Which sucks more: Private health insurance or socialized medicine?

[Divinus Arma]

http://www.cbsnews.com/stories/2007/...n3482856.shtml

This is B.S.

I hate the Democrats but damn we need to do something about health care. Socialized medicine alone won't do in America. We need a bit of both.

I think the Thai model seems pretty solid for us (although I still need to learn more about it). Public medicine with private practices legal and competitive; private hospitals capable of turning all non-payers but for imminent emergencies away to public health.

[AntiochusIII]

I think the Thai model seems pretty solid for us (although I still need to learn more about it). Public medicine with private practices legal and competitive; private hospitals capable of turning all non-payers but for imminent emergencies away to public health.

I think the hatters above America might have something to teach us about that.

I always thought the Canadian model is a rather excellent compromise. If adopted in America, it could be weighted slightly more to the business side of things of course to accommodate our more "rightist" outlook, but still.

The Thai system has the slogan "30-baht [~1$, not counting lower living costs] to treat all illnesses." The framework is simply your average socialized medicine, with the patient paying a nominal fee at each treatment while the real money comes from the taxes; but it has a lot of holes and does accommodate private healthcare to a large degree. Private healthcare is more business-oriented and of generally much higher quality (though it depends on the type of establishment), especially the "elite" hospitals which are relatively comparable to Western standards, but they are also much more expensive.

The current American model, if there is such a thing, is a complete mess. It's a complex, fragile arrangement that heavily relies on both a haphazard government subsidy (Medicare & co.), the insurance system, and the pharmaceutical industries to sustain itself. And I think your link quite clearly demonstrates to us how well insurance works for the truly needy...

[Papewaio]

Might want to go holistic. Start with looking at other Western nations with similar mixes of population of the different groups within the US... compare there life expectancies and then figure out which system(s) are working.

Medical, Food, Family, Fitness... all account towards health. It might be cheaper to give every kid a sportsball and every community a sportsfield to raise health levels then expensive after the fact medical treatments. Western lifestyle is a source of diseases much like lack of potable water is. Ours shows up in poor attention spans, expanding waist lines and coronaries... the distance between cause and effect is larger then in the 3rd world... but as always for the majority of us its our lifestyles that get us not some random act of violence or bad luck.

[HoreTore]

I think the Thai model seems pretty solid for us (although I still need to learn more about it). Public medicine with private practices legal and competitive; private hospitals capable of turning all non-payers but for imminent emergencies away to public health.

That's what you called "socialized medicine". It's what we have here in europe.

[Divinus Arma]

That's what you called "socialized medicine". It's what we have here in europe.

Right. I know. I just mean that a government-only system would be undesirable here.

I've come to view quality health care as integral to the basic functions of civilization as infrastructure. We have freeways paid by the public, but we also have private toll roads for those who desire to spend the money to get a higher quality drive in terms of distance and time saved.

Similarly, government-run health care will provide society with the essentials of care. And like toll roads, for those who are unwilling to wait for a procedure (a major flaw in public health IMHO) or desire more personal attention from a private family physician, the patient may choose to pay out-of-pocket or through an insurance provider for private medicine.

The only way for this to work is that private institutions MUST be able to turn away those who can't or won't pay. Forcing a private company to give services away for free is a major flaw in the current system. Only in immediately life-threatening instances should a private ER be forced to take a patient, and even then the government would be required to compensate the facility.


EDIT: One last thought. This dual-system will benefit the U.S. by retaining the competitive capitalist motivation that stimulates innovation while also meeting the basic needs of the public.

[lars573]

The only way for this to work is that private institutions MUST be able to turn away those who can't or won't pay. Forcing a private company to give services away for free is a major flaw in the current system. Only in immediately life-threatening instances should a private ER be forced to take a patient, and even then the government would be required to compensate the facility.

That's the thing though a private hospital shouldn't have an ER at all, if that's the case.

Also Canada's system is an insurance scheme. That is the provincial governments provide an insurance plan. That is paid for via the federal government and provincial government taxes. And that they are the only ones* who can provide such a service for the medical services it covers.



*Except Alberta whos government set up a public/private two tiered system. And in fact keeps trying to scale back the public one in near violation of the Canada health act.

[Geoffrey S]

Similarly, government-run health care will provide society with the essentials of care. And like toll roads, for those who are unwilling to wait for a procedure (a major flaw in public health IMHO) or desire more personal attention from a private family physician, the patient may choose to pay out-of-pocket or through an insurance provider for private medicine.

Tempted to agree, but the problem is where to draw the line of 'essential'. It's an easy thing to say, but far more difficult in practise to implement.

[KrooK]

Definitely socialised medicine sucks more. We have it into Poland and its awful system.

[IrishArmenian]

Definitely socialised medicine sucks more. We have it into Poland and its awful system.

Coming from someone who obviously is financially comfortable enough to afford a computer and time to spend on a forum.
I believe the Canadians have it right! They have socialized medicine but the financially secure can choose a private clinic. This is good for a number of reasons: the tax-supported hospitals aren't as full, giving many patients the attention they need and the private clinics give the monetarily gifted the attention they need. One takes the load off of the other! Genius!
If Hayastan were to do this, we'd need a whole lot more money, many more educated people and then I'd be oh-so-happy!

[Philippus Flavius Homovallumus]

I view healthcare like policing, the essential service should be provided by the government and paid for through taxes.

[Papewaio]

I can't recall any ER's in private hospitals in Aus. There might be, but not on the scale of the public health system.

I do know that the private health system is for those who don't want to wait, want their own private room while recovering or want elective surgery.

Also I do know that with giving birth that if there is a complication the patients are sent to the public system as it is generally better at handling problem cases (that and the private hospitals want to keep their stats high).

[Ice]

I wouldn't mind a more public system of health care, but implementation is the key.

I'd like to see it phased in over say 10 or even 20 years. Less and less private and more and more public.

Although, I do agree some or many aspects of the current private system should be kept in place.

[JAG]

Pft! Public health care is rubbish! You can't make any profit!

[Ice]

Pft! Public health care is rubbish! You can't make any profit!

That or many worry the quality/long waiting times is increased when you switch from a private to a public system.

Yeah, must all be about the profit.

[Kagemusha]

combination of both sucks, less.

[Shahed]

Socialised is more moral IMO, it is in Europe anyway. they don't turn people away, and only ask about payments once the patient is in a condition to talk about it (emergencies). Thai public hospitals are not that great. The private Bangkok (Chang Mai, Phuket etc) line, specially developed to cater to the tourists is pretty good. I've spent the night in one myself (bad gastrointestinal issues). It was acceptable but extremely expensive and I always felt like I'm in a department store, they treat you like a customer, rich foreign customer. Customer service was fanstastic though, they even bring you a food menu and a choice of rooms with the price boldy printed on the page pictures and all, while you are lying dehydrating in the emergency ward. Funniest part was when the doctor said, "Sir, take this room, also have balcony for smoker, only 14,000 Baht per night" (can't remember the exact price but it was expensive, specially the medication. I asked him do you really think I can eat Spicy Chicken Soup as starter, Steamed Jasmine Rice , Fried Chicken with Garlic and Chillies as main course, and ice cream for dessert or should I go for the complete American Meal to be safe? That was on the menu for that night and you could choose between a couple of dishes. I was on a drip and LOL even looking at food made me sick. He did'nt get the joke at first !

But like a lot of things in Thailand, the Thai people make it great. I even felt great being in the hospital for the night, looking out at the palm trees and smoking on the balcony, the first thing I did once I got out of bed (HA!!! HA !!!).

Thailand is a great country, and the Thai are some of the warmest and most sincere people anywhere.

I posted a thread couple of weeks back in the Frontroom about a GREAT Thai movie "Last Life in the Universe". You might wanna have a look if your interest in that part of the world extends beyond the medical system.

[Mikeus Caesar]

When you've got a choice between everyone having free healthcare that isn't of the highest quality, and everyone having to pay for high quality healthcare resulting in many poorer people not being able to afford it, i know i pick the first option.

After all, rich people who are dissatisfied with the quality of public healthcare can always fork out for private healthcare.

[Ice]

When you've got a choice between everyone having free healthcare that isn't of the highest quality, and everyone having to pay for high quality healthcare resulting in many poorer people not being able to afford it, i know i pick the first option.

After all, rich people who are dissatisfied with the quality of public healthcare can always fork out for private healthcare.

Once again though, that's not exactly the private health care we are discussing here.

The extremely poor are covered by Medicare and Medicaid. It's the lower middle class that usually have a hard time funding health care.

[Kralizec]

They never heard of "poverty trap" in Washington?

[Xiahou]

I'd prefer a system of pay-as-you-go general healthcare supported by charities for the poorest and then sensible insurance for emergency and long-term care.

I'd rather see government mandated HSAs before socialized medicine. The way to better healthcare is to get patients to care about service and cost, not to further remove them from them.

Everyone agrees that far too many Americans lack health insurance. But covering the uninsured comes about as a byproduct of getting other things right. The real danger is that our national obsession with universal coverage will lead us to neglect reforms — such as enacting a standard health insurance deduction, expanding health savings accounts and deregulating insurance markets — that could truly expand coverage, improve quality and make care more affordable.

As H. L. Mencken said: "For every problem, there is a solution that is simple, elegant, and wrong." Universal healthcare is a textbook case.

link

[Papewaio]

Where do vaccines go?

User pays or the broad population? After all who is the beneficiary of vaccines... just the user or having enough to create moats of immunity.

The economic benefit of having a healthy working age population is fairly obvious . What is often missed is the economic benefits of having a healthy elderly population... so who should pay then?

[Shahed]

Smoking, drinking, fast foods, processed foods, etc. All this contributes to an unhealthy elderly population. To take care of them the state pays i.e taxpayer pays. I'm not saying we should'nt do it, I'm saying more could be done to ensure a healthier elderly population.

[Kommodus]

Smoking, drinking, fast foods, processed foods, etc. All this contributes to an unhealthy elderly population. To take care of them the state pays i.e taxpayer pays. I'm not saying we should'nt do it, I'm saying more could be done to ensure a healthier elderly population.

I'm sure this isn't exactly a new idea, but perhaps we should impose large sales taxes on fast food like we do on tobacco? I mean, fast food is popular in part because it is quick and cheap. If people had to pay as much for fast food as they did for healthier food, maybe the healthier options could better compete!

Now I'm off to Wendy's...

[Divinus Arma]

A danger in the public health care system is that the government could then justify passing laws that limit our liberty in order to "keep us safe and healthy". Kind of like motorcycle helmet laws, but worse.

No fatty foods! No smoking of any kind anywhere ever! These are the entry level possibilities, but imagine how far the tyrants of congress could take it. After all, we don't really elect anyone in this country. We elect from the pool of crap that they give us.

[HoreTore]

How about.... Private clinics, but the state pays?

[Peasant Phill]

The key to to a good social or socialized health care system is IMO the quality of the hospitals and medical staff. The problem most people have with social (public) health care is the poor quality it provides in comparison to private health care. Long waiting time, less competent medical staff, worse equipment, ... This is, however, not inherent to a social health care system itself. Belgium for example is a benchmark on the matter of health care and is a social health care system.

The biggest problem IMO is the capitalism in health care. Private hospitals have more resources than public hospitals due to low governmental funding (in comparison to other countries). Private hospitals can then 'buy' the best medical staff. Doing so lowers the quality of public hospitals.
One should lower the average wages of medical staff to the point that public hospitals can afford to rival or at least approach private hospitals. I'm aware that this is unimaginable in the USA but I think that is the best (cost/effectiev) way to improve health care in general: the price will drop, comfort will rise and more people will have access to better health care.

[Papewaio]

You cannot just lower the prices locally you would have to do it throughout the world.

Drs and Nurses quite readily move cities, states, countries to get a better lifestyle. If you decide to pay them less they will move somewhere else, its the upside of capitalism... when you are in an in demand profession that is low on supply... you get to play the piper not the bean counters.

[Peasant Phill]

You cannot just lower the prices locally you would have to do it throughout the world.

Drs and Nurses quite readily move cities, states, countries to get a better lifestyle. If you decide to pay them less they will move somewhere else, its the upside of capitalism... when you are in an in demand profession that is low on supply... you get to play the piper not the bean counters.

Although I partly agree with you, your statement only works in theory. In real life a workforce isn't as mobile as you make it out to be. Doctors earn more in the US than they do in Belgium for example while the the quality is equal. Why isn't the majority of Belgium doctors moving to the US?
As long as the wage difference isn't that big, most people will stay in there familiar suroundings.

[Papewaio]

As long as the wage difference isn't that much... so if you artificially lower wages you will get more and more leaving. Not a hundred percent, but with highly skilled professionals they can more easily move then others. Halve the wage of a factory worker and they don't have much choice... even then you can see such workers from South-East Asian working in the middle east.

[Goofball]

Coming from someone who obviously is financially comfortable enough to afford a computer and time to spend on a forum.
I believe the Canadians have it right! They have socialized medicine but the financially secure can choose a private clinic. This is good for a number of reasons: the tax-supported hospitals aren't as full, giving many patients the attention they need and the private clinics give the monetarily gifted the attention they need. One takes the load off of the other! Genius!

If only that's what we were actually doing in Canada. Unfortunately, we're not.

No matter how rich you are, you can not go to a private clinic and pay for any medical service that would otherwise have been paid for by the government. That means evereybody has to stand in line for non-elective surgeries, MRIs, etc...

Based on some of the studies I've seen that compare the quality of health care in countries that offer some form of socialized medicine, the only catagory Canada was ranked first in was amount of $$ spent per capita. And the reason is that out of all of those countries, we are the only one that doesn't allow a blend of private and public health care.

Japan was actually very well ranked. They had shorter wait times, higher life expectancy, higher "survivability," and lower overall cost per citizen.

That is not to say that Canada was dead last among the ranked countries, but we're certainly not getting the bang for our buck that we should be.