After posting the piece about Nurses traveling to Germany and reading the feedback. I would like to open up a debate on this BB about "Universal Health Care" or "Single Payor Systems"
In doing this I hope to learn more about each side of the issue. I do not want to turn this into a heated horrific debate that ends in belittling one another as some other charged topics have ended, but a genuine debate about the Pros and Cons of proposed "Universal Health Care or Single Payor systems" I believe we can all agree to debate and we can all learn things we might not otherwise have the time to research.
I am going to begin by placing an article that discusses the cons of Universal Health Care with some statistics, and if anyone is willing please come in and try to debate some of the key points this brings up. With stats not hyped up words or hot air. I am truly interested in seeing the different sides of this issue. This effects us all, and in order to make an informed decision we need to see "all" sides of the issue. Thanks in advance for participating.
Michele
I am going to have to post the article in several pieces because the bulletin board only will allow 3000 characters.So see the next posts.
BSNtoBE... I dont quite think you read that post correctly... the poster you just quoted as "hitting it on the head" was saying that the US healthcare system is better than the Canadian one. Maybe I am misinterpreting you, and if I did then my apologies.
Here is the thing... Capitalism WORKS... Socialism does not... earlier a poster asked the question as to how socialism applies to the topic of universal healthcare... and I would like to ask said poster, do you know what the definition of socialism is? Socialism is any of various theories or systems of social organization in which the means of producing and distributing goods is owned collectively or by a centralized government that often plans and controls the economy. In other words, universal healthcare is just the begining of a socialized economy.
I believe it is NOT the governments role to pay for everyones problems. Rather that should be the community, friends, family and neighbors job to join forces, raise money to help those in need.
I just recently read an article that said that in many of those European countries, groups with a skyrocketing cost of healthcare are being left out to dry. I think it was in the Neatherlands, any babies born before 25 or 22 weeks (two differnt sources saying two differnt numbers) are pretty much left to die because the costs are so high and the insurance will not pay for health care. It is the same for disabled babies. Also, in the case of the elderly, they are being left out to dry because its not cost effective to spend tons of money for a sick elderly person who is going to die in the near future. Thats just the start of it. This doesn't account for the huge waiting lines to see a doctor, the months you have to live in pain just to get a simple sugury or even just a CAT scan/MRI. If its not life threatening (or if you are disabled, a premature baby, or elderly), then you can forget it.
In Holland babies born before 25 weeks arent given any treatment.
And if the US gets a universal healthcare system then those nice salaries you all have will soon dissapear. With the lowest price being the chosen route of treatment, the price cut will trickle down the chain and will affect your paycheck too.
I don't see that there are any surefire best ways to deal with health care. There is a spectrum of choices, with various pros and cons, and we disagree about where to draw the line.
In any system, there will be those who try to take advantage of the system. Some private sector companies try to take advantage. Some public servants try to take advantage. Some service recipients try to take advantage. We have many examples of both corporate inefficiency and of government inefficiency. No system is perfectly fair and perfectly efficient and perfectly innovative. We will have to live with imperfections in organizations and in individuals. We will continue to try to find a balance in society between individualism and collectivism (be it within family, community, country...).
Let's assume we all want a system that provides the best care to the most people - and not that people must be stupid or uncaring for holding certain views - then respectfully discuss our differences in perspective about HOW to provide the best care to the most people.
Specializes in burn, geriatric, rehab, wound care, ER.
We have so much information available on research based clinical practice guidelines that could make a profound difference on our Public Health, and in turn our economy, if only it were implemented in a consistent fashion. We have the information and we have the technology. We just need a good plan to marry the best of the HMO and the best of the PPO, mix it with some incentives, add a dash of personal responsibility and take out the over-inflated CEO salary factor. We just might come up with something bigger and better if we took our heads out of the sand for a moment, overcame our resistance to change and worked together. Do you FEEL me?
Just had to quote myself for the skimmers (me too) in case they missed it. I know universal health care has its limitations and I know our current system also has it's limitations. But can't we learn and grow and change and become better instead of arguing ideology. Our health care system is inequitous and broken.
People are broke (financially) because of it - bankrupt due to the need for catastrophic care, broke because their premiums are too high, out of work because their employer just could no longer afford to compete in a global market and physically broken because they didn't get inexpensive preventative care that could have saved the taxpayer millions.
People are still ripping off the system -from the MediCal Mom with SUV, cellphone, cigarettes and fake nails that still comes to the ER for tylenol to healthcare CEO's making millions (Aetna CEO- $22million, United Healthcare $124million, 2005 figures.)
Pride comes before a fall. The Roman Empire fell, the British Empire fell -who's next? Could it possibly be US?????? Can't you see the writing on the wall?
And just tell me what I'm supposed to do when Medicare has finally bitten the dust (approx. 2019) and I can no longer work. If I can't get affordable healthcare and I don't want to burden my dilapidated self onto my kids (presuming they'll have me), what am I going to do? Assisted suicide has been outlawed, so that's not an option. Maybe I'll turn up on someone's doorstep, maybe Timothy's, with my contracted, incontinent, demented body, smelling like a stage 4 fungating pressure sore and shrieking " Guess who's come for a long visit -tell me how much you like your libertarianism now?"
I just think that if we have the brains and we have the resources why can't we put our heads TOGETHER and come up with something good, something better than we already have and something better than other countries have. It might be difficult but it's not impossible. Look at how far we've already come.
Universal payer is not about communism. The government would not assume ownership of health care programs. It would pay for them. That's a form of democratic socialism. . .
Someone said I should think in terms of reality instead of ideology.
Fine. In REALITY, he who pays, decides. A single payor system where those who pay are NOT those who seek services are decided, not by those who seek such services, but by those who pay for them.
The result will be that the gov't determines your healthcare. If you think this isn't the case, take a long look at how Medicare DRGs have changed the face of what care is provided by all payor systems, including private insurance.
Some problems have been pointed out: outrageous disconnect between the pay of those at the top of 3rd party payor systems and their useful roles. I agree. I'm not a 'protect the rich' Republican. Most insurance organizations, such as car and home, are under regulation by State agencies to protect against rampant abuse. I'm not opposed to this.
There is a problem with access to preventive care: I agree. Expand THAT instead of co-opting and subverting the entire system.
Many argue that our care here provides less healthy Americans than socialized systems. I disagree. Americans are more unhealthy because we live more unhealthy lives. So, let's start with Aid to Families with Dependent Children. AFDC provides food stamps for a whole array of unhealthy food choices. Change the program to be like WIC - only coupons for healthy foods. That adds both health and incentive to the system. If you WANT coca-cola and frito-lay, go get a job and pay for it. But now, that would end the abuse by the largest abusers of AFDC: it is corporate welfare. (and you thought I was just a get the corporations rich Republican). No, cut out the corporate welfare from the system.
I'm not opposed to greater access to healthcare for all. I'm opposed to destroying the system for most of us in order to provide care for all of us. The result is that ALL of us will be less well off. That doesn't do ANY of us much good in the long run.
You want changes to make the system more equitable. I'm willing to discuss it. In MASS, they recently passed a mandatory health insurance law that stipulates that all citizens must obtain healthcare insurance and if they don't, the gov't will automatically provide it (while garnishing a pro-rated percentage of YOUR salary to pay for it). There's an incentive to be OFF the gov't dole if you can, and to deal with it when you must.
And successful program MUST include incentives for individuals to make wise choices. Universal healthcare simply doesn't do that. Neither, btw, does 3rd party payor systems, like we have now. Oh, they do in SOME cases: knowing I have to pay 125 dollars up front to use the ER means I don't abuse it for a papercut. But in the main, the problems with our system are inefficiencies built in by removing incentives.
BSN2009 has a good idea about a catasthropic insurance plans plus the requirement to pay out of pocket for routine care. There is an incentive based start. Add to that cafeteria plans or healthcare savings accts that allow you to CHOOSE your best care and pocket the difference, and you'd see a whole generation pondering this question when it comes to healthcare: what does it cost me? And that is the start of true economic reform. Because, economics boils down to incentives.
I'm against any program that removes personal responsibility from the concept. Because, in the end, with responsibility comes rights. And a system that deprives the incentives of individual responsibility is one that also deprives individuals of the right to seek the best care.
On the other hand I see people really taking Medicare/Medicaid for a ride. A few years ago, as a case manager, I had a 95 year old patient who was blind, demented, and dependent on both dialysis and a ventilator. I'll give you 3 guesses as to her quality of life. Try as we might we could not get her family to change her code status. Full code. But as long as the government was paying for her care the family had no incentive to change their mind. I would have given a week's paycheck to be able to tell them "sorry, the insurance has run out - how would you like to pay for her care: cash, debit or credit ?" I'm not trying to be mean, but you know how money talks, plus I have a big problem with patients being trapped in a body that no longer works with zero quality of life while their families sort out their grieving issues - the phrase "cruel and unusual punishment" comes to mind.
UKRN,
You hit the nail on the head!!!!! I just quit a job in a LTC facility and I saw way to much of this going on. As well, I am intending on writing to my elected officials about this issue. I know this is a 'hot topic', but we do have to admit that we have limited resources when it comes to healthcare. Many of these 'residents' are being kept alive by very expensive drugs that probably werent around 10 yrs ago - thereby giving them a quality of life (in a unsafe, chronically understaffed and underfunded LTC) of about....nothing. Where do you draw the line when it comes to end of life care??
Why is the infant mortality rate in the Netherlands is so much lower than it is in the United States. Could it be due to access to prenatal care? Could it be the same story in the Czech Republic, Andorra, Slovenia, Cuba or any of the other 38 countries that the CIA says have lower infant mortality rates?
Universal payer is not about communism. The government would not assume ownership of health care programs. It would pay for them. That's a form of democratic socialism, and it's akin to what's practiced in Sweden, one of 47 countries where the CIA says people live longer than they do in the United States.
Wow, I'm surprised to see Bosnia and Herzegovina have a longer life expectancy than the United States. I guess we need to get cracking on modeling ourselves after them.
I think we need to look at the reasons for the high cost of healthcare in the US. Outlaw huge punitive judgements. Limit lawyer's fees to actual hours times hourly rate. Outlaw phamaceutical ads and ambulance chasing ads. I'm tired of folks who think they need the new whatever-color pill because they saw an ad for it on TV and everyone in the ad was smiling.
What I don't understand is the argument that a single payer health care system will lead to abuse. Just because I will have health coverage, all the sudden I'm going to go out and start eating KFC and Big Macs, not exercising, and going to the doctor when I cut my finger? I don't think so. I am anal about my health, I don't LIKE fast food, and I don't really care for going to the doctor other than when I absolutely have to, or for preventative checkups that hopefull catch something before it gets too big. I have relatives all over the world, and geez they surely don't go to the doctor when they sneeze just because they can and know it'll be paid for.
Timothy, fat cat CEO's already determine our health care. It's ALREADY RATIONED!! That is just a plain old FACT. I know from experience that it is. And forcing people to pay for health care by "capitalizing" it isn't the solution either...I'm sorry. You can accomplish the same goals of cost competition with single payer. Poor people barely able to pay their bills as it is, are not going to pay out of pocket for preventative care that can save them from serious disease, just because they are forced to go out and get a doc to compete for their business. Most of the businesses in this country are consolidating and nearly monopolizing as it is. Don't expect all kinds of competition from small health care clinics and private practice doctors just cuz we "capitalize" health care.
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cabkrun
44 Posts
I would like to see studies that back these speculative thoughts up.
If Universal Health Care in Europe and Asia is failing, why are we so far down on the list of health of citizens?
Canadians (or Europeans) running over the US for health care is BS and a myth. Show me some info on this supposed fact.