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.
HA...some education we get. Being that I've lived all over the US and the world, I can tell you there is a VAST difference in the "education" that we get not only between states but also when compared to the world. We are brought up in a, You can't fail little Johnny because it will hurt his self esteem. When I was a Sophmore in HS we had a Russian Exchange student. I'll tell you what, he was beyond anything that my HS had to offer. Him as a kid my age was taking all senior courses in Math, Science, etc, it was review for him. This from a kid coming from a state school in Vladivostok. How pathetic is that. Did I mention I went to a Blue Ribbon HS, supposedly one of the best in the state/nation.
The government can't even manage Medicare without tremendous amounts of waste, yet you are proposing we increase substantially the amount of money and responsibility placed into their hands. No Thank you. The less government involvement in my life, the better. Not to mention what it would do to our economic prosperity. Taxes imposed by the government is a NEGATIVE in the overall economic equation of Y=C+I+G-T. Y=the economy, C=consumer spending worth 66% approx, I=investment worth approximately 20% of the economy, G=Government spending worth approximately 12%. T=taxes imposed on the consumer base by the government, well....thats variable depending on the amount of taxes. The taxes taken out of our pay checks will have a significant impact on the overall economy, even if they are spent by the government. This is the basic equation it does get much more in depth. But this is not the place to go that deep into it.
With no one but Politicians policing the system we would end up just as bad as Canada and the UK.
That is precisley why we need REFORM, why complain about all of this and then go ballistic when someone advocates reform? I am trying to make sense of your argument.As for our school system, my daughter went to a public school, went to a public university, UW Madison, went to a public Law school, in Tallahassee Fl. She is now a practicing attorney. Passed the Wisconsin bar with flying colors. If things are not as they should be in this country, then all the more reason for CHANGE.
Specializes in Pulmonology/Critical Care, Internal Med.
I never said anything about our public universities. They are some of the best in the world. I am talking about our public K-12 should have been more specific. Amazing how good something is when WE have to actually pay to attend there....hrmmm...do we see a similitarity. Don't have to pay directly for K-12 as in tuition, not so good....DO have to directly pay for tuition at a university....SUPRISE....we seem to excel there. Throwing more money at the problem isn't going to make it better, making teachers, parents and students accountable is.
What you are asking for is not Reform, it is more of the same only on a larger scale. You confused not wanting change with wanting a different type of change.
No you are very wrong here, I do not want more of the same, we've had enough of the same for the last 6 years, time to change.By the way, my daughters college and law school education were funded mostly by Federal GRANTS and loans, which she is very greatful for.
HA...some education we get. Being that I've lived all over the US and the world, I can tell you there is a VAST difference in the "education" that we get not only between states but also when compared to the world. We are brought up in a, You can't fail little Johnny because it will hurt his self esteem. When I was a Sophmore in HS we had a Russian Exchange student. I'll tell you what, he was beyond anything that my HS had to offer. Him as a kid my age was taking all senior courses in Math, Science, etc, it was review for him. This from a kid coming from a state school in Vladivostok. How pathetic is that. Did I mention I went to a Blue Ribbon HS, supposedly one of the best in the state/nation.
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1. Our schools are required to provide education through HS to ALL students not just those who pass a series of High stakes tests at age 13. (In Germany/Japan etc students who don't pass the high stakes test are on their way to trade shool.) Our system allows for a late bloomer effect.
2. Most exchange students are superior level students in their own right. (I know I used to work as an exchange program coordinator.) Comparing your Russian exchange student classmate to an average American student is an apples/oranges comparison.
Education and Health care are mutually shared responsibilities for a society. The original point of this thread was to ask the question "Why don't we have a system that guarantees access to health care at an affordable price?"
viking solution = blame the rich people, the problem with that is it is never enough, the rich can never give enough, you will keep taking more and more and more and more, like a parasite. news flash, the top 1% of income earners pay 38% of the taxes in the united states, so why not take more money out of their pocket right so we can give illegal aliens health care right? after all viking isn't that the "fair" thing to do. don't we really deep down want everything to be "equal" for everyone? the problem with you're angry mindset is that you resent wealthy people because you feel they are not contributing enough to society, even though as from a statistical standpoint they pay more taxes than you ever could.
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i most certainly do not resent wealth. i have said consistently that we live in a society together. we have a responsibility to work together to form and improve society. i have said and cited sources that show that the wealthy pay a lower marginal tax rate than the middle/working classes. there is no soak the rich mentality in my data. there is a call for true progressivity in the tax system. the estimates vary but typically to be considered extremely wealthy your income exceeds 300,000 per year. this person does not pay social security taxes on income above 94,000/year. to make the math simpler this means that 200,000 is excluded from ss taxes. this equals a 15,000 tax savings for our wealthy person. contrast this to the middle class wage earner. s/he pays ss taxes from dollar one earned. assuming a 50,000 wage this equates to about 3500 dollars in ss taxes or 7.5%. the wealthy person has paid about 2.5% of their income into ss. furthermore, the wealthy person is far more likely to have sources of dividend/capital gains income that are exempted from these taxes which reduces their marginal tax rate even further. my point is that ultimately the tax code should not be used to concentrate wealth at the very upper reaches of the economy but that it should be used to give people the tools they need to achieve their potential. (health care, education etc.) i refuse to be drawn into negativity by the tone of rhetoric.
put simply, the rich pay a lot of taxes as a total percentage of taxes collected, but they don’t pay a lot of taxes as a percentage of what they can afford to pay, or as a percentage of what the government needs to close the deficit gap.
mr. buffett compiled a data sheet of the men and women who work in his office. he had each of them make a fraction; the numerator was how much they paid in federal income tax and in payroll taxes for social security and medicare, and the denominator was their taxable income. the people in his office were mostly secretaries and clerks, though not all.
it turned out that mr. buffett, with immense income from dividends and capital gains, paid far, far less as a fraction of his income than the secretaries or the clerks or anyone else in his office. further, in conversation it came up that mr. buffett doesn’t use any tax planning at all. he just pays as the internal revenue code requires. “how can this be fair?” he asked of how little he pays relative to his employees. “how can this be right?”
even though i agreed with him, i warned that whenever someone tried to raise the issue, he or she was accused of fomenting class warfare.
“there’s class warfare, all right,” mr. buffett said, “but it’s my class, the rich class, that’s making war, and we’re winning.”
No you are very wrong here, I do not want more of the same, we've had enough of the same for the last 6 years, time to change.By the way, my daughters college and law school education were funded mostly by Federal GRANTS and loans, which she is very greatful for.
Yeah, I think we are in agreement here. The republican house and senate did manage to spend like crazy. And pass the prescription drug bill (which I think is the largest entitlement in years). But, alas, we probably disagree as to who to put in next.
I've never really been concerned about my lifestyle truly being affected by who is in power. But this health care thing scares the heck out of me. If my employer is being paid soley by the government, my paycheck is definately going to diminish. If I am not mistaken, US nurses are the highest paid in the world. I'm pretty sure this is due to our current health care system. Are there any examples in the world in which universal health care has not decreased nurses salaries? On top of that I will be paying more in taxes. Are there any countries in the world in which universal health care is not paid for by increased taxes?
I say, increase privitization, completely change our tax system and replace in with the Fair tax (a national sales tax). Let the free market work. Get the government out.
And I think kids who have been privately educated do much better on national tests than kids from government schools.
Yeah, I think we are in agreement here. The republican house and senate did manage to spend like crazy. And pass the prescription drug bill (which I think is the largest entitlement in years). But, alas, we probably disagree as to who to put in next.
Let the free market work. Get the government out.
And I think kids who have been privately educated do much better on national tests than kids from government schools.
The Free Market put us into the predicament we are in today.It was an experiment ruined by a human trait, GREED.Also, I disagree that kids who have been privatley educated do much better on national tests.All my four children, all publicly educated , all college grads, ranked in the 98-100th percentile throughout school. My daughter aced the LSATS. We as Americans with intelligence can come up with a Universal Healthcare plan, we as Americans can reform where reform is needed, but first we need to VOTE in people of EXCELLENCE, we should not make the same mistakes by locking ourselves into any one ideology. Change and the freedom to change, reform, etc is what made this country great and will keep it that way, we are stagnating in an old political/economic ideology, FREE MARKET, Milton Friedman type , its not working.
Specializes in Pulmonology/Critical Care, Internal Med.
"The Free Market put us into the predicament we are in today.It was an experiment ruined by a human trait, GREED.Also, I disagree that kids who have been privatley educated do much better on national tests.All my four children, all publicly educated , all college grads, ranked in the 98-100th percentile throughout school. My daughter aced the LSATS. We as Americans with intelligence can come up with a Universal Healthcare plan, we as Americans can reform where reform is needed, but first we need to VOTE in people of EXCELLENCE, we should not make the same mistakes by locking ourselves into any one ideology. Change and the freedom to change, reform, etc is what made this country great and will keep it that way, we are stagnating in an old political/economic ideology, FREE MARKET, Milton Friedman type , its not working."
Ohhh....My....God......the free market put us into the predicament we are in today. Have you fallen off your rocker? The Free Market is what has made this country what we are today, the richest, most powerful nation in the WORLD. Don't like a "Free Market" I suggest you live elsewhere, try China or Germany, see what 10+% unemployment gets you. My family didn't come to this country because we had life SO much better over in Germany, my family came to America because this IS the land of opportunity. A land where if one works hard enough they can make it, it wasn't the government who got her through school.....it was her who got herself there . Vote in People of Excellence, sounds more like left leaning liberal elitism. You have obviously not studied Economics at ALL if you believe Milton Friedman was wrong, please go pick up a text book and read it before you try to spout your economic ideals. I'm done arguing this with you, if you wish to argue economic theory, fine, but we will do it elsewhere.
Now back to the threads Intended purpose.....the only way to make a system where you can have care for all at an affordable price is where you have doctors who aren't making Half a Million a year, where you have patients who actually DO what they are told (ie. diabetics taking care of themselves like they should, etc) PERSONAL RESPONSIBILITY FOR YOURSELF, where you have hospitals not charging 10,000 a day for a one day stay, 100,000 plus for surgery, and where you don't have frivolous law suits and aspirin costing 12 dollars. Now I think a lot of this is that we have For Profit Hospitals which I have no problem with, I'm all for a for profit hospital, but it is the utter greed that I don't like. I have seen how hospitals can overcharge insurance companies just to make a buck, its not right, and it causes a lot of problems. Now in a perfect world where everyone's honest that wouldn't be a problem.
A system that you could have could be based off of the same sort of system we have now. The more you go to the doc's the higher your premium goes, why should someone who never goes to the doc, have to pay more? You go to the ER every three days, well you should have a higher premium, you use the resources more, as for how to decide how to charge the premiums or where to begin, well I'm not sure. I don't think someone just because they have a higher income should be made to pay more than someone with a lower income. I do believe there should be a level at which you don't have to pay. You could do it possibly like a Flat tax initially. Everyone pays 2% of their income, no way of getting out of paying that. Anyone who makes under 22,000 yr single, 30,000yr married combined, and under 40,000 yr married w/kids combined pay nothing. That is JUST an example. After that you pay 2 percent. Depending then on some arbitrary formula such as you are allowed to go up to 1% of your yearly income in billable doctors/hospital expenses, over that we raise your premium. Now that means your gonna have to make the rate at which you will reimburse lower, and drug costs will have to be lower as well, etc. There might be tiers on meds like we have now, generics are 5, brand name are 15, and nonprefered are 25 or 30. Something along those lines. I think having a doctor bill $90 for an office visit is absolutely absurd but I understand why they have to do that.
Insurance company's either reimburse at a Flat rate based on the code or as a percentage of. I know many a time we had to up the price so that we could get the retail value, now while its HIGHLY illegal, and extremely immoral, it does happen and it happens a lot in many offices. So I would go to a flat fee for services rendered. Same with surgeries, flat fee for a CABG based on the number of bypasses needed, etc. And this amount should be set so that the doctors still make a nice living commiserated with all the work they have had to do to get there, etc for nurses, and hospitals.
I would also employ FAR more PA's and NP's in the PCP areas. These pop up walmart mini-clinics I think are great. Fairly cheap, quick, and easy. NP's/PA's are more than capable of handling the vast majority of problems that walk into offices.
The next thing I would do is have a NP or PA be a triage person that can determine if the "emergencies" coming into the ER are actual emergency's or are merely someone coming to the ER because they don't have insurance and their nose is runny. I say a NP/PA only because I want someone who is able to diagnose illness not someone who is just trained to see things that are wrong but is not able to say what it is. For those noses that are runny, etc i would have a separate Urgent Care sort of clinic. Free up the ER, and you can save a good amount of money by having them go to the Urgent Care.
And the biggest thing of ALL is to have an element of PERSONAL RESPONSIBILITY built in to the system. I've said it once but it should be said again, as I recall, England's system was literally bankrupting the country and they have since instituted a form of personal responsibility in there. If I'm wrong any folks from the UK, please correct me.
That I think is a good start, the more you use, the more you pay, and personal responsibility built in.
"the free market put us into the predicament we are in today.it was an experiment ruined by a human trait, greed.also, i disagree that kids who have been privatley educated do much better on national tests.all my four children, all publicly educated , all college grads, ranked in the 98-100th percentile throughout school. my daughter aced the lsats. we as americans with intelligence can come up with a universal healthcare plan, we as americans can reform where reform is needed, but first we need to vote in people of excellence, we should not make the same mistakes by locking ourselves into any one ideology. change and the freedom to change, reform, etc is what made this country great and will keep it that way, we are stagnating in an old political/economic ideology, free market, milton friedman type , its not working."
ohhh....my....god......the free market put us into the predicament we are in today. have you fallen off your rocker? the free market is what has made this country what we are today, the richest, most powerful nation in the world. don't like a "free market" i suggest you live elsewhere, try china or germany, see what 10+% unemployment gets you. my family didn't come to this country because we had life so much better over in germany, my family came to america because this is the land of opportunity. a land where if one works hard enough they can make it, it wasn't the government who got her through school.....it was her who got herself there .alt john, my family came here as german displaced persons in 1955.we lived for 10 years in a dp camp in linz austria, where i was born. we escaped from yugoslavia, with the russians on our heels.we had lived in german communities for over 200 years and considered ourselves yugoslavian citizens.my family has embrace the freedoms that this country has given us and i am allowed to speak freely because of them, as we all are.i do not believe that in any way , shape or form universal healthcare makes a country socialist . do you think germany is a socialist country, or sweden, denmark, england , australia? china who has embraced capitalism , last i looked they were comminist. my family and i love this country, my brother fought in vietnam, my daughter is a navy nurse, i am very proud to be an american, we have the choice of liberal or conservative views. of course i know my daughter did not get through school as succesfully as she did because of the government, she was afforded an education with help of the government.this is still a land of opportunity, universal healthcare will not change that. relax. vote in people of excellence, sounds more like left leaning liberal elitism. you have obviously not studied economics at all if you believe milton friedman was wrong, please go pick up a text book and read it before you try to spout your economic ideals. i'm done arguing this with you, if you wish to argue economic theory, fine, but we will do it elsewhere.you only debase yourself and discredit our fine german heritage by being so insulting.there are folks out there that do not believe milton friedman to be the savior of humanity, maybe you should do some more homework too. back to the threads intended purpose.....the only way to make a system where you can have care for all at an affordable price is where you have doctors who aren't making half a million a year, where you have patients who actually do what they are told (ie. diabetics taking care of themselves like they should, etc) personal responsibility for yourselfwhy do you think that people who advocate universal healthcare do not beleive in personal responsibility? hospitals not charging 10,000 a day for a one day stay, 100,000 plus for surgery, and where you don't have frivolous law suits and aspirin costing 12 dollars. now i think a lot of this is that we have for profit hospitals which i have no problem with, i'm all for a for profit hospital, but it is the utter greed that i don't like. yes, greed is bad, i agree with alot of what you just wrote here.only we differ on how to get there. i have seen how hospitals can overcharge insurance companies just to make a buck, its not right, and it causes a lot of problems. now in a perfect world where everyone's honest that wouldn't be a problem. could that be why we could use government oversight, or who should we trust?
a system that you could have could be based off of the same sort of system we have now. the more you go to the doc's the higher your premium goes, why should someone who never goes to the doc, have to pay more? what about a person with a chronic disease?you go to the er every three days, well you should have a higher premium, you use the resources more, as for how to decide how to charge the premiums or where to begin, well i'm not sure. i don't think someone just because they have a higher income should be made to pay more than someone with a lower income.whoever said they should?healthcare for all, remember? i do believe there should be a level at which you don't have to pay. you could do it possibly like a flat tax initially. everyone pays 2% of their income, no way of getting out of paying that. anyone who makes under 22,000 yr single, 30,000yr married combined, and under 40,000 yr married w/kids combined pay nothing. that is just an example. after that you pay 2 percent. depending then on some arbitrary formula such as you are allowed to go up to 1% of your yearly income in billable doctors/hospital expenses, over that we raise your premium. now that means your gonna have to make the rate at which you will reimburse lower, and drug costs will have to be lower as well, etc. there might be tiers on meds like we have now, generics are 5, brand name are 15, and nonprefered are 25 or 30. something along those lines. i think having a doctor bill $90 for an office visit is absolutely absurd but i understand why they have to do that.
insurance company's either reimburse at a flat rate based on the code or as a percentage of. i know many a time we had to up the price so that we could get the retail value, now while its highly illegal, and extremely immoral, it does happen and it happens a lot in many offices. so i would go to a flat fee for services rendered. same with surgeries, flat fee for a cabg based on the number of bypasses needed, etc. and this amount should be set so that the doctors still make a nice living commiserated with all the work they have had to do to get there, etc for nurses, and hospitals.
i would also employ far more pa's and np's in the pcp areas. these pop up walmart mini-clinics i think are great. fairly cheap, quick, and easy. np's/pa's are more than capable of handling the vast majority of problems that walk into offices.
the next thing i would do is have a np or pa be a triage person that can determine if the "emergencies" coming into the er are actual emergency's or are merely someone coming to the er because they don't have insurance and their nose is runny. i say a np/pa only because i want someone who is able to diagnose illness not someone who is just trained to see things that are wrong but is not able to say what it is. for those noses that are runny, etc i would have a separate urgent care sort of clinic. free up the er, and you can save a good amount of money by having them go to the urgent care.
and the biggest thing of all is to have an element of personal responsibility built in to the system. i've said it once but it should be said again, as i recall, england's system was literally bankrupting the country and they have since instituted a form of personal responsibility in there. if i'm wrong any folks from the uk, please correct me. what about germany, australia, canada, denmark, sweden, etc.? is it possible to make our own american style of universal healthcare, learn from the other countries mistakes?
that i think is a good start, the more you use, the more you pay, and personal responsibility built in.
you seem to be a nice smart young man and do you know you could have said all that without being insulting, demeaning or rude? now relax, i plan on having a good german beer and ponder the nature of man......
Simplepleasures
1,355 Posts