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.
wealth in healthcare industry soars as coverage declines and the number of uninsured grows
highmark’s official surplus (profit) is $2.8 billion!
the ceo of highmark currently makes $2.5 million a year. the combined pay of the top 10 highmark executives increased 41% last year from 8 million to 11.3 million while premiums for small businesses went up from 6.6—7.6%.
upmc reports record profits of $523 million.
drug companies: the world’s 13 largest alone recorded $62 billion in profits in 2004
hmos: the 20 largest in the u.s. made $10.8 billion in profits in the most recent fiscal year.
hospitals: aggregate profits for u.s. hospitals reached a record $26.3 billion in 2004 – and profits have risen substantially the past few years even as the number of hospitals and hospital beds has been shrinking.
executive compensation: 12 top hmo executives pocketed $222.6 million in direct compensation in the most recent fiscal year. the top 12 drug company executives collected $192.7 million for the same period. the ceo of upmc was paid $2.8 million last year, a pay increase of $480,000!
federal lobbying: for the first six months of 2005, the health care industry outpaced all other sectors in federal lobbying, spending over $164 million to influence legislation, according to political money line. drug companies regularly top the spending charts.
sources: california nurses association december 21, 2005
pittsburgh post-gazette sally kalson “feed the beast, starve the patient,” june 4, 2006
“highmark reports strong performance in 2005,” march 2006, www.highmark.com
“upmc reports record profits,” pittsburgh post-gazette, august 18, 2006
* At the end of 2004, there were 18,827 patients on dialysis and 12,099 living with a functioning kidney transplant, for a total of 30,924 Canadians with kidney failure registered in the CORR.
While this US Article lists these numbers for the US,
*I remember my grandma telling me she knew she would get the vote and worked for it in Texas. She voted for the first time in 1921.
*I remember separate drinking fountains for "colored". We were told to go incremental because America wasn't ready for integration. Many of us continued and the Civil Rights Law was passed and signed.
*We were told it would be impossible to get safe staffing ratios into the law. We have them as the minimum with the requirement to staff up acording to the acuity of each patient.
*I pray and attend church even though sins are committed every day. I sin and pray for forgiveness. I think it would be a sin for me to just give up on people just because we are not perfect. We need to try to encourage our best. Not expect the worst.
* I think some day the good people of the United States will join the modern world and find it in our hearts to have healthcare for all. The people of Japan, Europe, Australia, and other countries with healthcare for all ar not more lazy than we are.
I do not believe that we Americans would just do nothing if ensured access to healthcare.
Healthy people are more productive. Americans are not more lazy than people in other industrialized countries.
"Whenever the people are well informed, they can be trusted with their own government; that whenever things get so far wrong as to attract thier notice, they may be relied on to set them to rights." Thomas Jefferson
So, though the positive aspects of single-payer are nothing new, two things strike me as worth pointing out today. First, this is a ripe area for a new, concerted effort at shareholder activism. The argument is simple: companies who don’t advocate for a single-payer system are endangering share-holder value, throwing money into a system that is dragging down profits and competitiveness. And, in particular, it’s the huge public employee pension funds, representing hundreds of thousands of current and retired workers, who have a significant financial interest in seeing the system changed; the California Public Employees Retirement System alone has $177 billion.
.....
We need to say that the real issue for Americans is that we want a society where everyone is in good health, a society where every person can have the opportunity to succeed and that that opportunity comes with the financial security and peace of mind that only a single-payer system can deliver. Wouldn’t it be better, we need to ask, if, instead of choosing the drug and insurances companies, we would stand for our families, for health security, for the wisest investment the government can make towards our collective well-being? And, finally, wouldn't it be better to stand for the stability and competitiveness of American business, from big companies all the way to the small businesses everywhere who would like to have healthy, productive workers?
dirty little secret #1: if for-profit insurers were forced to provide good health care coverage to all americans, they would still try as hard as possible to avoid insuring the people with the costliest conditions and charge premiums even higher than they currently charge.
that's why medicare was established. the health insurance industry was either unwilling or unable to offer affordable coverage to half of america's seniors. it's too costly for them. so, to rein in costs and ensure every older adult had coverage, the federal government offered the coverage directly.
as predicted, massachusetts is now seeing that requiring insurers to cover everyone in the state costs almost twice as much as projected. the way to reduce costs is not to eliminate benefits as some are suggesting , it is to eliminate insurance industry waste.
dirty little secret #2: eliminating insurance industry waste in our health care system--administrative waste and excessive prices--would cut our health care costs substantially.
check out the health insurance systems in france, germany and japan. they spend half as much as we on health care and deliver better results by relying on a publicly administered integrated health care system that pools risk and negotiates rates on behalf of their entire citizenry.
People like to chronically say that other countries outperform the US in outcomes, using the WHO as the qualifying agency. As soon as I read anything resembling this in an argument for socialized health care, I have to move on, because it's simply inaccurate.
The WHO is not a research agency. They do not have labs, or research projects, or employ researchers. They simply collect data as it is provided by the participating countries and assemble it. There are no rules as to what benchmarks are required or what rules are applied in reporting the data; that's why we then read conflicting information about how a baby survived being born before her 21st week in the US, yet a poverty stricken country like Cuba is applauded as having lower infant mortality rates. It's because a baby born before the 30th week in Cuba isn't even included in their numbers (falsely reducing real mortality numbers), while babies in the US are going to be given a fighting chance at a much earlier prematurity.
And the "every other civilized country" argument is pointless; most of these places chronically trail the US in progress and technology, and they are experiencing health care crisis's of their own, turning to increasing privatization to correct their problems. It makes no sense that Canada is repealing laws against privatization to provide health care to a mostly concentrated population that is 1/10th the size of the US, and folks here think that a more socialized model is an improvement on our system. Again...it makes no sense.
Finally, if socialized countries ride the coattails of the US in R/D. Economists have shown that if socialized countries engaged in similar rates of R/D, their per capita health care costs would increase dramatically. That is why we don't hear of much progress on stem cell research from all of these allegedly civilized countries...because they are spending far less on SCR than the US. Advocates of ESCR don't realize they are fighting against themselves when they also take a position demanding more tax dollars for SCR.
the goal of republicans is to aid the most individuals as possible. to say otherwise is useless hyperbole. even kennedy worried that the result of improving the lot of citizens is that it served to make them republican.
and me wanting to keep my money is not selfish. i'm entitled to the fruits of my labor. it's not the government's money, that's the bottom line.
president bush is planning on raising taxes, but he won't come out and say it. in fact, he has continued to loudly proclaim he can balance the federal budget by 2012 and not raise taxes one cent. his rhetoric on the budget is misleading, if not outright deceitful, precisely when having an honest discussion is paramount to implementing policies to confront the long-term fiscal challenges our nation faces.
although he claims that he can balance the budget by 2012 without raising taxes, bush's 2008 budget calls for increasing taxes on the middle class by $800 billion over the next 10 years.even more audacious is that those higher tax revenues are financing more tax cuts for the wealthy, especially those making over $1 million annually. if bush wants to cut taxes for the super wealthy and balance the budget on the backs of the middle class, he should say so, but he doesn't. he buries the plan in the fine print of his budget.
here's bush's sleight of hand: through a "stealth tax" known as the alternative minimum tax (amt), more and more middle-class taxpayers are being drawn into an alternate taxation universe each year. the extent to which amt tax liability falls on the middle class is startling. in 2006, 8.6 percent of the amt was paid by households earning less than $200,000, but in 2010, those households will be responsible for paying 45 percent of it. under current tax law, 50 percent of households earning $75,000 to $100,000 will be subject to the amt in 2010, up from 0.7 percent last year.
the bush administration claims that the guiding principle for its fiscal policy has been "lower income taxes for all, with the greatest help for those most in need," as the white house web site puts it. the reality is starkly different. the tax cuts enacted during george w. bush's presidency shift the burden of taxation away from upper-income, capital-owning households and toward the wage-earning households of the lower and middle classes. for all but the wealthy, this will ultimately cause substantial harm. shifting costs to future generations of workers to finance tax boons for today's owners of capital is unproductive, unfair, and unwise.
the bush administration presided over two major tax cuts, in 2001 and 2003, along with a smaller one in 2002. those cuts officially were going to cost the federal government $1.7 trillion between 2001 and 2014, and to add nearly $1 trillion in higher payments on the national debt over that period. that may sound like a lot, but in fact the official estimates are low, artificially held down by gimmicks, including the ostensible sunsets of all the tax cuts in 2010 or before. at least under the administration's plans, these tax cuts would continue beyond their official expiration dates. if they are extended, they would reduce revenue by $3.6 trillion between 2001 and 2014 and cost a whopping $4.8 trillion when the additional debt service is included. without a doubt, and despite white house rhetoric to the contrary, the direct effect of the tax cuts is to widen after-tax income inequality. if the tax cuts are extended into 2011, after-tax incomes will increase by more than 9 percent for households in the top 1 percent of the income distribution in that year, by between 2 percent and 3 percent for households in the middle 60 percent, and by only 0.1 percent for households in the bottom 20 percent.
meanwhile we continue to see obscene increases in the profits of health insurance companies and decreasing health coverage levels for the middle class......
consolidation has continued unabated. there are now two superproviders that increasingly dominate the for-profit healthcare field. one is unitedhealth, which capped a long series of acquisitions with the 2005 purchase of pacificare for some $8 billion. in 2006 united’s health services revenues reached an astounding $64 billion, and its medical enrollment rose to about 28 million individuals.
the other giant is wellpoint inc., created through the blockbuster 2004 merger of anthem inc. and wellpoint health network, formerly blue cross of california. wellpoint later spent $6.5 billion to acquire wellchoice, the publicly traded parent of new york’s empire blue cross blue shield. by 2006 wellpoint controlled the blues in 14 states, had some 34 million members and took in annual revenues of about $52 billion.
the second tier consists of aetna (2006 revenues and members, respectively: $25 billion and 15 million), humana ($21 billion and 11 million), cigna ($16 billion and 9 million) and health net ($13 billion and 7 million). the non-profit wing of the industry also has big players, led by kaiser permanente with 8.6 million members.
there is no evidence that the consolidation has enhanced efficiency or improved the quality of coverage. instead, the big carriers simply accumulate more power over healthcare providers and patients, using it to their own advantage.
while millions remain uninsured or underinsured, the industry’s profits swell. last year, the top six health insurance companies had combined profits of more than $10 billion. what’s amazing is that they netted so much after spending prodigious amounts on marketing and administration. in 2006 wellpoint alone burned up nearly $9 billion in such costs—nearly one quarter of what it paid out in actual benefits. by contrast, in canada’s government-run single-payer system, administration accounts for only about 3 percent of total costs.
think what 9 billion dollars would buy in coverage!
unitedhealth has been the subject of a federal investigation following reports last year that the company was routinely backdating stock options awarded to executives, especially long-time chief executive william mcguire, who--on top of annual salary and bonuses totaling $10 million--had accumulated some 29 million shares through option awards. thanks to the backdating scheme, mcguire had racked up paper gains of more than $1 billion on those shares. in october mcguire was forced to resign and to give up an undisclosed portion of those gains.
mcguire's excesses are emblematic of the fundamental conflict in the industry--the clash between maximizing gains for executives and shareholders, and the need of its customers for services that are often a matter of life and death. public officials should abandon the mission of saving commercial insurance and devote themselves instead to creating a healthcare system that substitutes the public interest for private profit.
look at what austria has to offer: longer life spans, less infant mortality, more caregivers and hospital beds per capita, fewer uninsured, and few if any families driven into bankruptcy by astronomical medical bills, according to the world health organization (who) and the organisation for economic co-operation and development (oecd).
sounds expensive? wrong. austria spends about $2,958 per person on health care, of 9.6% of gdp, according to the oecd. by contrast, the united states spends $5,711 per person--or 15.2% of gdp. and if us spending continues to rise at the same rate it has, that will double in just 20 years. how long can our economy handle a system broken this seriously?
who rankings make the comparison explicit. assessing health efficiency in 191 countries in 2001, the who placed austria 14th, the u.s. 72nd. overall, in total health performance, the who in 2000 rated austria 9th, the u.s. 37th.
HM2VikingRN, RN
4,700 Posts
wealth in healthcare industry soars as coverage declines and the number of uninsured grows
sources: california nurses association december 21, 2005
pittsburgh post-gazette sally kalson “feed the beast, starve the patient,” june 4, 2006
“highmark reports strong performance in 2005,” march 2006, www.highmark.com
“upmc reports record profits,” pittsburgh post-gazette, august 18, 2006