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[AbortedWalrusFetus]

So, here's what I don't understand about the pro-UHC side. You acknowledge that the US healthcare costs are much much higher than the rest of the world, and that US Healthcare costs are double those of Canada, for instance, and you hold that up as an example of how universal healthcare is the better alternative. Now, it's been shown that only 10-15% of healthcare money spent in the US goes to the actual insurance companies profits/operation, and the rest goes to paying for the care. How does that 10-15% magically turn into the extra 85-95% difference between the US private care system and the Canadian public care system? I'll give you a hint, it doesn't.

Even if we grant that private insurance does cause an increase in costs, the only increase in costs you can pin on them is the money that either goes into running the companies or the profits of the companies, which we know is a very small percentage of your healthcare dollars. It stands to reason then that this small percentage can't be the cause of the very large change in the amount of money the US spends on healthcare, and in fact that change more likely comes from problems with the healthcare system itself, rather than who pays for the coverage.

 

[Monroeski]

So, here's what I don't understand about the pro-UHC side. You acknowledge that the US healthcare costs are much much higher than the rest of the world, and that US Healthcare costs are double those of Canada, for instance, and you hold that up as an example of how universal healthcare is the better alternative. Now, it's been shown that only 10-15% of healthcare money spent in the US goes to the actual insurance companies profits/operation, and the rest goes to paying for the care. How does that 10-15% magically turn into the extra 85-95% difference between the US private care system and the Canadian public care system? I'll give you a hint, it doesn't.

Even if we grant that private insurance does cause an increase in costs, the only increase in costs you can pin on them is the money that either goes into running the companies or the profits of the companies, which we know is a very small percentage of your healthcare dollars. It stands to reason then that this small percentage can't be the cause of the very large change in the amount of money the US spends on healthcare, and in fact that change more likely comes from problems with the healthcare system itself, rather than who pays for the coverage.

Not necessarily; there is also the cost to the healthcare facilities themselves, for instance, the full time staff they need to hire and the computer systems they must purchase to keep up with all the different insurance companies.

Still doesn't make up the whole cost difference, of course, but the insurance system has an effect much larger than just what is on the insurance company's financial statements.

 

[Giganticus]

1. A large chunk of the costs of care are administrative: US hospitals spend a lot more on administration in order to get paid for the work they do. Chasing up multiple insurers for multiple plans is very expensive. A lot of this administrative cost also goes into the insurers, who also need to manage all their customers, review each payment etc. It's estimated the US cost of administration amounts to around 30% of all payments, whereas most countries measure around 10%.

2. Removal of costs such as advertising: This isn't that large except when it comes to pharmaceutical companies for whom advertising and overhead = 50% of the drug cost.

3. Power of the Government to negotiate as a single payer: Essentially a massive government purchaser can easily say to the drug companies "we want a price reduction or we're not buying". This happens in a lot of UHC countries, such as the UK where prices of proprietary statins were heavily reduced when the NHS didn't like the prices and promised to only buy generic Simvastatin.

4. Focus on preventative medicine: Vaccines will reach 100% of the population, heavily reducing costs. People with minor injuries or infections or diseases in their early stages will be more likely to seek help before a condition becomes more expensive and difficult to treat. A UHC system could even implement dieting schemes for obese patients, or anti-smoking programmes for smokers, to reduce costs before a health condition arises. This can also be tied with advertising schemes such as safe-sex adverts to reduce STD transfers and/or education schemes in school to check for early signs of conditions such as testicular or breast cancer. A private insurer not only would have an extremely hard time convincing shareholders to implement such long-term cost-cutting measures, but most likely lacks the clout compared to the Government.

 

[AbortedWalrusFetus]

Not necessarily; there is also the cost to the healthcare facilities themselves, for instance, the full time staff they need to hire and the computer systems they must purchase to keep up with all the different insurance companies.

Still doesn't make up the whole cost difference, of course, but the insurance system has an effect much larger than just what is on the insurance company's financial statements.

I actually included those costs in the 10-15% figure. Even if the estimates I used to formulate it were low, it still wouldn't account for more than 20%, which still doesn't address the discrepancy.

1. A large chunk of the costs of care are administrative: US hospitals spend a lot more on administration in order to get paid for the work they do. Chasing up multiple insurers for multiple plans is very expensive. A lot of this administrative cost also goes into the insurers, who also need to manage all their customers, review each payment etc. It's estimated the US cost of administration amounts to around 30% of all payments, whereas most countries measure around 10%.

That 30% figure is absolute bullshit. No offense, but there's really nothing backing it up. Even the least conservative estimates out there pin it at 25% of all spending, not 30%. This also completely ignores the fact that a huge portion of these administrative costs come from the work needed to adhere to government compliance standards that are leveraged on insurance companies and hospitals. Steamlining compliance standards and record keeping guidelines will easily cut much of those costs, and by instituting a better standard for the companies to follow in order to reduce hospital administration will achieve the same effect, while taking the onus off of the tax payer and putting it on the businesses.

2. Removal of costs such as advertising: This isn't that large except when it comes to pharmaceutical companies for whom advertising and overhead = 50% of the drug cost.

And this cost would be completely replaced by public education programs and workshops needed to help people learn their benefits, announce new treatments, and understand their rights.

3. Power of the Government to negotiate as a single payer: Essentially a massive government purchaser can easily say to the drug companies "we want a price reduction or we're not buying". This happens in a lot of UHC countries, such as the UK where prices of proprietary statins were heavily reduced when the NHS didn't like the prices and promised to only buy generic Simvastatin.

And yet for all of the massive power that existing public health programs such as medicare or the Veterans Affairs administrations have has done absolutely nothing of the sort for this country. In fact, they tend to be less efficient at cutting out unnecessary treatments and costs than private insurers have.

4. Focus on preventative medicine: Vaccines will reach 100% of the population, heavily reducing costs. People with minor injuries or infections or diseases in their early stages will be more likely to seek help before a condition becomes more expensive and difficult to treat. A UHC system could even implement dieting schemes for obese patients, or anti-smoking programmes for smokers, to reduce costs before a health condition arises. This can also be tied with advertising schemes such as safe-sex adverts to reduce STD transfers and/or education schemes in school to check for early signs of conditions such as testicular or breast cancer. A private insurer not only would have an extremely hard time convincing shareholders to implement such long-term cost-cutting measures, but most likely lacks the clout compared to the Government.

And all of this has nothing to do with who is paying for the health care and everything to do with the cost of the healthcare. These programs could be easily set up with the current healthcare payment system we have, they just require the costs to be lowered and educational programs to be started. You say the government can institute things like safe-sex adverts, anti-drink or smoking campaigns, etc, but health insurers have far more flexibility in this. In fact they can take it step further by increasing the payments for people who have at risk behaviors, whereas the government can't without seeming to favor certain groups. Many health insurance companies will contact people to explain that they should get a mammogram or other sorts of treatment at certain times throughout their life as it currently stands. There's also no reason the government couldn't do this without a public healthcare system. Private insurance already requires that a patient be referred to any specialist before they will authorize payment to prevent unnecessary expense.

And all of that still doesn't do much to address the real problem which is not who is paying, but how high the costs are. You've cited a 30% increase in healthcare costs and the lack of government created healthcare programs that could exist anyway as the reason for the skyrocketing costs, but it's way off base.

Edit:
Here is something I wrote up in the poli-gaf thread off the top of my head that I feel would be far more effective than UHC:

1.) Make a concerted effort to reduce the incidence of Malpractice litigation. Malpractice suits in this country are rampant. The average person in the US is 3.5 times more likely to initiate a malpractice claim than in Canada. This is absolutely devastating to the state of the healthcare industry. Malpractice insurance costs have skyrocketed, and to cover their costs Doctors and hospitals have raised their rates in order to compensate with the high cost of malpractice insurance. However, it doesn't end there either. Because of the high costs of malpractice litigation it has led to an astronomical rise in what is referred to as "defensive medicine", meaning that healthcare providers will take more care in avoiding litigation from the patient than actually doing their best to heal a patient. Defensive medicine has lead to huge amounts of inefficiency in healthcare. It leads to Doctors that fear to take risks in patient care, opting not to perform some high risk procedures whatsoever, and it also leads to redundant, unnecessary, and wasteful testing and diagnosis procedures, usually so that a doctor can claim he or she did due diligence in avoiding a negative outcome for the patient.

2.) Focus on apportioning appropriate measures of care. It's a well known fact, for instance, that visiting an emergency room costs thousands of dollars more than visiting a general practitioner, and yet every day ERs are used in place of alternative means of diagnoses or treatment. This is particularly a problem with illegal immigrant populations and impoverished populations. Because ERs cannot turn down anyone that goes to them for care, the impoverished or illegal immigrants use them as their primary source of healthcare. It would be far more effective (as much as my true-blooded conservative nature says otherwise!) to set up more free or discounted clinics to deal with patients like these. There should be legislation made against redundancies in medical testing, and initiatives should be made to help communities better interact with their healthcare providers on a more personal level, which will have people focus on their health as a whole and lead to more preventive care.

3.) Study more intently the disparities between racial background and medicine. The US is in a unique position in the world as having one of the most ethnically diverse populations in the world. Studies have shown that, even when controlling for income, blacks have higher mortality rates than whites in this country. Studies into the causes of higher mortality between races, and better targeted medicine for afflictions that effect certain races more than others could drastically reduce the overall healthcare costs of the country.

4.) Reduces ancillary costs of insurance. Management costs of healthcare have continually risen despite the rise of technologies that can be used to alleviate these problems. The government has very high standards for record keeping, and the administrations of private healthcare insurers are often inefficient. The government could relax the standards on the healthcare industry, or perhaps a better alternative, encourage a restructuring of the administrations of healthcare providers and insurers, and encourage adoption of technology to solve the headaches of recordkeeping.

5.) Drive a harder bargain with medicare. The US Medicare programs have huge power over setting rates for treatment, and often the prices private insurance pays are directly tied to the prices negotiated by Medicare programs. Medicare should focus more on paying rates that reflect medical costs regionally instead of nationally, or the entire program should be dismantled in favor of regional programs. The government should use its power to strongarm the reduction of rates if such programs are going to continue exist, as well as punishing abuses of the system. Many hospitals or care homes will order unnecessary or redundant testing, or simply charge for portions of care that should otherwise be included. Since the government healthcare programs are so large it's very difficult to track this sort of behavior, but more effort in doing so will lead to reduces costs of the programs, and the programs can then be expanded to cover more people.

 

[Clockwork]

I actually included those costs in the 10-15% figure. Even if the estimates I used to formulate it were low, it still wouldn't account for more than 20%, which still doesn't address the discrepancy.

Your numbers are in line for the most part with the report I posted a page or two back.

I enjoyed your post. Instead of misplacing blame, you offered solid and constructive solutions to the true problems at hand.

 

[Kinitari]

I hope no one thinks that the Canadian healthcare system is perfect. It is good, it has it's merits, but it has its problems as well. I think a lot of them can be solved by encouraging people to become doctors, or encouraging doctors from other places to come here (after we ensure they meet the standards of our country). But that's mostly it - it needs work but it's not a hell hole.

Also - taxes aren't as ridiculous as people might think they are, especially when you take into consideration tax returns/breaks.

 

[Monroeski]

I actually included those costs in the 10-15% figure. Even if the estimates I used to formulate it were low, it still wouldn't account for more than 20%, which still doesn't address the discrepancy.

Well, you first stated that

10-15% of healthcare money spent in the US goes to the actual insurance companies profits/operation

Which is different than what I'm talking about. Did you just mislabel it in the first post?

 

[AbortedWalrusFetus]

Well, you first stated that


Which is different than what I'm talking about. Did you just mislabel it in the first post?

I was lumping the extra cost to health care providers in with that, actually, I just didn't label it clearly.

Your numbers are in line for the most part with the report I posted a page or two back.

I enjoyed your post. Instead of misplacing blame, you offered solid and constructive solutions to the true problems at hand.

Thanks. My mother is a nurse and she worked for years in a position called RNAC for a large nursing home before she became disabled and couldn't work. Basically she was in charge of doing all of the paperwork associated with getting the bills paid and making sure all of the documentation was there. While she was doing it she was constantly pointing out the fact that the place usually made most of its money by nickel and diming the medicare programs for everything they absolutely could, and she actually spent far more time dealing with the administration for medicare/medicaid than she did with private insurers. It's anecdotal, so I don't really point to it often, but I think people overlook things like that.

If there's one message I'm trying to get across about this whole healthcare debate is that it does not matter one whit who pays the bills when there's an even more gargantuan problem with the skyrocketing costs of the actual care being given. We need to fix the big problem first, and it will probably fix that other smaller problem in the process.

 

[ronito]

If there's one message I'm trying to get across about this whole healthcare debate is that it does not matter one whit who pays the bills when there's an even more gargantuan problem with the skyrocketing costs of the actual care being given. We need to fix the big problem first, and it will probably fix that other smaller problem in the process.

Sometimes I think we'll never ever agree. I mean you even like Sakimoto. But sometimes I could just kiss you man.

 

[besada]

I'm identifying the root cause of the problem you're describing, and advocating its removal.

I've pointed out why I feel that its removal is the best and most direct resolution for the problem you're describing.

That's great. It also has no bearing on the actual conversation we're having, because it's not going to happen -- and you know that. The 1986 Patient Dumping laws aren't going to be repealed, because the majority of Americans don't want them repealed. Proceeding with an argument based on their repeal is a fantasy argument. It's equivalent to me proposing a solution based on having health care as a recognized right in the Constitution -- I'd love it if it were, but it's not, so making an argument based on it is naive at best, and disingenuous at worst.

Both are contingent upon something that's not going to happen. Both address an argument attached to a fantasy landscape that simply doesn't exist.

I know you've spent so long delineating your Platonic ideal of America that you've lost sight of the world you actually live in, but if the only arguments you have are contingent upon obliterating years of existing law, you're not actually proposing anything real and you're wasting everyone's time.

 

[Giganticus]

That 30% figure is absolute bullshit. No offense, but there's really nothing backing it up. Even the least conservative estimates out there pin it at 25% of all spending, not 30%. This also completely ignores the fact that a huge portion of these administrative costs come from the work needed to adhere to government compliance standards that are leveraged on insurance companies and hospitals. Steamlining compliance standards and record keeping guidelines will easily cut much of those costs, and by instituting a better standard for the companies to follow in order to reduce hospital administration will achieve the same effect, while taking the onus off of the tax payer and putting it on the businesses.

My numbers are never bullshit. Administrative costs are triple of what they are in canada, and account for 31% of healthcare spending.

Also the comment that these costs are due to "big gummint" regulations is ridiculous. Any country with a National Healthcare System has far more government regulations on standards as they are government facilities, compared to a US system that is far more deregulated. Even the EU countries that have non-government public insurance schemes have far lower costs, and yet usually have so much regulation that insurance companies and hospitals are practically non-profits.

And this cost would be completely replaced by public education programs and workshops needed to help people learn their benefits, announce new treatments, and understand their rights.

If you really think the Government's going to start doing PSAs during the superbowl halftime commercial break just like the pharmaceuticals do right now, then yes, it would be. If however you live in reality and realise the Government doesn't spend that kind of ridiculous money on advertising and in fact would never need to, then no, you're wrong

And yet for all of the massive power that existing public health programs such as medicare or the Veterans Affairs administrations have has done absolutely nothing of the sort for this country. In fact, they tend to be less efficient at cutting out unnecessary treatments and costs than private insurers have.

Because Medicare is legally restricted from negotiating drug prices. Not to mention legislation like the Medicare Modernisation Act (a few pages in) have hamstrung the efforts to reduce costs. Of course, it looks like this could change

However the VA is allowed to negotiate, and usually ends up with around 50% savings

The analysis also found that the VA prices were 54 percent lower than “full-cost” prices under Part D plans. The average per drug VA price for the six drugs surveyed was $22.06 per drug; the average “full-cost” price under the Medicare Part D plans in Broward County was $48.38. Full-cost price refers to that paid by beneficiaries who fall into the “doughnut hole” coverage gap.

More proof that a non-hamstrung public option reduces costs for all.

And all of this has nothing to do with who is paying for the health care and everything to do with the cost of the healthcare. These programs could be easily set up with the current healthcare payment system we have, they just require the costs to be lowered and educational programs to be started. You say the government can institute things like safe-sex adverts, anti-drink or smoking campaigns, etc, but health insurers have far more flexibility in this. In fact they can take it step further by increasing the payments for people who have at risk behaviors, whereas the government can't without seeming to favor certain groups. Many health insurance companies will contact people to explain that they should get a mammogram or other sorts of treatment at certain times throughout their life as it currently stands. There's also no reason the government couldn't do this without a public healthcare system. Private insurance already requires that a patient be referred to any specialist before they will authorize payment to prevent unnecessary expense.

You know what's even cheaper for an Insurance company? Doing absolutely fuck all with regards to preventative care and then refusing treatment when the condition becomes serious. The Government is forced to have the public interest at heart whereas an Insurer is just going for profit. Denial of care is an option for insurers, not the Government. You're right that the Insurers could have even more flexibility than the Government - though it would be much harder to run larger awareness programs and programs like "free condoms" are far more susceptible to Christian rightist pressure when run by a private institute - but they also have the flexibility to not give a shit. That's the main problem with the US system.

And all of that still doesn't do much to address the real problem which is not who is paying, but how high the costs are. You've cited a 30% increase in healthcare costs and the lack of government created healthcare programs that could exist anyway as the reason for the skyrocketing costs, but it's way off base.

Generally, it's profiteering. If the VA can negotiate 50% off a treatment, then the company producing the drug can clearly run at 50% cost still remaining at a profit. A 30% Admin cost reduced to 10% admin cost would make massive savings. With the clout of the Government, and the efficiency of a single payer system, you're looking at massive savings before you're even figuring in the focus on preventative care.

Idea stuff

I've addressed most of this already, mainly Medicare negotiation. As for ancillary costs, the Government is actually one of the more efficient bureaucracies that can exist, and is motivated to reducing costs no matter who is in charge (whereas insurance managers might prefer to keep their make-work posts).

Racial disparities mean fuck all to cost, but they are a concern for all public healthcare systems. Focusing diabetes tests on certain ethnicities has shown great success, and so forth. Of course, a private insurance based system could be possibly motivated to simply drop care for "at risk" ethnicities, if it weren't for regulation.

Now, for malpractice. I work with Gynaecologists and Obstetricians. This section of healthcare has the highest liability insurance costs so I get to hear about how terrible malpractice suits are. Costs amount to around £30k a year. I'm serious. But what's odd is the NHS is rarely sued directly (although it sometimes is). The reason is that the institution itself is rarely at fault, whereas the doctor might be.

So why are institutions in the US sued so frequently? Could it be a sue-happy culture (i'd imagine that's a part of it). But I bet the real reason is quite simply administrative incompetence. Take all the anecdotal stories in the US from patients who get shuffled from department to department to receive treatments they don't need or have to wait on a bed while an insurer approves an MRI or an X-ray for a broken wrist or something. Take all the horrific emergency room experiences from people stuck at the back of the line while uninsured people are waiting for the only healthcare they can receive. Take all the stories of people who "downgrade" their treatment as the insurance wont cover the better options and so die after treatment, or the people who get dumped onto other hospitals as that hospital isn't covered by that insurance plan or whatever. Most of this bullshit goes away with a public system.

But of course the AMA will push for malpractice regulation, after all it will reduce their personal premiums. The reality is, a public system would massively reduce malpractice costs on institutions while still clearing out bad doctors.

Also malpractice is a tiny cost to healthcare, fyi. read up before talking

 

[ItAintEasyBeinCheesy]

Another awesome reason to live in Australia! i been driven round in Ambulances got Airlifted in a helicopter spent about a week in hospital...... for free, was awesome.

 

[YYZ]

Australia is pretty awesome for a lot of reasons, but they need to stop their censorship craze and shitty internet access.

 

[hockeypuck]

Here is something I wrote up in the poli-gaf thread off the top of my head that I feel would be far more effective than UHC:

1.) Make a concerted effort to reduce the incidence of Malpractice litigation. Malpractice suits in this country are rampant. The average person in the US is 3.5 times more likely to initiate a malpractice claim than in Canada. This is absolutely devastating to the state of the healthcare industry. Malpractice insurance costs have skyrocketed, and to cover their costs Doctors and hospitals have raised their rates in order to compensate with the high cost of malpractice insurance. However, it doesn't end there either. Because of the high costs of malpractice litigation it has led to an astronomical rise in what is referred to as "defensive medicine", meaning that healthcare providers will take more care in avoiding litigation from the patient than actually doing their best to heal a patient. Defensive medicine has lead to huge amounts of inefficiency in healthcare. It leads to Doctors that fear to take risks in patient care, opting not to perform some high risk procedures whatsoever, and it also leads to redundant, unnecessary, and wasteful testing and diagnosis procedures, usually so that a doctor can claim he or she did due diligence in avoiding a negative outcome for the patient.

2.) Focus on apportioning appropriate measures of care. It's a well known fact, for instance, that visiting an emergency room costs thousands of dollars more than visiting a general practitioner, and yet every day ERs are used in place of alternative means of diagnoses or treatment. This is particularly a problem with illegal immigrant populations and impoverished populations. Because ERs cannot turn down anyone that goes to them for care, the impoverished or illegal immigrants use them as their primary source of healthcare. It would be far more effective (as much as my true-blooded conservative nature says otherwise!) to set up more free or discounted clinics to deal with patients like these. There should be legislation made against redundancies in medical testing, and initiatives should be made to help communities better interact with their healthcare providers on a more personal level, which will have people focus on their health as a whole and lead to more preventive care.

3.) Study more intently the disparities between racial background and medicine. The US is in a unique position in the world as having one of the most ethnically diverse populations in the world. Studies have shown that, even when controlling for income, blacks have higher mortality rates than whites in this country. Studies into the causes of higher mortality between races, and better targeted medicine for afflictions that effect certain races more than others could drastically reduce the overall healthcare costs of the country.

4.) Reduces ancillary costs of insurance. Management costs of healthcare have continually risen despite the rise of technologies that can be used to alleviate these problems. The government has very high standards for record keeping, and the administrations of private healthcare insurers are often inefficient. The government could relax the standards on the healthcare industry, or perhaps a better alternative, encourage a restructuring of the administrations of healthcare providers and insurers, and encourage adoption of technology to solve the headaches of recordkeeping.

5.) Drive a harder bargain with medicare. The US Medicare programs have huge power over setting rates for treatment, and often the prices private insurance pays are directly tied to the prices negotiated by Medicare programs. Medicare should focus more on paying rates that reflect medical costs regionally instead of nationally, or the entire program should be dismantled in favor of regional programs. The government should use its power to strongarm the reduction of rates if such programs are going to continue exist, as well as punishing abuses of the system. Many hospitals or care homes will order unnecessary or redundant testing, or simply charge for portions of care that should otherwise be included. Since the government healthcare programs are so large it's very difficult to track this sort of behavior, but more effort in doing so will lead to reduces costs of the programs, and the programs can then be expanded to cover more people.

You've brought up interesting ideas about solving the U.S. health care crisis. What's funny is that everything I've bolded would actually be more feasible with UHC, with exception to the last phrase I bolded.

-The larger federal government can institute a nation-wide litigation cap that standardizes interpretation of malpractice and would reduce the number of extraneous lawsuits.

-A centralized computer system makes it MUCH easier to catch redundancy testing. No one is paying a third-party to catch redundant tests ordered between two health insurances. You also mention preventive care, which has been unequivocally more effectively implemented in UHC countries because the message is singularly clear and gets to EVERYONE.

-The disparities between racial backgrounds and medicine are better studied under a standardized database. This is why the VA system can put out study after study about outcomes amongst different ethnicities across all states.

-You said it yourself, the government (specifically the VA) has excellent standards of record-keeping. I know from first-hand experience. This allows errors to be caught and appropriate action taken. This is why there is the occasional scandal at VA hospitals; well-kept records allowed the discovery to occur in the first place and thus less cover-up is possible. And you still say that who pays the bill doesn't really matter?

-The government would have even greater power to "strongarm the reduction of rates" if every American was under a UHC system and thus the only American customer available to these pharmaceuticals.

-Finally, the last bolded phrase: Because of a centralized, standardized record-keeping system, abuse behavior is EASIER to track, not more difficult. This is why Medicare expenditures are used to calculate how cost-effective all healthcare facilities are in the U.S. Now, if we could only apply this to all insured Americans, and not just those with Medicare, then we would catch even more inefficient behavior. But you can't do that amongst private insurers across different states.

And you still say that who pays the bill doesn't really matter? So many of your solutions are actually being done in other countries BECAUSE of UHC, not in spite of it.

Edit:

Thanks. My mother is a nurse and she worked for years in a position called RNAC for a large nursing home before she became disabled and couldn't work. Basically she was in charge of doing all of the paperwork associated with getting the bills paid and making sure all of the documentation was there.

You don't see the irony in that statement?

With all due respect, what is a shame here is that your mother, a professional health-care provider, was relegated to sorting out billing paperwork, something not directly related to improving patient outcome.

 

[HaL64]

Lying? Possibly mistaken?
I wasn't saying the American system was good first of all. Obviously it is not.

The 55-60% was based on what other people at my place of employment were telling me (maybe they were exaggerated horror stories). I got serious tax breaks for being American and got most of it back at the end of the year so I had nothing to complain about. Actually eventually I got them to not take it out of my paycheck at all, then my tax rate was minuscule.
Also this was over 5 years ago... so maybe things have changed but I doubt it.
I could have sworn mine was at least 45%. Maybe I did make too much money. Or maybe I was factoring in the other things in like sales tax.
Anyway any time someone brings up that movie and how great socialized medicine would be I can't help but think of my actual experience there. I was just trying to relay my experience as someone who was used to American health care and had to deal with socialized medicine first hand. Rather than taking a movie's claims at face value.
Every time I hear an American talk about socialized medicine and how the country needs it, I think about how I used to think that as well before experiencing it first hand and realizing the grass on the other side wasn't exactly greener. I wouldn't pay 2% tax for the quality of health care I got. Actually once I saw a doctor it was great.
It was the waiting to see a doctor and the realization of how much money is being flushed down the toilet because of people not taking care of themselves and tons of people abusing the "free" system.

OK now I know you're lieing.

Income tax rate in Quebec (which has the highest tax rate of all provinces) is 33.04% if you are making $100000 a year which is more than most people. There is many tax breaks also, school/transit/savings/kids, the average person can expect to reduce their income tax by 5-20% of the amount.

So let's say it's on the low end and you have no kids but you up away a bit of money in RRSP and take public transit, that's a 30% income tax.

Now let's take an average pay: $50000. That's a tax rate of 24.62%. So around 22% after the tax breaks.

Now I live in BC, tax rate at $50,000 is 18%, so around 16-17% after tax breaks.

Oh wait, I figured out how you could be taxed 50%, you make over a $1,000,000 a year and do 0 savings, have 0 kids, don't use transit, don't give to charities, don't expend anything for work, no gst credits, or any of the other 100's of tax breaks.

So in the end, I call FUCKING LIAR! This people is why the US doesn't have UHC, liars shouting off propaganda to make the American system look good.

 

[xabre]

Every time I hear an American talk about socialized medicine and how the country needs it, I think about how I used to think that as well before experiencing it first hand and realizing the grass on the other side wasn't exactly greener. I wouldn't pay 2% tax for the quality of health care I got. Actually once I saw a doctor it was great.
It was the waiting to see a doctor and the realization of how much money is being flushed down the toilet because of people not taking care of themselves and tons of people abusing the "free" system.

So you dismiss UHC on the basis of one experience while many people on this forum actually live in countries with UHC, and are often in these sorts of threads recommending it (including myself), and you think your opinion is on the level of ours? Righto.

Who on earth would ever say any health system is perfect anyway? The Australian system certainly isn't, neither is the British system and I'm sure you could even say the same thing about the holy grail that is France. The thing is though that proponents of UHC will usually say the American system is broken and inferior to the systems in other developed nations because of the many millions going without coverage and the absurd financial strain of medical costs forcing Americans into foreclosure, bankruptcy and worse. This does not happen in other western countries with UHC, it just doesn't. If that simple little fact doesn't filter into your brain and make you realise that the American system needs to be brought in line with the systems used in other countries then you really are a complete twat. Americans deserve the same quality health coverage as anyone else in the world, and it's really fucked that many don't, and that's due in many respects to people like you sadly.

 

[Gattsu25]

Back when my little sister was around 6 she had a temperature of 105F and my mother and I took her to the emergency room late at night. This is at a local hospital in Florida. We got there at near 11PM at night and it wasn't until after 5 in the morning when they took my sister in to check up on her. In the end, they gave her a penicillin prescription and a lolipop.

64, you must live in some rosy area of the US because you've had nothing except for positive experiences. I've been to the ER twice, for issues concerning myself, and both times I was left to wait for hours before something went wrong (the first time (Queens, NY) they only took me in when I had stopped breathing and the second (Bayshore, NY) only when I had fainted from blood loss).


An outlying case (similar to your Canadian health care story) is regarding my brother. My brother had stage 4 cancer; his employer of 10 years had terminated him over a month before they had notified him (yet remembered to contact the insurance company on the day of) and my brother's insurance company (blue cross blue shield) informed him that his last chemo treatment and hospital stay had been while he was uninsured--demanding over $9,000 dollars from him. The hospital staff (Cancer Treatment Center in Philadelphia) had never heard of anything like that before, so I'm not claiming it's a common occurrence, but it could have cost my brother his life. My brother's ex-employer was kind enough to give him under two weeks (thanks to the late termination notice) to request, fill out, hand in, and have processed the paperwork needed to cash in on his company's stock options and he used this money to pay off his insurance tab...but until he was informed that the paperwork was processed in time we were considering bankruptcy. When his cobra coverage kicked in, he resumed his treatment and thankfully his situation did not worsen.

Hell, maybe it's the other way around. Maybe 3 hour+ wait times really are uncommon in this country, despite news reports to the contrary. Maybe every insured american on this forum that bemoans the state of this country's health care system have it wrong..because, let's face it...you obviously have no qualms.

 

[Chinner]

PBS conducted a good discussion on UHC in America. It's 20 minutes + but its very interesting:
http://www.pbs.org/moyers/journal/05222009/watch2.html

 

[AndrewG009]

I'm now waiting for a thread having to do with US health care system being fixed thanks to GAF.

 

[itsinmyveins]

PBS conducted a good discussion on UHC in America. It's 20 minutes + but its very interesting:
http://www.pbs.org/moyers/journal/05222009/watch2.html

I'm watching it now and yeah, it's kinda interesting.

 

[Hari Seldon]

i been driven round in Ambulances got Airlifted in a helicopter spent about a week in hospital...... for free, was awesome.

LOL that doesn't sound very awesome. :lol

 

[dave is ok]

LOL that doesn't sound very awesome. :lol

The free part is awesome

 

[Sleeker]

Im gonna rent Sicko next time I'm at the video store.
or maybe buy it online

 

[itsinmyveins]

So, why do people dislike UHC, or rather; Why would anyone in their right mind argue that the current system--with insurance companies--is better?

 

[WickedAngel]

So, why do people dislike UHC, or rather; Why would anyone in their right mind argue that the current system--with insurance companies--is better?

Decades worth of fear-mongering and propaganda have taken their toll on many.

 

[Chinner]

Decades worth of fear-mongering and propaganda have taken their toll on many.

heh

 

[itsinmyveins]

Decades worth of fear-mongering and propaganda have taken their toll on many.

I'm sure that's apart of it, but according to that PBS-discussion very few trust insurance companies (and rightly so I guess). Even with that old fear mongering you'd think the actual situation at hand would be enough to make people realize that there should be better options.

 

[WickedAngel]

I'm sure that's apart of it, but according to that PBS-discussion very few trust insurance companies (and rightly so I guess). Even with that old fear mongering you'd think the actual situation at hand would be enough to make people realize that there should be better options.

People might not trust insurance companies but even more are terrified of "big guv'ment". It's funny in a way...people are so used to getting fucked by corporations that it doesn't even register as deception any longer.

 

[dave is ok]

Conservatives just have this crazy idea that everything is better handled through the private sector. Even their health

 

[Instigator]

Why would anyone in their right mind argue that the current system--with insurance companies--is better?

3 reasons:

General idiocy. Plenty of examples earlier in this thread.

Slippery slope-type arguments. If you let the government take over this part, then you'll surely let them take over that part. And then that part. And that part.

And pride. Many Americans haven't left the Cold War behind, as if Krutchev and Kennedy are stil in charge and fighting to prove which one has the best ideology/system.

 

[gutter_trash]

I love the civility of discussions on Bill Moyers on PBS.. nothing like the WWE partisan hackery on mainstream media on cable.

refreshing hearing an intelligent conversation

Tommy Douglas FTW

 

[BigGreenMat]

PBS conducted a good discussion on UHC in America. It's 20 minutes + but its very interesting:
http://www.pbs.org/moyers/journal/05222009/watch2.html

On a similar note. I think EVERYONE in this thread needs to watch or rewatch PBS' amazing Frontlines on both being Sick Around the World and being Sick Around America. Much less sensationalist than Sicko and yet even more freaking disturbing. The plain and simple fact is the American system doesn't work and we have to stop it NOW. Like it was said earlier it doesn't have to be an overnight thing, but it has to happen now.

 

[Chinner]

I'm sure that's apart of it, but according to that PBS-discussion very few trust insurance companies (and rightly so I guess). Even with that old fear mongering you'd think the actual situation at hand would be enough to make people realize that there should be better options.

 

[RiskyChris]

So, why do people dislike UHC, or rather; Why would anyone in their right mind argue that the current system--with insurance companies--is better?

I just freakin' love it when people without health insurance argue for this too!

 

[Zaptruder]

PBS conducted a good discussion on UHC in America. It's 20 minutes + but its very interesting:
http://www.pbs.org/moyers/journal/05222009/watch2.html

Even though I'm not american, I'm watching this and getting really angry.

Like pausing the video every minute or two, just because the gravity of evidence against the systemic corruption in the American system is so overwhelming. AND YET THEY STILL GET AWAY WITH IT! AT THE COST, LITERALLY OF THE LIVES AND WELLBEING OF THEIR OWN COUNTRYMEN*!

*who to me are just people, but hey, that's how I roll.

 

[NetMapel]

I just freakin' love it when people without health insurance argue for this too!

The better question should be why your health should be depended on insurance when it is a basic right deserved by everybody.

 

[itsinmyveins]

The better question should be why your health should be depended on insurance when it is a basic right deserved by everybody.

And yet you see people who argue that health care isn't a right but a government run police force is. Shit like that just boggles my mind.

 

[AbortedWalrusFetus]

My numbers are never bullshit. Administrative costs are triple of what they are in canada, and account for 31% of healthcare spending.

Right, you're quoting a figure from a pro-UHC lobbying group. There's absolutely no conflict of interest there.

Also the comment that these costs are due to "big gummint" regulations is ridiculous. Any country with a National Healthcare System has far more government regulations on standards as they are government facilities, compared to a US system that is far more deregulated. Even the EU countries that have non-government public insurance schemes have far lower costs, and yet usually have so much regulation that insurance companies and hospitals are practically non-profits.

I said that administration costs include costs of government regulations. I didn't say these costs were all because of government regulations anyway. This is pretty much a straw man. Regulations add costs, it's as simple as that, and the fact that we have regulations means we have added costs. If anything you're proving my point for me. We have administrative costs and public healthcare programs have administrative costs. That means we can write those costs off as a factor that would cause the healthcare cost disparity. As I said in my suggestions, we need to do what we can to streamline these requirements to reduce these costs. It really has nothing to do with who does the paperwork, and everything to do with how much paperwork there is. It doesn't magically cost a company more to hire clerks than it does for the government.

If you really think the Government's going to start doing PSAs during the superbowl halftime commercial break just like the pharmaceuticals do right now, then yes, it would be. If however you live in reality and realise the Government doesn't spend that kind of ridiculous money on advertising and in fact would never need to, then no, you're wrong

And once again you're confusing healthcare providers (IE, Hospitals, Doctors, Surgeons, Nurses) with the people that pay the bills. Last I checked there weren't even really all that many commercials by private health insurance firms, and certainly no more than what would be necessary to spread knowledge about a public healthcare option. This is a non-issue.

Because Medicare is legally restricted from negotiating drug prices. Not to mention legislation like the Medicare Modernisation Act (a few pages in) have hamstrung the efforts to reduce costs. Of course, it looks like this could change

However the VA is allowed to negotiate, and usually ends up with around 50% savings

More proof that a non-hamstrung public option reduces costs for all.

The VA may be able to negotiate costs, but it also suffers from lack of adequate care according to most veterans. Now, private insurance companies also base the prices they pay for medical fees around the prices that medicare/medicaid pay. Without creating a new plan whatsoever but by reforming medicare we'll already grant any advantage this gives to the private system.

You know what's even cheaper for an Insurance company? Doing absolutely fuck all with regards to preventative care and then refusing treatment when the condition becomes serious. The Government is forced to have the public interest at heart whereas an Insurer is just going for profit. Denial of care is an option for insurers, not the Government. You're right that the Insurers could have even more flexibility than the Government - though it would be much harder to run larger awareness programs and programs like "free condoms" are far more susceptible to Christian rightist pressure when run by a private institute - but they also have the flexibility to not give a shit. That's the main problem with the US system.

An insurance company can't legally refuse treatment for a condition if it was covered by the original healthcare agreement, and as much as we want to demonize them they typically don't behave like this. We already have a system in place to prevent this sort of thing as it stands, and with new regulation saying that people cannot be turned down due to pre-existing conditions this whole point of your argument is a farce. There are ethical codes these companies abide by, and where the ethical codes aren't sufficient there are typically regulations to prevent negative behaviors. The fact of the matter is that preventive medicine is in the interests of a healthcare insurer because it ensures future profits. Governments however are concerned with meeting budgets, and as we've often seen in the past they will cut funding in the present to meet budgets regardless of what impact it has in the future. Governments are fairly short-sighted in this way.

Racial disparities mean fuck all to cost, but they are a concern for all public healthcare systems. Focusing diabetes tests on certain ethnicities has shown great success, and so forth. Of course, a private insurance based system could be possibly motivated to simply drop care for "at risk" ethnicities, if it weren't for regulation.

Any type of care disparity that comes to light will help steer appropriate measures of medicine leading to gains in both preventive medicine or the effectiveness of treatment. But this is another case of a suggestion that has nothing to do with the insurance industry. This is part of the healthcare industry and cutting its costs, and could be done whether or not private insurers or public funds pay the bills.

Now, for malpractice. I work with Gynaecologists and Obstetricians. This section of healthcare has the highest liability insurance costs so I get to hear about how terrible malpractice suits are. Costs amount to around £30k a year. I'm serious. But what's odd is the NHS is rarely sued directly (although it sometimes is). The reason is that the institution itself is rarely at fault, whereas the doctor might be.

So why are institutions in the US sued so frequently? Could it be a sue-happy culture (i'd imagine that's a part of it). But I bet the real reason is quite simply administrative incompetence. Take all the anecdotal stories in the US from patients who get shuffled from department to department to receive treatments they don't need or have to wait on a bed while an insurer approves an MRI or an X-ray for a broken wrist or something. Take all the horrific emergency room experiences from people stuck at the back of the line while uninsured people are waiting for the only healthcare they can receive. Take all the stories of people who "downgrade" their treatment as the insurance wont cover the better options and so die after treatment, or the people who get dumped onto other hospitals as that hospital isn't covered by that insurance plan or whatever. Most of this bullshit goes away with a public system.

There are so many instances of it in this country because it was easy to make a lot of money doing it. Unfortunately it has huge reprocussions. As I already addressed, most of this shuffling and unnecessary treatment that you speak of comes from defensive medicine caused by the prevalence of malpractice cases. A federally mandated cap on the payouts of malpractice suits would reduce this sort of thing drastically. It already has in individual states that have adopted the legislation.

As far as the "downgrading" of treatment, I almost find it humorous that you point to this as unique to private health insurance when it's just as rampant in the public health insurance system. The public health systems across the world constantly pick and choose treatments they feel are unnecessary or overly costly.

But of course the AMA will push for malpractice regulation, after all it will reduce their personal premiums. The reality is, a public system would massively reduce malpractice costs on institutions while still clearing out bad doctors.

Also malpractice is a tiny cost to healthcare, fyi. read up before talking

A public system wouldn't do anything to reduce malpractice costs if it did nothing to address the reason the cases happen in general. Again, the person who pays for the healthcare has little bearing on how the healthcare is run. In this country less than 1/3 of hospitals are publicly owned or run, which means changes in how they are run have little effect on the overall costs of the country. What is needed is regulation on the overall healthcare industry to prevent malpractice suits and other unnecessary costs. Just because the government is paying a doctor now instead of an insurance company doesn't magically make people less likely to sue the doctor.

Now, regarding the costs of defensive medicine, well, you say potayto, and I say patata.

You've brought up interesting ideas about solving the U.S. health care crisis. What's funny is that everything I've bolded would actually be more feasible with UHC, with exception to the last phrase I bolded.

-The larger federal government can institute a nation-wide litigation cap that standardizes interpretation of malpractice and would reduce the number of extraneous lawsuits.

Why exactly does this require UHC do to? I mean, can't congress just pass a single regulation without having to completely overhaul the entire healthcare payment system in the country? Doesn't make sense.

-A centralized computer system makes it MUCH easier to catch redundancy testing. No one is paying a third-party to catch redundant tests ordered between two health insurances. You also mention preventive care, which has been unequivocally more effectively implemented in UHC countries because the message is singularly clear and gets to EVERYONE.

That's great. Except in this country the government doesn't run every single private practice, non-profit or private hospital, or most forms of personal care services. Which means we need to be regulating the healthcare system and not the healthcare payment system. Which means that you can do this just as easily without changing who pays! It's a great idea, and I hope they do it. Maybe preventive medicine is better in other countries because the care portion of their system doesn't have insanely high costs compared to ours so that they can put more money toward such things.

-The disparities between racial backgrounds and medicine are better studied under a standardized database. This is why the VA system can put out study after study about outcomes amongst different ethnicities across all states.

And as soon as they institute a centralized database for tracking vital/health statistics everyone will be able to do this. You don't need to be the government to do this. You don't even need this centralized database to be MANAGED by the government.

-You said it yourself, the government (specifically the VA) has excellent standards of record-keeping. I know from first-hand experience. This allows errors to be caught and appropriate action taken. This is why there is the occasional scandal at VA hospitals; well-kept records allowed the discovery to occur in the first place and thus less cover-up is possible. And you still say that who pays the bill doesn't really matter?

I'm not sure what this has to do with who is paying the bills though. It's great that the VA has a good system for patient records. So does the Mayo Clinic Health System! And it's not even public, just a non-profit!

-The government would have even greater power to "strongarm the reduction of rates" if every American was under a UHC system and thus the only American customer available to these pharmaceuticals.

Currently government healthcare programs in the US don't have the ability to strongarm rate reductions (except the VA). When they do, I wouldn't be surprised if private insurers continued to base the fees they pay around the reduced rates medicare got from this negotiations just like they do now.

-Finally, the last bolded phrase: Because of a centralized, standardized record-keeping system, abuse behavior is EASIER to track, not more difficult. This is why Medicare expenditures are used to calculate how cost-effective all healthcare facilities are in the U.S. Now, if we could only apply this to all insured Americans, and not just those with Medicare, then we would catch even more inefficient behavior. But you can't do that amongst private insurers across different states.

And this centralized standardized record keeping system has nothing to do with how the bills are paid, once again, and everything to do with the efficiency of the care portion of the industry.

And you still say that who pays the bill doesn't really matter? So many of your solutions are actually being done in other countries BECAUSE of UHC, not in spite of it.

Yes, obviously.

Edit:

You don't see the irony in that statement?

With all due respect, what is a shame here is that your mother, a professional health-care provider, was relegated to sorting out billing paperwork, something not directly related to improving patient outcome.

The point I was making was the the additional paperwork she had to do was BECAUSE of medicare, and not private insurance. If anything can be pointed to as being the cause of this it is a public healthcare program :lol

Regardless, she was in management and dealt with patients charts and documentation and making sure it was up to standard, which according to you is so important, not that I disagree.

Now, allow me to expand on the underlying problem here. I think most of you who are advocating for a UHC plan are under the impression that the government would assume ownership of all hospitals or private practices in the country and could magically turn them into these incredibly efficient machines of care. In reality there has been no healthcare proposal that even touched on this idea in general (and for good reason, it's a horrible idea). The only thing that healthcare reform initiatives that have been brought up in this debate have done is say that things would get better if someone else paid the bills but they've done nothing to address the underlying issue. The thing is this underlying problem could be completely fixed without changing the payment system by simply regulating the underlying problem away. The reason conservatives get so ticked off about this is because people say "If healthcare costs too much we'll tax people and give the money to the poor so they can afford it!" Conservatives look around and see that the healthcare costs are so high because the care portion of the system is inefficient, and they say "Why are you raising taxes and taking more of my money when you should be making healthcare cost less, not making me pay more!"

 

[itsinmyveins]

Wow, that's one mammoth of a post right there.

 

[AbortedWalrusFetus]

The better question should be why your health should be depended on insurance when it is a basic right deserved by everybody.

Maybe it should be a right deserved by everyone. So is the right to food, clothing, shelter, happiness, etc.

That doesn't mean everyone should get them for free. It means that no one has the right to deny you all avenues to these things.

And yet you see people who argue that health care isn't a right but a government run police force is. Shit like that just boggles my mind.

The federal government doesn't run the police force. They run the FBI, which only comes in to play in multi-state criminal investigations. The police is managed at a STATE (aka State Police) and LOCAL (aka NYPD) level. If states (like Massachussets) want their own state run health initiatives they can feel free to vote one in. If it ever gets on the ballot in PA you can be assured I will vote against it though.

Wow, that's one mammoth of a post right there.

:lol

I haven't been able to post since yesterday and I had to catch up. It's hard to address everyone when you're the only person arguing one side. I know there are gaffers out there that agree with me, but it seems I'm one of the few putting a lot of effort into the conversation. : (

 

[dave is ok]

The federal government doesn't run the police force. They run the FBI, which only comes in to play in multi-state criminal investigations. The police is managed at a STATE (aka State Police) and LOCAL (aka NYPD) level. If states (like Massachussets) want their own state run health initiatives they can feel free to vote one in. If it ever gets on the ballot in PA you can be assured I will vote against it though. (

All Massachusetts did was say "It's illegal to not have health insurance" without lowering the cost of state run MassHealth or Commonwealth Care - it's not like everyone in MA has health insurance now. I certainly don't.

 

[itsinmyveins]

The federal government doesn't run the police force. They run the FBI, which only comes in to play in multi-state criminal investigations. The police is managed at a STATE (aka State Police) and LOCAL (aka NYPD) level. If states (like Massachussets) want their own state run health initiatives they can feel free to vote one in. If it ever gets on the ballot in PA you can be assured I will vote against it though.

Well, I kinda assumed that UHC, even though going through the government, would be run at a state level.

 

[AbortedWalrusFetus]

All Massachusetts did was say "It's illegal to not have health insurance" without lowering the cost of state run MassHealth or Commonwealth Care - it's not like everyone in MA has health insurance now. I certainly don't.

Ah. I didn't know the details of the situation in Mass. I figured they had public healthcare for everyone. I did hear it wasn't working out too well for them, whatever they have going on.

 

[AbortedWalrusFetus]

Well, I kinda assumed that UHC, even though going through the government, would be run at a state level.

I'm not sure I follow? The states foot the bill while the government mandates they have to do it? That's not really how it works. I'm sure there would be state by state administrative branches, but they'd have to be all federal employees, and there would probably be very little flexibility allowed with how state to state branches would be run, and then we'd probably have a whole big mess with states and localities lobbying for a larger portion of the funding, etc. Usual government bureaucracy :lol

 

[dimb]

Even though I'm not american, I'm watching this and getting really angry.

Like pausing the video every minute or two, just because the gravity of evidence against the systemic corruption in the American system is so overwhelming. AND YET THEY STILL GET AWAY WITH IT! AT THE COST, LITERALLY OF THE LIVES AND WELLBEING OF THEIR OWN COUNTRYMEN*!

*who to me are just people, but hey, that's how I roll.

That video displays a single side to the story at the end of the day, and it is all idealist.

At the end of the day Obama's universal health care plan has "no details" as the video states. The government has no idea what it's doing beyond "I want!", and Obama wants universal health care without any idea as to how it will happen.

The video again and again comes to prevention over dealing with developed illness, but there are a number of problems with this philosophy. A UHC plan would immediately cover a staggering number of people with developed illness. This treatment would be a huge financial burden to the government, and to tax payers, and the treatment in many cases would prolong the inevitable rather than cure. There is no possible means of America being able to afford health care for everyone.

Just because people can visit the doctor regularly for preventative medicine it doesn't mean they will. What would the incentive even be for preventative medicine when a patient receives expensive late development procedures for free? Coverage is not the same as health care. According to CDC statistics, Medicaid/SCHIP beneficiaries use the emergency room for non-urgent problems at even a higher rate than the uninsured, due to a lack of access to primary care.

The better question should be why your health should be depended on insurance when it is a basic right deserved by everybody.

I'm not against universal health care, but the government can't just step in and say, "We'll cover everyone."

There are too many problems going on in America and too many external factors for us to feasibly offer free health care to everyone. Medicare is floundering, and it's projected annual costs are set to skyrocket in the next twenty years. Currently Medicare takes in about 3 percent of the GDP (as of 2006). In 2081 the SSA predicted Medicare (as it is now without covering the entire U.S. population) would take in more than 11 percent of the GDP. http://www.ssa.gov/history/pdf/tr07summary.pdf

America's debt is monumental. There's no way around it, and it's only going to get worse. The unplanned UHC Obama is proposing is on a sure fire route to being the new social security as a flawed system garroting tax dollars. It all falls back on the American tax payers at the end of the day, and the tax increase would be more harmful than keeping the current health care plan in place in favor of whatever Obama has "planned".

What can people afford? America is not Europe, and it's not Canada. We can't suddenly introduce new costs like this in a time of economic turmoil. It would be fantastic to cover every person around the country, but this isn't a utopia.

But maybe an ironic and sensational documentary in the Obama UHC future about people being unable to pay their taxes, becoming homeless, and needing regular health care because they can't take care of themselves would change people's opinions in this thread.

 

[Instigator]

I'm not sure I follow? The states foot the bill while the government mandates they have to do it?

That's essentially how it works in Canada. The provinces run and pay for each of their UHS, but the federal government sets up some national standards and can also give extra moneys in some circumstances.

 

[AbortedWalrusFetus]

That's essentially how it works in Canada. The provinces run and pay for each of their UHS, but the federal government sets up some national standards and can also give extra moneys in some circumstances.

See, the US was based around this idea of states rights. I think there would be a lot of states who would say "Bububu I thought you were going to pay for this Uncle Sam! Forget this idea!" and the entire thing would fall through.

 

[gutter_trash]

everyone acces to broadcast TV for both US and Canada or US and the UK

watching the national network news of any of the big US networks... watch them pharmaceutical commercials

then watching the national network news of either a main Canadian network and or a UK network news

see a difference? ask your doctor if Livetra is right for you

 

[itsinmyveins]

I'm not sure I follow? The states foot the bill while the government mandates they have to do it? That's not really how it works. I'm sure there would be state by state administrative branches, but they'd have to be all federal employees, and there would probably be very little flexibility allowed with how state to state branches would be run, and then we'd probably have a whole big mess with states and localities lobbying for a larger portion of the funding, etc. Usual government bureaucracy :lol

No, that's not what I meant exactly. Obviously, there are laws and routines you've got to follow. But essentially it should be worked out at a state level and the hospitals could still be run privately. I don't know what kind of flexibility you're talking about though?

That's essentially how it works in Canada. The provinces run and pay for each of their UHS, but the federal government sets up some national standards and can also give extra moneys in some circumstances.

Yeah, this.

 

[Instigator]

See, the US was based around this idea of states rights. I think there would be a lot of states who would say "Bububu I thought you were going to pay for this Uncle Sam! Forget this idea!" and the entire thing would fall through.

States can't secede. A whole civil war was fought over this. This notion of state rights is moot and is in no way an absolute, even in America.