RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (Full Version)

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tazzygirl -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 8:47:24 AM)

~FR

Something I found....

On costs, Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don't need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can't charge as much when they have to deal with a single payer.



Moonhead -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 9:29:39 AM)

Oh, like facts are going to convince anybody who thinks that socialised medicine is inherently evil and will eventually lead to a marxist autocracy...



tazzygirl -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 10:04:32 AM)

LOL... I know, but I have "faith" [;)]



IceDemeter -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 10:28:57 AM)

quote:

What I would like to see is for us to first abandon the notion that this is a matter for the Federal government and to leave it up to the state governments (this is not just a health care issue for me but a Constitutional one). Let each state decide for itself what it wants to do. If they want to have a fully tax payer funded health care benefit, they can. If they want no government assistance or something in between then they can have that as well.

This would have serveral benefits. First, it's a lot easier to convince the majority of twenty or thirty million people than it is three hundred million people to vote this way or that way. Second it creates a testing ground for various options. If the people of Colorado (for example) don't like the way their system is working they can say: "Hey! Look at what their doing in Main. That seems to be working pretty well. We should try that!" Third, if a state fucks it up, it means the people of that state only have to pay for their own fuck-ups, and can't inflict the cost of their fuck-ups on of people in other states. When the national government fucks up, we all pay.


This is an interesting thought, but a potential issue is that you would end up with varying levels of available care based upon the overall wealth of the state. This will leave an opening for private insurance to cover the costs of people going over state lines for care, or for the wealthy to do that as well. Not that either of those is necessarily a bad thing - just something to consider.

Here in Canada, health care is mandated federally but administered by each province. Some provinces have a separate tax, some have user fees, others work strictly from the general taxes received. This has resulted in vastly different levels of care available from one province to another. A few examples taken from my personal experience would be:

- different waiting times for surgeries
- some provinces having limited access to high-end testing (eg. PET scans)
- chemo drugs that are a standard treatment in one province not being approved in another

Unfortunately, these differences aren't generally recognized at voting time --- they are only discovered when you or a loved one needs these services.

It's a nice idea to say that you could vote for an increase to allow the same level of care, but if you are in a state that has chosen government-managed health care but doesn't have the same amount of available tax dollars to fund it as the one next door, what do you do? If you are in a state where the majority of the people haven't run in to this as an issue (yet) and don't have the same impetus as you do to vote for that increase, what do you do?

Just something to think about when looking at whether this should be federal or state issue in the US.



Marc2b -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 11:55:19 AM)

quote:

This is an interesting thought, but a potential issue is that you would end up with varying levels of available care based upon the overall wealth of the state. This will leave an opening for private insurance to cover the costs of people going over state lines for care, or for the wealthy to do that as well. Not that either of those is necessarily a bad thing - just something to consider.


I already have and for the most part I’m okay with it. Like I said, this is also a Constitutional issue with me. The Constitution makes it clear that if it doesn’t specifically grant a power to the federal government, then the federal government doesn’t have that power… it belongs (at most) to the states. Much of what the Federal government does is inherently illegal… an unconstitutional usurpation of power. Since people are different and one size does not fit all I think different states doing different things is okay. Nor am I against private insurance… I have nothing against a two tier system in which you have your government benefits and can supplement that with private insurance if you wish.

quote:

Here in Canada, health care is mandated federally but administered by each province. Some provinces have a separate tax, some have user fees, others work strictly from the general taxes received. This has resulted in vastly different levels of care available from one province to another. A few examples taken from my personal experience would be:

- different waiting times for surgeries
- some provinces having limited access to high-end testing (eg. PET scans)
- chemo drugs that are a standard treatment in one province not being approved in another

Unfortunately, these differences aren't generally recognized at voting time --- they are only discovered when you or a loved one needs these services.

It's a nice idea to say that you could vote for an increase to allow the same level of care, but if you are in a state that has chosen government-managed health care but doesn't have the same amount of available tax dollars to fund it as the one next door, what do you do? If you are in a state where the majority of the people haven't run in to this as an issue (yet) and don't have the same impetus as you do to vote for that increase, what do you do?

Just something to think about when looking at whether this should be federal or state issue in the US.


One of the nice things about not having a national standard for everything is that if you don’t like the way things are being run in your state you have forty-nine others to choose from. At this point someone will demand to know what we do about people who can’t afford to move. Well, unlike some people, I don’t pretend to have a one size fits all solution to everything. I don’t cling to the fantasy that we can legislate our way to utopia (nor do I believe that expressing concern for others or denigrating those who disagree with me automatically makes me a morally superior person). I also do not believe that so many people are quite as helpless as others make them out to be. It’s another ego stroke-off as far as I’m concerned… you can’t preen yourself as a good person unless there are people who need your concern (not help, mind you… oh no, that would be too difficult… all they want to do is shout “RIGHTS” and “JUSTICE,” because that’s all they need for their self flattery).


Besides, if there is only one standard and if it doesn’t meet your needs then you have no options left. In a state by state situation you at least have more options.



IceDemeter -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 12:42:07 PM)

quote:

One of the nice things about not having a national standard for everything is that if you don’t like the way things are being run in your state you have forty-nine others to choose from. At this point someone will demand to know what we do about people who can’t afford to move.


I had to laugh at this --- it's one of the reasons that I did move to a different province.

My personal preference is a nationally mandated minimum availability of care, with each locality going above that as their voters / budget allow. A second tier financed either individually or by insurance available as a personal choice also makes sense to me. We've got the first here in Canada, but the second is hotly debated and not yet available in many areas of the country. Which might explain so many Canadian plates in the parking lots of US doctors' offices...






willbeurdaddy -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 12:55:10 PM)


quote:

ORIGINAL: IceDemeter

This is an interesting thought, but a potential issue is that you would end up with varying levels of available care based upon the overall wealth of the state.


We already have the issue of some areas being underserved, that won't get any worse if Federal involvment is gone. If an area is so desirable for a person to leave there despite more difficult access to health care thats up to them. If the barriers to cross state coverage are removed those obstacles would be further ameliorated.



Marc2b -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 1:03:53 PM)

quote:

Which might explain so many Canadian plates in the parking lots of US doctors' offices...


That could be. I don't know the specifics of Ontario's (the province I'm next door to) health plan but it might be interesting to note that the over on Professional Parkway (the area in my town where most of the doctors and out paitent facilities are located) the buildings where you are most likely to see Candian licence plates are for Radiation Oncology... and the chiroprator. What that says about Ontario, I don't know.




IceDemeter -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 1:51:20 PM)

quote:

That could be. I don't know the specifics of Ontario's (the province I'm next door to) health plan but it might be interesting to note that the over on Professional Parkway (the area in my town where most of the doctors and out paitent facilities are located) the buildings where you are most likely to see Candian licence plates are for Radiation Oncology... and the chiroprator. What that say about Ontario, I don't know.


Chiropractors, as far as I know, are not included in the health coverage anywhere in Canada (neither are dentists or optometrists or a number of other fields), so we either pay for them ourselves or they are covered under personal insurance. I would be thinking that you've got some really good chiropractors there if you've got folks from Ontario willing to travel to see them!

As for the radiation oncology - that's one of the areas where different provinces have different rules. Some provinces will pay for a patient to go to another province or another country for treatment if that particular treatment is completely not available in that province or if it is not available in a reasonable time. It is possible that Ontario Health found it made more economic sense to pay for some patients to travel to your state for treatment instead of increasing their own capabilities, or they just didn't have the facilities in place fast enough for increased patient demand.

quote:

If the barriers to cross state coverage are removed those obstacles would be further ameliorated.


When looking at a state level system as opposed to a federal system this is another thing to think about. There are going to be times when it makes more sense economically to send patients out of state for treatment. Having some states private, some government, and some with some mix of the two might in fact create more barriers.



tazzygirl -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 1:57:25 PM)

http://www.toronto.ca/health/dental/index.htm

I dont know about all of Canada, but at least Toronto seems to offer some free dental care.



IceDemeter -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 2:14:35 PM)

You are right, Tazzygirl --- there are exceptions.

The standard provincial health care coverage does not cover dentistry, prescriptions, etc. but there is additional provincial coverage for these things depending on income. These have to be applied for and you have to meet the income criteria (and prove lack of access to insurance either personally or through work) in order to access it. In some cases services will be covered in full, and in other cases there will only be partial coverage (with the patient having to pay up front and apply for re-imbursement). Requirements vary from province to province.

The standard provincial coverage only requires that you are a Canadian citizen or landed immigrant and have been a resident of the province for a certain period of time (which,again, varies from province to province).

When looking at the concept of bringing in "universal health care" in the US, I wonder which services would be included in the base. Would dentistry, prescriptions, optometry, chiropractors, accupuncture, etc. be considered as basic health needs, or extras as they are here?




tazzygirl -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 2:26:31 PM)

quote:

When looking at the concept of bringing in "universal health care" in the US, I wonder which services would be included in the base. Would dentistry, prescriptions, optometry, chiropractors, accupuncture, etc. be considered as basic health needs, or extras as they are here?


I can see dentistry being included because so many health problems can occur due to bad oral health.

Prescriptions... thats an iffy in my mind.

Optometry, I would hope for a case by case basis. Getting your eyes checked? No. Its cheap enough here for an eye exam. Glaucoma surgery? Then yes.

Chiropractors... I adore mine.... but I can envision that being covered more by private than a national system.

The same with acupuncture and even plastic surgery, which you didn't mention but I thought I would toss in there.



IceDemeter -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 2:45:46 PM)

We split plastic surgery into "voluntary cosmetic" which is not covered, and other areas including "reconstruction" which are covered since they are considered to be necessary for the physical or mental health of the patient. Whether it is covered or not is a case-by-case decision.

Things like glaucoma surgery are considered basic medical and are covered - eye exams, various tests (including testing for glaucoma), and prescription lenses are not covered.

I know that there are quite a few here who choose their specialty in medical school based on whether they will be working entirely under the provincial health system or if they would be predominantly private. Unfortunately our provinces don't necessarily pay as much as a private practice would, so we have a chronic shortage of doctors (especially general practitioners). We also lose a lot of skilled medical practitioners (doctors, nurses, techs) to the US since they can get better pay there.

I wonder whether the US would see a similar situation arising with a universal health care system. I also wonder whether that effect would make a state-by-state choice eventually unworkable.



Termyn8or -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 3:04:56 PM)

"Unfortunately, these differences aren't generally recognized at voting time --- they are only discovered when you or a loved one needs these services. "

If true, that indicates that I might be correct - that people vote for selfish reasons. If they could forsee medical problems would they vote for candidates who would support coverage of their specific ailments ? I think so.

For example I have very good teeth for my age, so why should I pay for those with that problem ? However my whole family has a history of poor eyesight. So how would I vote ? Would I vote for covering others but not myself ?

I won't answer that, however if you notice here, it seems that poor people want to vote for more benefits which would be supported by taxpayers. At the same time those more well to do would vote for lower taxes.

I think it's human nature and that night make it more right to standardize the specifics nationwide, or even worldwide. But then of course that won't work either. Perhaps nothing will, and even if it does it will not please everyone. And as the old song goes, you got to please yourself.

T^T



tazzygirl -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 3:05:34 PM)

quote:

We also lose a lot of skilled medical practitioners (doctors, nurses, techs) to the US since they can get better pay there.


I worked with quite a few Canadian nurses... damn well trained. The international test is a bitch to pass though. In order for a US nurse to work in Canada, she has to pass US boards, then the international test, then the Canadian.



IceDemeter -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 3:34:45 PM)

quote:

For example I have very good teeth for my age, so why should I pay for those with that problem ? However my whole family has a history of poor eyesight. So how would I vote ? Would I vote for covering others but not myself ?

I won't answer that, however if you notice here, it seems that poor people want to vote for more benefits which would be supported by taxpayers. At the same time those more well to do would vote for lower taxes.


True for some, yet not for all --- I'm one of the dastardly Canadian Conservative types, comfortably middle class, yet I have no issue whatsoever in paying higher taxes to cover better health care across the board. I consider myself fortunate that I've been able to afford to leave the country for faster care when I felt it was required, but would prefer to have spent those $ in taxes so that nobody would have to do the same thing.

Health care is a service that must be paid for, at a reasonable market level. The only choice is whether it should be paid for individually (along with insurance) or through taxes. Looking at it strictly from a selfish economic standpoint, my country has less of an overall cost vs GDP with our universal health care, and we're in a better position to compete globally with a physically and mentally healthy population than we would be without it. Individuals are far stronger when they don't have to worry about bankrupting themselves with health issues - leading to less stress, higher personal savings, and ... potentially, a stronger overall economy.

I do vote selfishly in that I will vote to pay higher taxes myself to cover others in areas such as education and health care so that they are in a better position to keep making the economy stronger.



DomKen -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 3:41:52 PM)


quote:

ORIGINAL: IceDemeter

quote:

For example I have very good teeth for my age, so why should I pay for those with that problem ? However my whole family has a history of poor eyesight. So how would I vote ? Would I vote for covering others but not myself ?

I won't answer that, however if you notice here, it seems that poor people want to vote for more benefits which would be supported by taxpayers. At the same time those more well to do would vote for lower taxes.


True for some, yet not for all --- I'm one of the dastardly Canadian Conservative types, comfortably middle class, yet I have no issue whatsoever in paying higher taxes to cover better health care across the board. I consider myself fortunate that I've been able to afford to leave the country for faster care when I felt it was required, but would prefer to have spent those $ in taxes so that nobody would have to do the same thing.

Health care is a service that must be paid for, at a reasonable market level. The only choice is whether it should be paid for individually (along with insurance) or through taxes. Looking at it strictly from a selfish economic standpoint, my country has less of an overall cost vs GDP with our universal health care, and we're in a better position to compete globally with a physically and mentally healthy population than we would be without it. Individuals are far stronger when they don't have to worry about bankrupting themselves with health issues - leading to less stress, higher personal savings, and ... potentially, a stronger overall economy.

I do vote selfishly in that I will vote to pay higher taxes myself to cover others in areas such as education and health care so that they are in a better position to keep making the economy stronger.

Holy shit!

The real conservative pro business position. I miss having these sorts of conservatives in the US.



IceDemeter -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 3:43:34 PM)

quote:

In order for a US nurse to work in Canada, she has to pass US boards, then the international test, then the Canadian.


We do make it difficult, don't we? If I'm not mistaken, there are some provinces that will demand a provincial test as well. Considering that our countries have such similar levels of training requirements, and the chronic shortage of nurses that we have here, I've never understood what was gained by making it so difficult for skilled nurses from the US to work in Canada.

Seriously - somebody who is already trained, in a field where we need people, who is willing to take the lower pay, and is willing to deal with the Canadian winters - and we make it harder?!? Another of life's mysteries...



tazzygirl -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 3:49:30 PM)

quote:

Health care is a service that must be paid for, at a reasonable market level. The only choice is whether it should be paid for individually (along with insurance) or through taxes. Looking at it strictly from a selfish economic standpoint, my country has less of an overall cost vs GDP with our universal health care, and we're in a better position to compete globally with a physically and mentally healthy population than we would be without it. Individuals are far stronger when they don't have to worry about bankrupting themselves with health issues - leading to less stress, higher personal savings, and ... potentially, a stronger overall economy.


Allow me to say... wow! I didnt think real conservatives existed anymore. No sarcasm, no snark....

I completely agree with the part I copied. People are better workers when they dont have to worry about every dime, nickle and penny. Health care is the biggest worry, besides jobs, on peoples' minds

On top of just that, the reality is many worry about losing their homes, their jobs, being able to take another job and hoping insurance will cover whatever disorders you may have.

Imagine being able to take a job because its the job you desire, instead of turning it down because you have a pre-existing condition or their health care coverage isnt as good as the one you have.

Imagine knowing that the house you own wont be taken away because you get cancer.

Imagine knowing you can let your child play football and not have to worry about how to pay for a potential broken arm, instead of keeping your kid out of sports due to worry about lack of insurance.

I would love to live in that kind of world.




tazzygirl -> RE: Sen. Rand Paul: Right To Health Care Like Believing In Slavery (5/18/2011 3:59:33 PM)

Because each country has their own way of doing things when it comes to health care. Those tests are designed for basic nursing practice. But what the US considers basic, other countries may not.

I had heard that each providence requires its own test. The US doesn't, just one test, but a nurse has to apply to each state, unless they join one that is part of Nurse Licensure Compact. So far, 24 states have joined, with 6 more waiting approval. It basically means that a nurse holding a license in one state can practice in any other state that is part of the NLc.



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