The U.S. Health Care Debate

[Husar]

Make it honestly universal or don't bother at all, sez I.

Commie!

Spoiler Alert, click show to read: 

But I agree, this whole complicated system based on risks is a really weird capitalist's dream as it would also require significantly more bureaucracy than a simpler system, and we all know bureaucracy is bad and costs way too much money.

Concerning the whole choice thing, joining the military in the US is also a choice, does that mean soldiers would have to pay the most? Don't let patriotism get in the way of your judgement here...

[rory_20_uk]

AS far as I am aware, soldiers get free healthcare, and support after discharge. So it's a non-issue with the employer picking up the tab.

Massive detail into lifestyle would be difficult, but considering here in the UK most of the needed data is held by GPs it would be very simple to develop quite complex pictures about health. Would some lie? Probably. But as with all insurance it is invalidated if falsification is found.

[KukriKhan]

AS far as I am aware, soldiers get free healthcare, and support after discharge. So it's a non-issue with the employer picking up the tab.

Massive detail into lifestyle would be difficult, but considering here in the UK most of the needed data is held by GPs it would be very simple to develop quite complex pictures about health. Would some lie? Probably. But as with all insurance it is invalidated if falsification is found.

You've hit on another aspect of the talked-about but not yet written down plan over here: cut costs by digitizing med records, the easier to share patient history and treatment among Docs.

Makes sense to avoid duplication of effort, but many are worried about the security of such a system, and the use of the info by gov't, insurance and employer groups to deny treatment, coverage, or even employment, based on risk actuarial tables.

Why hire a 40-year old welder for your factory, if his father, mother & grandfather all died of heart attacks in their late 40's?

-edit-
Just thought I'd throw in this BBC story about an entire village smoking cigarettes one day every year.

[Hosakawa Tito]

Here's a take from a former Canadian doctor. Like BG, I was also concerned and disgusted that Lemur felt the need to doctor himself with that hand injury rather than jump through hoops with his insurance company. I think Kukri was on the money when he said it appears to be more of an insurance problem than a health care one. I really don't know what a viable solution would be, but something needs to be done. A not for profit health insurance company for those that don't have any sounds like a good idea to keep costs down, but will it eventually lead to all employers just dumping their health plans for employees and forcing most people into this government plan?

From a personal stand point, if what this doctor says about the Canadian health care system is true about waiting lists for CT/MRI scans... I'd not have survived that brain aneurysm several years ago.

[Evil_Maniac From Mars]

Concerning the whole choice thing, joining the military in the US is also a choice, does that mean soldiers would have to pay the most? Don't let patriotism get in the way of your judgement here...

There is a bit of a difference between smoking and joining the military, and American soldiers certainly should enjoy subsidized health insurance because:

1) They are working for their country in one of the most difficult jobs it offers.
2) There is a large difference between working in a necessary job and killing yourself with junk food.
3) For all the things that they sacrifice it is the least that we can do in return.

[Louis VI the Fat]

Some thoughts:

The litigation culture in the US drives up healthcare costs. This is partly owing to individual risks not being socialised. In Europe, if you become disabled, welfare will take care of you. In the US, somebody responsible must financially compansate you. (To put it very schematically, but the mechanism is there, and not just in healthcare)
Are European healthcare costs shifted to social welfare costs? Americans by contrast pay less for welfare, more for healthcare. Is a good deal simply a matter of where costs appear? I lack numbers, but I expect so.
(There are pro's and con's to either system. For the proponents of individual responsibility - which always at first glance sounds the more reasonable choice - the following joke, that I unfortunately don't know how to tell well: a man falls down on a New York pavement in agony, grabbing his heart with his hands. One man rushes towards him, another flees the scene. The former is a lawyer, the latter a doctor)


Surely, (insurance for) litigation can not account for several percent of GDP? Litigation is rampant in the US, but it can not account for the huge gap in healthcare spending between the US and other developed nations. I need numbers. (We are in dire need of statisticians and number crunchers in this thread!)


Capitalism has two meanings. Free market, and putting the interests of corporations first. American families suffer because they believe that what is good for corporate America, is ultimately good for them. The medicinal-industrial complex knows otherwise.
Free markets are great, therefore corporations will do anything to destroy them. The federal government ought to resume control of the healthcare market and put better incentives into place. Currently, they work to the disadvantage of the people.


The US scores very low on international healthcare comparison lists. Infant mortality and the like. Yet, America also scores near the top on other lists. I think this is more a matter of income distribution than healthcare. Simply put, poor babies die out of want, and the well-to-do have a $100.000 heart surgeory.
This is a cultural difference, a political and societal choice. Not a matter of disorganised healthcare.

[Alexander the Pretty Good]

Corporations are not free-market, as they take protection and privileges from the state.

[Crazed Rabbit]

Surely, (insurance for) litigation can not account for several percent of GDP? Litigation is rampant in the US, but it can not account for the huge gap in healthcare spending between the US and other developed nations. I need numbers. (We are in dire need of statisticians and number crunchers in this thread!)

I think malpractice insurance for one doctor can be in excess of $100,000 per year. So even if they never get sued, simply insuring against it can put them in dire finances.

Capitalism has two meanings. Free market, and putting the interests of corporations first. American families suffer because they believe that what is good for corporate America, is ultimately good for them. The medicinal-industrial complex knows otherwise.
Free markets are great, therefore corporations will do anything to destroy them. The federal government ought to resume control of the healthcare market and put better incentives into place. Currently, they work to the disadvantage of the people.

The Federal government very rarely helps the free market instead of corporations (see the latest tobacco bill, AKA The Phillip Morris Protection Act). Almost every time they put in a regulation it will help corporations and bind the free market. This is because 1) Politicians are dim witted morons who understand very little economics 2) They are eager to grab money for their districts, even at the expense of the nation 3) They are fond of giving privileges to special interests that support them.

There is probably a good deal the Feds could do to help simply by removing onerous restrictions, though I can't point out specifics.

I'd recommend reading the paper Hosakawa Tito linked to, as it shows the importance of allowing profits.

CR

[a completely inoffensive name]

It needs to be fixed.

[Adrian II]

Where does this story come from that 'people in Canada die on waiting lists' whereas this doesn't happen in the US? Can anyone show me where it says that in the US people don't die waiting for crucial treatments?

EDIT
Or any other country for that matter?

[Louis VI the Fat]

Where does this story come from that 'people in Canada die on waiting lists'

From a Canadian doctor who moved to Minneapolis because he can make obscene amounts of money there. He's now trying to convince the Americans that they mustn't adopt the Canadian healthcare system. Because, erm...the US system is good for the patients.

No, really, it is good for Americans.

Really.

[Adrian II]

From a Canadian doctor who moved to Minneapolis because he can make obscene amounts of money there. He's now trying to convince the Americans that they mustn't adopt the Canadian healthcare system. Because, erm...the US system is good for the patients.

No, really, it is good for Americans.

Really.

I see. So it comes from someone who practices social darwinism in the guise of medicine, a bit like our rory?

[Meneldil]

There's absolutely no valid reason to explain why members of the military have free healthcare and other people don't.
Breach of equity of the worst kind. Nationalism is definitely stupid.

[Husar]

There's absolutely no valid reason to explain why members of the military have free healthcare and other people don't.
Breach of equity of the worst kind. Nationalism is definitely stupid.

Why do you hate freedom?

[Alexander the Pretty Good]

But to say it's a breach of equity that the Military should offer me outstanding healthcare?

I believe Meneldil is saying it's a breach of equity that you need to sign up to bomb foreigners in order to get free state healthcare.

[Beskar]

My apologises to my earlier post. It was something I read some where and remembered it. I will however, post a proper source and proper results.

Best Healthcare in Rank according to the World Health Organization 2000 report.

1 France (Universal Healthcare Insurance System)
2 Italy (Universal Healthcare State-funded)
3 San Marino (Universal Healthcare State-Funded)
4 Andorra (Universal Healthcare Insurance System)
5 Malta (Universal Healthcare State-funded)
6 Singapore (Universal Healthcare Hybrid of Public and Private)
7 Spain (Universal Healthcare State-funded)
8 Oman
9 Austria (Universal Healthcare State-funded)
10 Japan (Universal Healtcare Insurance System)
...

37 United States of America (Does not have a Universal Healthcare System) (72nd by overall level of health)

[Alexander the Pretty Good]

I think it's the total opposite. You shouldn't look at it like it's state healthcare. It's not. It's employer-provided healthcare, subsidized by the government. The Army is a non-profit organization, after all.

Like welfare with more collateral damage.

Though then again, it certainly is for-profit for all the "defense" contracts we no-bid to people.

[Louis VI the Fat]

There's absolutely no valid reason to explain why members of the military have free healthcare and other people don't.

It strangely makes sense within the US system. Your employer pays your healthcare insurance. Great healthcare benefits are one of the perks of joining the military - together with education. Both not readily accessible to all in the US.

The system makes a person beholden to her employer for healthcare insurance. Power is the reverse of what it ought to be. To me, not corporations, but people ought to be the focus of society. Citizens should be free and healthy, at least, independent in access to healthcare. Then employers can bid for the services of these healthy, independent and free citizens - on their knees.

[Alexander the Pretty Good]

Nobody joins the Army on behalf of the Corporations that equip the military. Similarly, the military does not work for corporations. The Army works for the President. The President works for the people who elected them.

I really do appreciate the conspiracy theories, but the Army is hardly anything sinister. Uniformed opinions abound.

Technically the President works to get re-elected, which only sometimes coincides with the best interests of the people who elected him (which is only sometimes a slim majority of the people who pay the taxes that fund his military).

But regardless, the military is a state organization, and healthcare it provides is state healthcare. Hell, you have separate state hospitals if you'd prefer it.

Furthermore, what does it say about the military that recruitment goes up when the economy is bad? Maybe it's not all about "defending" America and apple pie...

[Crazed Rabbit]

Where does this story come from that 'people in Canada die on waiting lists' whereas this doesn't happen in the US? Can anyone show me where it says that in the US people don't die waiting for crucial treatments?

I don't think as many people die waiting for them - more may die because they can't pay for them. My point is that Canada's system is no great advantage over our current one.

CR

[Lemur]

I don't think as many people die waiting for them - more may die because they can't pay for them. My point is that Canada's system is no great advantage over our current one.

I think CR has hit on a very important distinction. My argument is as follows:

(1) The appetite for healthcare is infinite.
(2) No society can appease all healthcare needs and wants and survive.
(3) Therefore, rationing of some sort takes place in every market.

In our society, that rationing takes place in two ways: Either you are uninsured and must decide what you can afford, or you are insured badly, and must decide what level of bureaucratic hell you wish to endure.

Personally, I'd rather see the rationing hashed out in a more public way, but that's just me.

[Alexander the Pretty Good]

And since most don't see combat, it's a pretty sweet gig. Sure, you got to do the king's bidding for a few years, and it might be a bit unpleasant at times, but then you get the king's shilling...

[KukriKhan]

And since most don't see combat, it's a pretty sweet gig. Sure, you got to do the king's bidding for a few years, and it might be a bit unpleasant at times, but then you get the king's shilling...

Hahahahahahahahahahahaha!

:inhale:

Hahahahahahahahahahahahaha!

[Evil_Maniac From Mars]

There's absolutely no valid reason to explain why members of the military have free healthcare and other people don't.

Yes, there is, as I pointed out above. But it is like that almost everywhere - members of the military of Canada also get extra benefits of that nature.

[Alexander the Pretty Good]

Hahahahahahahahahahahaha!

:inhale:

Hahahahahahahahahahahahaha!

Oh come on. I could get an air force job no problem. If you've ducked the PBI, all you have to do is get through boot camp.

Mechanics still fix the crap we break, medics still fix the people we break, desk jockies still fix our paperwork problems...

So what's the big deal? You get better healthcare despite being comparable to civilian jobs.

[Alexander the Pretty Good]

How much better is the pay when you account .mil healthcare and all expenses paid world tours?

I assume that mechanic also gets combat theater bonuses as well?

[Alexander the Pretty Good]

Not my problem. None of you guys should be in theater because we don't have any reason to be there.

[Alexander the Pretty Good]

Can't make war without soldiers.

[Alexander the Pretty Good]

You joined an organization that hasn't made war to defend the United State since 1945.

[Alexander the Pretty Good]

Go to Bagdhad some time and ask your average citizen if he's happy to see us pulling out. That answer will almost universally be "No."

There's a difference between having wanted us to invade in '03 and wanting us to leave now. I'm sure the Iraqis agree whole-heartedly with the "you break it you bought it" line of thinking, as they are currently broken. But I don't know if they'd all say they wanted breaking in the first place.

I'm not saying our intentions are bad, at least on the part of the average servicemen and women. But the road to hell (and apparently financial ruin) are paved with good intentions, not to mention foreign civilians we've delivered high-explosive liberty to.