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.
the cruel quality of friedman's obliviousness. art hilgart, a retired industrial economist, recalls hearing friedman lecture in 1991 and recommend the destruction of medicare, welfare, the postal system, social security and public education. the audience was dumbfounded.
finally, a brave young woman asked what this would mean for poverty. "there is no poverty in america," friedman instructed. a clear voice arose from the back of hall: "bullshit!" the audience cheered wildly.
i don't believe that anyone really wants to live in milton friedman's america except for the crony capitalists and robber barons. we can build and live in a humane society. the scandinavian countries are a good example of how to build a society with high quality health care, environmental protections, and a rising standard of living.
thankyou again hm2viking, for so eloquently and clearly putting into words what so many americans are thinking, despite all the proponants of the milton friedman style of capitalism.
China might be benefitting from a trade imbalance, but it makes them even MORE beholden to the U.S., for two reasons. #1, we are their market and they have to hold a vested interest in their consumers, and #2, their money is directly tied to the dollar. It doesn't freefloat against other currency like most currencies do (Another Milton Friedman idea, btw). Our economic gain is theirs; our loss is theirs. They have become vested partners. Incidentally, THAT was precisely the geopolitical outcome that was desired by increasing trade with China.
faith,
Timothy.
What about the human rights violations that continue to happen in China? China is still a COMMUNIST country who by the way continues to build up its military.If things continue to go the way they are now with our economy and China's being so intricatly entwined, we all should be taking lessons in Chinese.Im streching a bit here, but only to bring attention to the dicotomy of voicing all the concern over "socialistic" healthcare, then lauding China and claiming that it is a good thing our economies are in bed with each other.We went into Iraq supposedly to help them get rid of the despot, Saddam, why are we not concerned anymore with the folks in China and their lack of freedom we hold so highly I this country? I know the answer, MONEY, the green god.Those who have the money have the POWER, looks like China may be gaining on us FAST, shouldnt anyone be concerned?
What they do not say is that he was also the most destructive public intellectual of our time.
First, the Fed has never followed Friedman's economic policy because his policy is quite simple: the gov't should keep hands off the economy, spend much less, and only introduce a fixed rate expansion of the supply of money that is basically, in tune with population growth. The gov't is too arrogant not to believe that IT has the power to manipulate markets.
The Fed believed and still believes that IT controls the economy by fluctuating money supply and interest rates. Friedman argued that at best, such control might tweak the economy, but it's a wash whether it is tweaking it for the better or for the worse. In other words, the Fed usually can only do too little, too late, or too much, too soon. (Much as Greenspan overtightened money control and interests to combat the 'irrational exuberance' of the '90's, thereby inadvertantly aiding a recession in '99-'01). Timing the economy, Friedman thought, was like trying to herd cats.
Actually, the first real test of Friedman's theories compared to Keynesian theory was the stagflation of the 70's. Keynesian theory and specifically, the Phillip's Curve, predicted that unemployment and inflation always had an inverse relationship. This allowed gov'ts to confidently tinker with the economy because if they went too far there was always a positive tradeoff: if they caused too much inflation, well that improved unemployment, didn't it? Conversely, if a shortened money supply caused too much unemployment, then at least inflation was under control.
The Stagflation of the 70's proved that the Philips Curve is garbage. It's widely abandoned. But, it also proved Friedman correct, gov't could do too little to improve the economy, but its very effort to do so could do too much to tank the economy.
The Fed continues to exert influence on control of money supply and interest rates. They just are not quite so overcocky and confidant that they can do no wrong. As a result, they tend to tweak money supply and interest much more gradually.
But, for the Record, the Fed has NEVER followed Friedman's economics. To DO so would be to keep their darn hands off the economy and develop more or less, an automatic pilot slow growth in money supply. THAT would require the Fed to give up its power.
When was the last time the gov't did that? (and elected or not, "private" or not, the Fed is still a gov't exertion of control.)
For the record, it's not fair to suggest that Friedman's economics are flawed as they have not been tried.
As far as his 'free market faith' producing the thing he denounced, that being uncontrolled lobbying, that's patently silly. IF the gov't deregulated the economy, then what would be the point in lobbying the gov't for your fav regulation? The opposite is true, the rise of lobbyists and political power is linked to the gov't trying to tinker with the markets, an idea against Friedman's theories.
For example, Friedman advocated a simple flat tax. No deductions, no loopholes. You make this much, you pay this much. If what you made was low enough to be poverty wages, you paid a 'negative tax'; the gov't paid you a check every month.
Such a code would rob Washington of power and so, defang the lobbyists. Washington GETS its power by manipulation of the tax code.
the result, rampant single parent-hood (can't get aid as easily if married) and rampant 12-13 yr old pregnancies (welfare became the defacto debutante outcoming of the lower class; once a child is born, that check became 'proof' of adulthood.) (btw, this anti-capitalist concept of social welfare explains why the gov't pays for so many births) so, in trying to help, social welfare made a variety of bad situations worse, much worse. that is why, trillions of dollars later, we are no closer to winning the 'war on poverty'. can you not see the connections to any other massive gov't undertaking that involves a dose of 'we know what is better for you then you'?
efforts by social scientists to explain the rise in out-of-wedlock births have so far been unconvincing, though several theories have a wide popular following. one argument that appeals to conservatives is that of charles murray, who attributes the increase to overly generous federal welfare benefits. but as david ellwood and lawrence summers have shown, welfare benefits could not have played a major role in the rise of out-of-wedlock births because benefits rose sharply in the 1960s and then fell in the 1970s and 1980s, when out-of-wedlock births rose most. a study by robert moffitt in 1992 also found that welfare benefits can account for only a small fraction of the rise in the out-of-wedlock birth ratio.
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cuts in welfare therefore have little effect on the number of out-of-wedlock births, while reducing dollar-for-dollar the income of the poorest segment of the population. the initial goal of the welfare program was to see that the children in unfortunate families were adequately supported. the support of poor children not the alteration of the behavior of potential mothers should remain the major policy goal of welfare in the united states. this level of support must be tempered by equity between those who collect welfare and do not work and those who do work and also are paying taxes that, at least in part, go to pay for the less fortunate. in this regard a generous earned income tax credit serves two roles. not only does it reward those who work, but by increasing the differential between the working poor and the nonworking poor, it allows greater benefits equitably to be paid to nonworking mothers.
this children-oriented approach to welfare should also inform the requirements of welfare. it only makes sense to cut mothers off welfare after two years, for example, if jobs and child care are available so that mothers can support their families and their children can receive adequate child care. it should be remembered that the proper care and nourishment of children should be the first goal of our society.
and access to affordable health care is the other piece of this puzzle. the other point that this article makes is that much of the increase in birthrate is actually attributable to the end of the "shotgun" marriage.
As far as his 'free market faith' producing the thing he denounced, that being uncontrolled lobbying, that's patently silly. IF the gov't deregulated the economy, then what would be the point in lobbying the gov't for your fav regulation? The opposite is true, the rise of lobbyists and political power is linked to the gov't trying to tinker with the markets, an idea against Friedman's theories.
Such a code would rob Washington of power and so, defang the lobbyists. Washington GETS its power by manipulation of the tax code.
~faith,
Timothy.
I respectfully diasagree. Corporations have used the lobbyist system to their benefit. The point of Grieders critique was that in the implementation of Friedman's ideas that the governement has become a profit center for corporations that is neither accountable to the taxpayers nor efficient. (Halliburton, KBR, pentagon contracting etc.) If the BUSHCO Social Security Corporate Welfare act of 2005 had been passed Wall street bankers would have been scooping 30% of our contributions right off the top for management fees vs. the 1% that the current system costs which is a mutually shared expense for society. We are seeing this effect in our current system for health care. 31% goes to administration with no benefit to the patients.
There is a tendency for proponents of social programs to depersonalize how those programs are to be paid for. "There are people who cannot afford a service, therefore 'the government' must provide that service for these people." By using the term "the government," proponents of socialization avoid messy the messy facts that might make their message less appealing.
Governments do not produce, they do not earn money. All the money that governments spend must come from somewhere. That somewhere is the people. So, when we are told "the government" must provide a service, what is really being said is that YOU must provide the service. The real message is that Person X cannot afford a service. I can. Therefore, it is my responsibility to provide that service for Person X. My question is "why?"
We, in the course of this debate, have villified a number of entities. Particularly hard hit have been the insurance and drug companies. I don't buy this villification, but for a moment, let's put that aside. Let's accept that, in seeking profits, the drug and insurance industries are rife with greed and dishonesty. The argument in favor of universal healthcare says that because these industries are so corrupt, we must take them out of the equation. We must make sure that everyone has healthcare, and we must do so immediately. Since there is a portion of the population who cannot afford healthcare, those who can must pay for those who cannot (or, as is often the case, will not). In essence, we penalize a portion (in reality, the majority) of our population. The ones who committed the wrong are penalized, but so are those who simply availed themselves of their services. And when members of that majority say "no," the first question is often "do you work for a drug or insurance company?"
Others here have talked about how "the majority" want universal healthcare. Fine, but the majority of the population fails to recognize that we cannot ever get something for nothing. When asked whether they would be willing to see a significant increase in taxation in order to provide that universal healthcare, the majority in favor of universal health care falls off steeply, becoming a small minority. Why? Because, like me, the majority of Americans are sick to death of the presumptions that underlie every single social program that is proposed. And what are those presumptions? Read on:
First presumption: What you earn is not yours. It is community property that we are allowing you to use until such time as we find other uses for it. What you earn is a bank account that "we" may draw upon to provide for those less fortunate than you. You have a responsibility to provide all the goods and services for those who cannot afford them as well as you can. If that has a negative impact on your life, tough.
Second presumption: There are those who can afford services, and those who cannot. It is the responsibility of those who can afford the services to pay for those who cannot. If, in providing those services to the "less fortunate," the higher earners must limit what they can provide for their own families, too bad. They should have had the good sense not to work so hard, and then "others" would be providing for them.
Third presumption: The wealthy are greedy leeches. They don't deserve their wealth. How hard they may have worked to become wealthy is irrelevant. It is wrong for one person to earn more than another, and therefore it is right to tax the higher earners to the point that their actual take home pay is no greater than the poorest among us. Since this is true, "we" can take that wealth at will, with no right of redress.
On a personal level, what it has come down to for me is this: I earn a very good living, though I am a long way from rich. I worked very hard to get where I am, and to be able to provide not only the necessities, but also some luxuries for my family. What you are in essence telling me is that my hard work is irrelevant. Since not everyone can afford the luxuries I have, you must lessen my ability to provide the support to my own family in order to provide for others.
What you are in essence telling me is that my hard work is irrelevant. Since not everyone can afford the luxuries I have, you must lessen my ability to provide the support to my own family in order to provide for others.
I am not being smart / cheeky here, I really want to know/understand the system in the US...
Coming from a country outside the US I have no understanding of how the health system works there. I understand that there is health insurance paid by the recipient that covers for any health care required. Can you clarify this so that I have a better understanding?
1. Is health care insurance part of a package when one is employed?
2. How does it work - do you pay up front and then be reimbursed?
3. Is there a gap between the amount you pay and the amount the insurance company reimburses you? (ie the company pays you less than you have had to pay the hospital)
4. Do you have general practitioners who then refer you to specialists, as occurs in Australia, or do you go direct to a specialist?
5. What happens to those who can't pay - are they turned away from ED depts? I have seen the word 'indigent'; does this mean that certain ppl qualify for free health care? Do only certain hospitals accept these ppl? How do they qualify?
6. We have to pay for ambulance services here. I guess that is the same there?
7. How about medications? What happens if you can't afford the appropriate medication required? For example, I am on Lamictal and Depakene. We have a Public Benefits Subscription scheme (PBS) whereby all medications are @ $30 AUD, and the rest is picked up by the government. If I was unable to afford this, would this mean I would be put on an inferior medication, such as Dilantin, which doesn't control my seizures?
The reason I quoted the above was because, what about those who work hard, but do not receive enough remuneration for their efforts? Are they penalised? The other thought I had was, we are willing to donate money to causes such as ppl suffering in other countries. Does that mean it is inappropriate to assist those who are suffering in our own country?
The reason I use the word our is because I think our government here is considering moving towards an American model. As usual, those on high like to treat their constituants like mushrooms, ie "Keep them in the dark and feed them s**t".
Thanks for considering my questions, and I hope I'm not being impertinent.
1. Is health care insurance part of a package when one is employed?
Many but not all employers offer health insurance as part of full time employment. I believe it is something like 60% of employers.
This is a fallback to WWII. During WWII, there was a 'wage freeze'. Employers could not legally pay their employees more money. So, instead, many companies began offering 'fringe' benefits, such as healthcare. A few yrs after WWII, the gov't codified this by giving employers a tax break for the amount they spend on healthcare for their employees.
2. How does it work - do you pay up front and then be reimbursed?
Normally these days, an employer pays a portion of your health insurance, and the employee pays a portion. The portion paid by the employee is normally withheld from their paychecks. Many plans have a deductible, that healthcare insurance doesn't kick in until an individual spends a certain amount, say 250.00 to 500.00 dollars in a year. Most plans cover the rest up front, although some plans require the individual to pay up front and be reimbursed later.
3. Is there a gap between the amount you pay and the amount the insurance company reimburses you? (ie the company pays you less than you have had to pay the hospital)
There is, but there are limits to how much this can be. Some plans will pay, for example, 80% of doctor bills, up to a limit of a few thousand dollars. Once you pay the 'out of pocket' limit, the plans normally pay 100%. All plans are different, but this is a common construction of a health plan.
4. Do you have general practitioners who then refer you to specialists, as occurs in Australia, or do you go direct to a specialist?
Depends on the plan. For example, with MY plan, I have a group of doctors 'in network'. I can directly seek the services of any of those doctors, whether they are my generalist, or a specialist. I don't have to to through my GP doc first, so long as I stay 'in network'.
Other plans, and especially HMO plans, require the GP to be the 'gatekeeper' for services; all specialist consults have to go through them.
5. What happens to those who can't pay - are they turned away from ED depts? I have seen the word 'indigent'; does this mean that certain ppl qualify for free health care? Do only certain hospitals accept these ppl? How do they qualify?
In the U.S. there is a law, EMTALA - Emergency Medical Treatment and Labor Act - that law says that Emergency rooms cannot turn away or even attempt to seek payment for any care until 'stabilizing treatment' has been rendered.
So, nobody can be turned away from an emergency room, regardless of ability to pay. It's the law.
What this means is, even if that patient must be admitted, they are normally admitted to hospitals even without the ability to pay. Most hospitals have budgets for 'indigent care' or care they will not be reimbursed for. It's the cost to doing business.
6. We have to pay for ambulance services here. I guess that is the same there?
Yes, but again, EMTALA - if an ambulance is called it must respond, regardless your ability to pay. In reality, many cities have ambulances as part of their city budget, they work under the fire depts. They still charge for services, but if you can't pay, that doesn't relieve the ambulances from the legal obligation to provide the service.
The saying is, 'you can't get blood from a turnip'.
7. How about medications? What happens if you can't afford the appropriate medication required? For example, I am on Lamictal and Depakene. We have a Public Benefits Subscription scheme (PBS) whereby all medications are @ $30 AUD, and the rest is picked up by the government. If I was unable to afford this, would this mean I would be put on an inferior medication, such as Dilantin, which doesn't control my seizures?
If you are truly poor, the gov't provides health insurance through Medicaid. Same if you are disabled. Most people that have problem with healthcare in this country are part of a 'squeeze group'; not completely poor but not well off enough to pay for some expenses out of pocket.
If you are on gov't insurance, most of the time, medications are free or you have to pay a co-pay. For me, on MY employer health insurance plan, I pay $20/month or $40/3 months per med. I'm on 1 prescription drug, a BP med, and so I pay about $0.45/day for that drug.
If you don't have a plan that helps to pay for drugs, then you have to pay for them out of pocket. That can be expensive. Some of the drug companies have plans that will help some people, but that's a crapshoot.
~~~
There ARE gaps in our system, but the combination of private and gov't insurance covers 85% of people and everybody has access to emergency services.
pasnap supports winning healthcare for all. to read more about this solution to the serious problem of access to health insurance in the us, see an article written on the issue by pasnap's president, patricia eakin, rn.
find out more about proposed federal legislation that would guarantee healthcare for all through a single payer system, hr 676. visit
healthcare now, the leading organization gearing up for reinroduction of the bill in january to the new us congress.
recent media reports on us healthcare crisis argue for a single-payer system.
if canada or the united kingdom funded their health care systems at american rates, i suspect that many of those problems would vanish: nearly doubling the money you're spending can pay for a lot of doctors, a lot of facilities in geographically remote areas (a particular problem in canada), a lot of dentists (a particular problem in the uk), and so on.
if they spent the money (per citizen) that we do, they'd also be way ahead of us - because nearly a big chunk of it wouldn't be vanishing into the bottom lines of insurance companies.
the american system is a great system if you're part of the industry that feeds off of it, sucking up health care dollars like a tapeworm in somebody's stomach. the question we should be asking is whether we want to spend our money supporting a for-profit industry while enormous numbers of americans go without routine care, our infants are more likely to die, and our adults are less healthy... or if we might want to rethink the whole proposition.
plus i think the american electorate has reached the "fear fatigue" point of no longer responding to the high fear psychology of the republican party as a means of manipulating and deceiveing the electorate.
the american system is a great system if you're part of the industry that feeds off of it, sucking up health care dollars like a tapeworm in somebody's stomach. the question we should be asking is whether we want to spend our money supporting a for-profit industry while enormous numbers of americans go without routine care, our infants are more likely to die, and our adults are less healthy... or if we might want to rethink the whole proposition.
plus i think the american electorate has reached the "fear fatigue" point of no longer responding to the high fear psychology of the republican party as a means of manipulating and deceiveing the electorate.
bravo hm2 viking! right on point once again.lets keep this issue in the forfront, we need to keep the pressure on the candidates , let them know this is what america wants. the folks who do not want it will also be speaking loudly, its up to us to get our elected officials from pulling the wool over our eyes.we need to stay informed and keep up the universal healthcare discussion. lets not let this slip away from us again.
Simplepleasures
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