# National education & health care

Staff Emeritus
Gold Member

## Main Question or Discussion Point

Originally posted by kat
Well, actually I think this is incorrect. I believe there is healthcare available for the poor in the U.S. and many programs to get the poor to college but..it's the middle class (lower middle maybe?) that struggles with health care and the cost of college because they make too much to be eligible for state and federal programs.
Are you sure kat?

"WASHINGTON - The number of Americans who don't have health insurance rose sharply in 2002, mainly because of unemployment increases and two straight years of cuts in employer-provided health coverage.

The number of uninsured Americans jumped by 2.4 million to 43.6 million last year, the U.S. Census Bureau reported Monday. That's 15.2 percent of the population, compared with 14.6 percent in 2001.
" This is from a 30 Sep 2003 Knight-Ridder news item.

AFAIK, "uninsured" in US-speak, when referring to medical insurance, means that the full costs of *any* medical treatment - even a visit to the local GP - must be paid by the patient ... and even a 15 minute local GP check-up may 'cost' over US$100. But then, what do I know? ## Answers and Replies Related STEM Academic Advising News on Phys.org kat Originally posted by Nereid Are you sure kat? Yeah, I'm pretty sure. Here's a wealth of information http://www.statecoverage.net/who.htm [Broken] If you scroll down you'll see a tan box that has a good outlay of who isn't covered. You'll note that in the first box there are 14 million people uninsured who are eligible but have not accessed available programs. Of those 14 million-13 million have an income less then 200% of the poverty level (or less then about 37k for a family of 4. 1 million of that first 14 million(who are all eligible for state/federal provided insurance programs) have incomes in excess of 200% of the poverty level. The 9 million people who fall in the middle column are those uninsured who have an income greater then 200% of the poverty level. Then the final column are the 18 million uninsured individuals who have moderate to high incomes. Last edited by a moderator: Originally posted by pocebokli I think most of the euro countries guarantee healthcare and higher education relatively cheap or free, which in the US only middle to high class can afford (education). This is not true. I grew up in a lower class home and my parents didn't have money to put me through college so I went to the state of Pennsylvania for help. They told me my parents made too much money for me to get a grant or partial grant so they gave me a school loan instead. I had a six year grace period before I had to start making payments on the loan and they stretch the loan out over 10 years. If my parents were really poor then I would have qualified for grant money. I think anyone who wants an education in the USA can get it. Monique Staff Emeritus Science Advisor Gold Member Yeah, well.. here in the Netherlands education is free. It doesn't cost$30.000 for a single year, no, it costs €1.500 for a year (in the US that could be a single class). The government pays for that too, including the cost of living and transportation. Ofcourse the trick is that you have to gather enough credits for it to become a gift instead of a loan.

Look at Belgium for instance, public transportation is completely free for every citizen of the country.

In Detroit they had to threaten to close down the major receiving hospital, because most of the incoming patients don't have insurance and the government doesn't pick up the bill. It was up to the hospital to help these people and pay everything out of their OWN pocket, leading them to the edge of bankrupty!

How about social security in the US? What happens when you get laid off? What happens if you have back problems and can't work? Will the government pay up to 70% of your income?

A socialist government provides for its citizens, gives subsidies and runs businesses. The US government would be exactly opposite. Why do you think taxes are so low in the US? In western Europe they are notoriously high.

Originally posted by kawikdx225

I think anyone who wants an education in the USA can get it.
Absolutely.
I recently quit a successful business to make what I was making 4 years ago. My last years tax return puts me too high for aid, but I don't make enough right now to cover school. Loans it is! No big deal.
I prefer that it is not free. Higher education for free is like giving pearls to swines - none will appreciate it (just as they don't appreciate the 'free' education you get until that point). Those that wish to go to school will pay for it, and will succeed at it because they don't want to waste their money.

Originally posted by Monique
1>Yeah, well.. here in the Netherlands education is free. It doesn't cost $30.000 for a single year, no, it costs €1.500 for a year (in the US that could be a single class). The government pays for that too, including the cost of living and transportation. Ofcourse the trick is that you have to gather enough credits for it to become a gift instead of a loan. 2>Look at Belgium for instance, public transportation is completely free for every citizen of the country. 3>How about social security in the US? What happens when you get laid off? What happens if you have back problems and can't work? Will the government pay up to 70% of your income? 4>A socialist government provides for its citizens, gives subsidies and runs businesses. The US government would be exactly opposite. Why do you think taxes are so low in the US? In western Europe they are notoriously high. 1>Only in med school. My medschool is slated to be roughly that each year. It's only about 20,000 for my entire 4 years of undergrad, and I'm still looking for some grant money considering a specific situation I am enduring. 2>cool! 3>Each state handles it's own unemployment insurance. In Texas there is a percentage up until a maximum. Also, there is an account labeled for you with XXXX dollars in it. When that account goes dry, you're out of luck. That account is paid for, in Texas anyways, by the businesses, not the employee. It's all setup as an initiative to make people not just ride the clock waiting to get a new job. You can alos work while being unemployed and make an extra 75bucks each week. That works like this: If you get 400 a week for Unemployment, but also work, you can make 475 a week. You make 300 at your job, you only take 175 out of your account. You make 200 at your job, you only take 275 out of your job. This gets people moving to atleast part time jobs while they are searching for the job they really want. 4>I agree. :) Do you prefer socialism despite it's inefficiency? Prefer capitalism? Or would you like to see a combination of both? russ_watters Mentor Originally posted by pocebokli well if there were no rich there would be no poor either because you'd loose something to compare with:-) Thats a logical fallacy (I guess thats what the smiley was for), unless of course you choose to define "poor" and "rich" in relation to each other (a flawed definition) - which we do in the US, instead of defining them by an absolute standard of living. As a result, the categorization "poor" has lost all meaning in the US: someone who is "poor" today is vastly richer than someone who was "poor" 40 years ago. And if you really want to make it comical, start comparing "poor" in the US to "poor" in other countries. This is not true. I grew up in a lower class home and my parents didn't have money to put me through college so I went to the state of Pennsylvania for help. I mostly agree, except where you say you were in a "lower class home." Clearly, by the state definition, you were not. I was in what you (and the state) would call a "middle class home," and my parents also had difficulty with paying for college for me and my sister (though not as much as yours). They essentially bribed my sister into going to state school instead of private school. free...free...free...free... Well, of course you know, Monique, "free" is a relative term. SOMEONE has to pay for it: what is your marginal tax rate? That word - I really hate that word. Its a lie fed to the public by politicians. And like candy,* people eat it up even though its not any good for you. *My local grocery store now sells jelly beans in 5lb bags. Boy, am I screwed now. Last edited: kat Originally posted by Monique is completely free for every citizen of the country. Hmmm..... Why do you think taxes are so low in the US? In western Europe they are notoriously high. It would seem that it's not free at all.... russ_watters Mentor Originally posted by kat It would seem that it's not free at all.... Kat, you and I apparently have some weird telepathy thing going... Originally posted by russ_watters Thats a logical fallacy (I guess thats what the smiley was for), unless of course you choose to define "poor" and "rich" in relation to each other (a flawed definition) - which we do in the US, instead of defining them by an absolute standard of living. As a result, the categorization "poor" has lost all meaning in the US: someone who is "poor" today is vastly richer than someone who was "poor" 40 years ago. And if you really want to make it comical, start comparing "poor" in the US to "poor" in other countries. The largest health problem with our nation's poor is.....OBESITY! honestly, and that's morbidly comical. Monique Staff Emeritus Science Advisor Gold Member Originally posted by phatmonky 1>Only in med school. My medschool is slated to be roughly that each year. It's only about 20,000 for my entire 4 years of undergrad, and I'm still looking for some grant money considering a specific situation I am enduring. Undergrad, that would be bachelors? How about a master? 4>I agree. :) Do you prefer socialism despite it's inefficiency? Prefer capitalism? Or would you like to see a combination of both? Socialism is good on the citizens, it gives them a confortable live and nothing much to worry about. As I mentioned, the money has to come from somewhere so taxes are high, but it gets distributed evenly across the nation, so I am all for that. The thing lacking is incentive. You mentioned it too, if education is free, you take it for granted. If you fall into unemployment, you still make a decent living. If you feign to have a back problem, you get even more money. That is one of the biggest problems at the moment: wáy to many people are in 'unemployment disability welfare'. The taxpayer is providing all these people with a living, while all these people would be perfectly able to find a job themselves, but why wóuld they? So very soon the government is going to implement more rigorous reexaminations of all people in disabilty (under the age of 55). But yes, I still like a government who takes taxes and uses it for the things I mentioned. kat Originally posted by russ_watters Kat, you and I apparently have some weird telepathy thing going... Great minds and all that... Last edited: Monique Staff Emeritus Science Advisor Gold Member Originally posted by kat Hmmm..... It would seem that it's not free at all.... I am a student: yes it is free! When you start to earn a living, do you get to pay taxes and do you start to provide the country with the means to provide a service like that. As I said: taxes are higher, but they are not equal to all. Staff Emeritus Science Advisor Gold Member efficiency and outcomes Onto our favourite (oops, 'favorite' for phatmonky and Russ ) topic, yes? Re health: the US's ~14% of GDP spent on health produces what ~100% better health outcome than the Netherlands' ~7% of GDP spent on health? Life expectancy at birth? (no) 5-year survival rate from major cancers? (no) Incidence of heart disease? (no) Average years of old age spent in rude health? (no) [Edit: fixed typo] Last edited: Monique Staff Emeritus Science Advisor Gold Member Originally posted by Nereid Onto out favourite (oops, 'favorite' for phatmonky and Russ ) topic, yes? Re health: the US's ~14% of GDP spent on health produces what ~100% better health outcome than the Netherlands' ~7% of GDP spent on health? Not sure what you mean to say there.. US Life expectancy at birth? 77.14 years Death rate: 8.44/1000 (median age 36) Infant mortality rate: 6.75/1000 Literacy: 97% GDP per capity:$36300 (2002)
Unemployment rate: 5.8%
NL
Life expectancy at birth? 78.74
Death rate: 8.66/1000 (median age 38)
Infant mortality rate: 4.26/1000
Literacy: 99%
GDP per capity: $27200 (2002) Unemployment rate: 3% (underestimation) taken from the CIA website Originally posted by Nereid Onto out favourite (oops, 'favorite' for phatmonky and Russ ) topic, yes? Re health: the US's ~14% of GDP spent on health produces what ~100% better health outcome than the Netherlands' ~7% of GDP spent on health? Life expectancy at birth? (no) 5-year survival rate from major cancers? (no) Incidence of heart disease? (no) Average years of old age spent in rude health? (no) I'll humour (;) ) you. First answer this: Does the Netherlands' have the queues that Canada, Australia, and England have for doctors visits and surgeries? I'm trusting an honest answer here. Monique Staff Emeritus Science Advisor Gold Member We don't directly step the the specialist, so cases that don't really require a specialist relieve the burden there. Also, what I have heard is that the General Practicioner to population ratio is especially favorable in NL (although there still is a shortage). Yes, there are waiting lists, but only for specialists. If I wished to I can show up in my doctor's office any time. Staff Emeritus Science Advisor Gold Member Originally posted by phatmonky I'll humour (;) ) you. First answer this: Does the Netherlands' have the queues that Canada, Australia, and England have for doctors visits and surgeries? I'm trusting an honest answer here. Last time I was in England and Australia (and Hongkong, and several other countries), there were no queues for doctor's visits or surgeries. Last time I was in the US, I couldn't go to see a doctor or a surgeon without having a) a valid credit card, and b) proof that I belonged to a health plan (quite an unnerving experience!) In all cases, except for emergencies, I needed to make appointments. In only one case have I had difficulty making a doctor's appointment (that I can recall), and that was in the US. Fortunately, when I've been in the Netherlands and Canada, I've not needed to visit a doctor (touch wood). So, how about those figures on the ~100% increased average (health) benefit in the US, for the 2x greater health spend? Monique has already given us data on > life expectancy: NL 1, US 0 Monique Staff Emeritus Science Advisor Gold Member Originally posted by Nereid Last time I was in the US, I couldn't go to see a doctor or a surgeon without having a) a valid credit card, and b) proof that I belonged to a health plan (quite an unnerving experience!) Oh don't get me started about US health care system, especially for aliens. I don't have a license and a passport is not a valid method for identification in the US, apparently :S I had proof that I belonged to a healthplan, but it was Dutch: soooo: they don't take it. Having to wait for HOURS in the waiting room, having to wait another hour in the small waiting room. Not getting service, having to pay... how much was it?$75 I believe for a 10 min consultation.

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Originally posted by Nereid
Last time I was in England and Australia (and Hongkong, and several other countries), there were no queues for doctor's visits or surgeries. Last time I was in the US, I couldn't go to see a doctor or a surgeon without having a) a valid credit card, and b) proof that I belonged to a health plan (quite an unnerving experience!)

In all cases, except for emergencies, I needed to make appointments. In only one case have I had difficulty making a doctor's appointment (that I can recall), and that was in the US.

Fortunately, when I've been in the Netherlands and Canada, I've not needed to visit a doctor (touch wood).

So, how about those figures on the ~100% increased average (health) benefit in the US, for the 2x greater health spend? Monique has already given us data on
> life expectancy: NL 1, US 0
Well I'm glad you have had such a great luck with those countries. My girlfriend from Toronto has been through the system and I know it all to well with great detail. But I will leave this alone, as I do not need to worry about the queues for my case. It was an attempt at just an extra point. BTW, what US city were you in?

1> Diminishing returns. A smaller country will cost less per person to keep well. Transport, population density, etc. all have to factor in. Again though, this is just to take in to account. I'm just knocking away at that 100% percentage difference right now.

2> Looking at your figures, you mention the infant mortality rate.
This is up for grabs. At the end of 2003 the EU, via Peristat Research, found that the mortality is actually 7.4/1000. Still not 100%, but we are working on showing where that extra money is going. Now why is it 7.4? Well the research points to lifestyles...ohh, that's a good one for my next point!

3>Dealing with life expectancy. You cannnot pin lifestyles or outside influences on the healhcare system. The US murder rates are 4 times that of the netherlands, with the aggravated assault rates 20 times. This all factors into the cost.

.....
WOAH, I'm not continuing.....

Well I'll be. While I was sitting here reading some figures I came to this....
http://society.guardian.co.uk/futureforpublicservices/story/0,8150,687030,00.html

But the government's targets are clear enough and the electorate will be able to tell whether it is delivering.

The maximum waiting time for an operation is due to fall from the current 15 months to six months by 2005, in time for the next general election.

Ministers say waiting times will be down to three months by 2008, when there will be at least 15,000 more doctors, 35,000 more nurses and 30,000 more therapists and scientists. The government is also promising 10,000 more hospital beds.

These are not soft targets. Without the money they could not be delivered.
15 months?! 6 months?! 3 months is a goal?! Granted, this is England, before finding this, you would have me believe that their system is fine and dandy.

Then I come across australia http://www.smh.com.au/articles/2003/10/15/1065917483680.html?from=storyrhs

Then research on waiting in Canada and the fact that they use US hospitals to alleviate some of the wait...
http://oldfraser.lexi.net/publications/critical_issues/2000/waitingyourturn/section_07.html [Broken]

Sadly, as a smaller country, not a lot of statistics about the netherlands could be found easily.

But looking at that, the netherlands has 15.2% of patients waiting for more than 12 weeks.
On the other hand, the US only has 5% waiting over 16.

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I'm not going to continue. I think the facts are clear. Murder, car accidents, research investment, and unhealthy diets all play into the healthcare costs.

The one thing I have found that is fully to blame on the healthcare system is waiting times. It is insanely excessive, just as I had predicted, in the countries mentioned.

Oh, and 15% is 3 times 5% - I think that'll cover the 100% difference you were looking for.

Hey Zero, can you cut this thread in half and save this train wreck?

I prefer a privatized healthcare system no matter what. When I say that, that doesn't mean I woudl be against looking at alternatives to the insurance setup. It means I am against having doctors and hospitals all put under government control,pay, etc.

I believe that doctors need to be given the autonomy to do what is best for the patient. Ask a doc who has worked in a heavily beaurocratic hospital, and you will know that they are told to stop ordering so many CTscans and other tests.

I also would like to see a revamp of our medicare/medicaid system. I believe that all children should have healthcare access,and I believe that for extremely high cost/income ratios there needs to be some sort of aide given.

With that all said, I don't support any system that will limit the patients ability to pay for the most superior service available, if they are so inclined. I also don't like the idea of a socialized healtcare because of the lack of incentives to NOT go to the doctor. I have spoken with canadian doctors who tell me about abuse of the 'free' system. The nurses would chew people out because they come up there with mosquito bites wanting a benadryl shot to stop the itching. How can such a system work, when people are so obese and unhealthy here already? The answer is, that it can't. Not without raising costs evenmore.

Cover children and extreme cases. Give selection, incentives to stay healthy, and doctor autonomy. Then you have the perfect system.

Originally posted by Nereid

All of which leads to: how does one measure the cost-efficiency of health care?
Well, it is a slippery slope. There have been studies done, but there a too many factors.

Obviously the first 1000 dollars gets you a lot more than the next.
Some studies indicate that we could accompolish the same end results we have now for 50% less for every dollar spent over 1 trillion. This could be done simply through investment in greater technology for patient records (cutting down indirect overhead). That is a 300 billion dollar savings at our current rate.

Originally posted by Monique