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Topic:
US Universal Health Care Discussion
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Kimball_Kinnison
Registered:
Oct '01
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Date Posted:
9/18/07 2:25pm
Subject:
RE: US Universal Health Care Discussion
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VadersLaMent posted:
I like the Kucinich plan. It's too bad most consider him unelectable and the plans of the front runners are more like favors for the private health care industry.
I can spot one big problem with his plan right now: He wants the government to buy prescription medicines in bulk.
The problem with that is that whenever you get the government deciding to buy something like that in bulk, you wind up in a situation with price caps. The government will start telling the drug manufacturers how much they can charge for the drugs. Historically, price caps have led to a decrease in availability, not an increase, for the items so regulated. Often pharmaceutical companies have large amounts of research costs that they need to recover, and many of their research projects don't result in usable medicines. That means that they have to charge more for the ones that are successful in order to make ends meet.
Of course, there are areas where those costs can be reduced. For example, the US patent system needs a major overhaul, which would ultimately reduce both the number of frivolous medical patents that are issued as well as reducing the term of patent coverage. Similarly, the FDA can streamline the procedures for approval of drugs (which is often one of the costliest parts of the process).
Unless the government's is going to take over manufacturing the drugs, you have to allow the pharmaceutical companies to make a profit, or else they will simply stop producing those drugs.
That's exactly what happened in the 1990s with flu vaccines. When the government established price caps for the Vaccines For Children program, the prices were set at well below the market rate by law. This led to most of the manufacturers leaving the flu vaccine market. Even after the price caps were lifted in 2000, there were only 2 manufacturers in the market. When one of them had to close a plant in the UK, it led directly to vaccine shortages in 2004.
You can see similar things happening with Medicare today. Medicare sets certain rates detailing what it will pay for different services. In many cases, it is not enough to cover the actual costs of providing those services. Because of that, many doctors are refusing to participate in Medicare.
Kimball Kinnison
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You deserve the wrath of Kimball...- OWM
Why, Kimball... I didn't know you had it in you.- KW
I think that Kimball just made a joke, and a funny joke at that.- Raven
Stupidity got us into this mess, why can't it get us out?
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Septhaka
Registered:
Nov '06
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Date Posted:
9/20/07 10:15pm
Subject:
RE: US Universal Health Care Discussion
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So KK's view is that the US healthcare is the best healthcare its just not available to everyone. If the only virtue to be evaluated is the quality of healthcare provided to those who receive it then KK why are you not advocating reduced healthcare coverage? Instead of spending $2 trillion on 200 million people lets just drop 100 million of them from the healthcare system and spend $2 trillion on the richest 100 million people? Think of the healthcare they would get then? Why not just drop it to the top 50 million get healthcare? the top 10 million?
Further, your "adjustment" excuse is a smokescreen. Show us your adjustment calculation and the statistics you utilized to determine that the US healthcare system, when adjusted for equity, is better than all other countries including those with universal healthcare. Then also provide us with the analysis of the marginal cost of that system and any superiority you identify and compare that to the lower costing universal health care systems of other countries and how that marginal cost is worth whatever marginal benefit you identify. The reality is you don't really know what the numbers will yield. But you seem satisfied to hide behind this idea of an adjustment without any idea what it will yield. If you are going to reject what the statistics say then you need to show us the more accurate statistics you are basing it on - if you are not basing it on such statistics then I'd like to introduce you to the word "sophistry".
Setting that aside completely though is what is the best basis to evaluate the effectiveness of a country's healthcare system. I am evaluating the effectiveness of the nation's healthcare system, amazingly enough, based on the health of the society in which it operates. It does not really matter to the uninsured in this country that Paris Hilton gets healthcare treatment better than this or that country.
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Kimball_Kinnison
Registered:
Oct '01
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Date Posted:
9/21/07 2:34am
Subject:
RE: US Universal Health Care Discussion
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Septhaka posted:
So KK's view is that the US healthcare is the best healthcare its just not available to everyone. If the only virtue to be evaluated is the quality of healthcare provided to those who receive it then KK why are you not advocating reduced healthcare coverage? Instead of spending $2 trillion on 200 million people lets just drop 100 million of them from the healthcare system and spend $2 trillion on the richest 100 million people? Think of the healthcare they would get then? Why not just drop it to the top 50 million get healthcare? the top 10 million?
Nice straw man there. You're personal feelings for me are obviously pushing you over the edge. Will you please get over it? So what if I told you to stop trolling in another thread. You were trolling. That doesn't mean that you have to single me out in every other thread and try and twist everything that I say. Get over it, altready.
And you still haven't answered my questions:Kimball_Kinnison posted:
So when you look at the specifics, how is the US system so bad? What specific metrics do you want to use, and why are they appropriate?
It's time that you put your money where your mouth is. If you think that the US healthcare is so bad, why don't you prove it? Show us the criteria that you use to determine the quality of healthcare, explain why it's valid criteria, and then we'll have a basis for comparison.
If you aren't willing to do that, why should I answer your badgering questions? You can't even answer those two simple, little ones!
Kimball Kinnison
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You deserve the wrath of Kimball...- OWM
Why, Kimball... I didn't know you had it in you.- KW
I think that Kimball just made a joke, and a funny joke at that.- Raven
Stupidity got us into this mess, why can't it get us out?
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Master_SweetPea
Registered:
Nov '02
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Date Posted:
9/21/07 6:08am
Subject:
RE: US Universal Health Care Discussion
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I just wanted to jump in and say that maybe we'll actually see some changes in the next few years.
the big Pharmacy Chains like CVS and Walgreens are working on thier own mini-clinics with P.A.'s or ARNP's on site, who will be supervised offsite by a MD. This will take care of the bulk of prescription refills, and basic diagnosis scripts.
This could be incentive enough for doctors and specialists to take on more and more patients and even accept insurances that they would have refused before.
Just a side note.
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Mr44
Registered:
May '02
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Date Posted:
10/17/07 1:01pm
Subject:
RE: US Universal Health Care Discussion
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Relating to this issue, a study released today and detailed here in the Chicago Tribune details some interesting results regarding a breakdown in one aspect of England's National Health Service:
A shortage of National Health Service dentists in England has led some people to pull out their own teeth -- or use super glue to stick crowns back on, a study says. Many dentists abandoned Britain's publicly funded health care system after reforms backfired, leaving a growing number of Britons without access to affordable care. Forty-five percent of dentists surveyed said they no longer accept National Health Service patients.
HERE
It certainly isn't a case of one system being better than the other, but that each bring their own limitations.
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DeathStar1977
Registered:
Jan '03
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Date Posted:
10/17/07 2:25pm
Subject:
RE: US Universal Health Care Discussion
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Perhaps they had trouble with all of the Hapes Corpses?
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Mr44
Registered:
May '02
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Date Posted:
10/17/07 4:25pm
Subject:
RE: US Universal Health Care Discussion
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They do tend to pile up if not looked after.
And man, the stench! 
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chibiangi
Registered:
Jun '02
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Date Posted:
10/17/07 5:33pm
Subject:
RE: US Universal Health Care Discussion
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I don't think tort reform is the answer. I think my life is worth a couple million to my family, especially if it results in a negligent, incompetent doctor being removed from practice. When doctor's do stuff like amuptate a penis instead of a testicle or the left leg instead of the right leg, etc, yes, I do think people should retain the right to sue for both their physical, mental, emotional and future damages without caps. Part of awarding damages is punitive in nature.
Blaming lawsuits for high medical costs is kind of like ignoring the elephant sitting in the room. The elephant of course being the insurance agencies who are making a ton of money through the health care industry. That is the issue that needs to be addressed, not taking away the rights of victims to sue for malpractice.
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Lowbacca_1977
Title: Senate Moderator
Registered:
Jun '06
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Date Posted:
10/17/07 11:09pm
Subject:
RE: US Universal Health Care Discussion
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chibiangi, wouldn't that be life insurance there?
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Cheveyo
Registered:
Oct '01
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Date Posted:
10/18/07 1:39am
Subject:
RE: US Universal Health Care Discussion
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What is broken with our health care system?
The impact of poor health care on the individual:
The leading cause of personal bankruptcy in the U.S. is unpaid medical bills due to insufficient or no health insurance. The death rate of uninsured Americans is 25% higher than that of those who are insured. Studies from the Institute of Medicine estimate that the number of excess deaths among uninsured adults age 25-64 is in the range of 18,000 annually, more than the number of deaths from diabetes (17,500) among the same age group.
The impact of poor health care on the state and nation:
Hospitals provide about $34 billion worth of uncompensated care each year. The uninsured are 30-50% more likely to be hospitalized for an avoidable condition, with the average cost of an avoidable hospital stay around the neighborhood of $3,300 (according to the Institute of Medicine). Emergency room visits and avoidable health issues are more costly than preventative health care and outpatient clinic care.
Who?
As of 2005, 16% of Americans (over 46 million people) did not have health insurance. The percentage of people with employment-based health insurance has dropped from 70% (in 1987) to 59.5% (in 2005). The number of uninsured children in 2005 was 8.3 million (11.2% of all children in the US). Almost 40% of the uninsured population reside in households that make $50k or more annually. The number of middle-income families who cannot afford health coverage (even when offered by their employer) is steadily increasing.
KK asks for a comparison, so let's look at top-ranked France.
France's infant death rate is 3.9 per 1000 live births. The US, 7 per 1000.
Average life expectancy in France, 79.4 years. 77 in the US.
France has more doctors and hospital beds per capita than the US.
Mortality rate for cardio-vascular diseases in France? 118.0 per 100,000 population. In the US? 188.0 per 100k.
Mortality rate for [preventable] respiratory disease in France is 31.2 per 100,000 people. In the US, that figure is 61.5 per 100k.
France spends just 10.7% of its GDP on health care, while the US spends 16%, more than any other nation. France's health care is such that everyone has access to the same basic coverage through national insurance funds, to which every employer and employee contributes (the government pays for the unemployed or those who cannot gain coverage through family members). There are no deductibles, just minor co-payments (which are annulled for those with chronic illness.
In Addition, almost all French buy supplemental health insurance that helps to cover the out-of-pocket costs and covers extra expenses like private hospital rooms, eyeglasses, and dental care.
Is it better to let ego get in the way and proclaim that America is the best despite the facts, or is it better to say we are American, and we strive for perfection, even if it means accepting that what we have now can and must be improved upon?
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Lowbacca_1977
Title: Senate Moderator
Registered:
Jun '06
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Date Posted:
10/18/07 1:51am
Subject:
RE: US Universal Health Care Discussion
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On the over $50,000 income with no health care... I consider that their own fault. Coming from the perspective of growing up in a family that had an annual income between 25,000 and 50,000 and always had health care.
On the comparison to France, I'd like to know how this effects the statistics:
"Bernadine_Healy" posted:
First, it's shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates. For this very reason, the Organization for Economic Cooperation and Development, which collects the European numbers, warns of head-to-head comparisons by country.
http://health.usnews.com/usnews/health/articles/060924/2healy.htm
That would effect both the infant mortality rate and, it would seem, also the life expectancy as its effecting what counts as a life to include in the life expectancy numbers.
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Cheveyo
Registered:
Oct '01
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Date Posted:
10/18/07 9:32am
Subject:
RE: US Universal Health Care Discussion
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Lowbacca_1977 posted:
On the over $50,000 income with no health care... I consider that their own fault. Coming from the perspective of growing up in a family that had an annual income between 25,000 and 50,000 and always had health care.
So when a family of four makes 47,000 [gross] annually, and neither parent's employer offers health insurance, you blame the family for not having enough money to finance private health insurance?
Comparing France, do you think their system of health care is flawed? Do you believe it to be inferior to that of the US? If so to either, why?
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Lowbacca_1977
Title: Senate Moderator
Registered:
Jun '06
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Date Posted:
10/18/07 10:23am
Subject:
RE: US Universal Health Care Discussion
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Well, I initially question the idea that they can't afford health insurance. It's a question of priorities. What other lifestyle choices are they making? Newer cars, larger house, fancier vacations, etc. It's a larger picture.
The issue I take with France is a matter of principle, largely. I don't like the government having the ability to make decisions on how I live my life. I do not believe that health care is the government's responsibility, but a personal responsibility, and I don't think the government should be giving me the health care it thinks I need rather than the health care plan I choose.
Example... say, the idea of dental or eye care being covered in insurance. You can get plans with those, and they up the cost. However, I don't need eye care at all, and I have little need for dental care. Government doesn't care and just puts everyone in the same catagory.
I do think there are still clear issues with a government run system, such as the large waiting lists that health care systems are starting to see (dental care in UK being the latest to get some attention for its problems). Also that government health care has in cases been slow to act for procedures, not considered them critical, or, at least in one case from England, refused cancer treatment because it wasn't going to be curable (if I remember details right, I'll find the article if I can). Does this mean every health care option in the U.S. will be great? Not at all, but I'm not paying for other people to use a bad plan, and I can simply change to a better one if I need to. With a government plan, I'm being forced to pay into a system that I might not want to use and that removes choice.
Of a more tin-foil perspective, I'm also concerned because once the government is paying for health care, it gives them greater footing to try to regulate matters of health like diet, which is something I think the government has no business in, because what I eat is a matter of choice and it doesn't harm others.
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dizfactor
Registered:
Aug '02
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Date Posted:
10/18/07 10:40am
Subject:
RE: US Universal Health Care Discussion
- Date Edited:
10/18/07 10:41am (2 edits total)
Edited By:
dizfactor
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Lowbacca_1977 posted:
Cheveyo posted:
Lowbacca_1977 posted:
On the over $50,000 income with no health care... I consider that their own fault. Coming from the perspective of growing up in a family that had an annual income between 25,000 and 50,000 and always had health care.
So when a family of four makes 47,000 [gross] annually, and neither parent's employer offers health insurance, you blame the family for not having enough money to finance private health insurance?
Well, I initially question the idea that they can't afford health insurance. It's a question of priorities. What other lifestyle choices are they making? Newer cars, larger house, fancier vacations, etc. It's a larger picture.
I think this is entirely dependent on where you live. To go back to the examples I used in the tax reform thread, a family of four in Lafayette, Louisiana living on $47K pre-tax is doing pretty well, and arguably has no excuse not to have insurance. A family of four in San Diego living on the same amount is living in the ghetto and eating ramen noodles and absolutely cannot afford it.
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Vaderize03
Title: Manager Emeritus
Registered:
Oct '99
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Date Posted:
10/18/07 12:12pm
Subject:
RE: US Universal Health Care Discussion
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Having once been staunchly opposed to universal coverage and now absolutely for it, I think you make some very good points.
We could save an awful lot of money with a stronger emphasis on preventative medicine and access, instead of universal catastrophic care, which is what we have now for all combers.
I don't know that a single-payer government system is the answer (in fact I believe that it isn't), but mandating coverage and providing tax incentives (as a start) is an absolute must, IMHO.
Peace,
V-03
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