The U.S. Health Care Debate

[a completely inoffensive name]

Well there is no doubt that the USA has a very unique history compared to the rest of Europe, and this has had both direct effects in terms of things such as economic development, and the values society holds, whether it's the work ethic, the role of the government etc.

And in that sense, the USA is special. But I think that over time it has been becoming much more similar to European nations. It started out as a nation welcoming all the poor huddled masses to a land of opportunity, now people talk about keeping the ordinary American's job from the foreigners. It started out as a nation which aimed to isolate itself from the power politics, state oppression, and imperialism seen in Europe, and yet eventually it would become notorious for policing the world. It was originally a diverse nation of many different people's, then people decided you had to be a WASP and nowadays the cheesy patriotism displayed by many Americans is becoming more similar to the nationalism seen in Europe with all the nasty connotations it has.

The US still has much of it's unique character, but it's only a matter of time before it disappears.

People have been talking about keeping foreigners out since at least the 1840s. http://en.wikipedia.org/wiki/Know_nothing_party

Yes, the oppressed as now become the oppressors. I am very sad to have to acknowledge that. Before WW2 the US was implementing a non-intervention policy but now we have in many ways yet to turn off the Cold War mentality. But that will end eventually, probably within our lifetimes.

As for the cheesy nationalism, blame the 1980s with Reagan and the New Right coming to power.

EDIT: Oh as for that last sentence, I don't think it will disappear any more then France and Britain and Germany have lost their national identity. I mean is Europe more unified and homogeneous? Yes, but I can still tell with ease which country is which when I travel through them.

[Tribesman]

I guess when the U.S. was founded by religious outcasts who were sick of the way thing were done in England,

Good point , apart from the fact that the founding fathers of the US were not religious outcasts and came from just about every flavour of christianity, apart from those who considered themselves diests and those who were anti-religion

when we decided we wanted a fully Representative government controlled solely by the people

and they didn't want a fully representative government or represent all of the people.

Perhaps you mean the founding fathers of Jamestown who were from the established British church and went there to make money as a charter company....or perhaps you mean the religious zealots who ended up in Plymouth after they were having trouble keeping employed where they were welcome in Holland so decided to get together with another bunch of British merchants with a new charter to try and make money in a new colony...them ones really screwed up as they were among the minority and were seriously in debt to the other colonists

[Idaho]

I guess when the U.S. was founded by religious outcasts who were sick of the way thing were done in England, when we decided we wanted a fully Representative government controlled solely by the people with a balance of power between the branches instead of a monarchy with a unrepresentative Parliament, when we adopted attempted a policy of non intervention while Europe made alliances and began two world wars, when we tried several times and failed every time to accept and adopt the metric system and soccer don't count.

Well there is no doubt that the USA has a very unique history compared to the rest of Europe, and this has had both direct effects in terms of things such as economic development, and the values society holds, whether it's the work ethic, the role of the government etc.

I don't know what they teach you in your history classes - but this is a load of cobblers.

The US wasn't founded by religious outcasts. They didn't want a representative government. Non-intervention in the two world wars was a military and economic strategy, not a desire to be distant from the old world (although that was how it was sold to the public).

As for the US having a unique history - everywhere has a unique history. And the history of the US is inexorably bound up with Europe and Europeans. The work ethic is entirely 'Anglo-Saxon' and notions of the role of government are copied directly from the British.

[Crazed Rabbit]

Another must-read, this time from Foreign Policy Magazine: The Most Outrageous U.S. Lies About Global Healthcare.

Article fail:

CANADIANS HEAD TO THE UNITED STATES FOR URGENT CARE

The lie: Canada's government-run health care is so bad that needy patients need to pay for care in the United States.

Some Canadians do come to the US and pay for treatments that they'd have to wait much longer for in Canada. I'm right on the border, and read of occasional cases in the local paper. They come because they can't get the care they want in a timely manner in Canada. Canada's supreme court has found that people die on waiting lists for treatments. Far from 'the most outrageous lies'.

In the way of evidence for freer-market plans, I give you this report. A review of ten years of "Consumer driven health care plans" in the USA.

CDH plans typically combine a high-deductible insurance policy with a health savings account or health reimbursement account.
...
The primary indications are that properly designed CDH plans can produce significant (even substantial) savings without adversely affecting member health status. To the knowledge of the work group, no data-based study has emerged that presents a contrary view.

Apparently Tort reform won't get us where we want to be (but we should still reform it anyway).

I've read that Texas has some success with that, and I am not persuaded otherwise by this article;

The experience of Texas in capping damage awards is a good example. Contrary to Perry’s claims, a recent analysis by Atul Gawande in the New Yorker found that while Texas tort reforms led to a cap on pain-and-suffering awards at two hundred and fifty thousand dollars, which led to a dramatic decline in lawsuits, McAllen, Texas is one of the most expensive health care markets in the country.

One anecdote about a single expensive town contradicts the huge drop in lawsuits and lowering of insurance rates? (No, I did not read the whole 8 page article in the New Yorker)

CR

[Idaho]

Article fail:


Some Canadians do come to the US and pay for treatments that they'd have to wait much longer for in Canada. I'm right on the border, and read of occasional cases in the local paper. They come because they can't get the care they want in a timely manner in Canada. Canada's supreme court has found that people die on waiting lists for treatments. Far from 'the most outrageous lies'.

Of course people die on waiting lists. But people in the US die not on waiting lists nor with any hope of ever being on a waiting list.

[rvg]

Then what's the point? Death is death, dying while on a waiting list doesn't feel any better than dying without being on a waiting list.

[ICantSpellDawg]

What, seriously? That's just absurd, "We won't/can't do it because we're American".

Really? That's your answer?

I'm sorry Tuff, but that's just plain arrogant and hard-headed, and not true either.

Let me put it another way; Not everyone should be doing the exact same thing. Did you lobby Apple to adopt the exact same processor structure as average PC's? Do you believe that one way is always going to be better than another, or do you think that different laboratories should test using the exact same methods?

Why should the US adopt a system that we disagree with and that hasn't worked for us in the past just so that we can be like everyone else?

We go our own way because we should. We are going to find an acceptable alternative system to the one used in Canada and the UK and the world will be better for it. That isn't ego, it is just reality and agrees with our understandign of our past. The UK knows a thing or two about going their own way.


Varied testing ground is important

[Idaho]

Let me put it another way; Not everyone should be doing the exact same thing. Did you lobby Apple to adopt the exact same processor structure as average PC's? Do you believe that one way is always going to be better than another, or do you think that different laboratories should test using the exact same methods?

Why should the US adopt a system that we disagree with and that hasn't worked for us in the past just so that we can be like everyone else?

We go our own way because we should. We are going to find an acceptable alternative system to the one used in Canada and the UK and the world will be better for it. That isn't ego, it is just reality and agrees with our understandign of our past. The UK knows a thing or two about going their own way.


Varied testing ground is important

This sounds like the usual nonsense that american conservatives come up with. You think that American politics and philosophy reached perfection with Ronald Reagan and any change from that is a betrayal of the constitution.

[rory_20_uk]

And Apple do use the same CPUs and GPUs as other PCs. They gave up on the old ones as they were inefficient...

[Idaho]

And Apple do use the same CPUs and GPUs as other PCs. They gave up on the old ones as they were inefficient...

lulz

[Tribesman]

And Apple do use the same CPUs and GPUs as other PCs. They gave up on the old ones as they were inefficient...

Is that change we can believe in?

[ICantSpellDawg]

And Apple do use the same CPUs and GPUs as other PCs. They gave up on the old ones as they were inefficient...

I know they do - that was the point. It was cooler to have two structure competitors. Do you beleive that every computer should use Windows? I love windows, but variance is important.

[Centurion1]

This sounds like the usual nonsense that american conservatives come up with. You think that American politics and philosophy reached perfection with Ronald Reagan and any change from that is a betrayal of the constitution.

Yeah well that sounds like the typical refutation by liberals who do not have an actual answer but decide they would just rather bash a large group of people indiscriminately. Yeah the only way YOU could be any more stereotypical is if you had blamed George W. Bush.

[Crazed Rabbit]

Apparently in Michigan,

Hospitals in border cities, including Detroit, are forging lucrative arrangements with Canadian health agencies to provide care not widely available across the border.

Agreements between Detroit hospitals and the Ontario Ministry of Health and Long-Term Care for heart, imaging tests, bariatric and other services provide access to some services not immediately available in the province, said ministry spokesman David Jensen.

The agreements show how a country with a national care system -- a proposal not part of the health care changes under discussion in Congress -- copes with demand for care with U.S. partnerships, rather than building new facilities.

And then there's this story of a 15 year ordeal dealing with the NHS.

It was a simple thing. Another blood test, some more investigations into whatever flawed gene or missing protein might be the cause of my daughter's troubled life, with her terrible seizures, her blindness, her inability to walk or talk or eat unaided. Over the past 15 years, there have been many such attempts to identify her condition.

One year later, we asked the doctor, a top geneticist at one of the world's most famous hospitals, what had happened to the results. His office told us a rambling story about financial restrictions and the need to send such tests to a laboratory in Germany. They said there was little he could do but promised to pursue our case.

It was a bare-faced lie. The precious vial of blood had been dumped in storage and forgotten. The following day it was despatched to a laboratory in Wales and 40 days later the specialists came up trumps. They identified her condition, an obscure genetic mutation called CDKL5.

The breakthrough was rather mind-blowing, giving us some peace of mind and the chance to talk to families of the hundred or so other children worldwide identified with the condition. It was also life-changing, since it means our other child and close relatives are in no danger of passing on the condition. Indeed, had we known sooner we might have even tried for more children.

But the most shocking thing was not the lying. Nor even the incompetence. It was our total lack of surprise at the turn of events, since after 15 years suffering from the failings of the National Health Service we are prepared for almost any ineptitude.

CR

[Tribesman]

And then there's this story of

Whatever happened to....

Enough of this, Lemur. You're just posting anecdotes,

But hey apparently in Detriot....

"I go to the hospital in Windsor and two hours later, I'm done having angioplasty in Detroit," he said. His $38,000 bill was covered by the Ontario health ministry.

Wow the Canadian healthcare is so bad they actually pay for their people to have treatment.
I like that though , the hospital got 400 foriegn visitors, so its only slightly behind that Thai hospital that took in 50,000 US patients who found they could get better treatment by crossing to another continent entirely.

[Centurion1]

He is fighting fire with fire. Or unexplained stories with unexplained stories.

[ICantSpellDawg]

The United States clearly has a unique path and variation in planning is healthy. It is hour our Federalized system is supposed to work - with each state as a seperate laboratory trying out ideas to see if they work.

The United states is exceptional in many ways. Other countries are as well, but the US is the destination of choice for more people immigrants than any other nation.

For example: After 2000, immigration to the United States numbered approximately 1,000,000 per year
http://en.wikipedia.org/wiki/Immigra...tes_of_America

Our history and our future helps to make us different. To deny that the United States is particularly special in the modern age denies history and current fact. Additionally, to deny that the UK has a unique position is important in its own way as has had a disproportionate impact on history would be foolish.

We are special - deal with it.

[Beskar]

http://bluehampshire.com/diary/8028/...-of-teabaggery

This is the voice of those against universal health care.

[Husar]

The United States clearly has a unique path and variation in planning is healthy. It is hour our Federalized system is supposed to work - with each state as a seperate laboratory trying out ideas to see if they work.

So basically the US is built on the idea that people are guinea pigs?

[Xiahou]

http://bluehampshire.com/diary/8028/...-of-teabaggery

This is the voice of those against universal health care.

Don't forget that they hate blacks too. Guilt by association ftw.

[Philippus Flavius Homovallumus]

Then what's the point? Death is death, dying while on a waiting list doesn't feel any better than dying without being on a waiting list.

Easy, you might die on a waiting list, you will die without treatement. Also, treatment is rationed based on need, not wealth.

Let me put it another way; Not everyone should be doing the exact same thing. Did you lobby Apple to adopt the exact same processor structure as average PC's? Do you believe that one way is always going to be better than another, or do you think that different laboratories should test using the exact same methods?

Why should the US adopt a system that we disagree with and that hasn't worked for us in the past just so that we can be like everyone else?

We go our own way because we should. We are going to find an acceptable alternative system to the one used in Canada and the UK and the world will be better for it. That isn't ego, it is just reality and agrees with our understandign of our past. The UK knows a thing or two about going their own way.


Varied testing ground is important

Rubbish. We have a socialised system, and while not perfect, only 12% of our population bother with private health cover. That private cover is efficient, because otherwise people will just go with the cheaper NHS.

America is not that different from other nations, unless you want to claim not to be art of Western Civilisation, it is certainly not that different from countries like Canada or Australia; unless it wants to be.

Given the abysmal state of the "American" system you might consider swallowing your nationalistic pride and copying either us or the Frech, or the Swiss.

[Centurion1]

Or maybe we should stay with a private payer system and reform medicare and the like so that it is not such a freaking waste of taxpayers dollars.

[Ariovistus Maximus]

Easy, you might die on a waiting list, you will die without treatement. Also, treatment is rationed based on need, not wealth.

Woah, wait a minute there.

What determines "need" anyways? Eh... wealth.

Except in obvious cases of course.

And that is one problem that we have, is that we don't like gov't determining our needs, or the significance of our needs.

For instance, there was a kid in MN who was FORCED to take conventional cancer treatments. The kid and his parents wanted to use other methods, herbal and organic etc. A court foced him to take chemotherapy.

Creeps me out a little bit. Not so much the specific situation, but that a court can force me into medical decisions. What if the court started sending people it deemed "maladjusted" to "reeducation centers?" I just don't want to go that route.

[a completely inoffensive name]

Good point , apart from the fact that the founding fathers of the US were not religious outcasts and came from just about every flavour of christianity, apart from those who considered themselves diests and those who were anti-religion

Umm, yes by the late 1770s, people from all different religions were in the colonies by that time.
I am talking about the people who originally settled what would become the different colonies. There were many different religious groups who were not looked upon kindly in England, so yes there were a variety but outcasts they were nevertheless.

and they didn't want a fully representative government or represent all of the people.

Perhaps you mean the founding fathers of Jamestown who were from the established British church and went there to make money as a charter company....or perhaps you mean the religious zealots who ended up in Plymouth after they were having trouble keeping employed where they were welcome in Holland so decided to get together with another bunch of British merchants with a new charter to try and make money in a new colony...them ones really screwed up as they were among the minority and were seriously in debt to the other colonists

Umm, if we didn't want a fully representative government, why did we rebel against England in the first place?

"Founding fathers of Jamestown" oh I see, you are a little confused over terminology. See "Founding Fathers" don't mean original settlers in America. They refer to the leadership during the war and the creators of the Constitution.

The Jamestown people went there not for money but to make a new life for themselves. To pay the company for their services they had to pay them back with the resources they gathered once settled, which didn't even work out so well considering most settlements including Jamestown had to keep all their supplies and resources harvested just to survive.

The Plymouth people left Holland because it was a different culture and lifestyle then they were used to. It wasn't for money, it was because they were used to a more agrarian lifestyle in the countryside of England while Holland was a much more compact, urban, commerce driven country.

[Philippus Flavius Homovallumus]

Or maybe we should stay with a private payer system and reform medicare and the like so that it is not such a freaking waste of taxpayers dollars.

You tried that, it didn't work. France has a government garenteed system, not "Single-Payer" as you call it, their healthcare is the best in the world. Your own private system doesn't work because there is no cheap government alternative.

Woah, wait a minute there.

What determines "need" anyways? Eh... wealth.

In Britain need is determined by the severity of disease, there is a cap on the amount the NHS will pay for a drug, but it's £22,000. Even then, the cap is only usually enforced with regard to drugs for terminal conditions that extend life only by a few months.

[a completely inoffensive name]

I don't know what they teach you in your history classes - but this is a load of cobblers.

The US wasn't founded by religious outcasts. They didn't want a representative government. Non-intervention in the two world wars was a military and economic strategy, not a desire to be distant from the old world (although that was how it was sold to the public).

As for the US having a unique history - everywhere has a unique history. And the history of the US is inexorably bound up with Europe and Europeans. The work ethic is entirely 'Anglo-Saxon' and notions of the role of government are copied directly from the British.

Ok, well let me say how wonderful it is that a British guy knows more about our own history then us Americans who obviously have no clue over our own culture.

Not founded by religious outcasts: False. From the top of my head, Maryland was first settled by Catholics who were looked down upon in England.

Didn't want a representative government: False. We fought the British because we just wanted our voices heard in Parliament.

Non-intervention was military and economic strategy not a desire to be distant: Well, I don;t see how those are incompatible. The US certainly did not want to get involved and dragged into wars in Europe which would have drained our money and military unnecessarily, so the people had a desire to be distant so such a thing would not happen.

So your argument is that, since everyone has a unique history we should all disregard our history and just become homogeneous according to what the rest do?

Yes, the US and Europe is greatly tied to each other, no denying that.

"Notions of the role of government are copied directly from the British": British philosophers such as Hume and Locke, greatly influenced our government (there are a few key differences so that you can't say it was "directly" copied) but not from the British government.

[a completely inoffensive name]

America is not that different from other nations, unless you want to claim not to be art of Western Civilisation, it is certainly not that different from countries like Canada or Australia; unless it wants to be.

Given the abysmal state of the "American" system you might consider swallowing your nationalistic pride and copying either us or the Frech, or the Swiss.

YOU ARE JUST LIKE US, YOU ARE NO DIFFERENT AND YOU MUST DO WHAT WE DO OTHERWISE YOU ARE ALL FOOLS.

[Philippus Flavius Homovallumus]

YOU ARE JUST LIKE US, YOU ARE NO DIFFERENT AND YOU MUST DO WHAT WE DO OTHERWISE YOU ARE ALL FOOLS.

Well, we use your 5.56 caliber round for our rifles, and the same rotating bolt action as the M-16, that's because they're good.

Your healthcare is rubbish, ours is better, by almost every measure.

[LittleGrizzly]

YOU ARE JUST LIKE US, YOU ARE NO DIFFERENT AND YOU MUST DO WHAT WE DO OTHERWISE YOU ARE ALL FOOLS.

The same way some Americans try and encourage democracy across nations without democracy (or argue for it) we Europeans (or some of us) try and encourage universal health care across nations without it (or argue for it)

Its not a pride thing, or a calling you stupid thing. We just genuinely believe if you looked past all the propaganda and hype you would see it is clearly a better system...

[Beskar]

You should judge a society on the basis of its poorest people, not its richest.