Can The US Learn Anything From Health Care In Other Countries?

Judging by the fact that 3 of the 16 remaining candidates for “Worst Company in America” are insurance companies, we suspect that some of you are not happy with the state of health care in this country. With that in mind, we thought we’d direct you to an interesting episode of the PBS documentary series Frontline.

In this documentary, Frontline examines 5 capitalist democracies to see if there’s anything that can be learned from how those countries run their health care. No system is perfect, but there are some interesting ideas being implemented all over the world.

Sick Around The World [Frontline]

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  1. consumersaur says:

    Universal healthcare for everyone!

  2. Bladefist says:

    I’m not going to turn this into a 250 comment debate. All I can say is, we are a much different country then the ones above. We are physically larger, and our costs will be much higher. The rest of the world gets to enjoy cheap health care, because our capitalistic nation keeps providing all the innovation. If we cut funding to innovation, then everybody is screwed.

    I’m okay with national health care if its optional, and those of us who want to opt out, don’t have a tax increase.

    Also our Government is notorious for screwing everything up. I prefer paying a little more then getting a DMV-quality health care.

  3. axiomatic says:

    Two words: Tort Reform

  4. johnva says:

    We’ve been over most of this before, so I don’t want to debate too much either on this. But there are some facts we can learn here:

    1) Single-payer plans have much lower administrative costs.
    2) The U.S. pays by far the most for healthcare of any nation comparable to our own in wealth. This is on both a per capita basis and as a percentage of GDP.
    3) The U.S. gets inferior healthcare to a lot of other countries when you look at aggregate statistics. Healthcare in this country is very inequitable, so although some people have very good care, a lot of people have terrible care.
    4) Government-run insurance does not necessarily mean long lines for necessary treatment, if the government plan is adequately funded. Most of the problems with that sort of thing in other countries have been caused by tax-cutting ideologues.

  5. Angryrider says:

    The US could but they won’t. Despite our girth, there are many things we are slow to adapt. We’re still the only country in the world that matters that still uses the antiquated and freakin’ confusing standard system. If we can at least do that, maybe I’ll see hope for a better more streamlined America.

  6. TheDiz says:

    My friend is from Sweden and they don’t pay for healthcare or dental (not to mention you go to school for free there. Heck, his country is paying him to go to school in the U.S. with the assumption he will move back to Sweden and use that knowledge there, he probably wont).

    Ofcourse, my argument was that Sweden taxes him over 33% so they take high taxes and then provide the healthcare and dental (and school) for free….but then I realized that after I pay my taxes (I am in a high bracket) plus the dental and healthcare and vision I pay…I myself pay over 33%. Not to mention, my insurance does not cover 100%. Only the first $2,500, then after that it breaks into 80/20% or 60/40 bull that is too confusing to figure out.

    All in all, yes, those countries are smaller and it would suck to cut funding from a country that is “innovative” but we are not the only innovative country when it comes to healthcare. Sweden, Australia, and Norway have all come up with amazing new health benefits and still get to have their patience go to the hospital for free.

    I will end it on this, my buddy from high school recently married a girl in Norway on purpose so that he can move there. He was diagnosed with cancer and was able to get his treatment for almost free. Including recovery and hospital stay. Imagine that. Getting cancer and getting treated for free. He lives there now because he wants his kids to grow up in a place where you can be taken care of instead of screwed over when you are sick.

  7. timsgm1418 says:

    @Bladefist: amen, amen, amen. I’ve been a lucky recipient of government health care way back in the 80′s when my children & I were on welfare, and no thank you. One of the doctors they assigned to my children was over 80 years old. My son desperately needed his tonsils out but no way was I letting that guy do it, and he wouldn’t refer us to a specialist. Frankly the extremely poor quality of health care is what made me go to my boss and say “I either need to be an employee with benefits or I need to find a different job” (I was a temp employee at the time) fortunately for me they hired me, I never want to go back to that kind of health care again.
    I don’t think people realize how bad it would be if the government was in charge of everyones health care. Since so many in Canada come here to get care, when their hospitals are full, or the waiting list is too long, where are we going to go when we need it if we adopt the same plan?

  8. Tightlines says:

    From what I understand, a lot of the basic stuff is free or very inexpensive–doctor’s visits, prescriptions, etc.–but you are able to purchase additional, perhaps better and/or more inclusive, insurance if you so choose. That sounds pretty good to me.

    I hate that in this country, in this day and age, providing basic health care to everyone is still a raging debate.

  9. spinachdip says:

    @johnva: “4) Government-run insurance does not necessarily mean long lines for necessary treatment, if the government plan is adequately funded.”

    Yeah, funny you bring that up. I recently had to wait 3 weeks for a dermatologist to see me for what turned out to be a 20-minute visit. It probably doesn’t help that I have UnitedHealth through my employer. It was hell finding a pediatrician who would take my insurance too.

    And about #3, I think we’re neck and neck with Cuba.

  10. spinachdip says:

    @timsgm1418: You do realize that a single-payer system will be nothing like Medicaid?

  11. Derp says:

    @Bladefist: You took the words right out of my mouth! Anytime I see a special on some sort of healthcare procedure, the patients are always coming to the United States for their treatment and care. I’m perfectly happy with my healthcare right now, and I don’t want to pay for someone else.

  12. Derp says:

    The U.S. can learn its healthcare is the world’s best!

  13. ARP says:

    @Bladefist: Doubtful. This will easily hit 250+ comments. I’m glad it will. We should be debating this.

    Health-care doesn’t need to be DMV-quality. In fact most other countries are not DMV-quality. They’re prompt and effective. Just like the left takes the horror stories of healthcare and pushes it as the norm, the right takes the (much fewer) stories of national health care gone wrong and pushes it as the norm. I agree that the primary motivation of insurers is to minimize the amount of money they pay and that often becomes a direct conflict with what’s best for the patient.

    Much of the healthcare based innovation is based on IP laws (i.e. patent laws), I disagree if you nationalize the market, some of the incentives will go away. Because there’s still an available market for those who either want to opt out or get care that exceeds the standard. So you don’t like the national system? Pay extra for the gold star care.

    The other thing that I have trouble with is the concept of, “I don’t want to pay for other people’s health care.” I think you do it already and don’t realize it. Workers comp claims, absenteeism, medicare payments, your employer’s cost, SS payments, etc. are all increased because people don’t seek preventative care an only go in when the pain/problem is unbearable. It ends up being much worse and much more costly to insurers and to the government. So I think the concept that you’re not paying is a misnomer.

    Finally, our economy directly suffers because we lack health care. Canada is preferred by employers because they don’t have to worry about health care, that’s a huge cost savings to them.

    So, my view is all issues you have with paying more is actually causing you to pay even more.

  14. johnva says:

    @timsgm1418: Government-run insurance is not the same thing as government-run healthcare. With government insurance, you could see whatever doctor you want.

    Also, it’s not really true that a huge number of people come from Canada to get care here. That’s a myth. Some people do, but it’s mainly not because they can’t get good care there.

    We actually already have both socialize medicine and socialized insurance in this country, as federal programs. They just don’t cover everyone. The VA is true socialized medicine, and they do a great job by most metrics these days (forget any myths you might have about that one). Medicare, Medicaid, and the FEHBP are socialized insurance, and they have much lower overhead than private insurers.

    The problem with making government insurance “optional” is that the people who would opt out for cheaper options in the private insurance market would be the young and healthy. That would increase the average cost per patient of the socialized system. It’s socializing costs and privatizing profits. Basically, that would be just a big scam for corporate insurers to profit on the taxpayer dime by being able to dump their unhealthy patients on the government.

  15. Derp says:

    @ARP: I think you make some excellent points, and I agree we often don’t see the hidden costs of healthcare we are paying for others. I would simply not allow it, if you can’t buy it on your own, you do without.

  16. katylostherart says:

    @johnva: “The problem with making government insurance “optional” is that the people who would opt out for cheaper options in the private insurance market would be the young and healthy.”

    i would disagree with this only because as a young person i cannot afford private insurance. starting salaries and costs of being a fledgling adult probably keep the young and healthy out of the private insurance market unless it’s part of an employee benefit package somehow. i know in a lot of people i know it already does because a) it’s not needed as much and b) it’s unaffordable.

    i find this really interesting because i work for an english owned company and when we have a brit in we discuss things like this. they think it’s a pain to wait. i countered once with the fact that it’s better to wait for something than never have a chance of getting it and i think they finally understood why nhs isn’t that bad.

  17. Erwos says:

    I’m perfectly happy with BCBS.

    Ultimately, if you want universal health care, the money is going to have to come from somewhere – generally the people paying for such programs are not the ones using them.

  18. johnva says:

    @spinachdip: Yeah, that’s another thing. We hear all this whining about how socialized health insurance would lead to “rationing” and long waits. I don’t think anyone who makes a statement like that has had to make many first-time appointments with specialists here in the United States lately. This year I had to wait almost 4 months for a first appointment with a specialist. We have the same problem here.

    Also, we already ration care here. It’s just done on the ability to pay principle instead of something more sensible and equitable like medical need.

  19. @Bladefist: Because your HMO is doing such a wonderful job, right?

    Seriously. I think the world could have spun on its axis just fine without Levitra, and let me simply remind you that most of the R&D is being done on the taxpayers’ dime. Don’t you think that makes you part owner of the patents for all these wonder drugs our sainted pharmaceutical industry keeps churning out. You know, the ones where it takes a three minute mini-infomercial to list all the side effects.

  20. AD8BC says:

    @Bladefist: @timsgm1418: @Derp: Amen to all, plus one further comment… our government can’t even handle our VA healthcare system, and the victims of that are all people we are all indebted to. Fix the VA, and maybe I’ll take another look at government healthcare. But just a look.

  21. @Bladefist: Oh, and my last visit to the emergency room was much longer and far more painful than my last trip to the DMV, and I HAVE insurance, so I would advise you to stop using that tired analogy because it makes you sound like an idiot.

  22. ARP says:

    @timsgm1418: @Bladefist: What would be nice if we could actually get some objective stats (difficult, I know) on what average wait times are in other countries compared to US for certain types of treatment. Both sides throw around the worst numbers as if that’s the norm. Those wait times often have no context. For example, I had to wait 2 months to see a dermatologist with private insurance. I didn’t have a life threatening problem, so I didn’t care.

  23. thegirls says:

    @Bladefist:
    Agreed that it’s not going to turn into a 250 comment debate. But I must say that the “stiffle innovation” argument isn’t a very strong one. Innovation doesn’t come from the insurance companies. And for the most part, pharmaceutical companies on their own. We’re already spending tax dollars on these innovations and research through the NIH. Pharms would rather spend more money and time working on money makers rather than innovative new drugs. They’d rather reformulate and market things like another heartburn med then do any independent r&d on innovative treatments in other lesser researched diseases and disorders.

    Also, charging Americans more for drugs just because this country is where the innovation supposedly comes from kinda feels like they’re biting the hand that feeds them!

  24. backbroken says:

    Folks I know in the UK seem to like their government health care. There are sometimes long waits to have non-emergency procedures. However, you always have the option to go ‘private’ as they say, and pay for it yourself and get it done on your schedule.

  25. bohemian says:

    We will never solve health care. We have too many of our fellow citizens that are too stupid to know what is in their own best interest or can’t form their own opinions and believe whatever health insurance lobbyists tell them to think.

    We could do this. My guess is until enough people wise up we won’t get it. I would be all for a voluntary national insurance system as long as those that opt out can never ever join it in the future. Let them bask in the unfettered free market economy they worship. Do I sound a bit bitter?

  26. EBounding says:

    One reason these countries can afford socialized healthcare/insurance is because they spend little on national defense. And the reason is because they get to free ride off the protection of a certain nation that spends large amounts on defense for itself and its allies.

    The problem with insurance companies in the US is a lack of competition that’s legally protected. Employee health coverage is exempt from payroll taxes. Since workers get these benefits as a substitute for wages, they’re going to want to get the most out of it. That means they’re going to take more trips to the doctor than they would have otherwise if they received the cash equivalent since there’s no incentive to shop around. This shifts the choices from the worker to the employer and insurance companies.

  27. johnva says:

    @katylostherart: Well, private insurance is really unaffordable right now in the United States for a lot of reasons that need to be reformed. If there was a comprehensive government plan in place the cost of private insurance would probably drop because all of the people with the worst health conditions would go to the government plan to save money. Basically, because a government plan is sort of a cost-sharing arrangement, it’s cheaper for you if you have high costs, but more expensive if you have low costs. So what you would see is people doing the private plans when their costs are low, and the government plan when their costs are high (ie, when they get sick, old, etc). So the insurers would get the financial benefit of having the younger, healthier group of patients while the government would have the burden of all the people who can’t pay their own way. If everyone was in a single pool together, then the costs would be shared equally and the insurers wouldn’t be taking profit out of the system.

  28. BryantSalo says:

    I lived in canada for 9 months and during that time i tore my ACL. Granted i was in a small town (about 2k), but over three visits this is what happend:
    1) knee is too swollen (!) to diagnose, take advil. My knee was swollen 2x normal size. i could not walk very well
    2) knee is sprained, take advil, take it easy
    3) knee is hyper extended, exercise, take advil.
    No Xrays, no prescription for pain meds
    I came home to the US, went and saw my regular doctor, one xray later, he came and diagnosed me with a 50% torn ACL.i needed to wear a brace for many years to get the knee back to normal.
    Ever since then, my opinion of govt insurance is not good.

  29. Bladefist says:

    @johnva: “The problem with making government insurance “optional” is that the people who would opt out for cheaper options in the private insurance market would be the young and healthy.”

    I agree. I am a young stallion, and I wouldn’t pay a dime for it. In fact, I would find a private insurer and stay with them.

    Really this is just wealth redistribution. To our congress, it’s not about health care. They want the rich to pay for the poor. And while Robin Hood was a fantastic movie, (the cartoon version), I don’t want my government taking from the rich for the poor. Because you know thats how it will be.

    @AD8BC: You are 100% right. All the social programs OUR government have, are failing. VA medical, social security is drying up because they keep taking the money for other uses. Welfare is an absolute mess. Nothing is done right. Maybe it works in other countries because they don’t have complete idiots running their country.

  30. Bladefist says:

    @Steaming Pile: Man, you had to bring the name calling. Why? It was going so good.

  31. spinachdip says:

    @AD8BC: Again, citing Medicaid or VA as failure of government-run healthcare/insurance (while ignoring Medicare) is silly. For one thing, they provide care where the private sector fails or ignores, so duh, the chips are inherently stuck against them. It’s a mistake to think of universal single-payer healthcare as simply an expansion of existing stopgaps.

    @Derp: “If you can’t buy it on your own, you do without.”

    Can we apply this to everything? Roads, fire departments, police, garbage collection, etc etc? You might be fine in the short term, but you can see the long term implication, I hope. You talk about hidden costs, yet you don’t see the hidden costs of poor people receiving sub-standard healthcare, if at all.

  32. Bladefist says:

    @ARP: Well, what would you guess would be the longer wait. The Dr who gets paid by private insurance, or the Dr who gets paid by the government.

    Also- When you open up free health care, everybody is going to go to the dermatologist for each and every zit.

  33. Trai_Dep says:

    It’d be awesome if any Consumerist readers living outside the US joined the conversation and shared their experiences. C’mon down!

  34. jamesdenver says:

    Here’s my take – from a type 1 diabetic, who, like other “maintenance” type health issues relies on filling prescriptions regularly.

    My health care is good: Because I have immediate access to the newest and best technology. When I decided to start using an insulin pump with a CGM (blood sugar monitor that tells me my level every five minutes,) it took one phone call, my doctor received in two weeks, and I they put $1,300 co-pay on a payment plan (Retail is 7,000)

    BAD: I’m tied to my job to keep getting the best insulin, eye checkups, and KEEP my excellent health. Even if I have the money, how the hell can I take a year off to travel, or work for a non-profit or somewhere that has less than steller insurance without having to pay sky-high doctor visits?

    Again I’m in great health. Some folks think of health care as “shit I cut my finger off with a saw,” but others, like me, NEED regular visits to MAINTAIN good health well into the future.

    So my job is tied to my health care 100% right now. I don’t mind that currently, but its something to consider for the future.

    james [www.futuregringo.com]

  35. katylostherart says:

    @johnva: the comprehensive government plan is pretend you have an accent, don’t present a social security number and give them a fake address.

    @Bladefist: i think it’s kind of funny that you say you’d find a private insurer and just stay with them. that’s the reason a lot of people don’t have insurance though, they don’t meet minimum requirements for state healthcare and they can’t afford private insurance. when you’re in that limbo there’s no preventive medicine, it’s all faith based medical care. you basically hope and pray you don’t get sick.

  36. ARP says:

    @AD8BC: That’s a republican tatic. You starve the agency you don’t like, when they inevitably screw up or become less effective, you parade that around and say, “See, the government can’t do the job, we should degregulate it and let private companies do it.” They never say, “well, gee, we cut their budget by 50%, so maybe that’s why they’re stuggling. Let fully fund them and see if they’ve effective.” The problem is that it often costs more in the end for tax payers due to their profit margins, tax credits and incentives, tax cuts, quality of service, no accountability, etc.

  37. bloatboy says:

    For anyone who thinks that Cuba’s health care system is great, it is. If you are an important government official or a tourist. For the regular citizens, healthcare, while free, consists of roach-infested hellholes masquerading as medical centers.

    Those denying that government provided healthcare automatically leads to long waits, I agree it is not automatic. Residents of Canada, England, and Italy may take issue with that statement though.

    As far as seeing a specialist, I have never had any trouble seeing one on short notice. Of course, my insurance provider is “self pay” so I only see any doctor when I really need to.

    The biggest problem with healthcare in the U.S. is, well, the government. When Medicare started to mandate reimbursement rates that were below the actual costs of providing care, that gave the various insurance providers leeway to do the same. This meant that healthcare providers had to scramble to keep afloat and increased charges everywhere they could or become bankrupt.

    The second biggest problem is the lack of tort reform. While many malpractice cases rightly paid vast but just compensation to victims, the abuse of the system has increased overall medical costs to enrich a handful of lawyers and the “victims” they created.

  38. spinachdip says:

    @EBounding: But the thing is, they’re NOT spending more money on medicine. As has been mentioned already, we’re spending more by any standard you can imagine – as percentage of GDP, per capita, in tax dollars, out of take-home wages. Seriously, look at the numbers before saying something so silly.

  39. Bladefist says:

    @ARP: Read up on why social security is failing, one party keeps starving it to use the money on other pork projects.

  40. Trai_Dep says:

    I’d be fine with healthy people being able to opt out of the coverage system if they were cool with hospitals refusing to heal them unless they paid cash on the barrelhead first. With no liability, of course.
    It’d take just a few people slowly bleeding to death on the doctor’s doorstep to quiet those saying, “But I’m too healthy to buy coverage!”

  41. thegirls says:

    The arguements that universal healthcare docs and healthcare will be worse isn’t correct. Even those of us with healthcare experience these same excuses others use against the plans in Canada and Europe, etc.

    I see two different specialists that won’t even accept any kind of insurance because they’re such a nightmare. They’re great doctors and they’re clients will pay out of pocket for good healthcare that they’re not getting from docs in their healthcare provider network. Thank the Lord I can afford out of pocket but for those who are poor, sub par healthcare is okay? I don’t subscribe that that kind of thinking.

    Even with the docs that are in my insurance network, the good ones have very long waiting lists…all of this even though we have a supposedly great healthcare plan.

    As mentioned above, no system is perfect, but there are some interesting ideas being implemented all over the world that far exceed what we get here.

  42. katylostherart says:

    @jamesdenver: my mother is in this type of situation. she has lupus. she’s on a cocktail of pills and has to get monthly and sometimes bimonthly blood/urine analysis as well as things like mris now and then depending how her kidneys are doing. she will never ever be able to not work and the older she gets the more it’s a miracle. lupus patients aren’t supposed to live much longer than she does, but strangely the longer she lives, the better chance she has of out living her working years and therefore her insurance and then the better chance she has of dying. she can’t manage her condition with things like diet and exercise (and i’m not saying that your condition is that simple but that could be a temporary bandaid). it really is a broken system.

  43. johnva says:

    @AD8BC: The VA has better health outcomes than most private insurers and providers. They have improved a lot in the recent past. The biggest problem veterans face is qualifying for VA treatment, not the quality of the care. Don’t confuse the VA with the Army medical centers like Walter Reed – they are entirely separate.

    @ARP: The WHO publishes stats on this sort of thing: [www.who.int] You can research it there.

    @bohemian: They may come around once our healthcare system entirely collapses, which is coming within about 5-10 years if no reform takes place.

    @EBounding: There is a fallacy in your statement: other countries with socialized systems actually spend LESS on healthcare than we do, per capita and as a percentage of GDP. So it has nothing to do with them being able to “afford” it because we help them out with defense needs. This is because socialized insurance systems are actually much more efficient than what we do here.

  44. spinachdip says:

    @ARP: “I didn’t have a life threatening problem, so I didn’t care.”

    That’s kind of the problem isn’t it? Waiting until something is life threatening kinda drives up the costs.

  45. spinachdip says:

    @Bladefist: The long term health of social security is actually better than the government budget as a whole. I do like to see an SWF-style investment program done with the funds (NOT a 401(k) style, mind you), but the “OMG, whither Social Security!” folks need to calm down a little.

  46. AaronC says:

    When it comes to goverment health care, it is not so much government run hospitals. it is the gov. paying for those trips. So wait times are not something you can go by. For example, one hospital may have top staff and be getting people in and out extremely fast. While another could have shoddy staff and could take hours to get you in and out. That has NOTHING to do with how you are paying. It is just slow at that hospital. I work in healthcare.. I.T. to be exact. And i have seen people who pay cash take just as long as people with insurance or Gov. funded help.

    p.s. Social Security was NEVER meant to be something to retire on. it was meant to HELP with your retirment.

  47. jscott73 says:

    @Bladefist: “Maybe it works in other countries because they don’t have complete idiots running their country”

    By complete idiots I hope you mean corporations that control who gets elected and what they do once they are, but are they really idiots for doing that?

    Corporate greed will always trump corporate responsibility.

  48. JustThatGuy3 says:

    @AD8BC:

    VA actually works extremely well. It delivers better outcomes at lower costs than either the private insurance/private delivery or the public insurance/public delivery systems.

    [www.cbsnews.com]

  49. @Bladefist: Let me explain something so that even the simple-minded can understand.

    Saying, “stop doing X. It makes you look like an idiot,” is not the same thing as saying, “You are an idiot.”

    However, if the shoe fits,…

  50. MaliBoo Radley says:

    I’ve lived in under both the American and UK systems. I’d rather have the UK system any day of the week. There is more emphasis on preventative care, the doctors seem to genuinely care more, and I didn’t have to worry about co-pays! I think the doctors are more interested in their jobs because all they have to worry about is medicine. No NHS doctor had to worry about medical billing an insurance companies. Their entire focus is on caring for people.

    Also, my experience with hospitals there was quick and easy. I was in a hospital in Hammersmith, London .. had about a 10 minute wait and was taken care of.

    My husband’s parents and grandparents live in England. We never have to worry that they would have to choose between food and medicine. All their prescriptions are free. Some doctors ever do housecalls.

    I do worry about my own side of the family, as they’re all Americans living in the US.

  51. katylostherart says:

    @spinachdip: but the other side of that coin is the inability to go to the dr BEFORE the situation gets desperate.

    @AaronC: social security may have never been meant to be something to retire on but american employers don’t provide the same kind of retirement support that our grandparents used to get. severance packages and pensions are slipping into nonexistence. 401ks are not the same and personal savings for a lot of people will never ever be able to make it livable. setting a timer on the rest of your life so your money doesn’t run out before you do is not the way to treat the elderly. especially since everyone will be that old one day.

  52. MrsLopsided says:

    @timsgm1418: Not all single pay systems are the same. In Canada (Ontario) you can see whatever doctor you want and get a second or third opinion.

    I pay much lower income tax in the US than I did in Canada with the difference offset by health insurance premiums. It’s not a wash because in the US, in addition to monthly premiums, I still have a huge deductible, co-pays and a cap that make me think twice about seeing a doctor unless its a dire emergency.

    One of the leading causes of bankruptcy in the US is medical expenses even among those with insurance.

    It’s a shame to see US relatives stuck in jobs they hate because they don’t want to lose their medical coverage.

    US Hospitals cherry pick the procedures they will undertake. Note that most Level 1 emergency centers are in
    government funded facilities.

  53. Bladefist says:

    @jscott73: Your theory sounds like a great idea for a movie.

    @Steaming Pile: I’m not coming down to your level. If you want to debate the topic at hand, bring an adult debate.

  54. johnva says:

    @Bladefist: All insurance is “wealth redistribution”. It redistributes money from people who don’t need it at the moment to people who do. There is nothing unique about the government doing that.

    And anyway, you’re missing my point. You would still be paying for the care of all the people stuck with the government system under a public/private hybrid approach (in fact, you already are, though it’s not as many people – think of Medicare, Medicaid, SCHIP, state insurance pools of last resort, etc). The government would be forced to raise taxes to cover the cost of the social program because the average cost would go up as all the healthiest people fled to private insurers. So you would still be paying for the cost of the more unhealthy people, but also paying your private insurer for them to make a profit. Do you see where I’m coming from on this? Since the costs would be shared anyway, you’d be better off just consolidating everyone into a single large risk pool so that you could eliminate insurer profit and overhead.

  55. Rajio says:

    Everybody knows, theres nothing the US can learn from any other country.

    No system is perfect but most systems are better than the US system.

  56. MrsLopsided says:

    @ARP:
    Wait times in Ontario can be found here.
    [www.health.gov.on.ca]

  57. spinachdip says:

    @katylostherart: “but the other side of that coin is the inability to go to the dr BEFORE the situation gets desperate.”

    I thought that was my point?

  58. Bladefist says:

    @johnva: Yes I understand. I’m saying, If I can completely wash myself of any taxes or other charges of a Universal health plan, then I would go to a private insurer. The private insurer may or may not cost me more, but I believe I will get better care, from better doctors. I also believe in paying more for better care.

    I still believe our system now will be cheaper then government care. If I’m wrong, I’m still happy to pay more for private insurance. I know thats hard to understand. But that is just my mindset.

  59. katylostherart says:

    @spinachdip: i either misread that or didn’t catch sarcasm in the text then. sorry.

    @Bladefist: because you CAN pay for private insurance. it is easy to say what you would choose when your options are broader. and i won’t bother saying “but if you couldn’t” cuz i’m sure “but i can” would be the response. and that is not snark.

  60. MaliBoo Radley says:

    @Bladefist:

    I think it’s probably unlikely that you could out of paying that portion of your taxes. Under the UK plan, you can get private insurance, but you still have to pay the taxes.

    But taxes are like that. It’s not a buffet, you can’t pick and choose. If I could do that, I wouldn’t pay for schools. I have no children, why contribute? But of course, by contributing, I help the nation as a whole …

  61. pal003 says:

    Why shouldn’t every american citizen have access to the same type of health care that taxpayer-paid members of Congress get? Biggest problems with current for-profit health care in US:
    1) Denial of care/services enables health insurance CEOs to make billions.
    2) Employer sponsored system makes US products like auto manufacturing unable to be competitive. And if you lose your job – you are completely screwed over trying to get health care.
    3) Lack of preventative care causes higher costs later on. Lack of incentives – why won’t my insurance pay for my YMCA membership? Don’t they want me to be healthy?

  62. barty says:

    @axiomatic: There’s a bulk of it right there.

    Then, let’s look at some of the reasons why healthcare and insurance have gotten out of control…most of which can be linked back to our own government. My employer can get a tax incentive to provide health insurance to its employees, but I can’t write off the same unless I’m self employed. Individuals don’t face the costs and headaches of shopping for a new provider every year, which would put pressure on the insurance companies to keep their costs low and quality of service high. Right now that incentive doesn’t exist because getting most businesses to change their health insurance provider is a glacial process. So many insurance companies don’t have much incentive to provide their service at the lowest cost available and with good quality.

    Then, let’s look at all of the mandated coverage folks are required to have, effectively to subsidize the coverage of others. Take a look at your policy sometime and look at all of the types of coverage you’re required to have, such as maternity coverage. That really works well for a couple in their 50s who never plans or is physically unable to have a child.

    Remember that ANY government run health system, regardless of what numbers you see thrown around, will turn into a nightmarish boondoggle once politicians begin manipulating it to curry more favor with their constituents. An economically depressed district may have a problem with unemployment…no fear, we’ll open a government health care administration office there! Then they’ll have to hire twice the number of people to get the job done since the bar will inevitably set low to meet various race and gender based hiring standards which will result in a bunch of pretty incompetent people being hired. Sad thing is, this isn’t a bunch of pure speculation. Look at almost everything the government has gotten itself into, and you’ll see a similar picture painted.

    Just remember…the money does have to come from somewhere.

  63. spinachdip says:

    @katylostherart: Well, my point is, under the current system, people are more willing to put off care until they really, really, really need it, and that’s just not good for anyone, be it the sick people, the rest of us who have to pay for uninsured ER costs, the economy losing productivity, etc.

  64. Sanveann says:

    I’m very happy with my health insurance, but I’m blessed to have a husband with a great job with great insurance. (I had decent insurance through my job, until I went to part-time.)

    HOWEVER, I certainly sympathize with people who have no health coverage. It seems like there must be a way to bring universal insurance to those who need it without mucking things up for those of us who are happy with our curent coverage.

  65. Juggernaut says:

    I didn’t read all the comments (I will after the post)so this might already be there…
    isn’t healthcare for our veterans “socialized”? isn’t it a shame what’s done to a lot of those veterans in this country? What about all that shit with Walter Reed Hosp. just last year? Do we really want the beauracracy that is US Gov’t running our healthcare?

  66. ARP says:

    @Steaming Pile: Easy on @Bladefist:, we’re trying to have a rational debate. We may not agree (on much of anything), but no need for name calling, even if it veiled by qualifiers.

    Besides, it’s good to test your faith, it often makes it stronger.

  67. johnva says:

    @Bladefist: If the healthy people can totally opt out of taxes, then the government system would go bankrupt because it would attract only the people who couldn’t afford private insurance. You might as well not have a government system at all if you allow people to opt out. Is that your goal? The status quo? Because that’s what the outcome of what you’re saying would be.

    If everyone was on a single-payer system, the doctors wouldn’t be “better” on private insurance because you could go to any doctor you want (since they wouldn’t have a choice except to take it). In the U.S., there is no way the system would be structured so that the government tells you what doctor to go to.

    You can believe whatever you want about the relative costs vs. government insurance (not government care). But the evidence is not on your side when you look at the fact that our system has worse care than numerous other nations, despite the fact that we pay a huge amount more for it. And I understand that a lot of this is really just anti-government ideology for a lot of conservatives and libertarians. The problem is that your actions in this area affect other people. You may be happy with the care you currently get, but there are many tens of millions of people who have NO insurance because they can’t afford private insurance and aren’t poor enough to qualify for Medicaid or something similar. The healthcare status quo in this country is just not acceptable, because it’s leading to a complete breakdown of the system (especially for the poor and sick, but also for people with insurance who can’t afford the out-of-pocket components that are seemingly ever-rising). Soon your private insurance options may well go away because your employer won’t be able to afford it if costs keep going up the way they have been. Even Republican politicians understand that, which is why they are proposing various ideas that they claim will cut costs. And when that happens, everyone who is medically uninsurable in the individual market is totally screwed.

  68. SpdRacer says:

    I know this is sort of(way) off topic, but my favorite drug side effect is the “intense desire to gamble” that is caused by one of those restless leg syndrome drugs. Speaking of which is that even a real disease or just another ploy to push drugs?

  69. ARP says:

    @Juggernaut: Disagree, that’s what happens when you ignore the problems, underfund it, etc.

    Don’t get me started on that topic- people who “support the troops” are the same that decided to keep VA funding stagnant, even though we’re in a 2 front war. Way to support the troops! [gets off soapbox]

    As mentioned above, you can’t starve a program and then complain how it doesn’t work. If you fund the program appropriately and it still doesn’t work, then you re-evaluate how its run. The problem is that we perpetually starve programs and then talk about how they don’t work and that private people should take over. Fund it fully, measure its overhead costs, costs to beneficiaries, quality of care, and then evaluate its effectiveness.

  70. speedwell (propagandist and secular snarkist) says:

    @johnva: If the healthy people can totally opt out of taxes, then the government system would go bankrupt because it would attract only the people who couldn’t afford private insurance. You might as well not have a government system at all if you allow people to opt out. Is that your goal? The status quo? Because that’s what the outcome of what you’re saying would be.

    “From each according to his ability, to each according to his need” is the slogan of Karl Marx. Are you a Marxist? Is Communist Russia your goal? Because that’s what the outcome of what you’re saying would be. (…cue the “nooo, buttt…”)

  71. johnva says:

    @Juggernaut: Yes, the Veterans’ Administration is true socialized medicine. And they do a better job, more cheaply and with better health outcomes, than private insurance and healthcare does with the same groups of people. The VA does have problems, mainly that it’s hard to get qualified to be seen by them. My understanding is that part of the problem there is that the VA itself doesn’t fully control that decision – they share the evaluation of whether injuries or disease are service-related with the military. But once you get to go to the VA, they do a very good job.

    Walter Reed is NOT part of the VA system. It is run by the Army, and treats people who are still part of the military (as opposed to veterans). The Army seemingly was not prepared to deal with all the influx of injuries from Iraq and Afghanistan, and this lead to severe problems. Also, medical care is not the core duty of the military, so it’s understandable (though outrageous) that they might cut costs there to pay for something more directly related to their main task of fighting wars. And finally, obviously the Army medical centers see a lot of people who have problems and injuries unique to military service, and have to deal with sometimes unpredictable numbers of people. So it’s not exactly comparable to a civilian medical system.

  72. EBounding says:

    @johnva: I understand that the US spends more than most countries on healthcare. But that doesn’t change the fact that other countries spend very little on defense compared to the US. The US spends more than all of Europe combined on national defense, and Europe is a beneficiary at no cost. When you spend little on defense, you’re going to be able to spend more on public healthcare. If they didn’t have this umbrella of protection, these governments would probably focus more on defense than providing healthcare to all.

    But you’re right in that the US has much higher health costs than other nations. That’s an important point. It doesn’t surprise me that administrative costs are higher in the US. But that’s because the US doesn’t have truly “private healthcare”. There’s a hodgepodge of limitations and inefficiencies. There’s already socialized programs in medicare and medicaid. You can’t buy insurance across state lines, which limits competition and increases costs. Instead of decreasing costs, the focus has been on “getting everyone covered”. This in itself is inefficient. When you cover everyone though, you’re also covering people who do not desire or need it.

    The US offers some of the highest quality and most responsive health care in the world. It’s just very expensive. So the focus should be on lowering the costs rather than forcing everyone to be part of a single health plan.

    Let’s put it this way. You’re a billionaire and you need brain surgery tomorrow. You can get treatment anywhere in the world. Where will you go?

  73. speedwell (propagandist and secular snarkist) says:

    @ARP: Fund it fully, measure its overhead costs, costs to beneficiaries, quality of care, and then evaluate its effectiveness.

    Right, because it’s soooo easy to get rid of government entitlement programs once you find out they don’t work or are counterproductive.

  74. SacraBos says:

    @Bladefist: Opting out of a tax? You must be kidding.

    @MrsLopsided: Wow! Did a wait time for Breast Cancer in Ontario, and the wait time was 22-84 DAYS. My Mother-in-law had breast cancer, and was in surgery within 2 days of getting test results to Baylor. No wonder people in Canada come here for health care – you could die before you get treated.

    Yes, we complain about health INSURANCE, but the health CARE is generally best in the world. I’d still rather take my chances with the Health Insurance company than the government. I don’t want my health care dictated to me by what Congress thinks is best. Remember that one of the biggest lies is “I’m from the government and I’m here to help”.

    Health Insurance is it’s own problem. If it wasn’t for health insurance, we wouldn’t need it. Think about it. They are simply a PURE overhead to providing health CARE. You pay the insurance some, you pay the doctor some, and they pay the doctor some. They also pay their employees, directors, VP’s, and Board members out of your health CARE dollar. Where we went wrong is the HMO/PPO. We should just go back to major medical coverage. Got a cold, pay the doctor. Got a broken arm, pay the doctor. Got cancer? Insurance kicks in and helps you out. Do you buy car insurance with a $10-copay for oil-changes, maintenance, and repairs? No, it would cost too much. Would you buy house insurance for $20-copay for lawn mowing, painting, repairs, and such? Probably cost more than the mortgage. Why do we do the same thing for health care?

  75. speedwell (propagandist and secular snarkist) says:

    s/b a close bold tag after “easy”

  76. johnva says:

    @speedwell: No, I’m not a Marxist, and in fact I have not advocated socializing the healthcare industry (only the insurance industry). All I’m really proposing is combining all insurance companies into a single pool run by the government. Other than that, no HUGE changes.

    Learn the difference between communism and socialism. They are not the same thing.

  77. thegirls says:

    @EBounding:

    You say – the US offers some of the highest quality and most responsive health care in the world. It’s just very expensive.

    Really?

    The World Health Organization says that about three dozen other nations have better aggregate health-care outcomes, and the RAND Corporation found that barely half of the treatments that Americans receive are considered “best practices.

  78. speedwell (propagandist and secular snarkist) says:

    @johnva: All I’m really proposing is combining all insurance companies into a single pool run by the government. Other than that, no HUGE changes.

    LMAO.

    Learn the difference between communism and socialism. They are not the same thing.

    Yeah, that sounds like you said something to put me in my place, but it has no evidence or even thought backing it up. Tell me, my steal-from-the-rich-give-to-the-poor friend, what the difference would be between socialist government-run rationed health care and Communist government-run rationed health care, besides the fact that because a Communist government owns and administers all means of production, there is a chance (a slim one) it might be more efficient than under a socialist government’s administration.

  79. Orv says:

    @Bladefist: Did you watch the documentary? I really recommend you do. You will probably find it tilted against the U.S. system, but it’s pretty frank about the problems the other systems are experiencing. If you watch it at least you’ll have a decent amount of knowledge about other countries’ systems to base your arguments on. It seems like the people who argue hardest for the U.S. system have never experienced health care in other countries and really have no idea what it’s like.

  80. johnva says:

    @SacraBos: The problem with just going to major medical only (which is kind of what the HSA/high-deductible proposals are) is that it would probably bankrupt anyone with a chronic disease. And it wouldn’t really help with costs all that much, because most costs (about 78%) ARE from chronic disease and catastrophic events. So going to major medical MIGHT decrease costs by 10% or so, max, while shifting tons of costs onto people who already pay much more than most people for healthcare. And it has other problems too, like potentially discouraging preventative care or even needed care. Studies have already shown that people who are on high-deductible insurance are much more likely to avoid screening tests like Pap smears, mammograms, and even things like vaccinations for their kids, all of which are scientifically indicated as good ways to reduce overall costs by catching problems early or preventing disease.

    Insurance just isn’t a good way to pay for healthcare.

  81. Kirk Douglas says:

    Yeah I’m not going to lie, I thoroughly enjoy my free health care, especially since, as a student, I do not pay a dime in taxes towards it, and instead, get the taxes I pay refunded to me.

    I’ve seen other comments above call the US system antiquated, and I would have to agree, it sure looks antiquated. But at least it isn’t Red, I suppose.

  82. johnva says:

    @speedwell: I’m not saying to “steal from the rich, give to the poor”. EVERYONE would pay into the system in the form of a payroll tax, even poor people. I’m JUST proposing social insurance, not huge subsidies for the poor.

    Anyway, you’re talking about this like it’s some theoretical thing. In fact, it’s already been tried and proven to be more efficient than our free-market, money-based rationed health care.

    But I know I won’t convince you with mere facts. You seem to follow a faith-based political ideology.

  83. JustThatGuy3 says:

    @bloatboy:
    Cuba’s system actually is great, for a country with that income level. Compare it to Switzerland, and, yes, it’s terrible. Compare it to other countries of comparable wealth, and it’s head and shoulders above. That’s not to justify the Cuban regime – health care is about the only thing they do well.

  84. thegirls says:

    @speedwell:
    Well then…what’s the difference between the current Republican Administration, the Libertarian point of view and Fascism or even Imperialism?

    You’re condescending a$$like tone has no place in this thread! The “screw you, I got mine so I don’t care how you get yours” kinda attitude you seem to ooze has no place in a truly civilized society!

  85. BlackFlag55 says:

    Can we learn anything????? CAN WE LEARN ANYTHING???? Hell yes. Stay The Eff Away From Nationalized Medicine!! Good Lord, as if this even needed to be considered.

    The system ran pretty well until Nixon froze wages and prices. Really. I was there. It’s government fiddling with health care pricing and guarantess that’s gotten us into the insurance mess we’re in. Just like government fiddling with guaranteeing price levels and loans for higher education has made it literally unaffordable UNLESS you take out student loans.

    In 1970, I paid for my own tonsilectomy at age 18. Paid for it with a check. $600 and change, for the surgery, overnight hospital stay, follow up, anesthesiology and everything. The insurance scam had not yet fouled up the free market and doctors and hospitals had to price their goods and services according to competitive pressures. Not today. Today, everything is priced like going to a mechanic. And pricing is based on government mandates of what the Feds will pay and won’t pay and how much.

    The problem is the complete erasure of the free market in medical matters. Except for plastic surgery. They still have to compete for patients and dollars and you know what? Prices are always lowering while quality and innovation are always inproving.

    Free markets mean competing for your dollars. Socialist guarantees means you get screwed.

    Really, this ain’t rocket science.

  86. Bladefist says:

    @katylostherart: It’s not my concern whether or not people can or cannot afford insurance.

    Next is nationalized car insurance. When will it end?

    @Orv: What documentary? I saw Sicko, and it made me sicko.

    @johnva: Ok, me and you have debated every possible part of the health care debate. Lets go to the underlying problem. You’ve heard me say I don’t mind national health care, as long as I can opt out. A lot of people, probably 100% correct, said I wouldn’t be able to opt out. The problem is the Governments role in America, and based off the Constitution. You call me status quo, I accept that. I love this country as it is. I think there are a lot of things to improve on. For example I support tort reform. But, in the end, this country is not founded on socialism ideals. It was founded on conservative ideals. The government here has a fixed job description. Yet our political parties keep expanding that job description, at the expense of the rich, and the middle class (me). You have the right to pursue life, liberty, and the pursuit of happiness. That doesn’t mean you have the right to have happiness. You have the right to pursue it. If you fail to pursue it, you’re quality of life will be less then someone who was successful at pursuing it.

    Unfortunately, this world is not fair. So in order for someone else to be giving a better quality of life, someone else has to give up some of their quality of life. That is the underlining problem with this, and all expansion of government. Call me a cave man, status quo, whatever you want, but if you add a 15% tax to cover health care, in my current situation, I would default on my mortgage, and go into foreclosure. I’ve been in all kinds of situations. I was born in low income bracket. I grew up in high-low income. I graduated collected in middle class, and now I myself, am middle class. In my experience, in NEED, the government always failed me. Now that I am successful, they want my money, to continue to fund their failed programs that couldn’t help me in my time of need, and probably don’t truly help others.

    In the end, you have to be self sufficient. If you can’t provide for yourself, or your family, then I’m sorry. There is nothing I can give to you. I am out there fighting for myself and my own family. Life is not fair.

  87. Pithlit says:

    We will have some form of UHC in the US in the future. It will happen. More people are in favor of some form of UHC and that number is growing all the time. The few people who are still stubbornly clinging to the old ways and nattering about those old industry-fed talking points about innovation and long wait times will be dragged kicking and screaming, I suppose. No matter how bad things get, there will be a few of them, but that’s human nature.

    I guess this debate is good for stretching the mental muscle, though. I have too much to do today to contribute much to this one. I’ll have to catch the next one.

  88. Sudonum says:

    @Bladefist:
    Which party would that be? The party that accelerated the insolvency of Medicad by passing the drug benefit? The one that has two of the worst pork barrel Senators from Alaska?

    Lets stop with the acrimony about who is to blame. Both parties share equally in getting us into this mess. Lets work toward getting them together to fix it. We solve nothing by blaming the other side. We can solve it by looking for common ground and addressing each others needs and concerns.

  89. thegirls says:

    @BlackFlag55:

    Really? Free market only? The free market plan is just as flawed as the that of which you’re rallying against. There already is a shortage of dermatologists that deal with just skin cancer and general dermatology diseases because there is more money in cosmetic dermatology. General Practioners are also in short supply…so by your way of thinking, that’ll be even worse because these GP’s even more so would rather specialize in a few procedures that make them most profit rather than focus on preventative care – Preventative care, that elusive health care right that eludes us all but would benefit our whole society greatly!

    Nice.

    Also, your $600 out of pocket for a tonsilectomy was a lot of money in 1970 (especially for 18 year olds) and is a lot of money to many people now!

  90. katylostherart says:

    @Bladefist: don’t need a car to breathe. and that was exactly the response i thought i’d get which is why i didn’t go into it.

  91. balthisar says:

    I face the fact that we’re probably going to be stuck with a Democrat as the next president (not endorsing Bush, just, a true Republican would be nice for a change), and due to that, we’ll probably start some obscene publicly-funded scheme here. I hope to God it only covers those tragic cases where someone is completely desolate and needs to have their gall bladder removed, they won’t become super-destitute. On the other hand, if you can’t find the means to get an annual check on your own dime or your own insurance, well, too bad. It doesn’t matter how poor you are or how little money you have. You CAN afford that small stuff. I don’t mind being forced to pay for something drastic, but you better figure out how to take care of your own daily business.

  92. lmbrownmail says:

    I am 59 years old and I have emphysema. I am un-insurable.

    Really. No insurance company will take me.

    So what do you suggest I do??

  93. cef21 says:

    @thegirls: The WHO study has been widely criticized because of the measurements going into its rankings. The US, for example, gets for things like “fairness in financial contribution” or the distribution of health outcomes. It also gets dinged for reporting child deaths during childbirth. Most countries never count those.

  94. consumerd says:

    Truthfully, I had thought about leaving the U.S.

    I am tired of the following

    1.) $4 gas prices
    2.) No or abysmal healthcare
    3.) no-responsibility industries
    4.) War funding for a lost, and corporate greed cause
    5.) The sub-prime market- enough said
    6.) Industries using goverment as the “whipping boy”

    That’s my top 6

  95. Juggernaut says:

    @ARP: @johnva: The rebuttals I see are that it’s underfunded and not their “core mission” but in essence isn’t that invariably what our gov’t does? Underfund mandated programs, obfuscate and then tell us it’s someone else’s screwup! Which leads to another “blue-ribbon” commision to get to the bottom of the problem… spend another $5 billion… and in the end we’re told the other countries with “socialized” healthcare were only able to do it because the US consumer was actually subsidizing it by paying outlandish fees for prescriptions and healthcare.

  96. helloashley says:

    I don’t think free-market healthcare is the solution because first of all, it’s still healthcare delivery based on profits rather than patient care. Also, you mentioned that plastic surgery prices lower with more competition and that’s true, but plastic surgery is optional. If you are diagnosed with cancer or you are seriously injured in an auto accident, what are you gonna do, say “hmm…I only have 5K in my savings account…no thanks, I’m not going to the ER because I can’t afford it” (which is what people do now).

    After a while, it becomes almost nauseating listening to professors in my school’s Population Health department talk about the flaws in the American healthcare system. There is no incentive for good care anywhere. Even those people who do have good employer-based insurance are not getting the best care they could (availability of physicians, etc) because of our profit-driven system.

    Other countries don’t have a perfect health care system, but there are systems who undoubtedly have it better. Isn’t that enough motivation to change?

  97. thegirls says:

    @balthisar:
    Regarding your statement – On the other hand, if you can’t find the means to get an annual check on your own dime or your own insurance, well, too bad. It doesn’t matter how poor you are or how little money you have. You CAN afford that small stuff.

    It cracks me up that some people can’t wrap their head around the fact that sometimes people are disadvantaged by circumstances not of their own doing!

  98. speedwell (propagandist and secular snarkist) says:

    @thegirls: Well then…what’s the difference between the current Republican Administration, the Libertarian point of view and Fascism or even Imperialism?

    Well, the difference between the Fascists and the current crop of Republicans is that one is a pack of powerful, superstitious, Anti-Semitic, murderous, military-addled maniacs who follow an insane, defective leader and don’t care what atrocities they commit at home and abroad so long as they further their imperialistic goals and keep their country afraid of them, and the other one was most notable for their actions in Germany under Hitler.

    The difference between either and Libertarians is that they, as well as Communists and socialists, are called “authoritarian” governments. Libertarianism is the opposite of authoritarianism. Libertarians do not feel the need to pick your pocket to pay someone you don’t know for something you didn’t authorize. Libertarians do not need to feel like they have to approve how you live your life. Libertarians feel like you have a right to protect yourself, your property, and your rights against authoritarian assholes… Sorry, I mean people like you who don’t care about rights.

    You’re condescending a$$like tone has no place in this thread! The “screw you, I got mine so I don’t care how you get yours” kinda attitude you seem to ooze has no place in a truly civilized society!

    I neither said that nor think it. You’re projecting. You are the one who doesn’t care how people live, so long as they hand their earnings over to others to give away. Free societies have been proven to be wildly profitable. When people have more, they give more. This is well known.

  99. synergy says:

    @johnva: I work across the street from the local VA hospital. I can tell you from first-hand experience and from metrics that the VA system was sued this year for patients having to wait too long to receive healthcare. Many also often have to travel great distances just to get their 20-minute visit. The VA system and places like Walter Reed AMC indicate that the little dabbling the government already does in socialized medicine isn’t that great.

  100. speedwell (propagandist and secular snarkist) says:

    @lmbrownmail: If no insurance will take you because of your emphysema, then you should probably appeal to the lung association, who can match you with private charities that may be able to help you. You’d have better luck with private charities in a society where the government does not compete with them for the public’s money. But since the government is in the business, there is undoubtedly some government program for people in your situation.

    My sister-in-law used to work at a Methodist health charity organization, and they measured their productivity by how much money they gave away per year. Each year’s budget is based on the amount they were able to give away the preceding year. Appeal directly to them and others like them. Arm yourself with the knowledge that they are actively looking for people to help. They have to in order to survive as an organization.

  101. EBounding says:

    @thegirls: WHO ranked the US as number 1 in responsiveness and 37 in overall performance. The methodology for the performance is suspect though. They just evaluated expert opinions, not the citizens of the country’s health care system. The use of the experts is fine, but more is missing to the story when the thoughts of the recipient aren’t even considered.

  102. Pithlit says:

    It’s well known, is it? Then how come societies with little to no safety nets fail without exception? Every single time? Give us an example of a society run by Libertarian ideals that grew and thrived? Tell us about our own history before social safety nets were installed, and tell us how brilliantly it worked.

  103. thegirls says:

    @speedwell:

    Hmmm..
    (…cue the “nooo, buttt…”) and ” Tell me, my steal-from-the-rich-give-to-the-poor friend”

    I’m projecting? Just because you didn’t same some verbatim doesn’t mean I’m wring.

    Please educate me, what country has/had a successful TRULY Libertarian government?

  104. Pithlit says:

    @thegirls: I know. That’s the internet for you. I don’t remember ever hearing such tripe before regularly going on message boards and blogs. It seems there’s such a high concentration of that, for some reason. I knew that viewpoint existed, of course, but it seems so magnified for some reason in just about every comment section and message board there is. Something happens to people when they plop down in front of that keyboard and start banging away.

  105. Bladefist says:

    @thegirls: wouldn’t a libertarian government being an oxymoron? lol jk

  106. katylostherart says:

    @synergy: because they do it wrong.

  107. Pithlit says:

    It is funny. The Libertarians would have to enact some sort of government to ensure that their viewpoint is upheld. That’s part of the reason it’s such a pie-in-the-sky movement.

  108. speedwell (propagandist and secular snarkist) says:

    @Pithlit: So far, moderately free societies have failed because they were inadequately free. When everyone is committed to upholding their own rights and the rights of others, then the society is as clean and orderly as a can of mixed vegetables. But if you let dishonest and greedy people make laws based on “good ideas” and enforce them on other people without those other people’s consent, then it’s like letting air inside the can. Everything inside begins to rot.

    As far as safety nets are concerned, who taught you that they do not exist in free societies? People in free societies may freely organize themselves into whatever groups best serve the members of those groups. To the extent that people are free to join and leave those groups, they are still free. Families, churches, businesses, all may and do organize “safety nets” for their people and others they wish to assist. The government is not the only player, as I’ve been saying.

    There was never a time when this country failed to have safety nets. There were always organizations and community efforts devoted to helping those who could not help themselves. If some individuals, such as Western settlers, wanted to go it alone, they were also free to do that. It was the choice of individuals to help, and it was the choice of individuals to risk themselves in places where help didn’t exist. Choice is what freedom is about.

  109. speedwell (propagandist and secular snarkist) says:

    @thegirls: No society, sweetie. No society has had a “Libertarian government,” whatever that may mean.

    The focus in Libertarianism is on the individual. Groups of individuals do not have a single mind. The Libertarian society is a society in which individual actors are the “atoms,” not arbitrary groups.

  110. SacraBos says:

    @johnva: “Insurance just isn’t a good way to pay for healthcare.” Agreed, which is why I hate it when people equate health care with health insurance. They are two completely different things, and the current health insurance racket is like no other “insurance” you can buy.

    “And it wouldn’t really help with costs all that much, because most costs (about 78%) ARE from chronic disease and catastrophic events. So going to major medical MIGHT decrease costs by 10% or so, max, while shifting tons of costs onto people who already pay much more than most people for healthcare.”

    More savings than that. What’s the profit margin the insurance companies? That’s the minimum we are over-charged for health care due to insurance. Then take into account all the processing, salaries, etc it takes just to juggle all those claims and such. And those with chronic disease pay higher premiums anyway (I know from direct experience), so the costs are already shifted to them. A 10%+ reduction in what I’m paying doctors+insurance by just paying doctors would still be very welcome. And I wouldn’t have to choose a doctor by “what’s in my plan”.

    “Studies have already shown that people who are on high-deductible insurance are much more likely to avoid screening tests like Pap smears, mammograms, and even things like vaccinations for their kids, all of which are scientifically indicated as good ways to reduce overall costs by catching problems early or preventing disease.”

    Yes, and changing your oil, rotating your tires, checking your brakes etc are good ways to reduce overall costs by catching problems early, too, but good luck finding an insurance carrier to underwrite that one – because people can’t afford it since it’s not a good cost/benefit model. It’s called personal responsibility, much like you’re supposed to manage your credit card debt.

    Remember the reason we even have health insurance (we didn’t always in this country) – the government. In the early 1900′s, the government forced companies to freeze wages. So in order to get around that, reduce taxes, and provide incentives to employees, they started providing “fringe benefits”. Now that this boondoggle has gotten completely entrenched and people think it doesn’t work, we’re going to make it the purview of the government that leveraged it’s creation – and that will somehow make it better?

    There’s already doctors who won’t accept Medicare/Medicaid, or new patients using Medicare/Medicaid, because it doesn’t pay enough. If all you have is government INSURANCE, eventually the same thing will happen there, too, and once again the have-nots have not.

    A lot of people that want government provided programs really need to research the concept of “Tragedy of the Commons”. If something it somehow perceived as “free” or an “entitlement”, it gets screwed up – or it gets rationed. And you end up with 22-84 wait times for cancer surgery, if you live that long.

  111. speedwell (propagandist and secular snarkist) says:

    @Pithlit: You’re doing it wrong. You’re assuming Libertarians have a group mentality to uphold. The essence of libertarianism is that group mentalities are not the way to go.

  112. SacraBos says:

    @Bladefist: I like the example from “Stranger Than Fiction”, where Will Ferrel asked the girl of she belonged to an Anarchist Organization…

  113. nedzeppelin says:

    @Bladefist: the common misinterpretation is that robin hood “stole from the rich to give to the poor”. that’s just how liberals rewrote it

    robin hood was actually stealing from the government (the sheriff) because he was taxing all the people into poverty. robin hood gave back the people what was rightfully theirs, which is typically the exact opposite of how people try to describe robin hoods in this day and age

  114. thegirls says:

    @speedwell:
    You didn’t answer my question. Please let me know where there is/was a truly successful Libertarian society?

    Social Security, FHA and many “safety net” programs weren’t there from the beginning. They were enacted because the free market failed us!

    Energy deregulation is a great example of free market screwing the consumer. But I’m sure your answer will be because of the gov’t interfered or because consumers made bad choices, etc.

    Gov’t has it’s problems but that doesn’t mean that many of it’s laws and programs aren’t necessary to protect against predatory “free market” practices.

  115. nedzeppelin says:

    @SacraBos: insurance companies make most of their profit from investment, not underwriting profit. so no, you’re not being “ripped off” by their margin.

    profit is also the stuff that keeps people employed at those companies, and funds the retirements of the millions of people who invest in these companies.

    at LEAST private companies have to answer to profit. if they don’t make money, they go away and die. but the govt answers to no one. if they inadequately fund it, who cares right? it’ll just be a 20 trillion dollar problem for the next generation.
    and you know that’s what will happen.

    look what a bang-up job our govt has done with medicare and social security.
    now let’s get some walter reed quality healthcare for everyone!

  116. speedwell (propagandist and secular snarkist) says:

    @thegirls: I did answer your question. To expand on my answer, there have never been fully free (i.e. libertarian) societies, so none have either succeeded or failed.

    Social Security and the other so-called “safety net” programs you mention were not enacted because the free market failed. The market was never free in the first place, so no free market failed.

  117. nedzeppelin says:

    @thegirls: social security has “saved us”? it’s trillions of dollars in the hole, and doesn’t actually rescue any feeble old people like AARP would have you believe.

  118. thegirls says:

    @speedwell:
    Okay! Exactly, it can’t and doesn’t exist in a “societal way”, so stay out of this tread with those views then! It’s a useless distraction to a serious subject.

  119. speedwell (propagandist and secular snarkist) says:

    @speedwell: Predatory practices are not part of the free market. Predatory practices are fraud. Fraud is a way of transgressing someone’s property rights, and thus their freedom. Transgressions of freedom have no place in a free market. To the extent such fraud exists, the market is not free.

  120. thegirls says:

    @Bladefist: LOL

  121. speedwell (propagandist and secular snarkist) says:

    @thegirls: If you feel uncomfortable about what I’m saying, you may simply stick your fingers in your ears and shout “LALALALA.”

  122. thegirls says:

    @speedwell:

    Again, you proved your maturity level!

  123. speedwell (propagandist and secular snarkist) says:

    @thegirls: I see you’re not addressing what I said.

  124. thegirls says:

    @Pithlit:

    Agreed…these types of folks do seem to come out in droves when it’s anonymous but you never meet them in real life!…It’s easy to surmise the reasons why! I feel sorry for them.

  125. speedwell (propagandist and secular snarkist) says:

    @thegirls: Your feigned pity is easier than refuting the arguments, isn’t it.

  126. thegirls says:

    @speedwell:

    I think I already said that since this isn’t and never will be a libertarian society “as a whole”, then those views aren’t really relevant to this thread, so I’m done with that.

    Also, I have to go and take my father in law to the VA for some tests.

  127. nedzeppelin says:

    well, this isn’t and never will be a socialist society, so get out of the thread

  128. Pithlit says:

    @speedwell: @speedwell: “As far as safety nets are concerned, who taught you that they do not exist in free societies? People in free societies may freely organize themselves into whatever groups best serve the members of those groups. To the extent that people are free to join and leave those groups, they are still free. Families, churches, businesses, all may and do organize “safety nets” for their people and others they wish to assist. The government is not the only player, as I’ve been saying.”

    No one taught me they didn’t exist. History taught me they aren’t efficient or effective. That’s why the government stepped in in the first place. Don’t get me wrong. Private charities do indeed have their place. They’re great for supplementing and filling in the gaps. But they cannot be relied on solely to provide for everyone across the board. This has been proven time and again. Governments and societies who provide for their own do better than those who leave it to the private sector.

  129. battra92 says:

    @Erwos: I’m perfectly happy with BCBS.

    Dittos!

  130. petrarch1608 says:

    hospitals in England are sometimes like greyhound bus stations

  131. Pithlit says:

    @speedwell: Which is exactly why I never take Libertarians seriously. We can’t all live in neat little individual bubbles with little to no interaction with each other. It would be neat if we could. But, we don’t live in La La Land. Reality has to be taken into account at some point. You can bet that when I’m “debating” with a Libertarian, I’m really just killing some time.

  132. IamNotToddDavis says:

    Before everyone gets all excited about the US Government creating its own Healthcare system, let’s examine how well the current US Government funded healthcare programs are doing.

    This is from Richard W. Fisher, Remarks before the Commonwealth Club of California San Francisco, California
    May 28, 2008 -

    “The infinite-horizon present discounted value of the unfunded liability for Medicare A(hospital stays) is $34.4 trillion. The unfunded liability of Medicare B(doctor visits) is an additional $34 trillion. The shortfall for Medicare D (drug benefits) adds another $17.2 trillion. The total? If you wanted to cover the unfunded liability of all three programs today, you would be stuck with an $85.6 trillion bill.”

    So people honestly think that if the Government took over running healthcare completely the costs would go down?

    “If you think health care is expensive now, wait until you see what it costs when it’s free. ” -PJ O’Rourke

  133. Skankingmike says:

    I suggest some of you read the article. I didn’t have time to read each interview but i picked Germany because I’ve heard good things about them.

    And they’re really not entirely Government funded. You still have to pay and it uses private firms in it’s health care field. It’s not prefect but you can stay 5 nights in a hospital and only pay around 70 bucks. You can visit a doctor everyday for an entire month and only pay 10 bucks. And the most you’ll ever pay for any prescription is 10 bucks.

    I don’t’ know about you.. but sounds better than what I currently have.

    All I’m saying is we don’t need a medical system exactly like UK or Canada. Our country would probably work best under something like Germany.

    I agree with many of the points that Bladefist makes, our country is larger than most of those other countries. But as far as innovation goes, our country is lax. We allow Viagra to be covered but there are hundreds of medicines allowed in other DEVELOPED countries that would greatly benefit our sick that we may never get because of FDA and BIG PHARMA.

    And the bigger problem is Hospitals not getting paid, we have too many illegal aliens in this country feeding off our hospitals that many of them are closing.

    But that’s not the only reason, recently all the HMO’s decided that they are not going to pay hospitals for patients who contract staff infections while in hospitals. So now hospitals have to spend millions of dollars and create (towers) almost hotel like, and keep patents in just one room to themselves. Sure this is a good thing for patent care, but how many hospitals can afford this enormous task on top of treating people who will never pay their bill?

  134. speedwell (propagandist and secular snarkist) says:

    @Pithlit: No man is an island. Libertarianism is not a way of separating people into individual bubbles. Individuals interact. Libertarian ideals are the best way of ensuring that the interactions are sane, decent, and free.

    Governments and societies who provide for their own do better than those who leave it to the private sector.

    Did you type that with a straight face? Better pony up some evidence to back that up. Start, if you don’t mind, with the effectiveness rates per dollar spent.

  135. pal003 says:

    bottom line is – No one should have to go bankrupt or lose their home because they get sick!

    How we solve that is the big question!

  136. Saboth says:

    @timsgm1418:

    I’d hardly compare modern socialized medicine with a WELFARE system from the 80s.

    People are afraid of poor coverage, care provided under universal care. Personally I am more afraid of the fact that if you have any pre-existing conditions, you cant even GET healthcare anymore, and even if you are one of the lucky ones that do, it is increasingly more common for companies to deny your claims and/or drop you.

    Capitalistic principals work when people have choices, and that is increasingly NOT the case with health insurance. Government needs to step in.

  137. QB says:

    I am a Canadian who spent a few years south of the border in the US so I’ve seen both systems up close. There are pros and cons to each system. The main cons for the Canuck system are the fact that we have higher taxes and that our waiting lists are getting unacceptably long. However, if we do get sick, the costs per family (tests, surgeries, prescriptions, etc.)are fairly minimal.

    When I was in the US, I got top-notch health care but I paid for it. I could afford a great health plan but I saw a lot of people in my office who couldn’t. Some couldn’t find a GP willing to accept new HMO patients. I was also disturbed by the fact that you can only go to certain hospitals and that Dr’s have to get the OK from the Insurance companies for procedures, etc. The upside is that if you can pay for it, you can get immediate treatment (although I’ve heard that waiting lists are getting longer down there too). I just don’t think that people’s health should be used as a profit center

    When you hear medical horror stories on the news in the US, its about people who are getting shoddy or no treatment. When you hear horror stories on the news in Canada, its about people having to wait long times for treatment.

    there is no perfect system and I like the fact that it is debated in both countries.

    My two cents.

  138. speedwell (propagandist and secular snarkist) says:

    @pal003: I agree. Nobody should have to suffer. But people in the real world do suffer. We need to focus on ways to prevent and mitigate suffering. it can be done without stealing from people in order to support other people’s “good ideas.”

    Wouldn’t it be nice if we had some sort of experimental lab in which we all, had, say, points that we could award to solutions that we thought were especially creative and useful and relevant to our needs? If we had some way of giving positive feedback to people whose solutions are better than all the rest, and negative feedback to those whose methods and materials are worthy of contempt? If we had some way of knowing whose solutions were better than others? If we had the liberty to make up our own minds and could support whatever we thought was best for ourselves, independent of factions and special interests?

    Oh, but that would be the free market, and many people here are uninterested in that.

    Amazing, that in a blog called Consumerist, that so many commenters are anti-consumer and anti-market. It’s really peculiar. But since I believe in their freedom of speech, I’m not ordering them out of the thread.

  139. Pithlit says:

    @speedwell: The thing is, Libertarian ideals do not take into account human foibles like greed and self interest. Those will muck it up every single time. It isn’t the ideals themselves I take issue with, really. It’s the total and utter impracticality of it all I take issue with. It’s the people who will thumb their noses at those ideals and quickly and gladly victimize those who will have no protections under the Libertarian way of doing things that I take issue with. I really would have no problem with living in Libertrian Land. I’m just a realist, sadly. That’s all. I’d love to live in a land where chocolate was a health food, too. Probably not happening any time soon.

    I can pony up plenty of evidence. There are plenty of places around the world with weak governments that don’t support their citizens. Let’s start with Russia after the fall of the wall, with Putin as President. Really, there isn’t enough space here. I think Libertarians really take way too much for granted, and really don’t think about the stuff we get in this country that is provided by our government, and how rough life would indeed be without it. It’s so fashionable in some circles to fear and mistrust the government, but it’s done with little to no thought at all.

  140. timsgm1418 says:

    @barty: that is definitely a good point. My sister works for United Healthcare, and some states have to include coverage for (imho) stupid things because of state laws. When my niece was pregnant with twins her insurance HAD to cover her getting regular massages. Sorry, a massage is nice, but definitely not a required service. A lot of the high cost of insurance can be traced right back to the states themselves for requiring things such as ED treatment and fertility treatment. I have a difficult time understanding why either of those should be covered by insurance. That’s not the federal governments doing, it’s the states.

  141. speedwell (propagandist and secular snarkist) says:

    @QB: That’s a good point about people getting shoddy or no treatment in the US, versus delays in Canada. But does everyone really get treatment in Canada? How about people who die while waiting in line for their “guaranteed” treatment?

  142. Saboth says:

    @speedwell:

    When it comes to life and death, I don’t really think a fre e market needs to be involved. Do you think insurance companies are scrambling for better methods, procedures, etc to “help” Americans meet their healthcare needs? No, they are scrambling to go through legal channels to see what “pre-existing” conditions they can get added to their lists so we are denied coverage. They are checking to see what procedures they can get removed from their “accepted” list. Meanwhile, more and more people each day go without insurance, and simply have to die/live in misery because to go get a procedure done would mean bankruptcy.

    The actual cost of medicine has gone up, but the profits of insurance companies absolutely dwarfs this. This is not an old industry, the new methodology of HMOs has only been around since the 70s and their greed has gotten out of control.

  143. QB says:

    @speedwell: Good question. Its been my experience (with older members of my family) that those in life-threatening cases get moved to the front of the line. However, if its not life-threatening, you can wait for a long time, no matter how much you are suffering. That is something I hope we can fix up here. Some people die waiting for treatment but a lot of those are transplant cases. Its still unacceptable but I think a lot of countries have that issue.

  144. Pithlit says:

    @Saboth: Exactly. There are some things a free market is suited for. Health care really shouldn’t be one of them, for what should be obvious reasons.

    It’s not as if many of us in the US have a whole lot of choice under the current system to begin with. I have pretty decent health care, relatively speaking, and I don’t get to pick what doctor or hospital I go to if I want to be covered. My insurance dictates which doctor and hospital I go to. Doesn’t seem like a real free market to me. I don’t think we’d be restricting a whole heck of a lot marketwise by overhauling the system.

  145. olegna says:

    Bladfist: I call BULL S**T. Firstly, watch the damn documentary before wanking off about it with Republican platitudes.

    Americans pay 25% of their health care in administration costs. That has nothing to do with the size of the country or whatever other lame “free market” excuses you can muster. These administrative costs are all the paperwork and time we spend arguing among consumer, insurance company and hospital. If we solved this problem, we’d knock 20% off the costs right there.

    Secondly, your “innovation makes the world go ’round” argument is also bollocks because pharmaceutical companies spend more MARKETING drugs than they do RESEARCHING new drugs. And though the innovation argument does hold some water, if nobody can afford these drugs, what’s point? To help Warren Buffet keep his cholesterol in check? Part of “innovation” is a little something we call “affordability”. Without it, innovation means nothing to 99% of us.

    Example: I have a friend with a dangerous auto-immune condition (one of those things that a bee sting will kill her) — she spend $900 a month on drugs to keep her alive AFTER her insurance. This is crime.

    So take your Republican talking points and shove it, OK? I’m getting fed up with apologists like you.

  146. timsgm1418 says:

    @speedwell: seriously, one of the most helpful posts so far….
    fortunately I’ll be getting my kidney removed before national health care takes place, and I do have a boat load of bills from the 10 surgeries I’ve had in the last 2 years. I am fortunate to have good health insurance through my company, but the reason is because I made sure, even in high school that I had skills that would get me a job with health insurance.
    I do feel for people that absolutely need medical care and can’t afford it, but from my personal experience most of the people I know that say they can’t afford health insurance, have cell phones, internet access, cable tv and a few even have SUV’s so they are paying a lot for gas. None of those things are necessities. I know not 100% of the people without insurance have those things, however I can’t tell you how many times I’m behind someone in the grocery store paying with food stamps while they talk on their cell phone.
    Way back in the 80′s when I was on welfare for 2 years, I didn’t even have a phone or a tv, much less cable tv, because I couldn’t afford them. When I went back to work I put a tv on layaway. I may have also been one of the last people in the country to get a microwave and a vcr. All my money went to taking care of my children. Back then food stamps were the actual paper stamps, I would have to take a calculator to the grocery store just so I could make sure I’d get as much change as possible from the food stamps so I could buy toilet paper or laundry detergent.
    I know there are people that have nowhere to cut back to get health care, but I don’t believe it’s the majority. It’s all about priorities.. And I have to agree with I think it was Bladefist, you have the right to pursue happiness, not the right to get it. I don’t remember the right to health care being in the Bill of Rights.
    I think a lot of the high cost of insurance is what people insist gets covered on their plan. From listening to my sister, most of your insurance premium goes to all the sales peoples bonuses, not the doctor

  147. verdegrrl says:

    Health care in Canada varies by province. They all have a lot of leeway in setting and changing their systems. Populous provinces with poor immigrant populations like Ontario and highly capitalist provinces like Alberta, tend to offer lessor health care than other provinces.

    I know somebody who was diagnosed with bladder cancer in Canada. Because he lived in a rural area, it more a matter of when he could travel to a larger town for treatment, than any waiting list for services. He was treated inside of a few weeks and could have been treated much more quickly if he wanted. As for the lead up to the operation, he had a physical, a blood test, and signed a single page consent form. In all, it took maybe an hour on the day before the operation. A refreshing change from waiting 3 to 4 weeks just to see a doctor, and then a specialist in the US, with every subsequent visit requiring a similar wait – unless you can pay out of your own pocket for immediate treatment.

    The problem with the US system is that it’s very bloated with red tape and middle men. Having a very litigious legal system does not help with costs either. Insurance companies won’t want to give up all the fat in the system.

  148. redkamel says:

    a) regulate insurance companies so they arent screwing docs and patients. Seriously. People list a few basic problems with healthcare that could all be taken care of (and I have posted it before) without completely restructuring the payment system (and thus, the whole system).
    b) govt run health insurance: good idea, bad in practice. What do you think Bush would have done to it if it was in place? I just dont like having non accountable people in charge (to me elected officials are far less accountable than CEOs and companies. Its easier to vote with my money, find tax irregularities, do a stock takeover, or class action than get one rep out of office).
    c) those countries had systems that worked better, with tradeoffs, I agree. But also, do you think they would work in the US? We have different health problems, obesity etc. Do you think the 2 minute appt in Japan would work in the US? people here go nuts over 15-30 minute appt. They would sue in a second over any mistake made in a 2 min appt. Do you think people would go to the doctors and take an interest in preventative care? do you think our drug and procedure driven healthcare system would change to a preventative one? do you think people would still go to school to be 30 with 200K in debt, and no equity (assuming school isnt paid for?) Do you think Pharma, the LARGEST lobby in Capitol Hill, would have no influence over national healthcare funding ie drugs pay docs more than prevention does? I am not being sarcastic, these are all serious questions I have.

  149. failurate says:

    I keep seeing the “so many in Canada come here to receive health care” bit… any idea where this bit of propaganda is coming from?

  150. cef21 says:

    @Saboth: So, you believe that the a government will be better at making decisions about how to allocate resources than the free market? If that’s true about health care, then why isn’t it true about food or automobiles or clothes or housing? If the government is so much better about making these decisions, then why limit it to health care? Why not let it decide how many computers to make, where airline flights should go and how many pairs of skis should be manufactured?

    What’s the foundational principle that says “the government will be better at managing the health care industry than the free market, but not better at managing the toothpaste industry”?

  151. SacraBos says:

    @nedzeppelin: But that’s investment profit that ought to be MY (and everyone elses) investment profit. I’ve done the math when I was self insured. There wasn’t that much of a difference between just paying out of pocket vs. having the insurance – but it’s damn hard to find a major medical plan anymore.

    I know we can just abolish the insurance industry overnight. It’s too entrenched in too many things. Just like dumping the IRS and going to a flat tax – put too many accountants on the streets. And the last thing we need is packs of feral accountants running loose.

  152. RandomZero says:

    @speedwell: So your argument is that the market is not free unless it is regulated, inhibiting the freedom of 50% of the actors involved? Or that it is not free unless people act counter to basic instinct, in a theoretically logical but practically difficult way, for no apparent reason and to their percieved detriment?

    Wauy I see it, you’re arguing for circular stupidity, or a system that works great in theory but falls apart in practice (see also Soviet communism, which failed because of [ironically] the same uunderlying assumption).

  153. Pithlit says:

    @timsgm1418: @timsgm1418: “but the reason is because I made sure, even in high school that I had skills that would get me a job with health insurance.”

    See. This is what gets you and people with your viewpoint in trouble. Right. There.

    Do you honestly think that there aren’t people who worked just as hard as you did, who are just as capable as you are, who still manage to end up without health insurance? Because there are. Millions of them! *Even the ones who got all A’s in highschool* Because life’s kind of actually complicated. There are things like getting laid off. It does actually happen. Because there are people called shareholders, and… Well, like I said. Complicated.

    Thing is, that whole thing about if you get good grades on your report card, and get a pizza party, and then the rest of your life is smooth and easy as pie, and you don’t turn out like the welfare queens riding in a Caddiac? See, that’s not always true.

  154. speedwell (propagandist and secular snarkist) says:

    @timsgm1418: I got my right kidney removed in November of 06. My thoughts are absolutely with you. I hope you have an intensive care nurse as cheerful and kind as the one I did.

    When the finance worm comes around on the day you are discharged, while you are full of Vicodin and antibiotics and barely able to walk, asking you to pay before you leave, do not sign any documents. Insist they present you with a fully itemized bill before you agree to pay one thin dime.

    You’re right about insurance. Their office overhead is horrific. I temped for an insurance management company once and it seemed that nothing was straightforward. Like lawyers, like any government-supported program, like any slacker who wraps himself with the “nobody understands this job but me” security blanket while slacking off, they purposely obfuscate things in order to make themselves seem indispensable. A properly programmed computer could do ninety percent of the work. Ah, but that ten percent’s a killer….

  155. Aphex242 says:

    Only an idiot (or someone who works for a health insurance company) could be against socialized medicine in the United States at this point, with even a meager education on the matter.

    The ‘downsides’ are scaremongering, and the statistics worldwide prove it.

  156. speedwell (propagandist and secular snarkist) says:

    @RandomZero: You are totally misrepresenting my arguments. I did not say one single word about needing government intervention. My whole point is that it is largely government intervention that creates the climate in which predatory practices can survive. You can’t have loopholes, after all, without a net.

  157. cef21 says:

    @olegna: You don’t seem to understand how drug companies work. Research is typically done in universities and smaller start-ups. Once they’ve been successful, the results of that research are bought by big drug companies that have the infrastructure to productize the drugs. Your argument is about akin to saying “the airlines spend more marketing than they do designing new airplanes.”

    As for your friend, consider this: 20 years ago, somebody with her condition would gladly have paid every cent they had to get that drug, because it didn’t exist yet.

    Think about where that drug came from: a scientist working in a lab someplace had a glimmer of an idea of how your friend’s condition could be treated. He managed to convince other people that it was a good idea. Those people realized that IF the scientist was right, they could make a lot of money. So, they invested in his research and 5-10 years (and tens of millions of dollars) later, this drug was finally approved. Now, thanks to the free market (even as corrupted as it’s been by FDA regulation), your friend can buy LIFE for $10,800 per year. (until the drug falls off patent)

  158. failurate says:

    The part that really sucks is that having insurance isn’t even enough anymore. The insurance companies find so many ways to dodge responsibility and screw you out of a buck. So for all the people going bankrupt without insurance, I am sure there is more than enough to match going bankrupt because their insurance hosed them over.

  159. QB says:

    @failurate: not sure, a lot of people talk about it or bring it up but very few do it. I personally don’t know of anyone who has ever done it. I do know that Canadians will go to the US to try experimental treatments that aren’t offered in Canada. Overall, I think it is a piece of propaganda used on both sides of the border (Canadian politicians use it to demand more money for health care and US politicians use it to defend their current system).

  160. Bladefist says:

    @failurate: I have spoken to Canadians. And it seems to be all over the board. Just like the debate in this forum, half of Canadians like their system, the other half are in huge waiting periods and end up coming here. I have heard that the big cities operate pretty well, but if you live anywhere else, you’re royally screwed. Also it can be industry by industry. Perhaps the dermatologist have a 3 year waiting period, but the gastro people don’t have any wait time.

    I’ve read a lot of stuff about that, and it appears every article is extremely biased. So I have objectively came to the conclusion that some people are getting good treatment, some people are screwed. Sounds kinda like, hmmm, here?

  161. Pithlit says:

    @Bladefist: I used to live right by the Canadian border, and have many Canadian friends. I’ve talked to countless Canadians about it. Not a single one would trade their system for ours, and none of them can figure out how we put up with it. They can’t fathom Americans who want to stick with our current system, and are so dead set against UHC.

  162. ShanghaiLil says:

    @Bladefist: Really this is just wealth redistribution. To our congress, it’s not about health care. They want the rich to pay for the poor.

    Look, baby, private insurance is all about wealth redistribution, too — just from the middle class to the wealthy classes.

    The entire idea of health insurance is to that everybody inputs the same amount (premium, reduced wages, taxes, whatever). Since most people are comparatively healthy, at any given point, their input dollars are paying to provide care for the minority who are not, the benefit being that if they suddenly switch groups (heart attack, hit by a bus, contracted TB on a plane), their care will be covered as well.

    What the modern insurance industry tries to do is to exclude all of those sick people, and take the healthier people’s premiums as profit, thereby providing as little care as possible while earning maximum return. In other words, take as much out as possible from an already-ailing health care system, while putting back in as little as possible.

    It’s all wealth transfer as well — it’s just concentrating wealth from a broad segment of the American middle class into the pockets of insurance industry shareholders.

  163. Pithlit says:

    @Pithlit: I want to emphasize that. Every single one. I could never find a single Canadian that hated their system and wanted to adopt the American system. A small few had some complaints but still preferred it overall. A vast majority loved it. The only Canadians I ever see complain about it are anonymous ones on message boards. I’ve never gotten a living, breathing one in my presence to complain and state that they were screwed over or wished to overhaul it.

  164. speedwell (propagandist and secular snarkist) says:

    @Pithlit: I appreciate that reasonable answer, thanks. Let me see if I can possibly address some of your concerns about human frailties.

    Libertarians do not believe people are perfect. If they did, there would be no need to concern ourselves with fraud and violence.

    Governments are particularly distasteful to “anarcho-libertarians” like myself because we see them as combining the worst fraud-and-violence excesses of the people they employ, without exercising the corresponding virtues. No single entity is better positioned to compromise the liberties of individual people. No single entity is more motivated to use the power they hold to take what they want from people who can’t resist. A famous thinker once said that all government power is held at the point of a gun. What that means is that there are perfectly good and wise choices that we could make for ourselves that we can’t because we fear government reprisal. Government cannot take individual circumstances into account. It is neither good, nor wise, nor loving, nor thrifty, nor peaceful. Although people seem to expect it to provide for them, defend them, make decisions for them, and act on their behalf, government is not God. At best it’s like a greedy priesthood that imposes its will on susceptible people and forces the community through manipulation, influence, and threats to sacrifice to its idols.

    Libertarianism is not about making people virtuous. Communism tried that and failed. Libertarianism is about making people as free and equal as possible in an essentially unfree and unequal world. There will always be bad actors, natural disasters, sickness, and death. Libertarian ideals are about equipping decent people to live as well as possible despite things like that. Communism and fascism and other authoritarianisms treat people like children. Libertarians prefer to think of people as adults who make both good and bad decisions, more good than bad on the whole.

    The free market is a tool for equalizing people based on their free agreements, not simply monetary trades, though that’s typical. It copntains its own feedback mechanisms. You’ve heard that “a rising tide lifts all boats.” Markets are not zero-sum. Prosperity benefits everyone. Fraud is a way of limiting prosperity, so it hurts everyone.

    Some way to defend your life and property is essential; it need not be a gun, and guns probably should not be relied on quite so heavily in this modern technological world where threats can be so nonmaterial. (How do you protect yourself against identity fraud with a gun?) Peace and goodwill benefit everyone. Violence hurts the public peace and therefore hurts everyone, even if they are not the immediate target.

    Religion is a form of government based on superstition. Superstition is fed by ignorance. The more you know, the less you are susceptible to such attempts to influence you to your harm. The more you know, the better equipped you are to take care of yourself and others. The spread of truthful information benefits everyone. Dishonesty and ignorance hurt everyone, directly or indirectly.

    In a free society, there are going to be as many ways to combat, work around, or starve out the bad influences and replace them with the good as there are individual cases of bad actions and thoughts. Just as individuals are best trusted to know what’s best for themselves, individual cases have individual best solutions. The broader concept of the “free market” teaches us that by trial, error, and feedback, we can arrive at the best practical solutions.

  165. ShanghaiLil says:

    @Bladefist: Just like the debate in this forum, half of Canadians like their system, the other half are in huge waiting periods and end up coming here. I have heard that the big cities operate pretty well, but if you live anywhere else, you’re royally screwed.

    You’re confusing issues. The same thing is true here in the US: live in a big city, and you’ll get pretty good care. Live in the ass-end of nowhere, and you’re gonna have to travel quite a distance for care. It has to do with the location density of health care providers, not with the form of payment.

  166. speedwell (propagandist and secular snarkist) says:

    @speedwell: Those Republicans who just “friended” me based on my posts in this thread may be reconsidering their decisions based on my last post, haha. If they aren’t, it might be because I’m articulating the small-government, liberty-oriented principles that Republicans SAY they stand for… but don’t, actually, in practice.

  167. Bladefist says:

    @ShanghaiLil: Canada is huge. Short of flying to the other side of the country, to a different providence, it does actually matter. You going to fly 500 miles for every lump?

  168. RandomZero says:

    Also, speaking as a Canadian, I’d like to clear up a couple of points. One: As some people have mentioned, government-funded insurance is different from government-controlled health care, and can be subsidized with private or group coverage. (And yes, even US employers outsourcing to Canada generally DO have to worry about group coverage; the reasons have more to do with lower labour costs or poorer worker rights, at least here in NS)

    Second, and one nobody seems to have picked up on: Crown corporations are not government entites in the traditional sense. They’re closer to companies in a regulated industry, for the most part – except for industry regulations and the appointment of the top execs, they’re effectively autonomous. It’s certainly not “DMV-style health care” up here.

    Third, I’ve never heard of a single case of essential care not being recieved in a timely manner. The distinction most people miss is that “timely” is very rarely “immediate”. Our hospitals generally operate on a triage system; the guy bleeding out from multiple lacerations will be seen before your migraine, even if you came in first. This is exactly as it should be. Anybody going to the States for treatment is either going for elective procedures, or is in possession of extreme amounts of money and little patience, and is in an extreme minority.

    Fourth, not everything falls within the purview of the government system. It varies from province to province, but generally vision and dental, among other things, are private practices not covered by gov’t insurance. Private clinics exist for non-hospital issues, and even hospitals are semi-autonomous Crown corporations (explained above).

  169. timsgm1418 says:

    [news.yahoo.com]

    interesting that our life expectancy has increased and deaths from top leading diseases have declined…looks like our health care isn’t so bad afterall

  170. speedwell (propagandist and secular snarkist) says:

    @timsgm1418: Or, perhaps, it’s because the individual person is better informed, through the media and the Internet, about how to take better care of themselves? It’s probably a combination of both, but remember that individuals can’t benefit properly from health care if they don’t know how to describe what they have, or don’t understand how to comply with their treatment.

  171. timsgm1418 says:

    @failurate: the news….one that comes to mind is the lady giving birth to 6 or 7 (can’t remember all the details) she went to Montana because of better care than she could get in Canada

  172. timsgm1418 says:

    @speedwell: thank you, mine gets removed on 6/25/08. took 4 urologists to find one that actually knew what to do to try to fix the kidney, but now even he admits, there’s nothing left, time to say bye-bye kidney, so I can get back to work

  173. AmbiUbi says:

    All I know is that I pay 6K a year out of pocket just for my premiums, and I still have to pay copays for visits and prescriptions, wait over a month to see a new doctor (IF they’re even accepting new patients), over 2 months to see any kind of specialist, and when I have my baby in October I’ll have to pay $500 out of pocket again, as a copay. Not to mention I don’t get any paid maternity leave as it’s not required by the state, but that’s another issue.

    My mother in law was diagnosed with breast cancer 3 years ago, and had to wait 3 months to be able to see an oncologist in her network. She was Stage 2-3 at the time they saw it on her mammogram.

    Not to mention that if I need to see a doctor for any reason, no one’s open past 4pm anymore, so I need to take unpaid time off work or dig into my limited vacation/sick time that I’m trying to save for maternity leave to do so.

    I’d gladly pay less than 6K a year in taxes that I can write off rather than having to pay it out of pocket every year when I barely even use it (with the exception of this year). I wouldn’t have a problem if I got some percentage back for NOT using it. But they pocket it all, or worse, still increase my premiums because some other schlub in the group got cancer or something.

    So regardless of what you all think, we’re starting to pay for everyone else anyway. If we put as much money into it as we did this stupid war or investigating steroids in baseball, we’d have the best healthcare in the world yet again.

  174. lua21 says:

    I’m from a country with universal health care and when I moved here I was shocked at how poor the health system is. Many members of my family have had to have major surgery and have always received excellent care and have never been but on long wait lists. My grandmother has many complications from her diabetes but has excellent doctors that are able to treat her immediately. My mother has Coeliacs and is able to get all treatment and information from the local GP in her small country town instead of having to see a hundred different specialists. If you have a road accident the government has a fund that covers all health related costs. When my mother needed to have surgery for ovarian cysts, even though she has private health cover (a perk that comes with her job) she was told to go to the public hospital because the wait was shorter. If I ever fell pregnant I would be on the first flight home because I just can’t trust a system that is more interested in the bottom line that the care of the patients.

  175. Pithlit says:

    @speedwell: Well, I appreciate the polite attempt, but…. Your view of the government is quite frankly, ludicrous. I’m sorry, I just don’t know how else to put it. What evils are you talking about, and what benefits do you think government does not have? You know, I have a lot more influence over my local government than I do over my employer, or the company down the road pouring pollution into my kids’ drinking water. I’m not getting it, here.

    I think you, and those with your viewpoint, conflate a whole lot into your viewpoint, and sometimes it’s quite simply hard to even understand. The bit about Religion? I’m not sure what that has to do with the government and the infrastructure and safety nets it provides, or personal liberties.

    One can’t be truly free without a solid infrastructure, and we don’t get that solid infrastructure without a government. Like I said in a post above, look at the countries where a government doesn’t supply one, if you don’t believe me. If you’re constantly having to worry about whether the water your drinking is contaminated because no one is watching out for that (the whole free market will sort that out, don’t you know?), or you can’t get to your job because the roads are shit because it’s to no one else’s advantage to pave it, then how free are you?

    I’m sorry. Like I said, I do appreciate the attempt, but your post really didn’t enlighten me much, and honestly only reinforced what I already thought about most Libertarians and the movement in general. It seems kind of kooky, and impractical, and just a little bit paranoid and delusional at times. Nothing personal :)

  176. ShanghaiLil says:

    @cef21: So, you believe that the a government will be better at making decisions about how to allocate resources than the free market? If that’s true about health care, then why isn’t it true about food or automobiles or clothes or housing?

    Sort of two answers to this question, but first some background. Three of these four things that you mention ARE currently regulated, more or less stringently. The FDA and the USDA are supposed to monitor the safety of food to ensure that it’s fit for human consumption — that’s why you’ll find those expiration dates on your carton of milk. If your landlord turns your heat off in your apartment in mid-winter in order to save money, the answer in an unregulated market would be, “Move.” But generally, you’re given other recourses.

    Now the answers. Some decisions, the average consumer can easily make: should I get Starbucks or Dunkin’ Donuts iced coffee this afternoon? Do I want the expensive silk blouse or the cheaper cotton one? Some decisions, most consumers are going to lack the basic information (and the ability to readily obtain that information) in order to make an informed choice, and the consequences of a poor one are high. For instance, would you necessarily be able to identify the chicken breasts with the salmonella infection? These decisions are properly regulated. When it comes to health care, the criteria that make for minimally appropriate health care (diagnostic ability, awareness of the range of therapeutic options, clinical experience, etc.) aren’t things that can be readily evaluated by Joe Q. Public. That’s why insurance companies can get away with labeling perfectly common procedures “experimental” and therefore not covered — because you don’t know the difference between the two.

    Reason number two is empirical: for-profit health insurance on average gives sucky performance. We spend more and get less than countries with national health plans, and the numbers on things like child mortality put us down around some third-world nations.

    Oh, sure, if you’re one of the people who is relatively healthy and has good insurance, you’re pretty happy. But when you hear Canadians who complain about the NHS, for example, remember that you’re drawing from a sample of all Canadians, whereas when you hear people praise their health insurance here, you’re drawing from only the sample of the insured. Factor in the uninsured, and THEN let me know if Americans prefer our health insurance to be privatized and for-profit. And the first person who talks about market forces making insurance companies compete, might I suggest that you just TRY to switch from your current plan to one that your employer doesn’t pay for that offers better benefits and performance?

  177. giggitygoo says:

    It seems that all of these healthcare threads miss some important points on the implications of the US going single-payer – so I’ll throw my $.02 in.

    You cannot accurately compare something as complex as healthcare between nations with a few high-level statistics like life expectancy and cost per person. There are thousands of variables that affect such numbers other than type of healthcare system. Two very important examples are pharmaceutical price controls and average lifestyle. The US has a much larger rate of obesity than most other western nations – this no doubt increases the cost of healthcare and decreases average life expectancy thanks to all the ill effects of obesity but has nothing to do with universal vs. private healthcare.

    Also, the US is the only industrialized western nation that does not have price controls on pharmaceuticals. These price controls artificially deflate the cost for other nations since the US indirectly subsidizes other nations. (Which is part of the reason prescription drugs are so expensive here – yet no one seems to realize it) If the US followed suit, R&D would suffer greatly as the whole industry would be practically unprofitable and would not be able to develop new medicines – Which are extraordinarily expensive to develop due to high failure rates, (only 1 out of 30 candidates ever make it to the shelf) extensive FDA requirements, and relatively short patent time frames in which to make a profit. (Generic drugs have insanely small profit margins)

    That being said, the current US system is seriously flawed. There’s no doubt major changes need to be made. We just have to be careful that we don’t de-incentivize innovation in pharmaceuticals and keep smart people from going into medicine.

  178. speedwell (propagandist and secular snarkist) says:

    @Pithlit: If you are concerned about clean drinking water, then so are other people. If you want to be part of a solution, then so do other people. By all means, be part of the solution. Do you really think you would not act together with like-minded people in the absence of the threat of government reprisal? That sounds just like someone who said to me yesterday, “Atheists can’t have morals. Without God, they’d rob and rape and kill.” Um, atheists are people who do not need the threat of Hell to frighten them into virtue, and anarcho-libertarians are people who do not need the threat of jail to frighten them into being good citizens.

    As far as religion is concerned, surely if you think for just a half a second about how religion brainwashes its adherents, compromises freedom of thought, and promotes ignorance, you’ll see my point. If you fail to spend the half second, or refuse to see the point, then you just proved my point instead.

  179. timsgm1418 says:

    @Pithlit: I’ve been layed off 3 times (by the same company)the first time was 6 weeks after I bought my first house. I didn’t have insurance for almost a year after that. During that time a mumps epidemic hit Phoenix, since I didn’t have insurance I went to the health dept to get a booster vaccine. And maybe in my little corner of the world people are a little different, but I hear my daughters friends (all between ages 21 and 30) whine about not having health insurance because they work in retail or as servers and the reason they work there is because they think working in an office is boring. Yes, working in an office is boring, but nobody ever told me in high school that I would love my job and be excited to be there everyday. There are days I dreaded going in, but I want health insurance (and with my kidney issues, I need it) and I like being able to have a place to live.
    They also complain about not having any money but none of them work a 40 hour week and they all have just one job. For most of my years before I had kids I had 2 jobs, because I wanted more money. If you want more, you work for it. there other complaint is never having a weekend off, again, you work in retail and restarants(sorry I never could spell that word, mental block) you’re not going to get paid vacation and weekends off. I also see people like my son-in-law decide that the $35 a month for dental insurance for his family of 4 is too much. $35 for a family dental is a bargain, yet he complains because he needs most of his teeth pulled due to his extremely poor dental hygiene and can’t afford it. If he had kept the insurance coverage it would have cost a lot less overall.
    Also as I stated, I don’t believe 100% of the people without insurance are like that, but the majority that I see are. I do believe for quite a few people (again notice I did NOT say 100%) they choose not to have health insurance because they would rather spend the money on something else.

  180. speedwell (propagandist and secular snarkist) says:

    I’m in danger of getting on a soapbox about religion, people, and I’m unwilling to troll the thread that way, and I may already have gone too far with it…. so back to work for me! Thanks, been fun…

  181. picardia says:

    @Bladefist: Well, I don’t drive, so I guess I won’t be paying taxes for upkeep of your highways, either.

  182. Pithlit says:

    @speedwell: And don’t you think it’s a heck of a lot easier to do something about those problems if we all get together and act as a group? Oh wait, what would we call it? Government. That’s the point you’re missing. That’s what government is! It’s all of us getting together and doing something about those problems. Because all of us acting as individuals gets nothing done. That’s the point.

    Government is us. We are the government. The government aren’t a bunch of spooky people that have us at the barrel of a gun. We control them. Just because the majority of people don’t elect the people you like doesn’t change things. We can wave a sign. Or we can work to get the government elected who will do something about it. Heck, we can become the government we want to be. Start local and get elected there! It’s not scary. They aren’t the boogyman. If you don’t like a law that restricts some sort of freedom you think you should have? You can do something about it! You can work to get the people who agree with you elected, or you can work to get yourself elected, or you can contact the people already elected and get them to see things your way. They aren’t going to shoot you.

    As far as religion is concerned, I’m an atheist. We could get into a separate discussion about that. We might have some common ground there, I don’t know. I don’t think all religion is evil, nor all its adherents ignorant, but I’m a huge proponent of separation of church and state. I still don’t see what it has to do with the discussion we’re having. I don’t think all Libertarians are a-religious, which is why I was confused about your inclusion of it.

  183. B1663R says:

    I just don’t understand why American’s put up with their health care system (if you can call it that).

    all the American’s that talk about “socialized health care is evil!!” should really, really travel to a country that offers it and see for yourself.

    The Canadian comments that support the Canadian health system are accurate. no one dies in waiting rooms, we are not assigned doctors, this is all American propaganda.

    seriously folks. watch Sicko (fast forward to the Canadian parts) and that is really accurate view of our health care system and our feelings towards it.

  184. RandomZero says:

    @Bladefist: Usually I find you insightful and well-spoken. Here, you are ridiculously off-base.

    Private health care is NOT a divisive issue in Canada. Even the richest province in the Dominion is 60% opposed, and staged mass protests when a two-tier system (essentially your “opt-out” model) was suggested. Guess what the response would be in poorer provinces?

    Half of Canada has to go to the US because they need health care? Don’t make me laugh. It’s considered major news to an openly-conservative national paper that 150 Canadians were sent south for this, entirely at the government’s arrangement and on their dime. Some go south for strictly elective procedures, true, but the number is more like 0.11% according to studies coming from the US.

    500 miles for every bump? You’re kidding, right? I currently live on the outskirts of a minor city (350k pop, counting everything within a 50 km radius). Population density is extremely low in this neck of the woods. I live 15 minutes from a major hospital, and can think of at least 3 local clinics on my way there, on top of the already-provided helicopter support, normal ambulance service, and the medical emergency response unit at every local fire department.

    I’ve lived in areas with lower population density (including one with a population in the double-digit range, accessible only by air), and never had to travel more than five minutes for medical care.

  185. speedwell (propagandist and secular snarkist) says:

    @Pithlit: Pithlit… I am going to do the trollish thing and reply anyway.

    If government worked like that, I could see your point. But it doesn’t.

  186. ShanghaiLil says:

    @Bladefist: (/I) Canada is huge. Short of flying to the other side of the country, to a different providence, it does actually matter. You going to fly 500 miles for every lump? (/i)

    I didn’t say it wasn’t an important issue, I just said it wasn’t the same issue as how health care gets paid for. If you’re a poor dirt farmer in rural Mississippi, getting to Birmingham for health care ain’t gonna be an everyday occurrence either.

  187. Pithlit says:

    @timsgm1418: I’m sorry to hear you’ve been laid off 3 tines. That really does suck. I’m surprised that didn’t do more to curb your Welfare Queen attitude. I’m sorry, I don’t mean to be harsh. But, that attitude is worse than nails on a chalk board to me. It turns me into a meanie, and I hate that. Instead of belittling you, I’ll try to calm down to attempt to get you to open your mind a little and realize that maybe your own narrow worldview is a little skewed. Maybe it’s possible you were indeed surrounded by an unusual amount of people who chose to be in those circumstances, and you really weren’t just prejudging then harshly. If that’s the case, please understand. Your experiences were unusual. The millions of uninsured in this country aren’t there because they are lazy and bad with money. Now, please understand that. That may help you from incurring wrath from highly irritable people like me in the future. Because that viewpoint really, honestly does come across as soooooo bad. You have no idea.

    It really isn’t useful in any way when discussing what we should do about this screwed up situation we’re in health care wise, either, because even if it were true, and it is just a bunch of welfare queens ruining it for the rest of us, we’ll still all suffer for it.

  188. @Bladefist: I would bring an “adult” debate (not the kind that would get me banned, the other kind), but I don’t have time for that. My observation is that the content of debates over health care on forums not moderated for ideology tends to go sort of like this:

    “conservative” poster – Why should the government get involved in health care. Bla bla bla DMV argument bla bla tax increases bla bla bla.

    “progressive” poster – Because the insurance companies have failed to effectively deal with the problem. Because employer-funded health insurance is hardly secure. Because single-payer costs less in taxes than you’re probably paying BCBS to “lose” your paperwork and deny your coverage. Duh.

    “conservative” poster – Oooh, what is this “duh” stuff? That was uncalled for.

    Tell me this isn’t how it usually goes.

  189. Bladefist says:

    @RandomZero: Sorry to disappoint you. I’m not claiming that as my own experience. Just what I’ve heard/read. I can’t stand behind its accuracy or not, just giving food for thought.

  190. Bladefist says:

    @Steaming Pile: You dont have time to be an adult? lol

  191. Pithlit says:

    @speedwell: It doesn’t? We don’t elect people to make laws? How does it work, then?

    S

  192. thegirls says:

    @timsgm1418:

    If every person that worked in retail or as servers left the industry for office jobs w/health insurance….then we’d really have a problem w/the service industry, wouldn’t we?….No service because there’d be nobody to serve us(;

    You may not realize it but your point proves that our system needs an overhaul. I’m a more productive member of society working freelance or as a contractor. That being said, I couldn’t do this prior to marriage as I’d loose my employer based health coverage and because of pre-existing conditions, individual insurance coverage wasn’t even possible. So I had to stay in a job that didn’t benefit me , or even society as a whole, in ways that I’m now able to do…but this is only because my husband has a good medical plan with his company.

    Yes, I’m aware that life isn’t fair, but that doesn’t justify a broken system. Insurance companies work for profits, even if much if that is due to investors..it’s still very backwards. They have to answer to the investors and if they’re not profitable, their shares go down…thus more incentive to deny medical claims, procedures and applicants that need and want insurance.

    Speaking from experience, my mother was laid off from Dow Corning when I was a child. She was a single parent of 3 young children and she always worked her butt off…she had to juggle shift work, school, lack of transportation and many other biases and obstacles that divorced women faced at that time. Just because some people are ill informed and irresponsible doesn’t justify a system that punishes a hard working woman with three young children who end up in circumstances beyond their control.

    And addressing another posting, I have excellent insurance, but because of a mis-diagnosis and general lack of care by some health care professionals – aside from the weekly payroll insurance deductions, I had an additonal 12K in health related expenses last year. How many people can afford that? Especially considering that fact that I already have insurance coverage.

  193. thegirls says:

    @Pithlit:
    I agree what everything you’ve posted!!!!!!!!!!!!

  194. RandomZero says:

    @Bladefist: Understandable; you’ve only lived under the one model, after all. To be honest, I’m not entirely sure how your system works, and I’m sure you’d be equally appalled at some of the tales I’ve heard.

    That said, I am a Canadian with family in the health care industry, other family that’s needed pretty much any treatment you care to name, and I’m a licensed insurance agent qualified for A&S. If anybody wants a btter understanding of our model, I’ll certainly answer all questions to the best of my ability.

  195. parnote says:

    @Bladefist: The rest of the world gets to enjoy cheap health care, because our capitalistic nation keeps providing all the innovation. If we cut funding to innovation, then everybody is screwed.

    There may have been a day when that was true, but it isn’t true any longer. In the field of medicine that I practice, nearly all of the new drugs and techniques in my field come from innovative companies in Europe, not the U.S.

    We must stop deluding ourselves by thinking that we lead the world in innovation. It just isn’t so, any longer. We must also stop thinking that we cannot learn anything from the rest of the world. We do not have a corner on the market for having good ideas or the best way to do things. There are a lot of other good ideas that we can use from others all around the world.

  196. dragonfire81 says:

    @B1663R: But our (the Canadian system) is not perfect by any means. The long wait times are a result of a system which does allow patients to be seen quicker if they have the money to do it.

    Having said that, I do like the Canadian system, if for no other reason that I can see a doctor or go to an emergency room for any reason at any time and get checked out at NO COST TO ME, even if I don’t have insurance or a job. There’s some security in there I appreciate.

    I have recently moved to the States so now I have to learn the jungles of the U.S. system. Should be interesting to see how my experiences differ between each system.

    I’d like to point out that in Canada citizens are taxed more and there’s also a Federal sales tax (5%) that applies to just about anything bought anywhere in the country. This tax is charged ON TOP OF any provincial tax (the Canadian equivalent of a state tax). In Ontario, total sales tax on purchases is 13% (8% Provincial and 5% federal). A great deal of that Federal money goes into healthcare. The U.S. has no such national tax.

    We can debate endlessly on healthcare but I think we can all agree on a few things:

    1) No healthcare system is perfect
    2) People should be able to get access to healthcare when they need it
    3) The U.S. system has serious problems
    4) Universal healthcare is STILL a ways off in this country (U.S.A)

  197. dragonfire81 says:

    That should have been a system that DOES NOT allow people…darn it consumerist when are we going to get an edit button?

  198. Free market health care for alllll!!!!!!

    The free market does no wrong!!!!!

    Unicorns and rainbows!!!

    Narrow minded, shortsighted, regressive thinking from people who believe what corporatist politicians tell them.

    I can not, for the life of me, figure out how people can be against universal health care. We are the ONLY industrialized nation without it.

    We pay billions upon billions to private contractors who overcharge us — no one really says anything.

    Cities and states spend thousands if not millions on pointless resurfacing and widening road projects so that they dont get their budget reduced, while, somehow, our infrastructure is crumbling — no one says a thing.

    We willfully look the other way while companies move over seas, take up residence in offshore tax shelters and exploit poor people and skirt US environmental regulations so that their CEOs can buy a second golden rocketship — no one even asks why or how.

    We have a tax system where the burden is overwhelmingly placed on the middle class, the people who keep this country functional, while the richest among us are provided tax break after tax break after loop hole after loop hole — and no one even raises the issue; and if they do, they present it in the form of the insulting stupid “fair tax” or some other such nonsense that will do nothing but make matters worse.

    Billions are handed out to multi-million dollar companies every year in the form of corporate welfair and billions are giving to oil companies making record profits. — People are barely aware and do little more than read the story and move on…

    All the while we are forced to either be sick or be broke. Pay more or lose your coverage. Don’t unexpectedly get sick or fix your kids teeth because you might lose your home.

    How can anyone, anyone take issue with universal/single payer health care coverage?

    God forbid the basics like “health” are subsidized by the government.

  199. @parnote: here here!

  200. h0mi says:

    It’s true the US spends more on health insurance as a share of GDP. But Finland & the UK spend less than Germany and Canada… what accounts for those disparities? They are not all single payer systems.

    Many of the cross country comparisons only look at specific stats that are either poorly defined across countries (infant mortality) or are significantly affected by things outside of the realm of health care (life expectancy). Not a whole lot of comparisons are done about things like… well which systems do a better job of curing diseases or preventing death from trauma, or life expectancy of people with specific illnesses. I know in the US, 90k or so people die from doctor errors. What is the rate in Canada? UK? Sweden? etc.? I’ve _never_ seen numbers published and never seen comparisons done about things like this, things directly related to health care.

    5% of the US population is responsible for 49% of the health care costs in the US, and the “sickest” 50% of americans are responsible for 97% of the health care costs in the US. Again, how does this work in those other countries? Do they have similar such disparities? Why does it cost so much in the US, is it overhead or are there other factors? What are our rates of mental illness, heart disease, cancer, pulmonary disorders and trauma vs. the rest of the world (these are our 5 most expensive conditions to treat)?

  201. IamNotToddDavis says:

    The US Gubmint currently has $85.6 trillion in unfunded liabilities for Medicaire.

    And yet people still think that if only the government would take over MORE of our healthcare responsibilities, everything would be fine.

    Has the government run a single service for citizens that is even remotely efficient?

    Anything? And some folks want to let them choose how we get healthcare?

  202. thegirls says:

    @h0mi:
    Regarding your statement – What are our rates of mental illness, heart disease, cancer, pulmonary disorders and trauma vs. the rest of the world (these are our 5 most expensive conditions to treat)?

    Some things aren’t going to be fairly comparable…

    A few examples:
    mental illness is woefully under treated in this country…with our without health insurance. Most health insurances have must stricter caps on mental health copays and limit the amount of visits. And other countries, such as England can be worse and view many mental health issues as taboo, thus these folks won’t get treatment, even if it’s available (see depression) or believe that some issues really don’t exist (see ADHD), even though the scientific evidence is overwhelming.

    Stats regarding treatment for alcohol abuse will be different in England than in Japan and the U.S….because of cultural views regarding drinking and the fact that many more Asians lack a specific gene responsible for the body’s ability to procession alcohol.

    Americans are overweight, esp. compared to other countries, but Japanese and most of the European nations are starting to catch up with us in obesity -thus more pulmonary disorders.

    We need to be careful if we want to use this as a criteria for the basis of “affordability” for the U.S. Maybe if we looked at the fact that IF things like mental health coverage was affordable and available for everyone, we would have a more productive, mentally and physically healthy society. And if the poor and uneducated had access to preventative health care measures (rather than only going when it’s a dire emergency), we’d have also have a more productive, wealthier society as a whole.

  203. thegirls says:

    @IamNotToddDavis:
    Well then, it’s a good thing our current health care program is working so well!

    Nobody is saying that gov’t is perfect, but those that make laws in gov’t are representative of the people that elect them…so if you’re so unhappy, then I bet you’re working really hard at the local, state and gov’t level to change that. Right?

    Many programs aren’t perfect, but I’m glad for the fact that public schools were available when I was a kid since my mother couldn’t afford to send me to a private one…public school education is a better choice than no education at all….I walked to my public school but the kids with more money drove to private schools….on roads created by “gov’t programs”! I take a medication that was researched and developed mainly through a grant from the NIH……another gov’t thing!

  204. rmz says:

    @Voyou_Charmant:

    insulting stupid “fair tax”

    I respect your empassioned arguments, but you unfortunately glossed over or willfully ignored the fact that many of your mentioned problems would be fixed by such a reform.

  205. IamNotToddDavis says:

    thegirls@thegirls:

    You are missing my point, and I imagine it’s intentional.

    The point, again, is that the Gubmint is already trying to run a healthcare system for people who cannot afford the costs of their healthcare for whatever reason. And this system is horribly bankrupt already, to the tune of $85 TRILLION (that’s with a “T”) in unfunded liabilities.

    I don’t understand how anyone can make the argument that the GOVERNMENT would be better at spending MY MONEY on healthcare based on these figures. This is not a “DMV” comparison. This is an example using a US government run healthcare system that is operating RIGHT NOW at an enormous deficit.

    Do you honestly believe that anything will get “cheaper” in terms of healthcare costs if Medicaire was running EVERYONES healthcare, and not just those who currently can’t afford it?

  206. timsgm1418 says:

    @thegirls: I’m not saying they should all leave the service industry, far from it. My daughter sometimes brings home $400 for an 8 hour shift. She does not have health insurance, or paid vacations or weekends off, but she chooses to have that job. I was also a single mother of 3 children under the age of 3 (set of newborn twins) for the 2 years I was on Welfare. Within 5 years of getting off Welfare I bought my first house, because I worked my butt off. I have been in the very-low income bracket, we lived in HUD housing where I saw numerous women in the same condition as myself, yet I was one of the very few that worked my way out of it. I am no super woman, and I don’t have a college degree. I’ve been working on my AA degree since 1992 mainly because of finances and the last 2 years because of my health. One of the women that lived in that HUD housing where I lived, was 25 and had 5 kids, the oldest being 11. Her youngest 2 ended up in the hospital for over a week because she didn’t bother to get them immunized for measles (it was a measles outbreak in Phoenix, not mumps as I stated in earlier post) She had state health care, and she had a car, she just didn’t feel like getting off her butt to take them for their checkups and vaccines. I knew her personally, so I’m not just guessing that was the reason. The preventative care was there for her, and she refused to use it, thereby costing a lot more money to have her children in the hospital for a week, this was all paid by our taxes, of course.
    I think our health care does need reform, but until I can be guaranteed it won’t be run like the Welfare system I would never vote for it. Just because the healthcare is there does not mean 100% will use it. There must be other solutions than putting it in the governments hands.
    After the years I spent fighting with Welfare, child support enforcement, day care assistance, and food stamps, the less the government is in charge of the better.

  207. thegirls says:

    @IamNotToddDavis:
    Actually, it wasn’t intentional!

    But since you asked…Correct me if I’m wrong here, but I seem to remember a relatively solvent SS system around the year 2000 with large reserves of cash. Then GWB came into office and well, with funding the war and all, he needed to get the money from somewhere and the SS fund seemed to be ripe for the pickin’. So if we stop rerouting the money, then problem solved! The “borrowing” from SS crap started under Reagan and needs to be made illegal. Remember Al Gore’s Social Security lockbox? I guess Big Al was right after all.

  208. IamNotToddDavis says:

    @thegirls: I haven’t said anything about SS or any lockbox. I would argue with you that SS has been “solvent” at any point in the last twenty years, but that’s a different discussion.

    What hasn’t changed is the fact that the Gubmint currently is running a healthcare system and it is a complete fiscal disaster. This makes any argument FOR MORE Gubmint involvement in running a universal health care system completely insane and irresponsible.

    Name me ONE SINGLE GUBMINT system that is currently efficient, solvent and pays for itself.

  209. RandomZero says:

    @speedwell: Are you really this clueless, or do you just play it on the Internet? Of course you can’t have loopholes without a net, but you don’t NEED them. Think about it this way: Without any sort of regulation whatsoever, what’s to stop someone from starting up a fly-by-night, lying outright to potential customers, and running away the moment they pay out? History says… nothing! Regulation does not encourage predatory practices in anything like the manner you’ve described. People have pointed you to power deregulation before as an example of this; read any one of the IDT posts here and think for ten seconds.

  210. I think Americans would be glad to wait 18 – 36 months for their hip replacement, or 8-12 for their cancer treatments, like in countries that give health care.

  211. @Bladefist: I would have come in and covered your back on this one, as I’m (predictably) in complete agreement with you on the issue, but I find that UHC is the an issue where people’s willingness to loudly argue is massively disproportionate to their command of the complex issues involved. A quick sampling of the comments validates this observation. It also sort of raises my blood pressure, which, even with my self-funded and rather satisfactory health coverage, isn’t a good thing to let happen.

  212. @ConsequencesIX: Do you always walk into a discussion and make shit up?

  213. Gasparzinha says:

    I’m late to the party because of the time difference…

    I can’t speak to the quality of public care in Hong Kong, where I’ve been living since last October, but I can say the implementation of private health insurance is worlds better than in the US and the cost is significantly lower. With my insurance (through my husband’s company), we pay the full amount of a visit or treatment, and then we receive reimbursement.

    An hour-long visit to the head of a teaching hospital’s neurology department costs US$120 and X-rays cost US$25. When I became concerned about certain symptoms I was experiencing, I was able to schedule an appointment for the next day, the blood work cost US$6, and the doctor’s office both SMSed me and called me two days later with the results.

    Compare that with going for, say, a pap smear in the US, where it can take up to three months to get an appointment for a regular check-up and then you’re told, “If we don’t call you, everything should be okay, but then, if we don’t call you, it could also mean we misplaced your results or forgot to call you to say you have cancer and are going to die, so you should probably call to see if everything really is okay, but then when you do call, we’ll be annoyed that you did and thus have to look for your results, because didn’t we tell you everything was okay if you didn’t hear from us?” Ugh.

    A few years ago, my uncle, who had already had one heart attack, experienced chest pains and went to his PCP-affiliated hospital, where he was told it was indigestion and he should go home and take antacids. Instead, he went to an out-of-network hospital, where they told him that, yeah, he’d had another heart attack and needed to be admitted for observation. Then he spent close to a year fighting with his insurance company to pay for the out-of-network treatment.

    The problem with the US health care system is that even with insurance, there’s no guarantee of treatment or that your insurance will cover the cost of treatment. Because most insurance companies are for-profit, of course they’re going to search for a way to lower costs, including routinely denying claims they should cover in the hopes that members will not fight it and pay it themselves. How strange is it to support a system where you can easily pay upwards of $1,000/month for insurance (if you have a family) that doesn’t guarantee coverage?

    While I think having some type of socialized health care system is a good idea, I don’t think it’s feasible in the US because there’s too much of an “I got mine” streak. What we need to do is find a way to fix the way private health insurance operates.

  214. swimmey says:

    What you’re describing is not Marxism. It’s called “risk pooling.” At any given time, you’re probably not sick, but other people are, so you pay premiums (or taxes) and they get care. When you get sick or hurt — and you will, tearing an ACL on the ski slope or running in front of a bus or something — the risk pool covers you.

    At least this is the way it was supposed to work, before insurers decided that they couldn’t make enough money that way.

    The Constitution puts it this way: “We the people, in order to … promote the general welfare.” Universal health care, doctor-patient focused health care that’s focused on outcomes, NOT PROFIT, is the right thing to do as a society. That it can be done at a substantial net savings is almost beside the point.

  215. @AtomicPlayboy: I would have sparred with both of you on this one, but we’re already 200 comments in and I don’t want to even attempt to sort through them. You’re right that it’s hard to hold a conversation over all the noise coming from all sides.

    I had this coherent response advocating some modest health-care reforms, but I opted instead for the snark in my preceding comment. Snark is at least 50% more fun, anyway.

    @RandomZero: @speedwell: Taking RandomZero’s point about regulation one step further, there’s a reason why there’s never been a sustained anarcho-libertarian society. It’s an unstable system, based on some fantasy that people play nice with each other.

    It’d only be a matter of time before someone figured out that the one with the most toys gets to make the rules. When that happens, you end up with mafia-like “microgovernments”: they make the rules, and you better not disagree with the new order unless you’re prepared for battle.

    Will the same mafia be running the show tomorrow? I don’t know. Tonight might be a fine evening for revolution. Who knows? Maybe the Bolsheviks will win this time.

    (In other words, an anarcho-libertarian society doesn’t have enough power to protect itself from those who seek to do it harm.)

  216. arcticJKL says:

    My question is where is the Church in this?
    Why haven’t organizations that claim to have love and compassion for their fellow human beings stepped up and provided basic health care for the poor?

  217. P_Smith says:

    Going point by point…

    @Bladefist: All I can say is, we are a much different country then the ones above. We are physically larger, and our costs will be much higher.

    Utter nonsense. Or have you never heard the phrase, “economies of scale”?

    Canada is physically larger and would cost more per person due to the distances involved, yet manages to run an efficient system. It’s the same in sparsely populated Australia.

    The real reason why universal medical care is not funding or bureaucracy, it’s American litigiousness. The US is a “me, first” culture with no sense of personal responsibility. All nations which have universal health care also have “loser pays” in the court system which tends to eliminate frivolous lawsuits. Similarly, these countries have more open drug patent laws allowing drugs to be made at lower cost in a shorter time; US patent laws protect pharmaceutical companies’ profit margins, not the public’s health.

    @Bladefist: The rest of the world gets to enjoy cheap health care, because our capitalistic nation keeps providing all the innovation. If we cut funding to innovation, then everybody is screwed.

    “Wow, the US invents everything.” You sound like a blowhard propagandist from the Soviet Union.

    First off, most medical advances come from other countries, especially those with universal health care; only a small portion come from the US. Second, university funding in the US is now almost always profit driven – if the research won’t make money, it doesn’t get funded. That’s not how scientific advances happen, they happen when somebody says, “That’s strange…” and decides to investigate.

    You do research without direction, then decide how to use it. Not the other way around.

    @Bladefist: I’m okay with national health care if its optional, and those of us who want to opt out, don’t have a tax increase.

    False inference. You wrongly assume that universal health care will lead to tax increases. An efficient system costs less, not more; Canada pays roughly half what the US pays per patient, so the issue is not taxation, it’s proper management and efficient spending.

    @Bladefist: Also our Government is notorious for screwing everything up. I prefer paying a little more then getting a DMV-quality health care.

    Another false inference. Are you always so dishonest?

    If government-run universal health care cost more because of government inefficiency and corruption, you can blame corporate interference and corrupt politicians, not universal health care itself. Unfortunately, the US has only a two party system which makes lobbying and bribery possible.

    All other nations with universal health care are multi-party democracies, with at least three parties, and minority governments are possible. Minority governments pay attention to their coalition partners for their own political survival and will ignore lobbyists.

    If universal health care failed in the US, it would be due to American culture and immaturity of the political system, and not universal health care as a system.

    I’m actually surprised that you didn’t make the false claim of “the US has the world’s best health care!” That means you must have heard that the US’s average life expectancy has dropped below some countries with universal health care; if you hadn’t heard, no doubt you would have said it.

  218. OK.SImpleton says:

    I would gladly wait in an emergency waiting room for hours on end to have a broken bone mended if it meant i would actually get treated. It is scary not living with health insurance. It is either stay healthy, die, or declare bankruptcy.

  219. Bladefist says:

    @P_Smith: You say I sound like the soviet union, but you support more government socialism? That statement made me not interested in arguing the rest of your points.

  220. All I know is if other countries want to learn from the U.S. they’ll find the perfect example of what NOT to do with healthcare.

  221. barty says:

    @Pithlit: Before people got this notion that there had to be a safety net, there was something called responsibility that really worked quite well. People who were truly in need got the help they required, either through family or charity. Like anything else a government has ever gotten its hands on, any assistance program turns into a way for politicians to buy off huge blocs of the population by broadening the requirements for assistance. Take the number of uninsured in this country, which seems to float around 45-50 million (so says the media). Shave off illegal immigrants, people who can afford to buy insurance but choose not to do so for whatever reason (self-insure, gotta have the premium cable package instead of health insurance, etc), those

    @Voyou_Charmant: Like our current energy situation, the problem is TOO MUCH GOVERNMENT. Give people CHOICE and FREEDOM to shop around and insurance companies and care providers will have to lower their prices! You folks complain about the power of the insurance companies and how corrupt they are, but how do you figure it got that way? Because the GOVERNMENT allowed it! They passed laws that stifled competition in the market and added layer upon layer of regulation and rulemaking.

    Let’s try something new for once. Let’s demand that the GOVERNMENT give us, the consumer, some of our choice back. Don’t put me at a disadvantage because I choose to buy a health insurance plan that fits my lifestyle better outside of my employer. Don’t tell me I have to carry coverage for lifestyle or family decisions that may never affect me. Don’t bury my doctor in paperwork and forms that don’t do anything to improve my health. Stop making me subsidize the healthcare costs of people who have led unhealthy lifestyles. Simple fact is, we do not have a free and open market in health care. When the day comes that I can tell my employer that I would like to decline their coverage and be compensated in cash, tax free (so I enjoy the same tax benefits I would if I stayed in house), to buy my own health insurance policy that better fits my needs and budget, only then is the market free and open.

    My problem with single payer/universal systems is that the GOVERNMENT has already done so much to screw up our system as it stands, I cannot see how they can possibly do a better job running the ship. Basically all that happens is that the responsible people in society will end up paying even more (through higher taxes) for the same amount of care. The rules and regulations will still be there. The bloat and inefficiency won’t magically disappear. We’ll get to pay for more government bureaucracy and waste. But all the socialist Utopians out there will rejoice because someone won’t have to make the choice between healthcare or cable TV, cigarettes, beer, $200 tennis shoes, etc. People who are truly in need and just aren’t freeloading the system get help, many times free of charge. I’ve seen churches or communities come together and pay off entire medical bills for people who faced putting a child through a heart transplant.

    I’m just getting sick and tired of people thinking the government is the only solution to society’s ills, while completely ignoring the fact that government is in large part the reason why we are where we’re at today.

  222. johnva says:

    @barty: I understand that it’s an ideology-based thing for you. The problem with anti-government ideology is that it often becomes a self-fulfilling prophecy. The Republican Party puts people who hate government in charge of government, and surprise surprise, we get bad government. No government is perfect, and we constantly have to work to maintain and improve it, not tear it down.

    As for the idea of charity, it’s a great thing. But it’s not sufficient to solve the problem of universal healthcare. Not even close. And the whole reason why social safety nets were established in the first place was situations like the Great Depression where private charity, family support, etc breaks down. Churches and such may be part of the solution, but they shouldn’t be the only choice.

    You’re totally missing what everyone has been saying. Many, many people CANNOT simply “shop around” for better insurance. Individual insurance is not really the answer. Here’s the problem: if the insurance companies can accurately predict who will cost them the most money, then they can either deny those people coverage or charge them more money. The problem with that is that, unlike with people who are a poor risk for auto insurance or something like that, health problems often are not the fault of the person who has them – they may be because of bad luck or bad genetics. So individually underwritten policies shift costs onto the sick. That would compound the already horrendous problem of people going bankrupt because of medical bills even WITH insurance. And it would make insurance unaffordable for virtually all of the medically uninsurable.

  223. @barty: Oh yes, totally, let’s make sick people responsible for getting well.

    That
    Makes
    PERFECT
    Sense.

    By the way, I’d love to see you toeing that line after you get cancer. Oh no, wait, you’re too perfect to get cancer. Silly me.

    The “good old days” were full of dirty hospitals, abandoned victims and people dying at the age of 40 from preventable illnesses. How about we stop lionizing them?

    And, I know some of us are healthy, but perhaps even we can muster some compassion and understanding for those that aren’t, eh? Just because your body works fine doesn’t mean your brain doesn’t need exercise.

    A good system is one that helps as many ill people as possible to get healthy, and which helps as many healthy people as possible to stay healthy. I really don’t think there’s any valid measurement other than that. If it’s costing too much to get and keep people healthy, then it’s time for those who are getting rich on the system to stop, period. It’s not ‘time to help less people’ or ‘fuck the poor, they deserve it’ or whatever other ridiculous is probably lurking in this thread.

    Health system = about getting and keeping people healthy.

    First and period.

    Until nobody is getting rich off it, nobody has a reason to complain that it costs too much. Again, Period.

  224. barty says:

    @johnva: I’m not anti-government, just anti-BIG government. Just like individuals, a government that tries to stick its nose in everything ends up doing more harm than good.

    I think alot of you completely miss what the point of INSURANCE is in the first place. It is asking someone else to assume risk for you. Its not meant to be charity! I’d also be willing to wager that most of the people you claim can’t find a better deal on insurance have health issues brought on by lifestyle choices, not because of something that got passed down through the family. Why shouldn’t someone who smoked their entire life pay more than I? Or someone who never exercised a day in their life and feasted on fast food, yet tried to push off their obesity on bad genes? In any event, your “many, many people” probably represents a relatively small minority of the population. But failing to make any distinction at all, ie., saying the smoker is entitled to the same price and level of service as someone who is 100% healthy is one of the biggest issues I have with so called “Universal” health coverage. Some people ought to pay more. If it weren’t for the government interfering as it has already, I can almost assure you that health and life insurance companies wouldn’t cover a smoker at all. You want to talk about reducing the cost of healthcare in this country, make someone decide between smoking and being eligible for health insurance.

    Also, we need to review quality of life vs. spending billions just to keep someone around in our society. I think this is an increasing problem with the elderly in particular. We look at life expectancy as some great yardstick of civilization, but are we really adding meaningful years onto people’s lives? Or are we just condemning them to years spent wasting away bedridden somewhere? I know that modern thought looks at letting people who are chronically ill die as a barbaric thing, but is it really? I think one of the biggest problems we have is the attitude that every available means needs to be taken to keep someone alive, just because the technology or procedure may exist. Doesn’t matter if that person doesn’t stand a chance of meaningful survival, but we’ve got to do it nonetheless. Before anyone calls me a heartless bastard, I’ve seen too many family members of my own and of my friends basically waste away because of “maintenance” medications and surgeries and procedures that do nothing more than stall death for another year.

  225. Bladefist says:

    @johnva: I wrote you a huge comment, I think back on Page 1, it was my last comment directed to you. I’ve been eagerly waiting for your response, you mind?

  226. johnva says:

    @Bladefist: Sure, I’ll get to it shortly. I got tied up with real work :)

  227. Bladefist says:

    @johnva: Thats unacceptable. :)

  228. johnva says:

    @Bladefist: I think our country was “founded on” a mix of conservative and radical ideas, actually. Remember that a lot of the ideas in the Constitution and DoI were VERY radical at the time. Regardless, society changes and evolves over time. In a sense, it’s not that relevant to me what the original ideals of this country were. I care about that because it’s part of the base for our tradition of democracy, but I’m more concerned with making things better in the here and now. And I think one of the main goals of the government should be to improve the lives of its citizens, not just to be the arbiter of law.

    This is one of the fundamental differences between liberals and conservatives, and also between idealists and realists. Your way of looking at the world seems to be that if things are going okay for the majority of people that we shouldn’t tinker with what has worked well. I agree with that, but only to a point. I, by contrast, tend to try to look at the data and evidence for what works and what doesn’t. And I don’t believe what we are doing right now in healthcare is working well, for anyone except for investors in and executives for insurance companies. I also think that the evidence clearly shows that single-payer is a superior system if your goal is to get some guaranteed level of healthcare to everyone as efficiently as possible. I know you may not agree with that goal, but it’s at the heart of my support for single-payer.

    I’m not discounting the value of self-sufficiency. I certainly agree with you that that is a core American value. My problem with this healthcare issue is that it’s placing way too much of the burden of risk and cost on individuals, and disproportionately on some individuals at that. I do think we need some compromise between shared and individual responsibility, but I don’t think the way to do that is to let private insurance companies do what they want and pick and choose their customers and rates. The fact is, there are plenty of people who right now cannot afford decent healthcare DESPITE the fact that they are hard workers who don’t lead unhealthy lifestyles. I don’t think people should be able to push all costs that are their own fault onto the government, but I don’t think people should be totally screwed because of bad luck, bad genes, etc. Our current system makes no differentiation in this regard, and it won’t as long as the profit motive drives social policy. An insurance company doesn’t care if you’re sick because you’re a smoker or if you’re sick because you have a genetic disease. Either way, they don’t want you as a customer unless they can charge you rates high enough to cover your risk.

  229. johnva says:

    @barty: I think you’re outright wrong that most people who can’t get affordable health insurance for medical reasons are in the situation because of lifestyle choices. Insurance companies are increasingly denying coverage to anyone with a vast array of preexisting conditions, even if the customer is willing to sign an exclusion absolving the insurer from having to cover that known preexisting condition. I guess their actuaries have determined that people with one health problem are more likely to have others or something. I also think that you’re making that rationalization to avoid dealing with the inhumane nature of your own stance. Chalking up health problems to “lifestyle” or whatever lets you view it as a moral failing and dismiss it as a personal responsibility issue. Reality is more complicated.

    Also, there is absolutely zero reason to believe that under a universal coverage plan that smokers or other people who genuinely DO cause their own health problems would necessarily be “entitled” to the same coverage and cost as everyone else. If you think that’s a problem, then they could easily do things to provide incentives to people to quit smoking, like charging them higher copays or whatever. It could work just like regular private health insurance in that regard, or you could simply do things like raise cigarette taxes and use the money to fund any extra costs to the system caused by smokers. There is no reason to believe a compromise couldn’t be reached just because it would be a government plan. Actually, it’s PRIVATE INSURANCE that makes no differentiation between lifestyle-based disease and genetic diseases. Insurers only care about whether you are going to cost them money, not why. I think that’s perfectly understandable, since they aren’t charities after all. So I don’t really fault the insurers so much as I fault our society for making for-profit insurance companies the sole gatekeepers to affordable healthcare. Insurance is simply incompatible with what I consider the important social goal of everyone having some minimal standard of healthcare.

  230. Mr. Gunn says:

    Bladefist: Also- When you open up free health care, everybody is going to go to the dermatologist for each and every zit.

    This is the biggest fallacy. Most people don’t wake up and think, “Gee, I think I’ll have a colonoscopy today!” People avoid medical care whenever possible, no matter the cost. Spending will initially go up under Obama’s plan, but whether that’s spending on preventative care that will reduce the later spending on palliative care for that ailment, or whether it’s spending on care that someone other than the patient wouldn’t deem necessary, will be hard to distinguish, and probably not the job of people other than the patient, the healthcare administrators, and the caregiver.

    There’s actual data on outcomes. This is a doable thing.

    There’s a great blog I read that often covers this stuff, called Stayin’ Alive.

  231. Mr. Gunn says:

    I’m sorry, Bladefist, but I don’t know of any mature adult that holds to an ultra-libertarian viewpoint. It’s just not consistent with reality and human nature. We all get along better when we take care of one another, but just as we have people to manage our investments and prepare our taxes and grow our food, we also have people who manage our efforts to help our fellow man.

    You have a personal, selfish, self-interest in people around you being educated and healthy, even if you don’t realize it right now.

  232. Bladefist says:

    @johnva: So what you’re saying is, you believe in constantly updating the Constitution, that it’s a living document? I believe it’s dead. You can’t interpret it, you can’t add to it, unless you go through the rules of adding to it. Which we never do anymore. We just make laws right and left.

    @Mr. Gunn:
    1) You need to get out more then.
    2) I’m not a libertarian, let alone, an ultra-libertarian.
    3) What makes America so great, is that it is not Western Europe. If you think Western Europe is so great, thats fine. Move there. Enjoy it. I don’t care how great people think it is, America is built on an entirely different view point. Capitalism. And it works!

  233. johnva says:

    @Bladefist: Yes, I support the Living Constitution idea ala Justice Stevens. I actually think it’s insane to say that you can’t “interpret” the Constitution. It was clearly designed to be interpreted; that’s why it doesn’t contain explicit authorization for all the laws we have. And moreover, I think that people who say they support “Strict Construction” or “originalism” or whatever usually do so solely out of a political position that they think is supported by that rather than a sincere belief. Justice Scalia, for example, goes on and on about this stuff but then he contradicts himself, in my view, whenever his principles would force him to make a decision he finds morally repugnant. So I basically think he’s a hypocrite.

    But that’s getting way off topic.

  234. Bladefist says:

    @johnva: Okay. Well that helps me in understanding you. I’m you won’t be surprised for me to say, I think Justice Scalia is absolutely amazing. I believe it’s a dead document. Making it a living document will take us back to the exact reasons we fled Great Britain. We aren’t there yet. But when you remove the absoluteness of the Constitution, men will NOT stop. They just will not. Right now you agree with what they want to do. But if you know people, and I’m sure you do, then I hope you realize this is a snow ball effect. That is how communism is born.

    I hope to God that I am completely wrong.

  235. barty says:

    @Mr. Gunn: I think its a complete fallacy that just because its cheap/free that you’ll see a drastic increase of people using preventative medicine and a drastic decrease in the amount of spending treating the people who have become ill. Unless you’re going to put a gun to someone’s head forcing them to get a checkup (hey, it wouldn’t be beyond the government to do that!) every year, you’re still going to have the same issues, regardless of cost. I have health insurance and the last time I stepped in a doctor’s office outside of a health insurance physical was about 2 years ago.

    @johnva: I think we, the people, are probably the ones directly responsible for allowing insurance providers to have the leverage they do on healthcare costs. People have willingly absolved themselves of most responsibility when it comes to this matter. Used to, people used to keep some money in a rainy day account and MAY carry some degree of coverage to protect themselves from catastrophic events. When people had greater participation in the billing process, you better believe people paid more attention to what their doctor charged them. Then some employers started offering more comprehensive health insurance as a fringe benefit, it quickly caught on industry wide, and by in large people stopped buying their own personal policies. When we moved towards these larger employer provided plans, people stopped paying attention to what they paid, both at the doctor’s office and for the insurance policy itself.

    Our media is great at sensationalizing a few isolated cases and I’m sure everyone has heard the “so and sos, sister’s brother in law’s cousin, was refused insurance by the big, bad insurance company” but the statistics say those left chronically without health insurance by no choice of their own is far less than the number we seen tossed around. Certainly not high enough to push the entire country into some bloated government program that we’ll never see the end of, particularly until the government finally gives the insurable the power to shop for their own insurance and take back control of their healthcare spending.

  236. johnva says:

    @Bladefist: Great Britain hasn’t turned out all that badly (though they have some problems with civil rights abuses, etc just like we do). My belief is that we keeps us free isn’t what’s on that piece of paper so much as the ideas behind it and the popular support for those ideas. The Constitution IS a practical bulwark against tyranny, don’t get me wrong, and neither I nor Justice Stevens want it thrown out altogether. I just think the interpretation needs to change as society changes. And I still say that EVERYONE is interpreting the Constitution according to their own agenda. It just so happens that “strict construction” coincides with a more conservative political agenda, so conservatives support it.

  237. johnva says:

    @barty: Well, public health studies have shown that when preventative medicine becomes more expensive because of high-deductible insurance plans, people make much less use of it. This is true even with clearly beneficial preventative care like Pap smears and vaccines. That’s sort of the other side of what you’re arguing, but it’s a data point nonetheless.

    What this shows is that people don’t always perform good cost-benefit analysis when it comes to health if it’s left up to them. There is a good reason why we rely on highly-paid doctors, and that is that normal people do not have the expertise and knowledge necessary to make good judgments about which tests are actually necessary, etc. This is a fatal flaw of consumer-driven healthcare, which is the hot idea in Republican circles to fix healthcare. Just look at how many people spend tons of money on crap like homeopathy for which there is no scientific evidence for efficacy. The public simply isn’t good at knowing what they need and what they don’t, and where the best places to save money are.

    And I don’t believe that you have an informed picture of how bad the individual health insurance market is. It’s not just the media sensationalizing it. It’s a real issue. It can be really hard to get insurance, except through a group plan at an employer, if you have ANY preexisting condition. Even having taken an anti-depressant drug in the last 5 years can get you denied. And this is the environment John McCain wants to dump us all into by undercutting the tax benefits to employers who offer group plans. I agree that insurance should be decoupled from employment, but I don’t agree that individual underwriting is a good solution. Government risk pools are the only other option I can see.

  238. Bladefist says:

    @johnva: Like I said. For better or worse, our two countries are different. And I like America better. If the Constitution, sounds conservative to you, it’s because it is. America is supposed to be conservative. The constitution came first in America. So there is coincidence or political Agenda here. Conservatives are just defending how America was intended to be ran. The party of the change, is the threat. Sorry. I still like you though!

  239. johnva says:

    @Bladefist: I don’t think the Constitution sounds conservative at all (though I think parts of it sound archaic since it was written over 200 years ago). I think the interpretation of the “strict constructionists” is meant to serve a conservative agenda. And your idea of what America is isn’t the only one. Progressivism is just as American as conservatism is, and has been a major part of our politics for a long, long time.

    I also think that sometimes sticking with the status quo can be more harmful than changing things. There are good examples of this throughout our history: slavery is a good one. And now I think healthcare is an example of that. The status quo is failing an ever-growing number of people. Will you agree that change is needed if 100 million people are without good healthcare? That may happen sooner than you think, especially with the potential for an economic downturn. The system is breaking down, and needs to be fixed. My proposed fix is simply what I’ve analyzed and found to be the most efficient and equitable solution.

    I like debating you too, or I wouldn’t do it. And I like to get these points of view out there. The American people have a choice to make, and I think the differences couldn’t be starker. John McCain’s plan is terrible, in my opinion, and will only accelerate the crumbling of the system. Of course, I’m not happy with Obama’s plan to fix healthcare, either, and I don’t think it will work very well unless the Dems end up going significantly farther than he seems willing to commit to. The problem with McCain’s plan is that it’s a move in the absolute wrong direction. The problem with Obama’s plan is that it’s a half-measure.

  240. @Bladefist: Medicaid/Medicare is one of the best run insurance programs they only have a 3-5% overhead cost while private insurers have 14-18% overhead thanks to absurd upper tier salaries–nobody in the government is going to make a seven figure salary let alone eight–corporate jets, and retreats at four star hotels on the backs on the backs of the customers.