Universal healthcare for everyone!

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.

Two words: Tort Reform

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.

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.

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.

@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?

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.

@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.

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

@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.

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

@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.

@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.

@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.

@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.

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.

@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.

@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.

@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.

@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.

@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.

@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!

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.

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?

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.

@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.

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.

@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.

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

@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.

@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.

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

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]

@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.

@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.

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.

@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.

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

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!"

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.

@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.

@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.

@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.

@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.

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.

@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.

@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]

@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,...