Universal Health Care is French for "Ze Germans".

[Roxanne Appleby]

Lets look at a few figures.


Life expectancy

CAN 80.43 years
USA 78 years
MEX 75.63 years

Why is the United States in the 29th position on a list of longevity of population, and why is Canada in the 10th position.



Infant Mortality Rate

CAN 4.8/1000
USA 6.3/1000
MEX 16.7/1000

Why is the US only at the 163rd place out of 195 countries on a list of the countries with the highest risk of infant mortality when Canada at the 173rd position on that same list?



We know the reason for Mexico's position, but does the "Greatest Country in the World" rank so poorly in life expectancy and infant mortality?


And why can't the United States afford universal health care for its citizens, when every other industrialized western power does?

Perhaps this 2004 statistic can shed some light:

Military spending by the World, except US: $500 billion

Military spending by United States alone: $623 billion


Nobody outspends the United States on killing.

Blah blah blah. Correllation does not equal causation. If you try hard I'm sure you can think of some factors that have nothing to do with the health care system that play a major role in things like life expectency and infant mortality.

 

[Ootpic]

Poll Shows Majority Back Health Care for All

By ROBIN TONER and JANET ELDER
March 1, 2007

. . . Americans showed a striking willingness in the poll to make tradeoffs for a better health care system, including paying as much as $500 more in taxes a year and forgoing future tax cuts. But the same divisions that doomed the last attempt at creating universal health insurance, under the Clinton administration, are still apparent. Americans remain divided, largely along party lines, over whether the government should require everyone to participate in a national health care plan, and over whether the government would do a better job than the private insurance industry in providing coverage. . . .

. . . . The poll found Americans across party lines willing to make some sacrifice to insure that every American has access to health insurance. Sixty percent, including 62 percent of independents and 46 percent of Republicans, said they would be willing to pay more in taxes. Half said they would be willing to pay as much as $500 a year more. . . .

.....

 

[Roxanne Appleby]

ROXANNE

I read that the real culprits of inflationary medical prices are MDs.

They buy equiptment they dont know how to use, their fund of knowledge remains what it was when they graduated med school, and many of them buy testing labs they require their patients to use.

Individual MDs are just responding to the skewed incentives within the system. To a signifigant extent they are responsible as a class for many of those, but not all. The watchword for real reform is "consumer directed." That isn't always in the interest of MDs, but in the long run it really is.

 

[kendo1]

I suspect it would cost too much nowadays to install a full national health system in the US, as in the UK. At least we started sixty years ago. It does cost a lot to run, but when everyone pays it's not so much. You just accept that it comes out of your salary before you get taxed.
As Og said, no matter where you are (well, 99%) in the UK, an ambulance will get to you within seven minutes. If you need an air ambulance- it's paid for. No question. Everyone is treated the same.

I see no problem with that, we're used to it. It's part of being British.


The cost to US private health companies would be considerable - you wouldn't want to upset the share holders. (I'm sure they have private health care)

 

[jomar]

Anything Hilary Clinton can do is better than the cold hard fact of debt (including tipping for good treatment) for many people in the current U.S. healthcare system. I advocate and have no criticisms thus far of her plan and I haven't since... oh about the mid 1990's.

1. Tipping doctors? I have trouble with tipping the mailman!
2. Except for managed care, which made a lot of people rich, drove provider reimbursement down and we still have rising premiums.

Roger all that, Og. It's Canada that's (mostly) banned private providers, which won't happen in the U.S.

Correct. In fact, small private medical clinics are springing up in Canada to serve those that don't want to wait months and more for 'free' healthcare. I also know a couple of successful business owners who moved their business to the US due to Canada's high taxes.

ROXANNE

I read that the real culprits of inflationary medical prices are MDs.

They buy equiptment they dont know how to use, their fund of knowledge remains what it was when they graduated med school, and many of them buy testing labs they require their patients to use.

I'd like to see that material. It is probably true that some increase has been due to more testing being done due to the threat of malpractice suits. In fact, rising malpractice insurance is probably part of the reason for rising healthcare costs - it sure has put some docs out of business.

 

[Stella_Omega]

I don't think being forced is a good thing, no. Isn't it a lot like "should there be a law for seatbelts"? Isn't it, truly, my life? My right to not pay for things I don't want?

I mean, arguments about "your son falls down the stairs" are a little more complicated, but doesn't her plan require single, low-income, unwilling people to spend their money on something they may not want?

Low-income people don't want health care. You can tell, because they don't pay for it.

That explains it all!

 

[Joe Wordsworth]

Low-income people don't want health care. You can tell, because they don't pay for it.

That explains it all!

No, but is it unreasonable to believe that low-income people don't want to pay for it because they can't afford it? Or that they may want it, but they don't have it because they can't afford to pay for it?

 

[Stella_Omega]

No, but is it unreasonable to believe that low-income people don't want to pay for it because they can't afford it? Or that they may want it, but they don't have it because they can't afford to pay for it?

Well, in the times when I've been in that income bracket, believe me-- I WANTED health care, but couldn't afford it. When I could pay, I did-- or in some cases when I had no choice at all about it, like when my daughter broke her arm, I scrounged the money from some other budgetary consideration, such as utilities bills or the rent.

So, yeah. I WANT a better healthcare payment system in this country. The Clinton proposal isn't perfect but it's better than what we have.

And as we've argued ad infinitum on this forum, you do pay the costs of the under-insured when you go to the hospital. It would be far better to shoulder your part of that burden in a more effective manner.

 

[Roxanne Appleby]

Poll Shows Majority Back Health Care for All

By ROBIN TONER and JANET ELDER
March 1, 2007

. . . Americans showed a striking willingness in the poll to make tradeoffs for a better health care system, including paying as much as $500 more in taxes a year and forgoing future tax cuts. But the same divisions that doomed the last attempt at creating universal health insurance, under the Clinton administration, are still apparent. Americans remain divided, largely along party lines, over whether the government should require everyone to participate in a national health care plan, and over whether the government would do a better job than the private insurance industry in providing coverage. . . .

. . . . The poll found Americans across party lines willing to make some sacrifice to insure that every American has access to health insurance. Sixty percent, including 62 percent of independents and 46 percent of Republicans, said they would be willing to pay more in taxes. Half said they would be willing to pay as much as $500 a year more. . . .

I guarantee they're paying more than that now in state and federal taxes for Medicaid, and Medicare payroll taxes.

BTW, it's worth noting that even though the benefit promises far exceed any ability of even our rich society to pay in the future, and recipients can all expect to take a means-tested haircut, the US does have a health care system for the aged - Medicare - that despite many flaws and some pernicious effects on the overall system does deliver the goods.

 

[Roxanne Appleby]

Well, in the times when I've been in that income bracket, believe me-- I WANTED health care, but couldn't afford it. When I could pay, I did-- or in some cases when I had no choice at all about it, like when my daughter broke her arm, I scrounged the money from some other budgetary consideration, such as utilities bills or the rent.

You probably qualified for Medicaid at those times, unless you had a lot of assets (in which case you would not have been scrounging.)

The Clinton proposal isn't perfect but it's better than what we have.

Don't be so sure, and be careful what you wish for.

 

[Roxanne Appleby]

I've referred to this earlier, here it is - what I view as a "happy future" in health care, which may be surprising to some here:

I do believe that health care must be consumer-driven for the reasons the OP article describes. With several reforms in that direction it becomes possible to provide every person in the country with a health insurance voucher that will cover all expenses above $2,500 year. Here's how:

First, we need to repeal the restrictive state licensure and scope of practice regulations that masquerade as consumer protection but actually only protect the provider cartels from competition. This would allow someone like Lucky (with perhaps enough extra training to acheive nurse practitioner status) to open an urgent care clinic that could treat all the various nicks and bruises encountered in daily life (like falling off 5 gallon buckets, or nasty cuts that require a dozen stitches and antibiotics). The cost would be be a fraction of what emergency rooms cost, manned as they are by highly trained MDs who aren't needed for 90 percent of the stuff that rolls through the doors. Naturally our Lucky would have the training to recognize the stuff that she can't handle and would refer it on.

Second, allow binding waivers of liability so you could only sue Lucky for screwing up the thing you paid her to do - sew up the 12 stitches and prescribe the right antibiotic, for example, instead of a bunch of crap that some shyster thinks of afterwards that she should have done. Oh, and Nurse Lucky would only need to charge you around $40 or so for that service, because this reform and the previous one lets her operate her clinic in the most efficient manner possible (think Wal-mart vs. Rodeo Drive boutique.)

Third, we would force individuals to make decisions early in life about whether they are willing to pay for extraordinary (and usually irrational) end-of-life care. We do this by making them pay substantially higher premiums throughout their working life to pay for it. Or not paying those, and accepting that they will receive no extraordinary procedures. Obviously lots of education and continuous messages will be required to avoid recriminations when the time comes, and an individual who made the (probably rational) choice to pass by the extra coverage has to pay the piper and make his peace.

Fourth, every adult over age 21 would be required to buy insurance with a $2,500 deductable. Because everyone buys, including young people who don't get sick much, the costs of those who do get very ill are "socialized," and there's enough left over that the money those healthy youngsters contribute grows sufficiently to cover their own old age costs. And, because of the high deductable and everyone paying in, the cost of this insurance would only be around $4,000.

Fifth, there would be universal community rating - every person pays the same. No "prior conditions," etc. This is impossible without the universal insurance mandate because the incentive is for individuals to "free ride" by waiting until they get sick to buy insurance (in which case it's not insurance but welfare). The only things the $4,000 policy would not cover would be extraordinary end of life expenses - if you wanted you could pay more to get insurance for those, but most people would decide it's not worth it. There would be some variation in the available policies, but not much. The policies would cover children as well as their parents - in the aggregate kids are a very small portion of total health care costs.

Sixth - and here is where you will be surprised - the government would pay for those $4,000 insurance policies for every person. Not just the poor - everyone. No more employer-provided health insurance, Medicare or Medicaid.

Essentially, this plan socializes the cost of health care, but leaves the provision of in to the private sector, and removes the skewed incentives and constraints on innovation described in previous posts by me. It is a win-win for every member of our society. I'm sure all those who imagine some socialist paradise will find 100 quibbles over this scheme, but there's no free lunch, including in the single payer plans. This one is sustainable, and the incentives are all in the direction of making it more cost effective and patient-friendly. That is not the case in the government-run systems.

I didn't invent this - it's described by Charles Murray in his "In Our Hands: A Plan to End the Welfare State."

 

[Huckleman2000]

I guarantee they're paying more than that now in state and federal taxes for Medicaid, and Medicare payroll taxes.

BTW, it's worth noting that even though the benefit promises far exceed any ability of even our rich society to pay in the future, and recipients can all expect to take a means-tested haircut, the US does have a health care system for the aged - Medicare - that despite many flaws and some pernicious effects on the overall system does deliver the goods.

So, why not just extend Medicare to everyone?
I guarantee I/my employers have paid far less for Medicare than I/they have for insurance coverage.

 

[Stella_Omega]

Don't be so sure, and be careful what you wish for.

I could say the same to you, Ms Ever-Present-Agenda.

I wish for affordable health care. I wish for that way past the being careful stage. I wish for it because I know all too well what the alternatives are.

 

[Roxanne Appleby]

I could say the same to you, Ms Ever-Present-Agenda.

I wish for affordable health care. I wish for that way past the being careful stage. I wish for it because I know all too well what the alternatives are.

Speaking of ever-present agenda, see my previous post, which crossed this one. The agenda in this case is something that has a plausible chance of actually providing what we both wish for in a sustainable manner, and that aligns the incentives of providers and consumers with the goals of innovation, increasing value, and maximizing efficiency. That's something Hillarycare or any socialized system cannot accomplish.

So, why not just extend Medicare to everyone?
I guarantee I/my employers have paid far less for Medicare than I/they have for insurance coverage.

Same answer, plus the problem with Medicare is that it is actuarily a house of cards. I'd rather create something stable and sustainable, and I'm sure you and Stella would too.

 

[Roxanne Appleby]

Stupid new lit software - dupe post.

 

[Stella_Omega]

Speaking of ever-present agenda, see my previous post, which crossed this one.

I'm sure that I'm recalling this incorrectly, but it seems to me that Bill's first healthcare plan was somewhat modelled on the Medicaid pattern. I always figured that was what precipitated the impeachment attempt-- he was jeopardising such a profitable business.

 

[Roxanne Appleby]

I'm sure that I'm recalling this incorrectly, but it seems to me that Bill's first healthcare plan was somewhat modelled on the Medicaid pattern. I always figured that was what precipitated the impeachment attempt-- he was jeopardising such a profitable business.

I know it's a bit long and perhaps boring, but do refer to my post just before your last. You may be surprised.

 

[Ootpic]

My prediction concerning universal health care is that while it is feasible — after all, every other industrialized western nation has some version of universal health care — no completely universal program will ever be allowed in this self-confessed greatest country in the world.

It’s not because of any financial difficulty, not while the United States can find the money to outdo the world on military spending. It is not because a workable system cannot be found. There are at least a dozen systems in other countries from which to crib, copy, cobble together different parts, or invent a new and better system from the ground up.

The problem is that a universal will is missing. There exists too large, a vocal stratum of American society that is deathly afraid that were universal health care to be enacted, someday their money might accidentally be used to save the life of some undeserving poor person.

Whether their definition of undeserving employs economic, racial, religious or any other yardstick, the result is that they would rather limp along in a broken system, than take that terrible risk.

And the corporations raking in the money are only too ready to whip up those fears whenever their cash cow is threatened.

I would like to be proven wrong, but I doubt that it will happen.

 

[Stella_Omega]

I know it's a bit long and perhaps boring, but do refer to my post just before your last. You may be surprised.

I remember this proposal of yours-- it, too, would be preferable to what we have right now.

I surely agree with you about restricting lawsuits!

 

[Huckleman2000]

[snip]There exists too large, a vocal stratum of American society that is deathly afraid that were universal health care to be enacted, someday their money might accidentally be used to save the life of some undeserving poor person.

Whether their definition of undeserving employs economic, racial, religious or any other yardstick, the result is that they would rather limp along in a broken system, than take that terrible risk.

And the corporations raking in the money are only too ready to whip up those fears whenever their cash cow is threatened.

I would like to be proven wrong, but I doubt that it will happen.

Exactly. The Ronald Reagan myth of The Welfare Queen. Somehow, somewhere, someone just might be getting more than their fair share, and they have those healthcare needs because they're bad people. Baa-aa-aad people. If they were good people, they wouldn't be sick, now would they?

 

[Joe Wordsworth]

Well, in the times when I've been in that income bracket, believe me-- I WANTED health care, but couldn't afford it. When I could pay, I did-- or in some cases when I had no choice at all about it, like when my daughter broke her arm, I scrounged the money from some other budgetary consideration, such as utilities bills or the rent.

So, yeah. I WANT a better healthcare payment system in this country. The Clinton proposal isn't perfect but it's better than what we have.

And as we've argued ad infinitum on this forum, you do pay the costs of the under-insured when you go to the hospital. It would be far better to shoulder your part of that burden in a more effective manner.

That doesn't answer my question, I don't think.

 

[oggbashan]

Exactly. The Ronald Reagan myth of The Welfare Queen. Somehow, somewhere, someone just might be getting more than their fair share, and they have those healthcare needs because they're bad people. Baa-aa-aad people. If they were good people, they wouldn't be sick, now would they?

We have such people in the UK - the benefit cheats, the scroungers, the could-work-but-won't - but they are a very tiny minority. True cheats are caught from time to time and dealt with by the legal process. Their existence is used to justify intrusive measures against those who are genuinely unable to work.

What is underestimated is the depression that is caused by long term unemployment or a prolonged spell of illness. It is very difficult to regain motivation and drive after months of no work. There are also perverse incentives that make unemployment pay more than a basic wage job if you have a family. The UK government is trying to change the system so that there are advantages to being employed even in a very mundane low-paid job but the welfare systems are so complicated that minor changes can have adverse effects on deserving individuals.

Two of my friends, a married couple, have been in and out of the system for years. Their problem is their basic lack of intelligence. They are great people but the politest word I can use to describe them is "dim". He has been through multiple training courses to try to give him some skills. He has failed on all of them despite trying his best. She has had several basic shop assistant jobs but doesn't last long because she is too "slow". She can operate a till but at about a quarter of the speed of her colleagues. When she fails to "improve" her employment is terminated - again. She is currently working as a volunteer in a charity shop. She is willing, cheerful, helpful but she has to have some other volunteer with her at all times because she gets flustered if hurried and is wide open to unscrupulous people who want change from a ten when they've given her a five. The welfare system and welfare professionals have been supporting them all their adult lives and now supports their adult children. In earlier times they would have been tolerated as the "village idiots". They are just as vulnerable as the mentally handicapped, the mentally ill and the physically disabled but because they don't fit in those neat categories they are constantly under review by the authorities. The people who know them know they are trying their hardest. The system sees them as worthless scroungers and work-shy. They'd love to have real jobs they can do. Those sort of jobs have been priced out of existence. What amazes me is that they remain cheerful and happy despite everything the system throws at them.

He can laugh at himself. He went on a course to be a "plumber's mate". His first attempt at soldering a pipe caused the workshop to be evacuated when he accidently set fire to the bench. He tried to be a "bricklayer's assistant". His wall fell on his feet before it was two feet high. So the authorities sent him on an IT course. He wrecked a keyboard and printer in the first hour...

I am pleased that we have a system that enables them to live a frugal but reasonable existence.

Og

 

[Roxanne Appleby]

Og's previous post raises a really important issue - the lives of dumb people. Let's face it, folks - all the children are not above average. It's a frightening fact that half the population have IQs below 100. Many of them well below it.

As Og says, these may be individuals of high virtue and sterling character, but their ability to earn enough to enjoy stable lives and a very basic lower-middle class standard of living is deeply challenged by the reality that the post-industrial economy places little value on having a strong back or performing other low-skill tasks that are all the intelligence-challenged can do.

This is why author Charles Murray is my guru in such matters, and why I support his plan to replace the welfare state with universal stipends (and the health insurance subsidies I described a few posts ago). These people do not deserve to be treated in the same way as the cheats Og refers to or the dysfunctional underclass I have referred to. That's what welfare does, though - it takes away dignity, among many other socially destructive byproducts. Murray's "Plan" avoids all that.

This reality is why I support things like the Earned Income Tax Credit, which subsidizes low-skill/low-pay work, rather than not-working.

 

[WRJames]

The US also spends a lot for drug and device research, and for all the unprinicipled ire directed at "big pharma" for making lots of money on things like viagra, this expense has arguably been the greatest contributor to human well being since the widespread adoption of public health practices. BTW, we're subsidizing you shiftless Europeans, who through price controls have gutted their own medical research industry, and are 'free-riding' on ours. Anyway, those things repesent real value that we get in return for paying a lot.

Well -- the drug companies are spending twice as much on advertising as on research -- and much of that is hidden -- direct marketing to doctors that warps medical treatment.

Drugs are being over prescribed -- and expensive drugs prescribed instead of generics that would be just as effective -- because of this. This is not "unprincipled ire." It is the drug companies who have failed the public trust.

 

[oggbashan]

...
The US spends a lot on health for a variety of reasons. For one thing, we have a generally very good system. If you're going to get sick anywhere in the world, you probably want it to be the US. The US also spends a lot for drug and device research, and for all the unprinicipled ire directed at "big pharma" for making lots of money on things like viagra, this expense has arguably been the greatest contributor to human well being since the widespread adoption of public health practices. BTW, we're subsidizing you shiftless Europeans, who through price controls have gutted their own medical research industry, and are 'free-riding' on ours. Anyway, those things repesent real value that we get in return for paying a lot...

Oops! Viagra was produced by research at Pfizer's UK base!

Pfizer's research establishment near Sandwich in Kent is the largest employer in the area and now does nothing but research.

Pfizer is not the only drug research company in the county of Kent.

Og