A Look at Healthcare Around the World - NY Times Op-Ed
The Swiss Menace
It was the blooper heard round the world. In an editorial denouncing Democratic health reform plans, Investor’s Business Daily tried to frighten its readers by declaring that in Britain, where the government runs health care, the handicapped physicist Stephen Hawking “wouldn’t have a chance,” because the National Health Service would consider his life “essentially worthless.”
Professor Hawking, who was born in Britain, has lived there all his life, and has been well cared for by the National Health Service, was not amused.
Besides being vile and stupid, however, the editorial was beside the point. Investor’s Business Daily would like you to believe that Obamacare would turn America into Britain — or, rather, a dystopian fantasy version of Britain. The screamers on talk radio and Fox News would have you believe that the plan is to turn America into the Soviet Union. But the truth is that the plans on the table would, roughly speaking, turn America into Switzerland — which may be occupied by lederhosen-wearing holey-cheese eaters, but wasn’t a socialist hellhole the last time I looked.
Let’s talk about health care around the advanced world.
Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken.
In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false. Like every system, the National Health Service has problems, but over all it appears to provide quite good care while spending only about 40 percent as much per person as we do. By the way, our own Veterans Health Administration, which is run somewhat like the British health service, also manages to combine quality care with low costs.
The second route to universal coverage leaves the actual delivery of health care in private hands, but the government pays most of the bills. That’s how Canada and, in a more complex fashion, France do it. It’s also a system familiar to most Americans, since even those of us not yet on Medicare have parents and relatives who are.
Again, you hear a lot of horror stories about such systems, most of them false. French health care is excellent. Canadians with chronic conditions are more satisfied with their system than their U.S. counterparts. And Medicare is highly popular, as evidenced by the tendency of town-hall protesters to demand that the government keep its hands off the program.
Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies.
In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured. And the most common form of health insurance in America, employment-based coverage, actually has some “Swiss” aspects: to avoid making benefits taxable, employers have to follow rules that effectively rule out discrimination based on medical history and subsidize care for lower-wage workers.
So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.
If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.
But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.
So we can do this. At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.
Correction: In Friday’s column I mistakenly asserted that Senator Johnny Isakson was responsible for a provision in a House bill that would allow Medicare to pay for end-of-life counseling. In fact, he is responsible for a provision in a Senate bill that would allow a different, newly created government program to pay for such counseling.
http://www.nytimes.com/2009/08/17/opinion/17krugman.html?_r=2&src=twt&twt=nytimesopinion
53 Comments
imstellar28 says...I saw him doing it, so I wanna do it too.
Not exactly the most advanced logical argument...
JiggaJonson>> ^imstellar28:
I saw him doing it, so I wanna do it too.
Not exactly the most advanced logical argument...
You're dumbing down the argument he's putting out there to make it sound illogical or ignorant. Sadly it only makes you seem ignorant. There is nothing logically unsound with taking something someone else has done well and mimicking/improving upon it for yourself/your country. We usually learn by example, why shouldn't the same thing apply to a bigger and more complicated system for accomplishing something like health care reform?
Farhad2000Yeah that's nice and all Krugman but how about we see your birth certificate...
dagComment hidden because you are ignoring dag. (show it anyway)
As an American citizen living abroad it hurts me to watch the US tear itself apart over something that should be a basic right of all citizens.
The ignorance and stupidity being promulgated is depressing. I would feel the the same if a bunch of Freeper trolls descended on VideoSift - the real world wingnut trolls seem to be framing this fight in their terms.
blankfistDag, to advocate health care as a right blackens the distinction and immovable basis of a right. They are, by nature, absolute and inviolable.
Having a right to free speech, a right to religious freedom, and a right to protect you and your family from harm by man or society or man's laws are all great examples of rights being something innate and elementary that gives us the unencumbered ability to protect ourselves from other humans and human government.
There can be no right that protects you from nature or your natural health. There is no human aggressor when you are ill; only nature.
Farhad2000^That's neither here or there. Usual libertarian clap trap of the middle class who don't understand not everyone is able to suddenly find $10,000 when they get a cyst.
Last time I checked its was America for the people by the people. The people want at least AFFORDABLE health care that has their interests at heart not the insurance industries.
blankfistThe expression is "neither here NOR there". Also, it's "of, for and by" the people. Don't forget the "by", please.
That aside, the fact that someone cannot afford medical treatment, as unfortunate as it is, has no place in the creation of "rights". We have to understand people die and people get sick, and this is a natural course of life whether you have health care or not.
Your issue, Farhad, seems to originate from the source that people cannot afford certain important medical procedures and operations. That, I will concede is something I care very deeply about. Still, health care shouldn't be a right because we're emotionally persuaded to make it so.
Reason before emotion.
Farhad2000It's not about emotion for me, its about logical benefits for a society provisioning health care for its citizens.
The economic benefits of a healthy workforce for me are clear. Furthermore the evidence shows that the current system is not efficient and is costing the US more then other nations.
No system is going to be perfect, however there is a clear evidence that medicare works for those over 65 and that the VA medical administration works as well.
I don't really come from this issue as a matter of a rights. I just find it funny that people would connect socialized health care with fascism. I lived under socialist health care in the USSR, I live under a single payer health care system now. Am allowed to peruse my life without being forced into paying huge deductibles for health care.
JiggaJonson^blankfist
We decide what the rights of our citizens are, I understand there is no 'human aggressor' but people pay taxes for social services. I feel like we have already acknowledged health care as a right in some way because you can't be turned away from a hospital. At the very least they have to stabilize you and why shouldn't they? becuase another person didnt cause your injuries?
Those emergency room visits already cost the tax payers way too much money, the reform would reduce the number of those emergency visits by making regular care more affordable. I'm one of the people who avoids going to the doctor unless im actually very sick, not because I don't want proper care or a check up - because it just costs me too damned much money.
The last time I went to the doctor I needed to have some kind of special X ray so they could check something out. It wasn't covered by my insurance but he still recommended I have it done, the bill came about a week later for $340 something dollars. I dont know about the rest of you, but that plus the doctor's visit cost me around $400 and I just dont have that kind of cash to spare...EVER. I get my bills paid, but I count myself lucky nothing terrible has ever happened to me medically (yet).
blankfistStill, these are terrible arguments for health care being a right. Benefits for society? That could be a parade. That could be a soda fountain. Loose language, in my opinion.
"people pay taxes for social services"
Still, that doesn't mean "social services" are a right. Let's be clear, I wasn't speaking against health care reform or Obamacare or whatever the colloquial way of addressing it is. I was explaining how health care cannot be a right.
dagComment hidden because you are ignoring dag. (show it anyway)
Equal access to healthcare may not have been an unalienable right envisioned by the crafters of the constitution- but, the right to life defintely was.
In the current system, the rich get access to longer and better life while the poor have the "right" to die an early, painful death working the night shift at Denny's.
It's not fair. Deal with this now, or prepare for a second American Revolution in 20 years when the rich live to be 140 and the poor die at 60. I'm serious.
blankfistThe right to "life" was never meant for semantician arguments. It was meant so other humans and human government couldn't take your life.
If you have a natural death, would you sue the government because they're supposed to protect life? Of course not, that would be silly. But, to some degree your argument is similar.
Fairness does not make a right. Sorry. If it was the case, I think we could all make arguments to drive Mercedes and BMWs. Listen, I empathize greatly, but health care is not, cannot and should not be a right.
dagComment hidden because you are ignoring dag. (show it anyway)
^You're the one talking semantics. What's a "natural" death - when one group of people gets to live to 130 and the other has to die at 60 because they did not inherit their daddy's Haliburton stock?
imstellar28 says...Clearly, blankfist and I are heartless, immoral bastards; the rest of the world is far more morally advanced than the US; everyone should live forever and never get sick, ill, unhappy, eat 5 course meals 3 times a day and have a personal chauffeur, a fast car, a giant house, several maids, infinite wealth, and never have to work a day in our lives.
We KNOW that. Can someone please explain (via logic) how the right to healthcare is compatible with all other human rights, why it is a right in itself, and what constraints exist on that right.
e.g.
Two guys live in a village with population = 2. Both have the right to use their own labor as they see fit (freedom from slavery). Both have the right to healthcare. One gets sick. The other guy must 1. be free to use his labor as he sees fit 2. be forced to provide healthcare (labor) to the sick guy.
Is the right to healthcare only valid for population > 2, or am I missing something?
e.g.
Hundreds of millions die of malaria. A worldwide movement involving all 193 countries costing over $5 trillion dollars focuses on the creation of an anti-malarial treatment. It is a success and malaria is cured. Millions are saved. A single person becomes ill with a rare, mutated form of malaria which is not susceptible to the current treatment, and has never been seen in any other person alive. Everyone has a right to healthcare, which means we are as morally obligated to cure the single rare case of malaria as we are to cure the worldwide, general case - so by law - via the "universal right to adequate healthcare" every single person in every single country from all 193 countries of the world has to stop work, and fund another $5 trillion dollars to create a modified malarial treatment for the single, rare case that a single, ill person is suffering from.
Is the right to healthcare only valid for common diseases affecting large populations, or all diseases equally? How do you decide which diseases get precedence in funding? I have lung cancer and you have heart disease but we only have enough resources to cure one. What do we do? Who do we save? If we both have a disease and we both have the right to healthcare, and we are both equal as human beings, how can we justify curing your disease over mine or vice versa?
???
blankfist>> ^dag:
^You're the one talking semantics. What's a "natural" death - when one group of people gets to live to 130 and the other has to die at 60 because they did not inherit their daddy's Haliburton stock?
Dick Cheney is going to live to be 130? Fuck.
You're correct that obviously modern medicine has enabled us to live longer. Most of which is experienced without an exorbitant, impractical price nearly all should be capable of affording. Antibiotics and vaccines are quite inexpensive, and these or the sorts of medicines that have allowed us to extend our lives.
We all have as much access to them as does the Haliburton exec, so I'm not sure what your issue can be.
imstellar28 says...What you really mean when you say "I believe everyone should have access to equal healthcare" is that you want someone else to cure your disease. You want someone to pay for your X-rays, someone to extend your lifespan. "Equal healthcare," as you are describing, means we both walk in with a disease and we both walk out without it. It means we all live to be the same age regardless of our condition or lifestyle.
Yet you don't care about people with Xeroderma Pigmentosum. Do you even know what it is? Why not? Why aren't you trying to cure it? Why aren't you donating as much money to the Xeroderma Pigmentosum society (http://www.xps.org) as you are to the American Cancer Society (http://www.cancer.org)? Kids with Xeroderma Pigmentosum rarely live past the age of 20.
Xeroderma pigmentosa, for those not in the know, is caused by an autosomal recessive genetic disorder, aka you are born with it. The symptoms are instant and immediate burning and malignant skin cancer upon even brief exposure to sunlight. Yes, you have all the drawbacks of being a vampire and none of the perks - you die if you go outside, even for an hour.
http://ds9.ssl.berkeley.edu/lws_gems/4/images_4/xp_lg.jpg
http://www.tidsskriftet.no/lts-img/2001/fig200101023.jpg
http://www.metastaticlivercancer.org/dark-skin-girl.jpg
Without genetically modifying your DNA, you cannot cure this disease. This is just one of millions of examples of ways in which people will never be equal. Equality was never about everyone being identical...same height, same DNA, same lifespan, same income, same musical talent, same level of attractiveness...it was about people being treated equally, despite being different.
IMHO, Martin Luther King Jr. would spit on your vision of "equality" and "morality."
You want to make an argument for universal healthcare? You better use logic because you do not have morality or pity on your side.
You are lucky to live in a time where you even have access to a 60 year lifespan or diagnostic X-rays, because as far as I can tell, you haven't done a single thing to enable either. You think human progress is allocated by the government, 2.5% at a time? How many millions of people suffered through all types of diseases, plagues, wars, long hours, deprived social lives, rocky marriages, and short lifespans to create the technologies you are not only demanding as "rights" but complaining about the cost there of?
You resent those who inherit the fortunes of their fathers, yet you yourself have inherited the wealth of all of humanity - language, mathematics, engineering, art, music, literature, agriculture, architecture, and all the lessons of history - a sum far greater than any pile of gold. You are living your entire life off of the sweat, blood, and tears of your ancestors - and you have the gall to complain about what you've been given?
The billions of people who died before you weren't nearly as lucky, and I bet they didn't complain half as much.
dagComment hidden because you are ignoring dag. (show it anyway)
^Nope, that's definitely not what I mean at all. I'm not looking for my particular disease to be cured. I'm looking for all people to have access to the same quality level of healthcare. It works in other countries - and it could work in the US if Libertarians pulled their heads out of Atlas Shrugged and considered reality instead of theoretical social constructs. I want my fellow Americans not to have to use this as their base level of health care.
blankfistThe Remote Area Medical shouldn't be seen as a sign of American medical end times. These are good people volunteering for the common good, and yet because they choose to do good for their community, their operation is spun as "Can you believe this is happening right here in the US?!"
Why is this video so shocking? I'd hope people would volunteer to help the have nots, and when they do I'd hope people wouldn't spin it to make a political point.
That aside, let's entertain your idea of "the same quality level of healthcare", dag. It sounds great. I, too, want people to have that, I just don't think it's fair to force people at the barrel of a gun to pay for it. To me, that would be immoral.
dagComment hidden because you are ignoring dag. (show it anyway)
The only authority I have in this matter is that I live in another developed country- similar culturally to the US in many ways - that has a government run health care system that works- very, very well. And your "barrel of a gun" rhetoric reminds me of the Wingnut hyperbole seen at the townhall meetings. We pay for equatable healthcare through our taxes - no guns involved - and I wouldn't give it up for anything.
imstellar28 says..."I'm looking for all people to have access to the same quality level of healthcare."
Is that not a theoretical social construct? It's much more idealistic than "Every man's labor should be his own." My point is that as long as there are uncurable diseases out there, everyone will not have the same level of healthcare.
Almost any "common" illness or injury can be treated quickly and easily in almost any area of the country - for under $100 in most cases - ailments that would have killed people not even 100 years ago. So I don't understand your argument about lifespan or "quality of healthcare."
Maybe you should include some illnesses that fall under "quality level of healthcare" because chemotherapy, triple heart bypasses, and $10,000 surgical removal of cysts are not treatments for "common" ailments. Cancer, heart disease, and diabetes - three of the main killers in the US - are rare diseases (1 in 100,000 one hundred years ago) that have only been recently made common (1 in 3) due to our lifestyle choices. Xeroderma pigmentosum, an extremely rare disorder (1 in 80,000) was actually more common than heart disease prior to the dietary intake of over 150lbs of sugar a year - as we see today. Smoke 5 packs of cigarettes a day and suddenly a "rare" form of lung cancer becomes real common.
Your lifestyle plays a large role in the development of "rare" illnesses and injuries. Many people will never have an injury requiring hospitalization, yet some fly through windshields and break half the bones in their body. These are not "common" injuries.
As I pointed out, there are simply not enough resources in the world to cure every rare disease or fund the correction of every poor lifestyle choice. So tell me, how can you justify funding research for any one particular rare disease over another?
If we exclude rare disease, which we must - there will always be rare disease regardless of our medical technology, where is the disparity in healthcare? As far as I can see, you can walk into a clinic on any street corner and be treated for 99% of the existing diseases and injuries for under $100.
blankfist>> ^dag
I don't think the dissenting opinions at the townhall meetings should be labeled as those of wingnuts. That's unfair, isn't it? I am a bit shocked that health care above all other things (such as the US's terrible foreign intervention policies) has become the dichotomous arguing point.
Still, any act of involuntary taxation is an act of aggression, dag. There is a threat of State violence if I do not pay (even for things I disagree with), and that means men with guns can and will show up at my home. Just because it is the widely accepted means of government doesn't make it moral or right.
dagComment hidden because you are ignoring dag. (show it anyway)
Sure there are always going to be rare diseases- and part of a public run system is that you do have to make decisions on what can and should be cured- this happens now with insurance companies in the US.
A public system uses a panel of doctors and ethicists to come to the same decisions. We have something in Australia called the Pharmaceutical Benefits Scheme. Most drugs are covered by it- though some are not. It's not a perfect system but at least there is a basic, equatable level of hospital and medical care for the public.
imstellar28 says...Quality healthcare, or access to healthcare is not the problem. The problem with healthcare is genuinely "rare" disease like Xeroderma pigmentosum which is presently uncurable. These people suffer in ways you and others can't hardly imagine. In all honesty, they are the ony ones with any right to complain about the quality of healthcare available.
I can buy car insurance for $200 a year that protects me up to several hundred thousand dollars in the event of a "rare" multi-car collision seriously injuring or killing multiple victims. I can also buy home insurance which protects me in the event of a flood, fire, earthquake, or burglary. Why isn't my health insurance similarly priced, when the cost and frequency of car crashes and property damage are comparable to the cost and frequency of rare disease?
How can health insurance not be expensive when three formerly rare, 1 in 100,000 diseases are now seen in 1 in 3 Americans? Its like forcing Geico to insure people for $200 a year when 1 in 3 people get in a fatal crash or 1 in 3 houses are burnt to the ground. Its physically impossible to maintain a positive balance with such statistics. It doesn't matter if Geico, Blue Cross, Obama or Jesus himself are running the books. That is idealism, and it will never solve anything.
You wanna start a government healthcare program? Fine, but make it voluntary or you are adding "oppression" to the laundry list of items a sick person has to deal with.
imstellar28 says...Heres my two cent idea for healthcare:
If I was an insurance company, I wouldn't insure a whole person - I would insure specific diseases and injuries. Just like buying separate flood, fire, or earthquake insurance. Moreso, I would do it based on geographic location, not personal medical histories.
Heres a sample:
Plan A: $100 / year
Diseases with an incidence > 1:100,000
No injuries covered.
Plan B: $200 / year
Diseases with an incidence > 1:50,000
Injuries rated up to serious condition.
Plan C: $400 / year
Diseases with an incidence > 1:10,000
Injuries rated up to critical condition.
Plan D: $800 / year
Diseases with an incidence > 1:1,000
Injures rated up to life threatening.
Plan E: $1000 / year
All inclusive, full coverage of all disease and injury.
Incidence rates for all known diseases would be revised annually, and rates could be adjusted based on either a profit or non-profit paradigm. You know your medical history so you can select the coverage you need to cover whatever rare disease you may have. You can also select a plan based on how healthy you feel and the amount of risk you feel you have for rare disease. This works because for every expensive 1 in 100,000 disease they have to pay out, there's 99,999 people (x $100) who never needed a dime.
The government could do this, or a private company - doesn't matter. All that matters is it is voluntary.
This solves the problem with rare, expensive diseases, like hemophilia, (1 in 10,000) which can require $30,000 in medical supplies a month to treat. With this plan, hemophiliacs are able to get by on a $33 a month plan ($400 a year) while the insurance company makes 9,999 x $400 = $4 million...enough to cover the treatment for that rare 1 in 10,000 individual with a cool $3.5 million left over.
Bidouleroux says...What imstellar28 describes is simply a way to leech off : he's proposing a way in which only those who have money (like him, presumably) can leech and game the system. Why is that? Because by having the option of not paying insurance, he can still count on the chronically sick/fearful/socially minded/provident to maintain healthcare facilities and services, drug manufacturing, R&D, etc. for him. So he only pays if he needs to, but in the meantime he doesn't contribute to the establishment of the future services he will inevitably need at some time.
What I'd like to see for those who don't want to pay insurance, is the whole bunch of them building their own hospitals, making their own drugs, forming their own medical staff, etc when they finally need it. That is to say, they couldn't use the facilities already in place. After all, they didn't want to shell out for them! And if you look at it that's the real "american way" : when a community was in need, everyone in the same predicament pitched in to build what was needed (provided remuneration of course). But I bet they'd sooner let each other die than do this though, because they've lost their ways : the rhetoric of the individual communities fending for themselves has now become the excuse of selfish individuals trying to run off with their neighbors' money. "E pluribus unum" my ass!
NetRunnerLet's just be clear here that the free market solution to someone being poor and sick is for them to die. If you’re too poor for HBO, you go without watching True Blood. If you’re too poor for a MacBook Pro, you make due without one. And if you’re too poor for statins you get a heart attack. And if you’re too poor to get your heart attack treated you die. That would be what a free market health care system looked like -- like free markets in other things.
(I blatantly plagiarized that rant, but it's one worth repeating.)
blankfistIf an HBO subscription meant saving your life, I'd hope those cable outlets offering it would consider lowering it enough to make it affordable to all. But, you ask they offer it for free at the point of a gun. Who then pays for their labor? Surely their labor is worth something?
If your answer isn't for them to offer it for free, then your answer must be government subsidy. In this case, the cable providers wouldn't need to lower the price... in fact they could certainly raise the price because the government has deep pockets and is very comfortable with paying top dollar for goods and services they subsidize.
Just to be clear, we'd all be paying for that government subsidy. And quite honestly future generations will continue to bear the debt we create in order to ensure we all live to be 130. That alone, in my opinion, proves this to be a selfish idea... just as selfish as the wars and corporate bailouts we've forced future generations to pay for during our lifetime.
NetRunner^ You don't need to make up an abstruse example about lack of HBO killing people. The real-world case of people needing statins, or getting a heart attack and dying was provided (and is only one example of necessary medicine).
I would hope that people wouldn't need to be forced at gunpoint to pay a tax that would provide people the care they need.
I would hope that they'd call their senators and representative, and beg them to pass the bill, because they don't want to think that their inaction led to even one more death.
If you're worried about the debt, the aim is to make the final legislation deficit-neutral over the next 10 years, and generate at least the potential of being a budget surplus further out (as more of the cost savings kick in, the revenue from the tax would remain constant). Right now the cost of the bill is estimated at $239 billion or so over the next ten years, and most independent analysts consider that a conservative estimate.
The real problem with deficits come in if we continue with the system we have.
rottenseedPeople that NEED to be covered: children whose parents can't afford it, the disabled and the elderly.
If you a person capable of holding a job, you should be able to afford health insurance. The average annual premium (as of 2007) was $2613 for single coverage. That's $217.75 per month, or $54 per week...I piss that away, and I'm no rich man. Now I know that not everybody can afford this. And if you can't maybe you should be able to get some government help. Maybe some of your taxes should be automatically forwarded to a health plan instead of uncle Sam.
imstellar28 says...>> ^NetRunner:
Let's just be clear here that the free market solution to someone being poor and sick is for them to die.
Die of what???
What proof do you have that anyone has ever died in the US from lack of health care?
Hospitals do not turn away dying patients! So unless you are too stupid to dial 911 and make it to a hospital or you have an uncurable disease,
HOW CAN YOU DIE IN THE UNITED STATES FROM LACK OF HEALTHCARE?
imstellar28 says...You used the example of "statins to prevent a heart attack."
You seem to be suggesting that healthcare should cover the prevention of every possible disease yet death is not preventable! No amount of prevention, money, healthcare, or health insurance can stop you from dying! Everyone dies. What kind of idealistic crap are you spewing that you expect free heart, lung, and skin transplants for every retard who eats 150 lbs of sugar, smokes 150 packs of cigarettes and spends 150 days in direct sunlight each and every year?
You eat 150 lbs a sugar a year you're going to develop heart disease. You smoke 150 packs of cigarettes a year you are going to get lung cancer. You sunbathe 150 days a year you are going to get skin cancer.
Those are the laws of the universe.
You get a heart attack, or stop breathing, or collapse from heart disease or cancer - call 911 and the nearest hospital will assign several doctors to save your life! What more do you want? You get in a car accident, you get shot in the chest, you show up to the ER holding your severed arm in your hand - any hospital or clinic anywhere in the US will treat you upon arrival.
Healthcare is already available for every single person in this country who can lift their fat finger to call 911.
You aren't asking for healthcare, you are asking to violate the laws of the universe - for a magical fairy life where anything and everything can be taken in excess and there will be no ill effects or consequences for anyone. Full-body transplants on the house. That is idealistic bullshit.
blankfistMost socialized health care supporters focus on the "treatment argument" instead of the real debate of corporate collusion and government regulations stifling a free market approach. In a free market there will still be costs associated with "treatment", but it would be significantly less than what we have.
Currently, I believe it costs somewhere between $10,000 to $15,000 a month for Chemotherapy (probably more, maybe less). Chemotherapy is a very common outpatient procedure. There is no reason for it to cost as much, and if the market was opened without government disallowing competition via regulation so much more health options would become available, and I'm sure this procedure would be fairly inexpensive.
Have you ever wondered why the Pharmaceutical companies export the same medication they sell us for much, much less? That's because they have to compete in foreign markets. Did you know no Pharmaceuticals can be allowed into the US for treatment except if accepted by the FDA? What does that translate to mean? It means, the same medication you are currently buying at restrictive prices could be sold be imported into this country for much, much less... and I mean, the exact same medication.
NetRunner>> ^imstellar28:
What proof do you have that anyone has ever died in the US from lack of health care?
http://www.politifact.com/truth-o-meter/statements/2009/jul/30/bill-pascrell/pascrell-says-22000-americans-die-yearly-because-t/
Also, did you see Sicko?
NetRunner>> ^imstellar28:
I'm somewhat confused where you found that strawman. There's a vast difference between "everyone should have insurance" and "everyone should be able to get unlimited care for free".
Perhaps the right way to look at what liberals want to do is to put a floor on the level of care all people have. It wouldn't be unlimited, but it would cover preventative care since it's cheaper for taxpayers to subsidize statins than it is to subsidize the treatment for a heart attack (not to mention better for the recipient, too).
On the other hand, nowhere in this plan is a ceiling on care. People will still be able to get some sort of ultra insurance plan if they want it, or pay out of pocket for procedures and treatments that aren't covered.
It's funny that you bring up organ transplants in particular though. Have you read up on how those are handled now? It's a centrally planned economy.
And yes, self-inflicted organ damage does tend to get you a pretty low spot on the transplant list, even if you've got all the money in the world.
blankfistA great Ron Paul speech from the recent Texas BBQ Bash... he speaks about health care briefly.
imstellar28 says...>> ^NetRunner:
Ya know...a link to conjecture isn't worth much more than conjecture straight from your mouth.
Even if we accept the ridiculous claim that 22,000 people die from a lack of healthcare, 33,000 people die per year from SUICIDE, you wanna spend 3 trillion dollars a year fighting that? You'd save more lives.
http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf
NetRunner>> ^blankfist:
Most socialized health care supporters focus on the "treatment argument" instead of the real debate of corporate collusion and government regulations stifling a free market approach. In a free market there will still be costs associated with "treatment", but it would be significantly less than what we have.
I think you're confusing health insurance, and health providers. Not even single payer would change the picture for providers directly. Providers have to compete with one another today.
The exchanges allow for the creation of a national market for individual insurance, with direct competition between insurers. The public option is also in the exchange.
The weak part of the plan? You're not allowed to use it if your employer offers insurance. You are however allowed to use it instead of COBRA if you lose your job.
Currently, I believe it costs somewhere between $10,000 to $15,000 a month for Chemotherapy (probably more, maybe less). Chemotherapy is a very common outpatient procedure. There is no reason for it to cost as much, and if the market was opened without government disallowing competition via regulation so much more health options would become available, and I'm sure this procedure would be fairly inexpensive.
Who's the monopoly provider for chemotherapy?
Have you ever wondered why the Pharmaceutical companies export the same medication they sell us for much, much less? That's because they have to compete in foreign markets. Did you know no Pharmaceuticals can be allowed into the US for treatment except if accepted by the FDA? What does that translate to mean? It means, the same medication you are currently buying at restrictive prices could be sold be imported into this country for much, much less... and I mean, the exact same medication.
It's also because other countries are having the government negotiate prices.
But hooray, you actually found one of the things I think is weak in the bill. The ban on imported drugs stays in place, but price negotiation would be allowed for Medicare Part D.
That's kinda weak.
imstellar28 says...Again 22,000 people dying from lack of healthcare is such a ridiculously high estimate, but lets use it. That means 305,507,237 people DIDN'T die from lack of healthcare last year.
Yes, 99.9927% of everyone in America had enough healthcare to save their lives according to the numbers YOU gave?
And this is a 3 trillion dollar a year problem????
Talk about pessimism.
burdturgler>> ^imstellar28:
Again 22,000 people dying from lack of healthcare is such a ridiculously high estimate, but lets use it. That means 305,507,237 people DIDN'T die from lack of healthcare last year.
Yes, 99.9927% of everyone in America had enough healthcare to save their lives according to the numbers YOU gave?
And this is a 3 trillion dollar a year problem????
Talk about pessimism.
Maybe the number would seem larger to you if we just left the bodies in the street so you could walk past them. If the grieving families were there lamenting the loss of their loved ones. How many people need to die for you to consider it a real problem?
imstellar28 says...^How about 631,636, the number of Americans dying of heart disease?
You could solve that problem for maybe, $30 million dollars. All you would need is a few national TV ads and a new food pyramid which doesn't include 150 lbs of sugar a year. And you'd get a 30:1 life saving ratio versus saving those without enough health insurance.
So lets see, 30:1 more lives saved at 1:3,000,0000 cost ratio. So 900,000% more effective? I'm no member of the "save the humans" campaign but that seems a lot better to me.
NetRunner^ Not from lack of health care. From lack of insurance. Lots of people are just debilitated due to lack of insurance. More people die in part because insurance refused to pay for a needed procedure.
You're also way off with your $3 trillion number. The highest estimate I've seen is $1 trillion over ten years, and that was a bill without the public option.
imstellar28 says...^We already spend 1.5 trillion a year!!!! I'm sure you believed the Iraq war would only cost $200 million over 10 years as well.
EndAllwhat a lot of people ignore is that there are too many people. they also ignore the fact that society will not continue at its present pace for too much longer.
NetRunnerHow about this?
http://www.washingtonpost.com/wp-srv/politics/documents/american_journal_of_medicine_09.pdf
To some degree the real issue seems to be that you aren't at all moved by the plights of others.
I doubt statistics are going to convince you that one dime of your money should be spent to aid others.
Perhaps you'll pass that off as "why should I trust the government with my money", but I think it goes deeper than that with you.
imstellar28 says...>> ^NetRunner:
^ Not from lack of health care. From lack of insurance. Lots of people are just debilitated due to lack of insurance. More people die in part because insurance refused to pay for a needed procedure.
I'm using health care and health insurance interchangeable because with insurance comes care.
When you say needed, you mean needed like a 50 year pack-a-day smoker needs a new lung? Or a chocolate-pie-a-day heart attack victim needs bypass surgery?
imstellar28 says...>> ^NetRunner:
To some degree the real issue seems to be that you aren't at all moved by the plights of others.
Am I unmoved, or do I understand the concept of "spending your money wisely" ? You are suggesting we save 22,000 people by spending $2-3 trillion. I'm suggesting we save 630,000 people by spending $30 million.
Who wants to save more lives, and who wants to increase the profit margins of "preventative medicine" ?
NetRunner^ I'm suggesting there's a lot more to it. You seem to assume that all the benefit goes only to people who would have otherwise died due to being completely uninsured.
I'd also suggest you're big on using incorrect numbers. $1.5 trillion is close to all medical spending public and private in the US per year. Why you think the bill doubles that is beyond me; CBO estimates that without offsets the cost is in the $800 billion range for ten years, as in the entire 2010-2019 period, total.
imstellar28 says...>> ^NetRunnerI'd also suggest you're big on using incorrect numbers. $1.5 trillion is close to all medical spending public and private in the US per year.
I'm getting pretty sick of your revisionist bullshit. This level of dishonesty and *lies has got to be worth a hobbling.
2008 Healthcare statistics:
Hospital care: $747.1 billion
Physician and clinical services : $501.7 billion
Prescription drugs: $247.0 billion
Nursing home and home health: $198.5 billion
Dental care: $102.4 billion
Other items: $597.6 billion
Total: $2.72 trillion
2007 Federal expenditures:
Medicare: $394.5 billion
Medicaid: $276.4 billion
Social Security: $869.6 billion
Health and Human Services: $70.7 billion
Total: $1611.2 billion
via http://www.gpoaccess.gov/usbudget/fy09/browse.html
^This link here is the difference between our positions. I'm a skeptic, and you're a believer. I read everything, critically, with a grain of salt, and verify both the logical validity of the argument and the source backing the claims. You believe whatevers written in the blog of anyone whose ideas match yours - facts, evidence, sources, logic - all irrelevant - the only requirement for you to be taken hook, line and sinker is the perceived authority of the author.
We spend $700 billion on Medicare and Medicaid alone. You think insuring another 40 million is only going to cost $80 billion? If that were true, it would only cost $2000 per person, or $600 billion to insure every single one of the 300 million americans in this country. $100 billion less than current levels which don't even cover a fraction of that number!
WTF are you smoking?
Healthcare funding in the next decade is going to triple or worse - even without increasing the scope of current funding. Your gullibility (denial?) is overwhelming.
NetRunnerSince when is Social Security health care spending?
I'll confess I was being lazy and not looking up what the total spending was, my memory was that it was between $2-3 trillion, and that currently about a third of that number is government spending. Your numbers actually confirm that.
What you were saying was that $1.5 trillion is being spent by government on health care now (it's nearly half that by your own numbers), and that HR 3200 would increase it to $3 trillion, when the costs estimated by the CBO show that they're not expecting anything like the cost increase that you are.
Now, as for your general smug self-righteousness, that much I can tolerate, but you and I have spent way too much time arguing with one another for you to honestly think I'm someone who just regurgitates propaganda without giving it a second glance. If you'd like to have a civil conversation with me about what liberals are actually trying to do, and why we think it will work, I'm happy to give you a good faith effort to explain and provide sources that I believe support my position.
If you just want to call me a moron, and engage in strawman arguments, I probably will just find something else to do.
Now, this statement:
You think insuring another 40 million is only going to cost $80 billion?
Shows that this statement is false:
I read everything, critically, with a grain of salt, and verify both the logical validity of the argument and the source backing the claims.
Because it means you haven't even read the summary of the bill you're supposedly arguing against.
The coverage expansion is largely accomplished by mandating that everyone purchase insurance. That's coupled with a mandate for employers above a certain size (I'm not being specific out of laziness) to provide an insurance plan.
That's why covering the uninsured won't raise government costs by that much. In fact, part of the CBO estimate includes a $200 billion-ish savings from Medicare and Medicaid due to employer mandates.
Most of the "cost" of the bill comes from a subsidy to cap the cost of insurance for people making between 133% and 400% of the poverty line to a sliding percentage of their income (1.5% at the low end, 11% at the high end).
Most of the expected cost savings are actually hinged on something I would suspect you'd like: the formation of a national insurance "exchange", where private plans for individuals would be allowed to compete nationwide. In addition, a Medicare-like public option would be made available for people to purchase with their own money in the same exchange. Recipients of the subsidy described in the previous page would be allowed to use it to buy any plan in the exchange, public or private.
Don't believe me? Then read the bill.
I will also confess that I have not found a rigorous study claiming to predict the effect on the overall cost of health care in the US, based on HR 3200. If you've seen one that looked at the overall public and private costs of either HR 3200 or a Medicare For All single-payer plan, I'd be happy to see it.
Personally, I tend to think the plan is setting up a market-driven experiment to find the best way to structure the insurance aspect of health care. Employer mandates keep much of the existing system intact, while the newly invigorated individual market gets both the free market cost-cutting gimmick (more competition!), and the evil socialist cost-cutting gimmick (no profit or marketing costs, total focus on patient care) going head-to-head.
imstellar28 says...1. What data do you have that shows that the 40 million people without insurance have full-times jobs, or jobs at all? If the cost is covered by employers, how does this help those working part time, or those who are unemployed?
2. Assume somehow it covers those 40 million people. Medicare/Medicaid insures how many people for $700 billion? Use this number to multiply by the 40 million insured to find the cost per person insured. How many hundreds of billions of dollars is this?
3. What data do you have to suggest that national employers can sustain a hit of hundreds of billions of dollars in increased healthcare payouts to their bottom line?
4. What data do you have that suggests that they won't layoff people, or reduce salaries to cope with the billions in increases healthcare payouts?
5. Social security is healthcare, what else do you call money thats used for food, clothing, shelter, medicine, and disabilities?
If you don't have this data off the top of your head, how could you possibly be arguing for this bill? Increasing the costs of employers necessarily increases layoffs and salary cuts. You aren't thinking of any consequences. Second of all, you have some nerve sending a link for me to read a 1000 page bill. Theres no possible way you read the entire bill straight through; even if I was the Highlander I wouldn't take the time to read that giant piece of crap.
None of any of what you are talking about the fact that we presently spend (at least) $700 billion on healthcare, and will be (at least) doubling that to $1500 billion a year - whether its employeers, employees, or the federal deficit who will foot the bill.
Current, historically proven figures
$700 billion / 300 million = $2,500 average across everyone
(by the way the number of Medicare + Medicaid recipients is about 90 million, so:)
$700 billion / 90 million = $7,888 actual amount per person treated!
This is what government healthcare looks like. $8000 per person! Nothing you have said so far has justified the $7,888 a year you want to spend per year on every single person in america.
I know you won't (can't) answer half of my questions, so why don't you answer just these two:
Why does every man, woman, and child need $7,888 worth of healthcare a year?????
Why do you want to extend that insane figure to another 40 million people?????
NetRunnerSeriously man, you're smoking something. First, let's touch on social security. You say:
Social security is healthcare, what else do you call money thats used for food, clothing, shelter, medicine, and disabilities?
It's a government pension program. You may as well take everyone's 401k's and call that private heath care spending. Why not add in all food sales, all clothing sales, Food Stamps, defense spending, plus all housing sales, and call those health care spending too? Seriously, doesn't that strike you as perhaps being more than a touch dishonest, especially since just that one line item more than doubled the number you thought was being spent?
As for the cost per person for Medicare, it's mostly a non-sequitor since we're not talking about giving any additional people Medicare. If we were, it might cost less than what the bill will do, in absolute share of the total economy, but people who're squeamish about converting a huge segment of private spending into public spending will prevent that from happening.
As for statistics on how many people fall into each category, it's on the first page of the CBO analysis, though it's expressed in terms of the projected number of people in each category under current law, with a delta based on projected effects of HR 3200.
By 2013 it's expected to reduce the number of uninsured by 23 million, only 6 million of which would be receiving direct government coverage via Medicaid, at a predicted cost of $29 billion, or approximately $4,833/person (which is about half what the cheapest plan available through my employer costs, incidentally). Another 11 million people would be covered by the exchange, whose costs would primarily be borne by the individual, but the government will provide $33 billion in subsidies to individuals purchasing plans from the exchange, which averages out to $3,000/person (but it won't be evenly distributed). Another 10 million are expected to be covered by employer mandates, while 3 million are expected to give up their existing individual plan in order to participate in one of the aforementioned groups.
Like I said, I don't have estimates of the private cost. I also haven't read a modern study of a Medicare-for-all plan that took a real look at the cost, rather than your approach of taking the current per-capita cost and assuming it scales linearly (which is dishonest, and lazy!).
As for your two bolded questions, they're both more or less moot, but I'll answer a version of the first one: Why does every man, woman, and child need health care?
Because it should be a basic human right. Once you're willing to take the step of saying that you're willing to tell Emergency Rooms to save people, even if they have no means of payment, you're acknowledging that. This is mostly an effort to say that the ER isn't the humane or cost-effective way to service that basic right. There is plenty of room to debate what kind of care one should be able receive via government assistance alone, but the way we do things now is both expensive and immoral, and has to stop.
Controlling costs is a whole other kettle of fish. If your chief objection to the plan is that it does not do enough to control the growth of cost, I think that's fair. But I don't think your fears of some sort of government-induced problem with runaway costs is justified.
rougyJumping in late.
Read Ted Rall's latest.
Read Roger Ebert's latest.
Great reads.
This should have been done sixty years ago.
Obama should bitch-slap Olympia Snowe and all of the other sell-outs.
This is like freeing the slaves. I don't own a slave, nor do you, but it's the right thing to do.
And I will stand by that.
imstellar28 says...>> ^NetRunner
I'll answer a version of the first one: Why does every man, woman, and child need health care.
Thats not my question, my question is why do they need $8,000 worth for health care. Your position is idealistic bullshit until you ground it in reality...part of reality is cost because we don't have unlimited resources on this plant
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