't taken any steps to do anything about it. Even a small step can reduce the problem.

As do I. You seem to be saying that the UK system is good, not me.

Actually you were the one doubting that the US government could negotiate discounts like the one the British government has, hence suggesting that the US government is not as capable.

Malbec

18th August 2009, 19:40

Starter, of course the US does indeed protect patents for longer than many other states but that again is the US's choice is it not? I don't think the role of any healthcare system should be to subsidise pharm companies or make drugs cheaper elsewhere. That appears to me to be a sideeffect of a shortfall in the system rather than a charitable act for the world.

That said, the drug companies that supply new patent protected pharm agents can be forced to reduce their charges in other ways.

One of my good friends is an executive at a US drug company but based at its research centre in the UK. Whilst he does not engage in negotiations with the UK government directly he knows exactly what the tactic is to drive down costs. The pharm company will try to charge what it can for its patent protected products. The government then suggests that if it doesn't cut the price then the pharm company may well find its other (often generic) products 'reconsidered'. IE if you don't cut the price you may find thats the last thing we buy from you. Looking at the whole product range it is then often in the pharm companies interests to negotiate a cheaper price, even operate at a loss for a brief period on that drug in the hope that its uptake will be higher than expected.

BTW your use of thalidomide as an example is flawed, it was introduced in Europe before rigorous testing was introduced and to the US much later. It is not a good illustration of the failures of drug testing systems around the world, although it is a good illustration of what happens when animal testing is skipped but thats another story.

These days pharm companies tend to get FDA approval first before approaching other countries, the reason being that many countries do not bother testing drugs themselves but use FDA approval as their own standard, ie if a drug is legal in America then it automatically gains approval in many other countries/markets. Certainly drugs tend to reach Britain later than the American market as the British still require separate tests and trials, although the trials required for FDA approval can be used to speed things along.

chuck34

18th August 2009, 19:52

Non-objective optimism? Thats what an economist would call a waste of money. If there isn't evidence or logic to back up a treatment, don't do it. Non-objective optimism isn't just a waste of money and resources, its also cruel to the patient by raising hopes that can't be delivered upon more often than not. I thought wasting money was precisely what you were against?

Well logically since somewhere in the neighborhood of 90% of a person's medical expences occur during the last 6 months of your life. And considering that the average life expectancy is somewhere around 72. Shouldn't we just off everyone at 71 and a half? That sure would solve a lot of the health care costs, logically.

You can't stop it but you can minimise it as I've suggested. The US is one of the few countries where such backhanders aren't even illegal and hasn't taken any steps to do anything about it. Even a small step can reduce the problem.

I'm not saying that we shouldn't take those steps. Far from it, we should do that. It just doesn't require Nationalization to do it.

Actually you were the one doubting that the US government could negotiate discounts like the one the British government has, hence suggesting that the US government is not as capable.

Ok the US system is broken, and by your own admission the UK system isn't perfect. So why again should we follow the UK model? Shouldn't we try something completely different? Wouldn't something different be to put insurance solely in the hands of the individual?

Malbec

18th August 2009, 20:15

I'm not saying that we shouldn't take those steps. Far from it, we should do that. It just doesn't require Nationalization to do it.

I couldn't agree more with that statement, which is why I said above that this is a separate issue from state funded healthcare, something that Obama isn't dealing with with his reforms yet could save a lot of money relatively painlessly.

Ok the US system is broken, and by your own admission the UK system isn't perfect. So why again should we follow the UK model? Shouldn't we try something completely different? Wouldn't something different be to put insurance solely in the hands of the individual?

No healthcare system is perfect, it would be foolish to think so yet there is nothing wrong with learning from other systems. Redefining the relationship between US healthcare and the pharm industry to cut costs for the former doesn't require socialisation, nationalisation or whatever term you want to use for it. There's no need to be ripped off and carry on being ripped off because you don't want to adopt someone else's system for the sake of it.

Drew

18th August 2009, 21:02

A couple of my Texan friends just told me that their Aunty told them that one of Obama's plans is to counsel the old and sick about death, so that they don't ask for more health care and thus die quicker.

Obama really needs to sort out what the hell his plan is, cos such rumours due to him being unclear really aren't going to help him.

chuck34

18th August 2009, 21:10

I couldn't agree more with that statement, which is why I said above that this is a separate issue from state funded healthcare, something that Obama isn't dealing with with his reforms yet could save a lot of money relatively painlessly.

Ok I must have missed it when you said that this should be done despite anything else. Sorry :-)

No healthcare system is perfect, it would be foolish to think so yet there is nothing wrong with learning from other systems. Redefining the relationship between US healthcare and the pharm industry to cut costs for the former doesn't require socialisation, nationalisation or whatever term you want to use for it. There's no need to be ripped off and carry on being ripped off because you don't want to adopt someone else's system for the sake of it.

Right, I'm not advocating discarding the UK model "for the sake of it". I'm saying, and you have said as well, that the UK model is not perfect. So why not strive for something better?

It seems to me that from what I can gleam from the jumbled mess comming out of Washington is that the Pres, and Congress are trying to inact some sort of mish-mash of the Canadian and UK systems. And they appear to be using the worst parts of both systems. On top of that they are trying to do it so fast that no one has time to examine exactly what they are doing, and stop it. I'm failing to see any logic in any of this except when you go back to then-Senator Obama's comments about wanting to have a single payer system.

Rollo

18th August 2009, 21:26

BS!!!! I can't say this any stronger without being censored. BS!!!!!!!

10-15 million of those are ILLEGAL. Why do we have to pay for someone that is here illegally? BS!!!!!

Healthcare statistics as compiled by the United States Department of Health and Human Services as as their primary collection device the Social Security Number (SSN).

If you don't have an SSN then you are not included in the statistics, so whilst there may in fact be 10-15 million illegal immigrants to the United States, they never appear in the statistics by the United States Department of Health and Human Services and as such aren't included in the 45-50 million people who do not have health care.

It's a subtle point, but one which was made in the Senator by Robert Byrd who is the current "Father of the House"

Alexamateo

18th August 2009, 21:56

Healthcare statistics as compiled by the United States Department of Health and Human Services as as their primary collection device the Social Security Number (SSN).

If you don't have an SSN then you are not included in the statistics, so whilst there may in fact be 10-15 million illegal immigrants to the United States, they never appear in the statistics by the United States Department of Health and Human Services and as such aren't included in the 45-50 million people who do not have health care.

It's a subtle point, but one which was made in the Senator by Robert Byrd who is the current "Father of the House"

I still think we have to know a little more about data collection methods.

I don't want to take this thread in another direction, but working and selling in construction, companies I have worked for and sell to all take out social security and medicaire taxes on their employees, and I would say fully 75% or more are illegal based on the #'s of mismatched letters recieved, but we would just stick them in the file and go on. They all had social security #'s.

Any survey of employers would show X # of workers not covered by insurance.

Also, this is OT, but our wages to workers actually went up when the Hispanic work force came in to Memphis in the mid-90's, but they were worth the higher wages, production went up so wages went up, and you wanted to keep them.

chuck34

18th August 2009, 22:50

Healthcare statistics as compiled by the United States Department of Health and Human Services as as their primary collection device the Social Security Number (SSN).

If you don't have an SSN then you are not included in the statistics, so whilst there may in fact be 10-15 million illegal immigrants to the United States, they never appear in the statistics by the United States Department of Health and Human Services and as such aren't included in the 45-50 million people who do not have health care.

It's a subtle point, but one which was made in the Senator by Robert Byrd who is the current "Father of the House"

I don't know where Byrd got his info. And I'm not sure he's the most reliable source anyway. Here's a few links from just a quick Google search to look at. Especially look at the WSJ one, it's really good.

http://online.wsj.com/article/SB124579852347944191.html
http://cnsnews.com/news/article/52593
http://keithhennessey.com/2009/04/09/how-many-uninsured-people-need-additional-help-from-taxpayers/

How many more do you want? Can you link to the HHS report? Everything that I can find says 9-10million illegals being counted in that number of 46-50million uninsured.

And as Alex pointed out, there are plenty of illegals that have SSN's. So that doesn't really mean too much to me.

anthonyvop

19th August 2009, 00:52

Lets hear it for the Great Government British Universal Healthcare system!!!

http://www.dailymail.co.uk/news/article-1207151/Woman-gives-birth-pavement-refused-ambulance.html

Then there is the Canadian model:

http://www.vancouversun.com/story_print.html?id=1878506&sponsor

WhooooooHooooooo......ObamaCare!!!!

Drew

19th August 2009, 01:45

Starter, what I mean is that he needs to clear things up. Rumours like that sure aren't going to help him.

Lets hear it for the Great Government British Universal Healthcare system!!!

http://www.dailymail.co.uk/news/article-1207151/Woman-gives-birth-pavement-refused-ambulance.html

It's funny how you highlight the case of one person unable to get healthcare, but yet don't consider 40-50 million people in your own country as anything special or anything to worry about. Funny that.

Malbec

19th August 2009, 02:53

The US patent system is based or greed, or at least the desire for a good gain from one's efforts. That's why it's set up this way. The purpose is to incentify people to use their ingenuity to find better ways/things. Knowing that many efforts will fail. The failure rate for proposed new drugs far exceeds the ones which come to market - the cost of that wasted effort must also be factored into the cost of those that do succeed. Why spend the time, effort, and frustration unless there is a payoff at the end?

Although you call it the US patent system, it is in fact global with a few notable exceptions like India. I've just had a look at the average patent length in the US, its about 10 years (20 from the inception of the drug but obviously trials etc take around a decade). In the NHS its also 10 although in other countries the period may well be shorter. It therefore doesn't explain why drugs are cheaper for the UK. Most countries seem happy to protect the patent for 20 years after the application is accepted as is the international treaty agreed norm.

The US healthcare system shouldn't be there to subsidise pharm companies, it should be there to deliver healthcare to US citizens. I know thats not what you're saying but again strong reform in this area would give quick savings. Problem is of course that those pharm companies have serious clout.

Rollo

19th August 2009, 03:10

How many more do you want? Can you link to the HHS report?

You don't need to. The LAW is sufficient:
http://www.ssa.gov/history/reg1.html
No member, officer, or employee of the Board, except as authorized by this regulation or otherwise expressly authorized by the Board, shall produce or disclose to any person or before any tribunal, directly or indirectly, whether in response to a subpoena or otherwise, any record (including any file, letter, application, claim, return, report, or other paper or document) or any information acquired therefrom or otherwise officially acquired, pertaining to any person.

The law itself prevents the official generation of reports unless consent is given to the Department by the individual in question. Since anyone reporting to the Department does so via the instrument of their SSN, they can't very well give consent for an official report to be generated without it.

An "illegal" person is simply unknown to the department, and if they're unknown then they can't very be included in the statistics can they?
There are known knowns; there are things the Department knows they know. They also know there are known unknowns; that is to say they know there are some things they do not know. But you are asking to provide details of unknown unknowns.

Mark in Oshawa

19th August 2009, 04:34

I must commend Dylan, Chuck, Starter and Rollo, for by reading their postings that they put in while I was at work, They gave a great debate of the merits of all the options, and what the proponents of what Obama is proposing haven't done is this sort of dialogue. All the politicians in favour of it do is say it wont be that bad. THAT isn't a debate, that is saying "Trust me". No one trusts politico's of either stripe with that sort of reassurance; and Obama's administration is out emailing its oppenents with their talking points. No violation of privacy there eh??? Not much....not far off Nixon's "Enemies" List.

If I was an American I would be very cautious about government involvement in the health sector, but woudln't be against it. Dylan's points in particular has given me the impression that the NHS is the best comprimise, but I am adamently sure that the US isn't going to get the NHS, they are going to get a mishmash of all the plans, with Canadian style exclusive care. In short a nightmare.

The only reason Canada's system works as well as it does because the R and D in the profit driven US system has brought in advances that we all need; AND the Canadian people have done their best to pay for a system that in the 1960's sounded like a very fair idea. For a decade or two it almost worked that way, but it is now starting to strain. In the end, I suspect within 2 decades we will be similar to the French or British model......and maybe with the right steps, with prudent protection for the private citizen, the US will be as well.

Mark in Oshawa

19th August 2009, 06:14

Want to bet? Anything said by Robert "Pork for my State" Byrd is open to suspicion.

The SAME Robert Byrd who was a paid up member in good standing once upon a time in the KKK. If there is any other proof you need for the blindness of the US media to the faults of Democratic party stalwarts, this is it. A Republican is crucified if they even look at a white sheet the wrong way, Byrd has always had a free pass.

The fact he has just about every road, bridge and building named after him in WV says to me he is great at digging into pork. THAT is essentially the WRONG kind of pol to have on side writing legislation on healthcare reform.

chuck34

19th August 2009, 12:29

Starter, what I mean is that he needs to clear things up. Rumours like that sure aren't going to help him.

It's funny how you highlight the case of one person unable to get healthcare, but yet don't consider 40-50 million people in your own country as anything special or anything to worry about. Funny that.

Again, that number is BS. And even if you choose to believe it isn't, it is against the law for any emergency room in the States to turn anyone away if they are in need of care.

I can not stress this point enough, especially sence people seem to want to ignore it. It is illegal for anyone in need of care to be turned away from an emergency room.

I would say that a woman in labor, is most definately in need of care, wouldn't you?

chuck34

19th August 2009, 12:34

You don't need to. The LAW is sufficient:
http://www.ssa.gov/history/reg1.html
No member, officer, or employee of the Board, except as authorized by this regulation or otherwise expressly authorized by the Board, shall produce or disclose to any person or before any tribunal, directly or indirectly, whether in response to a subpoena or otherwise, any record (including any file, letter, application, claim, return, report, or other paper or document) or any information acquired therefrom or otherwise officially acquired, pertaining to any person.

The law itself prevents the official generation of reports unless consent is given to the Department by the individual in question. Since anyone reporting to the Department does so via the instrument of their SSN, they can't very well give consent for an official report to be generated without it.

An "illegal" person is simply unknown to the department, and if they're unknown then they can't very be included in the statistics can they?
There are known knowns; there are things the Department knows they know. They also know there are known unknowns; that is to say they know there are some things they do not know. But you are asking to provide details of unknown unknowns.

So there are no illegals that have SSN's? And since the law says they can't report people without SSN's, I'm sure no one would like to exaggerate would they?

Again I can't find this HHS report that you and the estemed Sen. Byrd are refering to. Can you post a link? Everything that I have seen says that that 50 million number includes 9-10 million illegals at least.

chuck34

19th August 2009, 12:38

The SAME Robert Byrd who was a paid up member in good standing once upon a time in the KKK.

He wasn't just a member in good standing, he was the "Exalted Cyclops". A fact that for some reason the media likes to forget. I suppose because he's not from the "racist" Republican party. That idea is so laughable I don't even know where to begin. But now we're off topic, sorry.

Drew

19th August 2009, 14:17

Again, that number is BS. And even if you choose to believe it isn't, it is against the law for any emergency room in the States to turn anyone away if they are in need of care.

I can not stress this point enough, especially sence people seem to want to ignore it. It is illegal for anyone in need of care to be turned away from an emergency room.

I would say that a woman in labor, is most definately in need of care, wouldn't you?

Well say the figures are actually half of that, 20 -25 million, is that still not alot?!

What would happen to a woman like this in America then? Imagine she has no insurance, lived across the road and phone up for an ambulance. What would happen, would she have been taken care of and then left with a massive bill afterwards?

Btw she wasn't refused care as such, just refused an ambulance.

chuck34

19th August 2009, 14:52

Well say the figures are actually half of that, 20 -25 million, is that still not alot?!

What would happen to a woman like this in America then? Imagine she has no insurance, lived across the road and phone up for an ambulance. What would happen, would she have been taken care of and then left with a massive bill afterwards?

Btw she wasn't refused care as such, just refused an ambulance.

I'll say it again, and I'll keep saying it. No matter what the number is, no one is refused care in the United States of America, period, end of sentence. In fact we already have programs called Medicare and Medicaid that will take care of anyone that can not afford healthcare currently.

That system is broken. It does not work well. And has no money. Why don't we concentrate on fixing the systems we have before we go mucking up everyone else's system?

I seriously doubt anyone in the US would be denied an Ambulance ride if they were in labor. I have never heard of anything like that.

Mark in Oshawa

19th August 2009, 15:12

I was at an accident scene on the Penn Turnpike last Friday. The accident was about 300 yards ahead of me when it happened and a woman lost control and flipped. I stopped as a witness and helped direct traffic around her vehicle until the troopers and ambulance got there. The volunteer FD EMTs got there first and the ambulance shortly after. AT no point did anyone ask her about her coverage and health provider. She got care, pretty decent care by anyone's standard and she was hustled off to the hospital to be checked over and not once did anyone ask her about her coverage.

Chuck is right on this one, they look after you, and then in the aftermath, someone asks you how you are going to pay for it. I have been told that by friends of mine who have been hurt skiing or doing something in the US. Being Canadians, we apply to our provincial system to pay the American fee's but they wont always cover all of it...so just about everyone I know buys insurance for going south to cover what our nationalized plan doesn't cover. Apparently that can be a lot. That said, no one in need is refused care that I have seen or heard; and believe me, if a Canadian in the US was refused care, our papers would be all over it because they just LOVE to show those mean ole nasty American's abusing poor innocent Canadians..lol

chuck34

19th August 2009, 15:13

Listen, I think we are getting bogged down in the details here. Not that the details aren't important to the discussion. It's just that this is a much simpiler issue.

In order to add millions more people, who by definition are not currently, nor will they, pay into the sytem (the number doesn't matter 20 or 50 or even 10 is an increase). You must raise taxes (even on those making less than $250,000 because even if you tax those over at 100% you can not raise enough, $1,000,000,000,000 according to the CBO), and you must ration services.

I can not see any other way. Obama keeps claiming that he'll be able to save X money by doing this, that, and the other thing. Maybe that's true, maybe that's not. I say let's inact the cost saving measures now so that we can truly evaluate the savings, and base things on actual numbers, not theoretical.

Jag_Warrior

19th August 2009, 15:20

I think there's a fine line between saying that people in the U.S. are not refused (initial) care and people are not denied care.

People are denied care. I thought that became common knowledge when stories began appearing that patients without insurance were being forcibly discharged from hospitals in California, some even left on the side of the street or in homeless shelters. Many of these people were still wearing their hospital bracelets. I've never in my life heard of anyone who had money or insurance being dumped like a sack of potatoes on the side of the road. If you have insurance or money, the doctors generally want you to hang around as long as possible - order 10 more tests and schedule 5 more consultation visits (where they might poke their head in your room as they're headed for lunch).

I don't know what would have happened to this pregnant woman in the U.S. Mistakes and accidents happen everywhere (like people who have died in the ER before being seen), whether here or in the UK. But my local news carried a story last night about a woman whose husband was a contractor, and they had private insurance (non group). Her pregnancy was NOT covered by the insurance company because she got pregnant before he bought the policy. So it was considered a pre-existing condition, and they didn't have to cover her. I know from personal experience, even with a group policy, if something happens that takes you past your lifetime coverage limit, neither you nor your family has coverage (with that company). How often these things happen, I have absolutely no idea. But I know that it happens.

From insurance to pharma to doctors to lawyers, there are certainly a lot of opportunities to fix the broken parts of our system.

chuck34

19th August 2009, 15:23

From insurance to pharma to doctors to lawyers, there are certainly a lot of opportunities to fix the broken parts of our system.

Exaclty. No one is saying that there aren't problem. NO ONE. But why must the government take over healthcare in order to fix the problems?

Mark in Oshawa

19th August 2009, 15:30

Chuck...I think at some point tho, it is inevitable that the government will get involved. I just think it has to be a very carefully thought out and limited plan to cover the 10 to 20% of legal citizens who are not covered and who may NEED coverage. I think they have to couple it with some legislation for private insurers to have less ways to weasel out of covering people with policies, and to fix the malpractice/tort issue.

You do all of that, and I think some form of government insurance in a restricted income bracket for the poor and indigent is doable.

Jag_Warrior

19th August 2009, 15:33

Exaclty. No one is saying that there aren't problem. NO ONE. But why must the government take over healthcare in order to fix the problems?

To piggyback on what Mark just said, I don't know that the government must "take over" (all of) healthcare to fix these issues.

chuck34

19th August 2009, 15:54

Chuck...

1) I think at some point tho, it is inevitable that the government will get involved.

2) I just think it has to be a very carefully thought out and limited plan to cover the 10 to 20% of legal citizens who are not covered and who may NEED coverage.

3) I think they have to couple it with some legislation for private insurers to have less ways to weasel out of covering people with policies, and to fix the malpractice/tort issue.

4) You do all of that, and I think some form of government insurance in a restricted income bracket for the poor and indigent is doable.

1) In an expanded role over what they already control? Why?

2) That already exists with Medicare/Medicaid. It may not be a perfect system. So why not fix it? Obama has actually proposed to take money away from those plans. http://www.nydailynews.com/news/politics/2009/06/13/2009-06-13_to_pay_for_health_care_overhaul_president_obama _proposes_313b_cuts_in_medicaid_m.html

3) I am in 100% agreement with you that something should be done about the denial for "pre-existing" conditions, malpractice law, tort reform, the cost of drugs, etc. But NO ONE is talking about any of that outside of the "Public Option".

4) Again, we have that in Medicare/Medicaid. Let's fix those programs so that they are run more effectively and in a more cost effective manner.

Jag_Warrior

19th August 2009, 17:06

Roamy

19th August 2009, 17:16

1) In an expanded role over what they already control? Why?

2) That already exists with Medicare/Medicaid. It may not be a perfect system. So why not fix it? Obama has actually proposed to take money away from those plans. http://www.nydailynews.com/news/politics/2009/06/13/2009-06-13_to_pay_for_health_care_overhaul_president_obama _proposes_313b_cuts_in_medicaid_m.html

3) I am in 100% agreement with you that something should be done about the denial for "pre-existing" conditions, malpractice law, tort reform, the cost of drugs, etc. But NO ONE is talking about any of that outside of the "Public Option".

4) Again, we have that in Medicare/Medicaid. Let's fix those programs so that they are run more effectively and in a more cost effective manner.

Bingo - But the liars and cheating politicians won't address the attorney problem because most of them are one. Attorneys insurance companies and accountants have played a big part in ruining this country. Malpractice insurance has turned into a huge part of the cost health care. This is like putting a bandaid over cancer - it won't work. you have to cut out the disease.

If the gov takes it over the rich will take the basic service and then purchase insurance for thing over and above the national coverage. This will obviously create a two tier system with rationing to the unfortunate.

I think we are out of control in many areas and until we have a solid third party to come in and make the repubs and dems accountable we will continue on in turmoil. As I said Attorneys, accountants, insurance companies, and IrS = Cancer

chuck34

19th August 2009, 17:38

While I'm still undecided on the options for healthcare, I question how effectively an individual in the U.S., with pre-existing conditions, can purchase medical insurance as things stand now. If you've had cancer, diabetes, heart problems, polio or any sort of chronic condition, it's quite likely that those pre-existing conditions are going to prevent you from getting any sort of (affordable) coverage that will cover anything important.

A friend of mine had poliio as a kid and he was recently laid off from his job of 40+years. He and his wife are covered under COBRA right now. When that runs out, as he's explained his situation to me, he's sh## outta luck. He'll have to roll the dice and try to make it to 62, when I guess he can get on Social Security and Medicare. If he or his wife get sick in the mean time (and she has health problems too), everything they've worked for over the past 40 some years will be in jeopardy.

I agree this is wrong and needs to be fixed. But it can be fixed witout nationalization or a "Public Option". The easiest way is to get away from employer based healthcare. That way when you change jobs, your conditions don't become "pre-existing" because you don't change insurance.

Perhaps that doesn't work for your friend right now, but other things could be done to address that as well. Like saying that you can't be turned down for diseases that are currently "under control" or something like that.

Roamy

19th August 2009, 17:51

Pre existing conditions are just another example of ins company ripoff.

Jag_Warrior

19th August 2009, 18:19

I agree this is wrong and needs to be fixed. But it can be fixed witout nationalization or a "Public Option". The easiest way is to get away from employer based healthcare. That way when you change jobs, your conditions don't become "pre-existing" because you don't change insurance.

But who would enforce that move, if not the government? If I owned an insurance company, why would I (willingly) let a policy holder receive the same coverage and pay the same premiums that I offered to his employer? Why would I not cancel his coverage when he reached the lifetime limit? Why would I not drop him if it was found that he had some sort of chronic condition? If a woman has a baby with say, Downs Syndrome, why wouldn't I look forward to the day that I could get her and that baby off my rolls? If I'm running a for profit corporation, I am looking at things that might negatively affect my profits. That's the sole purpose of a corporation: to enhance shareholder value.

And anything that the government does to mandate that I have to look out for the public good is a form of government control or interference, no matter how you look at it. Right?

Perhaps that doesn't work for your friend right now, but other things could be done to address that as well. Like saying that you can't be turned down for diseases that are currently "under control" or something like that.

No, all he can do at this point is hope that neither he nor his wife suffer a serious illness. If I was him, I'd transfer ALL of my assets into his kid's name until he turns 62 and can get on Medicare. Until then, he wouldn't be able to pay for expensive care and may get turned out of the hospital at a certain point, but at least they wouldn't be destitute, even though they'd be (technically) bankrupt.

Jag_Warrior

19th August 2009, 18:25

Pre existing conditions are just another example of ins company ripoff.

Possibly. But it's also a smart (though possibly harsh) way to protect profits. Again, if I owned a medical insurance company, the last thing I would want is older people, sick people, fat people, smokers, people involved in dangerous jobs, etc. If I could (legally) get my hands on their genetic background, I'd use that in my favor too. They do risk analysis models that I can barely understand. But just like with auto insurance, the best day at an insurance company is one where all of the policy holders pay their premiums, and none of them files a claim.

anthonyvop

19th August 2009, 19:24

Starter, what I mean is that he needs to clear things up. Rumours like that sure aren't going to help him.

It's funny how you highlight the case of one person unable to get healthcare, but yet don't consider 40-50 million people in your own country as anything special or anything to worry about. Funny that.

It is funny how little you know about healthcare in the US yet seem inclined to comment on it.

NOBODY IS DENIED HEALTCARE IN THE US! NOBODY. NADA. ZIP. ZILCH.

NOBODY.

Illegal aliens get healthcare.

We even pay for career criminals to get sex change operation.

OK? Get it? Understand now?

Jeez.

chuck34

19th August 2009, 19:43

1) But who would enforce that move, if not the government?

2) If I owned an insurance company, why would I (willingly) let a policy holder receive the same coverage and pay the same premiums that I offered to his employer? Why would I not cancel his coverage when he reached the lifetime limit? Why would I not drop him if it was found that he had some sort of chronic condition? If a woman has a baby with say, Downs Syndrome, why wouldn't I look forward to the day that I could get her and that baby off my rolls? If I'm running a for profit corporation, I am looking at things that might negatively affect my profits. That's the sole purpose of a corporation: to enhance shareholder value.

3) And anything that the government does to mandate that I have to look out for the public good is a form of government control or interference, no matter how you look at it. Right?

4) No, all he can do at this point is hope that neither he nor his wife suffer a serious illness. If I was him, I'd transfer ALL of my assets into his kid's name until he turns 62 and can get on Medicare. Until then, he wouldn't be able to pay for expensive care and may get turned out of the hospital at a certain point, but at least they wouldn't be destitute, even though they'd be (technically) bankrupt.

1) Of course the government would have to enforce the laws. Laws aren't always bad.

2) What prevents the government from doing the exact same type of things? They may not be for-profit, but they do have to worry about costs.

3) Of course. However, I would much rather the government set up guidelines for corporations to work within than having the government actually running things. This is true of any corp.

4) Your friend is in a seriously crappy situation. Sorry about that. I don't know enough about moving money around and what not to know if that is a good idea or not. What I can tell you is that there may be companies that will insure him, maybe not. I have a cousin with MS, and she has insurance. Actually it is pretty good coverage. So it's out there, you just need to find the right place.

BDunnell

19th August 2009, 19:46

It is funny how little you know about healthcare in the US yet seem inclined to comment on it.

NOBODY IS DENIED HEALTCARE IN THE US! NOBODY. NADA. ZIP. ZILCH.

NOBODY.

Illegal aliens get healthcare.

We even pay for career criminals to get sex change operation.

OK? Get it? Understand now?

Jeez.

I find it a bit rich for you to ask someone else, in your usual charmingly light-hearted fashion, whether they 'Understand now?' in a post that is so badly typed as that.

chuck34

19th August 2009, 19:47

Possibly. But it's also a smart (though possibly harsh) way to protect profits. Again, if I owned a medical insurance company, the last thing I would want is older people, sick people, fat people, smokers, people involved in dangerous jobs, etc. If I could (legally) get my hands on their genetic background, I'd use that in my favor too. They do risk analysis models that I can barely understand. But just like with auto insurance, the best day at an insurance company is one where all of the policy holders pay their premiums, and none of them files a claim.

Again, what would stop the government from doing these type of things? They also want to control costs. Looking at a cost/bennifit chart rationally as you suggested the government would do, leads down some pretty nasty roads. Especially if/when the government is your only option. At least if you are turned down by an insurance company you may be able find another company to go through, or even pay out of pocket (I know that doesn't help the poor, but the gov. already "helps" them). If the government controls healthcare, once they turn you down, you're done.

Roamy

19th August 2009, 19:47

Possibly. But it's also a smart (though possibly harsh) way to protect profits. Again, if I owned a medical insurance company, the last thing I would want is older people, sick people, fat people, smokers, people involved in dangerous jobs, etc. If I could (legally) get my hands on their genetic background, I'd use that in my favor too. They do risk analysis models that I can barely understand. But just like with auto insurance, the best day at an insurance company is one where all of the policy holders pay their premiums, and none of them files a claim.

Which is precisely why we are looking at nat health care. Plus the capitalist failure to police themselves.. That coupled with the horrendous amount of crooks in government will have us in turmoil for quite a while now. with respect to smoking etal - unless you want big brother to handle your every move you just have to accept the whole package and move on. Gee we build all these fancy bars - sell tons of alcohol and then the police sit right outside the door waiting for you because we have no affordable, reliable transportation home. Expensive cabs and a urban lifestyle is really what does not mix with alcohol.

We can go on and on but there are many things that should be fixed here and probably the best way is to police the capitalists and let them have at it.

Jag_Warrior

19th August 2009, 19:50

Anthony, a man was just on Bloomberg and he was denied an operation unless he could come up with a $3000 downpayment for an eye operation. He couldn't get the money and so he couldn't get the operation. Because of his pre-existing diabetes, his premiums made insurance unaffordable. Pay the mortgage and buy food or carry insurance. I guess he liked to eat and live indoors. He's now partially blind. What's cruelly ironic about that situation: now that he's disabled, he is now covered by Medicare.

As far as I know, an emergency room will (eventually) see anyone who walks in. As far as I know, no one has been tossed out before getting some initial care or evaluation. But as I've pointed out, and I assumed we all knew, hospitals have forcibly discharged patients who did not have insurance or the money to continue being treated. So to say that no one is denied health care in the U.S. is not accurate.

BDunnell

19th August 2009, 19:50

I would much rather the government set up guidelines for corporations to work within than having the government actually running things. This is true of any corp.

Experience in all sorts of fields suggests that those guidelines have to be extremely stringent, and the penalties for poor performance utterly pernicious, in order to force the private company into performing in a manner conducive to offering the best service. All sorts of examples can be found in the UK, where private sector involvement in the public services has often been a disaster in terms of providing those services, yet extremely lucrative for the firms involved. The desire of successive governments to be seen as being 'business-friendly', or whatever, sees to it that this becomes just as damaging a status quo as any lumbering, inefficient publicly-owned body.

chuck34

19th August 2009, 19:50

I have yet to see anyone explain to me how you add millions of people to the "system" without raising taxes or rationing services.

Anyone?

BDunnell

19th August 2009, 19:51

As far as I know, an emergency room will (eventually) see anyone who walks in.

Just as they do here in the UK — and without the requirement for the patient to sit before a death panel in the course of their visit, as surprising as this may be to some.

chuck34

19th August 2009, 19:53

Experience in all sorts of fields suggests that those guidelines have to be extremely stringent, and the penalties for poor performance utterly pernicious, in order to force the private company into performing in a manner conducive to offering the best service. All sorts of examples can be found in the UK, where private sector involvement in the public services has often been a disaster in terms of providing those services, yet extremely lucrative for the firms involved. The desire of successive governments to be seen as being 'business-friendly', or whatever, sees to it that this becomes just as damaging a status quo as any lumbering, inefficient publicly-owned body.

Numerous examples can also be found where too much government involvment has made a mess of things. Ever hear of a little thing called the Community Reinvestment Act?

I'm not saying this is easy, quite the oposite, it's REALLY hard. That's why we need more than two weeks to debate this Bill in Congress.

BDunnell

19th August 2009, 19:54

I think you meant suburban. An urban lifestyle works just fine what with public transportation or walking arounf the corner.

But where are the worst alcohol problems — in the centres of large cities or the edges of smaller towns?

Jag_Warrior

19th August 2009, 20:14

I'm not saying this is easy, quite the oposite, it's REALLY hard. That's why we need more than two weeks to debate this Bill in Congress.

I don't disagree with that at all, Chuck. And a proper debate, based on facts and not baseless hysteria, is what will get us there. Do you agree?

As I've said, I've been a proud NRA member for most all of my adult life. I like my guns. I will not apologize for that. But it greatly concerns me when I see people "exercising their 2nd Amendment rights" in the middle of a townhall debate about health care. There are some true nuts running around out there who are just there just to be part of the show... or to create a show. And what concerns me is that one of these silly b#stards is going to eventually do something stupid, and life will get worse for all of us... especially people like me.

Let's rationally discuss the issue at hand. We, as a people, need to stop allowing ourselves to be played like puppets and sheep by the powers-that-be. What is the truth? What do we want? What is it going to take to get us there? I blame Obama for not being at all clear about his (non) proposal. I blame the Dems for not putting forth a rational plan. I blame the Republicans for not putting forth a rational counter plan. I don't feel like we're getting anywhere! Hell, I'm as confused as anybody else. It is clearly something that (IMO) needs to be addressed. But the interested parties really know the game and they're playing it extremely well. I doubt we end up with anything truly worth a damn.

I wouldn't go to one of these townhall meetings to save my life. I'm pretty calm most of the time. But when people get silly and really start going off topic, I do lose what little patience I have. I can't imagine how I might react if I'd driven three hours to go to a health care townhall meeting, and some kook wants to talk about birth certificates and the 2nd Amendment. You guys might see ol' Jag on CNN Healine News. I'd be the big guy screaming "STFU, you slack jawed moron!!!"... with my hands clamped around some Gomer's neck. :D

Probably best that I just stay at home...

chuck34

19th August 2009, 20:18

I don't disagree with that at all, Chuck. And a proper debate, based on facts and not baseless hysteria, is what will get us there. Do you agree?

As I've said, I've been a proud NRA member for most all of my adult life. I like my guns. I will not apologize for that. But it greatly concerns me when I see people "exercising their 2nd Amendment rights" in the middle of a townhall debate about health care. There are some true nuts running around out there who are just there just to be part of the show... or to create a show. And what concerns me is that one of these silly b#stards is going to eventually do something stupid, and life will get worse for all of us... especially people like me.

Let's rationally discuss the issue at hand. We, as a people, need to stop allowing ourselves to be played like puppets and sheep by the powers-that-be. What is the truth? What do we want? What is it going to take to get us there? I blame Obama for not being at all clear about his (non) proposal. I blame the Dems for not putting forth a rational plan. I blame the Republicans for not putting forth a rational counter plan. I don't feel like we're getting anywhere! Hell, I'm as confused as anybody else. It is clearly something that (IMO) needs to be addressed. But the interested parties really know the game and they're playing it extremely well. I doubt we end up with anything truly worth a damn.

I wouldn't go to one of these townhall meetings to save my life. I'm pretty calm most of the time. But when people get silly and really start going off topic, I do lose what little patience I have. I can't imagine how I might react if I'd driven three hours to go to a health care townhall meeting, and some kook wants to talk about birth certificates and the 2nd Amendment. You guys might see ol' Jag on CNN Healine News. I'd be the big guy screaming "STFU, you slack jawed moron!!!"... with my hands clamped around some Gomer's neck. :D

Probably best that I just stay at home...

Totally agree with this. Isn't that what we are doing, having a rational debate? I think you are putting forward rational ideas, and I (hopefully) am countering with rational ideas as well.

This is the way Congress should work. But it doesn't. Throw the bums out, all of them, D or R I don't care.

Jag_Warrior

19th August 2009, 20:50

Totally agree with this. Isn't that what we are doing, having a rational debate? I think you are putting forward rational ideas, and I (hopefully) am countering with rational ideas as well.

This is the way Congress should work. But it doesn't. Throw the bums out, all of them, D or R I don't care.

Yeah, here we are. What I mean is the national debate though. I don't know about you, but I don't feel like any progress is really being made.

Roamy

19th August 2009, 21:48

I think you meant suburban. An urban lifestyle works just fine what with public transportation or walking arounf the corner. Of course, it the walking part becomes an issue because of the intake volume then you're pretty much done anyway. :p

yes suburban thanks for the help! :)

anthonyvop

20th August 2009, 00:02

I find it a bit rich for you to ask someone else, in your usual charmingly light-hearted fashion, whether they 'Understand now?' in a post that is so badly typed as that.
U type on a blackberry then you can complain.

chuck34

20th August 2009, 12:32

Yeah, here we are. What I mean is the national debate though. I don't know about you, but I don't feel like any progress is really being made.

At least someone out there is thinking about an actual plan. I just wish one of our leaders would.

http://blogs.reuters.com/great-debate/author/jamespethokoukis/

"Call it the Purple Plan, one that brings red and blue together. Make health insurance mandatory and subsidize those who can't afford it. (That's the blue part.) But at the same time dismantle employer-based health plans, which prevent consumers from understanding the true costs of their healthcare decisions. In any case, employer plans are just an accident of history. (That's the red part.)"

It's not quite perfect, but it's a start and maybe at least politically possible.

chuck34

20th August 2009, 12:39

It's very Orwellian when the Dems are accusing the townhall protesters of being paid plants, when the one's actually profiting from all this are members of the Obama administration. Transparent and honest, my @ss.

http://news.yahoo.com/s/ap/20090819/ap_on_go_pr_wh/us_health_care_consultants

Malbec

20th August 2009, 12:42

Again, what would stop the government from doing these type of things? They also want to control costs. Looking at a cost/bennifit chart rationally as you suggested the government would do, leads down some pretty nasty roads. Especially if/when the government is your only option.

Insurance companies do exactly the same thing, look at how they can limit healthcare for particular levels of coverage and see how much bang they (and you) can get for each buck. How do you think they select how much to charge and ensure they make a profit?

Also I've noticed a few people claim the reforms will result in a 100% government funded healthcare system but as far as I can see this isn't on the cards at all, it looks to me like Obama is mainly concerned with reforming insurance cover, introducing a cap and subsidies for the poor whilst starting up a state funded alternative insurer. Have I got the fundamentals correct?

Malbec

20th August 2009, 12:47

Let's rationally discuss the issue at hand. We, as a people, need to stop allowing ourselves to be played like puppets and sheep by the powers-that-be. What is the truth? What do we want? What is it going to take to get us there? I blame Obama for not being at all clear about his (non) proposal. I blame the Dems for not putting forth a rational plan. I blame the Republicans for not putting forth a rational counter plan. I don't feel like we're getting anywhere! Hell, I'm as confused as anybody else. It is clearly something that (IMO) needs to be addressed. But the interested parties really know the game and they're playing it extremely well. I doubt we end up with anything truly worth a damn.

Thats the thing with modern politics though isn't it. Everything is so complicated I doubt the guys drawing the reforms up truly understand it all. I doubt a President who has to look at healthcare as one other thing amidst all the other things on his plate truly understands it, even though its his pet project. So what chance do the rest of us, and I include common or garden Democrat and Republican politicians, have in understanding the nuances?

Thats why the debate can easily be hijacked by nonsensical propaganda, because the reforms confuse the hell out of everyone.

Still, if I were you I'd feel lucky that the debate is being held in the public eye at all. In the UK the NHS has been 'reformed' many many times at huge expense with no public debate whatsoever. Most people are unaware about the huge changes made or exactly how much money has been wasted, nor about the frankly bizarre way in which private companies have been allowed to buy up NHS services or had ludicrously favourable contracts accepted.

Malbec

20th August 2009, 12:52

Anthony, a man was just on Bloomberg and he was denied an operation unless he could come up with a $3000 downpayment for an eye operation. He couldn't get the money and so he couldn't get the operation. Because of his pre-existing diabetes, his premiums made insurance unaffordable. Pay the mortgage and buy food or carry insurance. I guess he liked to eat and live indoors. He's now partially blind. What's cruelly ironic about that situation: now that he's disabled, he is now covered by Medicare.

Unfortunately that kind of case boosts the cost of healthcare further. Instead of a one off op that could have saved his sight the state now has to pay for his ongoing care as he is registered as disabled as a result, and its one of the big weaknesses of the system as it stands. His healthcare costs over the course of his life would likely have been cheaper had he had the op.

chuck34

20th August 2009, 12:58

Insurance companies do exactly the same thing, look at how they can limit healthcare for particular levels of coverage and see how much bang they (and you) can get for each buck. How do you think they select how much to charge and ensure they make a profit?

Also I've noticed a few people claim the reforms will result in a 100% government funded healthcare system but as far as I can see this isn't on the cards at all, it looks to me like Obama is mainly concerned with reforming insurance cover, introducing a cap and subsidies for the poor whilst starting up a state funded alternative insurer. Have I got the fundamentals correct?

I understand that insurance companies do that now. But what stops government from doing the exact same thing? I have heard too many stories out of the UK and Canada that say they are no better. Even if you are "not-for-profit" as the gov is, you still have to control costs.

Obama isn't proposing to do a 100% government funded deal right away. But he has said in the past that that is exactly what he wants. Add to that the fact that my company has already told us that if a "Public Option" is offered, we'll be dropped. I'm sure my company is not the only one thinking that. So you can see how fairly quickly a "Public Option" can become the de-facto only option. And that is precicely what Obama said he wanted to do.

chuck34

20th August 2009, 13:03

I have yet to see anyone explain to me how you add millions of people to the "system" without raising taxes or rationing services.

Anyone?

Getting lost in details again.

Anyone have any thoughts about this? Anyone? Bueler, Bueler?

Malbec

20th August 2009, 13:16

I understand that insurance companies do that now. But what stops government from doing the exact same thing? I have heard too many stories out of the UK and Canada that say they are no better. Even if you are "not-for-profit" as the gov is, you still have to control costs.

Obama isn't proposing to do a 100% government funded deal right away. But he has said in the past that that is exactly what he wants. Add to that the fact that my company has already told us that if a "Public Option" is offered, we'll be dropped. I'm sure my company is not the only one thinking that. So you can see how fairly quickly a "Public Option" can become the de-facto only option. And that is precicely what Obama said he wanted to do.

Of course the NHS and every other system rations healthcare. There isn't a single system out there that doesn't including the US. The way it works in the UK though is that everything is treated but that the treatments that give the lowest bang for the buck are not available to the NHS. All of the ones that are not available are almost exclusively the most expensive drugs around that offer a marginal benefit over existing cheaper alternatives or where there isn't evidence to suggest they'd be a benefit. The vast majority of people who are unwell are unaffected by this as it tends to affect terminal cancer care the most.

Still, in those cases if you want to pay cash for that treatment then there's nothing stopping you.

I don't see how the current American system can get anything close to being 100% state provided regardless of the current reforms, there are far too many powerful lobby groups around to let that happen, and it would require a total destruction of the current system and rebuilding for it to occur. Obama's proposing major changes to the system, but he isn't starting from scratch by any means.

BTW I've often wondered how the US health system hobbles its own industry. How hard would the UAW fought to have the best/most expensive healthcare options for its members if there had been decent free or cheap state funded healthcare available? At least most European makers aren't hobbled by the same expenses and the Japanese ones have to pay far less in contributions for their workers (in Japan at least).

Jag_Warrior

20th August 2009, 16:11

Originally Posted by chuck34 http://www.motorsportforums.com/forums/images/buttons/viewpost.gif (http://www.motorsportforums.com/forums/showthread.php?p=676984#post676984)
I have yet to see anyone explain to me how you add millions of people to the "system" without raising taxes or rationing services.

Anyone?

Getting lost in details again.

Anyone have any thoughts about this? Anyone? Bueler, Bueler?

Yes, the devil is (truly) in the details on this issue, Chuck.

Looking down from rom 1000 ft, all I can say is whether it's 10 million or 40 million people who are uninsured, these people are in the health care system, they just aren't in an insurance system. When they get sick, they tend to use the most expensive (and inefficient) means of care: the emergency room. If they need follow up care, they may wait until it's serious enough that they have to go back to an emergency room.

I don't have the figures and I don't know enough about this massive system of care and insurance to really answer your question. But I feel pretty confident that there is more than enough waste and inefficiency that could be attacked, that there should be significant cost savings if that approach was taken. Would the cost savings from getting them out of the ER cycle of care be enough to offset the increased cost of insuring these people? That, I don't know. But the fact is, they're being paid for by those who can pay already.

chuck34

20th August 2009, 17:41

But I feel pretty confident that there is more than enough waste and inefficiency that could be attacked, that there should be significant cost savings if that approach was taken.

The rational for all this has always been to save costs, and cover the uncovered. Well the "uncovered" are actually already covered, in one way or the other. It may not be the best, but people are taken care of. And everyone seems to "know" where all these inefficiencies are.

So that being said, why don't we fix Medicare/Medicaid to improve the responsiveness, quality, and costs, and then address the waste and ineffieiency? If there is so much money out there just being wasted away, why not fix that right now, without totally over-hauling the entire system?

I guess what I am saying is that we should be FIXING the root problems, not putting a feel good band-aid on them.

Malbec

20th August 2009, 20:10

I can't help but notice that no one is interested in addressing the questions I raised back in post #170. Don't blame you either - that'll get the juices flowing all around the table. :p

Is that the one about paying for other people? Well assuming you've got a health policy you already are paying for other people to be ill, right up until the point when you fall ill when the others pay for you. I assume you're somewhere south of 60 and don't have any serious conditions. On that assumption anything you spend on healthcare cover is likely to be a waste, so you are in fact subsidising others covered by your company.

Whether its an insurance policy or state provided healthcare the model is that you're buying into a healthcare collective, as communist as that may sound to you. Whether it covers all or a few is a relatively minor point in the grand scheme of things. If you truly don't want to pay for others don't get insured and pay as you go instead. Its the only guarantee your money won't be spent on others.

airshifter

21st August 2009, 00:25

The coverage for the truly poor and indigent already exists.

But to play devil's advocate here, let me ask this. Just exactly why should any one be forced (taxed) to pay anything for someone else's health care? I'm not taxed to provide food for my neighbor, and that is one heck of a lot more important than health care. I pay for my home, my electric, my own healthcare, food, water, my retirement and everything else that I use. Why should I pay to provide those services to someone else? Each one can choose what is most important to them and buy accordingly. Can't afford it all? Then work harder or smarter until you can. I select my own options in life and am willing to live with my own bad choices. I see no reason why I, or any one else, must cover for others who are stupid, lazy or have a bad turn of luck.

Please note that the operative word in the last sentence is "must". Anyone can give what ever they wish for those less fortunate. My wife and I contribute generously to local and national charities. But that's a choice, not a requirement.

Since you asked.......

I happen to agree with your point of view. Some think that Medicare is unfair since you are expected to pay if you are able, to include your assets. I think it's only fair to expect people to use their own assets first, as many people have reduced incomes but fairly large personal assets.

As an example, both myself and my wife left our jobs early last spring. I took almost all of the summer off and went back to work. At this point she is considering finding something very limited hours part time just to break up her time when our daughter goes back to school.

Right now my income is only about 30% of what our combined income was a little over a year ago. But, our house, our cars, and everything in them is paid in full. We have decent savings and some small investments, and my income more than provides for us.

If we wanted to we could get lower cost insurance, even reduced price lunches for our kid at school. I'm sure the Obama plan would more than take care of our "low income" situation. It would most likely however, ignore the fact that we could pay for the insurance ourselves.

I personally think I should be fully expected to pay for our insurance while I have the means, regardless of whether that is current income or personal assets. I also think that I should never be expected to pay higher taxes for those that think otherwise. I will raise holy hell with any of my representatives that support that logic.

I do disagree with one statement of your post Starter, that being...

I'm not taxed to provide food for my neighbor, and that is one heck of a lot more important than health care.

In a situation such as my family, if we chose to take advantage of the reduced price school lunches, not to mention the other available programs, you would in fact be taxed to help put food in a persons mouth who can afford it themselves. ;)

Rollo

21st August 2009, 01:03

But to play devil's advocate here, let me ask this. Just exactly why should any one be forced (taxed) to pay anything for someone else's health care? I'm not taxed to provide food for my neighbor, and that is one heck of a lot more important than health care. I pay for my home, my electric, my own healthcare, food, water, my retirement and everything else that I use. Why should I pay to provide those services to someone else?
In a purely private system you are paying to provide those services to someone else. Whether you happen to call the payment from your hands a "tax" or an "insurance premium" it still leaves your pocket and goes into someone else's who then provides the service, be it government or a private company. It really doesn't matter what colour you happen to paint the box.

I see no reason why I, or any one else, must cover for others who are stupid, lazy or have a bad turn of luck.
That is the whole point of insurance is it not? By pooling money together, claims are paid out to those people who happen to be stupid, lazy and/or have a bad turn of luck.

The question isn't necessarily of whether you are or not going to pay, but rather what is equitable and who has control of the system. The latter question is further confused by the motive that drives the system.

Malbec

21st August 2009, 01:19

The difference between the above and mandated or government provided is that with them you have no choice. No choice on what or how much coverage you get; the quality of same; the costs or anything else. Someone else is making those decisions for you - either a government clerk or a politician.

How is a politician or clerk making the decisions for you any different from a health insurance clerk doing the same? I find the way in which American insurance companies pick and choose which doctors you may use a rather distasteful form of rationing that I haven't seen people mention as yet. People talk about choice but how capable are you of ensuring that the hospitals your cover will send you to in case of particular diseases are the ones you would actually want to be sent to? What level of knowledge do you have that would let you choose? Are you aware of what treatments you are entitled to and what you aren't entitled to?

I'm afraid that with healthcare people keep talking about wanting a choice (the current NHS reforms are hot on that issue) yet when they're offered one they don't have a clue. Choice assumes you have knowledge about where's good and where isn't, what treatments are the best and what aren't. I'm sorry to get paternalistic but the vast majority of the population don't have a clue, they don't have the knowledge base to make such decisions.

As far as I can see therefore, all this stuff about people having a choice with private or public healthcare is all an illusion. The only INFORMED choice most Americans make with healthcare is whether to have some form of coverage or not.

Another point, it is perfectly possible to have varying levels of public healthcare. Singapore does it that way. Bronze gets you a bed on a ward, plain food and the medical care you need. Silver gets you your own room, a TV, nice food and AFAIK some improvement in nursing care (in Asia its a tradition that the family of the patient does most basic stuff like washing and changing the patient so the notion of different standards of nursing care isn't as alien). With Gold you practically get a hotel suite and a nurse detailed to you only. Bronze comes free, Silver and Gold require a premium.

There are a lot of models out there to take a look at. Lumping all 'socialised care' into one mass doesn't help at all.

And furthermore you ARE paying for others already, your taxes go towards Medicare/aid as it is and I believe the inefficiencies of denying non-acute healthcare and treating acute exacerbations or complications is self evident. That part certainly needs reform.

chuck34

21st August 2009, 01:44

How is a politician or clerk making the decisions for you any different from a health insurance clerk doing the same? I find the way in which American insurance companies pick and choose which doctors you may use a rather distasteful form of rationing that I haven't seen people mention as yet. People talk about choice but how capable are you of ensuring that the hospitals your cover will send you to in case of particular diseases are the ones you would actually want to be sent to? What level of knowledge do you have that would let you choose? Are you aware of what treatments you are entitled to and what you aren't entitled to?

At least with my insurance (at every job I've had so far), we've had a choice between at least two networks. So you pick the one that serves your particular area, or certain need, etc. Sure some don't have all the knowledge that they should (I'm probably in that group). But most of the time, you can opt for some other network that may serve your particular needs better. I don't deny that there is some rationing in the current system. But I would like someone to admit that in EVERY form there will be some rationing, and that if it is a government controlled system you have no further option. ie Canadians comming to the US for some treatments.

I'm afraid that with healthcare people keep talking about wanting a choice (the current NHS reforms are hot on that issue) yet when they're offered one they don't have a clue. Choice assumes you have knowledge about where's good and where isn't, what treatments are the best and what aren't. I'm sorry to get paternalistic but the vast majority of the population don't have a clue, they don't have the knowledge base to make such decisions.

One of the responsibilities of a free society is to inform yourself. If you do not, you will suffer the consequencies. It's always a risk. Life is full of risks. That's what makes life worth living. If you have "the Government Nanny" to take care of you at every turn, thus taking out all risk, you also remove all reward. Life's hard, wear a helmet. Sorry to be crass, but it's true.

As far as I can see therefore, all this stuff about people having a choice with private or public healthcare is all an illusion. The only INFORMED choice most Americans make with healthcare is whether to have some form of coverage or not.

I know it sounds quaint and simplistic, and many people don't understand it. But I want the freedom to choose. I want the freedom to succeed. I accept that comes with the risk that I will fail miserably. Again, one of the responsibilities you have in living in a free society is to inform yourself. If you don't ... well maybe we should start a government program that hands out helmets. :-)

Another point, it is perfectly possible to have varying levels of public healthcare. Singapore does it that way. Bronze gets you a bed on a ward, plain food and the medical care you need. Silver gets you your own room, a TV, nice food and AFAIK some improvement in nursing care (in Asia its a tradition that the family of the patient does most basic stuff like washing and changing the patient so the notion of different standards of nursing care isn't as alien). With Gold you practically get a hotel suite and a nurse detailed to you only. Bronze comes free, Silver and Gold require a premium.

We already have that here. Bronze would be sort of like Medicare/Medicaid. Silver would be like most insurance plans. An Gold would be what those evil greedy executives have. Why does the government have to impose these levels on us?

There are a lot of models out there to take a look at. Lumping all 'socialised care' into one mass doesn't help at all.

Yes we already have "socialised care" that doesn't work. I'm starting to sound like a broken record, but fix what we have before you go mucking up the entire system. Why is that such a hard concept?

And furthermore you ARE paying for others already, your taxes go towards Medicare/aid as it is and I believe the inefficiencies of denying non-acute healthcare and treating acute exacerbations or complications is self evident. That part certainly needs reform.

Yes reform is needed. Reform does not mean that you have to overhaul the entire system.

Mark in Oshawa

21st August 2009, 03:06

You (and others) still don't get it. It's not the coverage, or what it covers, it's how you get there. I'm talking about freedom of choice. Some may opt for NO coverage, it wouldn't be my choice, but I respect their right to make that decision for themselves. I also would never demand that choice be required of others - even though it'll save them a lot of money. Why then do so many people think that requiring the other extreme, ie: forcing coverage for all through taxation, is an appropriate policy?

I'm talking about basic personal freedom here. The ability to make your own choices, for good or for bad, and then live with them.

Starter, you are wasting your time. It is like the Borg collective, they cannot see that independence in thought and choice on this subject is in keeping with the way I have noticed a lot of Americans think.

I think in a perfect world, a healthcare system that gave everyone the best coverage and didnt cost anyone anything would be a utopian thing, problem is we don't live there. Obama says this program is a really good deal, his detractors don't believe him, the man on the street who has healthcare doesn't want the gov't taking his choices away and the whole damhned thing will cost more than the 1 trillion dollars Obama says it will cost. OH YA..and the country is broke. The inmates are running the asylum on this one.

I believe in having some form of public healthcare system and I wouldn't go for this mess.

I live in Canada where I still have to carry private insurance for a trip in the ambulance but my medical care is "Free". I pay for drugs while my care is "Free". I donate money to the hospital fund yet it is supposed to be "Funded" ANd I cant leave my doctor because 5 million out of 34 million people in Canada cant find a family doctor taking patients. So even tho I may not like my current doctor, I cant leave. THAT is the model that Obama's supporters really are holding up as an example. Here is the question they have to answer: If this goes through, will you Senator, or you Congressman use this system???OF course not, they have their own program....and you cant have access to it. They know what's best...just trust em.

You Yanks have fought a revolution over less....

Mark

21st August 2009, 12:25

The original owners failed too, however!

Malbec

22nd August 2009, 10:58

I don't deny that there is some rationing in the current system. But I would like someone to admit that in EVERY form there will be some rationing,

I've been very careful to state clearly that ALL systems ration to some degree, I suggest you read my posts again. I've also stated that politicians everywhere have been afraid to admit this to their population, instead trying to maintain some illusion that universal and total coverage is somehow possible.

and that if it is a government controlled system you have no further option. ie Canadians comming to the US for some treatments.

You're wrong I'm afraid. Canada might have a pretty rigid system but in the UK and in most other places if you don't like the government system you can go private. Why do you think in Britain people still buy private health insurance?

One of the responsibilities of a free society is to inform yourself. If you do not, you will suffer the consequencies. It's always a risk. Life is full of risks. That's what makes life worth living. If you have "the Government Nanny" to take care of you at every turn, thus taking out all risk, you also remove all reward. Life's hard, wear a helmet. Sorry to be crass, but it's true.

In principle I agree with you and I generally oppose anything that pushes for a nanny state, but I also suggest to you that issues such as healthcare etc etc are far too complex for anyone to be truly informed. In my earlier posts I suggested that even the writers of Obama's reforms (or him himself) do not FULLY understand the current system and the impact of those reforms, how are normal Americans, even senators etc supposed to?

Yes we already have "socialised care" that doesn't work. I'm starting to sound like a broken record, but fix what we have before you go mucking up the entire system. Why is that such a hard concept?

Because all I'm hearing from you is a comparison between the American system and all other systems lumped together under the monolithic 'socialised healthcare' banner which is nonsense. There are many ways to skin a cat and no two countries have an identical system with variable rates of private/state health provision. All systems have much to gain from studying others and picking and choosing the best bits to adopt themselves. I believe the US system has things to teach others but I don't see why you can't accept that there are things other countries do which the US can learn from.

Malbec

22nd August 2009, 11:00

THAT is the model that Obama's supporters really are holding up as an example.

If Canada is the model Obama's supporters are using then why don't their reforms resemble the Canadian system in any way whatsoever?

chuck34

22nd August 2009, 14:36

I've been very careful to state clearly that ALL systems ration to some degree, I suggest you read my posts again. I've also stated that politicians everywhere have been afraid to admit this to their population, instead trying to maintain some illusion that universal and total coverage is somehow possible.

I wasn't really refering to you, or really anyone else on this site, but the politicians. They keep perpetuating the "illusion that universal and total coverage is somehow possible", without any rationing or other nasty things the "EVIL" insurance companies do.

You're wrong I'm afraid. Canada might have a pretty rigid system but in the UK and in most other places if you don't like the government system you can go private. Why do you think in Britain people still buy private health insurance?

Yes but Obama's stated goal has been to transition into a single payer plan. That's why his "Public Option" is so distastefull to so many, we understand that it's being set up to kill private insurance.

In principle I agree with you and I generally oppose anything that pushes for a nanny state, but I also suggest to you that issues such as healthcare etc etc are far too complex for anyone to be truly informed. In my earlier posts I suggested that even the writers of Obama's reforms (or him himself) do not FULLY understand the current system and the impact of those reforms, how are normal Americans, even senators etc supposed to?

If no one including Senators, Congressmen, and the President can fully understand it, tell me again why we're going to turn things over to them? People in a free society have the responsibility to inform themselves on issues that effect them. If they don't they'll suffer to consequences. I know that's harsh, and I'm sorry about that. And that's why charities and the like are set up.

Because all I'm hearing from you is a comparison between the American system and all other systems lumped together under the monolithic 'socialised healthcare' banner which is nonsense. There are many ways to skin a cat and no two countries have an identical system with variable rates of private/state health provision. All systems have much to gain from studying others and picking and choosing the best bits to adopt themselves. I believe the US system has things to teach others but I don't see why you can't accept that there are things other countries do which the US can learn from.

Yes there are plenty of ways to skin the healthcare cat. All I'm saying is I would like to skin that cat with the least amount of government "help" that I can. Is that so wrong? Why is the government the solution to all problems? Why can't individuals take responsibility for their own lives? And yes I do lump this proposal into a monolithic 'socialised healthcare' banner, used interchangeably with the Canadian model. I do that because that's where I see this current proposal heading. The President, Nancy Pelosi, Harry Reid, and the rest of the "leaders" in Washington all seem to want single payer eventually. This "Public Option" is just the way to get there slowly so that the uninformed won't sqeal too much along the way.

If anyone in Washington was talking seriously about actual REFORM rather than total over-haul. I think it would be a different story.

BDunnell

22nd August 2009, 15:14

One of the responsibilities of a free society is to inform yourself. If you do not, you will suffer the consequencies. It's always a risk. Life is full of risks. That's what makes life worth living. If you have "the Government Nanny" to take care of you at every turn, thus taking out all risk, you also remove all reward. Life's hard, wear a helmet. Sorry to be crass, but it's true.

I for one do not want to have choice presented to me at every turn. I am busy enough as it is without having to wade through competing options for provision of gas, electricity, and so on.

chuck34

22nd August 2009, 21:14

Rollo

22nd August 2009, 23:56

Then you have made your choice. Don't force that on me, and I won't force my choice on you. Simple, right?

Why should I pay taxes for the socialist government provided single military for? If there were several choices, I could choose which military I'd want to defend me.

I think I'd prefer to choose a far cheaper one than the one I currently have. Surely we don't need that many planes, bombs and troops. New Zealand has a cheaper military, and they've never really been invaded.

chuck34

23rd August 2009, 18:46

Mark in Oshawa

24th August 2009, 05:14

Why should I pay taxes for the socialist government provided single military for? If there were several choices, I could choose which military I'd want to defend me.

I think I'd prefer to choose a far cheaper one than the one I currently have. Surely we don't need that many planes, bombs and troops. New Zealand has a cheaper military, and they've never really been invaded.

Many people, not just Americans would argue it is their large military presence that sorta mitigates anyone invading NZ, or CAnada for that matter. It is allowed some stupid people in this country to pretty much wipe out our military capabilities from what they were in the 50's and 60's. Still doesn't change the fact people need a military so they can at least assert some form of their sovreignty and participate as somewhat equal partners in UN based military actions.

Mark in Oshawa

24th August 2009, 05:23

I for one do not want to have choice presented to me at every turn. I am busy enough as it is without having to wade through competing options for provision of gas, electricity, and so on.

So let me get this straight: You look for the best deal for your utilities, or the way you get your TV (cable or dish?),the best deal to buy a car or a mortgage; and THEN it is too much hassle to shop for the best deal on health insurance? You just let the government assume that right?

Sorry Ben, I don't buy THAT for a second. You may be very left of center, but if you shop carefully for a tin of soup or anything else, you should be given the option of shopping for your insurance. I am not even given the option in my country....and that is my only wish. That I had a choice....

Mark in Oshawa

24th August 2009, 05:28

If Canada is the model Obama's supporters are using then why don't their reforms resemble the Canadian system in any way whatsoever?

They wont say they want Canada's system in the bills before the Senate and Congress because they know they would lose half the "Blue Democrats" and not get the bill passed. They want to enter the free market with their version of health insurance, and use the private insurers to subsidize their scheme. When the private insurers find out they cannot compete because of this, they will mostly bail on the whole idea of providing health insurance and over time, you end up with a mainly private system. This is the theory I have heard, and it I do think there is some merit to it.

I have no problem with private insurers existing with public system, but the government in question here is losing money hand over fist with the medicare/medicaid systems in existence now. Why should they regulate the game and participate in it ? I have no love for profiteering and HMO's not doing right by their patients, but a more unrestricted competitive enviroment would punish bad insurers. What the government of the US wants to do is play in the game and regulate it further. Right now, health insurers have to go state by state, which is a LOT more inefficient......

chuck34

25th August 2009, 18:22

Rollo

26th August 2009, 01:25

http://news.yahoo.com/s/ap/20090825/ap_on_go_pr_wh/us_obama_economy_5

They can't even get the deficit number right. Who still believes that this health care plan will "only" cost $1,000,000,000,000? Anyone?

Forget all the other arguments, how do we afford this?

Did you read the link you posted? I quote from it:
The new numbers come as he prods Congress to enact a major overhaul of the health care system — one that could cost $1 trillion or more over 10 years.

$1 trillion over 10 years = $100 million per year.

If you wish that's only 4% of the $2.26 trillion on health that the U.S. spent care in 2007.
http://www.cms.hhs.gov/NationalHealthExpendData/Downloads/proj2007.pdf

4% of total outlays to overhaul a system that at the moment isn't working sounds like an absolute bargain. Simple mathematics tells us that.

ShiftingGears

26th August 2009, 05:34

$1 trillion over 10 years = $100 million per year.

That would be $100 billion a year.

Rollo

26th August 2009, 05:50

Yes it would. But it would still be only 4%.

<Dang. I wish I could go back in time and learn how to spell.

DOES SOMEONE HAVE A SPARE TARDIS I COULD BORROW? :D >

chuck34

26th August 2009, 12:30

Did you read the link you posted? I quote from it:
The new numbers come as he prods Congress to enact a major overhaul of the health care system — one that could cost $1 trillion or more over 10 years.

$1 trillion over 10 years = $100 million per year.

If you wish that's only 4% of the $2.26 trillion on health that the U.S. spent care in 2007.
http://www.cms.hhs.gov/NationalHealthExpendData/Downloads/proj2007.pdf

4% of total outlays to overhaul a system that at the moment isn't working sounds like an absolute bargain. Simple mathematics tells us that.

Haven't you heard. We are running deficits. Huge freaking deficits. About $9,000,000,000,000 in deficits in the next 10 years. That means WE HAVE NO MONEY. NONE. 4%, 1%, 0.5%, 0.000000004%, it doesn't matter, that would be MORE than we have. Don't you get that? If you are personally in bankruptcy, can't pay your bills, have more money going out than comming in, what is the solution? Buy a bunch of more stuff? Come on man, that's crazy.

And yes the system is broken. NO ONE disputes that. But there are about 75-80% of the people in this country that are at least somewhat satisfied with their healthcare. So why should we (further) mortgage the futures of our childeren's childeren's childeren's childeren, to "fix" a system that for the majority works? Let's work on fixing the system for the 15-20% of Americans that are currently using the broken system. You know the bankrupt Medicare/Medicaid systems that are already administered by the government.

anthonyvop

26th August 2009, 13:00

WoooooHoooooo.
Gotta love that British Universal healthcare.

http://www.dailymail.co.uk/news/article-1209034/The-babies-born-hospital-corridors-Bed-shortage-forces-4-000-mothers-birth-lifts-offices-hospital-toilets.html

BDunnell

26th August 2009, 13:11

So let me get this straight: You look for the best deal for your utilities, or the way you get your TV (cable or dish?),the best deal to buy a car or a mortgage; and THEN it is too much hassle to shop for the best deal on health insurance? You just let the government assume that right?

Sorry Ben, I don't buy THAT for a second. You may be very left of center, but if you shop carefully for a tin of soup or anything else, you should be given the option of shopping for your insurance. I am not even given the option in my country....and that is my only wish. That I had a choice....

No, I don't shop for the best deal for my utilities. If there is a massive difference in price, then I would be tempted, but generally when I am responsible for the utilities where I live I get the gas from British Gas, the electricity from whatever the nearest thing to the local electricity board is, and so on. I can't be bothered to shop around for these things. It takes time I would rather spend doing other things and hassle I don't want. Far better the simple option. Likewise when I go shopping - I don't choose solely on the basis of value.

BDunnell

26th August 2009, 13:12

anthonyvop

27th August 2009, 04:08

Gotta love the fact that your choice of source is the paper of choice for unthinking morons.

The british are unthinking morons? Aren't you from a country that gave us Hitler and you call others unthinking morons?

Que Cojones!

Roamy

27th August 2009, 04:26

Gotta love the fact that your choice of source is the paper of choice for unthinking morons.

Well the sad think is that you morons are still multiplying. What are you going to do with your kids - give them to the Islams for canon fodder?? Get real what have you young s done for the world. over populate deplete all the resources, cause global warming, arm rogue nations with nuclear arms.
you people are disgusting and we brought you in to a pretty damn good world.
Look at you 1/3 of you are gay and incompetent and are cowards 1/3 of you are corrupt and have no integrity, and stretching it 1/3 of you may be a acceptable citizen!!

Get a frreaking mirror and have a look

GridGirl

27th August 2009, 07:30

The daily mail is a red top paper with an agenda to burn. Most educated people understand this and ignore it's opinions.

Vop, a low blow at Germany and Hitler is pretty pathetic. Can't you come up with a decent well thought ouyt reply instead of silly school boy insults?

Fousto, I have absolutely no idea where your rant comes from and how it relates to healthcare. Telling BDunnell to looking in the mirror is slighly rich with your extremest views.

BeansBeansBeans

27th August 2009, 08:45

The daily mail is a red top paper

No it isn't.

I'm not defending that odious rag, but it isn't a red top.

GridGirl

27th August 2009, 08:53

BBB you are right but I suppose I just view the stuff it publishes as nothing more than a red top with an axe to grind.

BeansBeansBeans

27th August 2009, 08:55

BBB you are right but I suppose I just view the stuff it publishes as nothing more than a red top with an axe to grind.

Yes, it is for those who share many of the views of red-top readers but believe that they are somehow a cut above the hoi polloi.

chuck34

27th August 2009, 14:43

So no one wants to talk about how we can actually afford this? Rollo? At least you are trying. Anyone?

BDunnell

27th August 2009, 21:09

The british are unthinking morons? Aren't you from a country that gave us Hitler and you call others unthinking morons?

Que Cojones!

I am British.

BDunnell

27th August 2009, 21:11

Well the sad think is that you morons are still multiplying. What are you going to do with your kids - give them to the Islams for canon fodder?? Get real what have you young s done for the world. over populate deplete all the resources, cause global warming, arm rogue nations with nuclear arms.
you people are disgusting and we brought you in to a pretty damn good world.
Look at you 1/3 of you are gay and incompetent and are cowards 1/3 of you are corrupt and have no integrity, and stretching it 1/3 of you may be a acceptable citizen!!

Get a frreaking mirror and have a look

Again, you demonstrate why your opinions can never be taken seriously.

BDunnell

27th August 2009, 21:12

So no one wants to talk about how we can actually afford this? Rollo? At least you are trying. Anyone?

Let's face it, the quality of the national debate in the USA in general has been appalling, largely thanks to such wonderful insights such as those about Stephen Hawking that ought to have been the subject of some sort of law suit.

chuck34

27th August 2009, 22:13

Let's face it, the quality of the national debate in the USA in general has been appalling, largely thanks to such wonderful insights such as those about Stephen Hawking that ought to have been the subject of some sort of law suit.

So since it's been "appalling", let's just give up? Without SOMEONE trying to have a real, honest debate about this we'll end up with something NO ONE likes. Why give up? If you are right, prove it. If I or they, or whoever is wrong, prove it. If debate is given up on, we're all lost.

BDunnell

27th August 2009, 23:19

So since it's been "appalling", let's just give up? Without SOMEONE trying to have a real, honest debate about this we'll end up with something NO ONE likes. Why give up? If you are right, prove it. If I or they, or whoever is wrong, prove it. If debate is given up on, we're all lost.

I am always suspicious when what is called for by politicians and others is a 'debate'. How is this meant to be conducted in a sensible manner, without the loudest, most extreme voices (like Sarah Palin in this 'debate') being those that gain the most attention? How is any conclusion supposed to be reached that will appeal to anything like everybody? Can everybody be expected to understand the issues being put to them anything like well enough to reach an informed judgement? I'm afraid I tend to think that such calls for debates are, by and large, meaningless, and an excuse to avoid taking an actual decision.

Rollo

28th August 2009, 00:52

So no one wants to talk about how we can actually afford this? Rollo? At least you are trying. Anyone?

The obvious thing would be to not necessarily raise taxes, but to impose a levy on the existing medical insurance companies. As far as I can make out, they're on the take in a major and bloody obvious way. If there was some system of regulation of what the maximum allowable charges were for procedures and medical items, then the access to the system would be more equitable in the first place.
People going into bankruptcy because they've had some medical procedure is quite frankly proves that people can not afford the existing system. Any overhaul has to be better in principle than what currently exists.

In Australia, there is a 1.5% tax imposed on income for the maintenance of the medical system, as well as a rebate for having private medical insurance. The system works as well as any other in the world I suppose.
But it took 11 years after the passing of the Health Insurance Act 1973, for Medicare as we know it in Australia to jump through all of the legal hoops.

The big problem with the American health care system is that so much power is vested with unelected people, making extravagant sums of money from it - and you're all paying for it.

ShiftingGears

28th August 2009, 10:37

The british are unthinking morons? Aren't you from a country that gave us Hitler and you call others unthinking morons?

Que Cojones!

What is it with you and mentioning Hitler?

Camelopard

28th August 2009, 11:48

I think he (foustina) actually has a deep seated, repressed admiration (dare I say 'love') for Adolf, presuming that is of course, that foustino is a real person ........

given that you can't have a normal discussion with him without the 'H' word being mentioned. :)

Come on foustus post a photo of yourself so that we know you are real..... :)

chuck34

28th August 2009, 12:29

I am always suspicious when what is called for by politicians and others is a 'debate'. How is this meant to be conducted in a sensible manner, without the loudest, most extreme voices (like Sarah Palin in this 'debate') being those that gain the most attention? How is any conclusion supposed to be reached that will appeal to anything like everybody? Can everybody be expected to understand the issues being put to them anything like well enough to reach an informed judgement? I'm afraid I tend to think that such calls for debates are, by and large, meaningless, and an excuse to avoid taking an actual decision.

So why have any debate at all. Whatever party gets in the majority, just passes anything and everything they want. That sounds like a good system. At least try to have a debate. At the very least it could be fun, maybe. And if someone is so extreme and wrong, as you say Sarah Palin is, then it shouldn't be too hard for someone with all the facts on their side to disprove said extreme person. If you can't logically talk your way through the points to convince people (or at least try to) that your side is right, how do you know that your view point is the correct one?

BDunnell

28th August 2009, 13:07

So why have any debate at all. Whatever party gets in the majority, just passes anything and everything they want. That sounds like a good system. At least try to have a debate. At the very least it could be fun, maybe. And if someone is so extreme and wrong, as you say Sarah Palin is, then it shouldn't be too hard for someone with all the facts on their side to disprove said extreme person. If you can't logically talk your way through the points to convince people (or at least try to) that your side is right, how do you know that your view point is the correct one?

I'm not saying there should be no debate. But how does such a debate work? The only accurate means of coming to a conclusion is surely to have a national referendum. I always cringe when I hear politicians calling for 'an open and honest national debate' on something. What exactly does this mean? How should it be conducted?

chuck34

28th August 2009, 13:23

The obvious thing would be to not necessarily raise taxes, but to impose a levy on the existing medical insurance companies. As far as I can make out, they're on the take in a major and bloody obvious way.

Really?

http://www.politifact.com/truth-o-meter/statements/2009/jul/23/barack-obama/health-insurance-company-turned-profit-not-rec/

Sure they make profits, but why are profits so "evil"?

If there was some system of regulation of what the maximum allowable charges were for procedures and medical items, then the access to the system would be more equitable in the first place.

That, I'm convinced, will lead to shortages of doctors and services because of less incentive for the doctors to perform their jobs. As far as I can tell, the premise of all this seems to be that doctors and insurance companies are evil and greedy. Why is it that if you start telling doctors and insurance companies what they can make (and that is less than what they currently make) that they all of a sudden become compassionate individuals that will do all this "good" out of the kindness of their hearts?

People going into bankruptcy because they've had some medical procedure is quite frankly proves that people can not afford the existing system. Any overhaul has to be better in principle than what currently exists.

Yes, but why does the government have to take over the industry to do this? A simple bill that says insurance companies can not drop coverage for people activly undergoing treatment would go a long way to stopping this.

In Australia, there is a 1.5% tax imposed on income for the maintenance of the medical system, as well as a rebate for having private medical insurance. The system works as well as any other in the world I suppose.
But it took 11 years after the passing of the Health Insurance Act 1973, for Medicare as we know it in Australia to jump through all of the legal hoops.

You said earlier that you didn't want to raise taxes, now you do? Obama has said over and over that he won't raise taxes on anyone that makes under $250,000 a year. How can you square that?

The big problem with the American health care system is that so much power is vested with unelected people, making extravagant sums of money from it - and you're all paying for it.

The power being vested in unelected people will not change even if the government takes over the entire system. Career beaurocrats will be running the system and they are unelected. There will always be people making loads of money, and sadly we're probably always going to pay for it one way or another. The trick is to harness the greed of those people.