So for those of you who haven't seen Sicko, the US is the only "western" nation that doesn't have socialized health care. As a result, our health care costs exceed 15% of our GDP (expected to increase to 20% GDP by 2017). That equates to over $6,000 per person every year. In countries like Canada, UK, France, Australia, Germany, etc, their socialized health care systems cost $3,000 or less per year per person . . . while also boasting higher life expectancies, better quality of life and care, and lower infant mortality rates.
A recent NY Times/CBS poll showed that 72% of Americans want a public option, yet it appears that Republicans and some Democrats are refusing to accept any form of a public option.
I've had friends tell me they'd support a public option if it excluded people who "didn't take care of themselves" like smokers who get lung cancer for example. As I live in California, I asked if they also thought we shouldn't help people who get skin cancer, because it's their own fault for being in the sun too much? . . . they normally don't respond to that.
Originally posted Wednesday, June 24, 2009 (2 years ago)
I dunno. I think some people have gotten into some crazy mindset about "punish those other people" when the right thing to do here is not to deny or reduce anybody's care, but to give incentives to people to live healthier lifestyles.
Besides, if healthcare is a public good it could probably be argued that it has to be accessible in some equitable fashion and I suspect a system of incentives is easier to legally defend than a system of punishments. After all, smoking or being fat isn't illegal, it's just not optimal. So give people a nudge to act more optimally.
Originally posted Thursday, June 25, 2009 (2 years ago)
Quoted from "mrz" I dunno. I think some people have gotten into some crazy mindset about "punish those other people" when the right thing to do here is not to deny or reduce anybody's care, but to give incentives to people to live healthier lifestyles.
That makes sense and I would like better then the punishment model. My friend works for an insurance co. and they give incentives if you walk x amount during the week (you wear a pedometer at work so basically if you take a stroll on your break instead of sitting down for coffee or something) or quit smoking, etc. It would be hard to keep track of, however.
Originally posted Thursday, June 25, 2009 (2 years ago)
As for punishment, aren't the 'vice' taxes continually going up?
And whats wrong with a 'high fructose corn syrup tax'?
That ingredient is in alot of products. -surprisingly in my favorite cinnamon raisin bread :( I'd pay a few cents more if that went to cover a national health care plan.
I also hope the arguement stays focused on Health Care, Access to health care, and protecting people from the financial devastation of catastrophic illness. (I would love to see that people never lose their homes to pay for medical expenses)
I don't think insurance companies operate in the public interest, nor especially the patients. A public option is a threat to them, and I think thats good. Insurance companies will still be around, and still offer 'gold star' payments for subscribers who want the latest and greatest fads in medicine (which currently is generally disfavored by insurance).
Penalizing of unfit people is a distraction argument.
The problem is that many people don't seek medical care until they have symptoms.
The cause and effect of alot of disease is often measured in decades.
And you can be quite fit and still come down with a disease common to 'unfit' people, such as respiratory illness and diabetes due to genetic and environmental conditions.
I hope the public coverage happens, lots of small business's will have an enormous worry and weight off their backs. I think you'll find more new business's opening, more entrepreneurs taking risks. And maybe fewer people working jobs they hate because they can't afford to give up their jobs health insurance.
Originally posted Thursday, June 25, 2009 (2 years ago)
Quoted from "PitStopPete" As for punishment, aren't the 'vice' taxes continually going up?
Taxes are one thing, reducing somebody's healthcare is something else entirely.
Though, this is sort of a good point. If you smoke or drink, you would already being paying more into a public system via taxes anyway. Assuming, of course, that the money in question makes it's way into the "pile" that belongs to healthcare.
Quote And whats wrong with a 'high fructose corn syrup tax'?
That's more complex. Rather than taxing HFCS, we could simply reduce the corn subsidy that makes it artificially cheap, and thus, attractive as something to add to things, even where it doesn't belong.
Originally posted Thursday, June 25, 2009 (2 years ago)
Quoted from "Capt Morgan" So for those of you who haven't seen Sicko, the US is the only "western" nation that doesn't have socialized health care. As a result, our health care costs exceed 15 of our GDP (expected to increase to 20 GDP by 2017). That equates to over 6,000 per person every year. In countries like Canada, UK, France, Australia, Germany, etc, their socialized health care systems cost 3,000 or less per year per person . . . while also boasting higher life expectancies, better quality of life and care, and lower infant mortality rates.
A recent NY Times/CBS poll showed that 72 of Americans want a public option, yet it appears that Republicans and some Democrats are refusing to accept any form of a public option.
What are you doing to have your voice heard?
I've called my Senator and Representative, how about you?
Don't you know you're not supposed to use the term "socialized medicine" since it's what the Republicans use to scare people.
The progressive Dems and Obama need to be a lot sharper in making the case for health care reform and a public option. There is a real danger that the conservative dems are going to be cowed by the Republican critiques and the cost of the program, and settle for minor changes. It amazes me how feebly the Dems respond to the really nonsensical claims of Republicans. Also the press hasn't helped since they just feebly parrot the GOP talking points.
GOP claim that reform will bring "socialized medicine" where government bureaucrats get between you and your doctor and make decisions for you - This is a stupid argument because right now insurance companies and HMOs ration and deny care all the time. So, right now corporate bureaucrats are all too often second guessing and hamstringing doctors, or making doctors waste time arguing for treatments to get covered.
Claim that reform is too costly - Given the state of the federal budget, of course it's reasonable to worry about spending another 1.2 trillion over ten years to expand coverage. Now that's not peanuts, but the Dems need to put this in perspective. This comes out to 400 per American per year. We're already spending 6,000 year per person, and the costs keep on going up. 400 is only a couple years worth of health care inflation at the rate we're going. If we don't get health care reform and contain costs, we're going to pay that and more anyways. Maybe it won't be on the government's books, but either companies or workers will bear the costs in increase premiums and reduced salaries.
Public option is unfair to private insurers - Maybe maybe not. Depends on how it's structured. We have a public option right now, and it's called Medicare. Has Medicare driven private insurers out of business? Also, Dems need to emphasize how inefficient and wasteful the public sector health care is in terms of administrative overhead, marketing costs, corporate profits, etc.
I think Obama in his talking points has been emphasizing cost containment too much at the expense of universal coverage. I think he's doing this intentionally because I think he believes it makes it more palatable. However, I also think Americans support the goal of universal coverage and it's easy to make a case that universal coverage will help spread out risk and reduce costs. It's also key to gaining the support of the health insurers, who see the uninsured as potential customers if the government helps subsidize coverage.
Originally posted Thursday, June 25, 2009 (2 years ago)
Quoted from "catlike" I think Obama in his talking points has been emphasizing cost containment too much at the expense of universal coverage. I think he's doing this intentionally because I think he believes it makes it more palatable.
And that's a big mistake, because it ends up with proposed plans that actually make the cost to the government worse. If people who can afford good insurance/care keep what they have, while the government takes on the burden for those can t afford it, the costs to the government will be too high. However, if they shift the cost from those who pay the most for insurance into the new system and just distribute the costs more fairly, we could support good health care for everyone without increasing what people have to pay out, and without breaking the federal budget.
Originally posted Thursday, June 25, 2009 (2 years ago)
Here's the practical part of social medicine - how it works.
As an example, in England, you have to register with a doctor who is within a certain distance of where you live. If you move outside of that distance, you have to change doctors.
If the doctor says you need to see a specialist, he/she chooses who you go and see, and makes the appointment. It can take months (unless you have a life-threatening condition).
I believe the USA should have socialized medicine (of course, the sales tax rate and income tax rates are a whole lot higher in England than here ... so perhaps taxes would have to be increased to pay for it) and also have private healthcare (as they have in England) for those who don't want to be restricted.
Right now, smokers who get life insurance pay a higher premium. It's not a "penalty" - it's simply risk management. Smokers have a higher propensity for dying young - they also have a higher propensity for getting smoking-related illnesses; likewise, overweight and obese people have a higher propensity to get obesity-related illnesses. It's all well and good to have incentives to get people to stop smoking, reduce weight etc, but what about rewarding those who have "deprived" themselves all their lives of these "treats"? You'll soon find it's an expensive proposition.
Life insurers use BMI to evaluate "healthiness" and adjust the premium accordingly - they question your use of tobacco, alcohol, and whether or not you engage in dangerous recreational activities (car racing, flying, etc). And your premiums are adjusted accordingly. No one sees this as "punishment" - it's simply risk management. And seeing a similar increase in healthcare premiums and labeling them as punishment is just silly, IMHO.
"Change your thoughts, and you change your world" - Norman Vincent Peale.
Originally posted Thursday, June 25, 2009 (2 years ago)
OpeningMinds--right now, in the US, in cases of non-life-threatening conditions, what makes you have to wait months before getting into a doctor is having to wait for an appointment in an overcrowded free/cheap clinic because you're poor.
Don't forget that you're comparing the British upper-middle-class wait time to the American upper-middle-class wait time, not the British lower-middle-class wait time to the American lower-middle-class wait time (probably pretty equivalent--for those Americans in the lower-middle-class who do even have a free/cheap clinic nearby enough to wait to go to).
Socialized medicine can still be the best option for a country (esp. one where its majority doesn't belong to the upper-middle or upper classes) even if the socialized medicine experience doesn't tie the "personally expensive" medicine experience for the upper-middle and upper classes.
Originally posted Thursday, June 25, 2009 (2 years ago)
Quoted from "kitkat" OpeningMinds--right now, in the US, in cases of non-life-threatening conditions, what makes you have to wait months before getting into a doctor is having to wait for an appointment in an overcrowded free/cheap clinic because you're poor.
I'm not sure what your point is. You have to wait months in the UK because it's free. If you can afford private healthcare (which most in the UK can't), then you don't have to wait - same as in the USA.
The point I'm making is that you won't get attention for free (viz. socialized health care) the same way that people who pay for it get it. You'll get medical care, yes - but on their schedule, with their choice of doctors. People who currently pay for health insurance and think it would be great to have free health insurance will have to adjust their expectations of service, etc. People who currently don't have the means to pay for healthcare will find peace of mind knowing that they will be taken care of.
I totally support having socialized health care - but my concern is whether or not the expectations of citizens is being managed. People talk in generalities about having "free" healthcare, but don't discuss the mechanics of its operation. The money has to come from somewhere - how will it be funded? There will be more people visiting doctors - will there be more doctors? More nursing staff? More space in hospitals? Or will it be almost impossible to see the doctor when you're actually sick?
"Change your thoughts, and you change your world" - Norman Vincent Peale.
Originally posted Thursday, June 25, 2009 (2 years ago)
Quoted from "OpeningMinds" I totally support having socialized health care - but my concern is whether or not the expectations of citizens is being managed. People talk in generalities about having "free" healthcare, but don't discuss the mechanics of its operation.
Ahhhh...okay, I get what you're saying. Yeah, I suppose upper-middle-class progressives talking around upper-middle-class friends about "free" could lead those upper-middle-class friends astray...(though in the end, I suppose they'll still just be able to afford something else, so although emotionally I see how it's an easy thing to visualize & spend time speculating, practically it seems low-priority to me. But that's just my thought).
Quoted from "OpeningMinds" The money has to come from somewhere - how will it be funded?
From the surplus income & wealth at the top of the income/wealth gap, I certainly dream.
Originally posted Thursday, June 25, 2009 (2 years ago)
Quoted from "PitStopPete" As for punishment, aren't the 'vice' taxes continually going up?
And whats wrong with a 'high fructose corn syrup tax'?
That agricultural policy would still be subsidizing cheap corn. Get rid of weird federal manipulation of our food sources and the food mix in the US would change quite a lot.
Several of Michael Pollan's books are in large parts extended rants about corn production and how it distorts the food system :-)
Originally posted Friday, June 26, 2009 (2 years ago)
Quoted from "OpeningMinds"
As an example, in England, you have to register with a doctor who is within a certain distance of where you live. If you move outside of that distance, you have to change doctors.
This is one example of how it can work, but not the only way. It's a practical one, though, because it makes sense to have your doctor serve the nearest hospital to your home, and it's what almost everyone chooses on their own anyway.
Quote If the doctor says you need to see a specialist, he/she chooses who you go and see, and makes the appointment.
That's one of the great parts. You get to see the specialist your doctor recommends AND they take care of the appointment for you. As long as you can choose a primary you trust, what else would you do but use the specialist your doctor chooses? Who better to advise you?
In our system, the doctor may recommend a specialist, but it's up to you to find out whether he's in your network or you're going to have to pay a lot extra to see him. If your doctor's choice isn't in your network, then maybe you have to find someone else to go to, which is not always easy. Then you have to remember to call them and schedule the appointment yourself. Sometimes when busy people have to go through that much trouble for something non urgent, they end up just not going... until the problem becomes urgent.
Quote OpeningMinds--right now, in the US, in cases of non-life-threatening conditions, what makes you have to wait months before getting into a doctor is having to wait for an appointment in an overcrowded free/cheap clinic because you're poor.
Well, that's one of the reasons some people have to wait. Some doctors have a long waiting list because they have a lot of prestige, and only people who can/will pay for them have that long wait. Some people live in areas where there aren't enough doctors because they just aren't particularly profitable places for doctors to work, so even the few people who can easily afford the cost have to wait. Some areas have too few of certain types of specialists because the risk of lawsuits is too high in that area for that speciality, so few doctors there are willing to practice it.
Quote Right now, smokers who get life insurance pay a higher premium. It's not a "penalty" - it's simply risk management.
For individuals, yes. For group policies, which are the most common -- they're what we get from our employers -- everyone in the group pays the same rate. That's actually one of the big reasons why group policies are so desirable.
Some of the normal things that are considered risk management by insurance companies are weaknesses of our current system that we hope to have fixed by having a national health care. The fact that it's impossible to get affordable health insurance if you have a history of cancer is risk management, and it's a problem. So how do you decide which risks are reasonable to ask people to contribute more for, and which aren't?
Originally posted Friday, June 26, 2009 (2 years ago)
Quote the US is the only "western" nation that doesn't have socialized health care. As a result, our health care costs exceed 15 of our GDP (expected to increase to 20 GDP by 2017). That equates to over 6,000 per person every year. In countries like Canada, UK, France, Australia, Germany, etc, their socialized health care systems cost 3,000 or less per year per person . . . while also boasting higher life expectancies, better quality of life and care, and lower infant mortality rates.
This is a load of whooey, as is any argument that we should do something because that's how Europe does it. Europe depends on the US for everything, including its very existence. It's only a pervasive inferiority complex that keeps this argument afloat. The way we do things, by definition, should be the primary way.
As far as comparing life expectancies, etc, also whooey. We Americans work harder, do more, produce more and achieve more. That takes a lot out of people. Maybe it's that, and not the healthcare system, that accounts for the marginal differences in life expectancies. Of course, there's plenty of data to suggest that America's racial diversity is the main contributor to that difference, but that's another story.
As far as better quality of life and care in Europe, you've got to be kidding. Ever been to Canada (located here, but with a European soul)? Everyone limps. Ever been to England? Austin Powers' teeth were parodied for a reason.
And how about this. You can guarantee that when social medicine comes to the US, the government will restrict or limit malpractice suits against doctors working for or accepting government insurance. Those same doctors are likely to be the least qualified and least able physicians, as the more able and more qualified will eschew the public system and accept only private patients (as is happening in Canada now). So you'll have more people, mostly poorer people, getting hurt by their doctors, and no system to compensate them.
Originally posted Friday, June 26, 2009 (2 years ago)
Quoted from "nugby"
Europe depends on the US for everything, including its very existence. It's only a pervasive inferiority complex that keeps this argument afloat. The way we do things, by definition, should be the primary way.
Originally posted Friday, June 26, 2009 (2 years ago)
Quote
The fact that it's impossible to get affordable health insurance if you have a history of cancer is risk management, and it's a problem.
That's assuming you're in remission and want to get new insurance.
A bigger problem is people who get serious illnesses like cancer and loser their job insurance and then can't get new insurance. If your spouse gets cancer, I hope you like your job and that your job likes you because you need you job sponsored health insurance until your spouse is cured.
That's just stupid. Why is health insurance tied to a job? Why is it that if you lose coverage, preexisting conditions are suddenly "out of bounds"?
Originally posted Friday, June 26, 2009 (2 years ago)
Quoted from "nugby"
As far as comparing life expectancies, etc, also whooey.
Ok, that's a sweeping statement backed up by nothing!
Why is it that studies of health outcomes point to the fact that America spends too much on health care that isn't as good as public health care models elsewhere...including controls, etc. for biasing factors? We have excellent doctors and technology but we're basically squandering a lot of money and not getting the full use out of our doctors and technology because we have a stupid model for health coverage. Inferiority complexes over Europe are a non-sequitor.
Also, public healthcare is not just available in Europe and even in Europe not all public healthcare is done the same way.
Originally posted Friday, June 26, 2009 (2 years ago)
Quoted from "nugby" And how about this. You can guarantee that when social medicine comes to the US, the government will restrict or limit malpractice suits against doctors working for or accepting government insurance. Those same doctors are likely to be the least qualified and least able physicians, as the more able and more qualified will eschew the public system and accept only private patients (as is happening in Canada now). So you'll have more people, mostly poorer people, getting hurt by their doctors, and no system to compensate them.
Not a guarantee at all. Here in Australia, you have quite alot of specialasts (I won't say all cos I don't know the numbers) who work in both the public and private sectors.
Originally posted Saturday, June 27, 2009 (2 years ago)
Quoted from "nugby"
This is a load of whooey, as is any argument that we should do something because that's how Europe does it. Europe depends on the US for everything, including its very existence. It's only a pervasive inferiority complex that keeps this argument afloat. The way we do things, by definition, should be the primary way.
As far as comparing life expectancies, etc, also whooey. We Americans work harder, do more, produce more and achieve more. That takes a lot out of people. Maybe it's that, and not the healthcare system, that accounts for the marginal differences in life expectancies. Of course, there's plenty of data to suggest that America's racial diversity is the main contributor to that difference, but that's another story.
As far as better quality of life and care in Europe, you've got to be kidding. Ever been to Canada (located here, but with a European soul)? Everyone limps. Ever been to England? Austin Powers' teeth were parodied for a reason.
And how about this. You can guarantee that when social medicine comes to the US, the government will restrict or limit malpractice suits against doctors working for or accepting government insurance. Those same doctors are likely to be the least qualified and least able physicians, as the more able and more qualified will eschew the public system and accept only private patients (as is happening in Canada now). So you'll have more people, mostly poorer people, getting hurt by their doctors, and no system to compensate them.
I like how you responded with out a single creditable link to support your statement. My "whooey" comes from the World Health Organization. You are just stating your opinion, all of which is a logical fallacy to appeal to fear.
It's time you get off your high horse, take off your foam finger that says "USA 1" and get with reality.
Essentially you are buying into the propaganda dating back to McCarthyism, and rehashed by Fox News.
If you don't like social health care, you tell us how to get health care costs in check.
Originally posted Sunday, June 28, 2009 (2 years ago)
Quoted from "kitkat"
Quoted from "OpeningMinds" The money has to come from somewhere - how will it be funded?
From the surplus income & wealth at the top of the income/wealth gap, I certainly dream.
That might have worked 40 years ago but not today. Partly due to excessive immigration, partly due to our lost manufacturing base, America's wealthy-to-poor ratio is approaching Brazil's--there's just not enough rich to take care of all the poor. At any rate, any additional taxation would have to first go towards our 1.5 - 2 trillion deficit.
The Europeans and Canadians tend to rely on VATs, indirectly or directly, to pay for their socialized medicine, but as they are imposed on imports and rebated on exports it would be tough to get past the "protectionist!" scare word to get them approved over here. Probably worth the effort though.
Originally posted Sunday, June 28, 2009 (2 years ago)
Quoted from "OpeningMinds"
I totally support having socialized health care - but my concern is whether or not the expectations of citizens is being managed. People talk in generalities about having "free" healthcare, but don't discuss the mechanics of its operation. The money has to come from somewhere - how will it be funded? There will be more people visiting doctors - will there be more doctors? More nursing staff? More space in hospitals? Or will it be almost impossible to see the doctor when you're actually sick?
I agree. It doesn't make sense to talk about universal coverage unless we also do something about the supply of doctors and the mix of primary care physicians and specialists. If nothing is done about this, there will likely be a problem with service delays.
I have a graduate student who works for me, whose family lives in Canada. Her father has liver cancer, and the lack of specialists and delays really harmed his treatment. As a result, his cancer spread and has become terminal. I'm not sure speedier treatment would have necessarily saved him, but I suppose it would likely have helped.
So, I agree that the shift to a new system may have some negative consequences for some people in some cases. On the other hand, it will lead to some important gains and a fairer distribution of health care to the entire population. We shouldn't romanticize how effectively our system currently works. Right now there is plenty of rationing going on, carried out by insurance companies. Doctors are second-guessed all the time by corporate bureaucrats and they have to waste time filling out paperwork and arguing with insurers rather than treating patients. There are plenty of delays in getting appointments. And there are tons of inefficiencies in the system. The conservative arguments simply don't deal with the health care system as it is. Rather they focus on some idealized notion of the system and how it currently works based on their ideology.
The reality is that some medical care rationing is necessary, since we don't have unlimited resources. The questions is how should this be rationed and by whom, and how should the money we spend on medicine (twice what other industrialized nations spend per person) be more effectively put to use. The reality is that the market is ineffective in allocating something like health care because: (1) there is an unlimited demand for health care, and there is a culture in America of not acknowledging that sometimes there is nothing that we can do about certain illnesses and perhaps the best thing we can do is to not try out some crazy experimental treatment but rather focus on maintaining quality of life for whatever time a terminal patient has left, and (2) there are plenty of problems with imperfect information, asymmetrical expertise, and skewed incentives in the health care system.
Single payer is certainly one way to go, but it's not the only option for progressives. Another possibility would be to run universal care through the private insurance industry but make it much more heavily regulated. Treat it sort of like a utility with clearer rules about coverage. I think that's how Germany does it. There are a lot of options. Obama, though, has to be a bit more honest about the tradeoffs that are involved with change.
Originally posted Sunday, June 28, 2009 (2 years ago)
Quoted from "Glen"
Quoted from "kitkat"
Quoted from "OpeningMinds" The money has to come from somewhere - how will it be funded?
From the surplus income & wealth at the top of the income/wealth gap, I certainly dream.
America's wealthy-to-poor ratio is approaching Brazil's--there's just not enough rich to take care of all the poor.
Of course there are, Glen. It just means that the few rich ones have to have it come from a higher percentage of their wealth/income. But hey, they're wealthier than they were 40 years ago, so they can afford it and break even w/ 40 years ago.
(Yes, I know they have no taste for going back to their 40-years-ago wealth/income level. I just think the rest of us have a taste for that happening.) :-
Originally posted Monday, June 29, 2009 (2 years ago)
Quoted from "Glen"
Quoted from "kitkat"
Quoted from "OpeningMinds" The money has to come from somewhere - how will it be funded?
From the surplus income & wealth at the top of the income/wealth gap, I certainly dream.
That might have worked 40 years ago but not today. Partly due to excessive immigration, partly due to our lost manufacturing base, America's wealthy-to-poor ratio is approaching Brazil's--there's just not enough rich to take care of all the poor. At any rate, any additional taxation would have to first go towards our 1.5 - 2 trillion deficit.
The Europeans and Canadians tend to rely on VATs, indirectly or directly, to pay for their socialized medicine, but as they are imposed on imports and rebated on exports it would be tough to get past the "protectionist!" scare word to get them approved over here. Probably worth the effort though.
Glen
You don't get how taxation works. If the top 10 of the population owns 90 of the wealth of the country, the government could only tax that population and continue functioning. 30 of a billion dollars owned by one person is taxed the same as 10 families with 100 million each.
And who says that money coming in has to go to the national debt? The entire time Bush was in office he spent the surplus and racked up the national debt the entire time, and the government kept on moving along. That's like saying, as soon as you get out of college, 100 of your income needs to go to paying back your school loans. Everyone lives with debt. It's a question of how you manage it not how fast you pay it off.
Originally posted Monday, June 29, 2009 (2 years ago)
I'm totally for socialized health care, but have no grand illusions about it. If it all gets approved, and you use socialized health care, you'll probably get all the Mexican med-school students telling you to take your clothes off to diagnose your headache.
All the top U.S. school MD's will have to work for private sector still. They have to. With the kind of education costs for med-school in the U.S., any new doctor would be stupid not to try to earn more money to pay back their mountains of schooling debts. It would be financial ruin for them otherwise. Of course, this means that if we want to use decent doctors on the universal health care plan, our education system has to change as well. Very few folks are going to be willing to go through 8 years of hard schooling/hospital work plus hundreds of thousands of dollars in tuition costs just to earn 50k coming out.
Originally posted Monday, June 29, 2009 (2 years ago)
It was mentioned above that there are concerns that wait time will increase to get to see doctors if we get socialized (or universal, or whatever you wanna call it) medicine in the the US.
In a number of different countries in Europe, I've gone to see doctors (you all know how accident prone I am...), and I've never had to wait more than an hour to see a doc, whether it was life threatening (in which case I was always seen right away) or something like a busted up foot. Usually have to wait longer in the US, in my experience, to get in to see a doctor for non-life-threatening condition.
I'm not sure how it is with specialists in Europe, but here it is HIGHLY annoying. To see any kind of specialist it is usually a minimum of 2 or 3 months wait time. Like when I had my last concussion last month, I couldn't get in to see my neurologist and was given an appointment for two months after the injury. I can't imagine it would be any worse across the pond.
Also, I have a question: Is the pay for people in the medical profession going to change? Because there is is significant pay difference in people working for the public health care system in Europe vs. the US. Its not that I don't think many doctors are overpaid here (because many of them are... not all, but many), but for the new system to work, I imagine there will be pay cuts. And people don't like pay cuts. Keep in mind that this is coming from a person who is taking a more than 50 pay cut to work in the public health care system in Italy vs what I could make in the US. So I'm not thinking 'poor overpaid doctors/other medical people who are only now slightly less overpaid", I'm worried about the reactions and what impact it will have on healthcare.
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National Public Health Care Option Activism Thread
So for those of you who haven't seen Sicko, the US is the only "western" nation that doesn't have socialized health care. As a result, our health care costs exceed 15% of our GDP (expected to increase to 20% GDP by 2017). That equates to over $6,000 per person every year. In countries like Canada, UK, France, Australia, Germany, etc, their socialized health care systems cost $3,000 or less per year per person . . . while also boasting higher life expectancies, better quality of life and care, and lower infant mortality rates.
A recent NY Times/CBS poll showed that 72% of Americans want a public option, yet it appears that Republicans and some Democrats are refusing to accept any form of a public option.
What are you doing to have your voice heard?
I've called my Senator and Representative, how about you?
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I've had friends tell me they'd support a public option if it excluded people who "didn't take care of themselves" like smokers who get lung cancer for example. As I live in California, I asked if they also thought we shouldn't help people who get skin cancer, because it's their own fault for being in the sun too much? . . . they normally don't respond to that.
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I dunno. I think some people have gotten into some crazy mindset about "punish those other people" when the right thing to do here is not to deny or reduce anybody's care, but to give incentives to people to live healthier lifestyles.
Besides, if healthcare is a public good it could probably be argued that it has to be accessible in some equitable fashion and I suspect a system of incentives is easier to legally defend than a system of punishments. After all, smoking or being fat isn't illegal, it's just not optimal. So give people a nudge to act more optimally.
That makes sense and I would like better then the punishment model. My friend works for an insurance co. and they give incentives if you walk x amount during the week (you wear a pedometer at work so basically if you take a stroll on your break instead of sitting down for coffee or something) or quit smoking, etc. It would be hard to keep track of, however.
As for punishment, aren't the 'vice' taxes continually going up?
And whats wrong with a 'high fructose corn syrup tax'?
That ingredient is in alot of products. -surprisingly in my favorite cinnamon raisin bread :( I'd pay a few cents more if that went to cover a national health care plan.
I also hope the arguement stays focused on Health Care, Access to health care, and protecting people from the financial devastation of catastrophic illness. (I would love to see that people never lose their homes to pay for medical expenses)
I don't think insurance companies operate in the public interest, nor especially the patients. A public option is a threat to them, and I think thats good. Insurance companies will still be around, and still offer 'gold star' payments for subscribers who want the latest and greatest fads in medicine (which currently is generally disfavored by insurance).
Penalizing of unfit people is a distraction argument.
The problem is that many people don't seek medical care until they have symptoms. The cause and effect of alot of disease is often measured in decades.
And you can be quite fit and still come down with a disease common to 'unfit' people, such as respiratory illness and diabetes due to genetic and environmental conditions.
I hope the public coverage happens, lots of small business's will have an enormous worry and weight off their backs. I think you'll find more new business's opening, more entrepreneurs taking risks. And maybe fewer people working jobs they hate because they can't afford to give up their jobs health insurance.
been away too long
Taxes are one thing, reducing somebody's healthcare is something else entirely.
Though, this is sort of a good point. If you smoke or drink, you would already being paying more into a public system via taxes anyway. Assuming, of course, that the money in question makes it's way into the "pile" that belongs to healthcare.
That's more complex. Rather than taxing HFCS, we could simply reduce the corn subsidy that makes it artificially cheap, and thus, attractive as something to add to things, even where it doesn't belong.
Don't you know you're not supposed to use the term "socialized medicine" since it's what the Republicans use to scare people.
The progressive Dems and Obama need to be a lot sharper in making the case for health care reform and a public option. There is a real danger that the conservative dems are going to be cowed by the Republican critiques and the cost of the program, and settle for minor changes. It amazes me how feebly the Dems respond to the really nonsensical claims of Republicans. Also the press hasn't helped since they just feebly parrot the GOP talking points.
GOP claim that reform will bring "socialized medicine" where government bureaucrats get between you and your doctor and make decisions for you - This is a stupid argument because right now insurance companies and HMOs ration and deny care all the time. So, right now corporate bureaucrats are all too often second guessing and hamstringing doctors, or making doctors waste time arguing for treatments to get covered.
Claim that reform is too costly - Given the state of the federal budget, of course it's reasonable to worry about spending another 1.2 trillion over ten years to expand coverage. Now that's not peanuts, but the Dems need to put this in perspective. This comes out to 400 per American per year. We're already spending 6,000 year per person, and the costs keep on going up. 400 is only a couple years worth of health care inflation at the rate we're going. If we don't get health care reform and contain costs, we're going to pay that and more anyways. Maybe it won't be on the government's books, but either companies or workers will bear the costs in increase premiums and reduced salaries.
Public option is unfair to private insurers - Maybe maybe not. Depends on how it's structured. We have a public option right now, and it's called Medicare. Has Medicare driven private insurers out of business? Also, Dems need to emphasize how inefficient and wasteful the public sector health care is in terms of administrative overhead, marketing costs, corporate profits, etc.
I think Obama in his talking points has been emphasizing cost containment too much at the expense of universal coverage. I think he's doing this intentionally because I think he believes it makes it more palatable. However, I also think Americans support the goal of universal coverage and it's easy to make a case that universal coverage will help spread out risk and reduce costs. It's also key to gaining the support of the health insurers, who see the uninsured as potential customers if the government helps subsidize coverage.
And that's a big mistake, because it ends up with proposed plans that actually make the cost to the government worse. If people who can afford good insurance/care keep what they have, while the government takes on the burden for those can t afford it, the costs to the government will be too high. However, if they shift the cost from those who pay the most for insurance into the new system and just distribute the costs more fairly, we could support good health care for everyone without increasing what people have to pay out, and without breaking the federal budget.
-- Rachel
Here's the practical part of social medicine - how it works.
As an example, in England, you have to register with a doctor who is within a certain distance of where you live. If you move outside of that distance, you have to change doctors.
If the doctor says you need to see a specialist, he/she chooses who you go and see, and makes the appointment. It can take months (unless you have a life-threatening condition).
I believe the USA should have socialized medicine (of course, the sales tax rate and income tax rates are a whole lot higher in England than here ... so perhaps taxes would have to be increased to pay for it) and also have private healthcare (as they have in England) for those who don't want to be restricted.
Right now, smokers who get life insurance pay a higher premium. It's not a "penalty" - it's simply risk management. Smokers have a higher propensity for dying young - they also have a higher propensity for getting smoking-related illnesses; likewise, overweight and obese people have a higher propensity to get obesity-related illnesses. It's all well and good to have incentives to get people to stop smoking, reduce weight etc, but what about rewarding those who have "deprived" themselves all their lives of these "treats"? You'll soon find it's an expensive proposition.
Life insurers use BMI to evaluate "healthiness" and adjust the premium accordingly - they question your use of tobacco, alcohol, and whether or not you engage in dangerous recreational activities (car racing, flying, etc). And your premiums are adjusted accordingly. No one sees this as "punishment" - it's simply risk management. And seeing a similar increase in healthcare premiums and labeling them as punishment is just silly, IMHO.
"Change your thoughts, and you change your world" - Norman Vincent Peale.
OpeningMinds--right now, in the US, in cases of non-life-threatening conditions, what makes you have to wait months before getting into a doctor is having to wait for an appointment in an overcrowded free/cheap clinic because you're poor.
Don't forget that you're comparing the British upper-middle-class wait time to the American upper-middle-class wait time, not the British lower-middle-class wait time to the American lower-middle-class wait time (probably pretty equivalent--for those Americans in the lower-middle-class who do even have a free/cheap clinic nearby enough to wait to go to).
Socialized medicine can still be the best option for a country (esp. one where its majority doesn't belong to the upper-middle or upper classes) even if the socialized medicine experience doesn't tie the "personally expensive" medicine experience for the upper-middle and upper classes.
I'm not sure what your point is. You have to wait months in the UK because it's free. If you can afford private healthcare (which most in the UK can't), then you don't have to wait - same as in the USA.
The point I'm making is that you won't get attention for free (viz. socialized health care) the same way that people who pay for it get it. You'll get medical care, yes - but on their schedule, with their choice of doctors. People who currently pay for health insurance and think it would be great to have free health insurance will have to adjust their expectations of service, etc. People who currently don't have the means to pay for healthcare will find peace of mind knowing that they will be taken care of.
I totally support having socialized health care - but my concern is whether or not the expectations of citizens is being managed. People talk in generalities about having "free" healthcare, but don't discuss the mechanics of its operation. The money has to come from somewhere - how will it be funded? There will be more people visiting doctors - will there be more doctors? More nursing staff? More space in hospitals? Or will it be almost impossible to see the doctor when you're actually sick?
"Change your thoughts, and you change your world" - Norman Vincent Peale.
...in the UK. Your milage may vary elsewhere.
HR 676! (Granted that's the pro-HR 676 lobby website, I'm biased, I admit.)
Single payer for the win!
Ahhhh...okay, I get what you're saying. Yeah, I suppose upper-middle-class progressives talking around upper-middle-class friends about "free" could lead those upper-middle-class friends astray...(though in the end, I suppose they'll still just be able to afford something else, so although emotionally I see how it's an easy thing to visualize & spend time speculating, practically it seems low-priority to me. But that's just my thought).
From the surplus income & wealth at the top of the income/wealth gap, I certainly dream.
That agricultural policy would still be subsidizing cheap corn. Get rid of weird federal manipulation of our food sources and the food mix in the US would change quite a lot.
Several of Michael Pollan's books are in large parts extended rants about corn production and how it distorts the food system :-)
This is one example of how it can work, but not the only way. It's a practical one, though, because it makes sense to have your doctor serve the nearest hospital to your home, and it's what almost everyone chooses on their own anyway.
That's one of the great parts. You get to see the specialist your doctor recommends AND they take care of the appointment for you. As long as you can choose a primary you trust, what else would you do but use the specialist your doctor chooses? Who better to advise you?
In our system, the doctor may recommend a specialist, but it's up to you to find out whether he's in your network or you're going to have to pay a lot extra to see him. If your doctor's choice isn't in your network, then maybe you have to find someone else to go to, which is not always easy. Then you have to remember to call them and schedule the appointment yourself. Sometimes when busy people have to go through that much trouble for something non urgent, they end up just not going... until the problem becomes urgent.
Well, that's one of the reasons some people have to wait. Some doctors have a long waiting list because they have a lot of prestige, and only people who can/will pay for them have that long wait. Some people live in areas where there aren't enough doctors because they just aren't particularly profitable places for doctors to work, so even the few people who can easily afford the cost have to wait. Some areas have too few of certain types of specialists because the risk of lawsuits is too high in that area for that speciality, so few doctors there are willing to practice it.
For individuals, yes. For group policies, which are the most common -- they're what we get from our employers -- everyone in the group pays the same rate. That's actually one of the big reasons why group policies are so desirable.
Some of the normal things that are considered risk management by insurance companies are weaknesses of our current system that we hope to have fixed by having a national health care. The fact that it's impossible to get affordable health insurance if you have a history of cancer is risk management, and it's a problem. So how do you decide which risks are reasonable to ask people to contribute more for, and which aren't?
-- Rachel
This is a load of whooey, as is any argument that we should do something because that's how Europe does it. Europe depends on the US for everything, including its very existence. It's only a pervasive inferiority complex that keeps this argument afloat. The way we do things, by definition, should be the primary way.
As far as comparing life expectancies, etc, also whooey. We Americans work harder, do more, produce more and achieve more. That takes a lot out of people. Maybe it's that, and not the healthcare system, that accounts for the marginal differences in life expectancies. Of course, there's plenty of data to suggest that America's racial diversity is the main contributor to that difference, but that's another story.
As far as better quality of life and care in Europe, you've got to be kidding. Ever been to Canada (located here, but with a European soul)? Everyone limps. Ever been to England? Austin Powers' teeth were parodied for a reason.
And how about this. You can guarantee that when social medicine comes to the US, the government will restrict or limit malpractice suits against doctors working for or accepting government insurance. Those same doctors are likely to be the least qualified and least able physicians, as the more able and more qualified will eschew the public system and accept only private patients (as is happening in Canada now). So you'll have more people, mostly poorer people, getting hurt by their doctors, and no system to compensate them.
that's where i stop reading your post.
That's assuming you're in remission and want to get new insurance.
A bigger problem is people who get serious illnesses like cancer and loser their job insurance and then can't get new insurance. If your spouse gets cancer, I hope you like your job and that your job likes you because you need you job sponsored health insurance until your spouse is cured.
That's just stupid. Why is health insurance tied to a job? Why is it that if you lose coverage, preexisting conditions are suddenly "out of bounds"?
These type of things must be fixed!
Ok, that's a sweeping statement backed up by nothing!
Why is it that studies of health outcomes point to the fact that America spends too much on health care that isn't as good as public health care models elsewhere...including controls, etc. for biasing factors? We have excellent doctors and technology but we're basically squandering a lot of money and not getting the full use out of our doctors and technology because we have a stupid model for health coverage. Inferiority complexes over Europe are a non-sequitor.
Also, public healthcare is not just available in Europe and even in Europe not all public healthcare is done the same way.
Not a guarantee at all. Here in Australia, you have quite alot of specialasts (I won't say all cos I don't know the numbers) who work in both the public and private sectors.
I like how you responded with out a single creditable link to support your statement. My "whooey" comes from the World Health Organization. You are just stating your opinion, all of which is a logical fallacy to appeal to fear.
It's time you get off your high horse, take off your foam finger that says "USA 1" and get with reality.
Essentially you are buying into the propaganda dating back to McCarthyism, and rehashed by Fox News.
If you don't like social health care, you tell us how to get health care costs in check.
CollegiateShag.com
That might have worked 40 years ago but not today. Partly due to excessive immigration, partly due to our lost manufacturing base, America's wealthy-to-poor ratio is approaching Brazil's--there's just not enough rich to take care of all the poor. At any rate, any additional taxation would have to first go towards our 1.5 - 2 trillion deficit.
The Europeans and Canadians tend to rely on VATs, indirectly or directly, to pay for their socialized medicine, but as they are imposed on imports and rebated on exports it would be tough to get past the "protectionist!" scare word to get them approved over here. Probably worth the effort though.
Glen
I agree. It doesn't make sense to talk about universal coverage unless we also do something about the supply of doctors and the mix of primary care physicians and specialists. If nothing is done about this, there will likely be a problem with service delays.
I have a graduate student who works for me, whose family lives in Canada. Her father has liver cancer, and the lack of specialists and delays really harmed his treatment. As a result, his cancer spread and has become terminal. I'm not sure speedier treatment would have necessarily saved him, but I suppose it would likely have helped.
So, I agree that the shift to a new system may have some negative consequences for some people in some cases. On the other hand, it will lead to some important gains and a fairer distribution of health care to the entire population. We shouldn't romanticize how effectively our system currently works. Right now there is plenty of rationing going on, carried out by insurance companies. Doctors are second-guessed all the time by corporate bureaucrats and they have to waste time filling out paperwork and arguing with insurers rather than treating patients. There are plenty of delays in getting appointments. And there are tons of inefficiencies in the system. The conservative arguments simply don't deal with the health care system as it is. Rather they focus on some idealized notion of the system and how it currently works based on their ideology.
The reality is that some medical care rationing is necessary, since we don't have unlimited resources. The questions is how should this be rationed and by whom, and how should the money we spend on medicine (twice what other industrialized nations spend per person) be more effectively put to use. The reality is that the market is ineffective in allocating something like health care because: (1) there is an unlimited demand for health care, and there is a culture in America of not acknowledging that sometimes there is nothing that we can do about certain illnesses and perhaps the best thing we can do is to not try out some crazy experimental treatment but rather focus on maintaining quality of life for whatever time a terminal patient has left, and (2) there are plenty of problems with imperfect information, asymmetrical expertise, and skewed incentives in the health care system.
Single payer is certainly one way to go, but it's not the only option for progressives. Another possibility would be to run universal care through the private insurance industry but make it much more heavily regulated. Treat it sort of like a utility with clearer rules about coverage. I think that's how Germany does it. There are a lot of options. Obama, though, has to be a bit more honest about the tradeoffs that are involved with change.
You can't have whooey without WHO.
Of course there are, Glen. It just means that the few rich ones have to have it come from a higher percentage of their wealth/income. But hey, they're wealthier than they were 40 years ago, so they can afford it and break even w/ 40 years ago.
(Yes, I know they have no taste for going back to their 40-years-ago wealth/income level. I just think the rest of us have a taste for that happening.) :-
(I said it was my dream!)
You don't get how taxation works. If the top 10 of the population owns 90 of the wealth of the country, the government could only tax that population and continue functioning. 30 of a billion dollars owned by one person is taxed the same as 10 families with 100 million each.
And who says that money coming in has to go to the national debt? The entire time Bush was in office he spent the surplus and racked up the national debt the entire time, and the government kept on moving along. That's like saying, as soon as you get out of college, 100 of your income needs to go to paying back your school loans. Everyone lives with debt. It's a question of how you manage it not how fast you pay it off.
CollegiateShag.com
Ad hominems against a serious organization like WHO does not bode well to your credibility.
CollegiateShag.com
I'm totally for socialized health care, but have no grand illusions about it. If it all gets approved, and you use socialized health care, you'll probably get all the Mexican med-school students telling you to take your clothes off to diagnose your headache. All the top U.S. school MD's will have to work for private sector still. They have to. With the kind of education costs for med-school in the U.S., any new doctor would be stupid not to try to earn more money to pay back their mountains of schooling debts. It would be financial ruin for them otherwise. Of course, this means that if we want to use decent doctors on the universal health care plan, our education system has to change as well. Very few folks are going to be willing to go through 8 years of hard schooling/hospital work plus hundreds of thousands of dollars in tuition costs just to earn 50k coming out.
It was mentioned above that there are concerns that wait time will increase to get to see doctors if we get socialized (or universal, or whatever you wanna call it) medicine in the the US.
In a number of different countries in Europe, I've gone to see doctors (you all know how accident prone I am...), and I've never had to wait more than an hour to see a doc, whether it was life threatening (in which case I was always seen right away) or something like a busted up foot. Usually have to wait longer in the US, in my experience, to get in to see a doctor for non-life-threatening condition.
I'm not sure how it is with specialists in Europe, but here it is HIGHLY annoying. To see any kind of specialist it is usually a minimum of 2 or 3 months wait time. Like when I had my last concussion last month, I couldn't get in to see my neurologist and was given an appointment for two months after the injury. I can't imagine it would be any worse across the pond.
Also, I have a question: Is the pay for people in the medical profession going to change? Because there is is significant pay difference in people working for the public health care system in Europe vs. the US. Its not that I don't think many doctors are overpaid here (because many of them are... not all, but many), but for the new system to work, I imagine there will be pay cuts. And people don't like pay cuts. Keep in mind that this is coming from a person who is taking a more than 50 pay cut to work in the public health care system in Italy vs what I could make in the US. So I'm not thinking 'poor overpaid doctors/other medical people who are only now slightly less overpaid", I'm worried about the reactions and what impact it will have on healthcare.
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