Universal Health Coverage

[Realitycheck]

I'm pretty sure that most everybody in this forum is too conservative to even give this idea a second thought. However, the truth is that most everywhere you go, medical prices are inflated due to inefficency, 20-30% unpaid medical bills (in public hospitals), and who knows what else.

 

http://news.yahoo.com/s/afp/20070901/hl_afp/uspoliticshealth_070901162222

 

Apparently, Arnold has embarked on his own campaign to do universal health coverage, giving the rest of the world another reason to move to California besides the year-round 70 degree weather. Apparently, Massachusetts has already established it. Might be something to study up on. I wonder if Hillary will try to revive it federally when she gets elected, if we ever get out of this war.

 

Just want to see what others have to say about this issue.

[CDarwin]

I would be cheaper.

[Realitycheck]

Yeah, but then wouldn't we completely wipe out the medical insurance industry? Isn't this a species that should be protected like all of the rest? And what about the medical industry lobby? Surely, they want to be protected. And of course the politicians who are supported by the medical industry lobby's fat pockets don't want to change things, or do they? Does competition in the medical insurance industry make the process more efficient or is the government more renowned for handling things more efficiently? Maybe you set up basic medical insurance via the government for everyone, but this is only good at hospitals which elect to accept this coverage, such as public hospitals. Then, people still can elect to pay for their own coverage which is good at all hospitals. Of course, the people who buy their own coverage will want a credit for what is deducted from their paycheck by the government, but that's just fine print. Frankly, I think the socialistic model is the most efficient, but I think we are too conservative and independent as a whole in this country to ever get that done.

[CDarwin]

Yeah, but then wouldn't we completely wipe out the medical insurance industry?

 

I have no problem with private insurance companies continuing to operate for people who might want more coverage than the government might offer and could afford it. I just think it's ridiculous to pay so much insurance overhead for the highest infant mortality in the developed world.

[Reaper]

I'm all for it, but I'm thinking that with our national debt on the rise it might not work as well as we like. IMO, it would be much better if it was on the state level, rather then the national level. Don't forget that your state also has responsibilities too, rather than depending so much on the federal government (which is getting increasingly corrupt).

[Realitycheck]

Actually, the current budget deficit is surprisingly relatively low at 1.58 billion. I'm thinking that all of this extra revenue has come from fuel tax on inflated gas prices.

 

I was thinking that it might be a problem to implement this type of change right as baby boomers start hitting the system. However, any system like this on a federal level would surely do away with Medicare and all of the accounting for baby boomer Medicare would just get conveniently merged into the new system. Of course, the overall issue of the bubble bursting would still be there, but the accounting of it wouldn't really be a problem.

 

I'm not so sure how or if a state-run system would be any better than a federal system other than it just complicates the system more than it already is. Many states do not tax employees directly, so that would be one obstacle, placing the entire burden on employers. Then you would be denying service to people who are from out of state, or forcing them to have secondary health insurance. Changing the entire meaning of the medical existence is a huge change no matter how you dissect it.

[John Cuthber]

"Apparently, Arnold has embarked on his own campaign to do universal health coverage, giving the rest of the world another reason to move to California besides the year-round 70 degree weather."

 

The weather might be a reason for me to move but I already have cradle to grave state-funded healthcare. I think most of Europe does too, so I don't see the rest of the world being very impressed.

[CDarwin]

I'm all for it, but I'm thinking that with our national debt on the rise it might not work as well as we like. IMO, it would be much better if it was on the state level, rather then the national level. Don't forget that your state also has responsibilities too, rather than depending so much on the federal government (which is getting increasingly corrupt).

 

State's just can't afford that any more. That's the problem. In Tennessee we had something called TennCare that was about as close to state healthcare as any state had ever come and it nearly bankrupted us. The last governor had to gut it to balance the budget. People just aren't willing to pay Federal income tax to their state as well as to Washington, and that's what it would take.

Then you would be denying service to people who are from out of state, or forcing them to have secondary health insurance.

 

That's a big part of how Bredesen 'fixed' TennCare. Now you have to be in the state for so many years before you get anything.

[geoguy]

I'm all for it, but I'm thinking that with our national debt on the rise it might not work as well as we like. IMO, it would be much better if it was on the state level, rather then the national level. Don't forget that your state also has responsibilities too, rather than depending so much on the federal government (which is getting increasingly corrupt).

 

Health care in Canada is run by the provinces. Under our constitution health and education are provincial jurisdictions. This makes it much more efficient to meet regional needs because of differencs in demographics. The Feds set standards and chip in with money so that all regions receive a base line quality of care.

 

We lived for a while in Nevada and or health coverage was fine. Many of the differences sited in the press between private and public systems are often due to regional conditions, availability of hospitals, specialists and so on. Evidence is cherry picked to support either system. Our province has excellent health services but we also have several billions in surplus every year. In the USA a medical system run by the states might work fine but some of the depressed southern states would need a helping hand or the poorest of the poor will be on the fringes whether it's a private or public system.

[pioneer]

The capitalist health care system in the United States has the advantage of using free market forces. The result is the best health care system in the world, as far as the range of goods and services that are available at the wink of an eye. The problem is that it is has gotten too expensive for many people such that many go without health care.

 

The alternate is a socialize or nationalize health system. The problem with this is govenment beaurocracy is very inefficient. To much resources end up going into overhead, such that medical care will be rationed. This has already occurred in other western countries, who have tried this.

 

The other problem with government involvement, is once you create this monster you can never get rid of it. It just gets fatter and slower. For example, in Atlanta, USA, they spend about $8-9000. per student per year in the public education system. If they gave the tax payers half that they could send their children to an excellent private school and return half back to the tax payers. But the bloated monsters needs to eat and won't go away, so you pay twice as much for lower quality education. It is too well entrench politically, you need to keep throwing money at it.

 

The free market system is not perfect. One of the problem has to do with the free market driving up demand for goods and services. It sort of like if you own a fast food resturant. If an obese person came in you will not direct them to the salad bar for a cheap meal. Instead, you will make sure you offer them the option to supersize the fries and add an apple pie. If someone has insurance there is no reason to refuse extra care. But this extra care increases the costs across the board making it more expensive.

The socialized system has the advantage that it will be too inefficient to offer all the extra frills. It will be lucky if it can maintain the basic stuff.

 

The other approach is to leave the free market health system in place, but look for cost savings by approaching the problem at the insurance level. This is a huge middleman that does skim quite a bit off the top. Medical insurance not only supports the medical industry but also the insurance industry. It is a risky business allowing higher rates of return.

 

Again the two approaches are to allow the free market to allocate resources or allow the goverment to socialize the insurance industry. One possible cooperative effort would be for the government to help set up buying groups, where the economies of scale will allow insurance rates to fall and allow an excess which will bring everyone under the umbrella. It would have to set up as a self sufficient business (post office) and not a govenment agency (EPA) that grows larger by meddling and interferring, in such a way, that assures it can to continue to grow fat and slow.

[ParanoiA]

I would be cheaper.

 

A government system that's cheaper? Exactly how many more examples of government waste and inefficacy do we need?

[Sisyphus]

A government system that's cheaper? Exactly how many more examples of government waste and inefficacy do we need?

 

You're acting like there's no counterexamples. Like, say, our health care system...

[CDarwin]

A government system that's cheaper? Exactly how many more examples of government waste and inefficacy do we need?

 

How many examples of the ridiculous overhead costs of the HMO/PPO system do you need? Americans overpay $477 billion per year for healthcare that by many indices is worse than that of the other developed nations.

[geoguy]

You're acting like there's no counterexamples. Like, say, our health care system...

 

Americans spends more per capita on health care than most western universal systems (every one else) but has the highest infant mortality rate and about the lowest life expectancy.

[Pangloss]

I realize this isn't an original thought, but I've been wondering if there's something to the notion that the main reason for spiraling healthcare costs is that a kind of feedback loop has developed between legislators, healthcare providers, pharmaceutical interests, and insurers. Each "solution" ratchets up the cost a bit higher.

 

A capitalist might blame that on legislation ("don't even think about socialized medicine -- look how bad it is already!") and a socialist might blame that on greed ("don't even think about avoiding socialized medicine -- look how bad it is already!"), but really what may have developed is something in between the two -- a kind of happy place where all parties get richer except the people stuck in the middle.

[Sisyphus]

I realize this isn't an original thought, but I've been wondering if there's something to the notion that the main reason for spiraling healthcare costs is that a kind of feedback loop has developed between legislators, healthcare providers, pharmaceutical interests, and insurers. Each "solution" ratchets up the cost a bit higher.

 

A capitalist might blame that on legislation ("don't even think about socialized medicine -- look how bad it is already!") and a socialist might blame that on greed ("don't even think about avoiding socialized medicine -- look how bad it is already!"), but really what may have developed is something in between the two -- a kind of happy place where all parties get richer except the people stuck in the middle.

 

That's pretty much how I see it, as well. It is very much like the military-industrial complex, with private military contractors and health insurance industry playing the same roll. A whole lot of money gets wasted, and that money buys the influence to make sure it continues to be wasted. The only difference is whether I'm writing my check to the government or the health insurance agencies.

[D H]

Americans spends more per capita on health care than most western universal systems (every one else) but has the highest infant mortality rate and about the lowest life expectancy.

 

Non-sequitor. How is this attributable to our health care system? I would attribute it instead to

• Obesity. Americans have a greater problem with obesity than do those in most other developed nations. There is a definite link between obesity and birth defects, birth complications, premature births, etc. Unfortunately, we are just leading the way. The rest of the world (unversal health care system or not), is starting to get obese.
  
• Poverty. Like it or not, there is a much greater income disparity in the US than in most other developed nations. The poor have worse health care (provided by the government) than the non-poor (provided privately). The poor have higher birth rates than non-poor and are more likely to suffer from alcohol/drug addiction, both of which magnify this effect.
  
• Illegal aliens. The US has a lot of illegal aliens, and illegals have lousy health care. If you want to make the problem with the number of illegals even greater, give them free, quality health care.
  
• Positive birth rate. Western European nations have a big problem with a birth rate that is below that needed to sustain their population. These nations also have universal health care. They pump an inordinate amount of money into prenatal and neonatal care to counterbalance this problem.
  

[Blade]

Medical insurance will not dissapear. People in my country can get treatment without medical insurrance but they will be fined because they don't have insurrance. here it's illigal to not be insurred.

 

And here in the Netherlands it's illigal fore hospital to refuse treatment. i'm not sure what will happen if they refuse to threat an not insured person but i am sure there will be hell to pay.

 

Hospitals get government money if they threat not insurred people.

[ParanoiA]

How many examples of the ridiculous overhead costs of the HMO/PPO system do you need? Americans overpay $477 billion per year for healthcare that by many indices is worse than that of the other developed nations.

 

So, how does investing in government lower those costs? With socialized medicine there is not competition. What method keeps finances in check and good quality of care? Why is a wasteful government monopoly preferred over private competition?

[Realitycheck]

I agree that socialized medicine would not promote advancement in the field, however, there should be a mechanism in place to garner payment from those who have no insurance and just get their credit reports thrashed in exchange.

 

Here is one major hospital corporation, Tenet. Basically, 16% of their revenue went unpaid due to lack of medical insurance. Apparently, this supposedly mirrors the national average of 16% not having medical insurance, or 46 million people.

http://asia.news.yahoo.com/061030/3/2s3sn.html

 

You ask how this is accounted for? Through higher prices for everyone else. Their is no other way to account for this unless it is subsidized. This is why Medicare tax should 6% rather than 1.45%.

[ParanoiA]

I agree that socialized medicine would not promote advancement in the field, however, there should be a mechanism in place to garner payment from those who have no insurance and just get their credit reports thrashed in exchange.

 

Socialized medicine doesn't do that either. It just redistributes the financial obligation to those who are already getting screwed by paying for insurance AND the copays for their own care - the people that don't sit around letting life happen to them and then crying because they have no insurance or any method of payment for health care costs.

 

You ask how this is accounted for? Through higher prices for everyone else. Their is no other way to account for this unless it is subsidized. This is why Medicare tax should 6% rather than 1.45%.

 

Then we're still paying for it. Either with taxes (subsidized) or with insurance and cost of care - either way the losers don't pay anything, but now you want those of us who DO pay to have to settle for a crappier system.... and why? Because of people who are supposedly poor and can't pay? Screw them. Let them get inferior care to mine. I pay. I work a job and don't sit on my ass crying about how the government, the people of this country, needs to fix my life.

 

The message should be: You want to whine bag and let life happen to you, fine, you'll get the same level of service returned to you.

 

This is the natural, inherent mechanism of incentive. I think people perceive it as heartless and cruel. It's not. It's quite appropriate.

[Realitycheck]

Socialized medicine doesn't do that either. It just redistributes the financial obligation to those who are already getting screwed by paying for insurance AND the copays for their own care - the people that don't sit around letting life happen to them and then crying because they have no insurance or any method of payment for health care costs.

 

You're just not seeing the big picture, or you have not read all of my posts. By forcing the issue, you are enforcing payment through taxes, eliminating costs, promoting efficiency. Plus, if someone wants to buy medical insurance for a higher standard of care at a better hospital, then it would only make sense to be able to deduct the same medicare costs from your health insurance, giving you exactly what you pay for. Of course, this is all very premature, as nobody is even discussing this on a federal level.

 

Then we're still paying for it. Either with taxes (subsidized) or with insurance and cost of care - either way the losers don't pay anything, but now you want those of us who DO pay to have to settle for a crappier system.... and why? Because of people who are supposedly poor and can't pay? Screw them. Let them get inferior care to mine. I pay. I work a job and don't sit on my ass crying about how the government, the people of this country, needs to fix my life.

 

The message should be: You want to whine bag and let life happen to you, fine, you'll get the same level of service returned to you.

 

Define loser. The homeless and jobless? Who really knows how many homeless there are? Here's one report that says 744,000, about .25% compared to 16% without insurance. Add another 5% for the jobless rate, and it pays to force people to buy insurance. It's a numbers thing. You shouldn't let your emotions get in the way of the facts.

 

I happen to care a lot about my credit report, so I don't whine. I get a payment plan and another job, where I am not self-employed. You do know how much more self-employed health insurance is than group coverage, right?

 

This is the natural, inherent mechanism of incentive. I think people perceive it as heartless and cruel. It's not. It's quite appropriate.

 

Yes, survival of the fittest is indeed wrapped up even into our government. Why can't we make obese people go on a diet? Why can't we make baby boomers take responsibility for their own generation? People are going to scam off the system regardless. Why not make them pay for it? It doesn't get any simpler.

[John Cuthber]

Last time I looked at an economics book it talked about economies of scale. In the light of that can someone please explain to me why a government run system (which is big) will always be less efficient than a private one (which is small)? I can see that it could be inefficient, but the assumption here seems to be that it will be lousy, just because it's run by a government. I think that if it's run badly by a government or a government agency like the UK's NHS, that means you have the wrong management. Because they are big they have big buying power and such; they ought to be able to do it more efficiently than a small scale operator.

[ParanoiA]

Last time I looked at an economics book it talked about economies of scale. In the light of that can someone please explain to me why a government run system (which is big) will always be less efficient than a private one (which is small)? I can see that it could be inefficient, but the assumption here seems to be that it will be lousy, just because it's run by a government. I think that if it's run badly by a government or a government agency like the UK's NHS, that means you have the wrong management. Because they are big they have big buying power and such; they ought to be able to do it more efficiently than a small scale operator.

 

It's not size, it's human nature. A government run business doesn't have any reason to save money, cut costs or anything. If they're losing money, they just raise taxes. Look at the US education system. In my city, they just poured 2 Billion freaking dollars into kansas city schools....guess what? Scores plummeted even worse - and now they want to pump in another 1.2 billion. Private business can't do that. It has to be competitive or customers go elsewhere or they go bankrupt.

 

There's no incentive for quality service. Who cares if you don't like the service, where else are you going to go? There's no punishment for losing business when you are a government enabled monopoly. Private business can't get away with that. Crappy service usually leads to a folded business.

 

When's the last time you had to deal with a government employee? Been to the department of motor vehicles lately? Have you ever seen any of these people give a shit about anything other than their sweet time? Have you ever seen any of these people get in a hurry for you? Please...

 

These are the idiots some want to handle healthcare. I thought everyone wanted to fix healthcare (as if something is wrong with it) , not bury it...

 

Look, I know socialism is trendy. But capitalism is our chosen system. It works and has problems. Socialism works and has problems too, but we didn't pick socialism. We're capitalists. We choose the benefits and disadvantages associated with capitalism. When you socialize medicine, you're just going to employ the same advantages and disadvantages as the other socialist countries deal with. How is that better?

 

Wouldn't it be smarter to diversify our systems from a global perspective?

[Realitycheck]

Paranoia gets 2 points for trying.