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.
Specializes in Spinal Cord injuries, Emergency+EMS.
The free market is the MOST moral way to ration care: unlike gov't control, the free market directly buffers supply and demand. The best combination of price and quality provides the absolute most people the absolute best coverage possible. You cannot get a better combination any other way.
this is healthcare not snack foods !
The gov't would totally destroy that equation. As it always does. Socialism is a proven failure. You cannot get what you want out of a failed idea, no matter HOW BADLY you want it.
yet another poster who confuses socialism with warsaw pact / stanlist Communism ... given the 'socialist' leanings of the 'conservative' parties in much of europe and in fact much of the western world outside the USA this is patently not the truth ... why do peopel across the world crave British or German products ... why does the US military when it comes down to the real nitty gritty buy from German or British suppliers (Land Rover, Heckler and Koch, BAe predecessor companies ...)
The NHS is trying to privatize as fast as possible.
wrong!
it's a logic extension of the purchaser / provider split that it doesn't matter who provides the service as long as the NHS funds it ... ifyou don't 'own' the buildings, durable equipment and staff you only need to pay for it when you use it ... it doesn't change the fundamental free at the point of delivery character of the service
Only Australia is relatively immune and that's because they adopted a two-tier system from the start. Private health care is still available there. Even so, the cost in taxation for their program is much more than Americans would willingly bear.
private health care has remained available in the Uk since 1948 predominatly concentrating on elective work for those who wish to pay to jump queues or seek none core services
We CAN learn from the social health care failures around the world. THEY are all trying to return to a measure of privatization.
~faith,
Timothy.
except of course your assessment is somewhat off the mark and very selective ...
Specializes in Spinal Cord injuries, Emergency+EMS.
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.
there seems to be some kind of assumption that a free at the point of delivery system comes without root and branch reform of systems
here is some important IF ... THEN statements
IF you have free at the point of delivery Primary Care THEN it is safe to be able to turn peopel away from the Emergency Department if if they don't have an emergent condition
IF you have free at the point of delivery access to Specialist Consultations THEN you can require a referral from the (also free at the point of delivery ) Primary care physician
Of course, you won't really have to pay more than 60% in payroll taxes if gov't restricted health care is enacted.
evidence base?
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.
save the tabloidisation and artificially emotive language ,
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.
incorrect as has been previously proven in other discussions on this site
given the highest rate of income tax in the UK is 40% the actual rate of tax doesn't approach 40% until the threshold is a small part of the overall income ...
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.
~faith,
Timothy.
do you have any proof of this prepostorous statement ?
You made a critical distinction. I too, CHOOSE to work without monetary benefit. I volunteer my services for a church camp one week a year.
That is my CHOICE.
That is not the gov't dictating to me.
Gov't restricted health care is anti-choice. The gov't dictating to me that a certain sum of my salary should be taken from me because it is entitled to somebody else: that's slavery for whatever sum of that salary is in question.
From a quick and dirty Google search on Chomsky, it looks like a stretch to call Chomsky "a known Marxist." In fact, he has been critical of Marxism. It does looks like some Marxist-thought groups give Chomsky's opinions a lot of weight. That is still different than Chomsky himself being a "Marxist."
I'm not noting this because I think Chomsky's opinions are beyond reproach. But I don't see the justification to dismiss his opinions on the basis that he's "a known Marxist."
Explain the difference, from a market perspective.
yet another poster who confuses socialism with warsaw pact / stanlist Communism
I haven't made any such confusion. Socialism is still a failure. Look no further than the NHS. Deny care until the next budget cycle, refuse life saving treatments because its unfair for someone to choose to live with non-NHS treatments, Rushing to privatize as fast as possible. EIGHTEEN WEEK WAITS to see a specialist, and they can't meet THAT goal, unrationale taxation to support the system and THAT isn't enough.
With all do respect, YOUR health care system is a dismal failure. It's crumbling before your very eyes. Not because it's communist. I haven't said that. Because it's socialist. The lesson of the 20th century is that socialism is an abject failure.
If the NHS is an example of the stunning success of socialism, you can keep it; I don't want it. (In fact, most of the posters here in favor of UHC point to the NHS as an example of how NOT TO DO IT.)
it's a logic extension of the purchaser / provider split that it doesn't matter who provides the service as long as the NHS funds it.
Simply not true. The first rule of markets is the payer is the customer. He who pays, decides. It doesn't matter who provides the service if the NHS funds it; only the services the NHS funds will happen.
Your NHS, the French System, the Canadian system, the Hong Kong system - they are every one struggling with costs they can't bear for health care they can no longer maintain. They violated the basic law of economics- unlimited demand (it's free!) must either equal unlimited supply (politically and fiscally impossible) or, rationed care.
The Canadian Supreme Court recently summed up gov't restricted care: "Access to a waiting list is NOT access to care." Amen.
With all do respect, YOUR health care system is a dismal failure. It's crumbling before your very eyes. Not because it's communist. I haven't said that. Because it's socialist. The lesson of the 20th century is that socialism is an abject failure.
"Dismal/Abject failure"? Again, a rather drastic conclusion. Is there room for improvement? Yes. There's lots of room for improvement in OUR health care system as well (and I know you agree with that).
EVERY system has it's problems if it's not regulated or run properly and efficiently. I know you recognize that for capitalism to work, there must be some level of government regulation going on. Without that, capitalism doesn't work. And even then, capitalism alone, without any other guiding principles, doesn't always address our needs in the most efficient or effective manner. Stark capitalism isn't concerned with human capital if it is easily and cheaply replaced. Stark capitalism isn't concerned with environmental damange if it doesn't hurt the bottom line. It can take a long time and a lot of damage before the negative effects of the exploiting human capital and the environmental come back to bite a profit-driven business. Do all of the instances of capitalism going awry mean it's a FAILURE as an ideal? Any system is subject to the whims and weaknesses of people and politics. There will always be on-going adjustments and re-adjustments to any policy or strategy.
You guys cringe and go into spates of denial when I call nationalized health care unveiled socialism. However, HERE, you quote a known marxist in your defense of it.
I would have picked a better source.
This would be like me saying the free market is a better idea, see, Rush Limbaugh says so. Actually, if you like, I could quote a link from him on the topic. . . would you find it credible?
~faith,
Timothy.
Not fair, Timothy, John Galt is a figment of Ayn Rand's mind, he personifies her principles, I wont AGAIN go into what her agenda is, to spare the rest of the folks on this thread. Rand is as far right as Chomsky is left .
Access to health care is what we all need even the 23 year old bum, doesn't have to be GIVEN away without fees or responsibility, we need to save our OWN health care system.
"Dismal/Abject failure"? Again, a rather drastic conclusion. Is there room for improvement? Yes. There's lots of room for improvement in OUR health care system as well (and I know you agree with that).
EVERY system has it's problems if it's not regulated or run properly and efficiently. I know you recognize that for capitalism to work, there must be some level of government regulation going on. Without that, capitalism doesn't work. And even then, capitalism alone, without any other guiding principles, doesn't always address our needs in the most efficient or effective manner. Stark capitalism isn't concerned with human capital if it is easily and cheaply replaced. Stark capitalism isn't concerned with environmental damange if it doesn't hurt the bottom line. It can take a long time and a lot of damage before the negative effects of the exploiting human capital and the environmental come back to bite a profit-driven business. Do all of the instances of capitalism going awry mean it's a FAILURE as an ideal? Any system is subject to the whims and weaknesses of people and politics. There will always be on-going adjustments and re-adjustments to any policy or strategy.
I disagree. The thing that makes capitalism work is that both sides of a trade must agree. It must be a win-win trade, or, it doesn't happen.
Socialism commands one side of the trade: yours. Here is what you get.
It's about choice.
I think maybe, a small amount of regulation might be in order, but I also believe capitalism to be inherently self-regulating.
I think the current problem with health care IS REGULATION. I certainly wouldn't advocate for more. What we need is MUCH LESS; the gov't is in the way, NOW.
When the gov't regulated Ma Bell, everybody had a nice black rotary phone. I guess, without comparison, that was functional and adequate. 25 yrs after deregulation and I NOW do not have a land-line; I have a cell phone with caller id, call waiting, 3 way calling, etc. etc. etc. My spouse and two of my kids have phones with their own number on the same account. I spend almost as much on my cell plan as I did back in the days of the baby bells ~$130 today vs. ~$100 in the early '90's.
BY COMPARSION, that black rotary phone is a dismal and abject failure to my cell phones. Adjusted for inflation, I spent more for that failure.
BY COMPARSION - a gov't (NHS) that fails to meet a standard of EIGHTEEN WEEKS to see a specialist is an abject/dismal failure to my ability to see a specialist, tomorrow.
After looking at the mess Canada, England and Europe have with their socialized medicine, I hope my patients never have to go through such disaster. That's all we need over "free enterprise", more government control... When you let the market work, deregulate, and encourage R&D, the industry does just fine, because of consumer wants and competition. No wonder we dislike our healthcare today, there is way too much regulation. Someone please tell me, rationally, why me, a male, need to pay for well-baby care, pregnancy care, besides the government saying I have to pay for it? Or, as a non-drinker, pay for alcohol rehab every month? Take a look at this site on socialized medicine first:
Specializes in Spinal Cord injuries, Emergency+EMS.
Explain the difference, from a market perspective.
a fundamental failure in meeting people's human rights when you try to equate healthcare delivery with any kind of product ...
I haven't made any such confusion. Socialism is still a failure. Look no further than the NHS. Deny care until the next budget cycle,
rather than deny care becasue you chose to change jobs ? because you failed to tell the insurer you stubbed your toe in 1963 ... ?
refuse life saving treatments because its unfair for someone to choose to live with non-NHS treatments,
what treatments would those be?
oh yes treatments which don't have an evidence base or aren't even part of proper clinical trials ? treatments which don't actually do anything except line the pockets of pharmaceutical companies and make people 'feel' that they have doen everything ...
Rushing to privatize as fast as possible.
evidence base?
PFI for buildings isn't 'rush to privatise' , primary care have been 'private' since 1948 under GMS so PMS and other directly NHS managed primary care are actually movement against privatisation ...
EIGHTEEN WEEK WAITS to see a specialist,
NO , eighteen weeks to completion of treatment unless it's long term treatment when it will have started within 18 weeks from you originally stepping into the GP surgery ...
and they can't meet THAT goal,
waits for initial specialist consultation are well below 18 weeks at present, completion of treatment in under 18 weeks is the current goal, except of course where it's already been brought down to days by previous targetted service review ( e.g. investigation of suspected Cancer and diagnosis / commencement of treatment for confirmed cancers)
the 18 week target is for ELECTIVE not clinical emergencies, conditions considered to be clinically urgent by the primary care physician or conditions where there is a reasonable possibility of the need to exclude cancer ...
unrationale taxation to support the system and THAT isn't enough.
i'm sorry that statement doesn't seem make sense in english ... is it in a foreign language ?
With all do respect, YOUR health care system is a dismal failure. It's crumbling before your very eyes.
dismal failure , crumbling before my very eyes ... hardly before my eyes i see a lot of hard work and an awful lot of investment or perhaps the new Hospitals going up before my very eyes where i work and on one ofthe other sites i nthe trust , new community facilities and complete renewal of the Ambulance fleet currently in progress are all mirages ...
perhaps the fact we are performing at 80 %+ on the 18 week traget acorss the entire trust is a mirage, not bad considering that this time last year the audiology service becasue it had no targets had a waiting list of 3 years for hearing aids ... and now has a wait of under 6 weeks and is has done the majority of analogue to digital reprovision ... (fixed term contracts involving a private contractor to achieve a rapid resolution )
Simply not true. The first rule of markets is the payer is the customer. He who pays, decides. It doesn't matter who provides the service if the NHS funds it; only the services the NHS funds will happen.
odd then that you can open any sunday newspaper and among the bits that will fall out are almost assured to be
a leaflet from a private health insurer offering top up cover alledglely for everything but in reality for elective work
a leaflet from a private provider of cosmetic procedures offering installent plans or other financing
somewhere i nthe classified will be an advert for the 'irradiate 'em til they glow ' merchants offering top to toe 'screening' CTs which rarely discover anything of consequence and load more and more work on to the NHS to investigate benign 'abnormalities'
Your NHS, the French System, the Canadian system, the Hong Kong system - they are every one struggling with costs they can't bear for health care they can no longer maintain. They violated the basic law of economics- unlimited demand (it's free!) must either equal unlimited supply (politically and fiscally impossible) or, rationed care.
The Canadian Supreme Court recently summed up gov't restricted care: "Access to a waiting list is NOT access to care." Amen.
unlimited demand with unlimited access in an unequal system is the current US model , where people are not encouraged to use healthcare responsibily either through misuse of specilaists - how many US citizens have regular specialist appointments despite not actually having anything wrong with them - due to inadequate gate keeping arrangements
perhaps peopel are confusing the 'triage' function of primary care in the NHS with rationing ?
perhpas peopel are confusing confirming diagnoses with enough information from additional investigations vs getting as much income from an artifically inflated 'standard of care' in terms of investigations with rationing...
After looking at the mess Canada, England and Europe have with their socialized medicine, I hope my patients never have to go through such disaster. That's all we need over "free enterprise", more government control... When you let the market work, deregulate, and encourage R&D, the industry does just fine, because of consumer wants and competition. No wonder we dislike our healthcare today, there is way too much regulation. Someone please tell me, rationally, why me, a male, need to pay for well-baby care, pregnancy care, besides the government saying I have to pay for it? Or, as a non-drinker, pay for alcohol rehab every month? Take a look at this site on socialized medicine first:
Until the day comes that we have an anarchy we are all still part of a democratic society. We pay into services that benefit the society.Unless society breaks down completely and everyone runs amok making their own individual rules, we abide by the rules of the society in which we live. Stop paying taxes.
ZippyGBR, BSN, RN
1,038 Posts
this is healthcare not snack foods !
yet another poster who confuses socialism with warsaw pact / stanlist Communism ... given the 'socialist' leanings of the 'conservative' parties in much of europe and in fact much of the western world outside the USA this is patently not the truth ... why do peopel across the world crave British or German products ... why does the US military when it comes down to the real nitty gritty buy from German or British suppliers (Land Rover, Heckler and Koch, BAe predecessor companies ...)
wrong!
it's a logic extension of the purchaser / provider split that it doesn't matter who provides the service as long as the NHS funds it ... ifyou don't 'own' the buildings, durable equipment and staff you only need to pay for it when you use it ... it doesn't change the fundamental free at the point of delivery character of the service
Only Australia is relatively immune and that's because they adopted a two-tier system from the start. Private health care is still available there. Even so, the cost in taxation for their program is much more than Americans would willingly bear.