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RE: Obama offers universal health care plan - 5/30/2007 12:16:53 AM   
meatcleaver


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quote:

ORIGINAL: daddysblondie

Simply put, any national plan is going to cost me more and provide me with less.


This shows how ill informed you are. Universal healthcare in western Europe costs about half the price of the US healthcare system and covers everyone. If the US had a similar system you would have more money in your pocket. If Americans paid the same amount as they do now on healthcare in a universal system, the US would have a system that would be the envy of the world. As it is now, people look at American healthcare and wonder why Americans insist on giving private companies profit for ripping them off and not providing value for money.

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Profile   Post #: 41
RE: Obama offers universal health care plan - 5/30/2007 12:23:39 AM   
meatcleaver


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quote:

ORIGINAL: Archer

The $99 airfares from NYC to LAX counter your argument LM.
Also in most cases the deregulated industries make up for the higher prices they charge by improving the product or service well above the levels formerly provided.



I wish this was Britain's experience. I'm struggling to think of one privatised industry that has improved service and costs. Actually I'm struggling to think of one that has improved either! Usually privatised industries increase cost and provise a worse service. Many European countires have looked at Britain's experience and thought oh-oh, don't bother.

The only industry I can think of is the airline industry which lives of tax free fuel, protected flights and other generous policies that don't apply to other industries.

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Profile   Post #: 42
RE: Obama offers universal health care plan - 5/30/2007 1:24:22 AM   
daddysblondie


Posts: 181
Joined: 3/17/2007
Status: offline 		It may cost less, but they are also getting lesser quality health care for less. Although I'm not sure how paying clse to 50% of your income in taxes equates to paying less for health care. I've seen many a report on how the elderly in parts of Europe are denied certain surgeries that the health care system deems too much to spend on someone over the age of whatever to be fooled into thinking that somehow it would be any better.

Also keep in mind that part of why the US pays more for prescription drugs is because of the money that American pharmaceutical companies put into R&D.

Dont fool yourself into thinking for one minute that you're going to get "Rolls Royce" quality health care for the cost of a "Ford".

(in reply to meatcleaver)
Profile   Post #: 43
RE: Obama offers universal health care plan - 5/30/2007 1:32:30 AM   
farglebargle


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quote:

Even when you work a full time job and have a family insurance can cost anywhere from 400 to 900 dollars per month for a family.


$ 1088.66/month HMO + Dental.



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Profile   Post #: 44
RE: Obama offers universal health care plan - 5/30/2007 1:33:33 AM   
daddysblondie


Posts: 181
Joined: 3/17/2007
Status: offline 		Hmmm... Perhaps you could give me an example of a single government run anything that is providing more for less?
At least in private industtry there are efforts made towards improvement and efficiency. There's little effort made in government to improve things. Like I said, I worked for a government agency and saw more time being wasted doing things the way they'd always been done than I ever saw time being spent on trying to improve things and get more done for less. Oh wait, except for when it comes to funding government projects such as construction, then the low bid always wins, and 8 times out of 10, they would have been better off spending a little more money to get the job done right. An example, there was recent freeway construction done to "improve" the traffic in my area. A week before a newly constructed overpass was set to be open to traffic, engineers discovered huge structural flaws that meant more money being spent to fix them. On another occassion, money was spent to retrofit a building to make it safe in case of an earthquake. The construction company decided half way through that they werent making enough money on it, and they walked away. The job eventually got finished, a year late and WAY over budget. Oh, and I personally put about 8 payroll hours into researching a case where a red light camera was installed incorrectly and the agencies involved had to clear tickets that were issued over the course of a month before the mistake was discovered.

Yep, government really knows how to run things efficiently and in the most cost effective way possible....

(in reply to Lordandmaster)
Profile   Post #: 45
RE: Obama offers universal health care plan - 5/30/2007 2:20:49 AM   
NorthernGent


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quote:

ORIGINAL: LadyEllen

As a result of this, the wealthier here now use private medical services, which are far more efficient but of course are only dealing with patients and conditions which they select - leaving the NHS to deal with more complex and more difficult and expensive to treat cases.



The rest of the post made sense. I'd question the far more efficient comment. Private care is undertaken by the same NHS doctors. Private patients are simply jumping the queue by paying for the privilege. This has its positives - for example: relieving some of the pressure on the NHS by reducing the number of patients waiting for treatment, but, ultimately, it's the usual case of money talking. This is in complete contradiction to the ideals of democracy and liberalism.

At its bare bones, the argument is reduced to asking people to pay tax from which they may take no benefit - this tax will certainly benefit other people. The usual individualism versus democracy argument.

Ultimately, you have to have a culture of democracy, liberalism and social provision for a national health service to get off the ground. Even in Britain, there is pressure from a significant proprotion of the population to reduce investment in our National Health Service. I would be amazed if the US introduced universal health care because the evidence suggests that the culture required to make it happen simply does not exist.

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Profile   Post #: 46
RE: Obama offers universal health care plan - 5/30/2007 2:34:29 AM   
NorthernGent


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quote:

ORIGINAL: meatcleaver

quote:

ORIGINAL: Archer

The $99 airfares from NYC to LAX counter your argument LM.
Also in most cases the deregulated industries make up for the higher prices they charge by improving the product or service well above the levels formerly provided.



I wish this was Britain's experience. I'm struggling to think of one privatised industry that has improved service and costs. Actually I'm struggling to think of one that has improved either! Usually privatised industries increase cost and provise a worse service. Many European countires have looked at Britain's experience and thought oh-oh, don't bother.

The only industry I can think of is the airline industry which lives of tax free fuel, protected flights and other generous policies that don't apply to other industries.


I'm not so sure about the quality of service comment. Ultimately, "quality" is intangible and difficult to measure, it's subjective and open to debate.

But, in terms of cost, you can bet your life that once privatised, costs will go through the roof, and they have done. One of the measures of public programmes is value for money. They have to provide value for tax-payers money. It follows that a performance indicator to measure this is the cost of the service to the tax payer. A nationalised industry is obligated to keep costs down so the tax required to pay for the service is good value.

A business, or private industry, has no such obligation. Their number one priority is long term shareholder growth. You could argue that shareholder growth is achieved by being competitive and, thus, driving down costs. This depends on the industry, however, and also depends on the advertising capability of the business. In monopoloies, duopolies and oligarchies, there is no such pressure to be competitive on price to the consumer/customer/citizen, and even in more competitive industries the power of advertising means businesses can sell any old shit at any old price.

If an industry/business can get away with selling their products/services at inflated prices, then they will do because they have no obligation to the consumer/customer/citizen.

< Message edited by NorthernGent -- 5/30/2007 2:36:43 AM >

_____________________________

I have the courage to be a coward - but not beyond my limits.

Sooner or later, the man who wins is the man who thinks he can.

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Profile   Post #: 47
RE: Obama offers universal health care plan - 5/30/2007 6:40:58 AM   
Archer


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Status: offline 		Lets see, VA Hospitals are the best indicator we have as to how the US GOVERNMENT will function in providing healthcare. One can cite European systems all day long and they may have some small level of validity but there is a difference in culture tha people forget about. That difference includes government and how it works.

Medicare was supposed to grow to $9 billion dollars from 1965 to 1990, the track record is it grew to $66 billion by 1990.

So if they tell me the increased spending will be 100 billion to provide healthcare for everyone until 2030 then based on This Nations History I can expect it to cost $700 billion in 2030.

The original medicare program was sold as the way to help seniors reduce the % out of pocket they spent on healthcare.
20 years later and the result was in 1985 seniors budget going to healthcare out of pocket was 20% same as it was when the law was enacted.  Rep. Claude Pepper (Dem.-FL) reported that in 1985

So based on this nations government spending and this nations healthcare demands we can expect that the program will cost 7 times whatever is projected and result in us spending the same % out of pocket for healthcare as we do now.

(in reply to NorthernGent)
Profile   Post #: 48
RE: Obama offers universal health care plan - 5/30/2007 7:19:15 AM   
DommeChains


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Status: offline 		I understand what you are saying and there is much validity in your statements.  I am curious as to what you propose we might do as a country to fix the issues we have with accessing and affording health care?  I am asking this in a sincere fashion since I respect the thoughtful way you address most issues.

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Profile   Post #: 49
RE: Obama offers universal health care plan - 5/30/2007 7:46:24 AM   
caitlyn


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Status: offline 		General response ...
 
The "need" for universal healthcare will be something we won't be able to agree on, as we're all unsure on how the system will work and what the financials will be. I do find it odd that some would trash the plan, before we really know what the plan is. To me, this is just putting politics ahead of what "might" be best for the citizens.
 
What I think we can agree on, is that something has to be done to regulate the prices we pay for service. In the instance of my sick family member, it has become completely clear that the healthcare industry is billing insurance companies far in excess of what you could pay for the same service out-of-pocket. Fargle mentioned insurance companies denying claims ... this is another problem and probalby goes hand-in-hand with the overbilling by healthcare companies.

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Profile   Post #: 50
RE: Obama offers universal health care plan - 5/30/2007 7:57:11 AM   
Lordandmaster


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Status: offline 		Then why are their health-care statistics uniformly better than ours?  Our life expectancies are 75/80 male/female; the UK's are 77/81.  We have 8 deaths per 1000 under the age of 5; they have 6 deaths per 1000.

(You can find all the data you need at http://www.who.int/countries/en/.)

This thread seems to be all about ideology, with everyone just spouting whatever truisms they happen to believe about government and health care, and not bothering to address facts, concrete proposals, or anything that might shatter their preconceived notions.

Edited to add: And Archer, I'm not even going to bother responding to an argument about why Cuba has a lower infant-mortality rate than we do.  Who cares about Cuba?  There are dozens of countries that rank higher than we do, not just Cuba.

quote:

ORIGINAL: daddysblondie

It may cost less, but they are also getting lesser quality health care for less.


< Message edited by Lordandmaster -- 5/30/2007 7:58:05 AM >

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RE: Obama offers universal health care plan - 5/30/2007 9:25:01 AM   
Archer


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quote:

ORIGINAL: DommeChains

I understand what you are saying and there is much validity in your statements.  I am curious as to what you propose we might do as a country to fix the issues we have with accessing and affording health care?  I am asking this in a sincere fashion since I respect the thoughtful way you address most issues.


I have mentioned the plan I like before but here goes again

Step #1
Make all health insurance premiums pre tax dollars not just those provided by employers.

This makes it easier for small business (one of the the largest source of employment)to provide the benifit to it's employees. This reduces directly the number of uninsured in the country

Step #2

Make all health insurance that is paid by the company transferable
on an idividual level. (ie if the employee wants to shift his $1500 a year that the company pays to another provider they can do just that) XYZ company gave you lousy service move your money over to ABC company.

This makes the insurance companies need to compete with each other for every individual customer rather than just satisfying the HR department who is looking more at the bottom line than the services the employee gets. Increased competition forces companies to do one of two things lower prices or raise quality either way the customers win. Assuming that some will reduce price to draw customers away from other companies (gain market share) this again reduces the number of people who can't afford insurance crating a larger pool of shared risk.

Step #3

Sell the private hospitals on the idea of sponsoring community clinics donating equipmet they updated from and giving actual cash donations based on the savings they would realize in their Emergency Rooms. (ie they get a new High resolution MRI and donate the old one to the Community Clinic and take the deduction)Keep the Community Clinics legally seperated from the sponsoring Hospitals so that liability is not an issue.

Step #4

Shift the focus of County Health Departments from just giving school shots and a few other things to a more widespread preventative medicine services, possibly combining them with or having them work in concert with the Community Clinics above.

Step #5

Tort reform so that malpractice insurance costs come down, cap awards so that punitive damages for doctors come out of only their own pockets not the insurance companies. The insurance company would still be on the hook for actual damages.

It's not an exhaustive solution but it would certainly reduce the problem to a level that makes it managable without creating a huge government program.



(in reply to DommeChains)
Profile   Post #: 52
RE: Obama offers universal health care plan - 5/30/2007 9:41:41 AM   
Archer


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quote:

ORIGINAL: Lordandmaster

Then why are their health-care statistics uniformly better than ours?  Our life expectancies are 75/80 male/female; the UK's are 77/81.  We have 8 deaths per 1000 under the age of 5; they have 6 deaths per 1000.

Because in the US we attempt to save infants under 1000g weight  in most contries even in the developed world would make no such attempt. And when we do make the attempt if it fails we record that as an infant death whereas in europe and other places it is not recorded as a live birth. In fact the WHO standards say don't report those cases in your Infant Mortality rate and yet we do. So we have nobody to blame for the discrepancy but ourselves.

(You can find all the data you need at http://www.who.int/countries/en/.)

This thread seems to be all about ideology, with everyone just spouting whatever truisms they happen to believe about government and health care, and not bothering to address facts, concrete proposals, or anything that might shatter their preconceived notions.

Edited to add: And Archer, I'm not even going to bother responding to an argument about why Cuba has a lower infant-mortality rate than we do.  Who cares about Cuba?  There are dozens of countries that rank higher than we do, not just Cuba.

Ah avoid the facts of the article that are based on the way records are kept because they don't mesh with your argument. Deflect them based on the fact that they chose the comparison counrty of Cuba rather than the UK.
The article specificly mentons that if you adjust the figures to report births only as the WHO reccomends then the US rates start to compare much more favorably not just to Cuba but to european countries who report their rates as the WHO reccomends.




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Profile   Post #: 53
RE: Obama offers universal health care plan - 5/30/2007 10:18:42 AM   
Lordandmaster


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Status: offline 		If you would care to read what I actually said, you'd see that I said "deaths per 1000 under 5 years of age."  That is not the same thing as the infant-mortality rate.  It's a much more telling statistic.

I see that you don't care to address our woeful life-expectancy numbers.  Look at this chart showing the life expectancies at birth for 14 European nations in 2003:

http://www.medicalnewstoday.com/medicalnews.php?newsid=46767

ALL expect Portugal had higher rates than we did, for both sexes, in 2003 (when we were at 74.7 for males, 80.0 for females).  And even Portugal was higher for females.

You can find U.S. data at:

http://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_14.pdf.

quote:

ORIGINAL: Archer

quote:

ORIGINAL: Lordandmaster

Then why are their health-care statistics uniformly better than ours?  Our life expectancies are 75/80 male/female; the UK's are 77/81.  We have 8 deaths per 1000 under the age of 5; they have 6 deaths per 1000.

Because in the US we attempt to save infants under 1000g weight  in most contries even in the developed world would make no such attempt. And when we do make the attempt if it fails we record that as an infant death whereas in europe and other places it is not recorded as a live birth. In fact the WHO standards say don't report those cases in your Infant Mortality rate and yet we do. So we have nobody to blame for the discrepancy but ourselves.


< Message edited by Lordandmaster -- 5/30/2007 10:19:20 AM >

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Profile   Post #: 54
RE: Obama offers universal health care plan - 5/30/2007 10:24:37 AM   
DommeChains


Posts: 415
Joined: 3/23/2006
Status: offline 		Thanks for the input and not making me look it up on search lol.  Much of it sounds reasonable......not comprehensive but I wasn't expecting anyone in the forum to devise a comprehensive solution.  I am also not too sure without further study if this approach works well for the working poor.  I still also see a need for some type of state sponsored medical coverage (i.e. Medicaid) for those unable to work due to disabilities or significant developmental impairments.

Now the hard part.....how to implement it.  Personally I foresee much resistance from the insurance companies and Big Pharma because they make deals for services, prices etc. 

At least you have taken the time to offer something feasible and not just full of bullet points and rhetoric.  A good springboard for discussion and consideration.

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Profile   Post #: 55
RE: Obama offers universal health care plan - 5/30/2007 10:44:41 AM   
Archer


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Status: offline 		OK I'll make the rest of the connection for you then LM.

If we have 40-50% more recorded births in the 1 day or less life span per capita.
(ie we attempt to keep a premie alive against all hope and they don't make it)
That also effect the averages for lifespan averages now doesn't it?

If we record a live birth under situations that are already predsposed to short lifespans (babies under 1000g weight) while another country does not record those births unless they live beyond the first day as the WHO reccomends be used for record keeping, then who's figures are going to look better?

average out all those births we record as live births that other countries do not report as live births and we end up being much higher in the overall lifespan catagory as well as having a better comparative for Infant mortality, Which is included in the figure for those (5 and Under).

The fact is recording as a live birth and death those babies 1000g and less that don't make it past the first day effects all those figures. (Infant Mortality, deaths under 5, overall average life expectancy)

From  SourceOECD Factbook 2007

Comparability

Some of the international variation in infant and neonatal mortality rates may be due to variations among countries in registering practices of premature infants (whether they are reported as live births or fetal deaths). In several countries, such as in the United States, Canada and the Nordic countries, very premature babies with relatively low odds of survival are registered as live births, which increases mortality rates compared with other countries that do not register them as live births.

Changing our record keeping wold not make us #1 in the statistic and is not the only thing that makes our rate so high but it is a major factor and scews the result enough to make the comparison not valid.

< Message edited by Archer -- 5/30/2007 10:54:18 AM >

(in reply to Lordandmaster)
Profile   Post #: 56
RE: Obama offers universal health care plan - 5/30/2007 10:58:53 AM   
Mercnbeth


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quote:

how to implement it.  Personally I foresee much resistance from the insurance companies and Big Pharma because they make deals for services, prices etc.
I agree with all the points and solutions proposed by Archer, especially on the subject of malpractice.

My idea, in answer to your question, would be to attack it at the entry level. Create a program where the government pays 100% of the education cost for Doctors. In exchange the graduating Doctors would commit to 5 years of service to the 'US National Health Plan'. The beneficiaries of the plan would only be citizens of the US with income's lower than an established, and livable, income level. Contributing to the plan would be any employer who does not offer full cover coverage to their employees.

The Doctors would be paid the equivalent of the average national salary reported by tax returns, for Doctors practicing in similar disciplines. The cost or 'tax' to the employers would be the average cost of private insurance; giving them incentive to provide coverage. From an actuarial standpoint, this will help bring down cost by adding more paying premiums to the pool. 

To document all the nuances would take pages, but basically, establish a national health care program under the 'Peace Corp' model, except with market income for the voluntary participants.

It should be noted that one of the current problems is the discrepancy of insurance costs by State. You'd be surprised how much the cost differers. It isn't as obvious or simple as NY being higher cost than Alabama. Health provider cost are a function of regulatory difference much more than the out of pocket cost of claims payment. The duplicity, reporting, and cross-purpose documentation is nearly 35% of the premium cost.

If you wanted to try something quick, eliminate the 51 State/DC bureaucracies and replace it with one national reporting and administration authority. The resulting reduction of administration costs to the insurance providers could lower the cost dramatically. Then again, they may just take in the additional profits with no 'trickle down' positive impact to the end using customers.

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Profile   Post #: 57
RE: Obama offers universal health care plan - 5/30/2007 12:20:14 PM   
Lordandmaster


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Status: offline 		But we don't have anything like 40-50% more recorded births in the first day of life.  Not even close.  The effect of the extremely low-birthweight infants that you're talking about is completely diluted when you look at the under-5 mortality figures rather than the infant-mortality figures.  Which is exactly why I cited them...

Still not willing to address life expectancy, eh?  One thing that would totally blow your theory out of the water is to look at life expectancy not at birth, but at the age of 10.  Look it up.  Every European country beats us in that department, too.

And, finally, stop talking as though anyone who challenges your misuse of numbers is just a fucking idiot who needs to have the dots connected.  It's annoying.  Persuading someone else involves showing the other person why your point of view makes more sense--not showing the other person why you think he's stupid.  That has a way of NOT persuading the other person.

quote:

ORIGINAL: Archer

OK I'll make the rest of the connection for you then LM.

If we have 40-50% more recorded births in the 1 day or less life span per capita.
(ie we attempt to keep a premie alive against all hope and they don't make it)
That also effect the averages for lifespan averages now doesn't it?


< Message edited by Lordandmaster -- 5/30/2007 12:21:17 PM >

(in reply to Archer)
Profile   Post #: 58
RE: Obama offers universal health care plan - 5/30/2007 2:05:49 PM   
Archer


Posts: 3207
Joined: 3/11/2005
Status: offline 		We don't? Cite the Statistic that counters the assertion
Make sure it counters the assertion that was made
40-50% more RECORDED live births who die the same day. than Lets say the UK so you don't go off on the I don't care about Cuba deflection.

US 12% of all births are Premature by medical definition http://www.msnbc.msn.com/id/13848085/site/newsweek
UK 7.1 % of all births are Premature by medical definition http://www.medicalnewstoday.com/medicalnews.php?newsid=4301

That's 40 to 50% more premature births in the US than in the UK If we assume that both countries take the same heroic measures to save a premie what else besides the record keeping rules explains that big a difference.
That difference seems on the face of it to explain the difference.

I'm using the numbers the same way that Source OECD Factbook saw fit to make a special note about.

As for their inclussion in a overall average life span what effect does 15,000 (0 years) have on the average
(30,000 premaure Births a year in the US with 50% mortality) Progressively less as you average them out over progressively larger groups certainly but still a difference. Is it a major factor in overall lifespan likely not but that's tying to shoehorn one subject to another. I made mention of the difference in Infant Mortality because it is a statistic that several unbiased sources have said is a faulty comparison because of the differences in the way the numbers are reported.

To address overall lifespan lets look at the cause of deaths and compare cultures to see what may cause the difference that is not directly healthcare related.

Possible major influences off the top of my head

Automobile Culture in the US- We certainly log more miles per capita than most countries and actuarially that would translate into a cetain number of deaths per year more than other countries
Drive more miles take more risk. Certainly with 38,000 + fatal Automobile Crashes we outpace most of the developed world. compare UK with 3,431 deaths from auto accidents 2002.















(in reply to Lordandmaster)
Profile   Post #: 59
RE: Obama offers universal health care plan - 5/30/2007 2:12:48 PM   
Lordandmaster


Posts: 10943
Joined: 6/22/2004
Status: offline 		Road traffic fatality rates are higher in Europe than in North America:

http://www.safecarguide.com/exp/statistics/statistics.htm

So much for that theory.

You're grasping at straws.

(in reply to Archer)
Profile   Post #: 60
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