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 private funding system doesn't seem to be working now, does it? Increasing health care costs and number of uninsured, it is becoming a 'survival of the fittest'.
With health care advancements, simple clinics don't cut it anymore.
Example: 35 y/o single mother, CNA local LTC, hx migraine headaches, mother died from brain tumor, uninsured. She uses the local free clinic when possible, but occasionally has to use the ER. What are her choices?
20 y/o uninsured working mother of 3 month old, husband works for sherriff's department, (which offers insurance for employee only), mother c/o deep constant leg pain, free clinic advises MRI (1800$) cash up front. What are their choices?
They both have amily members who have died for this country. Honest, decent, hardworking citizens.
Universal Health care is socialized health care. The payment for this comes from all of us taxpayers. To use a health care system is not a right. If you don't work, you don't have money, if you don't have money you may not be able to get the sort of medical help you need at the time you need it.
I don't think any kind of UHC should be totally free of cost at the time of service. There need to be built in incentives for not overusing the system. I do think it's reasonable to consider the potential benefits of subsidizing and maybe even standardizing certain health care costs to make it more affordable to all. I want to live in a society where health care costs are reasonably affordable for most.
How do you feel about public libraries? Should they not be supported by public monies? For-profit book lenders would do best to focus on high demand areas, such as detective novels & romance novels, not reference books or non-fiction. But because of public libraries, not only do those with few resources benefit from the availability of the resouces of the library, but all others can also benefit from the accessibility to a wide variety of resources.
How do you feel about public transportation? Without subsidization, there would be little profit motive to provide transportation services to low-income areas which creates much higher barriers for those people to improve their place because it would be much more difficult to get to work or to go to a local college or trade school. Impossible? No. But a benefit of public transport is that we can all benefit from it (if well-planned), so that I can take the bus to work when my car is in the shop or take the subway downtown to avoid high parking fees and slow traffic.
UHC could be similar. Yes our taxes help pay for others. But our taxes would also help pay for our own care. Instead of paying premiums to a private health insurance company, we pay into the UHC. We also benefit from reduced individual health care costs. And we also benefit from the assurance that our personal financial well-being won't destroyed by the bad luck of getting ill or injuried. And if you fear that whatever UHC provides won't be quality enough or will cut you off due to rationing, then you can contribute extra money for private insurance or private health care ON TOP OF the public plan. Kind of like paying a little in taxes for bus/subway service that you may or want need to use at some point but choosing to own and drive a car, which costs more than public transit (once you factor in maintence & insurance not just gas mileage).
The evidence says that UHC will deliver better results at a lower cost....
No chance. You can't break the laws of economics, even if you really really want it.
Unlimited demand must yield to unlimited supply (impossible), or, rationed supply. Rationing the care of 86% of Americans in order to cover 14% ISN'T better results.
There are far less socialistic and far less rationing ways to cover those 14%. UHC isn't about the care of those 14%; it's about the control of the care of the 86%. It's about choice. Congress and it's bedded lobbyists don't want YOU to have control of your own care. Gov't restricted care is anti-choice.
As far as costs, is that BEFORE or AFTER the gov't runs 300% over budget? Let's look at the major gov't medical program that DOES routinely run massively over-budget:
I linked the site here a few pages back: take a look at the TRUSTEE'S report on Medicare. Within 2 decades, Medicare is projected to cost MORE THAN Social Security. You currently have 15% payroll taxes withheld for SS (combined you and your employer) - and - it's not enough to save Social Security.
You currently pay 3% for Medicare (combined you and your employer) and the projected costs (not making it universal, the projected cost to cover ONLY CURRENT enrollees) will need to be greater than the cost of Social Security (at 15% taxation).
You are looking at MORE THAN 30% payroll taxation just to keep up the current Social Security and Medicare programs past 2028. Now, triple the number of Medicare Enrollees to get to Universal coverage. That will yield an effective taxation rate of MORE THAN 60% and that's just payroll taxes. That doesn't include income taxes.
Of course, you won't really have to pay more than 60% in payroll taxes if gov't restricted health care is enacted. Currently, seniors demand and vote equal access so the gov't must spend just like private insurance. Once the gov't eliminates competition with itself, it will have no such motivation to provide comprehensive coverage. At THAT POINT, it can reduce your taxation to 40%. It can save 20% of taxation by rationing out access to care.
So, you'll only have to pay more than 40% payroll taxes to fund greatly reduced care. This, btw, is consistent with what other nations pay for their gov't restricted care.
Your chief selling points here do not hold up to evidence, or reason. Universal health care is an equal share in a black, rotary Ma Bell phone. I'll take my cell phone plan, any day.
Gov't restricted care is anti-choice. That will cost you much more than just money. When you have a major illness, you better pray that the gov't hasn't decided that the numbers show that they can save more money THIS YEAR by limiting treatment for THAT illness.
I don't think that we need socialized healthcare. The countries that have it are not doing well. I don't want the government telling me what care I can have and what I can not have. I also do not want to be forced to pay for everybody elses healthcare. We already help indigent patients. Yes, I do think that something needs to be done about our current insurance system, but keep the government out of it.
P.S. As far as Michael Moore's movie "Sicko" goes, you have to consider the source. You only see what he wants you to see. You're not getting the whole truth.
So, you'll only have to pay more than 40% payroll taxes to fund greatly reduced care. This, btw, is consistent with what other nations pay for their gov't restricted care.
Of course, the last time we had greater than 50% taxation (MORE THAN 40% payroll tax needed for such a plan PLUS income tax), the massive equity exit from the economy to the government set up the malaise and stagflation of the '70's.
So, in addition to a crippling tax burden, nationalizing health care will tank the economy, as well. You will be paying more taxes in the face of massive job lay offs and out of control inflation.
Not to mention, for those of you on THIS site: the FIRST thing the gov't will do once it has a monopoly on YOUR salaries is to cap them, and cap them low. For example, under the FRENCH plan that many here so adore, the average doctor makes 60k/yr. If the average doctor makes 60k/yr, how much will YOU MAKE?
What a perfect storm: crippling taxation, wrecked economy and salary caps.
I lived in Taiwan for awhile where income tax is pretty low. They instituted a national health insurance plan a little over 10 years. There was a point of service fee involved. There were higher fees for more specialized care. So when I was there it was about US$15 to go to a clinic and about $40 to go to a specialist. There was some kind of payroll deduction and subsidies for those without resources to cover premiums. Last I heard, premiums costs were less than 5% of one's income. Providers could opt in or out of the system. Most opted in but there were also private pay clinics available for those who wanted it.
The NHI struggles with issues of rising costs, allocating resources (overcapacity/undercapacity), and misuse of services (eg people going to see a specialist even if a clinic would suffice) - as do all involved in providing health care.
I lived in Taiwan for awhile where income tax is pretty low. They instituted a national health insurance plan a little over 10 years. There was a point of service fee involved. There were higher fees for more specialized care. So when I was there it was about US$15 to go to a clinic and about $40 to go to a specialist. There was some kind of payroll deduction and subsidies for those without resources to cover premiums. Last I heard, premiums costs were less than 5% of one's income. Providers could opt in or out of the system. Most opted in but there were also private pay clinics available for those who wanted it.
The NHI struggles with issues of rising costs, allocating resources (overcapacity/undercapacity), and misuse of services (eg people going to see a specialist even if a clinic would suffice) - as do all involved in providing health care.
You report on two of the five methods that Taiwan uses to finance their health care.
1. Income tax dedicated for health care.
2. Co-pays to use the system.
They also use the following methods, each ultimately paid for by the taxpayer:
3. Employer contributions
4. Gov't contributions (additional general taxes not specifically dedicated to health care - in other words, the percentage of taxation purported to be for health care is purposely under-reported.)
5. Private care - the system opts out private pay. A two-tier system means that EVERYBODY has an equal access to a dismal outcome EXCEPT for those that can afford the best care.
It's also important to note that the Taiwan plan isn't 'universal coverage'. Only about 90% of people are covered under the program.
"As the population coverage of the NHI Programme increased, the premiums paid by the Government as a third party contributor and as employer would increase accordingly. However, such premiums were not included in the amount of Government health care expenditure. Due to the lack of breakdown of financial data, it is uncertain whether or not and how much the overall burden of the Government increased."
In other words, the true cost of the programme is purposely hidden.
The above is a policy paper outlining the problems with financing the Taiwan system. In effect, the system 'went broke' during its 4th year of Administration, in 1998. It forced a 'Retrenchment' of policy.
A two-tier system means that EVERYBODY has an equal access to a dismal outcome EXCEPT for those that can afford the best care.
"Dismal outcome"? A little pessimistic there, huh? Cost constraints may at times necessitate insurance policies from offering all of the services a patient would ideally want. This is true of private insurance policies as well.
In an all private system, the same holds true, does it not? Those who can afford it have more health care options and will be able to buy "the best care" while those who can't are still stuck with a relatively dismal outcome compared to those who can afford better. Of course, a person may go broke in the process of trying to obtain any level of care if the have chronic health issues or need expensive diagnostics or surgeries. Yes, rationing might mean the insurance won't cover everything... same with my private policy... but some kind of NHI would likely offer more options to more people than if the costs weren't being shared.
Anyway, I didn't bring up Taiwan's health plan as an ideal plan that everyone should emmulate and that has no problems. I also know that there is also employer contribution to premiums and government (tax) subsidizing of costs. I mentioned Taiwan and those first two points in response to the previously posted question
What is the average income tax that a person pays (%) if he/she works in a country that provides free healthcare for everyone?"
I noted that the tax an individual pays specifically for NHI was less than 5% last I was there and that overall income was relatively low. I noted the co-pays because they don't provide the care completely "free" at time of care.
FYI - part of one article reviewing some of the cost issues Taiwan has had with their NHI plan.
Since 1998, however, the NHI’s expenditures have outstripped its revenues. Over the entire period 1995–2001, NHI revenues increased at an average annual rate of 4.26 percent, while expenditures increased at 6.26 percent.58 The large cash reserves accumulated during the first three years were used to cover the deficits for the period 1998–2002. By mid-2002 the cash reserve had dwindled to less than a month’s expenditure, forcing the BNHI to borrow from banks to the tune of NTD$50 billion a month (about one-sixth of total monthly expenditures) to pay claims.59 The NHI has addressed this shortfall in several ways.
The original design of the NHI, embodied in the NHI Act of 1994, included the provision that the premium rate may be revised every two years, depending on actuarial assessments of NHI finances. During the first three years of its existence, the program ran a surplus because actuarially determined premium revenues exceeded actual expenditures, which the NHI banked as a cash reserve (Exhibit 3).
Only in September 2002, with the NHI facing imminent bankruptcy, was the DoH able to push through a premium rate increase of about 7 percent, from 4.25 percent of assessable income to 4.55 percent. For 90 percent of the insured public, this premium increase represents an average of NTD$40 (US$1.14) per month.60
sanddy
4 Posts
me too, I completely agree with it on principle.
thanks alot...