Let's talk healthcare

[iNow]

More food for thought:

 

http://globalpublicsquare.blogs.cnn.com/2012/03/28/dont-follow-america-on-health-care/

 

Roughly 50 million US residents (one in six) pay out-of-pocket for medical expenses.

<...>

The US is one of the few high-income countries that does not finance health care through a publicly funded prepaid system. On average, wealthier countries spend roughly 11% of their GDP on health, with more than 80% publicly financed and only 14% of spending taking place on a fee-for-service basis. Public finance (or, in some cases, government-regulated cooperative insurance funds that amount to public financing) pays for most discretionary medical services, with private insurance supplementing only minimal extra services.

 

Most rich countries choose to finance their health care publicly for several reasons. First, free-market health care is usually inequitable and inefficient. Individual needs vary significantly, and private companies are often unwilling to insure the very people who need the most care (such as those who are already ill, or who have conditions like diabetes, which predispose them to other health problems). Moreover, those who buy care – insurers and patients – are unlikely to have the information necessary to choose the safest and most effective treatments.

 

At the same time, public spending acts as a brake on overall spending, and prevents the rapid cost escalation to which America’s private insurance companies contribute. The US spends 1% of its GDP annually simply to administer its complex, unwieldy insurance system. Without reform of the type now before the Supreme Court, total US health expenditures will rise from 16% of GDP today to 25% by 2025.

 

You know... or we could stop letting idiocy rule the day in our country, help conservatives to pull their heads out of their asses, and fix things along the lines of Taiwan. At this point, even China, India, and South Africa are leaving the US behind, and Mexico already has... U.S.A! U.S.A! U.S.A!

[Realitycheck]

How is health insurance any different than auto insurance? The more risks that people take, the higher their premiums are - some people drive too fast, some people smoke, some people don't pay attention to what they are doing while driving - get tickets, cause wrecks, some people don't pay attention to what they eat - get fat, cause health problems. Some people have these mental issues that can be a real problem - they get too worked up and bent out of shape and BAM! another car accident while others have these addictions or can't control their urges to splurge, I mean, the list just keeps going and going. What is the difference? One thing I do notice is that almost all of these politicians do get sick- heart disease from eating fat foods or smoking or doing steroids, same as everybody else. So it seems to me that this risk pool should be all*inclusive since we have established that everybody gets sick and if you can establish without a doubt that you don't get sick for whatever reasons, then your premiums should be lower, everything works out. Its a risk pool, it's the result of evolution, it makes sense. If something is not unconstitutional, then it's constitutional. It's aconstitutional.

Edited March 29, 2012 by Realitycheck

[iNow]

Auto insurance is different because you can choosr not to drive, and further... Your choice to not insure yourself does not have a proximal impact on the costs of coverage for other drivers. You are right, however, that it can be mandated.

 

Also, I care about constitutionality, and you should, too. Don't myopically dismiss out core principles. The fact of the matter is that the coverage is most certainly constitutional, as evidenced by medicare. The challenge is most directly related to the individual mandate itself, and that's there solely because congress sought to keep private insurers involved and offer citizens a choice. Had they eliminated this choice and simply implemented a single payer univrtsal systrm, the question of constitutionality would be completely off the table.

[Green Xenon]

Speaking of the healthcare system...

 

...I believe all patients should have the right to life-support regardless of their budget or whether they have insurance.

 

For example, if I experience an injury that permanently locks me in a less-than-fully-conscious state, I hot-heartedly demand to be kept in the hospital and taken care of forever. In this situation, I would want to be kept alive for as long as possible. I want to be kept in the hospital and completely taken care of by licensed physicians and nurses even after they think me to be in "stable" condition. In this semi-conscious-state, I do NOT want to be sent home because this would severely-burden my family. This burden should be on the medical system, not my family -- and don't these creeps [who run the system] DARE "pull the plug" on me. I don't care how much it costs to keep me alive. As a law-abiding citizen and a critically-injured patient, I should -- in any civilized society -- be entitled to live for as long as possible. For the perpetrators of the "death panels" who disagree, feel free to pound sand where the sun doesn't shine.

[Realitycheck]

I wonder what the history of precedents look like in comparison. I'm sure none of them quite look like forcing marathon-running fitness freaks to load up on insurance, but then, that should all be worked into the actuarial figures. It makes sense and with our budget and Medicare the way it is, it seems like it should be a go, but today I found out who comprises the majority, along with their appropriately fitting remarks. With the president being a lawyer, it seems like he inherently wouldn't overstep his authority, waste so many resources on such a landmark case that is looking like it is teetering ever so much on the precipice. Surely, cooler heads will prevail and see beyond the minutiae. We are forced to buy insurance (only those of us who live here), because every one of us ... simply must be accounted for in order to run an accurate and efficient risk pool. Does accuracy and efficiency usurp individual liberty? It should be a small price to pay in order to help right our nation' financial woes. Does that sound like a good enough reason to enforce an individual mandate? One would expect a lawyer to have it all prearranged, preapproved. When the president said that "he had spent too much political capital on that single issue." I wonder if he meant that it was a valid deal or a waste. I wonder if he has a wildcard up his sleeve. He has seemed overly confident, given the political makeup of the Justices, but something needed to be done.

Recent reports of it being overbudget sound ominous ...

Edited March 29, 2012 by Realitycheck

[iNow]

Recent reports of it being overbudget sound ominous ...

Mostly because they are complete fabrications and misrepresentations of the what the Congressional Budget Office actually published, and those falsehoods have been propagated by rethuglican leaders and the Murdock empire (like Faux News and WSJ).

 

 

http://krugman.blogs.nytimes.com/2012/03/18/how-bad-the-debate-is/?pagewanted=all

 

http://www.whitehouse.gov/blog/2012/03/14/cbo-update-shows-lower-costs-new-health-care-law

[Phi for All]

How is health insurance any different than auto insurance?

Auto, home, even life insurance put a fixed dollar amount on what is being insured. Health insurance can't do that. How can we know what will happen to us health-wise? This is why I think health insurance should NOT be part of a private, market-based business model. There are way too many conflicts of interest there.

 

For the perpetrators of the "death panels" who disagree, feel free to pound sand where the sun doesn't shine.

So, people who disagree with you get rude comments instead of conversation? Are you feeling hateful about this community too?

[JustinW]

iNow,

 

Are you suggesting this is a valid comparison? You seem to be asserting that "providing universal healthcare to our citizens as a right... and not merely as a privilege for the wealthy... in a manner that aligns with the entire rest of the civilized world" is equivalent to having a "kid play with a gun because he saw someone do it on TV." If you see those issues as the same, I fear you're position may be immune to logic and reason. They are not, for many reasons.

 

Also, you are misrepresenting the argument. Nobody is here saying the only reason we should provide coverage to all citizens is because other countries do it. The point is that other countries DO provide it as a right and your personal stance appears like something out of the dark ages. We as a country are way behind the curve on this, and worse still we're paying twice as much as any other nation for lower quality care as measured by essentially every relevant health related metric... and despite that extra cost... despite that lower quality care... we STILL completely fail to cover a rather significant portion of our population.

 

I think you know what I was getting at. And no, I don't think I was misrepresenting the argument. You can't expect every point that I try to make to encompass the whole of the argument.

 

 

Further, if there weren't numerous other respected sources already provided in this thread that arrived at conclusions polar opposite to the argument you've been making, then perhaps your source may have seemed more acceptable to us. When it comes to the weight of the evidence (even just that small bit provided here in this thread), it disagrees with the central premise of your argument... and in response you have chosen to cite a single source itself known for consistent bias and lack of trustworthiness... So when their conclusions disagree with the 5 or 7 sources the opposing side this discussion has already offered... yes, you'll generally be dismissed as not serious or your argument deemed unsupported and without merit.

Most of which I have provided contradictory reasons and reports. Like this one, http://www.ncpa.org/pub/ba649 , is this not peer reviewed? Is the National Center for Policy Analysis a co-conspirator with the right-wing propoganda machine? The fact of the matter is that I can provide just as many reports that oppose as you can those that support.

 

And as Phi and I both already countered, the risk of litigation accounts for only 1-2% of our overall healthcare cost increases. Even if I'm EXTREMELY generous and concede that there are other indirect costs that bring that number up to 5%, that means that there are still other factors causing 95% of the growth in healthcare costs. Why you'd focus on one of the smallest contributors to cost is beyond me, not to mention that it's completely off-topic from the central discussion of private versus public coverage.

This is why I haven't argued it too much. Though I believe this is a big reason prices between providers and consumers are up, I just mentioned that it was a valid point. And yes I think it does fit into the discussion due to the fact that this will transform the insurance industry. I have a feeling there will be a lot of people that will be looking for a job if they allow this to proceed.

 

The reform already DID pass. It is a law. It is in effect. We'll learn more after this week if it will remain a law, but it is one right now, no matter how much you may wish otherwise.

Yes I didn't phrase that right. And it isn't looking good for your side so far is it?

 

 

Phi,

As iNow points out, this analogy is beyond flawed. The success enjoyed by other countries with national healthcare systems is not a fictional entertainment, it's a well-documented fact. And the point is not to "set our standards by the rest of the world", the point is that when you're having trouble with something, it's wise to look to others who've been successful and learn from them, see what they're doing right and adapt it to your own situation. We aren't too proud to admit we can learn from foreigners, are we?

Alright let's use a different one. I'll use someone elses so it's not so "off the cuff".

 

This is what was said in the supreme court yesterday. " Because health care is something we might all need some day in an emergency. A cell phone is also something we might need some day in an emergency. If the government can force us to buy insurance we might need some day to address an emergency that hasn't happened yet, it stands to reason they could force us to buy the cell phone we will need to call 911 to get the emergency response." I would half way agree that this analogy, but I would change it up a little bit to better fit the situation. I would have said that the government should PROVIDE you with a cell phone, MANDATE that the people buy the phone service, and TAX you either for sales tax on the service or as a penalty for those who decide to opt out.

 

 

John,

More generally, it's because you should adopt the best standards and (in spite of your determined refusal to accept this) there is evidence that government owned healthcare is the best.

To be blunt, you should do it because you recognise that it is folly to pay twice as much for a system that produces more dead babies.

Maybe you should take a look at the percentage numbers of the last link I have provided. Oh I forgot, it's probably to right-wing to pay attention to.

 

Also, don't forget that the countries with national healthcare systems decided to set them up and they decided to keep them.

I can't bring to mind any country that decided to abandon the system because it didn't work.

Is this why your always whinning about those governments trying to privatize portions of it? It seems that at least some want to change it by your own admissions.

 

 

Just a quick reminder to the citizens of the US: from point of view of about 95% of the world's population, you are foreigners.

And most of us are damn proud of it.

[iNow]

Like this one, http://www.ncpa.org/pub/ba649 , is this not peer reviewed? Is the National Center for Policy Analysis a co-conspirator with the right-wing propoganda machine? The fact of the matter is that I can provide just as many reports that oppose as you can those that support.

That reference supports my position. Thanks for sharing it. Wait times are longer... for non-time sensitive care. For time sensitive care, they get it done more quickly.

 

This is why I haven't argued it too much. Though I believe this is a big reason prices between providers and consumers are up

What you "feel" is moot, as the sources shared already show it to not be a "big reason," and only accounts for 1-2% of the overall reason costs are increasing.

 

This is what was said in the supreme court yesterday. " Because health care is something we might all need some day in an emergency. A cell phone is also something we might need some day in an emergency. If the government can force us to buy insurance we might need some day to address an emergency that hasn't happened yet, it stands to reason they could force us to buy the cell phone we will need to call 911 to get the emergency response."

Your choice not to buy a cell phone does not have a proximal impact on the cost to the rest of us.

The cell phone company is not legally required to provide you with a cell phone if you encounter an emergency. Healthcare providers are.

 

As was described to the justices when this argument was raised, the comparison fails due to the nature of healthcare and healthcare coverage.

 

http://www.huffingtonpost.com/david-katz-md/health-care-reform-hearings_b_1385350.html

 

Health care is something you get without asking for it when you happen to be hemorrhaging, seizing, drowning, or unconscious. When you've been chewed on by a shark, hit by a train, or shot. The situations in which someone forces you to use a cell phone you don't want are -- well, few and far between at best. I suppose it might occur during a ransom negotiation if you are the kidnapping victim. But even then, you don't have to buy the cell phone!

 

If you don't buy a cell phone, the body politic does not automatically absorb the cost of cell phone use you need but for which you didn't pay. That is exactly what happens with health insurance. You will get health care in an emergency whether you can pay or not -- and the costs are passed along to those who can pay, without our will or consent. To my knowledge, I have never borne the costs of anyone else's unpurchased cell phone. But I do have health insurance. If you do, too, we have both borne the disease care costs of those who do not -- and nobody asked our permission.

 

Routine use of health care as recommended by expert bodies can save lives and money. I am aware of no such evidence regarding cell phones. In fact, if anything, there is some evidence that routine cell phone use may be causing potentially serious health problems -- but that's a topic for another day.

 

I could go on, but it's pointless -- because the point is self-evident. Health care is nothing like cell phones, or any of the other things that "might" come in handy during some future emergency: a bulletproof vest, a car, a ladder, a fire extinguisher, a helicopter, a Hazmat suit, a gas mask, a tank, etc. Truly, about the worst analogy I've ever heard.

 

So, what is health care like?

 

It's a lot like the police. We all pay for police protection which we might need some day.

 

It's rather like (non-volunteer) fire departments. Ditto.

 

It's something like the TSA. We all pay the costs of the TSA -- even those who don't fly! Is that fair? The question may be moot, since we're already doing it. But the events of 9/11 suggest it is fair, since victims of lapses in air travel security could be minding their business in an office building.

 

It's rather like the military, for which we all pay. We share in the costs of defending the body politic. Sharing in the costs of defending our bodies would be much like that.

 

To my knowledge, there is neither a Democratic nor a Republican uprising to eliminate the nation's police, or the military.

 

Health insurance is also like Social Security, and... a lot like health insurance, in the form of Medicare. We are all required to support Medicare.

Edited March 29, 2012 by iNow

[Phi for All]

Alright let's use a different one. I'll use someone elses so it's not so "off the cuff".

 

This is what was said in the supreme court yesterday. " health care is something we might all need some day in an emergency. A cell phone is also something we might need some day in an emergency. If the government can force us to buy insurance we might need some day to address an emergency that hasn't happened yet, it stands to reason they could force us to buy the cell phone we will need to call 911 to get the emergency response." I would half way agree that this analogy, but I would change it up a little bit to better fit the situation. I would have said that the government should PROVIDE you with a cell phone, MANDATE that the people buy the phone service, and TAX you either for sales tax on the service or as a penalty for those who decide to opt out.

I don't think I can do a better job of ridiculing that analogy than you've done just by posting it. I'll let it speak for itself.

 

But this part that you liked, "Because health care is something we might all need some day in an emergency"? I'm very happy that you and your family enjoy such fantastic health that you only need health insurance for emergencies. I truly hope that no one you love has any health problems, but I want you to know that I'm completely willing to pay a nominal amount in taxes, with the risks spread out among millions of my fellow taxpayers, to make sure that your family, especially your kids, are covered by a single-payer insurance policy that won't deny them when they need it most.

 

And I'm probably like you, I haven't had much to do with doctors and hospitals in my life, thank goodness. But to me, good health is such a basic necessity of modern life, like clean drinking water, roads, libraries and education, that I'm willing to do my part as an American to help all of us enjoy living and prospering in this great country. We can pull together or we can pull ourselves apart.

 

Most of which I have provided contradictory reasons and reports. Like this one, http://www.ncpa.org/pub/ba649 , is this not peer reviewed? Is the National Center for Policy Analysis a co-conspirator with the right-wing propoganda machine?

Yes, they are.

 

From their website, regarding their president, John C. Goodman:

The Wall Street Journal and the National Journal, among other publications, have called him the "Father of Health Savings Accounts," and the Media Research Center credits him, along with former Sen. Phil Gramm and columnist Bill Kristol with playing the pivotal role in the defeat of the Clinton Administration's plan to overhaul the U.S. health care system.

Does John sound impartial and objective to you?

[John Cuthber]

Erm...? You seem to have missed something

At one level phones are like healthcare.

The service providers are required to provide them for us for free use in emergencies.

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

They call them pay phones, but they are free for emergency calls.

 

Centralised healthcare is a good thing for exactly the same reasons as 911 or 999 calls .

I accept that a 'phone box is not a mobile phone, but my mobile supplier will let me dial emergency numbers even if I have no credit.

[Green Xenon]

So, people who disagree with you get rude comments instead of conversation? Are you feeling hateful about this community too?

 

Absolutely not.

[JustinW]

Because we're not just talking of wait times and my damn computer keeps messing up. I've tried to respond about 3 times already and right before I finished every time somehow it would all get erased and I would have to start all over again. Aside from being frustrating as hell I must have lost track of a few things. But let's see if I can get around to providing you with something. Here's two things quoted from wiki which establishes who does the studies.

 

" As reported by the Health Council of Canada, a 2010 Commonwealth survey found that 42% of Canadians waited 2 hours or more in the emergency room, vs. 29% in the U.S.; 43% waited 4 weeks or more to see a specialist, vs. 10% in the U.S. The same survey states that 37% of Canadians say it is difficult to access care after hours (evenings, weekends or holidays) without going to the emergency department over 34% of Americans. Furthermore, 47% of Canadians, and 50% of Americans who visited emergency departments over the past two years feel that they could have been treated at their normal place of care if they were able to get an appointment. ^[58"

 

^"Studies by the Commonwealth Fund found that 42% of Canadians waited 2 hours or more in the emergency room, vs. 29% in the U.S.; 57% waited 4 weeks or more to see a specialist, vs. 23% in the U.S"

 

 

That last one could hardly be dismissed as right-wing since that is the same group that provided you with those lovely graphs.

Let e ask a serious question here. If wait times were not an issue in NHS countries, then why is it such a big policy issue over there?It seems that people usually don't adress things that aren't problems.

 

 

What you "feel" is moot

Kind of like your moral dilema when it comes to providing each and everyone with healthcare. Is what you "feel" moot, or is that what drives you on this subject?

 

 

as the sources shared already show it to not be a "big reason," and only accounts for 1-2% of the overall reason costs are increasing.

What exactly did your sources suggest as far as prices and who those prices are applying to? Did they refer to the CONSUMER/PRACTITONER cost relation? Or was it refering to 1-2% of the overall costs? My term "big reason" was applying to direct costs from practiToners.

 

 

Your choice not to buy a cell phone does not have a proximal impact on the cost to the rest of us.

So you're saying the people that CHOOSE not to buy healthcare have a proximal impact on the cost of healthcare, and you're using this as the reason that costs are so high?

 

The cell phone company is not legally required to provide you with a cell phone if you encounter an emergency.

Not yet. If the number of emergencies that were not responded to in time were to show that it was a lack of cell phone ownership. And this number looked worse than another country that provided their people with cell phones, would you be in support of our government mandating that we buy cell phones? It seems that if you follow your own moral imperative,that you would for the sake of those who suffer.

 

As was described to the justices when this argument was raised, the comparison fails due to the nature of healthcare and healthcare coverage.

It might fail in comparison to healthcare and what a practitioner is obligated to do, but it does not fail when compared to coverage.

[John Cuthber]

I think we have all accepted that there's something odd about Canada in this respect.

 

Enlightened self interest isn't just a "feeling". It's the acceptance that I don't know if I'm going to be lucky or not with my health- but if I'm going to be unlucky, I want the biggest possible pot of money behind me. The government is the biggest insurer. Also they get economies of scale.

Also, it's not just a gut feeling that the US system costs roughly twice as much.

 

If someone asked me if they could borrow my mobile 'phone to make a call in an emergency I would let them.

There's a simple enough reason for that.

 

Like I said,

If it's an emergency then (because of government mandate I think) the call will be free: underwritten by the service provider at the joint cost of all subscribers.

 

I think that 911 or 999 calls are free on mobiles in the US too.

This is nothing new. 'phone box/ public 'phones would let you make emergency calls for free.

Edited March 29, 2012 by John Cuthber

[JustinW]

iNow,

 

That reference supports my position. Thanks for sharing it. Wait times are longer... for non-time sensitive care. For time sensitive care, they get it done more quickly.

Where does it say this? Here, look again: http://www.ncpa.org/pub/ba649

 

 

Phi,

 

But this part that you liked, "Because health care is something we might all need some day in an emergency"? I'm very happy that you and your family enjoy such fantastic health that you only need health insurance for emergencies. I truly hope that no one you love has any health problems, but I want you to know that I'm completely willing to pay a nominal amount in taxes, with the risks spread out among millions of my fellow taxpayers, to make sure that your family, especially your kids, are covered by a single-payer insurance policy that won't deny them when they need it most.

You do such a fabulous job of twisting the context of people's word applications. The part you quoted wasn't the whole of the sentence and is broadly taken out of context. The end of the sentence needs a coma followed by the fact that in an emergency most people call 911 with a cell phone. It's not followed by "people only need healthcare in an emergency".

 

 

And I'm probably like you, I haven't had that much to do with doctors and hospitals in my life, thank goodness.

Well that makes one of us. I could give you a list if you like.

 

 

Does John sound impartial and objective to you?

About as impartial and objective as the WHO. Why don't I dig up some dirt on the members of some of those other organizations. I've got a hunch and I'll get back to you on it.

 

John,

 

They call them pay phones, but they are free for emergency calls.

Try finding one of those around every corner. It's not as easy as it used to be.

 

Anyway, the point of the analogy is what's on the table, not the details of it. The way yall attack analogies it's a wonder you ever let any of them slide. None of them would hold up to the qualifications that yall apply to the ones I post.

 

 

I accept that a 'phone box is not a mobile phone, but my mobile supplier will let me dial emergency numbers even if I have no credit.

As do they all. It was a point, not a situation to be taken literally. Apply the point to any analogical subject you want. Edited March 29, 2012 by JustinW

[iNow]

" As reported by the Health Council of Canada, a 2010 Commonwealth survey found that 42% of Canadians waited...

Yes, much as my sources said. We weren't talking about Canada. We were talking about NHS. NHS [math]\ne[/math] Canadian Medicare system. You're either moving the goal posts now that your original point was shown to be bunk, or you are conflating the universal healthcare systems of multiple countries without even knowing it. Neither of those options speak well of your ability to argue this issue reasonably.

 

Kind of like your moral dilema when it comes to providing each and everyone with healthcare. Is what you "feel" moot, or is that what drives you on this subject?

Not sure your point. You said that you "feel that the data says one thing" and I said that the data we shared says something else entirely, so your feelings are not really relevant. This is not a valid comparison, but I am sensing a theme in your posts. Broken logic. Lack of valid premises. Poor comprehension. Little grasp of the facts.

 

Or was it refering to 1-2% of the overall costs? My term "big reason" was applying to direct costs from practiToners.

Which source? There were about 6 of them shared, and each showed that risk of litigation and practitioner insurance was barely a blip on the radar when it comes to the rise in medical costs.

 

So you're saying the people that CHOOSE not to buy healthcare have a proximal impact on the cost of healthcare, and you're using this as the reason that costs are so high?

Close, but not quite. I am saying that people who fail to purchase their own healthcare coverage have a proximal impact on people like me who do. This is because they are mandated treatment when they get ill and land in the ER, and the ER winds up eating those costs. When the ER eats costs, they have to raise rates elsewhere to make up the difference. Those raised rates impact all of us who are doing the right thing by purchasing coverage.

 

I am saying that those who "choose" not to purchase healthcare are more accurately described as "choosing" to mooch off the rest of us and game the system.

 

Where does it say this? Here, look again: http://www.ncpa.org/pub/ba649

Your source references three other sources on the point of wait times. I drilled into those parent sources, and that's where it said it.

 

The US does WORSE than the NHS when it comes to access to time sensitive care. It is only in the realm of non-time critical care that the US does better... This point has already been supported by me more than once in this very thread. If you are ignoring my references, that's your problem, not mine.

[John Cuthber]

"About as impartial and objective as the WHO. "

OK, lets have a quick look at what they each aspire to do.

First here's what the world health organisation does according to their website.

"WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends."

 

I have highlighted a few bits to show my personal bias (or at least that's what I will be told I highlighted- other views may differ)

 

OK, now for the NCPA. Again this is a quote from their own website about what they do.

"The National Center for Policy Analysis (NCPA) is a nonprofit, nonpartisan public policy research organization, established in 1983. Our goal is to develop and promote private, free-market alternatives to government regulation and control, solving problems by relying on the strength of the competitive, entrepreneurial

private sector."

 

Now, for my personal tastes, being biassed in favour of evidence based policy seems better than being biassed against government.

[JustinW]

iNow,

 

Yes, much as my sources said. We weren't talking about Canada. We were talking about NHS. NHS Canadian Medicare system. You're either moving the goal posts now that your original point was shown to be bunk, or you are conflating the universal healthcare systems of multiple countries without even knowing it. Neither of those options speak well of your ability to argue this issue reasonably.

I thought we were talking about National Healthcare Systems in general. Hence "NHS nations".

 

 

But here are some examples: This is from the OECD Here: http://www.oecd.org/.../32/5162353.pdf

 

 

 

 

Table 1. Waiting between specialist appointment and surgical intervention

 

% of patients waiting for surgery more than 12 weeks (year 1990)

 

Germany 19.4

 

Hungary 13.3

 

Italy 36.3

 

Netherlands 15.2

 

Norway 28.0

 

Portugal 58.1

 

Spain 18.5

 

Switzerland 16.1

 

United Kingdom 41.7

 

 

And:Table 2. Percentage of patients waiting for elective surgery more than 4 months

 

Base: Those with elective surgery in the past 2 years (%)

 

Year 1998 Year 2001

 

Australia 17 23

 

Canada 12 27

 

New Zealand 22 26

 

United Kingdom 33 38

 

United States 1 5

 

Hmmm....

Oh here's a more recent one from the OECD: http://www.oecd-ilib...application/pdf

 

Not sure your point. You said that you "feel that the data says one thing" and I said that the data we shared says something else entirely, so your feelings are not really relevant. This is not a valid comparison, but I am sensing a theme in your posts. Broken logic. Lack of valid premises. Poor comprehension. Little grasp of the facts.

That would be fine if you've provided any facts. I can hand pick mine also. I bet the OECD is right-wing also?

 

Which source? There were about 6 of them shared, and each showed that risk of litigation and practitioner insurance was barely a blip on the radar when it comes to the rise in medical costs.

You've just cited it. What medical costs? There is a difference in the price that a private doctor charges a patient who pays out of pocket and what is charged to an insurance company.

 

John,

 

"WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends."

And I've stated the reason that those NORMS ans STANDARDS cannot be applied to this argument. It's hard to assess trends when the information being reported has different reporting criteria.

 

 

Now, for my personal tastes, being biassed in favour of evidence based policy seems better than being biassed against government.

And does that mean their data is manufactured or incorrect somehow. If so then how? I've already told you why the WHO's is incompareable to the argument. Hell, the WHO's data would even be bogus when comparing NHS nations against eachother. Explain to me how the methods of the NCPA don't apply. Edited March 29, 2012 by JustinW

[John Cuthber]

% of patients waiting for surgery more than 12 weeks (year 1990)

 

 

"And I've stated the reason that those NORMS ans STANDARDS cannot be applied to this argument. "

and I have pointed out that the US's own health watchdog says that you pretty much can, in spite of the issues you raised.

 

"And does that mean their data is manufactured or incorrect somehow. "

It's impossible to tell because it's not subject to proper peer review in the way that WHO's data is.

 

" I've already told you why the WHO's is incompareable to the argument."

No.

You have asserted it repeatedly. You have shown that the comparison is complex- but as I have pointed out, it is possible to make the comparison.

When you do so you find that the US still pays roughly twice as much for a service that isn't as good.

 

 

"Explain to me how the methods of the NCPA don't apply. "

Last time you asked me to challenge some data I did. I pointed out that their use of statistics was deceitful.

I don't propose to do it for each and every right-wing think-tank on the web.

In particular, I don't intend to do it in this case because I don't actually know what their methods were. They cite some reports, but rather a lot of them seem to be from the Fraser Institute who also produce stuff like this

http://www.fraserinstitute.org/research-news/news/display.aspx?id=18141

so they can hardly be viewed as neutral.

 

If you want to convince me then you need to cite evidence where there has already been proper independent peer review.

I do that sort of reviewing at work and I'm not doing any more of it than I can help in my own time.

Edited March 29, 2012 by John Cuthber

[Phi for All]

You do such a fabulous job of twisting the context of people's word applications. The part you quoted wasn't the whole of the sentence and is broadly taken out of context. The end of the sentence needs a coma followed by the fact that in an emergency most people call 911 with a cell phone. It's not followed by "people only need healthcare in an emergency".

I didn't "twist" anything. Everything after the part I quoted was only the slippery slope analogy they used about cell phones being made mandatory. My point was that we shouldn't be thinking of healthcare in terms of emergency only. Effective healthcare needs to be preventative and needs to encompass the vast array of individual needs present in a major economy like the US.

 

 

Well that makes one of us. I could give you a list if you like.

It truly grieves me to hear this. And it makes me more adamant than ever that we need to stop paying double for insurance that often fails us just when we need it most.

 

 

About as impartial and objective as the WHO. Why don't I dig up some dirt on the members of some of those other organizations. I've got a hunch and I'll get back to you on it.

Wow. I don't know what to say about your comparing the WHO to the NCPA. The WHO covers an extremely broad array of global health issues. The NCPA covers free market public policy, and only a fraction of their efforts revolve around healthcare, and all of that is focused on squashing policies that might hinder making a profit from the poor health of American citizens.

 

I don't know what you do for a living Justin. Most of my career has been about figuring out how to market products and services to people. Believe me, turning free market business strategies loose on healthcare for humans ensures one thing, and one thing only: LOTS of customers paying LOTS of money for as little as you can possibly get away with giving them. That's business, but it shouldn't be healthcare.

 

The way yall attack analogies it's a wonder you ever let any of them slide.

I absolutely love analogies but I have to stop using them. At a gut level, I think I use analogies because I don't have the confidence that those I'm conversing with will understand my points without them. And that's not right. The arguments should stand on their own. More often than not on a site like this, analogies don't cover the whole argument and thus confuse the issue. And they can be seen as strawmen, too. Smart people shouldn't need them, and I guess smarter people shouldn't use them.

[JustinW]

John,

 

and I have pointed out that the US's own health watchdog says that you pretty much can, in spite of the issues you raised.

Well at least you admit they are issues finally. Who's the watch dog?

 

 

You have asserted it repeatedly. You have shown that the comparison is complex- but as I have pointed out, it is possible to make the comparison.

When you do so you find that the US still pays roughly twice as much for a service that isn't as good.

No, as I recall you said it was too long and boreing for you too read when I presented the graph. You remember, the ones with all the little dots that you thought were price comparisons. Post #31 I believe it was. This is what you said

It's quite a long and complex page and I really don't have time to rubbish each part of it in turn.

 

 

Phi,

 

My point was that we shouldn't be thinking of healthcare in terms of emergency only.

Who does? That sentence once combined witht the analogy sure doesn't. IT, was talking about making emergency phone calls.

 

And it makes me more adamant than ever that we need to stop paying double for insurance that often fails us just when we need it most.

My insurance didn't fail me. Twice it was my insides and the rest was my own stupid ass fault. And guess what? The first time I was 5 and my parents didn't have insurance. (oh no!) I'm still kickin', to the dismay of a number of people.

 

I don't know what you do for a living Justin.

Funny you should mention it. I work for Enron. Now renamed EOG resources that drill for oil and gas. They bought two silica sand plants down my way to corner the market in frac sand. I guess it's just cheaper if you own the sand plant rather than buy the sand from others. I knew you would get a kick out of it. I sure did. Edited March 29, 2012 by JustinW

[iNow]

I thought we were talking about National Healthcare Systems in general. Hence "NHS nations".

I think you're being disingenuous here, but I have no way of knowing so will let it go. For future reference, you seem to be referring to UHC... or "universal healthcare," not the NHS, which is what they call the health services in England.

 

 

But here are some examples: This is from the OECD <snip> Hmmm.... Oh here's a more recent one from the OECD...

Yes. They say exactly the same thing I've been saying now for several pages. Countries with universal healthcare systems seem to have longer wait times for elective surgeries and care that is not time critical. Your sources only reinforce this point. You seem to be ignoring the more important factor, however, wherein care which is time-critical takes LONGER to receive in the US than in those other countries.

 

Why you see this as a benefit of the US system baffles me, and it boggles my mind even more why you'd use this as argument in favor of the existing US approach.

 

 

That would be fine if you've provided any facts.

Okay. Thank you for confirming this discussion is a waste of time. You are immune to evidence, I see. The classic "lalala... I can't hear you... fingers in my ears and eyes closed" argument. Always a winner.

 

 

 

---

 

And, on another note... More lies and spin from the RNC on this issue. That doesn't really seem like the behaviors one would see from a side arguing the stronger position... arguing for the truth.

 

 

http://www.scotusblog.com/2012/03/the-rnc-shoots-itself-in-the-mouth/

 

The RNC released an advertisement (embedded in the story linked below) with audio from the halting beginning to Don Verrilli’s oral argument on the individual mandate to make the point that (as the ad’s title says) “ObamaCare: It’s a tough sell.” So far as I can tell, it is less a real ad that would actually run than a stunt intended to draw attention – no less a stunt than the DNC surely has done in lots of other contexts.

 

But Bloomberg News had the good sense to actually compare the actual argument audio with what the RNC distributed. It turns out to have been materially doctored. As the Bloomberg piece says, “A review of a transcript and recordings of those moments shows that Verrilli took a sip of water just once, paused for a much briefer period, and completed his thought, rather than stuttering and trailing off as heard in the doctored version.”

 

I’ve been in practice for seventeen years, and the blog has existed for ten, and this is the single most classless and misleading thing I’ve ever seen related to the Court.

[JustinW]

iNow,

 

I think you're being disingenuous here, but I have no way of knowing so will let it go. For future reference, you seem to be referring to UHC... or "universal healthcare," not the NHS, which is what they call the health services in England.

What's the difference. I'm sure they're slightly different considering policies applied to resolve the issues, but the principle is the same isn't it?

 

Yes. They say exactly the same thing I've been saying now for several pages. Countries with universal healthcare systems seem to have longer wait times for elective surgeries and care that is not time critical. Your sources only reinforce this point. You seem to be ignoring the more important factor, however, wherein care which is time-critical takes LONGER to receive in the US than in those other countries.

Maybe I'm not understanding what you are talking about when you say time critical. When you say time critical I think emergency or critical care, and most of the information I've found with ER waiting times has the US doing better than most. If this is not what you are implying please explain.

[iNow]

Your source was from 1990. Mine was from 2007 and 2008. I have no idea what you're looking at or talking about any more.

And, no. Not all universal coverage systems are equivalent.

 

 

In 2007, the Commonwealth Fund released a report that compared U.S. health care against several other countries based on a variety of benchmarks. The data were principally derived from statistically random surveys of adult residents and primary care physicians from 2004 to 2006, in the following countries: United States, Canada, New Zealand, United Kingdom, Germany, and the Netherlands. This is what the researchers found:

 

* Canada had the highest percentage of patients (36%) who had to wait six days or more for an appointment with a doctor, but the United States had the second highest percentage (23%) who reported that they had to wait at least this long. New Zealand, Australia, Germany, and the U.K. all had substantially smaller numbers of people reporting waits of 6 days or longer. Canada and the United States, in that order, also had the lowest percentage of persons who said they could get an appointment with a doctor the same or next day.

 

* The United States had the largest percentage of persons (61%) who said that getting care on nights, weekends, or holidays, without going to the emergency room, was “very” or “somewhat” difficult. In Canada, it was 54%, and in the U.K, 38%. Germany did the best, with only 22% saying that it was difficult to get after-hours care.

 

<...>

 

The take-away message is that both the United States and Canada do pretty poorly, compared to most other industrialized countries, on how long patients have to wait to get a regular appointment with a primary care physician or after-hours care, but the U.S. does better than most on having shorter wait times for diagnostic procedures, elective surgery, and specialty care. Each of these countries, though, with the exception of the United States, has universal health insurance coverage, funded and regulated in large part by the government, so it doesn’t seem likely that government-subsidized health care, in itself, is the sole factor in determining how long patients are stuck in The Waiting Place.

[JustinW]

Your source was from 1990. Mine was from 2007 and 2008. I have no idea what you're looking at or talking about any more.

And my other sources were from 1998 and 2001. I was using them to establish that waiting times are a problem. If this part of our argument is just about doctors being over-booked and not working after-hours, then this problem is simple to explain. There are not enough doctors and those that there are work a full work day, in regular workday hours. (just like the majority of the country work at this same well established timeline) Would you have every general practitioner be on call 24hrs a day and through the weekend just because someone doesn't want to go to the ER if their doctor's office isn't open? And how can this "critical time" dilemma possibly be one of the reasons to support a universal healthcare stance? From what I see this critical-time problem doesn't relate to healthcare quality rather than quantity, which wont be solved by adding millions of more potential patients without adding doctors too. What, are we going to have the government start mandating who does what job and where? Are we going to have to pay out incentives for more people to go to med school. I'm sure that would help to cut costs. I hope I have the meaning of this "critical-time" phrase correct.