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ORIGINAL: Zonie63

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ORIGINAL: DesideriScuri

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ORIGINAL: Zonie63

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ORIGINAL: DesideriScuri
If it's so profitable that way, why hasn't private insurance done that? Wait. I wonder if that's because insurance isn't allowed to sell across state lines, making it impossible for it to be a "nation-wide" solution.

What do you mean insurance isn't allowed to sell across State lines? These insurance companies are nationwide outfits. Blue Cross, United Healthcare, etc. operate in multiple States, if not all of them. I was just looking at my old UHC card, and for medical claims, I have to write to an address in Salt Lake City, while pharmacy claims are handled out of Lexington KY. If they weren't allowed to operate across State lines, then all that should be handled here in Arizona where I live. So, what gives? Are they breaking the law or what?

No one said they can't operate across state lines. They can't sell across state lines. If you want to sell in Ohio, you have to be in Ohio. If you want to sell in AZ, you have to be in AZ. That you HQ in Utah, is immaterial. But, if you didn't have to have a presence in every state, wouldn't that reduce overhead costs?

Okay, so they have local branches and offices to satisfy legal technicalities, but how does that support your argument that it would be impossible to for a nationwide solution since they already operate that way in practice? FD's supermarket analogy made sense, since a lot of supermarkets might have different names in different States or regions, yet still affiliated or owned by a national chain. They're clearly managed and controlled by a centralized, national-level entity, not really free or independent in any way.

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ORIGINAL: freedomdwarf1

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ORIGINAL: DesideriScuri
So, you have no proof of super duper profits in the American health industry, then?

Yes we do.
Look at the prices of medicine in the US and elsewhere.
Made by the same company (usually in the US) and shipped abroad.
The Americans pay upwards of 10x the price for the same item made by the same US big pharma.
There's your proof - difference in cost to Joe Schmoe public.

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ORIGINAL: DesideriScuri
The US Government does run it's own national health insurance. It's called Medicare. Then, there's Tricare, CHIP, and the VA. There is also a State and Federal insurance program called Medicaid. And, there are already medical professionals who are starting to refuse to see some of those patients because of the low reimbursements.

And yes.... ALL insurance companies.
It isn't solely funded and supported by the government other than they pay the insurance bill.
All of them are provided for, and billed by, private insurance companies along the same lines as all the other policies.
It is still profit-driven insurance companies providing the cover, the care, AND the billing!!! They also tend to have the same exclusions too!
The only difference is, the tab is picked up by the government.
It is still nothing like socially-funded healthcare.

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ORIGINAL: DesideriScuri

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ORIGINAL: freedomdwarf1

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ORIGINAL: DesideriScuri
Some have already argued that reducing the pricing of health care won't reduce the price of insurance. It seems intuitive that it would, but it's been argued already.
If government were to come in tomorrow and set prices for everything, who is going to get fucked? There would be a meltdown, as providers close up shop. I agree there are excess costs somewhere in the system, but where? I agree with JeffBC, that every level adds some, but how do we place price controls at the top, when it's probably not something the top can just absorb? And, who gets fucked in the end of all that? Patients. Consumers.

This is what I mean about you not understanding Desi.
By putting in place a socially funded healthcare system, the patients/consumers will not suffer.
In fact, they will gain by having nationwide cover at a fraction of the cost.
There would be no question as to whether they would be covered out of state - it would be nationwide.
There would be no question to what is covered because there are no exclusions.
The only people that would lose out would be the insurance companies and big pharma.

Except, you are the one that isn't understanding, FD. Where is the "fraction of the cost?" Sure, the consumers won't pay at the point of service, but if reimbursements aren't high enough, there will be a reduction in where those consumers can go (providers will leave the Market). How is that going to be changed, then?

{sigh} Here we go again around the same mulberry bush for the umpteenth time.
The "fraction of the cost" is in the saving made by buying direct at bulk discounts.
And there aren't such things as "reimbursements"!! There is nobody to reimburse.
You really must get that out of your mind because this is where you are fundamentally not understanding.
Yes, providers will leave the market - they will be replaced by government funded facilities instead.
And no, that doesn't mean paying private companies to run a state-funded facility like Medicaid etc.
It means the facility is state funded, the staff and equipment is state funded, the parking lot and the buildings are state funded using state funded workers on state payroll. No private anything involved; no middle men, no insurance companies.

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ORIGINAL: DesideriScuri

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If a government came in and said:
Doctors, depending on skill/seniority will be paid on a pay scale of $80k-$200k per year salary, regardless.
Nurses, as per doctors, $40k-$100k.
Cleaners, porters and auxilliary workers, $20k-$50k.
Compare that to the current salaries - much cheaper.
And it will be a livable wage because they won't be paying health insurance or deductibles out of it.

Good luck with that.

It works everywhere else. So why shouldn't it work in the US???
That's why your healthcare is sooo expensive.

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ORIGINAL: DesideriScuri

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On top of that, if an aspirin costs about 10 cents around the world, that's what they will pay big pharma to supply hospitals, clinics and pharmacies across the nation. If big pharma complains and refuses, import them from any OECD country at the cheapest rate. If big pharma can supply boxes of aspirin at 10 cents a box to overseas countries, they shouldn't be allowed to sell on the home market at $1 a box and hospitals shouldn't be allowed to bill patients at 10 cents per pill. That is sheer greedy profiteering on a thoroughly disgusting level.
The same for every other item used in clinics and hospitals - buy at a wholesale price in big numbers and supply them nationwide at cost.
Remember, we are talking nationwide, not on a per-state level.

Any proof that's what Big Pharma is doing? I honestly don't know what the cost is to a hospital for a box of pills. I acknowledge that you could be right, but, without proof, how do we know?

The proof is every other country running similar single-payer systems.
Your graphs showed that. What more proof do you need??
When I lived in the US for 8 months, your OTC medicine costs were excessive compared to here for the same products made by the same companies.
Have you never bothered to ask at hospitals and clinics what these things cost??? I did.
That's how I can quote the costs of the scanner at my local hospital - I asked.
Pills and other medical supplies are at cost from our NHS supplies depot, not the full retail cost.
This is where money is saved hand-over-fist.
There is no profit margin added on to NHS supplies like there would be for private medicine.

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ORIGINAL: DesideriScuri

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Look again at your earlier graph. Even small countries and those with a lower GDP can do it.
We have private insurance here but if anything is done by farming out the work (like Japan, Canada and Australia does), they only pay the going national rate, not the rates charged privately.
Where is the waste?? Everywhere up the line and at every step.
The meltdown would be the insurance companies and the hundreds of middle-men adding their cut.
If the government can provide universal healthcare at 10% of income, with no deductibles, no co-pays, no exclusions, no personal billing requirements; wouldn't that be better than what the average Joe is paying??
Make it simple: Buy direct, buy in bulk, supply direct; nobody in the middle.
And just think, you'll also be creating jobs for supply drivers, warehouses and other stuff that you can also cap the prices on.

So,now we've got caps on care/services prices, and we're now capping supply drivers, warehouses, etc.

Yes!!
Because they are all government funded and government run by government salaries staff at NO profit!!

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ORIGINAL: DesideriScuri
If it's so profitable that way, why hasn't private insurance done that? Wait. I wonder if that's because insurance isn't allowed to sell across state lines, making it impossible for it to be a "nation-wide" solution. So, that would be "government regulation" preventing a potentially national solution.

There you go again.... private insurance companies and profit!! {sigh}
Stop thinking insurance companies - they don't figure in it at all.
And how many times have I said that socially funded healthcare does NOT have profit driving the service like insurance companies do??
They can all go to the wall unless they toe the national line and provide a competitive product and service.
Sell across state line?? Why the fuck not??
Too many people like yourself thinking in small boxes and state lines.
Healthcare should be nationwide and universal.
You can have a nationwide solution when you stop thinking of state lines and private insurance companies.
It wouldn't be "government regulation" because there again, you are thinking of regulating insurance companies.
There wouldn't be any; or at least very few left after the shake-up.

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ORIGINAL: DesideriScuri
Even if there are 100 insurance companies, if they all compete on a national scale, wouldn't that help out?

No, it wouldn't help because they are ALL working on bigger profit margins because they are all working in a closed market with a captive audience backed by legislation.
They need to be all-but eliminated from the loop.

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ORIGINAL: Zonie63

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ORIGINAL: DesideriScuri

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ORIGINAL: Zonie63
Considering what they pay their CEOs, it does indicate that they are making a rather hefty profit.

That goes back to my question of what's important when looking at profits, $'s or %?

I think it's important to look at both, in order to gain a full perspective on the matter.

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If you are limited to 20% max of your revenues that can be used to compensate employees, and pay overhead costs, it pays (literally and figuratively) to increase the number of members you have, so the better your CEO is at running the company and increasing the premium revenues, the more that CEO should be compensated, no?

Theoretically, that would make sense, but does it actually operate that way in practice?

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I am still shocked at how much companies pay CEO's. It's simply amazing. That they think someone is worth that much, is beyond me, too. I'm shocked at professional athlete contracts, too.

It's actually easier to see with some professional athletes, though. Those that have a certain celebrity and star power that attracts fans and boosts ticket sales, one can see a visible connection between that and the high salaries they earn. But it only works as long as they're good. If their athletic skills begin to decline, then they won't be such a great draw for the fans. But in any case, it's relatively easy for any fan to see who is actually "good" and those who are "not so good."
With CEOs, it's a bit more difficult to tell. In looking over the chart comparing the salaries of the various CEOs, are we to assume that the CEO of Aetna is three times "better" than the CEO of Health Net? They don't hit home runs or throw touchdown passes. What exactly do these CEOs actually do that can't be done by any number of people with similar credentials? What makes them so indispensable?

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ORIGINAL: eulero83

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ORIGINAL: DesideriScuri
That's a response, but not an answer. If you don't think there is a difference between profit margin and profit dollars, then just say that. I'll make it easier for you to answer.
Is $100B too much profit at 20% profit margin?
Is $100B too much profit at 5% profit margin?
Is $20B too much profit at 20% profit margin?
Is $20B too much profit at 5% profit margin?
Yes/No responses are easy enough, right?

I find this questions meaningless you probably want to make a point based on what my answer would be or hijack the discussion, so I will never answer that. If you have a point just write what you want to say.

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of course in the usa it's profitable to invest in providing health care, but your health care is not affordable, I really don't understand what you'd propose to solve the situation, from you I just heard "if health care costs were lower we would be able to afford it, but it's not gonna happen so suck it up!" there are multiple people from multiple countries telling you "in my country we had the same problem than changed to a public health care system and it's definitly better" and you are like "this would poison our soul" so when it's a matter of principle there is no more anything to say.

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ORIGINAL: eulero83
"in my country we had the same problem than changed to a public health care system and it's definitly better" and you are like "this would poison our soul" so when it's a matter of principle there is no more anything to say.

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ORIGINAL: DesideriScuri

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ORIGINAL: eulero83

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ORIGINAL: DesideriScuri
That's a response, but not an answer. If you don't think there is a difference between profit margin and profit dollars, then just say that. I'll make it easier for you to answer.
Is $100B too much profit at 20% profit margin?
Is $100B too much profit at 5% profit margin?
Is $20B too much profit at 20% profit margin?
Is $20B too much profit at 5% profit margin?
Yes/No responses are easy enough, right?

I find this questions meaningless you probably want to make a point based on what my answer would be or hijack the discussion, so I will never answer that. If you have a point just write what you want to say.

The point just might depend on your responses. So, either you answer the questions, or you don't. Your call.

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of course in the usa it's profitable to invest in providing health care, but your health care is not affordable, I really don't understand what you'd propose to solve the situation, from you I just heard "if health care costs were lower we would be able to afford it, but it's not gonna happen so suck it up!" there are multiple people from multiple countries telling you "in my country we had the same problem than changed to a public health care system and it's definitly better" and you are like "this would poison our soul" so when it's a matter of principle there is no more anything to say.

Where did I say anything like that? I started the whole fucking thread to talk about US Health Care Costs. Why? Because I certainly do believe that reductions in the cost of services and products will result in more people being able to afford care and/or health insurance.

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ORIGINAL: Greta75

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ORIGINAL: eulero83
"in my country we had the same problem than changed to a public health care system and it's definitly better" and you are like "this would poison our soul" so when it's a matter of principle there is no more anything to say.

One of the biggest problem with Obama care is that, people are complaining that they want a choice whether to be insured or not. Some feel they are so healthy, they don't need health insurance and do not want to be forced to take it up just to allow the poorer people to get lower premiums.

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Obamacare is a half baked solution and not a holistic solution.

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In my country, this problem was solve, by simply having the government manage their own insurance as well as the healthcare, and simply being cheaper and also better than private insurers and private healthcare in all ways, so people out of their own free will opt in to be insured and use the government facilities.

Infact it's by default for everybody to be auto-opt in, so people just need to opt out if they wish to.

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Of course, the other thing that works for us, which make people less unhappy is companies have to contribute an additional 16% of their employee's salary into an account, which the employee can't touch this money for anything else but health insurance and health related expenses. So they don't feel like they are using their own money anyway. And really for companies to handle this situation, they just calculate top down, as in, when they plan salaries, it would already be with the 16% inclusive, that means lower wages, but psychologically, it works to make people pay for health insurance happily.

And this country also is more republican minded and hates the idea of government using tax money to subsidize any less fortunate people's lives. We are a no welfare state. So people with this mentality needs different motivation and strategies.

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ORIGINAL: eulero83
I had that feeling, I won't.

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of course in the usa it's profitable to invest in providing health care, but your health care is not affordable, I really don't understand what you'd propose to solve the situation, from you I just heard "if health care costs were lower we would be able to afford it, but it's not gonna happen so suck it up!" there are multiple people from multiple countries telling you "in my country we had the same problem than changed to a public health care system and it's definitly better" and you are like "this would poison our soul" so when it's a matter of principle there is no more anything to say.

Where did I say anything like that? I started the whole fucking thread to talk about US Health Care Costs. Why? Because I certainly do believe that reductions in the cost of services and products will result in more people being able to afford care and/or health insurance.

Of course you didn't use that words, but it's implied in making the point that if profits were lower care providers would stop providing the service (that I agree) and that no public system is acceptable, ergo "suck it up". If you have any better idea in lowering the costs would be nice hearing or at least tell your theory about why the costs are so high, because the only thing you did is rejecting a public health service, and you had this discussion so many times that's impossible you didn't know every other one would have proposed that.

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ORIGINAL: freedomdwarf1

When I lived in the US for 8 months, I was looking for ways to possibly emigrate there with my family.
So I questioned all sorts of things including the healthcare any also why it was going to cost so much.
That was a few years ago now but recent developments have sure made me glad I didn't go there.

And living in the UK where my health isn't as good as it used to be, and also used to earning shitloads of money in the past, I have seen both sides of the coin here and can compare it to the USA.

If I were living in the US now, I wouldn't be able to afford my meds or my hospital visits.
Any insurance I might have taken, or been forced to pay for, wouldn't cover my pre-existing condition; so I'd have been paying for nothing or been fined under the present US system. Either way, I'd be using my food or rent money to pay for it.
Choose to starve or stay alive with meds. Not exactly a nice choice to have to make.
For me, that is not an acceptable way to be living. That's the major reason why I stayed in the UK.

My 2nd wife had the luxury of being one of the first to use the new scanner and I spent quite a while chatting to the technician and radiographer about it while she was "cooking". lol.
That's why I know a lot about it and how they came to acquire it and what it cost them.

I don't know a lot about the US healthcare system except what I learned while I was living over there.
But it's a lot more than someone who has never been there or only been there on holiday.
That's why I can speak about both sides and on both systems to a certain degree.

The final upshot is.... I couldn't afford to live in the USA and I certainly couldn't afford to retire there.
The medical side of things alone would have bankrupt me.
That and the gun attitude and gun laws, the US would be a good place to live even with the crappy weather they have!
Food-wise, it's cheaper and with much bigger portions for the money. Heck, I could live on eating out or take-outs and not bother to cook at home; I can't afford to do that here in the UK.
Most other consumer goods are cheaper than the UK.
The salaries are generally better for the same job than they are in the UK.
Overall, the Americans are better off than we are; but the killer, overwhelmingly, is the healthcare costs.

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ORIGINAL: freedomdwarf1

If I were living in the US now, I wouldn't be able to afford my meds or my hospital visits.

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ORIGINAL: freedomdwarf1

Food-wise, it's cheaper and with much bigger portions for the money.

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ORIGINAL: freedomdwarf1

Overall, the Americans are better off than we are; but the killer, overwhelmingly, is the healthcare costs.

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ORIGINAL: DesideriScuri

Where did I say anything like that? I started the whole fucking thread to talk about US Health Care Costs. Why? Because I certainly do believe that reductions in the cost of services and products will result in more people being able to afford care and/or health insurance.

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ORIGINAL: NorthernGent

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ORIGINAL: freedomdwarf1

If I were living in the US now, I wouldn't be able to afford my meds or my hospital visits.

Which is not necessarily a damning indictment of the United States, nor a glowing reference for England. It just so happens that you personally would not benefit from the way they do things over there.

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ORIGINAL: NorthernGent

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ORIGINAL: freedomdwarf1

Food-wise, it's cheaper and with much bigger portions for the money.

Where are these big portions? because I didn't see it when I was over there. What a let down. The reason they're bigger, or fatter depending upon point of view and completely ignoring any claim to political correctness, is because they eat some strange things as opposed to bigger portions. Syrup and cakes for breakfast and the like. Strange lot.

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ORIGINAL: NorthernGent

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ORIGINAL: freedomdwarf1

Overall, the Americans are better off than we are; but the killer, overwhelmingly, is the healthcare costs.

I don't think they are. It's a twist of fate that the people who left England to go there went partly to get away from monarchy and all the hierarchy and favouritism that it brings. Yet, I'd hazard a guess that the % of people commandeering 80% of the nation's wealth is at least comparable with England.

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ORIGINAL: NorthernGent
Purely anecdotal, but when I was over there I was talking to a lass in this place in Nashville and she was doing at least a couple of jobs, was at college or something and hard pushed for a bit of sleep. According to her this wasn't unusual; it is unusual in England to make ends meet.

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ORIGINAL: NorthernGent

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ORIGINAL: DesideriScuri
Where did I say anything like that? I started the whole fucking thread to talk about US Health Care Costs. Why? Because I certainly do believe that reductions in the cost of services and products will result in more people being able to afford care and/or health insurance.

Have to say, mate, my experience of the US health care system (1 hospital I should say in order to qualify whether or not this counts for much) is that it was a monumental piss take. The attitude seemed to be charge as much as possible for doing as little as possible.
In the interests of balancing this up, I enjoyed my time in the United States, and not everything is going to be to everyone's liking so you have to give an opinion on balance. My conclusion is that the United States is a great place to visit for many reasons, it just so happens that one of the few downsides was my one and only experience in a hospital in New Orleans where they all really should have been sacked for severe idleness.

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ORIGINAL: Marini

Several family members and myself think very seriously about leaving this country.

I have been considering moving to Canada, if not in the next few years, at least when I am 62.
It is so sad to HATE the way that your country is going, that you want to leave it.
The members of my family that are considering leaving range from 84 {she would love to leave}, to 19 and 21 {they see how this country is headed}.

At least if I migrate to the Toronto area, I will be close enough to travel to the States during the winter and to visit regularly.
**I do mean I am very, very, very, seriously considering this move.**

Thanks again for sharing, some of your life's decisions!
You were smart to stay put!
Cheers to you freedomdwarf!
I would love to meet you one day, when I travel across the pond. {Hopefully in the next 2 years}
[sm=goodpost.gif]
Not sure is I will ever move out of the States, but it is certainly on the table.