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.
I have a story about getting LASIK surgery in Canada. I was able to get it done in 2000 for 1000 dollars versus 4500 US at the time. What was the difference? Simply this in CANADA the clinics could own their biomedical equipment outright without payment of subsequent license fees to manufacturers. In the US at that time there was an ability for the manufacturer to either require that equipment could be leased only or that the Royalty fee be collected for each surgery. Admittedly prices for this surgery have come down (at least in MN) but the point I am making is that regulated competition will help bring costs down. We protect the manufacturers to the detriment of consumers. Single payer/Universal access ultimately protects patients and the broader interests of society at large.
One of the proposals is that HSAs would 'roll over' year after year. That way, while you are young, and theoretically healthy, you would be rolling money towards the day when health problems begin to appear.
Since YOU are managing those accounts, they would not only be portable, like retirement accounts, but you would have a vested interest in growing them, and therefore, a real dollar incentive to find the best healthcare bang for your buck.
If the HSAs were made portable, then coverage would not depend on current employment at any point in the system, but on aggregate employment. How many people are afraid to change jobs because of healthcare? Used to be the same way with retirement. 401(k)s and the like unhinged the concept of employer for retirement. Why not do the same for healthcare.
Employer sponsored healthcare IS a throwback to wage controls of WWII. An employer was prohibited by law to use higher wages to attract employees, so, they used 'fringe benefits' not regulated by those wage controls. Employer sponsored healthcare is a throwback to an outdated concept, just like the typewriter key positioning on this machine I'm working on, an 'agrarian' based school schedule, etc., etc.
Combined with catastrophic insurance for hospital coverage, HSAs have the potential to reintroduce real, consumer driven cost controls.
It's not a perfect idea and would have to address how to take care of the chronically ill, or those who are not healthy and young, but there are other ways to take care of that.
For example: means test SS and Medicare. IF you have more than 500k/yr assets, you don't qualify for either. Essentially these programs were designed as safety nets, "insurance programs" but have the same built in inefficiencies as 'pre pay' health insurance. Use the money saved by THAT to both shore up those systems AND to extend coverage to those more chronically ill.
I'm actually surprised that more people that believe the system is basically rigged rich vs. poor aren't advocating for means testing of SS/Medicare for the same reasons they advocate taxing the rich more.
There ARE innovative market reforms that can happen to healthcare.
Ultimately, I believe that both universal healthcare and our current system suffers from the same problem: by taking price out of the equation, there is no rational basis for controlling demand.
You can build incentive based access into the system that would benefit most people without throwing the, for lack of a better word, 'outliers' under such proposals to the curb.
~faith,
Timothy.
The argument against means testing is that with the income cap on taxing earnings they are in effect capped at the amount that they receive from SS. (Medicare taxes are not earnings capped.) Really the earnings cap on SS taxes needs to be raised to 500,000 AND applied to all forms of income including passive incomes such as dividends and capital gains. Warren Buffet argues and I agree that it is essentially wrong for his secretary to pay a higher effective tax rate than he does as a multibillionaire.
The problem that I see with HSA's is not necessarily in concept but the execution. With employer based health care it is not uncommon for there to be numerous different plans in any given area. Each one having different administrative rules. With HSA's I could see further fragmentation of benefit coverages AND increased administrative costs as a result. 31% administrative costs are plainly wasteful of precious resources!
well, deep subject! First off we have to spend most of our money on war, Then when it comes to health care we take care of the poorest Americans and the illegal immigrants and many legal ones but no one else. Then there are all the insurance companies that need their cut. then there's the lawsuits and the lawyers. Oh yes and the big companies and individuals might have to pay higher taxes. How about the long held American belief that everyone should take care of themselves. Well lets just say the US has a long way to go. I have no insurance last summer got a simple case of strep throat, that coast about $400.00 if i get anything serious I guess I'd have to go to Mexico to get treatment I could afford. In the area i used to live in had a doctor that took pt.s for $275 a year, what a deal. Have a good day! Here's to good Health!
2007 State of the Union: A future of hope and opportunity requires that all our citizens have affordable and available health care.
2006 State of the Union: Keeping America competitive requires affordable health care. Our government has a responsibility to provide health care for the poor and the elderly, and we are meeting that responsibility. For all Americans, we must confront the rising cost of care, strengthen the doctor-patient relationship, and help people afford the insurance coverage they need.
2005 State of the Union: we must make health care more affordable, and give families greater access to good coverage
2004 State of the Union: To make insurance more affordable, Congress must act to address rapidly rising health care costs.
2003 State of the Union: Our second goal is high quality, affordable health care for all Americans.
2001 State of the Union: Many working Americans do not have health care coverage, so we will help them buy their own insurance with refundable tax credits.
The reality:
The Reality
Americans without health insurance, 2000: 38.2 million 2
Americans without health insurance, 2005: 46.6 million 3
Average monthly worker contribution for family coverage, 2000: $135
Average monthly worker contribution for family coverage, 2006: $248 4
Percentage of annual bankruptcies due to medical bills: 55% 5
I hope I don't get in trouble for posting in the HM2viking forum, but I wanted to once again point out that just because you repeat lies, it doesn't make them true.
The numbers you use to identify those without health insurance are incorrect.
I hope I don't get in trouble for posting in the HM2viking forum, but I wanted to once again point out that just because you repeat lies, it doesn't make them true.
The numbers you use to identify those without health insurance are incorrect.
■ Uninsured, national — 46.8 million (15.9% of the population), 2005, up from 45.3 million in 2004. Hispanics highest rate of uninsured – 32.7%; African-Americans, 19.6%; Asians, 17.9%; whites, 15%; children, 11.2%; middle-income ($50k–$75k), 14.1%; work full-time, 17.7% (U.S. Census Bureau). 82 million, or one in three non-elderly Americans, went without health insurance during 2003–2004 (Washington Post, Dec. 13, 2006).
■ Lack of health insurance causes 18,000 unnecessary deaths every year (Institute of Medicine, January 14, 2004), the equivalent of six times the number who died in 9/11.
(Louisville Courier-Journal, Jan. 30, 2006)
■ Among Americans with colorectal cancer, those without insurance are 70% more likely to die within three years than those with insurance (Paul Krugman, Robin Wells, New York Review of Books, March 23, 2006) Uninsured lung cancer patients are less likely to receive surgery, chemotherapy, or radiation treatment; heart attack victims are less likely to receive angioplasty; people without pneumonia are less likely to receive X-rays or consultations (Malcolm Gladwell, New Yorker, Aug. 29, 2005).
■ Uninsured patients receive less preventive care, are diagnosed at more advanced disease stages, and receive less therapeutic care (drugs and surgical interventions). Having insurance would reduce mortality rates for the uninsured by 10%-15%. Better health would improve annual earnings and educational attainment (Kaiser Family Foundation report, May, 2004).
■ The number of Americans covered by Medicaid rose by eight million between 2000 and 2004, nearly matching the number of people covered by Medicare, 37.5 million to 39.7 million, reflecting how much higher the number of uninsured would be without Medicaid (Krugman, Wells).
■ Underinsured, national — 17.1 million people under 65 in 2003 (JAMA, Dec. 13, 2006). “Underinsured” person defined as someone with health expenses exceeding 10% of his or her income. Among the underinsured, 38% did not fill prescriptions due to cost, 32% went without seeing a doctor when needed, 30% avoided medical tests, treatment or follow-up care. 18% declined care from specialists. 46% reported being contacted by a collection agency about unpaid medical bills. 35% reported changing their lifestyle to cover medical expenses (Health Affairs, June 14, 2005).
■ 929 poor counties (more than half of all poor counties) lacked a health center, survey by the National Association of Community Health centers and George Washington University.
In 2004, 90% of qualified applications for new centers to gain funding were denied. (National Association of Community Health Centers, March 2005).
• the official poverty rate in 2005 was 12.6 percent, not statistically different from 2004 (table 4).
• in 2005, 37.0 million people were in poverty, not statistically different from 2004.
• the poverty rate in 2005 for children under 18 (17.6 percent) remained higher than that of 18-to- 64-year-olds (11.1 percent) and that of people 65 and older (10.1 percent)—all were not statistically different from 2004.
• non-hispanic whites accounted for 43.9 percent of people
in poverty and 66.7 percent of the total population
pg 27:
health insurance coverage in the united states
highlights
• the number of people with health insurance coverage increased from 245.9 million in 2004 to 247.3 million in 2005.
• in 2005, 46.6 million people were without health insurance coverage, up from 45.3 million people in 2004 (table 8).
• the percentage of people without health insurance coverage
increased from 15.6 percent in 2004 to 15.9 percent in 2005.
If we could just deny human nature to create the "communist man." I just know we could do it, even though the former USSR couldn't. They failed to create the person without self-interest, and with the appropriate motivation to work for the motherland as a productive worker for the common good of all. I also think that all persons should have the same pay. Ditch diggers, lawyers, RN's, brain surgeons because under the true thinking of communism, who should be entitled to earn more than the other? A ditch digger has his dignity as well as a RN. Let's start the movement to work for minimum wage to save the greedy corporations the money nursing fees cost, so they could be passed as savings to the medical consumer. I know I want my brain surgery to go to the doctor who was motivated by the interest of common good. I'll just bet he's a good one! We all know that a free system of healthcare will be the best! I know I always appreciate something free, don't you? I treat the free things just as significantly as the costly things. The free shades from Burger King are just as important to me as the Oakley's. I just think if healthcare were free, anytime I get a headache, toothache, well I'd just go to the Emergency Room. Heck, it's free! Then maybe we could get free food, free cars, free condoms. No, wouldn't need condoms because child birth would be free, treatment for STD's would be free. Gee, if everything is free, why should I work? You guys hurry up and get the free stuff. I'm feeling kind of lazy, and not wanting to work. I'd kind of like to lay up on the couch and have you support me for the rest of my life. After all, I deserve it, because it's ME. Until you guys make it happen, I'll still plan on going to work as an RN. Just let me know if it's going to happen soon. I have a test tomorrow and it's going to be hard. Why study for minimum wage? If I can make as much money digging a ditch, I'll quit the program. I already know how to use a shovel! NOT!
If we could just deny human nature to create the "communist man." I just know we could do it, even though the former USSR couldn't. They failed to create the person without self-interest, and with the appropriate motivation to work for the motherland as a productive worker for the common good of all. I also think that all persons should have the same pay. Ditch diggers, lawyers, RN's, brain surgeons because under the true thinking of communism, who should be entitled to earn more than the other? A ditch digger has his dignity as well as a RN. Let's start the movement to work for minimum wage to save the greedy corporations the money nursing fees cost, so they could be passed as savings to the medical consumer. I know I want my brain surgery to go to the doctor who was motivated by the interest of common good. I'll just bet he's a good one! We all know that a free system of healthcare will be the best! I know I always appreciate something free, don't you? I treat the free things just as significantly as the costly things. The free shades from Burger King are just as important to me as the Oakley's. I just think if healthcare were free, anytime I get a headache, toothache, well I'd just go to the Emergency Room. Heck, it's free! Then maybe we could get free food, free cars, free condoms. No, wouldn't need condoms because child birth would be free, treatment for STD's would be free. Gee, if everything is free, why should I work? You guys hurry up and get the free stuff. I'm feeling kind of lazy, and not wanting to work. I'd kind of like to lay up on the couch and have you support me for the rest of my life. After all, I deserve it, because it's ME. Until you guys make it happen, I'll still plan on going to work as an RN. Just let me know if it's going to happen soon. I have a test tomorrow and it's going to be hard. Why study for minimum wage? If I can make as much money digging a ditch, I'll quit the program. I already know how to use a shovel! NOT!
PURE RUBBISH.Last I heard Sweden, Canada, UK, Germany, Australia,etc, etc. had MDs doing brain surgery, not fast food workers.Since when did all the countries I mentioned turn communist? Was there a revolt ?!!!
Because the number popularly cited is from the US Census Bureau, and that number is more ACCURATELY the number of people who went without health insurance for any given period of time during the year cited, not the actual number of people without insurance at A given point in time as folks like HM2 like to improperly suggest with convenient wording.
That 44 million number would include ME...because I went without formal health insurance for three weeks while changing jobs, so I was one of those 44 million, but I was eligible retroactively for insurance from my previous employer by COBRA laws should I have needed insurance during that time.
That number does not differentiate between the millions of people who are only without health insurance for a day, or a week, or a month while changing jobs or providers, and does not accurately reflect the much smaller number of people who are without insurance at a given POINT in time, rather than the misleading number of people who were without insurance for a given period.
So if we decide to use a range, why pick a year? Why not pick a decade? If you use a decade, you might actually get a number that's larger than the entire population of the US, and that should be a great argument for universal care, right?
If we could just deny human nature to create the "communist man." I just know we could do it, even though the former USSR couldn't. They failed to create the person without self-interest, and with the appropriate motivation to work for the motherland as a productive worker for the common good of all. I also think that all persons should have the same pay. Ditch diggers, lawyers, RN's, brain surgeons because under the true thinking of communism, who should be entitled to earn more than the other? A ditch digger has his dignity as well as a RN. Let's start the movement to work for minimum wage to save the greedy corporations the money nursing fees cost, so they could be passed as savings to the medical consumer. I know I want my brain surgery to go to the doctor who was motivated by the interest of common good. I'll just bet he's a good one! We all know that a free system of healthcare will be the best! I know I always appreciate something free, don't you? I treat the free things just as significantly as the costly things. The free shades from Burger King are just as important to me as the Oakley's. I just think if healthcare were free, anytime I get a headache, toothache, well I'd just go to the Emergency Room. Heck, it's free! Then maybe we could get free food, free cars, free condoms. No, wouldn't need condoms because child birth would be free, treatment for STD's would be free. Gee, if everything is free, why should I work? You guys hurry up and get the free stuff. I'm feeling kind of lazy, and not wanting to work. I'd kind of like to lay up on the couch and have you support me for the rest of my life. After all, I deserve it, because it's ME. Until you guys make it happen, I'll still plan on going to work as an RN. Just let me know if it's going to happen soon. I have a test tomorrow and it's going to be hard. Why study for minimum wage? If I can make as much money digging a ditch, I'll quit the program. I already know how to use a shovel! NOT!
Oh no, I just want affordable and available healthcare. If universal healthcare is what it takes I'll take it. Heck I'm willing to pay for it. I wonder does your employer provide you healthcare or do you buy it outright?
HM2VikingRN, RN
4,700 Posts
I have a story about getting LASIK surgery in Canada. I was able to get it done in 2000 for 1000 dollars versus 4500 US at the time. What was the difference? Simply this in CANADA the clinics could own their biomedical equipment outright without payment of subsequent license fees to manufacturers. In the US at that time there was an ability for the manufacturer to either require that equipment could be leased only or that the Royalty fee be collected for each surgery. Admittedly prices for this surgery have come down (at least in MN) but the point I am making is that regulated competition will help bring costs down. We protect the manufacturers to the detriment of consumers. Single payer/Universal access ultimately protects patients and the broader interests of society at large.