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.
We simply can't afford to continue paying 25% of our health care dollars to private insurance companies for profit and administration. For reasons of efficiency and quality I prefer single payer. If the private insurance companies want to stay in business here is my modest proposal. They get 5% for administration. If they want to make a profit they match traditional medicares administrative fees of 3%. If they are truly more efficient they will get their costs below 3%. Its that simple to reduce health care spending to a sustainable level.
touche joy. It's a very complex issue. I just feel that more government involvement could easily lead to more mess and more wasted $$$.
How do you explain the well established data that shows that our peers in the OECD with single payer are able to hold medical inflation to single digits while we are at 16% with our "efficient" market system?
i have been reading jeffrey sachs' new book. common wealth economics for a crowded planet.
anyway given the somewhat vehement opposition to taking the country in a better direction i found the following information intriguing. in comparing us economic performance to the nordic countries or countries who follow a social welfare model the following data was intriguing.
p 262
in terms of wealth and per capita income, the social-welfare states again defy the stereotype that high taxation leads to lower living standards. on average the social-welfare states have a higher per capita gnp than the free market countries...the poorest 20 percent of households in the social-welfare countries take in around 9.6 percent of the national income, as compared to only 7.3 percent of the national income in free market countries.
(that means the average household in the social welfare countries brings in about 24,465 vs. 17,553 for a free market country.)
broadly based strategies for prosperity have yielded superior economic performance. the social welfare countries have very high technical innovation and patent creation. (pull your cell phone out of your pocket. if its a nolia or ericsson its from a scandinavian country.)
from page 263
free market r&d 1.8% gdp
social welfare r&d 3.0%
advantage social welfare model.
world economic forum technology average rank (1 best)
It's not lame, just unsupported. The government would have several options to become more cost effective. It is not necessary for a Universal health care system to cut costs by setting hours or wages. Cost savings can be realized by improved preventative medicine and by eliminating unnecessary duplication of services, for example. Why is the straw man argument so popular with those opposed to UHC?
::ignoring the straw man comment as it does not address add any substance to the argument and seems like a rhetorical question, thinking maybe it was a silly attack to try to get under my skin::
I agree the government would have several options to become more cost effective. But special interests would see to it that these cost saving options are not implimented (just as they do with all other government spending). I think pharmaceuticals is one of the biggest lobbies in D.C., right? Instead of giving an already innefficient government more money and more programs to waste money on, How about we demand some responsibility with the money we already send them?
How do you explain the well established data that shows that our peers in the OECD with single payer are able to hold medical inflation to single digits while we are at 16% with our "efficient" market system?
Inflation is held to single digits by keeping costs low. Costs are kept low by rationing care and making people wait for essential care. Yes it costs less, b/c less care is delivered.
I agree our current system in the U.S. is grossly inefficient. However, IT IS NOT A FREE MARKET. Our current system is what happens when a corrupt government caters to big business, and big business caters to a corrupt government. We haven't had a free market economy in this country in years. (To me a free market means: no government subsidies to huge corportations, a currency that is based on some commodity not just a piece of paper, Does not give tax breaks to big businesses but penalize the small business. A free market is one that is driven by competition not by regulation.) There are still some free-market aspects to our economy, but when you look at how much of our GDP (30+%) is government spending, you will surely see there is no free market here. Our government puts their hands in everything and wonders why things only get worse. More regulation and more intervention, lead to higher costs... that's ok we'll just print some more reserve notes. that is where inflation comes from, the federal reserve. Our current system is inefficient BECAUSE OF GOVERNMENT INTERVENTION, not b/c of free markets. If you want to see a free market, look at the U.S. before the introduction of the federal reserve (1913). We had a strong economy back then, we were the world's leader, and the dollar was worth something.
Currently we are living above our means in this country. America has been living well off the misfortunes of other countries for many years through the exportation of our inflated currency, and exploitating their cheap labor. The end of America's days as an empire are drawing near. Emperialism (nation building around the world) will eventually cause economic depression if not collapse. Spreading the military around a hundred different countries doesn't help either. Until we start acting like a soveriegn nation again and not imperialist, we will continue to increase debt. until our falling dollar brings our economy to its knees. And I know this probably sounds crazy to you, b/c you have been comfortable all your life and you think it can't happen in America. If we keep spending beyond our means as a nation, it will happen. We can't continue to promise every citizen everything. We already have enough unsustainable progams without adding Universal health care.
People have no sense of PERSONAL RESPONSIBILITY. When they find they have a need, they feel entitled to have that need met by the government. If the government doesn't meet their need, suddenly its a violation of their rights. Until we learn some fiscal responsibility in government, Universal health care is out of the question. I wish the government could provide everyone with health care, the public health implications would be invaluable. But such a system would be TOTALLY unsustainable. Look at social security, something as simple as social security (just a check each month, nothing complicated there), and we can't sustain it. How the heck are we going to provide something as complex as health care.
Am i to assume our government will suddenly become efficient when it starts overseeing health care? Looking the precedents i think not.
I am not trying to start an argument here :). I am trying to make my point that is all don't take anything personally.
Inflation is held to single digits by keeping costs low. Costs are kept low by rationing care and making people wait for essential care. Yes it costs less, b/c less care is delivered.
.
Please see:
The US ranks 5/6 for length of waiting times for care.
Here's another thought to show how the supply and demand of cosmetic procedures don't make a good comparison for other health care services.
Dental care. It isn't nearly as embroiled with insurance companies as other health care services and thus theoretically should follow more of the supply/demand model. People have to pay much of their dental costs out of pocket. We see lots of advertising for cosmetic dental procedures, such as whitening, so clearly these are profit generating. We see price competition because such procedures are elective and if the cost is too high, people will elect to not have it done.
And that really is what makes a big difference here because with necessary procedures, you have much less choice. You either suck it up and pay whatever cost is being asked or you suffer. And the costs of necessary dental procedures (root canals, crowns, etc) still cost several hundred to several thousand dollars. You don't have a lot of time to shop around or attempt to negotiate a better deal. And it's difficult to be able accurately judge who would give the best care, so while the highest price doesn't guarantee better quality, an exceptionally low price raises suspicions. Anyway, the point is that free market necessary health care services don't always lead to intense price competition & substantially lower prices.
And I still don't understand the criticism that some kind of national plan means rationing... health insurance companies ration as well... theoretically we can choose a different company, but most follow each other in their own cost saving strategies... in either case, you still have the choice to paying extra for services above and beyond what's offered through one's health plan (most places with national plans DO allow for that).
In regard to the fact that US doesn't have a true free market, I don't think we really want that. Some kind of regulation is necessary or else monopolies, gangsterism and the like will grow. How much regulation? People will always disagree. You may say "as little as possible" but don't we all think that? Who seriously advocates for more regulation than necessary? The problem is that one person's idea of what's enough, another thinks is too much or not enough.
I'm not totally sold on UHC but I do think something major needs to change.
Specializes in Med/Surg/Ortho/HH/Radiology-Now Retired.
I've just finished watching the Michael Moore movie; "Sicko".
While I appreciate that documentaries often inflate the facts in order to garner reactions, if indeed what was presented is factual, this film confirms my understanding of the American health industry.
It's expensive. It's shameful. It's unnecessary for it to be as it is.
What arrogance prevails in America, by those in power, to deny the citizens adequate healthcare.
HM2VikingRN, RN
4,700 Posts
We simply can't afford to continue paying 25% of our health care dollars to private insurance companies for profit and administration. For reasons of efficiency and quality I prefer single payer. If the private insurance companies want to stay in business here is my modest proposal. They get 5% for administration. If they want to make a profit they match traditional medicares administrative fees of 3%. If they are truly more efficient they will get their costs below 3%. Its that simple to reduce health care spending to a sustainable level.