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 U.S. spends an average of $7,000 per capita on health care. According to a 2007 analysis by McKinsey Global Institute, that's 28 percent more than any other industrialized country, even after adjusting for its relative wealth.
In the wake of the failure of managed care, no one is effectively reining in spiraling costs, say experts we interviewed.
"We have very high prices because people can get away with charging them," says David Blumenthal, M.D., director of the Institute for Health Policy at Massachusetts General Hospital. "In our decentralized, pluralistic system, no single purchaser has the market power or political authority to impose cost controls."
Insurers are no longer able to effectively negotiate prices with providers, but they make money anyway because they get a cut of premiums. Employers are paying more for insurance and are still passing on more costs to employees. Consumers who get health insurance from their jobs are neither selecting the plans to be offered nor made aware of how much they actually cost. (In 2006 the annual premium for family coverage averaged $11,480--more than the annual paycheck of a full-time worker earning the minimum wage.) And doctors, hospitals, and drugs are more expensive in the U.S. than anywhere else in the world.
It wasn't supposed to be this way. Back in the 1990s, employers and insurance companies embraced the idea that "managed care" could simultaneously save money and improve quality. Employees were put into HMOs, which in turn used their burgeoning membership numbers to force doctors and hospitals to cut their prices or lose access to patients. They also started telling doctors and patients they couldn't have all the care they wanted.
Breast-cancer patients sued and got some state legislatures to pass laws requiring health plans to cover $80,000 bone-marrow transplants (which were eventually proven useless, a topic we'll address more fully in a report in our November issue). And doctors and hospitals joined forces and, in many cases, successfully pushed back against managed care's demands for deep discounts to their fees.
Moviegoers cheered when, in the 2002 film "John Q.," Denzel Washington took an emergency room hostage to force his HMO to pay for his son's heart operation.
"Managed care effectively evaporated," says Gerard F. Anderson of Johns Hopkins. "Consumers wanted access to as many doctors as they could possibly get." The solution was the preferred provider organization, or PPO, which did away with the unpopular "utilization review" of HMOs.
"Insurance companies no longer had the ability to negotiate with a doctor or hospital because they couldn't throw them out of the system," Anderson says. "Prices for insurance took off."
"In our decentralized, pluralistic system, no single purchaser has the market power or political authority to impose cost controls." Quote by David Blumenthal MD, director of the Institute for Health Policy at MGH, taken from Mschrisco's post above
Thank goodness for that! If we allowed a single purchaser or political authority to impose price controls, we would also be inviting that same single entity to dictate our salaries. No, thank you. I'll allow mine to be set by competition.
Then why isn't the free market and competition working now? If there is money to be made, there is someone who can find a way to make it.
As Timothy has very clearly explained, we don't currently have a true free market system. We have 3rd party payors interfering with the process of consumers negotiating and freely choosing their health care providers and services.
There is plenty of money to be made in healthcare. The vast majority of facilities and providers (even non-profit organizations) are making money, or they would be closing their doors. On the contrary, we have new offices opening almost weekly in our area, with hospitals growing, expanding, re-building, entering new markets, etc. That would not be possible if they were not profitable.
I pointed out the flaw in your argument: more gov't control is NOT less gov't control.
Even if you want it to be.
~faith,
Timothy.
You don't get the logical flaw in a straw man argument. Cool, attribute anything to those opposed to your....not sure it qualifies as a point, but for lack of a better word...point. Then decide that those things you attributed to the opposing position is not correct and score.
Good job. I began following this thread only slightly leaning towards favoring UHC, your arguments have convinced me that the only rational choice is for UHC. I suspect you're actually playing devils advocate and in truth will be voting for UHC.
As Timothy has very clearly explained, we don't currently have a true free market system. We have 3rd party payors interfering with the process of consumers negotiating and freely choosing their health care providers and services.
There is plenty of money to be made in healthcare. The vast majority of facilities and providers (even non-profit organizations) are making money, or they would be closing their doors. On the contrary, we have new offices opening almost weekly in our area, with hospitals growing, expanding, re-building, entering new markets, etc. That would not be possible if they were not profitable.
Not adding up for me. Government, 3rd party payors, they are all stopping greedy people and corporations from making money.
Nope. Government, political powers, corporations, elected officials... pure greed. Rules would have already been changed, new regulations to prevent anyone or anything from getting in the way of the $$$.
"All other things being equal, the simplest solution is the best."
All too much time. My point is that timothy, and those opposed to UHC, are most effectively supporting UHC. The ostensibly opposed position is doing a very good job of supporting UHC.
I would sincerely, as I've written before, like to see a logical reason for opposing UHC. It must be possible, so far it has not happened. Red herrings, straw men, and well for that matter every sort of logical flaw has been used to oppose UHC. None opposed have presented a logical and supported argument. No tricks are needed, I simply want to be able to reasonably argue against UHC. Please, those opposed, do present something valid.
All too much time. My point is that timothy, and those opposed to UHC, are most effectively supporting UHC. The ostensibly opposed position is doing a very good job of supporting UHC.
I would sincerely, as I've written before, like to see a logical reason for opposing UHC. It must be possible, so far it has not happened. Red herrings, straw men, and well for that matter every sort of logical flaw has been used to oppose UHC. None opposed have presented a logical and supported argument. No tricks are needed, I simply want to be able to reasonably argue against UHC. Please, those opposed, do present something valid.
:yeah::bow::yeahthat::yeahthat:
Indeed, any claims to alleged efficiency of the private health care over Medicare are squashed simply through a comparison of Medicare's Administrative cost structure to that of private insurance. 3% vs 25%. Which yields more value per dollar spent. Its not if money will be spent on health care its how well we spend it. I wouldn't have a problem with private insurers bidding for large groups as long the bids meet some basic tests:
1. Accept all comers regardless of preexisting conditions.
2. First dollar coverage for treatment of the chronically ill.
3. Administrative costs do not exceed 5%. If they hold admiinistrative costs to under 5% that is where they make their profits. If they match Medicare they make 2% on every dollar managed. If they can get it below 3% they get 2.++% and so forth.
For that matter I wouldn't even oppose bonuses for meeting certain population health targets for members of the group. (Eg mean hgba1c at
sorry-you can't have biblical quotes and the "separation of church and state".
pick one.
i reveiwed my post. it did not reference any religious texts. jefferson wrote from a natural rights perspective and if memory serves was a deist. personally i think that he would have pursued health care reform as a pragmatic necessity to preserve the nation.
my quote about the public library was my own philosophical statement. undoubtedly as a sentiment it exists in some variant throughout the universe of political philosophy.
i don't remember reading the following before but in the interests of academic inquiry:
presidential initiative
libraries: the cornerstone of democracylibraries are . . . essential to the functioning of a democratic society . . .
libraries are the great symbols of the freedom of the mind.
franklin d. roosevelt
democracies need libraries. an informed public constitutes the very foundation of a democracy; after all, democracies are about discourse—discourse among the people. if a free society is to survive, it must ensure the preservation of its records and provide free and open access to this information to all its citizens. it must ensure that citizens have the resources to develop the information literacy skills necessary to participate in the democratic process. it must allow unfettered dialogue and guarantee freedom of expression.all of this is done in our libraries, the cornerstone of democracy in our communities.libraries are for everyone, everywhere. they provide safe spaces for public dialogue. they disseminate information so the public can participate in the processes of governance. they provide access to government information so that the public can monitor the work of its elected officials and benefit from the data collected and disseminated by public policy makers. they serve as gathering places for the community to share interests and concerns. they provide opportunities for citizens to develop the skills needed to gain access to information of all kinds and to put information to effective use.ultimately, discourse among informed citizens assures civil society. in the united states, libraries have greeted the self-determination of succeeding waves of immigrants by offering safe havens and equal access to learning. they continue this mission today. indeed, libraries ensure the freedom to read, to view, to speak and to participate. they are the cornerstone of democracy.
can america afford to pay more? what america can afford is largely a question of values. the united states is one of the least taxed industrialized countries. twenty-eight out of 30 countries in the organisation of economic cooperation and development (oecd) pay a larger share of gdp in taxes than does the united states. only korea and mexico pay less. in 2005, total federal, state, and local taxes in the united states were 25.8% of gdp; the other 29 oecd countries paid 35.5% (citizens for tax justice 2007).
citizens for tax justice. 2007. “united states remains one of the least taxed industrialized countries.” washington, dc: citizens for tax justice. april.
as i wrote earlier in regards to some of the tax and finance issues:
as to the tax question every credible proposal that i have read speaks to the idea of replacing premiums with either a payroll tax or allowing employers and individuals the option to purchase health care insurance directly from medicare, or febp. if private insurers want to stay in the game they will have achieve dramatic administrative cost reductions. 1 dollar should buy at least 95 cents of health care instead of our current 70 cents. we simply cannot afford double digit administrative costs or health care inflation.
the oecd average is about 9% gdp for health care. we spend 16% gdp. a substantial driver of the difference is administrative inefficiency and duplication along with incomprehensible and inconsistent benefit plans.
the case for a social insurance model of health care finance:
social insurance was a wise admission on the part of supporters of competitive economies that citizens would take the risks such economies require only if they are provided with a degree of security against old age, unemployment, the sudden death of a spouse and the vicissitudes of health. social insurance arises from the understanding that competitive economies sometimes break down. competition has benefits and costs, and both are shared unequally.… risk is tolerable, even desirable, as long as every one of life’s risks is not an all-or-nothing game. that is especially true when one’s family is put at risk. protecting citizens against risk is a fundamental role of government. as fdr noted after passage of the social security act, the first americans to seek government protections against risks beyond their own control were not the poor and the lowly but the rich and the strong. they sought protective laws to give security to property owners, industrialists, merchants and bankers. he did not blame the wealthy for seeking these protections. instead, he saw these as models for comparable protections for workers and families.
:yeah:
:bow::yeahthat::yeahthat:
mscsrjhm
646 Posts
Interesting from Consumer Reports:
Why health care costs so much
The U.S. spends an average of $7,000 per capita on health care. According to a 2007 analysis by McKinsey Global Institute, that's 28 percent more than any other industrialized country, even after adjusting for its relative wealth.
In the wake of the failure of managed care, no one is effectively reining in spiraling costs, say experts we interviewed.
"We have very high prices because people can get away with charging them," says David Blumenthal, M.D., director of the Institute for Health Policy at Massachusetts General Hospital. "In our decentralized, pluralistic system, no single purchaser has the market power or political authority to impose cost controls."
Insurers are no longer able to effectively negotiate prices with providers, but they make money anyway because they get a cut of premiums. Employers are paying more for insurance and are still passing on more costs to employees. Consumers who get health insurance from their jobs are neither selecting the plans to be offered nor made aware of how much they actually cost. (In 2006 the annual premium for family coverage averaged $11,480--more than the annual paycheck of a full-time worker earning the minimum wage.) And doctors, hospitals, and drugs are more expensive in the U.S. than anywhere else in the world.
It wasn't supposed to be this way. Back in the 1990s, employers and insurance companies embraced the idea that "managed care" could simultaneously save money and improve quality. Employees were put into HMOs, which in turn used their burgeoning membership numbers to force doctors and hospitals to cut their prices or lose access to patients. They also started telling doctors and patients they couldn't have all the care they wanted.
Breast-cancer patients sued and got some state legislatures to pass laws requiring health plans to cover $80,000 bone-marrow transplants (which were eventually proven useless, a topic we'll address more fully in a report in our November issue). And doctors and hospitals joined forces and, in many cases, successfully pushed back against managed care's demands for deep discounts to their fees.
Moviegoers cheered when, in the 2002 film "John Q.," Denzel Washington took an emergency room hostage to force his HMO to pay for his son's heart operation.
"Managed care effectively evaporated," says Gerard F. Anderson of Johns Hopkins. "Consumers wanted access to as many doctors as they could possibly get." The solution was the preferred provider organization, or PPO, which did away with the unpopular "utilization review" of HMOs.
"Insurance companies no longer had the ability to negotiate with a doctor or hospital because they couldn't throw them out of the system," Anderson says. "Prices for insurance took off."
http://www.consumerreports.org/cro/health-fitness/health-care/health-insurance-9-07/why-health-care-costs-so-much/0709_health_cost_1.htm
(This article doesn't mention government involvement)