News The US has the best health care in the world?

[cristo]

Amusing advertisement from Gordon Brown state TV.

I'm sorry, but are you claiming that was a staged scene, and that the people interviewed were actors? If so, I'd like to see your evidence. What I see is a documentary from one of the best documentary makers in the world. If you've actually ever watched anything from the BBC, you'll know that it is not a puppet channel.

BTW, Brock, the orgnizer of that clinic also comments:

I'm not going to argue that there aren't problems with the dental system, but then, what are the odds of dying of toothache against dying of cancer? The fact is that every single citizen of the UK can see a doctor at any time by walking into a clinic, or making an appointment with their GP, for no charge. The same thing cannot be said for the US, hence why people are fighting their way into a sports hall at 4am to be seen by a third world charity (as per the above film).

 

[Al68]

After rereading the bill, it's clear that it's a complete government takeover of health insurance in the U.S. Although there is a 5 year grace period for some employer based plans, and a grandfather clause for some policies, they are only relevant in the short term. After that all health insurance in the U.S. that are not part of the government "system" will be outlawed. Source: Section 102(c)(1) of http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200:

Although private companies may offer insurance as part of the system, they cannot offer private insurance plans "outside" the new system.

Anyone who chooses not to subsidize the things they find objectionable, or simply have no interest in being in the new system, not only will have to pay an income tax penalty, but will not be able to obtain other health insurance at all in the long term.

Apparently, Democrats are just counting on the fact that most people won't read the bill, and the media won't report the facts, to get away with not telling the truth, and demonizing anyone who does.

The tree of liberty in the U.S. is getting thinner and thinner.

 

[WhoWee]

Full disclosure, I'm a licensed insurance broker. I operate a self quote website with multiple carriers. I am very unhappy with the current discussion in Congress. Health insurance underwriting is down by as much as 80%, as are renewals. People who have lost their jobs are opting for the COBRA extension are facing the reality of future disqualification (pre-existing conditions) due to a new event happening while between policies. I know of cases where people have actually dropped their coverage to (save money now) because "free" health care is on the way. Agents have told me the people opting out of coverage aren't worried about getting sick because the government will take care of them. This is very risky behavior.

As the President mused recently about UPS and FedEx getting it right and the Post Office always being in trouble, the same is true with private insurance companies and Medicare/Medicaid/Social Security.

The biggest challenges to profitability the private companies have are in dealing with government regulation and lawsuits. Otherwise, the insurance companies already have the very best IT in place. The insurance companies are efficient. Insurance companies are rated by how fast they can pay a claim. This information is public and must be disclosed to all applicants.

If you want to address health care reform, start with Tort reform. Then, clean up the fraud and waste in the government run programs.

One aspect of private insurance that works is high deductible catastrophic coverage ($10,000 to $25,000 deductibles) coupled with Health Savings Accounts. Under these plans, patients pay all of the doctor visits and routine tests out of pocket and can write off roughly $5,000 per year. They only use their insurance for large claims such as surgery or cancer treatments. The Health Reform Bills under consideration will outlaw this type of plans.

The next issue is eligibility. Why should US taxpayers pay for the health care of illegal immigrants? If you want to break the law and sneak into this country to work, then pay for your own health insurance - just saying.

Last, modern medicine has extended life-spans. The longer we live, the more medical care will cost. We can debate quality of life (well, until we die) but the prospect/fear of someone making that decision for us is terrifying to most people.

 

[mheslep]

I'm sorry, but are you claiming that was a staged scene, and that the people interviewed were actors?

No I'm not claiming any staging. I claim a great deal of the commentary was bogus, and I suspect the scenes were cherry picked.

If so, I'd like to see your evidence. What I see is a documentary from one of the best documentary makers in the world. If you've actually ever watched anything from the BBC, you'll know that it is not a puppet channel.

And I see a state run broadcasting station, with some good quality programming, but to my mind still biased out over the horizon.

...I'm not going to argue that there aren't problems with the dental system, but then, what are the odds of dying of toothache against dying of cancer?

The cancer treatment is better in the US, better odds of survival.

...The fact is that every single citizen of the UK can see a doctor at any time by walking into a clinic, or making an appointment with their GP, for no charge.

Even if that's true, to what end? Seeing a free GP does not necessarily equal good medical care, as the survival statistics and the waiting lists show. And every single US citizen can walk into an emergency room in the US, and not be turned away based on ability to pay (though I'd change this).

The same thing cannot be said for the US, hence why people are fighting their way into a sports hall at 4am to be seen by a third world charity (as per the above film).

I'd like to know how many of those folks qualified for US Medicaid (single payer for the poor), and avoided that government run system to attend the hall, perhaps because they thought so little of it.

 

[mheslep]

...

One aspect of private insurance that works is high deductible catastrophic coverage ($10,000 to $25,000 deductibles) coupled with Health Savings Accounts. Under these plans, patients pay all of the doctor visits and routine tests out of pocket and can write off roughly $5,000 per year. They only use their insurance for large claims such as surgery or cancer treatments. The Health Reform Bills under consideration will outlaw this type of plans...

What section of the House bill would outlaw HSAs?

 

[cristo]

No I'm not claiming any staging. I claim a great deal of the commentary was bogus, and I suspect the scenes were cherry picked.

Cherry picked or not, the fact of the matter is that such scenes exist.

And I see a state run broadcasting station, with some good quality programming, but to my mind still biased out over the horizon.

What would be the gain to the viewers to be biased about this? It is providing documentary coverage of the situation in a completely different part of the world to the UK. The NHS is not under debate in the UK-- both major parties support it-- so there really is no point to the alleged bias.

The cancer treatment is better in the US, better odds of survival.

Sorry, are you reading different things to those that I'm writing? I don't recall questioning that in the quote...

Even if that's true, to what end? Seeing a free GP does not necessarily equal good medical care, as the survival statistics and the waiting lists show. And every single US citizen can walk into an emergency room in the US, and not be turned away based on ability to pay (though I'd change this).

But a GP and an emergency room are two completely different things, aimed at solving completely different issues. Are you telling me that I can go into an emergency room in the US and say "I think I've got cancer, can you test me and find out?" and walk out, having been tested, and given treatment to help cure me without having to pay a penny?

I'd like to know how many of those folks qualified for US Medicaid (single payer for the poor), and avoided that government run system to attend the hall, perhaps because they thought so little of it.

So they'd rather die than use the aid they could be provided with? Not very likely to me!

 

[Al68]

...One aspect of private insurance that works is high deductible catastrophic coverage ($10,000 to $25,000 deductibles) coupled with Health Savings Accounts. Under these plans, patients pay all of the doctor visits and routine tests out of pocket and can write off roughly $5,000 per year. They only use their insurance for large claims such as surgery or cancer treatments. The Health Reform Bills under consideration will outlaw this type of plans...

What section of the House bill would outlaw HSAs?

I think WhoWee was referring to the insurance plans being outlawed, not HSA's. It's in section 102(c)(1).

Personally, I like the medium deductible ($1,000 to $5000) catastrophic coverage plans. They're a fraction of the cost of comprehensive health plans, and a bargain for people that just need insurance in case they are seriously injured or get sick, but don't need a comprehensive plan that covers everything under the sun.

Democrats apparently have no problem outlawing private agreements between private parties, violating the right of private individuals to contract.

 

[mheslep]

...But a GP and an emergency room are two completely different things, aimed at solving completely different issues. Are you telling me that I can go into an emergency room in the US and say "I think I've got cancer, can you test me and find out?" and walk out, having been tested, and given treatment to help cure me without having to pay a penny?

Yes the GP and emergency room serve different purposes. But then GP's also don't test for cancer, specialists do. Are you telling me you can walk into a specialist office? I just had a family member go to a specialist for a cancer test within two days of a GP visit. And I don't agree w/ the the not-paying-a-penny. You simply don't pay at the door. Also we've heard in this thread that if you ask for say, a PSA test for prostate, its sorry we don't do that, its unnecessary.

So they'd rather die than use the aid they could be provided with? Not very likely to me!

Again there the suggestion that all aid is the same. Visibly it is not. Maybe the government aid was known to be rude and indifferent, and this at the town hall was not.

 

[mheslep]

...What would be the gain to the viewers to be biased about this? It is providing documentary coverage of the situation in a completely different part of the world to the UK.

Why would a government run broadcasting network travel around making documentaries emphasizing how superior this of that government run program is to private alternatives? Not hard to imagine.

The NHS is not under debate in the UK-- both major parties support it-- so there really is no point to the alleged bias.

Perhaps that is a reflection of the BBC coverage. Perhaps the lack of debate reflects that the fact the NHS employs 1.2 million voters. I know of at least of one UK EMP (back bencher) that attacks it regularly.

 

[Hurkyl]

Cherry picked or not, the fact of the matter is that such scenes exist.

Is that relevant? Is mere existence the thing you (or the documentary) were trying to argue?

Or were you trying to argue something about the extent to which such scenes exist? In that case, cherry picking scenes and presenting them as if they are representative is a rather nasty bit of intellectual dishonesty.

 

[Al68]

The NHS is not under debate in the UK-- both major parties support it-- so there really is no point to the alleged bias.

Are you serious? There's no point in the BBC being biased in favor of British policy over the U.S.? Come on, now.

 

[WhoWee]

I think WhoWee was referring to the insurance plans being outlawed, not HSA's. It's in section 102(c)(1).

Personally, I like the medium deductible ($1,000 to $5000) catastrophic coverage plans. They're a fraction of the cost of comprehensive health plans, and a bargain for people that just need insurance in case they are seriously injured or get sick, but don't need a comprehensive plan that covers everything under the sun.

Democrats apparently have no problem outlawing private agreements between private parties, violating the right of private individuals to contract.

I didn't mean to infer the (individual and family $3k to $5k approx) HSA's were on the chopping block. I'm referring to high deductible Catastrophic Plans. I'll double check the section.

 

[cristo]

Yes the GP and emergency room serve different purposes. But then GP's also don't test for cancer, specialists do. Are you telling me you can walk into a specialist office?

No, I'm saying you can walk into a GP's office and they will then arrange an appointment with a specialist.

You simply don't pay at the door.

No. If I had no job, and thus didn't pay taxes, I would be able to walk into a GP's office and then get an appointment with a specialist. In the US, I could not walk into an emergency room and then get an appointment with specialist. That is my point.

Why would a government run broadcasting network travel around making documentaries emphasizing how superior this of that government run program is to private alternatives? Not hard to imagine.

The BBC isn't run by the government, it is supported by a royal charter, and supported by license fee money. The monarch is not part of the government! (That's a very basic lack of knowledge for someone who wants to debate this issue!)

Perhaps that is a reflection of the BBC coverage. Perhaps the lack of debate reflects that the fact the NHS employs 1.2 million voters.

Idle speculation.

Is that relevant? Is mere existence the thing you (or the documentary) were trying to argue?

Existence is exactly what I was trying to argue! The fact that 100 people are in a situation where they have no access to healthcare is good enough proof that the current healthcare service does not work in the best interest of every American!

 

[Al68]

The fact that 100 people are in a situation where they have no access to healthcare is good enough proof that the current healthcare service does not work in the best interest of every American!

Why would you refer to individual private agreements between private parties as a "current healthcare service"?

 

[russ_watters]

Existence is exactly what I was trying to argue! The fact that 100 people are in a situation where they have no access to healthcare is good enough proof that the current healthcare service does not work in the best interest of every American!

How is that useful? Are you saying that there is a way to provide healthcare that is within the best interest of everyone? I can assure you that no system will ever satisfy everyone at once.

It's been pointed out before, but maybe it is worth pointing out again: what makes the US different from the rest of the west is the level of freedom and with it the level of personal responsibility its citizens have. It is a double-edged sword, of course, but in the US we don't sacrifice the freedom of 80% of the population for the sake of picking up the 20% who have failed to live up to their personal responsibility...at least not yet.

The idea that those 80% somehow owe something to those 20% just isn't how the US works, philosophically.

 

[cristo]

Why would you refer to individual private agreements between private parties as a "current healthcare service"?

If you don't see it as a healthcare system, then you are essentially admitting that it's an every man for himself situation. Then, it's clearly the poor (the most in need) that will be missing out. Are you happy living in a situation where you just ignore the health needs of poor people who cannot afford to be enter into such private agreements?

 

[cristo]

I can assure you that no system will ever satisfy everyone at once

No, but you can have a system whereby everyone is on an equal footing, and advantages are not given out by how wealthy a person is.

It's been pointed out before, but maybe it is worth pointing out again: what makes the US different from the rest of the west is the level of freedom and with it the level of personal responsibility its citizens have. It is a double-edged sword, of course, but in the US we don't sacrifice the freedom of 80% of the population for the sake of picking up the 20% who have failed to live up to their personal responsibility...at least not yet.

This is always quoted, but I fail to see how this has anything to do with "freedom". Unless, of course, you take the view that it is the poor's fault that they are in the situation they are in. I live in a world where I will try to help my fellow countrymen, and not first judge whether they have "live[d] up to their personal responsibility" or not.

 

[Al68]

If you don't see it as a healthcare system, then you are essentially admitting that it's an every man for himself situation. Then, it's clearly the poor (the most in need) that will be missing out. Are you happy living in a situation where you just ignore the health needs of poor people who cannot afford to be enter into such private agreements?

You missed the point. I never suggested we should ignore poor people. I said that the private agreements referred to aren't made for that purpose, and aren't intended or claimed to be for that purpose.

Just like my car insurance policy isn't intended to help poor people. Or my agreement with the plumber I had to call last week. Or my cell phone contract.

Is it the fault of my cell phone contract that some people can't afford a cell phone? Should I say that the "cell phone system" is defective as a result? Is the "plumber system" defective?

Is the car insurance "system" defective since it doesn't fix the cars of people without a policy or cover pre-existing conditions?

Is there any chance at all this debate can stop being so absurd and fraudulent?

 

[WhoWee]

If you don't see it as a healthcare system, then you are essentially admitting that it's an every man for himself situation. Then, it's clearly the poor (the most in need) that will be missing out. Are you happy living in a situation where you just ignore the health needs of poor people who cannot afford to be enter into such private agreements?

There is a big misconception in this area. The "poor" people already have free healthcare.

It's the working poor that lack coverage. People who earn from minimum wage to (as much as) $20 per hour based on family size are the ones struggling to pay for coverage.

Comprehensive 80/20, $1,000 deductible, individual/family health coverage can easily cost $200+ per person per month. One of the reasons the working poor don't have insurance is that small business owners can't afford the minimum wage, let alone benefit programs.

The other major problem is people who have adequate income, but only qualify for (some are very expensive) indemnity plans or discount (association/network) plans due to pre-existing conditions.

 

[Al68]

No, but you can have a system whereby everyone is on an equal footing, and advantages are not given out by how wealthy a person is.

Given out? By who? Equality of outcomes is obviously incompatible with individual liberty.

This is always quoted, but I fail to see how this has anything to do with "freedom". Unless, of course, you take the view that it is the poor's fault that they are in the situation they are in. I live in a world where I will try to help my fellow countrymen, and not first judge whether they have "live[d] up to their personal responsibility" or not.

Huh? The issue isn't whether you should help your countrymen, it's whether you should force them to help each other against their will and outlaw private agreements. That's how "freedom" is relevant.

Being reluctant to advocate the oppression of others (ostensibly to help the poor) isn't equal to "the view that it is the poor's fault that they are in the situation they are in".

Personal responsibility is a necessary consequence of freedom for obvious reasons, not something imposed by others.

 

[cristo]

You missed the point. I never suggested we should ignore poor people. I said that the private agreements referred to aren't made for that purpose, and aren't intended or claimed to be for that purpose.

Ok fine, then let's put it another way. What should be provided for the people who cannot afford to enter into private agreements?

There is a big misconception in this area. The "poor" people already have free healthcare.

It's the working poor that lack coverage.

Well, I would still class the working poor as "poor"! Still, you're right. Whilst medicare will of course support the very worst off, there are still be people in poverty who will not be supported by medicare (whom you refer to as the working poor).

Given out? By who?

"Given out" by whoever decided the healthcare policies.

Being reluctant to advocate the oppression of others (ostensibly to help the poor) isn't equal to "the view that it is the poor's fault that they are in the situation they are in".

I don't see how it's oppressive for a government to help out the people who can't help themselves. I'll ask the above question again, then: what should be put in place to help such people?

 

[Al68]

Ok fine, then let's put it another way. What should be provided for the people who cannot afford to enter into private agreements?

Provided by who? Charitable organizations? I'd say it would be a compromise between what is needed and the resources of the organization.

It should be obvious that the difference between positions on this issue isn't about what poor people "should have".

The difference is about the violations of liberty contained in the proposal. The fact that such violations are claimed to be for the purpose of helping the poor doesn't mean that being against the violations equals being against the poor, despite the propaganda.

This type of propaganda has been used to promote the hatred of libertarians for decades in the U.S., and has no basis in fact. According to the oppressors, anyone opposing them must "not care about poor people", "be for the rich", etc.

Most importantly, the people who are against violations of liberty have no obligation to justify the conditions claimed to be the reason the violations of liberty are "needed". It is those that advocate such violations that have the obligation to justify them (other than "the ends justify the means").

 

[cristo]

Provided by who? Charitable organizations?

No, by the government. Clearly you don't believe that the government should bear responsibility for people who cannot afford to look after themselves. That's fine, it's your opinion. In my opinion, it's certainly a good thing that you have a leader who is looking towards taking on some of the responsibility of the problem.

There's probably no point continuing this, since neither of us will change our opinion.

 

[Al68]

"Given out" by whoever decided the healthcare policies.

They can give out whatever they can afford. The more the better. After all most of them are far richer than the rest of us.

Being reluctant to advocate the oppression of others (ostensibly to help the poor) isn't equal to "the view that it is the poor's fault that they are in the situation they are in".

I don't see how it's oppressive for a government to help out the people who can't help themselves.

I didn't say it was. The means used ostensibly for that goal are often oppressive, as is the case with the current proposal.

 

[Al68]

Provided by who? Charitable organizations?

No, by the government.

The U.S. government doesn't have it's own money, so is it safe to assume you mean that the government should take it by force from people for that purpose?

There's probably no point continuing this, since neither of us will change our opinion.

There's certainly no point in continuing as long as you insist on ignoring the point of disagreement between us, and concentrating on something that everyone agrees on (poor people need help) as if we disagreed on that. That's both fruitless and insulting.

 

[cosmo123]

How is that useful? Are you saying that there is a way to provide healthcare that is within the best interest of everyone? I can assure you that no system will ever satisfy everyone at once.

It's been pointed out before, but maybe it is worth pointing out again: what makes the US different from the rest of the west is the level of freedom and with it the level of personal responsibility its citizens have. It is a double-edged sword, of course, but in the US we don't sacrifice the freedom of 80% of the population for the sake of picking up the 20% who have failed to live up to their personal responsibility...at least not yet.

The idea that those 80% somehow owe something to those 20% just isn't how the US works, philosophically.

It seems like the ultimate version of personal responsibility would be one where there are no taxes and you pay for what you use.

The top 90% can afford to use the roads.
The top 80% can afford healthcare.
The top 70% can go to school.
The top 60% can afford the police.
The top 50% can afford the fire service.
The top 20% can afford the lifeguard service.

Sounds like a rosey future we should all aspire to.

 

[WhoWee]

Yes, have you read anything that was posted about Adjusted Gross Income? Do you understand Adjusted Gross income? Have you ever filed an itemized tax return and understand the reason behind it? Do you undersatand US tax laws? You don't seem to.

I've made over $250 a year and had tons of exemptions, and the percent of tax I paid, when averaged over my actual gross income, not the percentage I paid on the AGI that was taxable, was a much lower percentage than I pay now, and I make just under $100k a year now and have no deductions. I'll say it one more time. I'm not talking about the % of tax on AGI, I'm talking about the $ amount of taxes paid, and what percent of a person's total UNadjusted gross income that equates too. Do you understand now? Based on a person's TOTAL ACTUAL annual income, unless they do not itemize, the rich pay a lower percent of tax based on their TOTAL annual income.

There is another aspect to this discussion that's not talked about much. Income taxes are only one form of taxation.

Taxes based on consumption/use are a much higher portion of income for people who earn less. Taxes are included on everything from (the most noticeable) retail sales, fuel, utilities (including phones and cable), syrup, alcohol, tobacco, and etc. An individual (rich or poor) can only consume so much per year.

For a modest person that only saves or invests 5% per year, it's possible the other 95% is subject to some form of tax. To compensate, luxury taxes, etc. have been imposed on the wealthy, but it doesn't bring equality.

In the context of this point, the next very dangerous threat to the middle class tax rates will be INFLATION (as we print Dollars and borrow from China due to increased deficit spending). As consumer prices inflate, the TAXES on those purchases INCREASE accordingly. (I know the savings of the wealthy are devalued - that's not the point).

 

[mheslep]

...No. If I had no job, and thus didn't pay taxes, I would be able to walk into a GP's office and then get an appointment with a specialist.

Obviously the vast majority of UK citizens pay substantially through the tax system. And in the US if one has no or very little income (<~20k/yr), then they are eligible for government based health care via the Medicaid program as I posted before, and before, and before. I make no claims about the quality of that, or any other government sponsored health care program.

In the US, I could not walk into an emergency room and then get an appointment with specialist. That is my point...

Right, you go see your US GP and get to the specialist in short order.

...Idle speculation.

Speculation, but not idle. That's where you've taken us with claims like "...there really is no point to the alleged bias." about the BBC.

 

[Ivan Seeking]

Right, you go see your US GP and get to the specialist in short order.

In short order!

Wait six weeks to see the GP, and then eight to ten weeks to see a specialist. If the situation is hypercritical then they MIGHT get you in quickly.

I recently made an appointment with my dermatologist - I have psoriasis and had a bad outbreak this summer. It was making life miserable.

I called in early July and got an appointment for September 1st.

My wife struggles with a thyroid condition that ranges from being a minor nuisance, to being virtually incapacitating. When she starts having problems, first we have to wait six or eight weeks for her to see the specialist. Then we have to wait another two or three weeks for the tests to be scheduled, and another week or two for the results. Then, after another week or two, they will decide on new dosages for her meds. After a month they begin to take effect. So from the day we know she is having problems, by which time things are getting serious, there is no hope for help for at least the next two months, and normally it takes more like three months.

People who think this system is so wonderful obviously have little experience with the health care systems; that or they were just one of the lucky ones.

My father just had a heart attack and is not doing well. Unliked my mother who fell victim to private care, my dad is a vet. The VA hospital [you know, that socialist organization] has been WONDERFUL! Thank God for government run health care!

 

[Al68]

In short order!

Wait six weeks to see the GP, and then eight to ten weeks to see a specialist. If the situation is hypercritical then they MIGHT get you in quickly.

I recently made an appointment with my dermatologist - I have psoriasis and had a bad outbreak this summer. It was making life miserable.

I called in early July and got an appointment for September 1st.

My wife struggles with a thyroid condition that ranges from being a minor nuisance, to being virtually incapacitating. When she starts having problems, first we have to wait six or eight weeks for her to see the specialist. Then we have to wait another two or three weeks for the tests to be scheduled, and another week or two for the results. Then, after another week or two, they will decide on new dosages for her meds. After a month they begin to take effect. So from the day we know she is having problems, by which time things are getting serious, there is no hope for help for at least the next two months, and normally it takes more like three months.

People who think this system is so wonderful obviously have little experience with the health care systems; that or they were just one of the lucky ones.

Your post indicates you believe there is only one dermatologist and one thyroid specialist around, or that you are part of some insurance system that I am not, and never would be. Or a receptionist told you you "had" to wait and you took it literally. You certainly never explained why you waited, so it doesn't even provide any anecdotal evidence.

Regardless of how long you waited, the fact remains that I would not have waited that long. Period. If a specialist doesn't have time to see me, he/she loses my business and another one gains it. It's that simple. I'm in charge, not some imaginary "system" some people seem to think they're a part of.

While I have been told a specific doctor couldn't see me any time soon, I have never been forced to wait for care. No one in this country currently has the power to tell me I must wait, and I'd like it to stay that way.

And no, I'm not rich, far from it, but I do choose my insurance policies wisely. And I don't let my employer choose it for me, despite the tax code's attempt to coerce me to do so.

 

[mheslep]

...Wait six weeks to see the GP, and then eight to ten weeks to see a specialist. If the situation is hypercritical then they MIGHT get you in quickly.
I recently made an appointment with my dermatologist - I have psoriasis and had a bad outbreak this summer. It was making life miserable. I called in early July and got an appointment for September 1st.

So 6 to 8 weeks in your case.

You might consider a new GP or insurance network. http://www.merritthawkins.com/pdf/mha2009waittimesurvey.pdf" Average time to see a Dermatologist is 25 days. In Boston, where they've instituted a near universally run government program, the wait for a GP is 63 days, the worst in the country by far. Dermatologist wait in Boston is 54 days. Interestingly, the worst case wait in Boston for a Dermatologist jumped to one year in 2009, tripling the old worst case of time of 120 days in 2004 before the universal plan kicked in.

These longer US times I would call unacceptable, but they're still short compared to, say, Canada. Orthopedic surgery wait in Portland is 9 days, http://www.fraserinstitute.org/researchandpublications/publications/2548.aspx"

http://www.youtube.com/watch?v=AqD-...ation-in-lego/&feature=player_embedded#t=130"

Of course though it won't get you into a specialist, for http://nurse-practitioners.advanceweb.com/editorial/content/editorial.aspx?cc=116098" , Walmart houses many of them.

A personal aside, my wife recently got into see her GP after ~4days. She got into see a specialist on a semi-urgent matter 48 hours latter. I seriously wish yours the same fortune.

Also, Medicare is coming your way soon (now?). Do you expect quality to greatly improve under Medicare? Do you expect Medicare will have some drug that doesn't take a month to have impact after taking it? The Mayo clinic for instance has http://www.mayoclinic.org/billing-rst/faqs2.html" , they got fed up with Medicare's payments.

My father just had a heart attack and is not doing well. Unliked my mother who fell victim to private care, my dad is a vet. The VA hospital has been WONDERFUL! Thank God for government run health care!

I'm happy your father's care went well after his illness , but the VA has had many well publicized disasters.

http://www.washingtonpost.com/wp-dyn/content/article/2007/02/17/AR2007021701172.html"

 

[mheslep]

I didn't mean to infer the (individual and family $3k to $5k approx) HSA's were on the chopping block. I'm referring to high deductible Catastrophic Plans. I'll double check the section.

Turn's out HSA's are on the chopping block in HR 3200. http://blog.heritage.org/wp-content/uploads/2009/08/cantor-26.pdf" and it was voted down.

No Freedom to Choose Health Savings Accounts. Once again, the president has said repeatedly that if Americans like the coverage they have today, they would be able to keep it. But under the House bill, the benefits and the terms and conditions of the health benefits that are included in Americans’ health insurance would be determined by federal officials. The House bill would set conditions for what is or is not “acceptable” health insurance coverage.

Many Americans have personally chosen to enroll in high-deductible plans combined with a Health Savings Account (HSA). They have chosen this option because they want to have more direct control over their health-care dollars and how their health-care dollars are spent. To protect consumers who currently hold these plans, Rep. Eric Cantor (R., Va.) proposed an amendment that would include high-deductible plans with HSAs in the House bill’s definition of a “qualified health benefits plan.” The amendment would have prohibited the Secretary of Health and Human Services (HHS) from restricting enrollment in private health plans with HSAs. The Cantor amendment was defeated. In other words, contrary to the president’s promise, under the terms of HR 3200 Americans with HSAs could be forced to switch out of their current plans.

Likewise, Rep. Dave Reichert (R., Wash.) introduced an amendment that would repeal the House bill’s statutory prohibition on new enrollees into individual private health-insurance plans. As currently drafted, HR 3200 prevents individual plans from enrolling new members after 2013 unless the plan is specifically “grandfathered” under the law or is transformed into a “qualified health benefits plan,” as determined by federal officials, and available through the national Health Insurance Exchange. The Reichert amendment was also defeated. This means that Americans would be prohibited by law from enrolling in a private individual health-insurance plan and would be forced by the federal government to buy a different health plan in the national Health Insurance Exchange.

http://healthcare.nationalreview.com/post/?q=MzdiZGU2YjA0ZGQ1ZTQxODRmNjY3NjI5ZGQ3Yzg5NGQ=

 

[mheslep]

Dr and politcal columnist Charles Krauthammer is to my mind the most thoughtful conservative columnist writing today. His health ideas here. Short and to the point as usual. Only two parts: 1. Tort Reform, 2. Kill the employer tax rule and give people the money back directly.

http://www.washingtonpost.com/wp-dy...08/06/AR2009080602933.html?hpid=opinionsbox1"

 

[WhoWee]

Turn's out HSA's are on the chopping block in HR 3200. http://blog.heritage.org/wp-content/uploads/2009/08/cantor-26.pdf" and it was voted down.


http://healthcare.nationalreview.com/post/?q=MzdiZGU2YjA0ZGQ1ZTQxODRmNjY3NjI5ZGQ3Yzg5NGQ=

I'll be shocked if HSA's are eliminated. They are the most popular (relatively speaking) new products out there. The Health Savings Account plans allow individuals to purchase higher deductible plans (typically $3/$5K) at a lower premium and save money in a special bank account (most have debit cards assigned) to use strictly for medical expenses. The funds are allowed to accumulate and roll over to the next year. Plus there are tax incentives.

The other high deductible plans I mentioned are the $10,000 to $25,000 deductible plans. The premiums are very low, but the risk is obvious. These plans have also been growing in popularity with self employed people, often coupled with accident plans and/or association benefits.

A quick explanation of the $25,000 deductible plan... even though the deductibles are high, the "in-network discounts" are still in effect and the services rendered may actually reach $50,000 total ($25 "in-network" discounts and $25 out of pocket) before the insurance company actually pays anything. Insurance companies love these plans, medical providers aren't as happy about them.

 

[cristo]

Obviously the vast majority of UK citizens pay substantially through the tax system.

Substantially means nothing, unless you are using a comparison. The UK spends a lot less on healthcare per capita than the US, for example (and has a higher life expectancy...)

And in the US if one has no or very little income (<~20k/yr), then they are eligible for government based health care via the Medicaid program as I posted before, and before, and before.

Not true:

http://www.cms.hhs.gov/MedicaidGenInfo/]Medicaid[/PLAIN] does not provide medical assistance for all poor persons. Even under the broadest provisions of the Federal statute (except for emergency services for certain persons), the Medicaid program does not provide health care services, even for very poor persons, unless they are in one of the designated eligibility groups.

Speculation, but not idle. That's where you've taken us with claims like "...there really is no point to the alleged bias." about the BBC.

You know nothing about the things you're trying to debate. Please try and stop being so ignorant. It's fine for you to admit that you don't understand how the BBC is funded, but to claim that it is run by government is incorrect.

 

[mheslep]

Substantially means nothing, unless you are using a comparison. The UK spends a lot less on healthcare per capita than the US, for example (and has a higher life expectancy...)

The comparison in this context was to your statement about not having to https://www.physicsforums.com/showpost.php?p=2308009&postcount=356" as you well know.

 

[mheslep]

Not true:

Yes, generally, regarding Medicaid it is true. Clearly the eligibility criterion are more complex than my one sentence statement, it includes other things including the size of ones assets, such as a fat bank account or a flashy boat in the backyard. I might have said simply 'poor', but that has such a wide definition that its not useful. Generally speaking:

Medicaid is health insurance that helps many people who can't afford medical care pay for some or all of their medical bills.

And in fact Medicaid covers "http://www.cdc.gov/pcd/issues/2009/Jul/08_0153.htm" "

In general, you should apply for Medicaid if your income is limited and you match one of the descriptions of the Eligibility Groups. (Even if you are not sure whether you qualify, if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworker in your state evaluate your situation.)

Low-income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds

An able bodied adult male with no dependants will have a hard time qualifying.

Clearly neither Medicaid nor Medicare cover everyone that lack insurance, though given that the US is closing in on spending a trillion dollars annually on the two programs collectively one might think they would. So given the 58 million people on the Medicaid roles alone along with funding, it is simply nonsense to claim only the 'wealthy' have access to medical help in the US.

There remains roughly 3-4% of US citizens that don't qualify for help as destitute but still can't manage to afford access. I'd like to see action taken to get it to them, though not via what's on the table now.

 

[turbo]

There remains roughly 3-4% of US citizens that don't qualify for help as destitute but still can't manage to afford access. I'd like to see action taken to get it to them, though not via what's on the table now.

How do you know what's on the table? Have you read any of the mark-ups coming out of the various committees? Do you have a crystal ball to see what could emerge as a reconciled bill merging the House's language with the Senate's? Nobody has a clear view of where all this will end up yet, which is why the neo-cons are stirring people up to shout "We don't want it." when they haven't a clue what has come out of committees. One thing for sure - if we don't contain costs and rein in the cost of health-care, the US is headed for economic catastrophe.

Reps Bachman and Kline have both come out saying that public insurance would be cheaper. So as true neo-cons, they are against cutting waste and inefficiency, and want to let insurance companies decide who lives or dies.

http://minnesotaindependent.com/39874/bachmann-kline-oppose-public-option-because-its-cheaper

 

[mheslep]

How do you know what's on the table? Have you read any of the mark-ups coming out of the various committees? Do you have a crystal ball to see what could emerge as a reconciled bill merging the House's language with the Senate's? Nobody has a clear view of where all this will end up yet, which is why the neo-cons are stirring people up to shout "We don't want it." when they haven't a clue what has come out of committees. One thing for sure - if we don't contain costs and rein in the cost of health-care, the US is headed for economic catastrophe...

I'm only ~familiar w/ HR3200, as much as I can understand it without running down all the redirections, and with various statements from this or that Senator. There's some good in there, but mainly I think its a mistake. There are other plans I do like, mostly, and have posted about them here.

 

[WhoWee]

How do you know what's on the table? Have you read any of the mark-ups coming out of the various committees? Do you have a crystal ball to see what could emerge as a reconciled bill merging the House's language with the Senate's? Nobody has a clear view of where all this will end up yet, which is why the neo-cons are stirring people up to shout "We don't want it." when they haven't a clue what has come out of committees. One thing for sure - if we don't contain costs and rein in the cost of health-care, the US is headed for economic catastrophe.

Reps Bachman and Kline have both come out saying that public insurance would be cheaper. So as true neo-cons, they are against cutting waste and inefficiency, and want to let insurance companies decide who lives or dies.

http://minnesotaindependent.com/39874/bachmann-kline-oppose-public-option-because-its-cheaper

I agree that we need to allow Congress to do their job. However, their first priority should be to address the problems with the existing Government run systems. Instead, the President has pushed for his $600 billion+ "down payment" to restructure health care. Bigger doesn't always mean better - adding to the problem will undoubtedly make it worse.

One place to start in the Government programs might be to encourage doctors to volunteer at free clinics (reward them with tax credits - not cash). This would certainly cut down on treatment at emergency rooms for colds, flu and other non-emergency treatments. This will require new free clinics - which some of the stimulus money could build-out.

Next, one of the biggest problems with private health insurance is denial of coverage for pre-existing conditions. I'm sure the insurance industry could teach the Government how to design and manage one super-sized risk pool to address this issue. The Government is the only entity that could establish such a pool.

Last, if someone sneaks into this country to work - that is take a job away from a citizen - they should use their earnings to pay for their own health insurance. If they snuck into this country to live off welfare and enjoy free health care - they should be deported. We can't be expected to provide health care for people who are here illegally.

The bottom line is this - health care should not be a political matter. This is not a Democrat vs Republican issue and we shouldn't allow it to be a left vs right issue.

Everything the Government touches cost too much and is mired in red tape. The less involved the Government is in the details, the better. If they want to fund a risk pool to cover un-insurable people, clean up their own programs, reward doctors for helping under-insured people, and tell illegal immigrants to go home (instead of trying to get their votes), the industry can fix itself - they now understand they don't have a choice.

 

[3thanol]

I have never been to a medical centre in the US, or know enough about the US healthcare system to make a fair comment. Like many Americans making comments about the NHS or other social healthcare you don't know our/there system either to give an un-biased opinion. Each have there problems and many people can pick faults in both.

However I rest assured that at any time any place, me or any member of my family can make an appointment, or if an emergency, make a simple call and we will be given an appointment or rescued and taken care of to a very good standard.

I or my family don't have to worry about forms, insurances, level of cover, money.

I don't mind putting money into the pot for everyone to get healthcare if they need it, it should be a given right like the air we breath. I have paid into the system all my life and do not begrudge someone who may not have paid as much as me into the system. As are the current world circumstance, if I ever lost my job and could not get another for awhile, and could not pay insurance for healthcare it would not worry me, I rest assured the NHS is there for me and my family regardless.

If the issue is paying for people who do not pay there share towards healthcare or the system. Then why is this issue not raised when billions are given in aid to foreign nations for grain and vaccinations etc in Africa, Asia etc these people don't pay into your system, yet you pay for all of it through your taxes. then you question helping a fellow citizen when they need it. your government spends hundreds of Billions on defence to safeguard it's population etc yet 1000's die or have ill health because the lack of health insurance. Because of what seems a capitalist healthcare system. If half the healthcare system was non profit yet the doctors are getting paid well and the drug company's are still making profit everyone is getting treated, I struggle to see the issue

There are certain things that should not have been or be privatised or for profit.
Health, Water, Power (to the home) all are necessities and should be available to all at a cost which covers running costs and a percentage for future required investments, not excess amounts to pay shareholders.

Sorry if it turned into a small rant, no one likes there country being picked on or highlighted to having flaws. ours is far from perfect like yours but we will defend it when highlighted for the wrong reasons :).

 

[turbo]

I agree that we need to allow Congress to do their job. However, their first priority should be to address the problems with the existing Government run systems. Instead, the President has pushed for his $600 billion+ "down payment" to restructure health care. Bigger doesn't always mean better - adding to the problem will undoubtedly make it worse.

Next, one of the biggest problems with private health insurance is denial of coverage for pre-existing conditions. I'm sure the insurance industry could teach the Government how to design and manage one super-sized risk pool to address this issue. The Government is the only entity that could establish such a pool

Denial of coverage and refusal to pay for covered services are the insurance companies' biggest money-makers. A not-for-profit government-run system would be much better at bringing down costs. Neo-cons know this and have made it an arguing point.

 

[mheslep]

Why after opening with a reasonable comment like this

I have never been to a medical centre in the US, or know enough about the US healthcare system to make a fair comment. Like many Americans making comments about the NHS or other social healthcare you don't know our/there system either to give an un-biased opinion. Each have there problems and many people can pick faults in both...

do you then follow up with this comment?

...yet 100,000's die because of what seems a capitalist healthcare system.

 

[WhoWee]

Denial of coverage and refusal to pay for covered services are the insurance companies' biggest money-makers. A not-for-profit government-run system would be much better at bringing down costs. Neo-cons know this and have made it an arguing point.

Turbo,

I honestly don't believe the Government can run anything at a lower cost - it's just not their specialty. If they can fix medicare, medicaid, and social security (without blending it into a bigger program), I'll eat my words.

The reason insurance companies deny pre-existing conditions is because the pre-existing conditions (diabetes, high blood pressure, high cholesterol, cancer) all lead to other very expensive conditions.

Insurance companies don't insure people who build in flood plains or in wild fire or earthquake areas unless they build the risk into their pricing. Dangerous drivers pay more for car insurance. Insurance companies don't place bad bets. AIG is an example of what happens when they do something risky.

A Government led risk-pool to assist with the associated costs of assuming the risk of pre-existing conditions could solve the problem. By sharing the risk, insurance companies won't risk their ability to pay other claims (and earn profits).

When a region is declared a disaster area due to a natural disaster, the Government steps into help, it's the same basic model. The insurance companies pay their claims and the Government helps the under-insured and un-insured.

 

[drankin]

Turbo,

I honestly don't believe the Government can run anything at a lower cost - it's just not their specialty. If they can fix medicare, medicaid, and social security (without blending it into a bigger program), I'll eat my words.

The reason insurance companies deny pre-existing conditions is because the pre-existing conditions (diabetes, high blood pressure, high cholesterol, cancer) all lead to other very expensive conditions.

Insurance companies don't insure people who build in flood plains or in wild fire or earthquake areas unless they build the risk into their pricing. Dangerous drivers pay more for car insurance. Insurance companies don't place bad bets. AIG is an example of what happens when they do something risky.

A Government led risk-pool to assist with the associated costs of assuming the risk of pre-existing conditions could solve the problem. By sharing the risk, insurance companies won't risk their ability to pay other claims (and earn profits).

When a region is declared a disaster area due to a natural disaster, the Government steps into help, it's the same basic model. The insurance companies pay their claims and the Government helps the under-insured and un-insured.

That makes too much sense to be something the Government would do. I like it, though.

 

[cristo]

Yes, generally, regarding Medicaid it is true.

Again are you reading different things to me? You say:

And in the US if one has no or very little income (<~20k/yr), then they are eligible for government based health care via the Medicaid program as I posted before, and before, and before.

Yet, I quoted from the source:

Medicaid does not provide medical assistance for all poor persons. Even under the broadest provisions of the Federal statute (except for emergency services for certain persons), the Medicaid program does not provide health care services, even for very poor persons, unless they are in one of the designated eligibility groups.

The poverty line in the US is something like a wage of $10,000. Now, pray tell, if the medicaid guidelines state that being in poverty is not sufficient to receive aid, how is every person with a wage of $20,000 eligible to receive such aid?

Your figures just don't add up, yet you try say that I'm wrong. Prove it, or stop making such claims. That's now (at least) two cases of misinformation you've made in this thread, and this discussion is getting pretty tiresome.

 

[Al68]

How do you know what's on the table? Have you read any of the mark-ups coming out of the various committees? Do you have a crystal ball to see what could emerge as a reconciled bill merging the House's language with the Senate's? Nobody has a clear view of where all this will end up yet, which is why the neo-cons are stirring people up to shout "We don't want it." when they haven't a clue what has come out of committees.

Nothing passed by any committee as of yet changes the bulk of the objectionable parts of the proposal. Any attempt by Republicans to amend it so that it doesn't outlaw all insurance plans that aren't part of the new system will fail according to my crystal ball.

One thing for sure - if we don't contain costs and rein in the cost of health-care, the US is headed for economic catastrophe.

Unsubstantiated bunk.

Reps Bachman and Kline have both come out saying that public insurance would be cheaper.

As has been pointed out to you before, what they actually are saying is that public insurance will be "cheaper" to a consumer because they will pay for 30-40% of the public insurance by taxation whether they choose it or not, then pay the other 60-70% directly for the (subsidized) public insurance. If they choose private insurance, they will pay the premium (100%) plus the 30-40% on top, making the public plan the cheaper choice artificially.

So as true neo-cons, they are against cutting waste and inefficiency, and want to let insurance companies decide who lives or dies.

This is an outright hateful lie, and you know it. Forum rules can be found here: https://www.physicsforums.com/showthread.php?t=113181

 

[turbo]

It's not an outright hateful lie. I only wish it were not true. Right now, if you own a small business and offer health insurance to your employees and one of your employees comes down with a catastrophic illness the insurance company will either jack up your rates or refuse to renew your policy. If you have been paying for private coverage for years and you come down with a catastrophic illness, it's likely that your insurance company will drop you on some pretext to avoid paying for your care. This is the status quo, and this is the system that the GOP wants to perpetuate. We can speculate about their motivations, but the end result is the same.

In regard to "death panels" cited by Palin, Gingrich, and Grassley, guess who voted to fund end-of-life counseling in 2003? The blatant lying and fear-mongering on the right are disheartening. They seem determined to undermine reform by whatever means available.

http://swampland.blogs.time.com/2009/08/13/oh-those-death-panels/

 

[gravenewworld]

http://jama.ama-assn.org/cgi/content/full/298/6/638?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=1900&resourcetype=HWFIG

Despite the ability of vaccines to prevent illness and death, our current system of vaccine financing has resulted in a gap for underinsured children. Current trends in health insurance products, including enrollment in high-deductible health plans that may or may not provide immunizations or other preventive benefits before a high deductible has been met, are likely to increase the magnitude of this gap and must be carefully monitored. Furthermore, the impact of the gap in vaccine financing for underinsured children on vaccination rates deserves further study once data on coverage rates for new vaccines become available. Evidence from past studies supports the premise that the availability of financing affects immunization rates.11, 21 Meanwhile, strategies are needed to address the current needs of underinsured children and should include efforts to enhance immunization benefits through requirements or incentives for insurers and employers. Until such enhancements in private insurance coverage for immunization are implemented, however, support of the public sector safety net is critical to ensure the protection of this vulnerable group of children in the United States.

Sounds like the best system of health care in the world to me.

 

[WhoWee]

It's not an outright hateful lie. I only wish it were not true. Right now, if you own a small business and offer health insurance to your employees and one of your employees comes down with a catastrophic illness the insurance company will either jack up your rates or refuse to renew your policy. If you have been paying for private coverage for years and you come down with a catastrophic illness, it's likely that your insurance company will drop you on some pretext to avoid paying for your care. This is the status quo, and this is the system that the GOP wants to perpetuate. We can speculate about their motivations, but the end result is the same.

http://swampland.blogs.time.com/2009/08/13/oh-those-death-panels/

This is a result of small group risk pools. One sick person can raise the rates of everyone in the pool.

Without restating my earlier posts, this is a major problem in covering high risk individuals. To look at the problem another way, when the Government looked at the mortgage industry they identified certain "toxic assets". Plans were developed to isolate these assets and deal with them as a group. The same type of approach could be used for health insurance. Basically, move people out of low risk pools into Government subsidized pools as they develop more serious conditions. Government doesn't need to run health care, just guarantee the catastrophic and ensure availability of Prevention/Wellness.

If you think of health care as tiered - similar to the way prescriptions are categorized you would have the following (based on the way health insurance policies are organized):

Tier 1 - Preventative Care/Wellness This includes all of the annual physicals and routine exams, diet and exercise evaluation and routine testing.

Tier 2 - Emergency/Outpatient Care/Rehab

Tier 3 - Hospital/In-patient Care/Surgery

Tier 4 - Long Term Care/Disease Management

Tier 5 - Critical Illness/Intensive Care

The cost/risk increases through each Tier. Currently (as Turbo pointed out) if only 1 person in a small group becomes seriously ill, everyone's rates in that group can be affected.

At the same time, the current Government plans do not address the prioritization of illness. As an example, if a person on welfare catches a cold (and can't afford to pay for an $85 doctor's visit) they often go to the (Tier 2) emergency room for diagnosis and medicine - it's their best option- but far more costly to the system than seeking Tier 1 Wellness care.

This is part of the "waste" component in the Government program - it's like going to the car dealer to buy tires or a battery for your used car - it will cost more than if you went to a tire or battery store - the dealer has more overhead and a higher hourly rate.

Many of the problems with our current system can be fixed by applying common sense.