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DesideriScuri -> RE: A question for Canadians, Brits and any other citizen of a country with nationalize health care (10/11/2013 7:28:34 AM)
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ORIGINAL: freedomdwarf1
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ORIGINAL: DesideriScuri
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ORIGINAL: tweakabelle
While it's impossible to prove until it happens, a properly designed universal healthcare system will reduce cost significantly.
Surely there is proof from some other country switching over, isn't there? You claim the US is spending twice as much as anyone else and the situation would be so much better if we switch, but you can't show where that has taken place?
There are many examples of where national single-payer systems have been brought in to the benefit of the whole country.
Our NHS wasn't born until 1948.
Until then, is was a free-for-all with regard to healthcare.
Source: http://www.nursingtimes.net/the-birth-of-the-nhs-july-5th-1948/441954.article
[image]http://www.historyandpolicy.org/papers/images/gorsky_figure1.jpg[/image]
The %GDP cost of the NHS has gone from, roughly, 2½ 3½%GDP in 1950/1 to, roughly, 7¼% in 2007/8.
http://blogs.telegraph.co.uk/news/files/2012/07/nuffield.jpg (the image comes out huge here, so I'm linking to it instead)
This shows the NHS costs rising from 3½% GDP to 9%GDP from 1949/50 to 2009/10.
What proof is there that US costs will go from roughly 17%GDP to 9%GDP, based on the experience of the UK?
[image]http://www.bmj.com/highwire/filestream/612194/field_highwire_fragment_image_m/0/F1.medium.gif[/image]
Since 1970, everyone's health care expenditures are rising. Where is there any proof that going to a national care model will cut costs? Where is there any proof that going to a national care model has cut costs?
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ORIGINAL: DesideriScuri
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There are tremendous potential savings in eliminating (for example) the advertising, marketing and profits of private companies. The unnecessary duplication of services, and the abolition of private monopolies will also generate areas of potential savings.
Private monopolies? What private monopolies are you talking about? Insurance companies are now required to spend at least 80% of their premium revenues in medical care costs, leaving 20% for everything else, including advertising and profits. Even the national care models have administrative costs, so that 20% isn't going to be completely erased.
The private monopolies that dictate the cost of drugs, treatment, machinery, even waste disposal - the whole system whereby every company involved gets to make a profit all along the line.
As Tweak pointed out, a system funded by taxes doesn't need to advertise.
A nationally funded system can, and often does, negotiate a mega price drop on the cost of drugs.
This is evident in another thread that jlf brought up. A pack of pills in the US costs $145. Those same pills, even with the exorbitant cost of international shipping, costs $10 across Europe.
Eye surgery that costs hundreds of $$'s in the US is costing Nigeria $10 per patient.
This is because those very same drug companies and physicians don't get a chance to rip-off customers when that 'customer' is the government of another country with a single-payer system.
You're still only talking about the 20% (less, actually because there are still administrative costs associated with national health care systems) of the costs.
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ORIGINAL: DesideriScuri
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An example of how this works in practice can be seen in the operation of Pharmaceutical Benefits Scheme, which ensures that medicines are affordable by all Australians. The Govt acts as a single buyer, negotiating a fair price for purchasing drugs from the drug companies and subsidising the cost of the more expensive ones. This purchasing power enables considerable savings to the consumer, as can be seen in the relative costs of medicines in the US and Australia.
At what cost (with regards to R&D, jobs, etc.)? Is the cost actually a negotiated cost or a mandated cost?
None whatsoever.
The difference is, the CEO's and shareholders don't get to make such fat profits when dealing with a whole nation rather than individuals.
Have any proof of that?
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ORIGINAL: DesideriScuri
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One of the reasons why US healthcare is so expensive is that service suppliers can charge whatever the market will pay. Restrictions on the numbers of service providers (through, for example, limiting available training and entry into the professions) have created (an artificial) sellers market. A universal scheme, which would act a single consumer nationally on behalf of all consumers, reverses this dynamic, (a power that individual consumers lack) by effectively creating a buyers' market without any concurrent drop in standards of excellence .
The restrictions are there. There is a monopoly on the licensing of physicians. It's a government sanctioned monopoly, too. Is Medicare a buyer's market? Medicare has Government negotiating the reimbursements for services. They are lower than private insurance reimbursements. Lowering them will have more of a negative effect than anything, as physicians would either reduce the number of Medicare patients they see, reduce the amount of time they spend with Medicare patients, or stop seeing Medicare patients altogether. The costs of providing care are high enough that reducing Medicare reimbursements is not a popular stance. Even politicians aren't in support of it, as proven by the continuing passage of "Doc Fix" bills (which are passed to prevent legislated reductions in reimbursements enacted during Clinton's Presidency).
There are some restrictions, yes.
But the whole system is based on profiteering, not providing a decent, affordable service.
You say there is a government monopoly on the licensing of physicians.
I don't see that anywhere - not even in the US.
No, I said there was a government sanctioned monopoly (the AMA).
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Someone does the study, passes the exam, they can apply for a license in whatever field they passed in.
Where do they get that license? Here, it's the AMA.
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When they have that license, they join a practice or setup shop themselves and charge what the fuck they like.
Where is the monopoly restriction? All I see is profit and greed.
In a state-funded system, you are paid a salary negotiated between the unions and the government body. You can't charge any more for treating existing pre-conditions or for someone coming twice a week for months on end and the prescription charges are the same regardless of the cost of the medication that is prescribed.
Are you saying that a healthy individual presents the same income for a practice as a chronically ill individual?
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Profit doesn't come into it - and there's the essential difference.
Private companies need to advertise against their rivals and they need to make a profit or they go bust. This is standard business practice - emphasis on making profits to re-invest (or line your CEO's nest egg).
State funded single payer systems don't nned to advertise (hence no advertising costs) and the emphasis is on providing the service, not making a profit. If you don't make a profit and more funds are needed, you just re-route taxes from another budget into the one that needs more funding.
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