Quote :

"no, rationing. Meaning we will do X number of procedures. Or we will provide X number of medicines."

This doesn't have to occur.

Quote :

"Its amazing how the human race was able to survive without govt insurance isnt it moron?"

I don't know about you but I wouldn't want to go back to live in the early 1900s, or really any other time in history... at least not if I wanted to enjoy a long life expectancy.

8/27/2008 3:52:26 PM

Quote :

"This doesn't have to occur. "

LOL, and how do you propose it doesnt? It absolutely does


^Yes, because technology hasnt improved things either.

8/27/2008 3:56:22 PM

surviving and thriving are different things.

Do you think that society should remain stagnant?

8/27/2008 3:57:29 PM

^haha, that last line is kinda vague imo

8/27/2008 4:00:25 PM

^ most things on TWW are vague.

8/27/2008 4:02:17 PM

moron, please explain to me how in the world you think we wouldnt have to ration? Please

8/27/2008 4:04:53 PM

Quote :

"seems like if we got universal health care the gov would limit what we eat so we wouldnt have so many unhealthy fat asses roaming around...which is a good thing antithetical to everything America stands for"

fixed

8/27/2008 4:40:14 PM

I've posted the below in another thread and thought it would be relevant here. For those who think we have a free market in health care, pay close attention to the chart below, which quantifies the impact of just state regulations.

Quote :

"The employer-sponsored system is vastly inefficient. The most perverse effect it has is on consumer choice. When we buy car insurance, we have a wide array of options. With health insurance, our choices are largely confined to what our employer is offering. This leads to less competition among insurance providers as they only have to compete for the business of businesses rather than all consumers. Additionally, businesses are often looking for a one-size-fits-all policy, further reducing the likelihood a plan will fit the consumers needs. We are far, far from a Laissez Faire health care system. On the contrary, it is government regulation that has gotten us into this mess. What competition is there among insurance providers? Competition and consumer choice have been systematically diminished as a direct result of federal and state policies. On the federal level, the structure of our tax code has led to our current employer-sponsored system, which diminishes competition and consumer choice as mentioned above. On the state level, each state has its own set of regulations and mandates it imposes on insurers. Given most states mandate an excessive list of benefits that all insurance plans must include (often-unnecessary benefits such as in-vitro fertilization, chiropractic care, contraceptives and alcohol-abuse treatment), premiums must rise to cover all benefits. Such mandates limit the consumer’s ability to choose a plan that meets his or her needs. (Even those who religiously oppose contraceptives or do not drink alcohol must subsidize distribution of the former and therapy for the latter). In many ways, forcing insurance providers to offer a laundry-list of additional benefits is analogous to forcing all car companies to offer only cars with cd players, leather upholsteries and automatic transmissions. It is no wonder that premiums continue to rise as additional benefits are mandated. Another by-product of mandates is they attract special interests who will lobby for additional mandates that cover their services. Unfortunately, there has been an upward trend in state mandates. The number of state-imposed health benefit mandates has increased 25-fold over the past quarter-century, with more than 1,000 state-mandated benefit laws on the books today. See the chart below that shows the difference in insurance premiums due to state mandates. "

http://www.ncpa.org/pub/ba/ba558/

8/27/2008 5:17:38 PM

^ those charts are for a healthy person best I can tell from their site. It may go well in the other direction for a person who has a high health risk.

There are also the mandates. So the low cost areas might not pay for your hearing aid if you needed one. Or marriage counseling...


I understand why this is generally a bad thing, and I agree. When the government requires a company to include a service in its product, that's not what's happening. What the government is really doing is telling poor people that they can't buy health insurance that just covers the basics. Pretty much the government telling poor people they can't have health insurance.

And... that's 15% of the population.

8/27/2008 5:31:39 PM

A good portion of that 15% can afford health care but chooses not to have it.

8/27/2008 5:44:24 PM

wtf, you can do so much better than this ambiguous crap.

Unless you can't afford rent and food, you can afford health care. Obviously, those who do not buy it choose to use the money on something else. That doesn't change the fact that if the price went down, more would buy it.

there is some "amount" of health care that people will buy for a certain amount. The reason that the vast majority of those 15% do not buy health care is because there is no package available that costs less than what they are willing to pay.

8/27/2008 6:28:18 PM

Quote :

"moron, please explain to me how in the world you think we wouldnt have to ration? Please "

That's like if I asked you to explain to me why you're NOT a good eye dr.

Or why water ISN'T wet.

Or how heavy feathers are NOT.

Why don't you explain to me why we WOULD have to ration?

There are hundreds of ways to implement socialized medicine, and some of them probably would require mass rationing. But it would be easy to pick one that is superior to our current system that doesn't need rationing, and in a non-single payer system like what Obama has proposed, rationing wouldn't be a big concern.

8/27/2008 8:42:02 PM

this was probably already mentioned but i hope everyone does realize that regardless of whether or not there is a federally implemented program, we're ALL still paying for the healthcare of the uninsured. people that don't have health insurance don't just stay home when they have a problem. they go to emergency rooms. not only does this clog up the ER it also wastes time and resources. and it isn't free. and do you know who pays for it? taxpayers. so i don't want to burst anyone's bubble, but you've BEEN paying for the healthcare of the uninsured. i guess we can keep doing it inefficiently and waste $$$. or maybe try something a little more efficient.

8/27/2008 8:55:50 PM

but would you rather pay for that in your hospital bill or with your taxes?

8/27/2008 9:12:33 PM

well lets see...either way you are wasting YOUR money on an inefficient method. there have been studies on what saves taxpayers the most money...state sponsored healthcare programs, or cutting healthcare programs. cutting the programs drives up the cost for everyone AND forces taxpayers to make up the deficit in SOME form.

prevention is cheaper. wellness is cheaper. effectively treating and preventing disease is cheaper than bringing your kid to the ER every time they have a stuffy nose or a fever.

8/27/2008 9:21:08 PM

Quote :

" Why don't you explain to me why we WOULD have to ration?"

By subsidizing consumers' health care costs we are insulating them from the effects of price changes. Doing so removes any incentives to cut back on demand as prices rise, leading to the over-consumption of health care goods and services. Given the supply of medical practitioners is artificially low due to licensure laws, the supply-demand imbalance ultimately leads to rationing.

I have yet to see any way around this under a socialized system; neither empirically nor even theoretically.

Quote :

"i guess we can keep doing it inefficiently and waste $$$. or maybe try something a little more efficient."

The most efficient solution to ER abuse would be to let hospitals have greater discretion on who they can turn away.





[Edited on August 27, 2008 at 9:39 PM. Reason : .]

8/27/2008 9:31:30 PM

Right but are we really going to dehumanize our citizens so much as to turn them away from ERs and deny them affordable healthcare?

I get the rationing fear, as universal healthcare has failed in other countries. But what about the healthcare system in France? I'm not an expert in economics. Or healthcare. But France has a system without waiting lists and has avoided rationing by SOMEHOW using the market to control over consumption and rationing.

Would a scheme like this not work in the U.S.? That is an honest question (not a rhetorical question) because I honestly don't know.

8/27/2008 9:39:47 PM

Quote :

"In my opinion, the problem isnt people not having insurance, or insurance not being affordable. Its responsiblity and govt intervention."

Actually, the problem is not even that. The problem is that the cost of routine health care is so high that insurance is needed for it. The perfect system is one where doctor's visits are 20-30 bux WITHOUT insurance, your average prescription is 25-40 bux, and major surgery is still expensive. A system like that would negate the need for the "poor" person to obtain insurance for the purpose of getting routine care. And such a system is perfectly attainable if we decrease government intervention.

Much has been said about how insurance companies are trying to "make a profit by denying coverage," but the main reason some companies resort to this is because there is so much the have to cover by law. The big ticket items are the obvious choice for insurers to try and avoid, because they offer a lot more bang for the buck if they can successfully deny it. Plus, by allowing all of the smaller items through, they can look like they aren't denying coverage much at all! However, if insurers are mainly insuring only big ticket items, you know, like insurance is supposed to do in general, then the percentage of denied claims will be substantially higher, making it much more obvious when a company is being unscrupulous.

Quote :

"Would you like to see uninsured people left on the side of the road after a car accident to die?"

Such a thing would never happen, and I'll explain why in a second.

Quote :

"Any 911 call has to be responded to regardless of insurance, and anyone who presents to an ER has to receive care regardless of insurance."

This is disgustingly misleading, and you know it. 911 is NOT a health-care service. 911 is an EMERGENCY service. It ties together police, firefighters, both of them government agencies, as well any available hospitals. 911 is a convenience offered to the citizens by their local governments, because it simply makes sense to coordinate the efforts of emergency responders. Transportation to health services is tacked on as an added benefit; it is not the primary focus of 911; never has been, never will be. To claim, then, as you eventually do, that 911 shows that we have deemed health care as a basic right is entirely unsubstantiated. Basically, you'll have to do better than that.

So, just to humour you, what would happen in the absence of 911? Would people be left to die on the side of the road after a traffic accident? Nope. Citizens would simply have to know the phone number for the local hospital, which would then dispatch an ambulance. The free market would still take care of it. All the LOCAL government is doing is providing the added convenience of a simple number for access to emergency services. The free market is still providing the health care. And, the only reason that 911 can't reject a call is, because, obviously, a government must provide equal protection under the law to all citizens with its services, of which 911 is a member.

Quote :

"However, in the single payer plans, you do away with the thousands of insurance companies, their 30% administrative costs, and the profit motivation for paying for care. You turn it into a highly efficient administration of the funds that does not take a profit and has very low administration costs."

You grossly underestimate the power of the government to waste money. Yes, doing away with thousands of insurance companies would make it easy for health-care providers to file insurance claims; there is only one payer, so there is only one person to bill. That much makes sense. However, you neglect to include the fact that now the government is running the insurance racket instead of a company. The government has no profit motive to drive it to an efficient method of administration, so the 30% that the doctors save will be met by a tripled increase in cost, at best, on the side of the government, and that is simply for administration. That doesn't include the added cost of administering the employees themselves or the business of collecting the taxes to pay for the system. Add to this the fact that the government WILL contract out this administering business, and you will most certainly have a more costly system.

The government has no incentive to be efficient or effective. All it has to do is provide the service, and with no competition to offer a better service, the people will not be as able to see how much they are being screwed over.

I get to see every day, firsthand, just how inefficient the government is at handling even the simplest of matters. Where I work, we had a plan proposed that would have effectively created a second IT department at our facility, which would duplicate all of the services of the facility's current IT group. This plan would have my department, 350 employees in all, have two desktop computers for every employee, not counting development systems. One desktop would connect to the facility-wide intranet and the internet, while the other desktop would connect only to a department-wide intranet. The purpose of this plan was to provide added security to our computer networks in response to some federal mandates. The sad part is, though, that such a plan would actually provide no added security whatsoever. Tell me, what company do you know of would, in their right mind, undertake such an endeavor? What company would hire, in effect, two separate IT departments? What company would implement a plan so doomed to failure? No company would do so, but the government will do it all day long. Why? Because it can.

And you want to know the best part of all of this? In talking with one of the higher-ups today who was in charge of writing this plan, I was told that a computer BIOS was a "new technology," and we didn't want to be involved with new technologies when it comes to computer security. This guy is effectively an IT manager and he thinks that a BIOS is a "new technology." How many low-level IT managers at Microsoft do you think hold such a belief? I'll bet Cindy McCain's 7 houses on the answer to that question, and I don't even know a single worker at Microsoft.

Don't kid yourself about the government actually being able to bring down the cost of something. The only thing the government can ever do is increase the cost of something. Even a subsidy ultimately increases the cost of the subsidized product.

Quote :

"I get the rationing fear, as universal healthcare has failed in other countries. But what about the healthcare system in France? I'm not an expert in economics. Or healthcare. But France has a system without waiting lists and has avoided rationing by SOMEHOW using the market to control over consumption and rationing. Would a scheme like this not work in the U.S.? That is an honest question (not a rhetorical question) because I honestly don't know."

Where do the French go when they need major specialized care. If you say "French health-care providers," then you are wrong. They come here because we offer the best medical care in the world. And we do so because of the free market, not in spite of it. If you look at the history of health care in the US, what you will see is that as government intervention has increased, so has the cost of health care increased. As I stated before, the only thing a government can ever do to costs is increase them.

Furthermore, any comparison involving Europe and America is wholly inadequate, because the level of personal responsibility in America is completely different than it is in Europe. Free schemes work fairly well when everyone is responsible enough to use it correctly. Such a hope is destined to failure in America. That is the sad truth

8/27/2008 9:49:26 PM

the government? or this government?

i wish someone would respond to my question.

8/27/2008 9:52:19 PM

Quote :

"that the current free market solution is that the insurance industry is horribly inefficient because it is for profit and thus only makes money by denying care to customers."

The system is inefficient because the gov't has interfered in it so much over the years, that the benefits that competition have dwindled to almost zero.

Quote :

"are we really going to dehumanize our citizens so much as to turn them away from ERs and deny them affordable healthcare?"

You know we forget that the health-care system ran pretty smoothly in the 1950s and 60s. No one was left to die on the side of the road. Charity hospitals took care of that. Competition held prices for health insurance low enough for most everyone to purchase.

Unfortunately, over the past 50 years, politicians have gotten their hooks into the healthcare system and have twisted it while they make ridiculous promises in order to gain power.

The last thing you want are soul-less politicians with total control (single-payer) over your health-care decisions.

8/27/2008 10:02:38 PM

^ exactly. the perfect way to "prove" a need for government intervention is for the government to fuck it up in the first place and then claim it needs intervention.

8/27/2008 10:04:59 PM

Quote :

"I get the rationing fear, as universal healthcare has failed in other countries. But what about the healthcare system in France? I'm not an expert in economics. Or healthcare. But France has a system without waiting lists and has avoided rationing by SOMEHOW using the market to control over consumption and rationing."

France has a much larger supply of doctors than we do as there are fewer restrictions on medical schools (the US gov't, under the influence of the AMA, systematically keeps the number of med students low. For instance, even if NCSU wanted a med school, it would most likely not be given the right to have one)

France also does not have as bad a tort system as we do, so doctors are less likely to deliver unnecessary and costly care as US doctors.

From what I understand, it wasn't until 2000 that the French system was truly universal. Since then, there has been trickling evidence that rationing is taking place.

Consumers also must pay a much larger co-pay in France (up to 40%, if i remember correctly), so the consumer is not entirely insulated from costs and is thus incentivized to respond to rising prices with lower demand. Obama's plan to subsidize more people's health care would be based on what Federal employees get, which largely insulates consumers from price changes.

[Edited on August 28, 2008 at 7:21 AM. Reason : .]

8/28/2008 7:17:53 AM

france also has crazy high taxes (like any other country with socialized medicine), which americans would never go for.

i think the solution is deregulation. most of the uninsured or underinsured in the US are the working poor, who either can't afford insurance because the premiums are outrageous, or their employer/business is so small that they don't offer any insurance.

NC is ranked 8th nationally i think for most uninsured, probably because we have so many rural counties.

8/28/2008 8:37:51 AM

i'd rather the US not have health care for my own selfish reasons. I never go to the doctor, I never get sick, have good genes, etc- dont understand why I should have to pay part of my tax money for others that are less fortunate

8/28/2008 10:19:51 AM

^ You shouldn't.

8/28/2008 10:22:43 AM

Quote :

"i'd rather the US not have health care for my own selfish reasons. I never go to the doctor, I never get sick, have good genes, etc- dont understand why I should have to pay part of my tax money for others that are less fortunate"

Yeah, I would have to agree. It must be that extra chromosome that keeps you so healthy.

I'm jealous. Not everyone can have the superior genetic makeup that you have.

8/28/2008 12:49:07 PM

Quote :

"dont understand why I should have to pay part of my tax money for others that are less fortunate"

you do know this is how regular insurance works, right?

Everybody pays a certain premium, certainly adjusted based on certain circumstances, but in general that premium is higher than what a normal person will ever receive the benefits of. Then when you stay healthy, and someone else gets cancer, part of your premium pays for their cancer treatment.

8/28/2008 1:13:22 PM

Healthcare has very very high accountability, which results in high costs for everyone involved.

8/28/2008 1:26:46 PM

The cost of health care should be lowered. If that was to happen, doctors and nurses would probably have to take a pay cut. So maybe if the government paid off all their educational loans after X number of years of practicing medicine, these proffesionals would actually agree to make less money. Then we can talk about universal healthcare.

8/28/2008 1:28:07 PM

^^^imo i dont need insurance either...orange juice cures everything that could possibly go wrong with me

[Edited on August 28, 2008 at 1:28 PM. Reason : .]

8/28/2008 1:28:33 PM

Another thing, under a socialized health-care system, the monetary disincentives for smoking, drinking, excessive eating, among others would largely diminish.

8/28/2008 2:04:27 PM

I believe we need a much greater level of government control in health care, but roughly the same or lower level of enforcement. This will enable the development of an efficient black market for health care. I won't mind going to the doctor after hours.

8/28/2008 2:31:02 PM

^^^ including getting hit by a bus?

8/28/2008 3:13:34 PM

while DNL is being a douche, I also think there is some room for cynicism.

We have certain expectations for 'health care', this is in terms of the frequency of checkups and the range of things treated. Almost all of you would be outraged if the 'range' of things in the normal package of health care (that you are already buying) included marriage counseling.

What what are reasonable expectations? Why do we need 'check-ups'? And only an idiot would think that the only the purpose of the check-up could only be accomplished by a 20 min 1-on-1 with a doctor. Just line 'em up and check thair balls!

So, what could be reasonable health care expectations?

Practically nothing.

Really, they should have a list of things to be checked for every so often. And then if you're healthy you don't need anything else. This is already the way it is, it just costs every fucking person in the nation 2k/year more than it should. Aside from that aspect, there should be another area or two treated completely differently.
1.) you physically fuck something up (ouch, my arm's broken, I need to see a doctor) - and there is a SHOCKINGLY high number of people who are not getting this treatment because of the other bullshit
2.) a medical observable change. You either early-detect something, or you detect it by it hurting, or fainting, or something. This can already be said to be more visceral and expensive than the first point, but it is actually needed.

8/28/2008 3:47:52 PM

Quote :

"If you regularly read The New York Times or listen to NPR, you probably believe the following: 1. Doctors are rich. The most common specialties – e.g. internal medicine, pediatrics – make, on average, after 5 years of practice, $170,000. “Not bad!”, you say. Now, remember, Mr. Wizard: you are 300,000$ in debt from med. school; you made sub-minimum wage for 4 years in residency; you made probably less than 100,000$ in your first five years of practice considering “partner buy-in” and being “junior” in your group; you likely employ 1-2 staff per physician (secretary, nurse etc.) on your dime; you are in the highest tax bracket, so ~50% of that 170k goes to federal, state, social security, medicare etc.; and worst of all, you are almost 40 years old when you start pulling a good paycheck. Now, do you think doctors are “rich”? Well, if you still do, go fuck yourself... and film it for me. 2. Doctors are overpaid. First, compare physician salaries (considering what I said above) with almost any other professional job (law, business etc.) and this is obviously untrue. Second, every doctor I know does, minimally, 10’s of thousands of dollars of charity work (free care) every year. This work is NOT tax deductible, making it a “double-whammy” financially (when I do free care I give up the opportunity to do something I am paid for). Now, do you think doctors are “overpaid”? Well, if you still do, eat my ass, and don’t forget the reach-around. 3. Doctors play golf on Wednesday afternoons. Joining a Country Club costs 50-100,000$ and has average annual fees of about 5-10,000$. Are you fucking kidding me? I don’t shit diamonds. And on top of that, I fucking WORK on Wednesdays so I can pay my fucking staff! Now, do you think doctors “golf on Wednesdays”? Well, if you still do, gargle my ball-sack with a shot of peppermint Scope. 4. Doctors have a God-Complex. Sure, a few doctors are douchebags and think they are the second-coming, but certainly no more than any other group in a position of authority. Docs are severely self-critical and are always trying to improve. Every single doc I know got into this field to “help people” and “do something that makes a real difference”. A telling quote I heard on the radio the other day by a physician was, “Do not practice medicine if you cannot handle being humbled every single day”. Doctors in general are very aware of their limitations, and if not, quickly end up being fired. Now, Freud, do you think doctors “have a God-Complex”? Well, if you still do, you are welcome to play some Mozart on my Magic Skin-Zauberflöte. 5. Doctors have potty-mouths. OK. This may be true. "

[Edited on August 28, 2008 at 3:48 PM. Reason : .]

8/28/2008 3:48:03 PM

I work with Doctors on a daily basis and the God-complex stereotype is vastly over exaggerated. Most Doctors are very caring people that make decent money. Not all Doctors make as much as you think they would. In some cases, lawyers make a lot more, no pun intended.

[Edited on August 28, 2008 at 3:57 PM. Reason : -]

8/28/2008 3:54:39 PM

Here's something wrong with health care

http://tpmelectioncentral.talkingpointsmemo.com/2008/08/mccain_advisor_emergency_room.php

This is starting to get more and more attention today: In an interview with the Dallas Morning News, a health care policy adviser to John McCain appeared to suggest that anyone with access to an emergency room effectively has health insurance.

The adviser, John Goodman, who is not paid by the McCain campaign but is widely quoted as one of the campaign's advisers and an author of McCain's health care policy, offered the following solution to the health care crisis to the paper:

"So I have a solution. And it will cost not one thin dime," Mr. Goodman said. "The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American -- even illegal aliens -- as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.

"So, there you have it. Voila! Problem solved."

8/28/2008 4:52:32 PM

the Emergency Room situation in general fucked up. So many people using the ER instead of a clinic or doctor's office like they should for most circumstances.

I'm sure everyone has an "i waited for 3 hours at the ER story", but here's mine
I had to take my wife to the ER a couple months ago after a cycling accident that resulted in several wounds that needed about 12 stitches overall. We would have gone to Urgent Care (which is another system that most people don't know about), but it was ~8pm and all the local urgent care centers were closed. So I drove her to Rex, and we walked into the ER - she is crying with blood literally running down her leg, soaking her shoe, and not insignificant chunks of skin peeled off of her leg. The nurse at the desk didn't even glance at her, and just gave me a stack of paperwork to fill out and told us to go sit in the corner. The place was packed, and as far as I could tell, not a single other person in there was bleeding, had a broken bone, or other outwardly physical ailment. I'm sure some people had legitimate problems that were not visible, but my wife was most definitely the only one with a pool of blood gathering at her feet.

I handed in the paperwork and reminded the desk-nurse that she was bleeding and when would we get back and at least clean it up, and she said "in the order you came in". I would expect her to do a bit of triage, and elevate at least people with broken bones or blood to the top of the list. but nope - had to wait for 20 other people who probably had 99-deg fevers or an upset stomach to go back first.

anyway - whole point is - people, many without insurance probably, treat the ER as a doctor's office, driving up the cost and wait times for people who have actual emergencies.

8/28/2008 5:15:33 PM

well at least you didn't die while waiting like that one person in NYC did. (I'm not joking)

8/28/2008 5:25:46 PM

Quote :

"Right but are we really going to dehumanize our citizens so much as to turn them away from ERs and deny them affordable healthcare? "

well, here's the thing:

Part of why they can't afford/aren't willing to pay for health insurance and end up going to the ER is because the cost of health insurance is inflated from what it should be, because the cost of healthcare is inflated from what it should be, because healthcare providers gouge insurance companies to cover the cost of things like people without insurance going to the ER.

8/28/2008 11:10:16 PM

The main problem is that too many people don't take responsibility for their own health and health needs. In addition, the problem is compounded when the government rewards these people for their irresponsible choices by providing them services often paid for with someone else's money.

8/29/2008 6:11:40 AM

Quote :

"Part of why they can't afford/aren't willing to pay for health insurance and end up going to the ER is because the cost of health insurance is inflated from what it should be, because the cost of healthcare is inflated from what it should be, because healthcare providers gouge insurance companies to cover the cost of things like people without insurance going to the ER. "

So its like a positive feedback loop....

Quote :

"The main problem is that too many people don't take responsibility for their own health and health needs. In addition, the problem is compounded when the government rewards these people for their irresponsible choices by providing them services often paid for with someone else's money."

Hey man need those chrome rims and health insurance takes money away from me buying crack

8/29/2008 4:36:20 PM

moron, I think you have ruined your credibility on this issue.

Quote :

"That's like if I asked you to explain to me why you're NOT a good eye dr. Or why water ISN'T wet. Or how heavy feathers are NOT. Why don't you explain to me why we WOULD have to ration? "

So basically, You dont have an answer? So ill give you the answer. Why would we have to ration? We dont have unlimited doctors, facilities, or money. There is your easy answer.


Hooksaw, I agree with your last comment. Simply having health ins wont make people take care of themselves. In fact, ill argue, that in some cases it makes people less responsible bc they have less consequences for thier own actions.

8/31/2008 9:50:46 AM

Here is an article that I think all Democrats should see. The kicker quote:

Quote :

"“It’s a nice thing to think, and it seems like it should be true, but I don’t know of any evidence that preventive care actually saves money,” said Jonathan Gruber, an M.I.T. economist who helped design the universal-coverage plan in Massachusetts. "

http://www.nytimes.com/2007/08/08/business/08leonhardt.html?_r=1&oref=slogin

The reason all Democrats should see this is because they all seem to over estimate the cost-savings of preventive medicine. I sure did. Up until earlier this year, I used to think that solidly behind some form of universal (or near universal) health care coverage (ala the Edwards/Clinton plan). I thought it would help improve access to health care services among the poor and that it would help address the problem of rising health care costs that plauge the middle class that already have insurance and pay taxes.

Articles like this seem to indicate there really are almost no cost-savings to preventive care. So while the Edwards plan would certainly improve access for the millions of people that can't afford insurance at some point in their lives, it will not help rising costs, which is the true problem for the middle class.

Obviously this won't change everyone's mind. Some people will surely say they would pay anything to get everyone equal access to health care services. But I think it makes the choice much harder, which is probably why the Democratic candidates like Barack Obama would rather forget this inconvenient evidence.

9/19/2008 10:32:39 AM

This singular article has blown the lid off everything. And you know, it's true. Healthcare is trapped between being nationalized and privatized, and as such it is inefficient and expensive. We pay more than the rest of the world per capita, but the WHO ranks the US healthcare system 37th, behind such countries as Costa Rica, Morocco, and pretty much all of Europe. So what is the way to assure that Americans can actually afford medical treatment in an age where the most innovative product is an insurance you pay for but won't actually give you coverage due to provider's attempts to deny any claims it possibly can?

Well, here's what McCain had to say about it in the September/October issue of Contingencies, the magazine of the American Academy of Actuaries: "Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation."

In the wake of the Lehman Brothers and AIG buyouts, I can only assume he means that he's waiting for the whole system to completely collapse so we can socialize it.

9/20/2008 10:37:08 AM

How is allowing people the freedom to buy insurance from other states the same as amending the capital requirements of investment banks?


The central problem with our current system is that insurance has transitioned from its traditional role of covering only low-probability events to covering just about everything under the proverbial sun. In such an environment, consumers are not factoring costs into their decisions. This has a spiraling effect as we, as consumers, are insulated from price changes, causing us to increase our demand for unnecessary care and not scrutinize the efficacy or efficiency of the care we receive.

Having the government provide too-generous of an insurance policy would only exacerbate this. New, expensive technologies would be brought to market without regard to cost-effectiveness or overall efficacy - as is happening now.

If you look at health care sectors where we do foot most of the bill, such as laser-eye surgery and plastic surgery, technology has led to decreasing prices, not the other way around. The reason for this is because the end user, by responding to price changes, places a demand on providers to be more efficient as happens in almost all other sectors of the economy where the consumer votes with their own dollars.

The AARP recently had an article revealing that roughly 30% of health care expenditures are attributed to tests and procedures that have no health benefit, roughly 30,000 medicare patients die each year from unnecessary care and about 18 billion is spent each year on spinal fusions even though there hasn't been a single comprehensive study showing their effectiveness. Why does this persist? It's because neither consumers nor producers are conducting cost-benefit analysis. The only parties doing this are the ones footing the bill, the insurance companies and Medicare/Medicaid, who must ration care and dictate doctor's fees to avoid going bankrupt.

The solution will most likely involve transitioning back to the traditional-type insurance and set up tax-free health savings accounts for routine expenses. This would incentivize consumers to be more cognizant of costs, which would subsequently force providers to do the same. This is why universal health care is inherently doomed to fail without resorting to inefficient rationing.


[Edited on September 20, 2008 at 11:15 AM. Reason : ,]

9/20/2008 10:51:52 AM

Nicely said ActionPants. It seems my insurance company spends about half of it's time figuring out how they can get out of paying.

Part of the problem stems from insurance companies trying to skim the cream of the health pool. Part of the reason for the high medicaid and medicare costs is because those people just can't get insurance any where else because of "pre-existing" conditions. In other words, they changed jobs and now can't get insurance.

I like the Austrailian system, where everyone gets a base level of national healthcare (with a global risk pool), and then you can buy supplimental insurance. It's multi-tiered, but there is no reason that people with money shouldn't be able to buy extra care ...

9/20/2008 4:07:47 PM

Quote :

"Part of the problem stems from insurance companies trying to skim the cream of the health pool."

And why do you think they do that? It couldn't possibly be because our gov't requires them to cover so much shit, could it?

Quote :

"Part of the reason for the high medicaid and medicare costs is because those people just can't get insurance any where else because of "pre-existing" conditions. In other words, they changed jobs and now can't get insurance."

Actually, the real reason for the high cost is that it is a gov't program, pure and simple. It's a system that rewards useless tests and procedures, and it rewards innefficiency.

Quote :

"I like the Austrailian system, where everyone gets a base level of national healthcare (with a global risk pool), and then you can buy supplimental insurance."

I like the US Constitutional system, where it says the federal government STAYS THE FUCK OUT of places where it is not allowed to be in the first place.

9/20/2008 4:15:11 PM

ActionPants

Quote :

" Well, here's what McCain had to say about it in the September/October issue of Contingencies, the magazine of the American Academy of Actuaries: "Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation." In the wake of the Lehman Brothers and AIG buyouts, I can only assume he means that he's waiting for the whole system to completely collapse so we can socialize it."

So your argument against opening the health insurance market to competition it to compare it to our current financial woes which have NOTHING to do with institutional requirements that block such competition????

I have to say I'm lost.

PS* It also had nothing to do with how Obama and others underestimate the costs of their programs because they overestimate the cost-savings from preventive medicine.

[Edited on September 20, 2008 at 4:19 PM. Reason : ``]

9/20/2008 4:17:50 PM

aaronburro:

Quote :

"I like the US Constitutional system, where it says the federal government STAYS THE FUCK OUT of places where it is not allowed to be in the first place."

I know. Everything is the government's fault (unless it's time to blame Republicans)... and the market can do no wrong. The government has no business getting involved in the health of it's citizens, that should be driven by the profit motive.

Welcome to the land of #1 in healthcare spending, and 37th in healthcare quality ... I know, I know, it's because of government interference ... it always is, when your perception is filtered through your idealology.

9/20/2008 9:00:20 PM