Published
From Bloomberg:
Universal Health Care
Six in 10 people surveyed say they would be willing to repeal tax cuts to help pay for a health-care program that insures all Americans.
...
Most of the highest income group polled, those in households earning more than $100,000, support it. While more than eight in 10 Democrats say they like the plan, most Republicans oppose it.
Most of the highest income group polled, those in households earning more than $100,000, support it. While more than eight in 10 Democrats say they like the plan, most Republicans oppose it.
...
An agenda focused on health care and education spending would be better for the economy than returning money to taxpayers through tax cuts, she said: ``In the end it would cut costs.''
By 52 percent to 36 percent, Americans favored health and education spending as a better economic stimulus than tax cuts
Source: http://www.bloomberg.com/apps/news?pid=20601170&refer=home&sid=a2TWmuh3vHHI accessed today.
The law of supply and demand actually does work, when demand isn't artificially propped up by gov't and when the gov't's hand isn't on the scale. You point out the effect of the gov't's hand on the scale and chalk that up to the failures of capitalism. No. It is the failure of GOV'T. THIS is what you want to make the standard - gaming the gov't system. Let consumers own their own care, and see how fast the market adjusts to reflect REAL demand.
Let me give YOU an example. Medicare pays based upon DRGs. They pay a set fee, based upon the admission codes. In the 80's, the gov't made an exception to this rule. It WANTED to increase acute skilled nursing care, so it allowed unbundled care (charge by charge billing) in order to do so. The result: EVERY hospital and many nursing homes in the nation suddenly opened up a skilled nursing unit. Was there a market demand for such services? Maybe, maybe not. What there wasn't, until the gov't changed the rules, was a BUYER for such services. Fast forward 20 yrs. Since everybody is doing it, skilled care became a glut the gov't could no longer afford. So, they changed the rules, again. Overnight, most skilled nursing units went bye-bye. Did the market for such services suddenly dry up? Maybe, maybe not. What DID happen is that there was no longer a BUYER for such services.
You want to suggest that single payer would not affect the choices available to individuals seeking care. Nothing could be further from the truth! Single payer means that the available system is the result, not of a mosaic of consumer demand and need, but of a mosiac of gov't policy. That policy will invite gaming of the system. It will create gluts in some places, shortages in others. A cadre of economists simply can't 'plan' an economy better than can catering to the supply and demand of an empowered consumer. THAT is why the Soviet Union failed in the face of a better economic system. The parallel is the same. THAT is why socialized medicine will be a disaster compared to a better healthcare economic system.
That better healthcare economic system will be one where the 'healthcare professional economists' are individuals, negotiating independently for their healthcare wants and needs.
I have more faith in 300 million independent 'healthcare professional economists' than I do in any cadre of gov't ones.
~faith,
Timothy.
I am going to let Paul Krugman speak:
Excuse No. 4: Socialized medicine! Socialized medicine!
Rudy Giuliani’s fake numbers on prostate cancer — which, by the way, he still refuses to admit were wrong — were the latest entry in a long, dishonorable tradition of peddling scare stories about the evils of “government run” health care.
The reality is that the best foreign health care systems, especially those of France and Germany, do as well or better than the U.S. system on every dimension, while costing far less money.
But the best way to counter scare talk about socialized medicine, aside from swatting down falsehoods — would journalists please stop saying that Rudy’s claims, which are just wrong, are “in dispute”? — may be to point out that every American 65 and older is covered by a government health insurance program called Medicare. And Americans like that program very much, thank you.
http://www.nytimes.com/2007/11/09/opinion/09krugman.html?_r=1&n=Top/Opinion/Editorials%20and%20Op-Ed/Op-Ed/Columnists/Paul%20Krugman&oref=slogin accessed today.
The profit motive in the finance end of health care is inconsistent with cost control.
The profit motive in the finance end of health care is inconsistent with cost control.
The financing of healthcare today IS inconsistent with cost control. That's not because of profit motive. That is because THE GOVERNMENT is interfering with the financing of healthcare, both with Medicare DRGs and with employer-based tax breaks.
Profit motive is the ONLY consistent means to control cost, in any endeavor. THAT is why gov't costs are always subject to massive over-runs. Gov't monopolies have no incentive to curtail costs.
Self-motivated interest, on the part of the buyer and seller, ensures that the best combination of quality and price will be achieved.
Gov't 'planners' can't do this. They never have been able to do so. Planned economies always fail.
The best economic plan is power to the people, and not some gov't 'crat.
It comes right down to this: mistrust of 'profit motive' is really mistrust of individuals to conduct their lives absent gov't approval or control. When you say you don't trust 'profit motive', what you mean is, you don't trust people to make their own best decisions.
Fine.
However, don't be surprised when those very same people rebel at either your interference generally, the type of 'plans' you have for their lives specifically, or both.
When it comes to my life, I have a message for both the gov't AND liberal do-gooders: My life is NUNYA.
~faith,
Timothy.
The reality is that the best foreign health care systems, especially those of France and Germany, do as well or better than the U.S. system on every dimension, while costing far less money.
The reality is that the primary method France has employed to keep costs low is to pay their doctors squat. As a result, they don't have nearly enough providers. AS A RESULT, France is giving serious consideration to privatizing part of their system.
Great Britain has been trying to go down the privatization road for sometime.
Canada's private system - once outlawed and still legally questionable - is expanding by leaps and bounds. "Access to a waiting list is NOT access to healthcare" isn't just some hyperbole. THAT is the decision of the Canadian Supreme Court. Dismiss the inherent and unworkable structural problems of gov't restricted healthcare all you like; it doesn't make them go away.
Unhinging demand from supply by creating unlimited demand (It's FREE!!) means either creating unlimited supply (impossible) or rationing supply. The law of supply and demand cannot be repealed by Congress or liberal do-gooders. Even if you want to. Even if you want to, really really badly.
The ONLY socialized healthcare systems still working are America's and Australia's - because BOTH have kept a private system at least partially intact and those private systems have functioned to bail out and offset the public ones.
The NHS is in shambles. It has no idea how to right its sinking ship. It is pouring more tax dollars in for less result. This is not a road we want to go down. We should learn from the MISTAKE that is socialized medicine. What an unfettered disaster!
~faith,
Timothy.
Canada is addressing the waiting time issue by adopting EBP guidelines for prioritizing care. (Which as is usual is quoted out of context.) Furthermore, the US has problems with waiting times and access to care that are worse than even the worst designed of the single payer systems. Woolhandler addresses this issue in the following:
Objectives. We compared health status, access to care, and utilization of medical
services in the United States and Canada, and compared disparities according
to race, income, and immigrant status.
Methods. We analyzed population-based data on 3505 Canadian and 5183 US
adults from the Joint Canada/US Survey of Health. Controlling for gender, age,
income, race, and immigrant status, we used logistic regression to analyze country
as a predictor of access to care, quality of care, and satisfaction with care,
and as a predictor of disparities in these measures.
Results. In multivariate analyses, US respondents (compared with Canadians)
were less likely to have a regular doctor, more likely to have unmet health needs,
and more likely to forgo needed medicines. Disparities on the basis of race, income,
and immigrant status were present in both countries, but were more extreme
in the United States.
Conclusions. United States residents are less able to access care than are Canadians.
Universal coverage appears to reduce most disparities in access to care.
(Am J Public Health. 2006;96:XXX–XXX. doi:10.2105/AJPH.2004.059402)
http://pnhp.org/canadastudy/CanadaUSStudy.pdf (available full text at that link.)
France's system is partially privatized (at least that can be inferred from Ezra Klein's Health of Nations.)
From a population standpoint the canadian system is outperforming the US. Most of the problems in the Canadian system are attributed to underfunding. The PNHP proposal does not call for funding cuts but does call for maintaining current funding levels with a significant reduction of administrative costs.
The claims about seeking privatization by these systems are made on a rather regular basis but are not sourced so it is difficult to evaluate the veracity of claims to that effect.
Since we could finance a fairly good system , like the Norwegian, Danish or Swedish system with the public money we are already spending (60% of health costs), why do we need to raise the additional 40% (from employers and individuals)?
There are three reasons why the U.S. health care system costs more than other systems throughout the world. One, we spend 2-3 times as much as they do on administration. Two, we have much more excess capacity of expensive technology than they do (more CT scanners, MRI scanners, mammogram machines than we need). Three, we pay higher prices for services than they do. There is no doubt that we do not need to spend more than we currently spend to cover comprehensive care for everyone. But it would make the transition to a universal system very difficult at first if we spent less. That is because we have a tremendous medical infrastructure, some of which would likely retain its slightly larger than necessary capacity during the transition phase. Secondly, we would likely retain salaries for health professionals at their current levels. Thirdly, we would cover much more than most other countries do by including dental care, eye care, and prescriptions. And for these reasons we would need the extra 40% that we are already spending – but NOT more. We could cover all the uninsured for the same amount we are currently spending!
Source: http://www.pnhp.org/facts/singlepayer_faq.php?page=4
See also:
France’s health system is great, but isn’t the cost of universal coverage hurting their economy?
One of the main contentions of those opposing some form of non-profit universal health coverage is that many of these countries are in trouble economically. For instance, France's tax burden as percent of GDP is much higher than ours, it has a larger bureaucracy & higher unemployment (partially because far fewer in prison & they don’t count part-time as employed). According to the CIA World Fact Book 2006†(available on the web), the French national debt as percent of GDP was exactly the same as ours, 64.7%. Since France's population is 1/5 that of U.S., for comparison, I multiplied French stats by 5. They actually have more gold & currency reserves than we do. The U.S. trade deficit is 4.5 times the French. The French have much higher rates of household savings & lower household debt. Their companies invest a greater percentage of gross revenues on infrastructure. And according to the World Investment Report 2006 of the United Nations Conference on Trade and Development (available on the web), foreign investment in France is 1.9 times more per capita than in the U.S. However, the French budget deficit was 20% higher than ours in 2006. In 2007, the U.S. significantly reduced its budget deficit, something the French are also working on, but the other stats in France's favor remain. Those who trust the wisdom of private corporations might wonder why the world’s business community prefers to invest in France. So altogether which economy is in stronger shape? The U.S. economy is living on borrowed time & borrowed money. The causes are multi-factorial. However, our health care system is a major contributor.
Source: http://www.pnhp.org/facts/singlepayer_faq.php?page=6
A letter from a patient:
http://www.pnhp.org/news/2007/november/is_reform_to_benefit.phpAs a Type 1 diabetic I have had first-hand experience with health care in America, Canada and most recently, Japan.
In America when I became diabetic I lost my job (it was a medical disqualification) which meant that I also lost my employer -provided health care. With what was now a pre-existing condition and no income I was unable to afford health insurance. I paid cash for my medical care and I paid full price, not the reduced rate that insurance companies negotiate with doctors and hospitals. Major diabetic complications (which I have so far been spared) could mean bankruptcy.
By contrast, in Canada I went to any doctor I chose, received excellent care paid for through the single-payer system there, and never had to worry about filing claims or denial of a claim by an insurer. I met no Canadians who were interested in converting to an American-style system. Ms. Trautwein would have us believe that Canada has “substandard care, long waiting lists, loss of physicians, forced outsourcing and healthcare rationing.” Surely there would be hordes of Canadians clamoring to do away with the “inferior” single-payer system.
In Japan I get prompt, competent care without worry about bankruptcy. The citizens seem satisfied with the system.
Ms. Trautwein tells us that black is white and night is day while she benefits from a system that causes pain and misery to those around her. Why should she have any credibility?
Thanks for telling the truth, Don.
Best regards,
Jeff Aaron
In the Free Market Model (FMM) advocated by ZASHAGALKA ,as I understand it Consumers would purchase catastrophic care insurance , then pay for any other care they receive themselves . I would be grateful if somebody could tell me how a consumer with a chronic condition such as Diabetes Melitus , or a Cancer requiring complex treatment be managed in the FMM and be able to pay for their care .
My fear of the FMM is how will the avarice of the Healthcare corporations be kept in check .They will fight to maintain their market share ie.small provider opens up , charges less , Big corporation will reduce its costs in that market , by using profits from rest of chain ,once small provider put out of business , Corporation will recoup its loses .
Whilst I believe that we as RN may have the ability to research our healthcare and possibly be able to finance it, there are many consumers of health care who would not be able to do so , how is this group to be cared for ?
In the Free Market Model (FMM) advocated by ZASHAGALKA ,as I understand it Consumers would purchase catastrophic care insurance , then pay for any other care they receive themselves . I would be grateful if somebody could tell me how a consumer with a chronic condition such as Diabetes Melitus , or a Cancer requiring complex treatment be managed in the FMM and be able to pay for their care .My fear of the FMM is how will the avarice of the Healthcare corporations be kept in check .They will fight to maintain their market share ie.small provider opens up , charges less , Big corporation will reduce its costs in that market , by using profits from rest of chain ,once small provider put out of business , Corporation will recoup its loses .
Whilst I believe that we as RN may have the ability to research our healthcare and possibly be able to finance it, there are many consumers of health care who would not be able to do so , how is this group to be cared for ?
Our system does not perform very well:
In the Free Market Model (FMM) advocated by ZASHAGALKA ,as I understand it Consumers would purchase catastrophic care insurance , then pay for any other care they receive themselves . I would be grateful if somebody could tell me how a consumer with a chronic condition such as Diabetes Melitus , or a Cancer requiring complex treatment be managed in the FMM and be able to pay for their care .My fear of the FMM is how will the avarice of the Healthcare corporations be kept in check .They will fight to maintain their market share ie.small provider opens up , charges less , Big corporation will reduce its costs in that market , by using profits from rest of chain ,once small provider put out of business , Corporation will recoup its loses .
Whilst I believe that we as RN may have the ability to research our healthcare and possibly be able to finance it, there are many consumers of health care who would not be able to do so , how is this group to be cared for ?
Catastrophic care would kick in both with a single major illness, OR, with a high amount of deductibles (chronic care). It would STILL be far cheaper than what we have today, which isn't insurance, but rather, pre-paid care.
The savings from moving away from the now higher pre-paid plan, PLUS the transfer of the tax breaks for healthcare from business to individuals, would be more than enough to fund a healthcare savings account that would cover the gap to the catastrophic plan.
In that way, chronically ill patients would not be left out of the loop. In fact, bringing the price of healthcare down to affordable levels will allow them to have more options at better pricing than they do now. Those that must use the system more benefit the MOST from bringing market competition to available care. It is the current system that does the most harm to chronically ill individuals. The gov't has conspired with employers to make coverage unattainable by yourself. THAT is dastardly.
THAT is what a socialist system will just entrench. When cost controls must be implemented in a socialist system, it is those that use the service the MOST that will feel the pinch the worst. If you want to get rid of crime, you lock up the 10% of people that commit 90% of crimes. What do you do when you want to get rid of cost over-runs for healthcare? Simple. Deny access to the 10% of people that use 90% of care. Makes good sense if you are the average, healthy American tired of paying ever more taxation to fund a socialized boondoggle. But, what if you are one of those 10 percenters? It is gov't restricted care that you should justly fear if you are chronically ill. Who will feel the burden of high wait times and lack of providers and over-crowded EDs the most? The average healthy American, or the chronically ill?
The avarice of big healthcare inc., is already rampant because they use the gov't as a shield to prevent from having to be directly accountable to you. When you make that gov't shield absolute, with single-payor, your opinons - and choices - will cease to matter at all. The ONLY thing that WILL matter is which lobbyists convince which politicians in which backrooms for which loophole for their clients.
You lose. You lose in such a system because it's not designed, with you in mind. The gov't is for sale. Unless you are rich enough to buy your fair share, you can't afford it.
You can't afford the gov't taking over any more of your healthcare than it already has. It has done enough damage. It's time for a change. It's time to actually empower the healthcare USER. What a unique idea: power to the people.
~faith,
Timothy.
decartes
241 Posts
interesting thread