gdi
Veteran
Your logic would appear sound on the surface but it doesn't account for the impact competition has in keeping costs down. When there is competition, in the private sector companies will look for inefficiencies to remove from the system in order to stay competitive, achieve advantage, or maximize profit.
If you have a single entity answering to no one, the incentive to increase efficiency is basically nil. To keep costs down you simply have to withold payment or services. (And by the way, the government is already neck deep in the US healthcare system - it is a highly regulated industry and many of those regulations contribute to the high costs.)
ANd of course there will almost certainly be a drop in quality of care, as R&D for new drugs and treatments are reduced.
Few would disagree that there is a need to provide insurance for those who cannot afford to buy it. No citizen of this country should be without access to our best healthcare. But we are better off expanding access to to our high quality system to all citizens than eliminating the private industry and bringing everyone into a lower quality Medicare-esque system.
THis is a very important issue in our country - but it is not the cause of our current economic/credit/banking crisis, regardless of who tells you it is. I hope that people, and particularly our legislators, will take time to do some research and understand what the change to socialized medicine will mean. "Free " lower quality care has many hidden costs.
ebolton
Number 7614
I respectfully disagree on most points.
One cost I forgot to include on that simplistic analysis is marketing. Right now, umpteen private health care insurers are competing for accounts with major employers, including my own. In three years with the company I'm at now, we've switched twice. In the 9 years I was at my previous job, we switched almost as many times. All that competition means each of those insurers has a marketing department, which ultimately the citizen pays for.
As far as research, the government already pays for most of the basic research going on that will have long-term benefits. Drug companies are famous for only researching things that have near horizon, substantial benefits. Insurers, of course, do no basic medical research (other than what is required for actuarial tables, which is essentially a study of the past.)
I don't know much about medicare (not being of a certain age yet), but I suspect if it is weak, it is probably because the government is scared of stepping on the toes of the insurance industry. I say crush 'em.
Health care is the only cost that has not been going down as a result of technology. I'm a mechanical engineer by trade; I can get a machined aluminum prototype now for less than a quarter of the cost I could ten years ago, from the USA, in real dollars (no adjustments) thanks to widespread adoption of CNC technology. The real cost of computer power has famously gone down as much or more. But I don't see that same cost decline in health care, maybe because the health care industry goes though middlemen- the insurers- who make their profit as a percentage of cost. It is in their interest to keep costs up, which hurts everybody.
gdi
Veteran
Do some reading on different perspectives - look at research on the effects that government regulation has on the rise in prices in healthcare. It is not a subject that should be dismissed with over simplified analysis.
You make a comparison with your CNC technology - would the price be so low if the government regulated that instead of you paying only for your prototype, you had to buy a copy of every prototype that the company has made - for anybody. That is what the governments - State and Federal - do with "benefit mandates". The state decides which insurance you have to buy - you're a thin 22 year old in really good health - fine you have to buy the policy that covers morbid obesity surgery, and a lot more - averaging 30+ such mandates.
You have a disdain and misunderstanding about the nature of insurance that clouds your view and arguments. You want to crush insurance companies - because they make a profit based on a % of cost? That is far from the truth, insurance companies have to estimate participation and cost increases, they have to carefully price their services through accurate underwriting - or they can easily lose money. It simply is not a 'markup' on cost! Insurance companies want costs low - and have done a lot to try to drive them down. If medical costs are lower the insurance can be priced lower and more people can afford it - good business.
You see no need for insurance companies, but ask someone who has a had serious illness whether having a good health policy was a good thing. Insurance is a critical part of of our quality system, it offers many people treatment they could never afford otherwise.
Your solution is to turn the whole process over to government with the belief that it will be free and of the same high quality. It simply can't and won't happen. Your choices, available treatments, and value will be greatly limited. Fortunately, I believe that move to a full socialized plan will not be palatable in the end and we will have some form of hybrid system.
Here is a link that references some hard facts that show why we shouldn't trade "value" for "free". I encourage you to read it with an open mind..
http://liberty.pacificresearch.org/docLib/20081020_Top_Ten_Myths.pdf
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ebolton
Number 7614
That's going to take awhile. It's appears to be 190 pages of propoganda. I see the name "Hoover" memorialized there! I've heard that name before- President when the Great Depression started, maybe?
EDIT
I read it. Lots of right wing spin and talking points. Questionable "facts". It definitely did NOT change my mind.
EDIT
I read it. Lots of right wing spin and talking points. Questionable "facts". It definitely did NOT change my mind.
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Olsen
Well-known
Sorry, but I also disagree with most of this. The purpose of a private company is to make profit. Compared to an organisation that don't have to take a profit into the calculation they have to be very much - 20 -25% more efficient.
Compare also the part of the US health care industry has of GNP compared to countries that have health care as a public/state run industry. This shows that it is the US health care industry (private) that is inefficient and expensive, - not even covering the whole population, even. While state run health care-countries has a system covering the whole population to a lower cost (fraction of BNP).
So, it is the state run health care industry that is efficient. The quality can vary, and is dependant on a good democracy and a active media.
Whenever you open a newspaper here in Scandinavia, you will always find some article about some complaint about 'some' section of the health care industry. - With a minister of heath that has to answer for himself. We have people waiting in cues to be heart operated or certain eye operations. But there is an open public discussion about these matters. The media have the right to go through the lockers of all of the health care industry. If it had been private, all this information would have been 'private'. A hell of a difference. The democracy and the media see to that the quality is assured, and in line with people's expectations.
Most meaningful medical research is financed by government anyway. - Sometimes some 'jewels' are picked out of these state run programs and 'privatized' - with fine little of the profit going back to the government. This happens just as much in USA as here in Europe, though.
The large multi national medicine producers talk a lot of hogwash about their 'need to be profitable' so they can invest in new research. Their contribution, when it comes to it, is 'pure marketing and distribution', for what they are paid handsomely. To put it mildly. Every new medicine launched - of any importance, can be traced back to some state run research program. Of which the state in question, gets nothing of the profit. The tax payers take the cost and some smart guys take the profit. Sure, medicine is not the only area that this happens.
So, if USA established a public health care service, it would cover the whole population, be far cheaper and just as good. If not better. Unfortunately, that is not going to happen. Why?
1)
You can't fight the interests of a trillion dollar industry.
2)
You can't afford it. It will double the tax burden on the average American. And he is busy paying interest on 11 trillion dollar federal debt, financing the World's Largest Defence Bill, etc.
If you are going to have a wellfare state; first you got to have your governmental finances in order. You don't. The smartest way to prevent a nation having a wellfare state is to let it sink into debt. Look up Argentina under Peron. Or the development of Israel, from Ben Gurion (the communist) to ultra conservatives of today, that has destroyed the Israel's financial position. - Or look to USA, - or Sweden under the new conservative government...
Olsen
Well-known
US deficit - how is it going to be financed?
US deficit - how is it going to be financed?
It is extraordinary that the Chinese prime minister Wen Jiabao, prime minister of US largest creditor, expresses concern that investment in US treasury bills just might not be a safe investment. - And that Obama's administration has to rush out and 'reassure' the Chinese leadership, the folks that the Obama administration is relying on to finance the 2009 budget.
I think that USA is close to the day that the size of the Federal Budget is determined by 'what can be financed by collecting taxes' and 'what can be borrowed'. It is the latter that is not unlimited anymore.
See link: http://www.bloomberg.com/apps/news?pid=20601087&sid=aOZ5WKjIF5aE&refer=home
US deficit - how is it going to be financed?
It is extraordinary that the Chinese prime minister Wen Jiabao, prime minister of US largest creditor, expresses concern that investment in US treasury bills just might not be a safe investment. - And that Obama's administration has to rush out and 'reassure' the Chinese leadership, the folks that the Obama administration is relying on to finance the 2009 budget.
I think that USA is close to the day that the size of the Federal Budget is determined by 'what can be financed by collecting taxes' and 'what can be borrowed'. It is the latter that is not unlimited anymore.
See link: http://www.bloomberg.com/apps/news?pid=20601087&sid=aOZ5WKjIF5aE&refer=home
bmattock
Veteran
40oz
...
gdi-
The idea that your insurance premiums are higher than they "should" be because of senseless gov't mandates is ludicrous. The concept that someone who is not at risk for a condition somehow pays extra to be covered for it is ignorant. Premiums are based on five year costs divided by five and multiplied by 1.25 or so. It's a pretty simple calculation usually. The profit part is obvious, and for putting up the money, pretty fair. If you don't like your current plan, exercise the free market and find another that makes you happier. How much money is doing nothing but complaining about the gov't saving you?
***
If anything, in this discussion is the balance. I don't want to live somewhere they let people die in the street. Right now we pay for visits to the ER by those who have no other choice. Preventive care is cheaper and has a higher success rate. I have no problem with a base level of care for those who have no other options.
The private healthcare system in the US offers choices. Hospitals in US border towns are popular with Canadian citizens who don't think the best care is the same care for everybody. Everybody in the US thinks they deserve Ferrari healthcare, so it costs Ferrari prices. If we all decided F150 healthcare was OK, we'd collectively save a ton of money.
The idea that your insurance premiums are higher than they "should" be because of senseless gov't mandates is ludicrous. The concept that someone who is not at risk for a condition somehow pays extra to be covered for it is ignorant. Premiums are based on five year costs divided by five and multiplied by 1.25 or so. It's a pretty simple calculation usually. The profit part is obvious, and for putting up the money, pretty fair. If you don't like your current plan, exercise the free market and find another that makes you happier. How much money is doing nothing but complaining about the gov't saving you?
***
If anything, in this discussion is the balance. I don't want to live somewhere they let people die in the street. Right now we pay for visits to the ER by those who have no other choice. Preventive care is cheaper and has a higher success rate. I have no problem with a base level of care for those who have no other options.
The private healthcare system in the US offers choices. Hospitals in US border towns are popular with Canadian citizens who don't think the best care is the same care for everybody. Everybody in the US thinks they deserve Ferrari healthcare, so it costs Ferrari prices. If we all decided F150 healthcare was OK, we'd collectively save a ton of money.
gdi
Veteran
Well facts are stubborn things - you can try to wish them away and call them stupid, but they remain. If you don't know anything about government mandated coverages, then you should do some research,before you call those better informed than yourself ignorant.
What composes the "five year costs" in your simple formula?
I have no desire to see people unable to get healthcare either - as I clearly stated in a previous post. However, I also don't want to see treatment options limited by government bureaucrats. We can do better than that.
You are correct here - that too, was a point I tried to make - you must consider value, or what you get for the high cost of care.
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gdi
Veteran
Of course I would expect you to disagree - and to confidently present some statements as facts. But could you really surprise me with some references to the sources of your information?
The % of GDP spent on healthcare is simply not a valid barometer for efficiency - in fact it is absurdly over simplified. To ignore the amount and types of care provided and results of such care and look straight at the costs, shows a huge lack of understanding on your part. I guess we would have a great system if we simply outlawed all care, right? We could reduce those GDP numbers nicely
Again - where is your backup for this - please define "meaningful". Do you keep a list? It would be interesting to see.
Again, total Bull until you provide some backup, can you ?
For goodness sakes Olsen, you continually produce these ill-informed opinion pieces, and never offer any supporting sources for your statements. Do yourself a favor and challenge your beliefs - many times you will find they are incorrect. I am very willing to do that and welcome any informative responses that offer substance beyond your person opinion or religous beliefs.
Olsen
Well-known
"But could you really surprise me with some references to the sources of your information?"
Comparisons between the 'European/public' v 'American/private' health care has been discussed for years. I am sure that it is a lot of of it on the Net. Try Wikipedia. I am informed because it is part of my profession and education. As for some of the information, it is simple public school algebra.
The arguments that you are launching are all the arguments of the private health care industry of USA. They are well known. They do not persuade us, some close to 400 million Europeans to change to a private system. I notice that 140 million Russians, after more than 70 years with Communism, also want a public health care system.
And so on...
The US health care system is a catastrophe. Not only is it very expensive, it does only cover a fraction of the US population. Since employers are expected to cover all or parts of this cost, it makes USA less competitive. Except for the fact that it makes 'tragedies' out of the lives of many people.
Hillary Clinton tried, during her husbands presidential period, to reform the US health care industry. She concluded that 'it is impossible to fight a Trillion dollar industry'. That is the most tragic part of it.
Comparisons between the 'European/public' v 'American/private' health care has been discussed for years. I am sure that it is a lot of of it on the Net. Try Wikipedia. I am informed because it is part of my profession and education. As for some of the information, it is simple public school algebra.
The arguments that you are launching are all the arguments of the private health care industry of USA. They are well known. They do not persuade us, some close to 400 million Europeans to change to a private system. I notice that 140 million Russians, after more than 70 years with Communism, also want a public health care system.
And so on...
The US health care system is a catastrophe. Not only is it very expensive, it does only cover a fraction of the US population. Since employers are expected to cover all or parts of this cost, it makes USA less competitive. Except for the fact that it makes 'tragedies' out of the lives of many people.
Hillary Clinton tried, during her husbands presidential period, to reform the US health care industry. She concluded that 'it is impossible to fight a Trillion dollar industry'. That is the most tragic part of it.
Olsen
Well-known
Down Jones
Down Jones
I don't know if anyone noticed: Dow Jones, often named as 'the most reliable empiric stock index of the world's stock markets'. They have decided to cut out, - remove from the index, all shares with a price of 10$ or less...! If these shares would still have been included, the Dow Jones index would have been even lower!
This means that the Dow Jones index no longer can be regarded as a 'comparable empiric study'. It can no longer be reliably compared to itself. But functions now as some weird advertising for the stock market. It will make the stock market - and it's participants, look better.
Where will this end...?
Down Jones
I don't know if anyone noticed: Dow Jones, often named as 'the most reliable empiric stock index of the world's stock markets'. They have decided to cut out, - remove from the index, all shares with a price of 10$ or less...! If these shares would still have been included, the Dow Jones index would have been even lower!
This means that the Dow Jones index no longer can be regarded as a 'comparable empiric study'. It can no longer be reliably compared to itself. But functions now as some weird advertising for the stock market. It will make the stock market - and it's participants, look better.
Where will this end...?
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gdi
Veteran
That is the expected response - all of your nonsense "facts" should be simply common knowledge to be accepted without question.
Of course responding to your posts on this topic could prove no more productive than responding to your other anti-American drivel. Your nonsense argument that % of GDP is the measure of efficiency of a healthcare system, fabricating the 20-25% efficiency requirement of a private vs public system, and then vague claims of a "fraction" of people being covered (did you know that both 99/100 and 1/3 are both fractions) are all well known tactics of those who have replaced reason with religion.
Socialized medicine is not a cure all - waiting lists - months and longer for people in pain, denials of drugs and treatments from those who could benefit to meet a bureaucrat's budget goals, rampant, proven fraud and abuse, special treatment and options available only to the elite and politically connected.
The US needs to work on improving access for those who cannot afford it or are out of the workforce for any period of time, not scraping a high quality system in favor of the lowest common denominator.
Olsen
Well-known
gdi,
It is simply impossible to discuss this with people who don't know the issue - at all. And who also blows me off as 'anti American'.
Now; USA spends a larger part of it's GNP on health care than - say, Sweden, Denmark, Finland and Norway (I am mentioning these countries because I know their health care structure in detail). This is a fact!
The health care expenditure for the European nations mentioned covers 'all inhabitants', while the US health care expenditure covers 'only a fraction' of the population. How does that compare?
Yes, we have waiting lists. If we had a private system they would simply have 'increased the prices' to the point were people could not afford to have a heart operation etc. Still I regard the waiting list system to be efficient. People get their operations. Either at our own hospitals, or they are sent to some other country that has the capacity. If things get too bad, then we have a free press that makes a lot of noise, and the politicians have to intervene with 'more money' to solve a certain HC issue.
Call it socialism, or what you like but, I am absolutely fore a 'public' health care system. - We picked up the idea, - not from Carl Marx, but Franklin D. Roosevelt,- as earlier mentioned. I think it is unethical that an industry shall 'profit' from other people's illnesses and distress.
The European public health care system costs 'a lot'! The social budget (child care, health care and care for old people, care for 'the poor' etc) is largest part of Norway's total budget. I pay 42% in tax on my salary. My employer pays an additional 12%. Our sales tax is 20% on all we buy. Except cars, tobacco and alcohol. Here taxes are more than 50% of the price. Etc.
In general terms; Europeans pay 'twice' as much tax as Americans. Sometimes more. Still, the Europeans get more service from the state for the taxes paid. Like health care, care for the elderly etc.
Look up the Norwegian 'State' budget (eq. to Federal in USA - you can find the Swedish, Danish - or whichever, yourself) and make your own comparisons with the US budget:
http://www.statsbudsjettet.dep.no/upload/Statsbudsjett_2009/dokumenter/pdf/budget_2009.pdf
Please note that the tax to local communities and their services is not included. They come in addition.
Now I expect you to launch a row of arguments telling us that 'high taxes' is poor for business. Well, sure. For 'certain' (consumer related) businesses, that might be. But the money is still put to use and is circulated in the society. Taxmoney does not dissappear. - Unless it have to cover interest expenditures to offshore debitors, - like the Chinese.
It is simply impossible to discuss this with people who don't know the issue - at all. And who also blows me off as 'anti American'.
Now; USA spends a larger part of it's GNP on health care than - say, Sweden, Denmark, Finland and Norway (I am mentioning these countries because I know their health care structure in detail). This is a fact!
The health care expenditure for the European nations mentioned covers 'all inhabitants', while the US health care expenditure covers 'only a fraction' of the population. How does that compare?
Yes, we have waiting lists. If we had a private system they would simply have 'increased the prices' to the point were people could not afford to have a heart operation etc. Still I regard the waiting list system to be efficient. People get their operations. Either at our own hospitals, or they are sent to some other country that has the capacity. If things get too bad, then we have a free press that makes a lot of noise, and the politicians have to intervene with 'more money' to solve a certain HC issue.
Call it socialism, or what you like but, I am absolutely fore a 'public' health care system. - We picked up the idea, - not from Carl Marx, but Franklin D. Roosevelt,- as earlier mentioned. I think it is unethical that an industry shall 'profit' from other people's illnesses and distress.
The European public health care system costs 'a lot'! The social budget (child care, health care and care for old people, care for 'the poor' etc) is largest part of Norway's total budget. I pay 42% in tax on my salary. My employer pays an additional 12%. Our sales tax is 20% on all we buy. Except cars, tobacco and alcohol. Here taxes are more than 50% of the price. Etc.
In general terms; Europeans pay 'twice' as much tax as Americans. Sometimes more. Still, the Europeans get more service from the state for the taxes paid. Like health care, care for the elderly etc.
Look up the Norwegian 'State' budget (eq. to Federal in USA - you can find the Swedish, Danish - or whichever, yourself) and make your own comparisons with the US budget:
http://www.statsbudsjettet.dep.no/upload/Statsbudsjett_2009/dokumenter/pdf/budget_2009.pdf
Please note that the tax to local communities and their services is not included. They come in addition.
Now I expect you to launch a row of arguments telling us that 'high taxes' is poor for business. Well, sure. For 'certain' (consumer related) businesses, that might be. But the money is still put to use and is circulated in the society. Taxmoney does not dissappear. - Unless it have to cover interest expenditures to offshore debitors, - like the Chinese.
ebolton
Number 7614
I'm an American, with private health insurance, and I'm on a waiting list right now! For my 'annual' checkup at my plan-approved doctor. I'm 1 month in on a 4 month wait.
40oz
...
I could say the same to you. Five year costs are the sum of money spent in the last five years. This is the simplest breakdown. Adjustments are made to address factors such as risk and markets.
Smokers pay more for health insurance because smoking increases the costs of care. If you don't smoke, you don't pay those increased costs. Simple, really. No different with morbid obesity, pregnancy, or whatever.
Whoever told you that mandated coverages force you to pay for things you aren't at risk for was mis-informed. Repeating those mis-informed statements makes you look mis-informed.
***
I'm not sure there is a real, functional difference in employer health care plans paid out of wages based on individual and group risk, and a public plan paid under the guise of taxes taken out of wages. There is a real functional difference in for-profit medical clinics and state-run health centers, but at the end of the day I don't think the care itself is all that different. Both systems have pros and cons. It's not like one is spawn of demons and the other is sunshine and puppies.
And in point of fact, we have state-run health plans in the US. The VA system is one example, and it is far from perfect or ideal due to the rampant possibilities for abuse. It's a system that begins to seem organized around the concept of preventing fraud rather than providing care to military veterans.
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bmattock
Veteran
You need better insurance. I can go in for a checkup whenever I want. Maybe a week for an appointment that matches the times I have available, but if I'm in a hurry, I just bend my own schedule a bit.
Roger Hicks
Veteran
There is of course the point that you have (basically) the USA versus the rest of the world on this one. Just about every other wealthy country has considerably broader public health care. Ever wondered why?
Google infant health mortality figures (a good general guide) and you'll find that there are 179 countries worse than the USA (180th @ 6.30 per 1000 live births, CIA 2008 figures). Admittedly 181 is South Korea (5.94) and Cuba is 182 (5.93) but 183 (5.84) is the overall EU average where the figures are probably at least as reliable as the USA. Canada is no. 191 at 5.08. Even the UK is under 5, at 194th place. The four best countries (Hong Kong, Japan, Sweden, Singapore) are under 3.0.
Of course there are lies, damned lies, and statistics, but there are also reasonable figures and mindless propaganda. Oh; and my sister-in-law is a doctor in rural Alabama.
Cheers,
R.
Google infant health mortality figures (a good general guide) and you'll find that there are 179 countries worse than the USA (180th @ 6.30 per 1000 live births, CIA 2008 figures). Admittedly 181 is South Korea (5.94) and Cuba is 182 (5.93) but 183 (5.84) is the overall EU average where the figures are probably at least as reliable as the USA. Canada is no. 191 at 5.08. Even the UK is under 5, at 194th place. The four best countries (Hong Kong, Japan, Sweden, Singapore) are under 3.0.
Of course there are lies, damned lies, and statistics, but there are also reasonable figures and mindless propaganda. Oh; and my sister-in-law is a doctor in rural Alabama.
Cheers,
R.
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ebolton
Number 7614
That's the thing, isn't it. This is the plan my company offers. I'd have to find another job with a better insurance plan, and hope the new company stays with it. Or become self-employed and get everything myself. Not a practicality in this economy.
ebolton
Number 7614
Roger, it's worth clarifying on that CIA list that the higher numbers are better, and there are 220 countries total on the list (including a bunch lumped together as the EU). So basically, the US is bottom-of-the-barrel of the developed countries, but better than most of the abjectly poor nations experiencing open warfare.