How many DU'ers would prefer a one payer system....

[Bread and Circus]

Where all doctors were paid by the federal government,
where insurers were not part of the transaction, and people
didn't have to pay out of pocket for doctor visits?

[rooboy]

1. Comment...

last year, my 4 year old daughter had a seizure and fell unconscious. We called an ambulance - 2 turned up at our house within 10 minutes. One ambulance then took my daughter to the main children's hospital in our city, where my kid was treated and tested. She went home early in the morning.

Cost to us? Zip. zilch. nada. And we have NO health insurance.

Our federal government pays the doctors for consultations, and our public hospitals are free and paid for by the state government. What the hell are Americans thinking???

[Bread and Circus]

3. Good question. I don't know. But right now our system is broken..

to all hell.

[SpartacusSC]

10. In the US that would be paid for......

by indigent disproportionate share funds (taxes) plus cost pass alongs by the providers which show up in the prices we all pay.

But it won't cover regular office visits, regular lab work, preventive medicine etc. So things wait, get worse (and more costly) until someone goes to the ER.

Personally, I think some form of universal health insurance would be both more efficient economically and better from a public health perspective. Lots of interesting threads on this in the health/social policy forum.

[bleedingheart]

2. I have "insurance" but yet I keep paying and fighting with insurers

I pay $5000 a year for my part of an employer/employee funded program.

My insurer pays only 90% of the costs I incur medically. I pay 10%.

For 2 hospital visits and a three day stay for asthma related problems I have had to fork out over $1200 for my part of the cost...and that doesn't count the cost of the medication.

Due to rising health costs my salary has been stagnant for the past three years....

I also find that I spend a lot of time fighting with the insurance companies over who is going to pay for what. So even though i have insurance I find myself having to coax the insurer into paying the doctor and all the while I get nasty notices from the doctor's office ....the system is broken and I would love to work on fixing it as process improvement and cost analysis are two areas i have some expertise in.

[Bread and Circus]

4. I pay $15,000 per year in malpractice insurance and that is nothing...

Other doctors are paying 30, 40, $50K per year not
even ever having a suit. Hospitals are paying millions
yearly.

It all gets funneled toward insurance, drug, and medical goods/machines companies and their ceo's.

The system is broken on many levels. Doctors are definitely part
of the problem, but a small part of it. Over 50% is administrative
overhead at all levels, stuff you pay for that has nothing to
do with you getting better.

[Wapsie B]

13. What I would love to see right now

is research on this "administrative overhead." It just never ceases to amaze me how these hospitals can throw money around like it grows on trees, build opulent buildings, hire MBA's like there's no tommorrow, and at the end of the day tell caregivers there's no money for a needed wage increase. Plus hide behind the veil of non-profit status to avoid taxation.

[Nobody]

142. If you take the administrative overhead

in the form of the exec in yesterday's paper getting 94 million dollars, you've got a lot of waste. Multiply that by the number of execs. That's a lot of money that could go to research and development and making sure that we can have adequate health care coverage for all.

An example as to why we must have universal health care:
If I as an uninsured working American contract strep throat, I can't afford to see a doctor and get the prescription antibiotics. It doesn't go away on its own quickly and it's contagious. Not only can I not afford to take time off of work (as a temp I have no sick time), but I would spread it to all of the other temps who are also uninsured and unable to afford to see a doctor.

Imagine now, that I work with the public as a cashier (I don't, but many uninsured workers do). Think of the number of people I would be infecting with strep throat all because I would not be able to afford to have it treated.

And we call ourselves civilized.

[Wapsie B]

151. And it's not just those inflated

CEO salaries. Many hospitals around the country see no problem of having armies of MBA's/MSN's in various administrative roles. This is an enormous cost on the system. Many departments are top-heavy because of all the suits they employ. Is Canada and Europe like this?

[outinforce]

155. "Aministrative Overhead"

If the USA went to a single payer system of health insurance, does anyone seriously believe that there would be no "administrative overhead"?

Look, for instance, at the Social Security Administration -- I don't know for sure just how many employees the SSA has, or what it costs to pay all of those employees not just their salaries but also the benefits that federal employees receive. I do know that the Social Security's Headquartes Offices in the Baltimore suburbs are large.

And I would venture to guess that the SSA employs a fair number of people in highly-graded positions that have nothing to do with health care.

And, although I have had little personal contact with the folks in the SSA, friends tell me that it is not unusual at all to spend an entire day -- an entire day! - waiting in an SSA office to see some "customer service rep" who explains to you that your benefits are being denied because you failed to complete the proper form in the correct way.

Do we want more of that in our health care system???

[mouse7]

195. All day in an SSA office? That's RUBBISH and I would know

I've been on Social Security Disability for more than a decade. Now, I never wait more than 10 mins to be seen, and I'm done in 20 mins. The worst I've ever seen, when I was living in LA and went to Hollywood branch AND I had to go down without an appointment on the 3rd of the month, I waited an hour.

About half of Medicare administrative costs would disappear under a single payer system. The half that would disappear is the half that currently spent dealing with the problems caused by for-profit care system abuse.

[outinforce]

217. Rubbish?

You have your experiencees (and I do not doubt them).

My friends have had their experiences with SSA. Why do you choose to doubt the experiences my friends have had?

And, I am curious about something here.

You say; "About half of Medicare administrative costs would disappear under a single payer system. The half that would disappear is the half that currently spent dealing with the problems caused by for-profit care system abuse."

Do you have any statisics to back-up your claim that about half of Medicare's administrative costs is currently being spent to deal with problems caused by for-profit care system abuse?

Or is that mere rubbish?

[LearnedHand]

73. 'Preciate that post, doc...

...and I'm definitely on your side in this matter. I don't begrudge doctors a penny of what they earn because of the shit they have to go through with the HMOs. Bastards (the HMOs, that is).

[BritishHuman]

141. I believe in the NHS

The percentage of costs that go towards administration is about half of what it is in the private medical sector.

[NavajoRug]

Your post illustrates a lot of the problems . . .

. . . with any kind of health care system that is based on insurance -- regardless of whether the "insurance company" is a private company, HMO, or government.

This is why I'm not convinced that a "single-payer system" is really going to work in this country without some drastic changes in the way we view health care.

[hedgetrimmer]

105. I agree

The con of health = business needs to change...
the whole-istic living experience (stress, food etc.) all contribute to health

blah blah blah... yes, drastic changes.

[Pithlet]

5. I would

I don't understand the resistance to the idea. I would think that everyone would be thrilled to not have to worry about going bankrupt and losing everything because you had the audacity to become ill or injured after you lost your job, or your insurance dropped you, or your insurance was inadequate. Very few of us are completely immune from that happening, let alone the millions among us that have already suffered.

[SarahB]

6. I think it will cost us all less

There are so many uninsured people and generally they don't receive check-ups or preventative care, so they head to an emergency room often when things get really bad (or even a simple cold because there's no where else to go). I ties up time and forces us all to pay more. Health care is a right in every other civilized nation. What the Hell is wrong with us???

[Feanorcurufinwe]

7. I blame Clinton

if there was a time in recent history to push for single payer, Clinton's first term was it. By pushing for (and losing) the disaster of incremental change he chose, he set the terms of the debate for years to come. That what the time to show bold leadership and he blew it.

[Cleita]

9. I agree. He really let us down and this is why I voted for him.

eom

[cms424]

11. not exactly...

Single payer will never make it through congress in this country. If anything, Clinton's plan was not incremental enough.

[Cleita]

12. If it doesn't., anybody who doesn't have adequate coverage,

should make a point of dying on the steps of Congress, when they know their time is coming. Or even have a die-in in the rotunda.

[blondeatlast]

163. I had to declare bankruptcy because of health insurance fraud--

my Congresspeople are well aware of it. I made DAMN sure they knew.

[Feanorcurufinwe]

14. Never say never.

A lot of people thought they would never outlaw slavery, or give women the vote. At least if Clinton had lost the battle for single-payer, instead of the battle for a 'reform' that no one understood, we would have advanced the debate towards the only solution that makes any sense.

[Kanary]

18. You are sooo right! We roll over, saying it can't happen here,

then complain about the companies running our lives.

It's not only the politicians who need more spine....

Kanary

[salin]

45. I predict it will happen, and within the next 10 years or so.

And it will happen because big corporations start getting behind it because the costs of employee health insurance continue to escalate at such a rapid and steep pace that it will reach the point where slightly higher taxes to pay for the program will be much less costly than the costs of insurance benefit rates. The battle will be between different corporate sectors - titan interest group against titan interest group.

[blondeatlast]

166. Business is starting to see this as a win-win situation:

http://www.sltrib.com/2003/Jan/01112003/commenta/19187.asp

http://www.consumerwatchdog.org/healthcare/nw/nw002215.php3

When they see the light, it will happen.

[blondeatlast]

162. It will. It benefits patieents, doctors, and most of all--

the ones who can get it passed--BUSINESS. They are cutting health benefits by the truckload, and many bigger businesses are starting to push for U-SP as a cost-saving measure for themselves.

[blondeatlast]

161. Gotta agree; when the heatr was on he backed down and made the entire issu

look like a loser.

It could have been the '(0s "War on Poverty" and he blew it big time.

[American liberal]

192. that's odd...

I remember that Hillary was put in charge of evaluating and making recommendations re: universal health care and that this country couldn't handle the concept of "first lady" having that kind of responsibility. The media were criticizing her hairstyles, for crying out loud. She was forced under public pressure to step back into the stereotypical role and President Clinton was powerless to push a single-payer proposal forward. If I recall correctly, both the House and Senate were Republican controlled during Clinton's first term and they wouldn't hear of any radical changes.

So, really, I don't think you can blame Clinton. I guess you'd have to blame all the people who voted in that particular Congress and then blame all the people (something like 60% of Americans over the age of 18) who chose to stay home from the polls altogether!

In summary, you can't blame lack of leadership. Clinton tried. He got shut down by all those other people WE put in office!

[sir_captain]

194. Not really correct

there was a pretty big *democratic* majority in congress for the first two years of clinton's first term. the 1994 republican midterm massacre was brought on largely by clinton's inability to make his promised changes to health care.

[Cleita]

8. Universal health care is possible.

You have to cut out the middle-man, the insurance company, the HMO and any other traded on the stock market for profit entity. The healthcare provider then bills the single payer directly. Fees and such are hammered out on a yearly basis so that everyone is happy. Money comes out of the general fund of our US Treasury like it does in Canada. Done deal, except that we are going to have to fight those for profit sharks, the Insurance companies and HMOs tooth and nail to get it done.

[NavajoRug]

15. You have to understand something about universal health care . . .

It only works when the "single payer" is given the kind of authority over things that you may not really want them to have. Setting prices is one thing that seems to work well, but one thing most people may not realize is that the biggest cost savings in a single-payer system is not from "eliminating the middle-man" . . . it's from taking away the last bit of control that doctors and patients still have today.

I've said here a number of times in the past that this country does not have a health care crisis -- it has an INSURANCE CRISIS. Eliminating private insurance companies and replacing them with one big "insurance company" is not going to solve the problem.

[Pithlet]

16. It works in every single European country

Japan and Canada. The US ranks near the bottom of almost every health category, including choice of doctors and availability of treatments. Your contentions aren't borne out by facts.

[NavajoRug]

20. I can understand why the U.S. ranks near the bottom . . .

. . . of a category like "choice of doctors" -- because that is something that is dictated by insurance companies. Though technically, there is no limitation on someone's choice of doctors -- it's not an issue if you are willing to pay the doctor yourself.

I have a hard time believing that the U.S. ranks behind Europe, Canada, and Japan in most other areas, though.

[camero]

21. Tadaa..they do

They rank 37th out of 191 countries in the W.H.O. standings. Last among industrialized countries.

http://www.centrecountyfordean.org/000807Myth.htm

A commentary published in the July 26, 2000 issue of the Journal of the American Medical Association notes that in a comparison of 13 countries based on 16 health indicators, the U.S. ranked on average 12th. The countries included in the study were, in order from the top-ranked (best health care) to the lowest-ranked, as follows: Japan, Sweden, Canada, France, Australia, Spain, Finland, the Netherlands, the United Kingdom, Denmark, Belgium, the U.S., and Germany. Of the 13 countries compared, only Germany ranked lower overall than the U.S. In fact, the U.S. ranked dead last for three indicators. These were low-birth-weight percentages, neonatal mortality and infant mortality overall, and years of potential life lost. The U.S. ranked 11th for life expectancy for females at one year and 12th for life expectancy for males at one year. These rankings do not paint a picture of a country that has the world's best health care.

On June 21, 2000, the World Health Organization released the World Health Report – Health Systems: Improving Performance, which is accessible at http://www.who.int/whr/ (World Health Report). The World Health Report ranked the U.S. 37th out of 191 countries. According to the World Health Report, the objective of a health care system is to be both good and fair. Thus, a health care system should strive to achieve the highest possible average level of health with the fewest disparities among individuals and groups. Americans must face the fact the U.S. health system is not good and fair as so defined. (See The Health Care Fairness Act of 1999 at http://www.law.uh.edu/healthlawperspectives/HealthPolicy/991118HCFAct.html for a discussion of the lower health status of minority populations in the U.S.)

According to the World Health Report, of the 191 countries in the study, the U.S. spent the highest percentage (13.7%) of its Gross Domestic Product on health care but still managed only to achieve an overall ranking of 37. The World Health Report also found that private (non-governmental) health expenses as a percentage of total health expenses in most industrialized countries average only 25% because most have universal health coverage. In the U.S., however, private (non-governmental) health expenditure runs 55.9%

[NavajoRug]

26. Most of these figures aren't necessarily relevant to this discussion . . .

. . . because they aren't accurate indicators of differences in health care. Statistics related to life expectancy, infant mortality, birthweight, etc. are particularly misleading. The U.S. ranks poorly in these areas not because our "health care system" is inferior, but primarily because: 1) we have a substantially higher incidence of social pathologies like drug abuse, alcoholism, etc. than almost every other developed country in the world (to this day, I don't think the phrase "crack baby" can even be translated into Japanese!); and 2) we have comparatively more people living in sparsely-populated areas (and therefore not readily accessible to health care facilities) than most developed countries.

This is why we often end up looking at statistics and deriving erroneous conclusions from them. More than 30,000 people die in car accidents in this country every year -- most of these deaths show up in our mortality statistics as "premature" and reduce our overall life expectancy, but very few of these deaths have anything to do with the quality of our health care.

[camero]

31. hahahahahahahaha

Ignore the facts as "not relevent to the discussion". Nice strawman.
:eyes:

[NavajoRug]

38. That argument is not a "strawman" at all . . .

Do some research and see how many children in this country don't even have the proper inoculations when they reach the age of five. Then realize that the "quality of our health care system" has nothing to do with these figures -- because these things are given out to children at no cost to the parent.

[camero]

46. You'll have to do better than that

Takes a big person to come on here and make accusations without links to back it up. :eyes:

[Pithlet]

32. The reason

we lag behind everyone else is because we drink too much? I would just like to point out that drinking is the national sport of a good chunk of Europe. Drugs are legal in a good portion of it. You have to do better than that.

And, thanks to Camero for providing the links :hi:

[NavajoRug]

41. Why don't you go back and read my post more carefully . . .

"Drug abuse" is not the same as "drug use."

"Alcoholism" is not the same as "drinking."

I don't have these statistics at my disposal right now, but I would be SHOCKED if any of the countries that rank above the U.S. on these lists of health statistics have higher rates of violent crime, mental illness, domestic/child abuse, driving under the influence of alcohol/drugs, etc.

[camero]

44. No problem

More evidence:

http://www.who.int/whr2001/2001/archives/2000/en/press_release.htm



In North America, Canada rates as the country with the fairest mechanism for health system finance – ranked at 17-19, while the United States is at 54-55. Cuba is the highest among Latin American and Caribbean nations at 23-25.
:hi:

[NavajoRug]

57. I can see why Canada has the "fairest mechanism" . . .

. . . for health system finance -- their single-payer system is financed by a 7% national sales tax, which means that EVERY PERSON IN CANADA pays for their system. Which is certainly fair -- because every person in Canada benefits from it.

Now, do you think there are any prominent candidates for public office who have the balls to suggest a national sales tax to pay for something similar here in the U.S.?

[camero]

72. and just where did you get that from?

[NavajoRug]

77. Get what from?

My contention about the financing of the health care system?

I used to live in Canada, and I travel there for business on a regular basis.

The next time you go up there, take a look at your hotel or restaurant receipt. The "GST" you see there is the 7% Goods and Services Tax that I referred to -- it is levied on everything you purchase. It is above and beyond any sales tax you also pay to a specific province -- in Quebec, for example, you pay the 7% GST in addition to a 9% provincial sales tax.

Add a 16% tax to almost everything you purchase, and ask yourself if you still think a single-payer system is a good idea.

[camero]

79. Link please

I am not gonna believe anything you say without links. :eyes:

[Pithlet]

80. Because

we can only do it exactly the way Canada does?

[sir_captain]

82. Well, we could also jack up income tax

like many european countries do to pay for it.

I'm largely for a single-payer system, but we do have to understand that it will have to be paid for.

[Pithlet]

84. Oh, I understand that

There is definitely a trade off. I just think it is ludicrous to suggest that we'd have to add a national sales tax because that is how Canada does it (if indeed that is how they do it).

I would prefer higher taxes if the trade off is not having to worry about being bankrupted by medical bills, and my fellow Americans also don't have to go without. We would all benefit from everyone having access to health care.

[iverglas]

187. well that's just fascinating

My contention about the financing of the health care system?
I used to live in Canada, and I travel there for business on a regular basis.

Goodness, I can think of all sorts of things I must be an expert on now.

Your statement that the Cdn health care system is funded by the national Goods and Services Tax is balderdash.

The health care system is funded mainly out of general revenues at the provincial and federal levels. The GST is part of those general revenues; the GST is *not* a dedicated source of revenue. Income tax is, of course, a much larger component of general revenues than the GST.

There are some specific funding mechanisms other than general tax revenues. In Ontario, there was, for a while, a small payroll tax dedicated to health care, with small surtax on self-employed persons (maximum about $1,000 per year, for the highest earners). I believe that Ontario has gone back to general revenue funding.

Some provinces have premium payments. British Columbia is an example. The scales are sliding, and at their highest are under $100 per month for a family, as I recall.

Add a 16% tax to almost everything you purchase, and ask yourself if you still think a single-payer system is a good idea.

Well, you do the math. Or here -- someone's done some of it for you:

http://www.policyalternatives.ca/bc/wa-bc.html

An average family in BC pays almost $1,700 more a year in provincial taxes than a WA family pays in state taxes. But WA spends more than $1,000 less per person on public programs, and the effects of "smaller government" are evident in higher out-of-pocket spending by WA families for important goods and services.

Students in WA pay almost $1,700 a year more in tuition fees for public universities than students in BC.

Families in WA pay $540 more per year for the water, electricity, and fuel they use in their homes.

At $763 a year, the difference in private spending on health care alone wipes out much of WA's tax "advantage."

Families in WA spend $2,300 dollars more per year on life insurance, public and workplace pensions (excluding RRSPs), and unemployment insurance than families in BC.

I recommend the entire article, of course.

.

[Lydia Leftcoast]

156. Sure, if explained properly

"Now, do you think there are any prominent candidates for public office who have the balls to suggest a national sales tax to pay for something similar here in the U.S.?"

Definitely, if it meant never having to pay insurance premiums or copays or fight an HMO for coverage or go to the emergency room when you're critically ill because you haven't had proper health maintenance care.

People absolutely hate insurance companies.

By the way, NR, do you work for an insurance company?

[blondeatlast]

169. Well put!

[Cleita]

33. Yeah and imagine if those people you mention with social

pathologies had gotten health care when they needed it. Maybe that's the reason other countries don't have the problems we have.

Oh and the car accident argument, that one too. Sorry bub, they tried to justify 9-11 and the death toll in Iraq with that one. There is a word for it in the realm of logic but I can't think of it right now. I'm sure someone will.

[iverglas]

189. chasing smoke

That's what talking to some people feels like.

2) we have comparatively more people living in sparsely-populated areas (and therefore not readily accessible to health care facilities) than most developed countries.

Uh, yeah ... like Canada. I believe that if you look up "remote" in a dictionary, you'll find a map of Canada with most of the country highlighted.

This would be the reason that we are the world leader in certain high-tech aspects of health care. We don't just use distance as an excuse; we do something about it.

http://www.lhsc.on.ca/about/history.htm

2002 - Canadian Surgical Technologies & Advanced Robotics (CSTAR) and MD Robotics, maker of the world-renowned Canadarm, announce a partnership to develop the next generation of surgical robot.

http://www.lhsc.on.ca/about/medical.htm

2001 - LHSC conducts the world's first robotic-assisted surgery using videoconferencing technology where one surgeon assists and mentors another surgeon from a remote site, both able to manipulate the robotic technology in the operating room.

Hell, that's just one hospital in one small to middling sized city.

Yeah ... us poor sheep dying under the heel of "socialized medicine" just don't have access to all that newfangled stuff you USAmericans take for granted. Well ... at least the ones other than the 40 million of you who don't have any health care coverage ... and the ones whose health insurers actually pay for the care they need ...

Yesterday would have been my dad's 74th birthday. He died just a little before his 73rd. The summer before, he'd had a pacemaker installed; this involved a 3-day stay at a secondary hospital in a small town where he was admitted to the ICU immediately after the doctor he went to sent him to the ER, ambulance transportation to the "world-class" cardiac institute in the big city, etc. Six weeks before his death, he was admitted to hospital and found to have metastized melanoma; in those six weeks in hospital, he had x-rays, bone scans, biopsies, pain management by medication, daily consults with an internist, oncologist and orthopaedic surgeon as required, and radiation therapy, and would have had an MRI but for his pacemaker, and would have had hip replacement surgery, purely for pain relief, but for his deteriorating cardiac/respiratory condition (both the MRI and surgery were scheduled, each on 2 days' notice). All in a regional hospital outside a large city. All without a single penny paid out of pocket.

My mum sees a specialist regularly at a "world-class" eye institute in that small to middling sized city mentioned above, for glaucoma. And is contemplating joint replacement surgery, which might indeed take a little more than 3 days to schedule, not being urgent.

My partner has been in touch with his doctor at our local community clinic (where we go by choice rather than to a private practice, both involving no out of pocket charges) every day for the last week or two, either in person or by phone, because of difficulties managing the type II diabetes he was diagnosed with 4 years ago. He's going to see an endocrynologist; the appointment will be in two months - again, his situation is not urgent. We've already had the nutrition counselling the clinic offers free of charge, but the doctor offered to refer him again.

Me, I need new glasses. If I get around to replacing my health card, which went with the purse I had stolen 2 years ago, I'll go see my optometrist (I detest every ophthalmologist I've ever met, so I save the plan some money by avoiding them); adults get eye exams for no charge every 2 years, but I'll have to pay for the glasses myself, being self-employed and having no supplemental insurance coverage. Like I paid the surcharge for a private room when I spent 4 days in hospital for a biopsy a few years ago, and would have paid the $100 for a fibreglas cast on my broken foot a few years ago (rather than the standard issue, no-charge plaster cast), except that the doctor thought it was a waste of money and we decided I didn't need any cast at all. When I broke the same bloody foot again last year, I followed the rules developed at a Cdn hospital (ask google for "ottawa ankle rules"), diagnosed the problem as a break rather than a sprain, and insisted that I have an x-ray (the clinic doctor didn't see much point, but I wanted to know). No charge.

Oh, and if I decided to pay for laser eye surgery out of pocket (not being a "medically necessary service", it isn't covered by the plan), it would cost me something like a fraction of what it costs in the US. USAmericans travel to Canada for the surgery for precisely that reason.


But ... it's always just the same old crap, over and over, whenever somebody with some agenda starts talking about the Cdn health care system. Me, I'm just a dummie. I only live here. I only have myself and my friends and family and neighbours and our experiences to go on. I don't know nuttin. In actuality, I'm being denied a whole world of medical miracles that I'd have access to if only I gave up my foolish notion that everybody ought to have equal access to the health care they need.

Y'know, what it is, is just plain tiresome.

.

[juajen]

209. How do you know?

Every time I contemplate having no health care at age 62 with major health problems, I also contemplate getting drunk, having a pill or two and driving my car into oblivion. Cause and effect, man, cause and effect. I also get, let me see, depressed, angry; all sorts of emotions that can further effect my health. Tis a vicious circle.

[Bjornsdotter]

36. It Works in Sweden

Hi,

While no system is perfect, it has worked well in Sweden.

Cheers,
Kim

[Cleita]

50. Hey Kim.

Welcome to DU :toast: and thanks for the input. Bring your friends. We need to know what a decent health care system is like. We don't look for perfect but health care for all.

[blondeatlast]

170. Welcome to DU!

I love hearing the voices from overseas!

:toast:

[Cleita]

17. Haha. That old argument has been around a long time and has

no basis in fact. What's taking away control is the Heartless Money Organizations we have today.

Insurance sucks in my book at any level anyway. It has only one purpose and that is to collect as much money as possible and deliver as little compensation as it can get away with when necessary. I know. I used to work in the industry.

No one who has single payer, even in Great Britain, would trade their system for ours any day. That's what it's all about.

[NavajoRug]

19. I've "enjoyed" a single-payer system before . . .

. . . and while I'm not going to bad-mouth it, I will point out that it had its positive and negative sides.

First and foremost, what you find in a single-payer system is that it works well at providing basic health care but does not do a good job of providing high-quality care for complicated injuries or illnesses. There's a reason why the U.S. spends so much on health care compared to the rest of the world -- because we insist on having a high level of care while having someone else pay for it.

This is borne out by the fact that health costs in general are skyrocketing in this country while at the same time the costs of procedures that aren't covered by insurance are actually declining (laser eye surgery, for example, costs more than 20% less today than it did even just a couple of years ago) -- because people will always be more selective when they are paying for something out of their own pocket.

[Pithlet]

22. Got any statistics?

The US does poorly in almost every area of health care as compared to the rest of the industrialized world, including life expectancy, which is one indicator of how well emergency care does. So, I don't see how what you are saying has any basis in reality. The reason the US spends so much on health care is partly because our system discourages wellness care, and partly because our system wastes 10-30% of its money on paper work and profits for insurance companies.

Health care costs have been rising steadily for the last 10 years. A lot of companies, for example, are dropping health insurance because it costs too much.

[NavajoRug]

27. See Post #26 for my explanation . . .

. . . of why these "indicators" don't necessarily mean anything.

[Pithlet]

35. I did.

I actually thought it was kind of funny, the drinking and drugs bit. I apologize for being flippant, but those indicators actually do mean everything, and are entirely relevant to the discussion.

[Cleita]

24. You really are trotting out all the old "why it won't work for us"

adages. Been there and heard them all. Maybe Donald Trump insists on a high level of health care. Most of us would like access to health care period. Let's face it, most competent doctors can do many health procedures well. It doesn't require a specialist for every hangnail. Your argument is not valid.

[blondeatlast]

171. So put your "money" where your mouth is...

Which do you prefer?

[NavajoRug]

61. Well, let's think about this . . .

"No one who has single payer, even in Great Britain, would trade their system for ours any day. That's what it's all about."

Great Britain does not have a single-payer system. They also have a private health insurance system.

I agree that most people wouldn't trade "their system" for "our system" any day. I also contend that most people in these countries would gladly use our system if they thought they needed it. That's why you almost always see AMERICAN doctors performing delicate operations in foreign countries (conjoined twins, organ transplants, etc.), and that's why foreigners with life-threatening illnesses who can afford to do so always come to the U.S. for their treatment.

Ask any cancer patient in the world who is familiar with medical facilities and treatment options to list their preferred facility for treatment in order of their preference, and the Sloan-Kettering Center in New York will be at the top of the list. Do the same thing for heart patients, and the DeBakey Institute in Texas or the Cleveland Clinic will be at the top of the list. Do the same thing for almost any other debilitating disease, and the Mayo Clinic in Rochester, Minnesota will be at the top of the list.

Do you think this is all just a coincidence?

[Kanary]

23. Are you in the insurance industry?

[Cleita]

25. I'll bet not directly involved, but perhaps works for a PR firm

hired by one of these corporate behemouths to carefully spread disinformation about how awful single payer health care would be. They lurk at all these bulletin boards ready to strike when the subject comes up. Well, it would be bad for the insurance and HMO industry because they would have to go find another way to make money on the backs of the sick and elderly.

[sir_captain]

29. Not cool

I'm more on your side in this debate, but I think it's really unfair to cast aspersions on people just because they disagree with you. I don't believe single-payer systems (though I am generally for them) are so black and white that anyone who is against them is a shill for industry.

[Cleita]

37. Whether it's cool or not to you doesn't matter. These people

are ruining any chances of fixing our health care system and I know they exist. I have read about it on websites devoted to health care issues. If this person doesn't have a health care organization for a client then I am sure he will explain who he is.

[NavajoRug]

48. Stop being so dramatic . . .

Nobody's ruining anything. Our "health care system" (we don't really have one, but I'll go along with it for now) is not in shambles.

I run my own business (that has nothing to do with insurance or public relation), and I've educated myself on the current state of medical insurance in this country so I can deal with issues as they arise for my company.

[Kanary]

56. Bwahahahaha What a comedian!

You "kid" another poster that she must be in the porn business because of her views on health care,
but you accuse me of being "dramatic".

You're cute.

Whatever pull you had in this conversation you have burned up in smoke.

If you were so "educated", you would KNOW the ways that the US rates so low. It ain't in choice of drs.

Back to the studies. You have some work to do.

Kanary

[blondeatlast]

172. A small business? Wouldn't single payer save you money

in terms of covering your employers?

Or do you cover them at all?

[Kanary]

185. Of *course* it would

Small business people are some of the most vocal for a single-payer system.

Others just aren't paying attention, or think that whether their employees can get health care at all isn't a concern of theirs.

I really can't think of a valid reason to NOT have Universal, single payer health care.

Kanary

[mouse7]

202. Explain how a person on Social Security Disablity has no drug coverage

I was a broadcaster. I was a victim of random violence during the period in which I tried to upgrade my academic credentials to go into broadcast management. Lower brain head trauma. My claim for Social Security Disability was approved on the first application in less than 9 months. I'm the poster guy for why a social safety net was created was created in this country.

I'm supposed to be on $800 worth of prescriptions a month. I can't get them. My prescriptions cost more than my income every month. The drug company free drug programs DO NOT work. They give small inventories of the pharmaceuticals and they intentionally drag out the paperwork so that you always spend just as much time off their drugs as on them. I had 4 social workers in 3 agencies, a doctor and a resident and 4 medical staffers all trying desperately to stay on top of the drug company paperwork to try to keep me on my prescription drugs. They were getting new paperwork out the same day as it was recieved. Social workers literally driving to the doctors offices to get signitures and FedExing the paperwork out same day. All pointless. I had a social worker on my phone burst into tears apologizing because they had failed so badly. I stopped trying. The drugs cause more problem than they solve if you are constantly starting them and stopping them.

Bush's Medicare changes do me no good. Never mind not eating. The co-pays are so ludicrously high that I would have to give up my HUD housing and live in a shelter WITH the new changes to get my prescription drugs I'm supposed to be on. The only option I have is the one I've had for a while. Throw my hands up and move into a nursing home to get the medications I need every day. I'm 40. I'll be forced into that choice within 3-5 years if changes aren't made. THAT solution will force Medicare about half a million a year to pay my bills.

Now, NavajoRug, tell ME this system isn't broke.

[sir_captain]

51. Why should he have to explain who he is?

This is not a McCarthy witchhunt! People are *allowed* to have their own opinion. I don't happen to agree with some of his points, but I respect his right to have an opinion, and so should you.

People have to explain who they are in places like China and Cuba and the old Soviet Union. Give me a break.

[Cleita]

59. And we are getting him to express his opinion, not the opposite.

It seems you don't think we have a right to an opinion by questioning his.

[sir_captain]

62. No, of course you do

as I've said several times now, I even more agree with yours.

I do not object to discussing the issue. I object to your assertion that he must work for an insurance company because he disagrees with you, and your subsequent demand that he reveal his personal business. That's simply poor form, plain and simple.

[NavajoRug]

63. Thanks for standing up for me, Sir! . . .

No harm done here. I'm used to that kind of reaction to unpopular sentiments of mine here! ;-)

[Cleita]

65. For one thing, the post was to another person not the person

being discussed initially. I am allowed to post to others in your world aren't I? On edit your right I am wrong. I should have just PM'd the other person, but that always seems so sneaky to me.

[NavajoRug]

34. Let me guess . . .

You make child pornography for a living.

I'm kidding, of course . . . But my guess at your occupation is about as well-founded as your guess at mine.

[Kanary]

39. Oh yeah, you're "kidding"... hahahahaha

Trotting out ignorant objections to an insurance-based system would logically have a connection to an insurance-purveyor.

Porn does NOT in any way connect to caring enough about ALL people to be working for Universal health care.

But, of course, that doesn't mean you don't have a good sense of humor.

:eyes:

Kanary

[Cleita]

40. Well, then don't make us guess.

Tell us if you are employed by a PR firm hired by a health care organization or not.

[NavajoRug]

43. If you had waited a few minutes . . .

. . . while I responded to another post, you would have learned that I do not work in the insurance industry.

I don't work for a PR firm, either.

[Cleita]

47. So then explain why you bring up all the points the

insurance company shills do to discredit single payer health system? I mean is it coming out of your pocket that you don't wan't everyone to have health care, like elderly widows and little children? Believe me the experiences of the Canadians, Swedes, Norwegians, the Danes, the British and many more have disproved everything you object to.

[NavajoRug]

49. Heck, I'll even go one step further . . .

. . . to prove that I have nothing to do with the insurance industry, I'll even go so far as to call for the elimination of the medical insurance industry entirely.

[Cleita]

53. HMO's too.

Then we can get a system in. These guys are blocking anything meaningful that can be done.

[NavajoRug]

54. OK -- get rid of all of them . . .

I will point out, though, that a "single payer" is no different than an HMO in how it functions.

[Cleita]

67. Wrong again.

Whose giving you all this misinformation? In Canada, you can go to any doctor or hospital you want to, flash your card and get care. Under the HMO system you are limited to the doctors and hospitals they say you can go to. If you travel, you aren't covere out of the HMOs area except for emergencies and having experienced this personally, you could die waiting for them to approve emergency care.

In my area most caregivers won't accept any HMO because of the poor reimbursement rate so people have to travel miles to other cities to see a doctor.

[NavajoRug]

71. Bingo -- that's exactly how a single-payer system works . . .

"In my area most caregivers won't accept any HMO because of the poor reimbursement rate so people have to travel miles to other cities to see a doctor."

This is exactly why Canada has such a problem with a chronic shortage of health care professionals -- because the reimbursement rate is so poor, but there is only one "HMO" (the government). That's why so many Canadian doctors end up practicing medicine in the United States.

[Cleita]

85. I'm sparing with you right now because it's kind of fun

to see you bring up these for profit health care industry points, which I have seen posted many times. However, I think it's time for you to start quoting your sources because nothing you have said is true. I have not been able to find one resource that states that doctors and nurses are abandoning Canada because of this. Now maybe you have been sold a bill of goods, but if you are sincere, Kanary and I can supply you with a list of reputable sources about how other systems work in other countries and what is wrong with our system.

[NavajoRug]

89. Even before I lived there, I knew there was a problem in Canada . . .

. . . Because EVERY TIME I traveled there over a period of ten years, one of the lead stories on the news was a strike or slow-down by health care professionals in one province or another. Without fail.

[Cleita]

91. That's because they have unions that are effective.

Their health care professionals have a voice. I love socialism.

[NavajoRug]

96. Like I've said before . . . it's a trade-off.

What's great for the union is absolutely abysmal for the patient. And the "patients" in Canada are also the "employers" of the workers who are on strike -- and nobody is happy when push comes to shove.

[camero]

106. Myth. All myth

http://www.pnhp.org/facts/singlepayer_myths_singlepayer_facts.php

Myths about National Health Insurance (NHI)

The government would dictate how physicians practice medicine.

In countries with a national health insurance system, physicians are rarely questioned about their medical practices (and usually only in cases of expected fraud). Compare it to today’s system, where doctors routinely have to ask an insurance company permission to perform procedures, prescribe certain medications, or run certain tests to help their patients.

Waits for services would be extremely long.

Again, in countries with NHI, urgent care is always provided immediately. Other countries do experience some waits for elective procedures (like cataract removal), but maintaining the US’s same level of health expenditures (twice as much as the next-highest country), waits would be much shorter or even non-existent.


Government programs are wasteful and inefficient.

Some are better than others, just as some businesses are better than others. Just to name a few of the most successful and helpful: the National Institutes of Health, the Centers for Disease Control, and Social Security. Even consider Medicare, the government program for the elderly; its overhead is approximately 3%, while in private insurance companies, overhead and profits add up to 15-25%.


People will overutilize the system.

Most estimates do indicate that there would be some increased utilization of the system (mostly from the 42 million people that are currently uninsured and therefore not receiving adequate health care), however the staggering savings from a single-payer system would easily compensate for this. (And remember, doctors still control most health care utilization. Patients don’t receive prescriptions or tests because they want them; they receive them because their doctors have deemed them appropriate.)

[NavajoRug]

116. One thing is definitely not a myth . . .

. . . any single-payer system that "works" to any degree requires a substantial level of indemnity for the government and health care providers against lawsuits. Is the United States prepared for this?

[camero]

117. Again. Evidence

That's your opinion. Who made you the patron saint of health care?

[Cleita]

121. If the US isn't, then we have no right calling ourselves

a superpower. Are you sure you aren't in the insurance industry? All these insurance terms keep sneaking into your posts. If you are, I think you kind of owe it to us to be upfront what your iron in this fire is. We have been upfront with you.

[NavajoRug]

124. I am not in the insurance industry . . .

I run a small engineering consulting firm. If these "insurance terms" creep into my posts, it is because I am constantly reviewing materials from my insurance companies every time our policies are up for renewal.

[blondeatlast]

178. Again, wouldn't single payer remove a huge burden of funds and time?

[blondeatlast]

177. I guareantee he does not have a chronic or debilitating illness,

as many in this thread advocating FOR U-SP do.

That changes one's perspective REAL fast.

[Cleita]

107. Well, imagine having happy workers caring for you. How

abysmal. I doubt if anyone didn't get the care they needed. Do look up and article or too for me that reports on the conditions in hospital emergency rooms and such that were so abysmal. My understanding is that elective and non-urgent procedures maybe were moved back, not a wholesale abandonment of the medical facilities.

[blondeatlast]

176. Strong unions are the best thing for patients;

they advocate, among many other things, for lighter workloads, less paperwork, more time in direct patient care...

I have been hospitalized probably 30 times in my life, and I have learned more about health care workers than even they may be aware of.

The only contemptible greedheads in the medical industry are the insurance companies. My experience has truly borne that out.

Edit: and some employers who offer "health insurance," then don't pay the inscos.

[blondeatlast]

174. And HMOs are beholden to their shareholders, so the bottom line is; well,

the bottom line.

[blondeatlast]

173. Huge difference; single payer bears no shareholder responsibility.

ENORMOUS difference.

[NavajoRug]

52. How many "elderly widows" and "little children" are there . . .

. . . in this country who don't have access to health care? My guess is that the number is miniscule -- because hospitals are prohibited by law from turning away patients who don't have the werewithal to pay their bills.

[Cleita]

64. Wrong.

Our Medicare is being destroyed as I type. In a decade elderly ladies are going to have to go out in the bushes and die like a cat if this doesn't stop. Little children can't get jobs. If their parents have a few assets they'd like to keep for the kid's education, they can't get Medicaid.

I did another post that didn't post about your business. Why wouldn't you want all your employees covered with health care by a single payer? If I was a business owner, this would be a welcome thing and one less thing that I would have to worry about.

[NavajoRug]

68. Your post is very confusing . . .

. . . because you've made a strong argument in support of what I've been saying. Medicare and Medicaid are the closest things this country has to a single-payer system, and they're on the verge of collapse due to the inherent weakness of a single-payer system in this country -- WE SIMPLY CANNOT AFFORD THE QUALITY OF HEALTH CARE THAT WE WANT TO HAVE. Medicare is being destroyed because it is a demographic house of cards that can't survive. Medicaid is being destroyed because the number of "recipients" is grossly out of balance with the number of "donors" (taxpayers).

"Why wouldn't you want all your employees covered with health care by a single payer? If I was a business owner, this would be a welcome thing and one less thing that I would have to worry about."

I agree. What I don't want is: 1) to have all my employees covered by a single-payer system that I myself would be forced to use; and 2) to have all my employees covered by a single-payer system that my company would have control over but would be forced to support financially.

I have said for years that the best thing we could do in this country to "fix" our health care system is to get rid of this silly, outdated idea that employers should pay the cost of medical insurance for their employees. I don't pay the mortgage or rent on my employees' homes, nor do I make their car payments.

[Cleita]

75. Medicare is being undermined by the idiots in Congress who

are trying to privatize it out of existence. As it was before the HMO's got their nose under the tent, it worked fine. The laughable drug benefit was designed to bankrupt it sooner rather than later. Medicare as constructed by the Johnson administration was a life saver. We should extend Medicare to everyone and fund it fully like it should be.

[NavajoRug]

81. I think your understanding of these things is incorrect . . .

"The laughable drug benefit was designed to bankrupt it sooner rather than later. Medicare as constructed by the Johnson administration was a life saver. We should extend Medicare to everyone and fund it fully like it should be."

Medicare as constructed by the Johnson administration was only a lifesaver in the same way that Social Security as constructed by FDR was a lifesaver. They only worked because most people did not live for very long after they retired. Once the life expectancy of Americans reached a point where a substantial number of people would spend several DECADES on Social Security and Medicare, it was only a matter of time before these programs would collapse.

The prescription drug benefit wasn't designed to bankrupt Medicare -- it was designed to relieve the burden of large numbers of retirees on private pension plans for major U.S. corporations like General Motors. GM can't even compete in the global marketplace anymore, because the average car they produce must include about $1,200 on top of its price to pay for their exorbitant pension and health care costs for retirees.

[Cleita]

88. Your GOP talking points are inaccurate and constructed as

propaganda by the disinformation spreaders at the RNC. They believe I guess that people should all die when they are fifty, unless it's one of them I suppose. If Mr, Bush can spend what he has on this war, we can have health care and Social Security and child care and decent education for those who deserve it.

[NavajoRug]

93. You and I agree on one big thing . . .

"If Mr, Bush can spend what he has on this war, we can have health care and Social Security and child care and decent education for those who deserve it."

Absolutely. But this has nothing to do with whether a single-payer system is better than what we've got now.

[Cleita]

98. Anything is better than what we have now.

A witchdoctor would be better than what we have now and much more affordable.

[NavajoRug]

101. Just remember this . . .

. . . YOU WILL GET WHATEVER YOU WANT TO PAY FOR.

If your insurance plan costs $8,000 per year today, then you are going to pay something close to it no matter what system you have in place. If you want to get that cost down to $5,000 per year, you'd better be prepared to settle for less -- about $3,000 less.

If you want to spend $500 per year, be prepared for the witchdoctor!

[Cleita]

109. The problem is I'm paying for what I'm not getting.

Capice?

[NavajoRug]

114. Exactly . . .

That's what insurance pools are all about. That grim reality for you is not going to change under a single-payer system.

The bulk of the population that will never need a kidney transplant, radiation treatments, open heart surgery, etc. will always pay far more into the system than those who do need these things.

[camero]

115. WTF?

You really think most of us die of natural causes? Just more right wing talking points. :eyes:

[NavajoRug]

119. Are you kidding me?

"You really think most of us die of natural causes?"

Absolutely.

That wasn't my point, anyway -- I simply pointed out that in any insurance pool, most of the "members" will pay far more in premiums than they ever get in benefits.

Look at homeowner's insurance. It's so damned cheap even in high-risk areas because most people can live in a home for 30+ years and never file a single claim.

Medical insurance, on the other hand, is very expensive -- because most people file claims with boring regularity.

[camero]

122. Not even close

http://www.cdc.gov/nchs/fastats/lcod.htm

Number of deaths for leading causes of death

Heart Disease: 700,142

Cancer: 553,768

Stroke: 163,538

Chronic lower respiratory diseases: 123,013

Accidents (unintentional injuries): 101,537

Diabetes: 71,372

Influenza/Pneumonia: 62,034

Alzheimer's disease: 53,852

Nephritis, nephrotic syndrome, and nephrosis: 39,480

Septicemia: 32,238

I think most of us will die of one of these things.

[NavajoRug]

127. Maybe I'm missing something here . . .

Heart Disease: 700,142
Cancer: 553,768
Stroke: 163,538
Chronic lower respiratory diseases: 123,013
Accidents (unintentional injuries): 101,537
Diabetes: 71,372
Influenza/Pneumonia: 62,034
Alzheimer's disease: 53,852
Nephritis, nephrotic syndrome, and nephrosis: 39,480
Septicemia: 32,238

According to my calculations, 95% of the causes of death you've listed here are "natural causes" (all of them except the 101,537 in the "Accidents / Unintentional Injuries" category).

What do you think constitutes a "natural cause" of death?

[camero]

128. How do you define it?

I don't necessarily define cancer and heart disease as "natural".
Now you're just being preposterous.

[NavajoRug]

133. By your definition of "natural causes" . . .

. . . it seems to me that anyone who dies can't possibly die of "natural causes."

I'll go one step beyond what I posted before -- I recently read an article in a medical journal that said something to the effect that not only do the vast majority of people die of "natural causes," but something like 95% of the U.S. population dies of the "natural cause" that THEY WERE GENETICALLY PREDISPOSED TO DIE OF. I found that quite remarkable -- and based on what I've learned about family history of illnesses, etc. I tend to believe this.

[camero]

138. Where is your evidence?

I haven't seen any yet.

[blondeatlast]

181. Citation?

[blondeatlast]

180. And many are preventable or controllable--I have ID diabetes

and at least one other poster on this thread has non-IDD and we are all too familiar with the shambled medical system we have now.

I hope you are disease free; I'm willing to bet that you are.

[camero]

193. I'm IDD now

Good points all blondeatlast :hi:

[blondeatlast]

214. Damn, I'm sorry about that.

You know where to ask the questions, though!

[Cleita]

120. Insurance works by taking a calculated risk that an event is

not going to happen that you are insuring for. Like you get car insurance because you may get into an accident, however, you aren't planning on it. It this way insurance is good. It's when it starts insuring for things that are inevitable is when it get bad. This is what happens with health insurance. It's starts cherrypicking the lowest risk clients at the expense of those who will need health care the most the sick and the elderly. It's not fair to have paid into health insurance all your life and seldom use it except for routine care and then when the big cancer comes along they dump you, or you get old and they dump you.

This is why pooling health care dollars for those who need the health care today makes sense. When your turn comes and you need health care, those dollars should in a fair system be available to you without any profiteers mucking up the works.

[NavajoRug]

123. Your understanding of insurance . . .

. . . is right on target. One thing I would dispute, though, is that "insuring for things that are inevitable" is somehow a problem. There is nothing more inevitable than death, and yet life insurance is a remarkably stable business in terms of costs.

The real problem with health insurance isn't so much the "big cases," but the relatively minor ones that take up so much time and paperwork. For the life of me, I can't understand why anyone thought it was a good idea to have an insurance company cover routine visits to the doctor. The whole purpose of insurance is to have something that covers catastrophic illnesses and injuries -- not "ordinary" medical care.

"It's not fair to have paid into health insurance all your life and seldom use it except for routine care and then when the big cancer comes along they dump you, or you get old and they dump you."

This is exactly why I have been such a strong supporter of tax-deferred accounts for medical expenses. Because the flip side of what you've said is also true -- it's really not fair to ask an insurance company to pay for medical procedures that often didn't even exist for all the years that you were paying premiums. That's why health insurance costs are so high these days -- because the standard of care is rising so fast.

[Cleita]

126. Not so fast.

Life insurance has always been a candy store for insurance companies. By the time people pay into life insurance in a lifetime, they would have been better off saving the money and accumulating the interest. What the life insurance company will pay in a death benefit is a paltry sum compared to what they earn off a person in their lifetime. The calculated risk is when a young person dies unexpectedly and they have to ante up. Watch those policies dry up when some guy goes into the army dudring wartime or has a end stage disease or a dangerous job. Even Lloyds won't touch many of those.

And you just made my point about health insurance. Insurance companies don't belong in health care.

[NavajoRug]

131. I think your life insurance company has been screwing you . . .

The situation you describe really only applies to a term life insurance policy.

The next time you talk to an insurance agent, ask him about a universal "flex" life plan with an enhanced death benefit option and. Basically, you pay a pre-determined premium every year for as long as you live, and your premiums are invested in mutual funds, etc. of your choosing. Depending on the performance of your money over your lifetime, it will eventually (as long as you survive for a reasonable length of time) exceed the death benefit. At this point, you can either: 1) stop paying the premiums entirely; or 2) continue to pay the premiums, which means your death benefit will grow as you accumulate more money over time.

"By the time people pay into life insurance in a lifetime, they would have been better off saving the money and accumulating the interest."

This is nonsense. The insurance plan I described above is no different than a personal savings plan, for all intents and purposes. Here's the catch, though -- you are better off with the insurance policy even if your rate of return with the insurance investments is less than what you could get on your own -- BECAUSE THE INSURANCE BENEFIT IS EXEMPT FROM ALL TAXES WHEN IT IS PAID OUT TO YOUR BENEFICIARY.

[Cleita]

146. I think you need a reality check.

At my age no insurance company offers to senior citizens what you younger guys get because there is no profit in it. Back in my youth term life was all that was available. I never had life insurance anyway unless it was a work benefit I couldn't do anything about because even at a very tender age I knew it was a screw the insuree benefit. I worked for insurance companies and salespeople were always pressured to sell life insurance because it was one of the cash cows the companies could rely on.

[blondeatlast]

182. Cripes--routine visits keep me from having catastrophes.

Saving the insurance companies countless dollars.

I have 4 dotors I see regularly to keep my diabetes in control and the rest of me healthy. I can't afford the "routine" visits; I would be bankrupt.

What's sadder is the gratefulness for what coverage I do have. Without it, I'd be ...

DEAD.

It's as simple as that.

[revcarol]

211. We don't get what we pay for because of profits, high CEO and other

administrator costs,incentives to keep from delivering care,etc. I would gladly take the increased care I would get, instead of the 15-30% overhead and profit the insurance companies get.Make the system conform to the 3% overhead of Medicare and GIVE US THE CARE WE ARE ALREADY PAYING FOR.

[Spazito]

153. What a crock!

I pay 63 dollars a month, get great healthcare, have NEVER had to wait an inordinate time to see my doctor, the doctor I CHOSE. I was in an accident in another province, was not badly hurt, went to emergency, saw a doctor within 30 minutes, was treated, came home, got an appointment immediately to see my doctor, etc. I can't help but laugh at the spurious arguments used against Universal Health Care. Is UHC perfect, no, is it better than having millions with no coverage, etc, YES!

[blondeatlast]

183. That's it--I'm moving. The kid will come, the husband will

have to decide...

[Lydia Leftcoast]

157. Let's see now

I'm paying $161 a month with a $1000 deductible and 20% copays after that. That's absolutely the best deal I could get.

Since I'm pretty healthy and haven't seen the doctor except for routine checkups for years, I'm paying nearly $2000 a year out of pocket for NOTHING.

And forget about shopping around. Doctors have fixed expenses (office expenses, staff), as well as malpractice insurance and student loans to repay. Do you think a sick person is really going to phone around and ask, "How much do you charge for an office visit?" They all seem to charge about the same anyway--$90 to $100.

For a member of the working poor, this means no office visits. Oh, and a lot of doctors (like my brother) are under insurance contracts in which they're NOT ALLOWED to offer discounts to people who pay cash.

[blondeatlast]

179. Many small business organizations are advocating U-SP fro the very

reasons you cite.

It's sensible, so it can't possibly be good for US citizens.

:eyes:

[camero]

83. Children

http://www.childrenspartnership.org/pub/next/0598/uninsured.html

70% of uninsured children have family incomes at or below
200% of the federal poverty level ($27,300 for a family of three)
- making them potentially eligible for SCHIP or Medicaid.


4.4 million uninsured children are eligible for Medicaid but
not enrolled.

More than 90% of uninsured children have one or more parents who work.


3 in 5 uninsured children live in two-parent families.

Almost 30% of all Hispanic children do not have health insurance -
compared to 19% of African-American children, 16% of Asian and Pacific Islander children and 14% of white children.


Uninsured children are almost 5 times less likely than insured children to have a regular provider of care.

http://www.amsa.org/cph/CHIPfact.cfm

Nearly 10 million children age 18 and under are uninsured.

[NavajoRug]

86. It should be noted, of course, that . . .

. . . the assumption that someone who is "uninsured" does not have "access to health care" is completely false.

[Pithlet]

87. Oh?

People aren't turned away from doctors and hospitals because they can't afford them? People aren't denied life saving procedures because they can't afford them? Are you sure about that? I'd do a little fact checking, if I were you.

[NavajoRug]

90. Here's your assignment for the week . . .

"People aren't turned away from doctors and hospitals because they can't afford them?"

Document any such cases that you find, and report the hospital in question to your state medical board.

"People aren't denied life saving procedures because they can't afford them? Are you sure about that?"

Of course they are. And guess what -- they're going to be denied life-saving procedures under a single-payer system, too . . . because that's the only way such a system can survive.

[Pithlet]

103. Bull

First of all, I'm going to go and find some cases because it can't be all that hard to find. There was recently a story on my local news after all about a mother with cancer who will die because her insurance will not cover the procedure needed. Most insurances do, however, because the one that her employer chose does not, she does not get the treatment. There was a fundraiser mentioned for members of the community to pitch in so this mother does not have to die. Have you ever seen TV Nation, the show by Michael Moore? He had the father who needed a liver transplant that his insurance wouldn't cover, a surgery that he needed to survive. And these are people WITH insurance! If I can just think of a couple off the top of my head, I'm sure my little assignment will be a piece of cake.

Talk about assignments? Find me evidence to back up your claim that the only way a single payer system can survive is to deny life saving procedures.

Lastly, even in cases where people are not turned away, they are often plunged into deep debt and bankruptcy because of those bills. Many people don't seek out the care they need because of situations like those.

[NavajoRug]

111. I hate to break this to you . . .

. . . but rationing care is the foundation of a single-payer system. Even Hillary Clinton admitted this was the case when the Clinton health care plan went down in flames in 1993.

"There was recently a story on my local news after all about a mother with cancer who will die because her insurance will not cover the procedure needed. Most insurances do, however, because the one that her employer chose does not, she does not get the treatment. There was a fundraiser mentioned for members of the community to pitch in so this mother does not have to die. Have you ever seen TV Nation, the show by Michael Moore? He had the father who needed a liver transplant that his insurance wouldn't cover, a surgery that he needed to survive. And these are people WITH insurance! If I can just think of a couple off the top of my head, I'm sure my little assignment will be a piece of cake."

There is no doubt in my mind that these things happen all the time. You have to understand, though, that you will ALWAYS have cases like this involving insurance companies (or GOVERNMENT AGENCIES) that deny payment for what they deem "unusual" procedures. There's no way any health care system can possibly cover every possible treatment for every illness or injury. Insurance, whether private or government-sponsored, is nothing more than a means of spreading risk among a large pool of people. There is simply no way to get around the harsh reality that there are limits on what can be paid to cover a patient's costs. Those harsh realities don't disappear just because a government is paying for a procedure instead of an insurance company.

[Pithlet]

125. It's being rationed now.

The determining factor now happens to be who can afford it, or who has adequate insurance, not who needs it the most. Right now, rationing is not based on need, but on who can afford it, and who profits.

You may have to wait longer for non life threatening medical conditions, depending on the system we implement. You have not proved that rationing has to include denying life saving medical care simply because it isn't being run by corporations.

I don't think anyone is saying that all of our problems magically disappear. But, we've been using a system based on profit and run by CEOs and it is spiraling ever downward. You keep repeating over and over again the same thing: "There's no way it can be done". Look at all the other countries that are doing it! Surely we can come up with our own version. Surely we, the "richest nation in the world" can make sure that every single citizen has access to decent health care. Instead of repeating yourself, show me examples of people in Canada or Europe suffering and even dying because of lack of health care. Show me the millions of people who can't see a doctor because they can't afford it in those countries. Where is the proof?

[blondeatlast]

188. Rationing by severity and immediacy--NOT by who can pay and who can't.

Are you SURE you've been to Canada?

[blondeatlast]

186. They are sent to woefully underfunded county and city hospitals.

My sister is a county hospital worker and she can tell you some cases that will make your hair stand up...

[camero]

100. Touche'

http://www.newswise.com/articles/view/503692/

Health care for children covered by government programs like Medicaid and the State Child Health Insurance Program (SCHIP) appears to be improving, but the gap in care is widening between these publicly insured children and poor children without insurance, a new national report by the University of South Florida and federal Agency for Healthcare Research and Quality (AHRQ) indicates.

“Publicly insured children still do not receive the same type or amount of health services as privately insured children, but they are better off than uninsured children,” said lead author Lisa Simpson, MB, BCh, MPH, professor of pediatrics at the USF College of Medicine who holds the All Children’s Hospital Endowed Guild Chair in Child Health Policy. “In fact, the proportion of uninsured children who made at least one office visit (to a physician or other health care practitioner) dropped from 52 percent in 1987 to 43 percent in 1999.”

Despite our gains in insuring more children,” Dr. Simpson said, “we’re spending less of our overall health care dollars on children.”



Man, where is your evidence and not just your opinion?

[Cleita]

112. He doesn't have any because everything he has brought

up has been debunked with facts by us in previous threads.

[camero]

113. I dunno

I keep daring him/her but he/she doesn't want to take the challenge.

:shrug:

[Cleita]

147. Because he can't. He doesn't have any factual

figures and historical analysis to do so.

[blondeatlast]

184. BULLSHIT. If I had not had health insurance when I had

a near heart attack AT THE AGE OF 38, you think I'd be debating you now?

What a crock, indeed. I have no illusions about that situation whatsoever. I know far too many people in the hospital industry NOT to know.

Wanna trade lives for a day? I would love to...

[Kanary]

92. Do you know people have actually been jailed for not paying those bills?

Nope, didn't think you knew that.

THat's right.. JAILED.

Hounded and JAILED.

That's after they were charged much more than an insured person would have been charged.

Your compassion is truly touching.

What book is it from?

Kanary

[NavajoRug]

99. I have never heard of a case like that . . .

. . . at least not where I live.

"That's after they were charged much more than an insured person would have been charged."

Usually it's the other way around -- the insurance companies pays exorbitant rates for medical care, to make up for: 1) the cost of providing care to the uninsured; and 2) the low reimbursement rates for government-paid programs like Medicare, Medicaid, CHIP, etc.

[Pithlet]

129. It's true.

I didn't believe it either when I first heard that people are actually arrested. I was naive to think that couldn't happen in the good ol' US of A. But, it's true.

http://www.democracynow.org/static/healthcare.shtml

snip

Take the case of Jim Bean, a musician in Urbana, Illinois. More than a decade ago, he received treatment at the Carle Foundation Hospital, the primary teaching hospital of the University of Illinois at Champaign-Urbana, for a gunshot wound after a failed suicide attempt. He attended 13 court dates to answer to his $7,718 hospital bill. But then Bean missed a hearing, which he says he did not know was scheduled. The hospital asked the court for an arrest warrant.

"They put out this body attachment that I found out about the next day. I went and turned myself in," recalls Bean. "I went to find out what was going on, and they told me to go across the street to the county sheriff's office where I turned myself in. I was jailed, and I was put into general population at the satellite facility here until my brother could come up with 10% of $3,500 to bail me out of jail."

snip

There's more at that link.

[NavajoRug]

132. I accept that as true, but I think you picked a bad example . . .

If I were an insurance company I'd have that guy thrown in jail, too. No hospital or insurance company should ever be asked to foot the bill for a self-inflicted injury like that.

[camero]

134. Your health care system is dying

http://www.mercola.com/2002/feb/27/death_of_medicine.htm

The Death of Medicine

No Cure, No Vaccine, No Treatment
By Nicholas Regush

There is no way to be nice about this. There is no point in raising false hopes. There is no treatment or vaccine in sight. There is no miracle breakthrough on the horizon.

Medicine, as we know it, is dying. It is entering a terminal phase.

What began as an acute illness reached the chronic stage about a decade ago and progression towards death has been remarkably swift and well beyond anything one could have predicted.

The disease is caused by conflict of interest, tainted research, greed for big bucks, pretentious doctors and scientists, lying, cheating, invasion by the morally bankrupt marketing automatons of the drug industry, derelict politicians and federal and state regulators - all seasoned with huge doses of self-importance and foul odor.

[NavajoRug]

135. I agree with that post 100% . . .

. . . which is one reason why I have no illusions about a single-payer system in this country:

"The disease is caused by conflict of interest, tainted research, greed for big bucks, pretentious doctors and scientists, lying, cheating, invasion by the morally bankrupt marketing automatons of the drug industry, DERELICT POLITICIANS and FEDERAL AND STATE REGULATORS - all seasoned with huge doses of self-importance and foul odor."

[camero]

136. Single payer will work much better

The state and federal regulators regulate insurance. So the way to go is to get insurance out of the game.

Oh, and the derelict politicians are REPUBLICANS.

[Pithlet]

137. Ugh

I'm truly gobsmacked. I cannot even think of a reply to such a statement. That doesn't happen very often.

[camero]

139. What's next?

Debtor's prison? Go ahead and say it. You know you want to. :)

[Kanary]

130. Didn't think you had

It's been posted here before, in previous health discussions.

The Dickensonian times have arrived in the US.

No, it's not "usually the other way around".

Check into your statement again.... your "facts" just don't measure up.

Kanary

[eridani]

165. They do it anyway, illegally

18,000 people a year die in the US because of being unable to pay for health care.

[blondeatlast]

215. They can't turn them away, but they have NO obligation to give adequate

treatment to the poor and indigent beyond ethics.

You seem to think you know wmuch about the health care "system" yet some of your info is woefully lacking in depth.

If you think hospitals don't treat the uninsured and ind insured differently, all I can say is...

Disneyland must be a very nice place to live.

[NavajoRug]

28. No . . .

I'm not.

[blondeatlast]

167. Take out the word "insurance" from the issue and replace with "care."

[IndianaGreen]

30. Another issue in which Dennis Kucinich is right about!

Go Dennis, go!

[Kanary]

42. As someone once said....

Ten years from now, Dennis' ideas will be mainstream.

Then, everyone will be saying "Why didn't we do this 10 years ago?"

So, avoid the rush and implement the Kucinich ideas NOW......

Kanary

[stopbush]

55. This might be OT, but I had an interview with AFLAC this week.

I didn't take the job (sales - bleech! Not for me!), but the interviewer lady was telling me about their supplemental cancer insurance. She stated that having a cancer victim in a family is the leading cause of bankruptcy in the USA. Scary.

[Kanary]

58. Half of all bankruptsies are due to medical expenses.

Lovely country this is.

NOT

What people who are trying to fight cancer need most is to fight with insurance companies, drs and hospitals, and have nightmares about losing everything they have.

Yeah, what a great country.

Kanary

[blondeatlast]

190. I'm an example, and I'm not afraid to say it.

We paid the employer, employer pocketed the funds without paying the insurance company.

I had a near heart attack. Fortunately, the insurance company, for whatever reason, considered me covered, so I had the lifesaving surgery.

Thirteen months later, we get a bill for an incredible amount--and we had perfect credit. Perfect. The only way to save ourselves was to declare.

If the insurance company had not confirmed my coverage, for whatever bizarre reason they did, I wouldn't be here.

I'm certain of it.

And my Congresspeople know the whole sordid story--oh, yes, they know.

[SOteric]

60. I'm more for a single payer system than against one, -but

a close friend of mine from New Zealand has much to say about how socialised medicine bankrupted their healthcare system and so overburdened their economy that he makes excellent point about doubting it can be simple.

It brings into question the quality of care as well. I have to wonder if some blend of systems, one which allows the wealthy to engage in healthcare at their discretion and to hire the most reputable specialists at the highest fees, but still allows the middle class and the poor access to healthcare funded by a government program.

[sir_captain]

66. Good points

Socialized health care systems are not as slam dunk of a success as they are sometimes made out to be. First, they depend on very high taxes that I doubt even liberals in this country would want to pay. Second, doctors in socialized systems are undercompensated for the level and amount of work that they do, imho. Though maybe I think this just because it is the line of work I'm going into! ;-)

Of course, I think another issue is that the system gets clogged because so many people take advantage of the free care for maladies that they might usually not bother with. I once sat with a friend in the ER in Canada for almost 36 hours holding a compress to the gash on his head. I'm not sure if it was the triage or if they were just too swamped, but it didn't seem too great to me.

I guess a single-payer system, rather than a straight out socialized system, would avoid the latter issue to a certain degree, but I don't feel like I really know enough about it.

[SOteric]

118. I think this is possibly the case even with the current HMO

"Second, doctors in socialized systems are undercompensated for the level and amount of work that they do, imho. "

situation. HMO's have effectively eliminated a lot of specialisations for physicians and made referrals to specialists dependendent upon the judgement of a primary care physician, usually a general practitioner. Those general practitioners are strongly encouraged to take on some of the simpler tasks specialists may have done in the past. Less hefty fees available for specialists. More work for the general practitioner.

[Cleita]

69. The blended system lowers the quality of health care.

Study the British system for how that happens. This is why the Canadian system works so well because they refused a class structured system, so the quality of care is better for everyone.

[NavajoRug]

74. I think your post is a little naive . . .

"This is why the Canadian system works so well because they refused a class structured system, so the quality of care is better for everyone."

The Canadian system IS a "class-structured system" -- though they don't like to admit that it is. The upper tier of their health care system is called the United States.

[sir_captain]

76. To be fair

one could probably describe the US as the upper tier of *every* health-care system.

[Cleita]

78. Here we go again.

"Busloads of Canadians crossing our borders to get decent health care."

Heard that old canard before. We have many Canadians on this board who will tell you differently. Yes, there are a few retarded Canadians who believe our system is better. One was complaining to me about having to wait in the emergency room for a whole hour and blah blah about their system. When I pointed out that most emergency room waits are several hours here and if you don't have insurance you have to pay $250 up front to get in the door, her eyes got wide and her mouth dropped.

Nothing like a little reality check there.

[FlaGranny]

143. Good one - the Canadians I know (many)

go home to get health care.

[Cleita]

148. Yes, and we American who have been getting drugs from

Canada and Mexico by the busload on both borders. This is the truth no one reports.

[Kanary]

97. The naivete' is on your side

The Canadians have a much more innovative treatment for diabetes than the US, and are excelling in other areas, also.

Sorry, your "talking points" just won't cut it here.


Kanary

[NavajoRug]

104. When was the last time . . .

. . . a child from a Third World country in desparate need of an organ transplant was flown to Canada for treatment?

I didn't think so.

How about an operation to separate conjoined twins? Would they even try to do something like that in Canada?

[Kanary]

140. Do you know the answer?

Didn't think so.

However, I notice you don't even have the grace to reply to the fact that Canada *IS* more innovative in some treatments than the US.

While I wish *everyone* had good treatment for whatever befalls the human race, in all fairness, there are certainly a lot more people with diabetes than there are conjoined twins.

It would be interesting if you would really state your real reasons for so much animosity for a system that would benefit so many.

But, I won't hold my breath. Bushwa didn't state his real reasons for a war, either.

Kanary

[Lydia Leftcoast]

158. If they were, it would not be reported in the U.S. press

I have heard of Third World children being flown to Europe for surgery, though.

[sir_captain]

196. In this case

I will have to disagree with you. People come from all over the world to go to hospitals like Johns Hopkins, Mass General, Columbia-Presbyterian, and the Mayo Clinic. These are among the very best hospitals on the face of the planet. Much like our education system, there is not a problem with our high-end services--the problem is that 90% of people don't have access to that quality care.

[camero]

197. John's Hopkins

The very same people that mistreated tonsilitis in me FOUR times and led to my hearing loss. World class? I'll bet.

[sir_captain]

198. That's obviously horrible

but it doesn't also mean that top American hospitals, Hopkins included, don't have some great, best-in-their-field doctors too.

[camero]

199. I don't doubt that

How they use their skills is what I doubt. And you have to admit that is a simple diagnosis and treatment. We patients all too often get caught in the middle of medical debate and suffer for it.

Don't just take up for your own. Learn to see the faults and root them out and you will be a better doctor for it.

[sir_captain]

200. oh, absolutely

i'd like to think that i'm pretty objective, and i've worked with lots of terrible doctors as well as good ones. lord knows i know where i want to be taken in NY in case of an emergency, and it's not my local hospital ER.

clearly, in your case, there was a serious malpractice situation.

one major problem, though, as i see it, is that most people have a double-standard when it comes to the medical profession. on the one hand, they want their doctors to be perfect machines, inhuman in their ability to diagnose and treat every possible symptom. and on the other hand, they criticize doctors for being inhumane, unfeeling, and greedy. doctors are, after all, human, and they are going to make mistakes. i don't know one doctor who hasn't, and who doesn't think about his or her mistakes every day. once upon a time, doctors were nearly gods in the minds of most people, and now most people can't stand them. imho, the truth lies somewhere in the middle--both those extremes are bad.

but of course, none of that really has to do with your situation. it sounds like your case was really unforgivable.

[camero]

201. It was a part of medical debate

It was at the time where they were taking tonsils and adenoids out of practically every child and when I walked in the debate was going the other way towards treatment with antibiotics. Not really unforgiveable. I never tried to sue them though I very well could have.

The problem I see is with the "code of silence" that doctors have like the police and thier inherent urge to diefy themselves.

I don't see my doctors as machines but certainly wish they had better ethics.

[sir_captain]

203. no argument there

i think most people could use better ethics

medical ethics is starting to be a starndard part of the medical school curriculum--here's hoping it makes a difference. i think part of the problem is that the application process to med school is so nuts that it's kind of impossible to do anything except taking science classes; and lord knows science classes aren't going to help anyone learn anything about how to treat people with humanity. it's one of the reasons i majored in history in college, actually--i thought it would make me a better doctor down the road.

[camero]

204. Agreed

It will make you a better doc down the road. The best doc I ever had was one who was in my small town and was a pediatrician by craft but took all patients because our town had too few doctors and the government helped him with his loans and costs. The man knew alot.

When the town got bigger he returned to his specialty.

Edit: I also agree in that people all around could use better ethics. I shouldn't have left that out originally.

[sir_captain]

205. yeah, i'm thinking

about doing work in needy areas in order to have the government help forgive my loans. (also cause it seems like a worthwhile thing to do, of course)

[camero]

206. It's a winner all the way around

Your loans get paid quicker and you don't have to deal with the rat race of the big city for awhile anyway. If you like that part, I don't know. You just won't be a millionaire right away.

Not a bad choice IMHO.

[sir_captain]

207. eh

it's not that great a way to become a millionaire anymore anyway. and i don't see myself as a plastic surgeon or dermatologist or anything like that.

[camero]

208. Then that's probably the best route for you then

Didn't know you were looking at being a primary care doc. And with the malpractice crisis, you're right about that which I largely see as an overall insurance crisis that has more to do with insurance companie's stock manipulations rather than a litigation crisis.

You'll be ok I see.

[SOteric]

108. Actually a pretty good case can be made for the British system.

The British system does skim the cream of the crop off for private hospitals for the wealthy, but that provides a specific incentive for the physicians in the public, socialised sector to excel. In an entirely socialised system, quality quickly atrophies as physicians are rewarded the same whether they do crap work or excellent work. As much as we like to think about those in medical professions and healers holding something akin to a religious duty, they do, after all, suffer the same needs and insecurities as does the rest of humanity.

[Kellanved]

216. pretty much the German system

Mandatory Health Insurance, paid by employer and employee. The "public" system is managed by pseudo-private insurances ("Kassen", many companies used to operate one for their employees), which operate in a federal frame for price, service, prescription drugs and doctor payment.
Freelancers, self-employed, people with more than EUR 43500 annual income and civil servants are not part of the public system (but they can opt-in) - for those it's basically the American system, albeit cheaper.
I think it's a good system, as it creates competition among the public insurances, the private insurances, the hospitals and the doctors. The argument that it's not single payer and thus not good is IMHO wrong: without the money paid by foreign patients and/or privately insured patients the Hospitals would hardly be able to perform at their current level.

Competition among pharma-companies is the major weakness: the German drug prices are the highest in the world.

[LearnedHand]

70. It is the ONLY equitable solution ...

... but we GOTTA override those who continue to call it Socialism or Social Medicine. Long as those who stand to gain can scare folks with these terms, we'll not get anyone to consider a one-payer system.

[Cleita]

95. That's because the opposition defines it that way to scare

people. That it's commie so it's gotta be bad. We need to make socialism acceptable. It makes their argument seem silly then. We have to educate people with the truth. I don't know where to start though. Maybe if writers tried to get as many articles about this published in as many periodicals as possible over and over again like a blitzkrieg to get the truth out about this matter.

[Kanary]

110. Well, think about it...... "Insurance is socialism"

How's that for silly?

But, isn't it, really? Don't we *all* pay for each other, including the bad health habits of others?

Same difference.

Kanary

[wasichu]

94. yes , but

how do we get around the Insurance corporations lobby?
Business owns our government, even if 99% of the population was for single payer.

[Cleita]

102. This is the problem.

The insurance lobby stops at nothing to scare people away from this with the very same arguments used by Mr. NavajoRug on this thread. They are all there. Every single one of them. Scare tactics, disinformation and propaganda used by those very lobbyists you speak of. I'm not saying he's one of them, but he has certainly been brainwashed by them.

[Iceburg]

144. Canadian Health Care System Explained

While our system is not perfect ... it does work (for both patients and physicians) and costs are considerably less than the US model.
From a physician's perspective, "salaried doctors" as inferred by the poll above is not a route that should be followed. Doctors in Canada are indeed paid by a single payer (provincial gov) but they are paid on a "fee-for-service" basis. In this way, bad doctors are not rewarded for bad service.

http://www.newrules.org/equity/CNhealthcare.html

Since 1971 all Canadian citizens, regardless of income, employment or health, have enjoyed access to basic health care, whether it's provided in a hospital, home or clinic. Canada provides this coverage at a fraction of what the United States pays in health care costs. Americans spend 14 percent of their GDP on health care expenditures; Canadians only 9 percent. Yet despite its high cost, the U.S. system fails to insure more than 44 million of its citizens. Some analysts predict that figure will grow to 60 million by 2008.

Canada's system is a unique blend of local and provincial control with federal enforcement and funding. Today there is no "Canadian" health care system, but rather ten separate and distinct provincial health care plans, each designed to meet its population's unique resources and needs.

Befitting its decentralized framework, Canada's system was created not by federal decree but by provincial innovation. In 1946, spearheaded by colorful premier Tommy Douglass, Saskatchewan introduced the country's first universal hospital insurance scheme. By 1961 all provinces had adopted a similar plan. A year later Saskatchewan had expanded its plan to include care provided outside of hospitals, and in 1966 the federal government passed the Medical Care Act of 1966.

Under the terms of medicare, as the Medical Care Act is referred to in Canada, provincial governments must meet five requirements to receive federal funds to help finance their programs: portability, public administration, universality, comprehensiveness and accessibility. Medical fees are determined through negotiations between doctors (represented by their provincial medical associations) and provincial governments. The bill also prevents patients from paying doctors directly-- the government is the single payer.

The key to the Canadian system is that there is only one insurer-- the government. Doctors generally work on a fee-for-service basis, as they do in the U.S., but instead of sending the bill to one of hundreds of insurance companies, they send it to their provincial government. This single payer or public administration requirement is what makes the Canadian system so much more efficient than the U.S. HMO system, both because of its very nature-- it's nonprofit-- and because the single payer system boasts enormous administrative efficiencies over multiple-payer systems.

Facing budget crunches and a rising deficit, the Canadian government for the past two decades has been reducing the amount of the federal contribution to provincial health care. Initially set at fifty percent, the federal contribution has dwindled to a little more than 20 percent on average. Cost cutting has led to concerns about longer waiting times, lack of hospital beds and overall quality of care. Provinces are aggressively experimenting with ways to maintain a high standard of care while reducing costs. Among the proposed remedies are to increase the private provision of care and to further devolve health care authority to local boards. The jury is still out on these and other reforms.

But despite problems in Canadian health care, the principles enshrined in the Medical Care Act remain sacred to Canadians. As one doctor puts it, "Today a politician in Canada is more likely to get away with canceling Christmas than he is with canceling Canada's health insurance program."
---------------------------
See also: Canada's Health Care System at a Glance
http://www.hc-sc.gc.ca/english/media/releases/2002/health_act/glance.html

[Bread and Circus]

145. I did actually mean "fee for service" basis...paid by the government.

I guess I didn't make that clear though. Thanks.

[sadiesworld]

149. Yes, but co-pays on a sliding scale should be required.

[Cleita]

150. No, they shouldn't.

Means testing always kills a social program. The argument goes: "Should Bill Gates or Donald Trump get free health care?" Well, pooling your health care dollars to benefit everyone is not free health care. Bill Gates and Donald Trump would probably pay more than any of us for a program like this, proportionately, so it seems fair that they should get the same bang for their buck that everyone else does.

[Vladimir]

152. It would be an improvement

but my preferred method is the nationalization of all health care, funded through a progressive income tax. When I say 'all', I mean that private medical practices should not be allowed to operate. Here in Britain, NHS waiting lists for things like brain scans are 3 months, if you go private you can have one in 3 days. The spare capacity that is always present in the private system is by its very existence lowering the standard of care for all patients who rely on national healthcare.

V

[Cleita]

159. Here in America we would never bring the medical profession

on board with this. They are willing to consider the Canadian system.

[sir_captain]

160. It's not unreasonable to stay private

In many countries with national healthcare systems, the government pays for the doctors' education and subsequent salary. Most doctors in this country leave medical school with $200,000+ in debt and then spend the next 4-7 years working 100+ hours a week for far less than minimum wage. In order to eliminate private doctors, the entire medical education system would have to be fundamentally altered, and I don't think there's much of a chance that's going to happen.

[Vladimir]

210. Yeah I know the reality

I was speaking in hypotheticals... in reality of course single-payer is a massive step in the right direction. Phychologically and concretely.

V

[qb]

154. 40,000+ uninsured sucks.

So do my $20 copays. I'd wait in line for single-payer health care.

[Mattforclark]

164. you left out 3 zeros

:(

[qb]

213. Thanks for the heads-up - revised number: 40,000,000+ uninsured

Dang brain's been quittin on me again.

[LWolf]

168. This DUer wants

single-payer, not-for-profit health care.

[eridani]

175. Reframing the issue -repost

Arguing about health care
[e-mail]

Effectively convincing people who haven't spent much time thinking about health care policy requires countering the blather that the likes of Harry and Louise have been using to make people in the US afraid that however bad the current situation is, change is too scary and government is bad anyway. The market is good, no matter what problem you are addressing. A way to effectively counter this attitude occurred to me after listening to Dennis Kucinich speak in Seattle. Talking about his universal health care plan, he said, "The market has failed!" three times, with an invitation to the crowd to join in, which people mostly did. He was, of course,preaching to the choir. This is a slogan that will cut no ice with the "market good, government bad" crowd, and it caused me to think about the various ways in which it could be taken.

Obviously, what Kucinich meant was that the market has failed to deliver health care, but the statement taken plain could also be seen to refer to markets in general. In that case, anyone who bought a computer ten years ago and has upgraded recently (and who almost certainly doesn't spend any time on being a health care policy wonk) is going to think "What on earth is this idiot ranting about?"

Clearly the markets for health care and the market for computers are pretty different. If you ask free market believers what governments should be doing, they will often say something like "Roads and police and firefighting are legitimate government occupations because that is infrastructure." What we need to do is to present a good case that health care is infrastructure too. Almost no one will argue that government should have no role in creating and maintaining infrastructure, other than a few Libertarian hard cases whose arguments are ignored by average citizens anyway.

Health insurance paid for by individuals is extremely expensive, and people who pay that way commonly feel ripped off because after they pay, they never see a penny of it. But if health care is infrastructure, it is analogous to police and fire protection. These services are also expensive, but do people feel that if their houses don't burn down and they don't get assaulted or robbed, the property taxes paying for these services are a ripoff? Should the expenses for these services be paid only by the people who are immediately served by them? Obviously not.

The slogan "Health care is infrastructure" beats "Health care is a right" as well. The latter makes people think of endlessly inflating entitlements that will drive the country into bankruptcy and still not satisfy everyone. Saying that health care is infrastructure not only directly and inevitably implies that health care is a right, but it gets people thinking about the issue in the most productive manner, namely as active citizens responsible for helping to determine public policy.

The reality is that health care providers and firefighters are very similar in an economic sense. Computer makers want to sell more computers, and people always want more memory, more bandwidth and more speed, but people would rather not get sick and rather not have their houses burn, but want effective help fast should those things happen. Imagine a city with three or four fire departments, paid for by dozens of different employer insurance schemes plus a few subsidized plans for the poor which a lot of low income people earn too much money to qualify for. A real mess, right? The firefighting equipment has to be duplicated several times, and the private insurance is always shifting around with employment patterns. ("Whaddya mean you won't send a truck out? My employer turned in the new insurance paperwork last week!" "I'm sorry sir, but you must still be with Company X. We don't have you in our records.") And you'd also have a bunch of sorryass parasites sitting around trying to calculate which zip codes are likely to have the most fires, so they can stick their unlucky inhabitants with higher fees. Also each company would adjust prices dramatically upward to include profits as well.

Since no city in real life is actually stupid enough to have several different fire departments, there is no way of comparing that hypothetical situation with the current state of affairs in the provision of health care. But this was not always the case. There used to be private fire departments, and markers designating fire protection eligibility can still be found in antique shops. If your neighbor's house caught fire from the cinders of your fire, your personal firefighting service would just let the other house burn. If there was a dispute about coverage, competing services would often spray more water on each other than on the fire. Before the revolutionary war, that well-known commie rat bastard Benjamin Franklin put a stop to this practice with America's first public fire department in Philadelphia.)

We do know what happens to health care prices in towns with more than one hospital compared to towns of similar size with only one hospital-namely that the more hospitals, the more expensive health care is. And it's perfectly obvious why-if you think about the proper economic analogy, namely that of the fire department. And it's exactly the opposite of what happens with restaurants, barbers and computer manufacturers-more of those means better and cheaper products and services. Since firefighting is paid for as a public investment, they'll go to a house of $100,000 assessed valuation just as rapidly as one with a million dollar valuation, even though the property taxes are higher in the latter case. People in wealthy areas may have some overall service advantages, but the difference is trivial compared to the difference between people with and without health insurance.

Competition actually degrades performance directly as well. The single most important factor in determining your chances of surviving a complex operation is the number of those operations previously performed in that hospital. Divide the number of operations by the number of similar facilities in town, and you have calculated the relative incompetence factor. The same goes for firefighters-they keep their skills up by practicing on buildings slated for demolition that have been set on fire, or on fire towers which have serious restrictions as to where they can be located. Therefore there are limited numbers of these, and dividing them up among competing departments would mean that everyone would have lower skill levels. Compare this with computers, where sales and product improvement efforts mean more computers are made and sold. Somehow you just can't sell people on the virtues of having more heart attacks and house fires, so more competitors means less real-life practice for everyone.

In one respect, public payment for health insurance is more like paying for roads than firefighters. Just as roadbuilding is paid for by the public but almost always contracted out to private outfits, medical providers would continue to be private operators even though publicly financed. Road maintenance is done by both public and private employees-how you decide between the two options is by putting the matter up to public debate and arguing about it. (This is called "activism" these days, although it used to be just plain old "citizenship.")

That firefighting is a public business leads to putting arguments of how to pay for it in the public venue. Service providers will always want to do less work for more money, and service recipients want more service for less money. No conceivable social arrangement can alter that basic fact of life. What happens is that unions and professional organizations argue about the solutions in public, bond issues and tax rates are proposed, and everybody comes to a compromise arrangement. And there is no reason to think that the same process won't work with health care providers. You can't cover everything and pay everyone what s/he thinks s/he deserves, so you put all the arguments on the public table and come up with a compromise.

And this segues into other public policy areas as well. In the case of firefighting, there are building codes and enforcement to argue about, fire safety and extinguisher training, smoke alarm requirements, etc. In the case of health, there is urban design (making walking and biking easier, for instance), health education and awareness, arguing about how to evaluate various technologies for proven results, etc. By comparison, making matters of computer design subject to this kind of public dispute would be unbelievably stupid.

And finally there is the question of how do we afford single payer. Establishment opinion says that the Kucinich proposal is outrageously expensive compared to the proposals of other candidates. Of course they fail to mention that we would no longer have private insurance expenses, that out of pocket expenses would be dramatically reduced, and that we would continue to have the government funding that we now have. The fact is, as Dennis keeps saying, that we are already paying for universal health care-we just aren't getting it. Suppose your electric bill is $400 and you don't have that much. And suppose that you check your back yard and find out that someone is tapping into the line between the power provider and your house, siphoning off as much as they can get by with. All of a sudden the fact that you don't have $400 isn't the main problem any more.

The health care plans of most of the other candidates are in fact more expensive than that of Kucinich, because they all assume that we continue to spend what we are already spending, but should add more to that total in order to further subsidize private insurance companies, who would continue to drain off funds in the pipeline flowing from the public to health care providers. For those who like equations, those plans would cost out as

Total proposed health care spending = Current spending + incremental proposal extra expenses - x, where x is whatever unknown amount of savings would be produced by the plan. (Extending preventive care, no matter how incrementally, can be expected to produce some saving.)

Kucinich plan = current spending only - x.

So remember boys and girls-HEALTH CARE IS INFRASTRUCTURE!

For a nice analysis of Canadian Single Payer with references, see below.

http://www.geocities.com/stewjackmail/pdf/uhc-canus.pdf

A note on cost control--an analogy is controlling the movements of a herd of cattle. You can do the sensible thing and build a fence around them, allowing them to move freely within the confines, or you can hire a passle of cowpokes with sets of reins controlling each cow individually. The former is what Canadians do with global budgeting, and the latter is what HMOs and insurance companies do in the US. It's obvious which system gives providers and patients the most choice.

[flaminbats]

191. Single-payer or single-healthcare?

We need single-payer to achieve lower drug prices, universal coverage, and more public funding for the training of medical professionals. This doesn't mean that patients should be restricted to only one doctor, one hospital, or just one type of medication. Increasing the funding for basic research as well as the number of available doctors and nurses will decrease the tax burden necessary to meet the goal of universal coverage, while increasing the competition in medicine to meet exploding demand shall ultimately lower healthcare costs for all.

This will also help our government to solve the healthcare crisis, the entitlement problem, and growing unemployment with a single stroke. But clearly this can only happen if we start to pay down the national debt now! :thumbsup:

[Midwest_Doc]

212. As a practicing physician, I vote YES

Health care has declined in the U.S. because of the for-profit health care providers (ie. Bill Frist)greed.