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.
We do not live in the same world. You describe a place that used to be not a place that is today. The middle class is not growing it is shrinking due mostly to the loss of jobs in what used to be big industries. Have you ever been to the Rust Bowl? Have you seen the areas that used to make automobiles in this country? Go visit Detroit, Cleveland. My states used to have chemical companies that were the backbone of our economy.. Union Carbide, Dow Chemical, DuPont.. all of them gone (to where..over seas?) Now Wal-Mart is our largest employer in the state . Go visit any small town in midwest and see how they fare these days. Steele companies have lost their market to Japan and their jobs. These industries were the back bone of middle class, they were the middle class and now they are gone and nothing but Wal-Mart has replaced them. You have got to take them blinders or rose colored glasses off sometime. Texas won't have oil forever.
I am not advocating socialism. I am just trying to say that I think capitalism has had it's day and will probably come to an end in the not to distant future. I don't know what will replace it nor do I have a clue as to what would be the best choice or even know the choices. I just know that things can not go on like this for very much longer and still be called capitalism.
I think the other failure of conservative ideology is that wages have been essentially flat for the middle class over the last 30 years. Ultimately a society has to work together to meet common goals. The Nation recently had articles describing how America has become a 2 class society and that social mobility is now less available to Americans than it is to European Union countries. The koolaid of the right has poisoned our politics and our ability to work together to make a better future for our children.
I think the other failure of conservative ideology is that wages have been essentially flat for the middle class over the last 30 years. Ultimately a society has to work together to meet common goals. The Nation recently had articles describing how America has become a 2 class society and that social mobility is now less available to Americans than it is to European Union countries. The koolaid of the right has poisoned our politics and our ability to work together to make a better future for our children.
Not to mince spirited characterizations, but 'the Nation' isn't kool-aid?
"The bottom-line is that some workers are clearly going through tough times as productivity growth causes a reduced demand for labor in many old-line industries that were once considered untouchable engines of growth. Nonetheless, the vast majority of workers are much better off today than they were five, 10 or 15-years ago.
With productivity booming, the unemployment rate well below 5%, tax rates low, and Fed policy still accommodative, the future looks pretty darn bright. Not only are workers better off at this point in the business cycle when compared to the last one, but the best is yet to come."
We don't need to make it a right wing conservative vs liberal issue. Believe it or not I am as right wing as you can get on most issues. We need to forget political lines (Personally being a republican or democrat unless you are running for office neither has done anything for me). We need to get back to grass roots, what is good for the common man, back to the original American ideals. Let healthcare for everyone be the first step toward that goal.
Zashgalka, or anyone else that is against universal healthcare , what would be your model of a good healthcare system, or do you think the one we have in place today is good? Try to be as simplistic as possible for us slow learners out there. Any countries that you know of have what you would consider better healthcare than the USA? Or is our current system of private insurance the best?
Zashgalka, or anyone else that is against universal healthcare , what would be your model of a good healthcare system, or do you think the one we have in place today is good? Try to be as simplistic as possible for us slow learners out there. Any countries that you know of have what you would consider better healthcare than the USA? Or is our current system of private insurance the best?
Get rid of third party payor systems and have the average citizen directly pay for his/her basic healthcare. THAT will return some financial frugality to the system.
1. Catastrophic insurance that everybody must pay into, on a means tested basis, like the proposed Massachusetts plan signed by Gov. Romney.
2. Tax exempt Healthcare savings accounts for basic health needs. Our 'insurance' system is not really an insurance system because it doesn't just provide for 'insured' needs, like catastrophic care. In reality, it's a 'pre-pay' system in that you are pre-paying for all your health needs.
Can you file with your electric bill on your homeowners insurance? Can you put your gas bill on your car insurance? But, you can file routine bills on your healthcare plan. What's the difference? One's an insurance program, and one's a default pre-pay plan.
Instead of 'pre-paying' some insurance company, health savings plan would allow you to 'pre-pay' yourself. As the consumer, if YOU are paying for the bills, you have much more control on the services you get. Right now, as many have pointed out, if an insurance company pays your bills, it's THEIR choice. If we move to the gov't paying your bills, it would be THEIR choice.
The greatest mix of choice and cost control would come from consumers paying the bill and minding the costs.
That's not nearly as expensive as it sounds. First, if you are already paying 3-4 grand a year for insurance, paying only 1 grand for a purely insurance model catastrophic plan plus shielding 2-3 grand into a HSA would not cost more money. Second, with individual consumers minding the price, do you think any company could really charge a grand for a CT scan?
How many drug companies could charge 150 dollar for a prescription if consumers were much more interested in the 15 dollar generic of the same class of drug?
What we normally say NOW is that you are paying for yourself and the 3 people that didn't pay. But then, the market would be forced to directly match demand. Costs would spiral downward.
If you want to fix the system, introduce more direct capitalism into it, not less. Less will just get you more of the same. Much more.
"Unfortunately, U.S. healthcare policies still tend to limit competition, restrict consumer's freedom to choose, and discourage consumers from shopping for value. Thus, there are too few choices and there has been little attention paid to price and quality of service. The answer is clearly not more government intervention, but instead letting competition and the power of the marketplace drive down prices and increase quality and access to care.
Health Savings Accounts are the Solution
There is increasing recognition that third-party health insurance payers are actually a major cause of escalating medical costs and the decline in the quality of service. The increasing adoption of HSA plans has already begun to cause greater transparency and competition in the medical marketplace. There are now physicians available by phone, medical kiosks setting up in malls, doctors that accept only cash (and charge significantly less), and others competing directly for the consumer's healthcare dollar."
"can you file with your electric bill on your homeowners insurance? can you put your gas bill on your car insurance? but, you can file routine bills on your healthcare plan. what's the difference? one's an insurance program, and one's a default pre-pay plan." zashagalka
exactly right tim.
i think it would take a blanket change that turned back time to when you paid for your own regular doctor's appts and meds. and insurance was only for the catastrophic.
i pay more into my medical insurance program than i spend in a year on anything related to healthcare. in fact i opted out of optometric insurance because it cost more than my check-up appt and new glasses per year.
doctors and hospitals and pharmaceutical companies raised prices because insurance would cover it . . . . and that was the start of this whole mess.
So the wealthier will get better healthcare and the poor will get what? I remember when I was a child , my father was self employed, no insurance , we kids practically were dead before our parents took us to the doctor, they were not bad parents, but very frugal hard working immigrants from Europe after WW2. Going to the doctor was considered a luxury only the rich could afford.
"When managed care was debated in the United States, I remember vaguely thinking there was something good about the idea: After all, government should be involved in health care. I had never even been to Washington, D.C.
But when I stepped into that emergency room, it got me thinking. Again, I was a Canadian. There are three things I absorbed from that environment: One was a fondness for ice hockey, the second was an ability to convert Fahrenheit to Celsius in my head, and the third thing was a belief that if the government did it when it came to health care, it must be compassionate.
Eventually, I began to think about these things. In Canada at the time, there were really two schools of thought with regard to health reform. There were the people who thought we should spend more--I like to call them the spendthrifts--and the people who thought we should just hire more administrators and make the system work better--I like to call them the magicians. I started to think about these things, and I became a spendthrift, and then I became a magician, and then I became agnostic, and eventually I became an atheist on health policy in Canada because I realized there was something going on which was much more fundamental: that there was a problem with a government-run system."
* * *
"I don't buy it (that medicine is more expensive because it's more advanced), because in every other aspect of the economy, technological advancement has been accompanied by a fall in prices. Look at unit price. Computers are much more sophisticated than they were 10 years or 20 years ago. The computer on my desk is faster; I can download stuff from the Internet--whatever I want. It's so much more sophisticated, and yet it's so much cheaper. Look at the macro level: Agriculture is much more sophisticated than it was 50 years ago. We feed more people a more diverse amount of food, and yet as a percent of GDP it has dropped.
Why is it that health care keeps rising year after year? Why has cost doubled since 2000? I think, unlike so many of my colleagues, the answer is because of the odd way we pay for health care in America."
"Of COURSE socialism wants to diminish my healthcare."
"so Capitalism is good for some and to heck with the rest."
These arguments aren't particularly useful. There is some truth in them but they are inaccurate and very inflammatory. Making such statements only offends the very people you are disagreeing with and does nothing to encourage them to listen to you. The implication is that if you support universal health care you "want to diminish people's health care" and that if you don't support universal health care your attitude is "to heck with the rest." Neither is accurate.
Socialism doesn't "want" to do anything. People who support socialist style programs don't want to see people suffering from lack of a resource. Sometimes, pooling resources IS an effective way to meet people's needs. Socialist style programs, though, do need to work in some kind of incentive to discourage people from wasting their generous gift from society and then asking for more.
Many people who support capitalism truly believe that it provides the most benefits for the most people. Capitalist endeavors have done much to improve our quality of life. Capitalist systems, though, do need to work in some regulations to keep people from monopolizing vital resources or exploiting vulnerable people and places.
So while we may all have certain assumptions about the "root" of a problem (bleeding heart liberals passing out money like it grows on trees or greedy corporate interests that would let people die if it increased their bottom line), the reality is somewhere in the middle and the solution will hopefully incorporate the best of socialist intentions and the best of capitalist incentives. And the willingness to acknowledge that no solution is permanent and will continue to need to be tweaked over time in a process that is ever a few steps behind as it tries to keep up with ever-changing societies.
I do think Tim has a point that "health insurance" is a misnomer. This point is vital in a debate over affordable health care.
Insurance is ideally paid into with the hope of never having to use it. It is to cover an unlikely but possible one-off expense that would otherwise be unaffordable. For example, let's say I owe $200/mon on a car loan worth $5000. Without insurance, if that car were totalled, I'd still have to continue paying that load off. So I decide to pay an extra $25/mon for insurance that will pay off my loan if my car is totalled. Over the course of several years, I may pay close to $1000 for that insurance, and I don't get any of it back if I don't total my car. Maybe after I owe less than $1000, I decide to drop that coverage and take the chance that I won't have an accident.
That's totally different than a car dealer's warranty where any major mechanical problems will be fixed "free of charge" for 3 years or 50,000 miles after purchase (I'm pulling those numbers out of the air). The cost of that is bundled with the purchase price or perhaps is an extra warranty you can buy for a set price. Either way, the dealer is playing the odds that a majority of their cars won't need expensive fixes during the warranty period. It's pretty obvious why used car dealers don't offer much in the way of warranties. Too many of those cars WILL need expensive repairs.
HMO's began by covering healthy people most of whom wouldn't generate major medical bills - like new cars that won't need much maintenance. They were covering large groups of employees who by nature of being employed were fairly young and fairly healthy. If a large employer wanted to sweeten the pot of benefits for it's employees, it could offer "free health care" and get a pretty good deal by using an HMO. Someone told me that after World War II there were caps on wages and that's when benefits packages became more common place. That's information that I still need to check out.
This type of plan, though, doesn't work as well when you throw in a larger percentage of people with chronic health conditions (like used cars?!) and when the overall costs of health care are higher (with more technology and health care break throughs, basic health care for a healthy person still adds up while there are many more possible treatments for those with health issues).
As to your analogy, we have less new cars today as we do old clunkers in need of repair. Old or new we still have maintainence costs, and unlike health insurance, auto insurance does not cover those cost. I would much rather pay the $50 for oil change,lube job and tires rotated and fluid levels checked for my car than the $480 that it cost on my last doctor visit just in lab work not counting the stress test and PFT's. Not a practicle analogy.
burn out
809 Posts
We do not live in the same world. You describe a place that used to be not a place that is today. The middle class is not growing it is shrinking due mostly to the loss of jobs in what used to be big industries. Have you ever been to the Rust Bowl? Have you seen the areas that used to make automobiles in this country? Go visit Detroit, Cleveland. My states used to have chemical companies that were the backbone of our economy.. Union Carbide, Dow Chemical, DuPont.. all of them gone (to where..over seas?) Now Wal-Mart is our largest employer in the state . Go visit any small town in midwest and see how they fare these days. Steele companies have lost their market to Japan and their jobs. These industries were the back bone of middle class, they were the middle class and now they are gone and nothing but Wal-Mart has replaced them. You have got to take them blinders or rose colored glasses off sometime. Texas won't have oil forever.
I am not advocating socialism. I am just trying to say that I think capitalism has had it's day and will probably come to an end in the not to distant future. I don't know what will replace it nor do I have a clue as to what would be the best choice or even know the choices. I just know that things can not go on like this for very much longer and still be called capitalism.