Healthcare in the US

you may be on to something here. call morgan spurlock!

You pay your taxes so that poor people can receive the same police aid, can use the same roads, are defended by the same armed forces; so what's the deal with healthcare?

I recently chose to see a private pay psychitrasit (there were only three on my health plan) and the differnce in quality from past plan-approved psychs was amazing. His whole office is private pay - no insurance accepted - and I had to pay $240 for the initial appointment. (cost of seeing him is not included in my above average). But damn was it worth it. he talked to me for an hour and a half, really getting to know me, my history and family history and past treatments. It was amazing. Unlike past pyschs who would just throw one pill after another at me 'till one stuck b/c the insurance only allowed for 15 minute visits, this doctor truly got to know and I feel better in trusting his judgement for my treatment.

Now I'm not among the poor and uninsured but I'm certainly not rich. Choosing to go to a private pay dr. was a big sacrifice for me, but worth it. It's a shame though that not everyone who needs that kind of care will be able to get the quality I was able to afford.

I save the most money on medications, a presciption drug card is a godsend.

The Reaganite mantra of "waste, fraud and abuse" that was aimed for so long at the federal government should be trained at the insurance industry, pharmeceutical industry and for-profit hospital corporations. The amount of profits being made is astronomical, while the care becomes worse and worse. You can almost track the deterioration year to year, it is crumbling so fast.

However, since the ideology of conservative Republicans and Libertarians both forbid any criticism of profit-making under any circumstances, no matter how it weakens the nation or undermines the economy, we can't expect to see any reasonable discussion of this problem in the political arean as it is currently constituted. Things are going to have to become catastrophic before the issue will be addressed in a serious way.

Maybe not even then. After all, big corporations have discovered that they can use skyrocketing health care costs as a tool to reduce pay and benefits, weaken the working and middle classes and bring them further under control. Americans in general have no idea what is happening to them, mainly because the great majority of the working and middle classes truly believe the picture of the USA that appears on their television screens 24/7 and that picture seldom wavers in its rosy coloration.

And it may be the case that Europe has private clinics too, but when you have to pump money into a public system you dont use, you're wasting money on what could be better coverage for yourself. Not that it's necessarily a bad thing, if you *choose* to do so. But when the government takes the money from you with no ifs, ands, or buts, then you have a problem. Charity should never be forced.

Jeff-PTTL's post, all you've done is point out the nature of a private system. We're aware that some people recieve better treatment then others, that's no excuse to move to a government system. Id much prefer we fix the errors in our private system then have more of our freedom taken away by the government.

Well, if conservatives stay in power long enough, they'll take care of those other things too. (Why should we have to pay for roads in places we never go?!) Except the army. They like guns.

Id much prefer we fix the errors in our private system then have more of our freedom taken away by the government.

Yes, losing our freedom to be uninsured would be a terrible blow to liberty and justice.

Dude, if the boondoggle of the American private health care system doesn't convince you, nothing I say is going to. Who here do you think you're going to convince by moaning about the "loss of freedom" that would come with universal health care?

Disadvantage
-Higher cost in health care coverage
- -consequence: 45 million uninsured
- - -consequence: lower then average rates concerning health

Advantages
-Greater patient comfort
-Different tiers of health care coverage.
-Greater innovation in medical technology
- - advantages are felt globally (even to those nations which dont spend squat on medical innovation and testing)

That last one is very important. I highly doubt you're going to find cures for cancer, aids, or other disease plaguing our world from a public health care system. And though the US will find them, you can sure bet that everyone else is going to take advantage of it.

What is even more sickening is the fact that you seem to begruge the rest of the world access to American healthcare innovations. Perhaps we should paint stars and stipes on these wonderful new cancer pills you've got so everyone knows their are munching on the 'freedom' cancer cure.

before you open your mouth, why not go and find out ecxactly what medical advnaces do come out of the inferioir public health systems that us poor disadvantaged folks suffer in the rest of the world.

Greater innovation in medical technology

you do know that NIH research gets just a lil' public funding, right? and that a publicly funded health system would not detract from private investing in health tech, right?

xpost

So, yeah, wot Ed said.

"A major difference between the Canadian and American health spending is on investment in technology. This is a long-standing difference noted long before government polices on health diverged in the 1960s. American doctors and hospitals are far more likely than their Canadian counterparts to purchase new and expensive devices and technologies. Canadian doctors have a tendency to be far more skeptical and thus wait until technologies are proven and have fallen in price. The United States has far more specialists for each general practitioner than in Canada. Canada has more hospital beds per capita and Canadian patients spend more time in hospitals than Americans. An American patient is more likely to be rapidly treated by a specialist with the most up to date equipment. A Canadian one more likely to be treated by their GP and cared for over a period of time in hospital. Comparisons have found little difference between the effectiveness of the two styles, but the Canadian one is cheaper. The lack of the most recent technology is one of the most common causes of Canadians crossing the border to seek treatment in the United States. To a certain extent sending some patients south is cost effective for Canada. The most expensive medical equipment is also often some of the most specialized. In much of Canada it makes financial sense to occasionally pay to rent a piece of American equipment than to buy it outright and have it sit unused much of the time."

"None of your advantages sound that great to me and your last two are just plain wrong"

Ha, Id like to see what proof you can produce that public funded system produces the same amount of innovation as our private system. And the different tiers of health care is also known as increased freedom, probably the greatest advantage of the three. Leave it to a European to not value it.

"Public universities and public hospitals do a great deal of medical research, as do private drug companies of course"

Which is part of the reason why US medical schools and hospitals are much more popular and generally better, as well as draw the best doctors from around the world. They might do research themselves, but it's nothing compared to what the US does. We dont have the best schools and best doctors because we decided to cut investment to lower insurance prices. Oh yeah, and we didnt get the funds to support the NIH because we support socialist programs. Even with the NIH, Id rather have them and a long list of other research centers aside from just the NIH specializing in different areas of health research. When it comes to R&D, countries with public health care systems just cant step up, because a publicly funded health system does detract from private investing. The proof is in a simple comparison of the quality of medical centers in the US versus the rest of the world.
http://www.usnews.com/usnews/health/best-hospitals/tophosp.htm
I challenge you to find any nation that remotely compares with what the US produces.

"What is even more sickening is the fact that you seem to begruge the rest of the world access to American healthcare innovations. Perhaps we should paint stars and stipes on these wonderful new cancer pills you've got so everyone knows their are munching on the 'freedom' cancer cure."

We pay for it, why should we hand it out to such ingrates? Dont worry though, for now we'll consider it charity to those in need. As big as our economy is thanks largely to the fact that we dont support such socialist policies, we can afford it.

'"You're taking the short, and very incorrent, financial view of the situation, friend. It's already your responsibility to pay for these people. Universal healthcare would make it cheaper for you."

I want to believe this, and I will if you explain how. How does the numbers add up? Show actual numbers to get the point across.'

This UMaine paper points to the fact that the US health care system despite having the hightest per capita expenditure in the world (and the highest expenditure in proportion to GDP), also has the highest administration costs (approachign 25%) due to the fragmented and complex nature of how healthcare is paid for. It also produces the highest infant mortality rate of any OECD nation and is the 37th best performing system in the world (France 1, Italy 2, both fully socialised systems although both have some form of patient contribution, in France up to 30%). Even the Uk which when these figures were collected was spending half that of the US and 2/3rds that of France was still ranked 18 in the world in terms of performance.

They have no financial incentive to do so.

I'm trying to find a citing for this, but many private companies base their work on research already done by publicly funded/gov't group.

why should we hand it out to such ingrates?

makes it so conducive for argument. Or upsupported statements like,

Private and Public Health care coverage produces the same result in treatment

then later mentioning the varying levels of medical specialists in American vs Canada, which of course don't mean shit if you're too broke too ever see one.

Still, ignoring all this, the tone of your posts is illustrative.

Much of the traction against and framing around doing American universal healthcare has a core of "I shouldn't have to pay for health care that I can't immediately see as benefitting me." I.E. only those who can afford it are worthy(the rich as Blessed by God), and poor folks are poor 'cuz it's just their own damn fault, thus ain't worthy for our help. "Ingrates" in our own borders, even!

Poor folks obviously chosen their status, so they should have to live with the consequences. If you spoil them by reducing their costs to a level they can actually afford, they'll never develop the thrifty, hard-working, disciplined character required for success in our obviously meritocratic society. Why, all those poor black folks in New Orleans were stuck in that city since they were spoiled by relying on government.

Why, just look at our Dear President! He'd never have been so successful in life as oilman, ball-team owner, or elected official, were it not for his rugged individualism! Everything he's enjoyed in his lifetime was all earned thru the determined sweat of his own brow, and a product of his labor and his labor alone.

Etc.

So, to thses folks, it doesn't matter that having a baseline, minimal level of treatment for everybody would save plenty of dosh for all in the end, it's all seen in the framing of "the gubmint is taking my money to pay for those lazy, undeserved layabouts." It's a framework entrenched so deeply that no amount of actual facts will dislodge it, as Lakoff would say.

xpost: again, wot Ed said.

Bullshit. Disease prevents consumption of goods. Businesses of all types cannot profit if consumption falls. Businesses are thus incentivized to search for ways to cure disease, prevent disease, or provide care for the afflicted to support further consumption. Q.E.D.

Tim F. at Balloon Juice has been posting about this off and on for a bit (see here for his thoughts last month re: this issue and Obama, specifically:

Needless to say, tossing together American industry behind universal healthcare isn’t beginner chess. Somebody will have to overcome business leaders’ instinctive mistrust of socialist-sounding ideas and Democrats in general. Then we can even start talking about problems like institutional inertia. For that reason it seems unlikely that John Edwards, career trial lawyer, will make much headway. Fairly or unfairly Hillarycare gives me shudders. Obama, though, has a knack for making unlikely friends, a pragmatic tendency to look for common ground and little to no skeletons to get in the way. The idea of marshaling American industry against American insurance may be a fool’s errand for any pol, but I have an odd feeling that Barrack Obama may have what it takes to pull it off.)

Today, he's noted what looks like a big sea change at work -- WalMart and the SEIU joining up on healthcare matters. From the head of SEIU:

It is time to admit that the employer-based health care system is dead—a relic of the industrial economy. America cannot compete in the new global economy when we are the only industrialized nation on earth that puts the price of healthcare on the cost of our products.

That is a major drag on American business competitiveness, and job creation—and it is a stupid 21st century economic plan as well.

American business by 2008 will pay more for health care than they will make in profits. That is untenable.

...

It is time – in fact it is long overdue – for America to come together and insure that every man woman and child has quality, affordable health care by 2012.

That seems to be widely accepted everywhere but Washington, D.C.

We can’t keep tinkering, hoping that incremental change will fix our broken health care system. We need fundamental change, meaning new thinking, leadership, and new partnerships; some risk taking, and compromising.

And that’s why I chose to be here today, standing with several major corporations—some of whom I don’t always agree with, and of some of whom, frankly, I have been critical.

Which is why this partnership of unlikely allies offers even greater hope that we can finally stop talking about health care and do something about it.

That’s what we all owe our country.

Tim F.'s thoughts:

It is about time somebody figured out that Democrats need powerful allies to move healthcare reform forward, and it will never be the insurance biz. I have only pointed this out now in three separate posts. You can read those to get the gist of my point so I will just observe that it is very, very exciting to see Stern working together with Wal-Mart on this. For one, Wal-Mart is the single largest employer in America and a heavy contributor to party politics. That’s a lot of pull.

Equally interesting, Stern’s SEIU is naturally positioned to represent Wal-Mart’s 1.2 million employees in America. As most know Wal-Mart practically stands by itself in the fierceness of its union-busting policies. It has a history of forcing employees to watch misleading anti-union propaganda, firing managers who don’t stop meetings and closing entire branches when the union gains a foothold. Wal-Mart and Andy Stern come pretty close to sworn enemies. Seeing Stern and the Waltons working together on this is about the best possible illustration of my point that real progress will necessitate making some awkward friendships.

...

Finally, I would love to see the right wing boycott Wal-Mart over this. In rural America Wal-Mart has long since quashed the competition. Where else ya gonna go?

His commenters are generally skeptical. *checks watch and waits on Dr. Morb and Roger Fidelity's first posts*

A family friend of ours just had a major stroke at an unusually young age (late 30s or early 40s, I think) and has no health insurance. Her family and friends basically have to take a collection to pay for the treatment. I know this isn't a new or unique story, just a part of it that happens to touch me. This system fucking sucks. Fuck this country.

^^^^^^^^^^^^^

Is this being discussed elsewhere? http://www.nytimes.com/2008/12/03/health/03nice.html

Going out on a limb, I'm going to guess that the real problem is not the British NICE putting a price on six months of a person's life, it's what the drug companies are charging to begin with.

How any course of pills can be 50k is completely and totally beyond me. Patients should be folded into ongoing studies of drugs with FDA/NICE clearance and some cost benefit should be available to the patient in a private system. I am slowly starting to labour under the 'truthy' feeling that in many ways it was easier to suffer with cancer in the early '70s than it is now.

How Pharma and Insurance Intend to Kill the Public Option, And What Obama and the Rest of Us Must Do

http://tpmcafe.talkingpointsmemo.com/talk/blogs/robert_reich/2009/06/the-public-option-smokescreens.php/

Once those who want to kill the public option without their fingerprints on the murder weapon begin to agree on a proposal -- Snowe's "trigger" or any other -- the public option will be very hard to revive. The White House must now insist on a genuine public option. And you, dear reader, must insist as well.

This is it, folks. The concrete is being mixed and about to be poured. And after it's poured and hardens, universal health care will be with us for years to come in whatever form it now takes. Let your representative and senators know you want a public option without conditions or triggers -- one that gives the public insurer bargaining leverage over drug companies, and pushes insurers to do what they've promised to do. Don't wait until the concrete hardens and we've lost this battle.

can't make this shit up

have to wonder if it would have been easier to just apply for medicaid

amazing