Should the US Start with the Premise that it WILL Provide Universal Healthcare?

[jackson33]

I'll accept your 0/2 defeat of my argument, but feel your totally mis-understanding my discussion with John. He feels the Australian Medicare System, would work for the US and I disagree. He feels the system is best for Australia, where I could argue that, this has not been my argument.

 

We in the US, are governed by laws and our laws 'in short' does not allow refusal of health care to any person. Whether laws in one State to folks from another, to visitors, travelers or people just coming here for services. While I may disagree with many laws or the reasons for them, it's our system. For any universal US Health Care System to work in the US, a good many laws would have to change, or the US will become the International Health Care provider for any person that can reach a Medical Facility, operated in the US or any Diplomatic/Military installation on the planet....IMO.

 

In Australia to even receive Medical Hospital Service, you must be a citizen of that Country, fall under a reciprocal agreement between several 'Commonwealth Nations' or HAVE an acceptable form 'International Medical Insurance'. I seriously doubt a person visiting will be denied life saving service, under international laws, but it and most all UHC programs are nothing what so ever like those in the US.

 

------------------------------------------------

Overseas Patients

TREATMENT COSTS FOR VISITORS THAT ARE PARTY TO

THE RECIPROCAL HEALTH AGREEMENT

The Reciprocal Health Agreement between eligible countries and Australia means that eligible travelers who visit Australia on a temporary basis can receive urgent medical treatment from the Australian publicly funded health system. This covers both illness and injuries. Click here for detailed information.

TREATMENT COSTS FOR ALL OTHER OVERSEAS VISITORS

Overseas patients are not eligible for Medicare, Australia’s Government health care program, which provides benefits toward the cost of medical treatment and free public hospital treatment. Therefore, overseas patients are responsible for the cost of their care. The average daily cost of care is AUD$1,300.00. Payment is required in full on discharge. Click here for a detailed brochure.

http://exwwwsvh.stvincents.com.au/index.php?option=com_content&task=view&id=515&Itemid=574

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If you go to the site, do click on details, finding the differences between service under Medicare (Austrailian UHC, program name) and those covered by private insurance. Note; Most those additional services with additional cost, goes to the Hospital a brief saving grace, for the losses no doubt from their States payments.

 

Another point has been the 2.4T dollar annual US Health Care Expenses and no one has addressed where or why those cost appear so high. Lets go over just one reason; To build and equip one facility in the US can range tremendously from place to place. Union labor, contract labor, right to work States or not, cost of land, permits, environmental impact and other studies, along with compliance to thousand of laws involving traffic flow, access to facility to every single stage of the construction itself. While cost of equipment is set by the manufacturer and pretty much consistent, the people that install, maintain, operate and diagnose can vary no less than under any business model. The same holds true for personnel, the janitors/maintenance folks to Nurses/Doctors, local taxes to States if applicable on toward the utility cost.

 

http://www.ahd.com/state_statistics.html

 

This site, gives you a slight view of where that 2.4T cost actually is spent, coming from Government, Insurance Companies to out of pocket patient care which for the most part is based on operational cost, including for those that cannot or do not pay their own bills. 1.6 Trillion and does not include Government Funded Institution, or Full/Partial Service/Care Nursing Homes or the cost of every School or business required to have medical personnel on staff, during certain times.

 

Another point, I have tried to make is the already wide ranging of needs and services, based on different life styles in different areas of this Country. The above site, gives an interesting peek into how wide a range this actually is. The average of USED hospital beds per day of all States is about 66% or two thirds, over the year. These are 'Staffed Beds' which are so, 24/7/365. I feel sure, most if not all are not truly staffed but could be in a moments notice and these folks are either doing odd jobs around the hospital/facility or relieving others that are running other departments running near capacity. Then cost of care per day per used bed DAY on average in the US is $8584 ($700.00 above the annual cost per person for medical service). In Guam that means 2104/day.

 

CharonY; Sorry, but I feel 'knee jerk' responses are based on personal desires for free (thought) coverage itself, then without an understanding of US Federal Authority on the issue itself. If I though for one minute, that every person in the US, could possibly receive the same quality of Medical Attention under a Federal Program and this would reduce the cost to every tax payer or person receiving to even one cent less, I would be pleased to argue FOR that plan.

Edited April 23, 2009 by jackson33

[CharonY]

So it boils down to the assumption that there are specifics in the US not found anywhere else in the world? Jackson, you do provide arguments I am not able (with my limited knowledge) to deduce whether the points really address the issues. I am not saying that you may not have a point somewhere, but it is hard for me to see what you want to convey. John tends to address specifics and elaborate on it, making it easier for me to understand. This is not meant as criticism it just appeals more to the way I analyze things.

 

At this moment it may be easier to limit it to a comparison of the Australian system, however, it has to be noted that no one is advocating a 1:1 carbon copy of it, and there are plenty of other systems around. I am a bit limited on time atm, however just to address your first point:

you mention that

We in the US, are governed by laws and our laws 'in short' does not allow refusal of health care to any person.

This is not true to my knowledge. You only cannot be refused in the emergency room, but I am pretty sure that it also applies to Australia. You also stated that they have then to pay for treatment out of pocket. However this is also true in the US. If I am not insured physicians can deny treatment unless I go to the emergency room. And if I do, I have to pay out of pocket (if I am not insured). So I do not see anything here right now that justifies additional costs in the US (if that was your point).

 

Edit: with knee-jerk I was essentially referring to other sites in which the it was argued that it is bad because it is socialism. And then everything went downhill from there. I was not referring to any particular post here.

[iNow]

Jackson et al. - Don't let the desire for the perfect become the enemy of the good.

 

We need drastic change in our healthcare system, and this assertion is accepted by nearly all involved stakeholders. Any changes we make won't be perfect, but the changes can still be amazing, useful, and have profound impact on our collective benefit and well-being, as well as the well-being of countless future generations.

[jackson33]

CharonY; Every State regulates Health Care or backs institutions (Hospitals/CLINICS) by different degrees. Nationally the policy IS no Hospital Emergency room can deny, but most States have the same requirement for Clinics. However it's my understanding no person can be denied service from any Hospital or Clinic to a person being delivered by ambulance (reason so many illegals/legals) use ambulance in the first place. Prior to admittance and if not critical, a person can be refereed to another facility (Charitable/Religious/Benevolent) but if critical NO, they must by LAW treat the person and regardless of the persons ability to pay. California is changing some of these laws now...

 

http://cbs13.com/local/california.health.care.2.959918.html

 

In Texas, for instance a woman cannot be denied Prenatal to Birth medical attention. This may be true in other States as I understand 'Octomom', the lady given birth to 8, was in intensive care for some time and the 8 children given needed care, although possibly on welfare to begin with. http://en.wikipedia.org/wiki/Nadya_Suleman

 

As said, if the US actually forms a UHC system, all 50 States, 4 Territories, DC and the Federal Government are going to have to change hundreds of laws, in addition to several Amendments (Social/Government Acts based on) to the Constitution, or what I suggested would happen, would indeed happen. IMO.

 

Yes, I believe the US is unique, with regards to diversity under all it's member States, to any governing force on the planet that has even remotely initiated a form of UHC. I also don't think it's possible and any attempt by the Federal to take over the 75-80% NOT already Federal will first destroy the quality now offered, second destroy the incentives that created the first and in the end crumble the 20% of the US GDP that is now Health Services related, servicing those on UHC or other Systems around the world dependent on the US, climaxing in failure of the US as it is and the worlds economy. If this sounds 'Doom and Gloom" rhetoric, then my point is being made. Medicare/Medicaid, set out by itself is not sustainable, added already is the CHIP's program http://www.chipmedicaid.com/english/chart_income_guidelines.htm has already brought the time line down and any additional inclusion of free medical care (in many cases the main reason some work) IMO will tighten the time line. Think about it; The private sector, at least has an ability to increase the value of premiums over a time line and according to those chose to insure, where government TAKES by taxation from the economy (in the first place), has no desire or reason to properly handle and will not...For the rest of the CHIP's program see; http://www.chipmedicaid.com/english/index.htm

 

iNow; I would agree, no perfect solution for Health Care problems here or worldwide would be possible. Where I DO disagree with your premise ("We need drastic change") on is the suggested failure of the US system today, certainly comparable to others around the World and arguably those with 'said' UHC Systems.

 

My concerns for the latest generations or those in the future, go well beyond Healthcare. HC today being an obstacle to available wealth for these and those to enjoy life to the degrees most over 40 can remember. Frankly it's not current or future cost that will come with UHC, in any form (IMO), but that debt and cost which already exist or is obligated to now by todays generation and those in the future. My generation FAILED, though be it for benevolent reasons and the current sentiments seem to be adding onto or creating of like policy to those failures.

[JohnB]

He feels the Australian Medicare System, would work for the US and I disagree.

Not quite. I have continually said that it might be a good place to start. There is a difference.

 

To take your points:

On complex diagnostic equipment, think your talking about MRI Machines, can cost well over a million each (US, Canadian or your$), can weight 7/8 tons and require complex structures to house/maintain. It's not so much the cost but the potential use for the equipment in the first place. I live in a little town of 30K in NM and we do have one, built INTO the largest medical center in 100 miles any direction, probably servicing 100k people.

Of course. That is why we don't even bother a lot of the time. Private companies create Diagnostic Imaging Clinics that service the surrounding areas. Note that while the feds or insurance pay part of the bill, these are wholly privately owned companies with no managerial or other (except acceptable standards) input from govs.

 

I would add that in many (most) parts of Oz, 100 miles won't get you to the next town, let alone the next clinic. Hell, there are places where 100 miles travel won't get you to your next door neighbours house.

 

A thing to keep in mind about our system is that the govs run the "Public" hospitals. While these will have Clinics incorporated into them, all other Clinics are privately owned. Quite often, even the DI dept in a public hospital is actually a private company leasing space from the hospital and is a separate entity. So there are no "Government" Clinics, which I think is one thing that counts against other UHC systems.

List of fees; Again in the US, the cost per any service is based on local conditions. In large towns, some services (Dentures, Eye Glasses) can be extremely low compared to small town USA. A small town may be supporting a business model (cost of equipment/personnel etc) based on a small consumer base, while metropolitan areas have large population to draw from.

Again, how does this make the US situation special in any way? There are massive differences here between city and country costs, fully on a par with the US situation. This is a non-argument, invalid.

When government gets involved or the benefit/service is based on one figure, your forcing an arbitrary and artificial value for at least most of the rest.

I think I see what you mean, but I disagree. If a hospital is "Public", then it's on gov land and pays no rent, if "Private", then they own the land and pay no rent. This means that the costs are for equipment and staff, which will be roughly similar. If anything they are higher for those centres outside major areas as a premium is paid to get people to work there. Transport costs for supplies and equipment are also higher.

 

In general, the costs of running a 200 bed hospital will be roughly the same no matter where it is. So again, argument invalid.

 

Whether or not there is a large enough population to support a 200 bed hospital is a different question. Distribution of hospitals is (or should be) based on getting the widest coverage.

What if some one suggest to you, that all 53 members, should be involved in some activity that could only harm Australia in some way or that your PM suggested the other 52 States should bend to the needs of one Australian problem?

However, we are a group of nations, not one nation. My point in bringing up the Commonwealth was that it has as it's basic qualification for membership, Democracy. Just as I believe that UHC should be a basic qualification for membership in the group called "Developed Nations." While it shows my view that you should have UHC, it has no bearing on how such a system should be run.

Another point, I have tried to make is the already wide ranging of needs and services, based on different life styles in different areas of this Country. The above site, gives an interesting peek into how wide a range this actually is.

Again, so what? Alaska has 16 hospitals with 1,107 beds while North Dakota has 14 hospitals with 2,070 beds. Aside from showing that the average hospital size is smaller in Alaska, what's your point? We have big hospitals, medium sized hospitals and small hospitals too. The American situation is neither unique nor unusual.

 

There is no requirement in a UHC system to only have big hospitals. Smaller local sized hospitals with ambulance transfer to larger city hospitals is quite capable of providing adequate care and treatment.

Another point has been the 2.4T dollar annual US Health Care Expenses and no one has addressed where or why those cost appear so high. Lets go over just one reason; To build and equip one facility in the US can range tremendously from place to place. Union labor, contract labor, right to work States or not, cost of land, permits, environmental impact and other studies, along with compliance to thousand of laws involving traffic flow, access to facility to every single stage of the construction itself. While cost of equipment is set by the manufacturer and pretty much consistent, the people that install, maintain, operate and diagnose can vary no less than under any business model. The same holds true for personnel, the janitors/maintenance folks to Nurses/Doctors, local taxes to States if applicable on toward the utility cost.

All these things apply in every nation, they are not unique to the US. So another non-argument.

 

None of the above however explains the cost. The fact is that you are already paying 3 times as much per capita as everyone else to recieve second rate services. The question is not what you spend the money on, but rather why does it cost 3 times as much? Is someone profiteering?

 

Just to be clear. I am a fan of our system, it's not perfect, but works tolerably well in providing world class services at reasonable cost. The main reason for comparing the US to Australia is that in the Western World there are only three nations of comparable size. The United States, Australia and Canada, and I know bugger all about the Canadian system.

 

Solutions that work for piddly litle European nations will not work for our nations because of size and variations in needs. The United Kingdom packs 50-60 million people into an area smaller than Michigan, solutions that work there just won't work for us.

 

So it's not that I think you should have our system, it's just that there is nothing else that the idea of a US UHC system can be compared to. The field is severely limited.

 

Some more points as to costs;

The average daily cost of care is AUD$1,300.00.

St. Vincents is a good hospital, BTW. Right next to the high cost Sydney CBD, in one of our largest cities.

Then cost of care per day per used bed DAY on average in the US is $8584 ($700.00 above the annual cost per person for medical service). In Guam that means 2104/day.

So why is the US cost per day per bed 8 times the Australian figure?

 

It's not the pay rates, that's for sure.

Nurses in Australia recieve about A$22/hour. Payscale.

Nurses in the US recieve US$21.90/hour. Payscale.

 

These rates are for Registered Nurses with less than 1 years experience. (They're worth more than that though.)

 

In a nutshell. The US is not special in any way WRT pay scales or costs, yet you pay 3 times as much for less service. (And that's without including bankruptcies and the like which effectively deny some 2 million Americans every year of reasonably priced healthcare.) The system model you are using is flawed.

 

This is where your "District" model falls down. It is esentially a modification of your current "Insurance" model. The current model fails. It doesn't work. It doesn't come remotely close to providing world class care at reasonable cost.

 

A "District" model, as I showed previously, will result in more inequality and less choice for the individual. Tying yourselves as you do to the Insurance companies is creating a class of "serf" workers whose aspirations are limited by what insurance they can get. People are limiting their careers depending on their cover.

 

This isn't "Freedom", it's barely more than slavery. It's just plain wrong. A system that limits the dreams and aspirations of it's citizens is wrong and should be abolished. Not modified or changed, outright abolished. It is against everything your Founding Fathers stood for and dreamed of for your nation.

I also don't think it's possible and any attempt by the Federal to take over the 75-80% NOT already Federal will first destroy the quality now offered, second destroy the incentives that created the first and in the end crumble the 20% of the US GDP that is now Health Services related,

Bollocks. The US economy didn't crumble when health spending was only 10% of GDP, why would it crumble if dropped from the current 20%?

 

Secondly, as has been abundantly shown, the current quality of care is substandard when compared to the ROW.

Yes, I believe the US is unique, with regards to diversity under all it's member States, to any governing force on the planet that has even remotely initiated a form of UHC.

This is the real reason that you have a stumbling block. You have too many State govs (and apparently people) who put their petty posturing and selfishness before the good of all the people. You will never have a working UHC system until your people decide that access to world class service at a reasonable price is more important than petty State rights.

 

You've done this before, in Defence, in Policing, Mail, why not healthcare?

[The Bear's Key]

Thanks JohnB for caring about our nation enough to dedicate all the time/effort you've put into your research and writing it here.

[jackson33]

Health care in South Africa

South Africa's health system consists of a large public sector and a smaller but fast-growing private sector. Health care varies from the most basic primary health care, offered free by the state, to highly specialised hi-tech health services available in the private sector for those who can afford it.

The public sector is under-resourced and over-used, while the mushrooming private sector, run largely on commercial lines, caters to middle- and high-income earners who tend to be members of medical schemes (18% of the population), and to foreigners looking for top-quality surgical procedures at relatively affordable prices. The private sector also attracts most of the country's health professionals.

http://www.southafrica.info/about/health/health.htm

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John: Have sited So. Africa, since it seems to be going against the grain, privatizing over Government Control by the people themselves. Also Health Care is offered in total, for primarily essential services.

 

Results of any Health Care System practiced anywhere, SHOULD be considered, including the failures. My question is whether the US as a collective (all States) is obligated to any National Policy covering people with little to no financial obligation (toward or from) another. Then staying under the US System for governance where States are obligated for Social needs as seen by their people. Remember, I think the "starting point" should be from and by the States, then based on how they feel other systems have worked. I did suggest 'Districts', only to emphasize the differences in attitudes/need from one to another.

 

I did explain we are one Nation, but with limitation to what that Government of all means. Health Care, Education, Trash Pick up and thousands of issues are the States right to decide course. Where this has worked is when ONE State has adopted some acceptable means to solve a problem, others then follow to some degree. Keep in mind 7 States have absolutely NO income taxes, most others are based on a percentage paid to the Federal (5-20%) and each has adopted other forms of taxation to make up differences to whats needed to fulfill their obligation (acceptable to the people) such as Property Taxes, School Taxes, Sales/Motel Taxes, Gas/Diesel/Toll Taxes, in the adding up that requirement. Federal Taxes were and are intended to the 'Cost of a Federal Government' and have only recently been connected to social needs. These are redistributed back to the States, which in effect makes no sense...at least to me.

 

Even today in the US, for a Hospital/Clinic to qualify as a Medicare/Medicaid provider, must conform to certain requirements, are regulated and must provide documentation. Also each person on these programs are told what is or is not covered. I received a 207 page 2009 such book, in most part telling me what's not included. Each year since 2003, these 'NOTS' have increased.

 

In 1990, cost of Health care per patient in the US/Canada and Australia per each currency were about the same, around 2k per capita/year. People going on SS would buy their own Insurance over accepting Medicare (minor cost differential with a great deal of choice and better services) and General Medical Policies were affordable to a great majority of Families. What generated the increases from then to now here and not everyplace else are arguable and can vary for causes, but in my mind there has been some political agenda involved. Not only from the Federal Level (Ms Clinton 1993) but in many if not most States. This all another topic and not very interesting to most...

 

Your making my point on National sizes and/or population density. England and NJ or Delaware are about as dense and many metropolitan areas in the US are higher than London. Then Alaska, Montana, Wyoming ARE similar to Australia (Add Canada) where most of their totals are localized. Florida, Texas, Ohio have reasonable space with concentrated areas are well spread out...In all cases they have different priority for general needs and based on different 'cost of livings' have different afford abilities, disregarding the their rights/obligations to determine policy in the first place. Might add Russia, has by far the largest land area of any country, with about 140 million folks and probably a far worse Health Care System than most. Australia and China about the same land area, with no comparison. You have to add needs/cost of living and acceptability by the people into any equation.

http://www.geohive.com/earth/pop_top50.aspx

 

I am impressed with your arguments, feel you have a slightly misguided understanding of the US Government/System in general but most important sincerely feel we (US) should as a group of States should show compassion for all out States and Territories. It's simply not economically practical IMO, with an end result of going off that cliff (irreversible, once implemented) would be the end of very proud, individualist society.

 

You've done this before, in Defence, in Policing, Mail, why not healthcare?

 

Please accept this educational; Defense in the US was originally a State Issue, under what was called 'State Militias'. We also had a National Military, but it's obligation concerned with co-ordinating these Militias and/or protecting the the frontier (western expansion) or where militias would have no authority. During the 1898 Spanish/American War it was decided the militias were ineffective as independent defenders and militias disbanded becoming whats known as a "National Guard'. The NG in any one State remains under the authority of a State Governor, to this date....

 

Policing, very much the same thing and has not changed; The Federal FBI or whatever, can only be used on National Issues, where more than one State is involved or when the State request assistance. Unless one of these things are invoked the Federal cannot step in on any States policing activity, nor can any State Issue be decided by the Federal Courts, until the issue has gone through the State Courts and show cause for having a US Constitutional or US Law connection.

 

Yes mail service was set up as a Federal Obligation, probably because even then most mail would travel between States. The funny thing here is there have been and are now alternative systems in mailing (FedEx/Big Brown/Telegrams/Phone Calls/public airways-Radio TV) just few that competed over time with the mail, all regulated by the same laws the USPS is...

[JohnB]

I ignored Russia and China for the simple reason that while both those nations are similar in size to ours, their societies are not. Because of the societal differences between (for example) China and the US, I doubt any comparison would be meaningful.

 

The changes in South Africa probably have more to do with their 21% unemployment rate than providing full service to their people.

 

What generated the increases from then to now here and not everyplace else are arguable and can vary for causes, but in my mind there has been some political agenda involved. Not only from the Federal Level (Ms Clinton 1993) but in many if not most States. This all another topic and not very interesting to most...

Actually I would like to hear your thoughts on this, would you care to start another thread on this matter?

I am impressed with your arguments, feel you have a slightly misguided understanding of the US Government/System in general but most important sincerely feel we (US) should as a group of States should show compassion for all out States and Territories.

Well shucks, I thought they were rather good myself. Seriously, from the outside the Federal/State relationship over there sometimes looks really, really strange.

It's simply not economically practical IMO, with an end result of going off that cliff (irreversible, once implemented) would be the end of very proud, individualist society.

Concerning the financial side, as has been shown, everybody else is spending less money than you are. So I honestly can't see how it's not "economically practical".

 

As to the second part, I think you're over reacting. Your proud and individualistic society is already being destroyed by the growing percentage of people whose dreams are being subjugated by the need for insurance. People who are forced to choose their employer or profession not by their own wishes and desires, but by whether or not it provides health cover are not free.

 

They are not individuals, they are drones, serfs. Because of their desire to protect their families access to (company provided) healthcare they will endure indignity and exploitation without complaint. They might be many things, but "proud" will not be one of them. Held hostage by their families health needs, and powerless to do anything about it, they will be happy little slaves. Or Else.....

 

A properly run UHC system doesn't make people dependent upon the state, it frees them. It allows them to experiment and try new enterprises, secure in the knowledge that even if they do stuff up "Little Jimmy" will still have access to good healthcare. It's the states way of saying "Go on, try. If you fall it will be from your own mistakes (which are your problem) and not from sickness, disease or medical bills."

 

How many brilliant chemists, physicists and researchers have you lost because they couldn't afford to study and pay for insurance so they took a job instead? Could one of them have found the cure for cancer? We'll never know because your system won't let them try.

 

I urge you to consider the words of your own Pledge of Allegaince:

"I pledge allegiance to the flag of the United States of America, and to the Republic for which it stands: one Nation under God, indivisible, with Liberty and Justice for all."

 

Before you continue to let petty State politics divide your nation to the detriment of it's people.

 

Others have said it before me;

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness. That to secure these rights, governments are instituted among men, deriving their just powers from the consent of the governed. That whenever any form of government becomes destructive to these ends, it is the right of the people to alter or to abolish it,

Liberty includes freedom of choice, something that fewer and fewer Americans have. I would say that your current health care system is "destructive to these ends", wouldn't you?

 

The choice of action is, as always, in the hands of the American people, and I, like Senator Carl Schurz before me have faith in you. I finish with this quote from the Anti-Imperialistic Conference, Chicago, Illinois, October 17, 1899;

“I confidently trust that the American people will prove themselves … too wise not to detect the false pride or the dangerous ambitions or the selfish schemes which so often hide themselves under that deceptive cry of mock patriotism: ‘Our country, right or wrong!’ They will not fail to recognize that our dignity, our free institutions and the peace and welfare of this and coming generations of Americans will be secure only as we cling to the watchword of true patriotism: ‘Our country—when right to be kept right; when wrong to be put right.'"

 

I think he would agree that the way you are heading is wrong, and should be put right.

 

Cheers.

Edited April 28, 2009 by JohnB

[jackson33]

John; Obviously were repeating our arguments over and over, with different analogies to justify them. Briefly, your original point (to me) was that the US should look at the Australian Plan for HC and that in your opinion our cost, probably quality and fairness issues would be solved. My arguments have allowed looking at all HC plans, including your program, but that for several reasons that program, "In my opinion" would not or could not work. I have based my arguments on our form of Government, our differences in cultures, attitudes and all the laws that govern each State. I have suggested this is a misunderstanding on your part and no doubt many American's that have stopped posting, but would agree with you in principle.

 

What your seeing through media, a fear of being critical of a historically elected president and an almost alarming National acceptance that one person can personally change so much that each individual with a specific grievance is expecting an actual change in his/her grievance. Just yesterday for example, an apparently intelligent business owner (Limbaugh radio show caller) and considering himself a 'Conservative' was complaining that Mr. Obama had promised to give HIM relief on his mortgage payment, by pressuring HIS bank to to reduce his 2,400.00 monthly payments, while HIS business was suffering from the economy. People have been dropping insurance by the thousands, letting auto payments, credit card payment, home loan payment and hundreds of such obligations go unattendent thinking if they show stress, government will step in and cure their self made ills. Not to forget the 5/6 million folks that have lost jobs this year alone, have real problems and in many States eligible for unemployment for over a year and up to 95% of their original pay.

 

If any other Country is similar to you (today), IMO it may be Russia. 150 million folks spread out over twice the land area as the US, BUT populations are concentrated in a couple areas. They are also a commodity driven economy and rely a good deal on tourist, have a deep cultural background and though different ideologies are accepted by their peoples. However it's the extension of that thought or the differences in cultures/traditions that is American, I still don't think you get. There is very little likeness from our NE States (New England) and the Southern States, including Virginia. There are tremendous differences in the NW (Idaho/Montana, the Dakota's and the farm belts of Kansas to Ohio. WV is a mining State, as is Ky/Tn and no place is like Texas, California or Alaska. The Spanish traditions/cultures are strong along the south and up the west coast, French Cultures in Louisiana, German along the northern sections, Irish in the the far NE and so on...

 

Briefly on the 'preamble' to the 'Declaration of Independence' made to the 'King of England', which by the way was rejected; All people are created equal, whether from a theological or genetic viewpoint, and it's agreed that all people should have equal opportunity (opposed to birth rights, royalty etc). However there are simply no equals in reality. Each conceived fetus is subject to it's mothers choices ( or the sperm donor) and then a parent or parents choices on to their own choices through life. At any point, even in old age a person can alter the course of his/her life for the better or worse. What your are suggesting is that these choices if not made for the better are the responsibility of those that played by the rules or chose well (wealth not always the end result). We have laws, we have all kinds of programs, all kinds of treatments, many offered free to help the helpless and or guidance for those not playing by the rules, but to carry this to 'birth to grave' government responsibility, which is the intend, is neither possible, practical or traditionally American.

Frankly from my study of your Country, it's should not be traditionally Australian.

 

Two not addressed issues which are involved with US HC, are the Constitutional Responsibility and laws, and how we got to this mixed obligation in the first place (Where cost factors began to rise). I may try a thread on the combination, but it will be when I can spend more time posting. I do thank you for your interest, admittedly have learned a few things while researching my answers, but will also admit my opinions have firmed on whats been learned...

[iNow]

I must say, Jackson... It seems to me that your entire argument is, "I can't personally fathom how it would work in the US." You have offered no on topic rebuttals, no specific challenges which cannot be overcome, and are basing everything on your opinion alone. From a third party perspective, your opinion is not enough, and the numbers speak for themselves. John has managed to place you into checkmate, and I wonder if you realize it.

 

Not only can we provide UHC, but we can do so by spending less than we are today. More care at less cost. The logic is inescapable, no matter how much you raise the specter of state power.

[JohnB]

jackson, I realise that ther are many different facets to the American society. The big thing here is to simply ask "Are the people in each State American or not?"

 

Is someone a Texan first and an American second or vice versa? From what you say, it would appear that people are loyal to their State first, and their nation if it's convenient. That's a recipe for disaster.

 

I'm a fiercely proud Queenslander, the only thing I have in common with Victorians is that we both hate Sydney. But I'm still Australian and accept that what is good for the vast majority of Australians will also be good for the vast majority of Queenslanders.

At any point, even in old age a person can alter the course of his/her life for the better or worse. What your are suggesting is that these choices if not made for the better are the responsibility of those that played by the rules or chose well (wealth not always the end result). We have laws, we have all kinds of programs, all kinds of treatments, many offered free to help the helpless and or guidance for those not playing by the rules, but to carry this to 'birth to grave' government responsibility, which is the intend, is neither possible, practical or traditionally American.

So a person who cannot get insurance due to a congenital heart condition is "not playing by the rules"? They have some sort of "choice"? You must be kidding.

 

A friend of mine is about to have a hysterectomy to prevent her cancer spreading. Exactly what wrong "choice" did she make? Come on, she's 28, she must have done something wrong by your arguments. Or did she just break the "rule" about not getting cancer? Under your system she would never again be eligable for insurance because she will have a "pre existing condition".

 

It's not about "cradle to grave" security, it's about showing compassion for people caught by things they can't avoid. It's about realising that someone who is having to face the fact that she will probably never have children has enough on her plate without having the extra worry of how to pay for the operation.

 

Also, as I've said before, our system doesn't cover Dental, Optical or Cosmetic Surgery. Although we do cover reconstructive surgery and some cosmetic surgery if the psychs deem it necessary. "Cradle to grave" security is about the last thing it is.

 

I find it personally amazing that Americans can think the way they do about their own. If there is a disaster anywhere on the planet the US is there as fast as possible to help. You'll divert entire fleets to give aid to striken nations and ask for nothing in return. Yet when it is suggested that the same compassion could be shown to your own people, the cries of "cradle to grave" security arise. Frankly, I don't get it.

 

iNow, thanks for the vote of confidence. Cheers.

 

The Bear's Key,

Thanks JohnB for caring about our nation enough to dedicate all the time/effort you've put into your research and writing it here.

Not a problem. As you might have gathered I'm a great fan of American civilisation. And I will do all I can to help it happen.

[iNow]

I find it worth noting that Jackson33 is not representing an American majority opinion here. Most of us recognize country first, and have only minimal concern over state power (recognizing that it's relevant and hugely important in many arenas, but that healthcare for citizens is not really one of them). Most of us see that we can do better, and that splitting things up state-by-state is a recipe for disaster, regardless if we support UHC or not.

[Saryctos]

I find it worth noting that Jackson33 is not representing an American majority opinion here. Most of us recognize country first, and have only minimal concern over state power (recognizing that it's relevant and hugely important in many arenas, but that healthcare for citizens is not really one of them). Most of us see that we can do better, and that splitting things up state-by-state is a recipe for disaster, regardless if we support UHC or not.

 

I think federally allocated funds for state run UHC systems would provide better results than federally funded & managed UHC. States have an easier time changing legislation, since it affects less people and smaller dollar amounts. If you create a multitude of systems you get to see what works and what doesn't. In a sense the states' separation represent their own form of insurance against failure by spreading the risk over the federal budget and maximizing possible success through variations of implementation.

 

I'm starting to sway towards the UHC side of this thing. Simply because if the gov't is paying directly for services instead of "insurance"(even though it's in the name) then you can remove the primary bloat in the cost of medical care. The purchasing power of the federal gov't also greatly out weighs all the separate insurance companies, which can again reduce costs for the consumer.

[jackson33]

John; The only reason I have for arguing THIS issue in the first place, is my concern for the future of the American Traditional Culture. If you honestly believe my concerns are over the futures of individual States, then I am not articulating my points. I would expect you to argue anything that in YOUR opinion, would destroy Australia or it's culture, taking down Queensland along with it. I would suspect, from your comments, that you already have some disagreements along these lines, maybe not realizing there may be 'domino effect' happening and that at some point you may question, just where the heck is the ending of these seemingly unending changes in what was, not always in the best interest of anybody, much less the total populace.

 

It's difficult to take individual cases of what appears to be 'hard luck' and configure into what would or should be best for everyone. It's even harder when the person is a family member, a friend or neighbor. But, you have me in a corner....

 

If a person, no fault of their own develops a problem, has not been insured (for any reason), that person has a good many choices to secure attention. Most have family members (a spouse/parent or children or just some good friends), who can if they wish back (cosign) for loans to cover expenses for absolutely any problem. In the US, we have probably a thousand plus hospitals/clinic or foundations, designed to help virtually any problem and beyond that every State has advisory agencies which follow up and help. For the record, I have had the unfortunate obligation to tell a doctor twice, to go ahead with one full hysterectomy and one partial. One lived to 58, died from liver problems (yes, alcohol abuse) and the partial will probably live to 100.

 

The problem is many people have already made choices, having kids knowing their ancestry has had some problem or another (very common in Heart/Cancer/Respiratory conditions), has chose to drink excessively or do drugs (very common in todays aging American Society), has chose to work in mining/trucking/law enforcement/military or any number of what can be extremely stressful jobs or to shorten just done exactly whatever they have wanted with full knowledge of what could or even would likely be the consequences. I have and every one posting here today has to some degree done something. indulged in some activity or ignored advise. I won't take any case and follow to a cause, but would suggest, at some point most people know how and for what reason they will become sick, mentally impaired, physically disabled or in some manner dependent of some one else. I no more think it is the responsibility of government to pay for my errors in life, than I feel obligated to pay for others.

 

As for what American's want; Those with paid Insurance (employer, Unions or not) overwhelmingly are happy with out UHC, or the wealthy. Those on SS or covered already by government are reasonably happy, which includes most our poor folks and those with current problems (for whatever reason) and can't afford the added cost, or those that simply believe it's a government responsibility in the first place. Below is a fairly good poll, on the issue, but in general polls vary so much, I don't feel any are creditable. Think in 1987 or so, Reagan wanted to Federalize Catastrophic Insurance and was defeated by AARP, for the record...

------------------------

 

Public Preference:

Current System or Universal Coverage?

 

Current system: 32%

Universal coverage: 62%

Universal, with waiting lists for non-emergency treatment: 39%

Universal, with limited choice of doctors: 35%

 

 

 

Current Satisfaction Among Insured Americans

 

Satisfied with current costs: 64%

Dissatisfied with current costs: 34%

 

 

 

Future Worries Among Insured Americans

 

Worried about future affordability: 59%

Not worried about future affordability: 40%

 

http://abcnews.go.com/sections/living/US/healthcare031020_poll.html

 

 

Massachusetts also began an experiment with socialized health care a few years under Governor Mitt Romney. While initially touted as a wonderful utopia, reality is now beginning to seep out and we are seeing the same cost explosion and increased wait times that befalls every other socialist experiment in the world. Why do we never, ever learn???

I lived in England for three years and saw nationalized health care up close and personal. I experienced it first hand a few times, one of those sitting in an empty waiting room for hours vomiting into a garbage can waiting to see a doctor after getting food poisoning.

http://www.dakotavoice.com/2009/03/poll-most-americans-satisfied-with-health-care-system/

--------------------------------------

 

John; This site, gives an idea how actual labor (nurses) can very in this one country, think you referenced some post back...

 

http://www.payscale.com/research/US/Job=Pediatric_Nurse/Salary/by_State

[Pangloss]

I find it worth noting that Jackson33 is not representing an American majority opinion here. Most of us recognize country first, and have only minimal concern over state power (recognizing that it's relevant and hugely important in many arenas, but that healthcare for citizens is not really one of them). Most of us see that we can do better, and that splitting things up state-by-state is a recipe for disaster, regardless if we support UHC or not.

 

iNow, appeal to ridicule is not an acceptable argument on this forum. It is a logical fallacy. You do not speak for this community, and I expect you to challenge opinions from your own perspective, not the perspective of others whom you purport to speak for.

 

http://en.wikipedia.org/wiki/Appeal_to_ridicule

[iNow]

I was not making an argument. I was making an observation. JohnB kept commenting, "I don't understand you Americans with your huge focus on states rights" and the like. I was simply informing John that I don't believe Jackson is representative of the majority.

 

No appeal to ridicule. I do not think that phrase means what you think it means. I was not making any argument, nor using an attempt to mock Jacksons character in place of supporting a specific point.

[Pangloss]

Really? Let's see...

 

I find it worth noting that iNow's opinion above is not representing an American majority opinion here. Most of us recognize that we speak for ourselves, not others, and have only minimal concern over local community opinion (recognizing that it's relevant and hugely important in many arenas, but that community support for one's opinion is not really required). Most of us see that we can do better, and that subverting one's opinion to the will of the community is a recipe for disaster, regardless of we support the community or not.

 

Nope, still seems like appeal to ridicule to me.

[iNow]

Nope, still seems like appeal to ridicule to me.

 

Actually, that would be a strawman, but whatever.

[ParanoiA]

In a sense the states' separation represent their own form of insurance against failure by spreading the risk over the federal budget and maximizing possible success through variations of implementation.

 

Sadly, this built in benefit is largely ridiculed rather than being used. We're too busy standardizing and centralizing to notice we missed the point.

 

 

The only reason I have for arguing THIS issue in the first place, is my concern for the future of the American Traditional Culture.

 

You certainly have fought a brave battle. The problem with your logic here is a structural one and can't be repaired with layers of tradition. One's health problems are *not* determined solely by "bad choices", but rather by an essentially unquantifiable mix of choices and genetics. While that still doesn't make a case for government's responsibility, it at least makes the case that it's not realistically feasible for everyone to make a perfect decision and have every dime they'll ever need for health care and it does not support the moral appeal in accounting for one's behaviors.

 

This may be a piece of the American traditional culture that needs to be buried.

Edited April 30, 2009 by ParanoiA

[JohnB]

jackson, I think it's fair to say that we can agree to disagree on this topic.

 

While I think I came out ahead on points, I'd like to thank you for your comments. It's nice to see that a topic can be debated from widely different viewpoints without descending into insults and the like.

 

You are a respectable and honourable debating opponent. Thank you.

 

A thought that occurred to me today as to why I think a wholly private enterprise system won't work well is this. A company exists to make money, the directors of that company have a legal obligation to maximise the profits.

 

The insurance companies don't exist to help Americans pay for their healthcare costs, they exist to make a profit. Almost by definition, the health needs of the citizens must come second to profit making.

While that still doesn't make a case for government's responsibility,

The thing is that we are talking about the health of the citizens of a nation. Companies don't have citizens, they have customers. As soon as you speak of "citizens", you automatically involve the government.

 

jackson, I take your point about the British system and I've heard horror stories as well. The thing is to look at systems and find out why they went wrong as you can avoid those mistakes. A fully nationalised system is IMO as bad as a fully private system. That's why I like ours, it's a mix of the two.

 

As I said earlier, I would be interested to hear your thoughts on why costs relative to other nations have blown out in the US. And again, thank you for the thoughtful debate.

 

Cheers,

 

JohnB

[ParanoiA]

The thing is that we are talking about the health of the citizens of a nation. Companies don't have citizens, they have customers. As soon as you speak of "citizens", you automatically involve the government.

 

But where's the limiter in that statement? I can justify all out socialism, or even communism using "health of the citizens of a nation". Food is more important and vital to the health of the citizen than medical care. Everyone will need to eat, every damn day, but not everyone will need healthcare everyday. Food is far more important to the health of the citizen than medical care, yet we don't have a universal grocery system - we just swoop in at the last minute and offer food stamps to those who can't afford it - just like healthcare, swooping in at the last minute and providing service at the ER.

 

What about nutrients and vitamins? The health of the citizen dictates we must provide all of those for the citizens, since they're not customers. Same with college education. It must be nationalized because stupid people make unhealthy choices, for the sake of the health of our citizens we must nationalize every single thing we can think of that makes a connection to "health of the citizen".

 

These moral arguments fall flat on their face because there is no automatic implication that your neighbor is somehow responsible for your plight. When you use the word "government", replace it with "your neighbor", because that's what our government is - the citizens themselves.

 

So, you're saying that when we start talking about the health of the citizen, it automatically involves my neighbor - somehow he's obligated to me. I object to that. He doesn't owe me squat. It doesn't matter if I got an illness I didn't deserve or had no control over - it still doesn't create a logical obligation on strangers in the land.

 

To me, the stronger argument is pointing out the structural, foundational problem with capitalism and healthcare - we *cannot* use free market forces exclusively since the most basic economic requirements of trade in our free society cannot be implemented - we will not let people die; we will not restrict services for non-pay; we are undermining free trade between citizens - and Thank goodness!

 

Perhaps that's a moral argument as well. But as long as we're going to undermine the fundamentals of capitalism, then any downstream implementation of nationalized healthcare is justified. We are rationalizing around the principle of free trade, no doubt, and I see no way around it. As libertarian as I am, I still feel justified in robbing my neighbor to save a sick citizen. I think we have to admit that instead of doing intellectual flips and summersaults, trying to make believe we're performing a necessary function of government.

 

Universal healthcare, in whatever form it takes, is justified because we have already established we are not willing to follow through on the basic principles and obligations of trade in our society - therefore, the next logical desicion is to make it function better and more efficiently.

 

I agree with Universal Healthcare, just for entirely different reasons. No surprise there.

[jackson33]

ParanoiA; Traditional was linked to individualism, which IMO is what created this country. Most of the World pre-1776, was based on 'birth right' of those born. You were what you were born into, whether be it a surf, for breeding, a gladiator or into royalty. Many that formed this country were in fact English Royalty, giving up those rights (plenty) to establish their own significance. Generations of American's, along with other Nations that followed including Australia, Canada, England and all the Industrialized Countries have recognized this trait as something good for their people and in some manner have followed. No, I don't think it's time to bury Individualism, the spirit that makes a person feel special to themselves, their family, friend, City, State or Nation, or in a few cases the World, something important. It has been that spirit, that trait or quality in a person that has spawn both good and bad in humans and brought the world to an understanding of the importance of accepting the acceptance of diversity.

 

This thread applicably was started on the notion, the US Government should establish the premise, that they are should to some degree provide all citizens with Health Care, then working up to how to accomplish that result. My first impulse was 'what's so bad about the system to begin with' and elsewhere had written;

 

--------------------------------------

"I am really not sure the American Health Care System is all that bad. Cost are

explainable, though not acceptable, service by comparison must be pretty good

and the latest, most up to date equipment available to every person. We do have

a shortage of Doctors, again explainable, but utilize only 2/3rd's the Hospital

Beds, have all sorts of specialized services available for any segment of

society, with the easiest accessible service on the planet to anyone that get to

a Hospital, Clinic or receive treatment on any ailment known to mankind. I

really don't understand folks from around the world that seemingly do not trust

their government placing the one necessary service for existence in those hands

or the average American, knowing full well our Federal Government is lacking

something, from one Administration to the next, wanting their health care

dependent on that entity. It makes absolutely no sense to me..."

---------------------

I do agree, that a person born in the US, or any Nation in their County, should have certain rights, do believe in law and my National/State Constitutions and will obliged to the City Charter, where ever I live. This may include paying School Taxes, for children that have long graduated, of Tobacco Tax's, gas/diesel Taxes, State Income or City/State sales tax or any number of things which in many cases are five or more time lower or higher than elsewhere, but I have always had that choice as every other person has today. I just don't think the Federal Government was established or should pretend to be responsible/obligated to all the problems each of the current 306 Million residents whether Housing, Education, Health Care or the thousands of issues any thousand people may have a personal grievance with. I am on SS/Medicare, and accept my 1200.00 per month but am as opposed to that as UHC or anything that people have become reliant on through government actions. Fortunately I did plan on alternative incomes, but know for a fact many planned on SS, disability, some indigent program to take care of them. It has not, by any means, has demoralized millions IMO and destroyed the spirit of those people that need it the most...

 

John; Yes, I will agree to disagree and move on, thanks for you comments and yes it's not only possible to maintain decorum in a debate, but according to my email the conversation has been read. I wasn't out for points, realize I am on the losing side of this issue. It is interesting however, that am arguing with a Brit elsewhere on the same issue, who firmly believes his system is flawed BUT the best in the world.

I am not going to have time to follow up a thread, at least for awhile, but will get you started if you wish to start one arguing a couple sites...Personally in the US, the issue itself is politically driven, creating/legislating regulations that could not be followed under free market/capitalism principles and kind of an indoctrination of the populace that they are not capable of decision.

---------------------------------------------

Despite the 1.2 percent decline in the U.S. economy from 1990 to 1991, the Census Bureau estimated health care services revenue rose 9.5 percent from an estimated $521.7 billion to $571.3 billion. The highest revenue growth areas occurred in home health care services (19.2 percent), kidney dialysis centers (18 percent), specialty outpatient facilities (17.4 percent), and nursing and personal care facilities (15.7 percent). Hospitals realized a 10.8 percent increase, while offices and clinics of doctors of medicine grew 7.2 percent during that period. Hospitals accounted for 53 percent of all revenues for the health services industries in 1991. Hospital revenues rose by $29.7 billion to reach an estimated $305.9 billion

 

International Comparisons

In 1990, on a per capita basis, health care expenditures among nations ranged from a low of $2 to more than $2,700. Low-income countries, such as Bangladesh, India, Pakistan, Egypt, and most sub-Saharan African countries with per capita income of $100 to $600 spend between $2 to $40 per individual on health care. Another set of countries called middle-income, whose per capita income ranges between $600 and $7,900, spend about $20 to $400 per capita on health care services. Among them are South Africa, Zimbabwe, Costa Rica, South Korea, Turkey, Poland, and the republics of the former Soviet Union. Established-market economies whose per capita income ranges between $5,000 and $34,000 consume per capita health care expenditures of $400 to $2,500. However, the United States, with a per capita income of 22,000, spent more than $2,700 on health care services in 1990 (Table 1).

 

Health Care Expenditures

The cost of the nation's health care (SIC 80) rose about 12 percent in 1993 to reach an estimated $942.5 billion, or about $3,900 per capita. By 1993, the U.S. health and medical care sector outlays amounted to 14 percent of the nation's economy. As health care expenditures have risen, there has been an accompanying shift from the private to the public sector. Private sector health care expenditures represented about 54 percent of total health care spending in 1992, down from 58 percent in 1980. Medicaid programs accounted for most of the 4 percent increase from 1980 to 1992.

 

 

 

http://findarticles.com/p/articles/mi_m3617/is_1994_Annual/ai_14698436/pg_2/?tag=content;col1

--------------------------------------------

Then, I wonder where 'Health Care' falls as important to the average 20-50 year old in the first place. On average those with out the desire to BUY insurance, own Homes, Cars, Boats, RV's, spend hundreds of dollars on entertainment or have elaborate home entertainment centers. Any of which dwarfs what Basic Health Insurance would actually cost and in many cases not all eligible for Group Company Policy's. I understand the pre-existing conditions and those arguments, have already addressed their solutions, but insurance, compared to medical expenses has not increased together. One example, assume the basic, any family should be concerned with;

 

-----------

The Coverage

We’ve partnered with one of America’s most trusted names in insurance to provide coverage for the day to day health care services you use most.

Doctor's Visits

Prescriptions

Diagnostic Tests

Daily In-Hospital

Emergency Room

Surgery

Ambulance

24 Hour Nurse Hotline

Accidental Death Insurance

Coverage includes giving you best-rate access to over 400,000 doctors, 3800 hospitals, and 52,000 ancillary providers.

The Cost

Compare our coverage and price. We believe --- offers America’s best health insurance value.

Single - $99/mo.

Single + Children - $169/mo.

Couple - $169/mo.

Family - $249/mo.

-----------

[ParanoiA]

No, I don't think it's time to bury Individualism, the spirit that makes a person feel special to themselves, their family, friend, City, State or Nation, or in a few cases the World, something important. It has been that spirit, that trait or quality in a person that has spawn both good and bad in humans and brought the world to an understanding of the importance of accepting the acceptance of diversity.

 

That's not what I was talking about, as I agree with individualism. In fact, my beliefs count on it. Diversity follows from individualism, and only maximized liberty can provide for both.

 

No, I was referring to our healthcare tradition in particular. Not all of our traditions are good and noble, and their status as "tradition" is not a sound argument anyway.

 

If you're not willing to let people die on the hospital entrance steps, or deny laboring mothers access to the delivery room since they don't have any money, then you're not doing free market capitalism. Capitalism can't function correctly, naturally, when you undermine its function.

 

So, the tradition has been to give away services that folks can't afford at the worst possible moment, when they're in the ER. We could have saved that person a lot of pain and anguish and potential permanent disability (which then costs the taxpayers exponentially more money for life) or even death, AND saved money, reduced demand at the ER and have a healthier tax base to boot if we would have covered the health expenses of that person before it got bad enough for the ER. That's the tradition I'm referring to.

 

This is not really about pretentious nobility in using other's money to fix the sick. This is about acknowledging we are going to spend money on fixing the sick, no matter our political affiliation or preferences on the matter, so let's be smart about it instead.

 

Either that, or start arguing for letting sick people fend for themselves until they have money for health service. That's the only way to stick up for free market forces and exclusively lean on capitalism without being a hypocrite or thoughtlessly wasteful safety net funding.

[JohnB]

ParanoiA, I think you misunderstood what I meant.

 

The relationships between people and organizations are defined by the terms they use. Companies have clients or customers, clubs have members but only political groups have citizens.

 

There is no limiter because the word citizen describes the type of relationship, not it's extent.

[JohnB]

I don't normally bump old threads, but as I've just been to the Drs I thought some hard and fast data on how the Aussie system works in practice might be of interest to some.

 

I'm afflicted by skin tags, most are small but occasionally 1 becomes objectionable and gets removed. The one on the back of my neck needed cutting as it had got too big. Roughly 4 cm long and 1 cm wide and high.

 

I decided this last Friday and made an appointment at my local private practice clinic for saturday morning. I had the consult but due to time constraints had to schedule the removal for this morning.

 

Cost of consult to me: $67.00

 

This morning I went in and after a 15 minute wait (which I think is not excessive) I had the tag and another removed. This took about 30 minutes.

 

Cost of this visit to me: $105.00

 

With my two receipts I drove a couple of suburbs over (about 10 mins) to the Medicare office where I got my queue number.

 

When I arrived they were serving number 151 and I was number 188.

 

After a 20 minute wait I was served. Again I don't think this wait is excessive as they served some 40 people in that time.

 

I handed over my Medicare card and the two receipts and was then given my rebate of $97.30.

 

It's calculated in this fashion. We have what we call a "Scheduled Fee" for proceedures and the rebate is based on this figure.

 

The scheduled fee for the first visit was $33.55 so that's my rebate. Note that my Dr charged me $67.00.

 

The sceduled fee for the proceedure is $63.75, so that's my rebate for todays visit. Again note the actual charge was $105.00.

 

So 2 Drs visits and a minor proceedure cost me, in total, $74.70. Which is also not unreasonable, and I was home around 1 PM.

 

Again, while my rebate was paid under the universal system, my Drs are fully private practice. Aside from the standard oversight that all healthcare provider busnesses get, they are not answerable to the gov in any way.

 

I think this a good example of how a universal system does not limit the Drs ability to have an income. The scheduled Fee might be $33.55, but he is able to charge $67.00 for his services. The Sceduled Fee limits my rebate, not his income. Of course, if he charges too much then people will go elsewhere, a true free market option.

 

Also by having some out of pocket expense, we reduce the attractiveness of going to the Drs for every tiny little thing, a situation that can overload a "free" universal system. If it's free, people go the Drs for a headache, if it costs them $30.00, they wait a bit and see if it passes before they go.

 

Anyway, I thought that some actual times and costs might be of interest to those still thinking about this topic. I dare say that it will be on the American political scene for some time yet.