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| So you think universal health care is good for America huh?
Posted: 6/27/2008 6:20:03 AM |
Watching FEMA during and after hurricaine Katrina, I want nothing to do with government run programs, especially healthcare.
I wouldn't want a healthcare system run by a Bush partisan appointee either, good thing that won't be an issue. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 6:51:16 AM |
Watching FEMA during and after hurricaine Katrina, I want nothing to do with government run programs, especially healthcare.
No you watched FEMA after Bush thats not really a fair comparison. Thats what happens when you privatize government responsibilities and put a complete and utter moron in charge. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 8:26:03 AM |
I wouldn't want a healthcare system run by a Bush partisan appointee either, good thing that won't be an issue.
This is not political. The government screws up everything it gets involved with. I don't care who is in office republican or democrat the performance of government run programs is very poor at best. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 8:28:54 AM |
No you watched FEMA after Bush thats not really a fair comparison. Thats what happens when you privatize government responsibilities and put a complete and utter moron in charge.
FEMA is a government run agency.
Hence the F in FEMA stands for Federal. Dosent matter who is in charge of it it still sucks. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 8:45:10 AM | I understand why Americans are leery of universal health care. They spend more (per capita) on public education than almost everyone on the planet but Americans get mediocre results (to put it diplomatically).
The argument that universal health care would be inefficient is somewhat suspect, however. The opposite is true according to the experience of other OECD nations. Costs are dramatically lower in nations with some form of single-payer or universal health care. That's not to say that a universal health care system would automatically decrease costs in the USA. The devil, as always, is in the details.
The problem in nations with UHC is effectiveness, not efficiency. Universal health care systems do not react quickly to the changing health care needs of a country.
A hybrid system is the answer. Costs are kept reasonable benefiting consumers, taxpayers and industry. People don't delay going to the doctor because there is no out-of-pocket cost for basic medical care. That reduces overall costs, increases longevity and the health of citizens. And the market can be used to react to those areas where there are insufficient resources. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 9:15:08 AM |
Watching FEMA during and after hurricaine Katrina, I want nothing to do with government run programs, especially healthcare.
Then check out FEMA's acitons BEFORE, during & after the hurricanes in the state run by Dubya's brother (Florida). It worked amazingly well there for some reason.....
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 10:40:09 AM |
I wouldn't want a healthcare system run by a Bush partisan appointee either, good thing that won't be an issue.
You live in Canada so it would never be an issue for you anyway. Republican or Democrat, government run programs are wastefull and inefficent. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 12:05:01 PM |
Republican or Democrat, government run programs are wastefull and inefficent.
They are wasteful and inefficient because of those selected to run them, not because they are inherently so by definition.
Anyway, this is basic economics: Remove the profit motive from health care and it will cost less to provide. It's very simple. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 12:13:38 PM | How about we tweak that slightly?
Move the profit motive in a health care system to where it rewards coverage & efficient care, rather than revolving door wharehouse care. Base salary upon results (human term results, not bottom line)...just like in a 'capitalist' approach. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 12:30:48 PM | Kanadah, you have your right to an opinion, but frankly the current non-system we have is incredibly wasteful and inefficient and the nationalized systems in other countries are far more efficient with little room for waste.
You have it completely backwards.
People need to understand something about nationalized health care.
1. It does not mean that the federal government runs medical operations. Doctors in groupa nd private practice and hospital-based do, independantly.
2. It does mean that the federal government acts like a big insurance umbrella, like it does with Medicare now. However, it contracts with a large insurance company in each state to process bills and pay claims, etc. at 5% overhead. So, while it acts like a big umbrella, it doesnt even set up to act like an insurance company, it just contracts with places like Blue Cross and Blue Shield.
3. All a single payer system means is that instead of lots and lots and lots of different, private insurance companies, each with their own forms and policies, etc....a doctor's office might have 100 different kinds of health insurance plans to deal with .... there is only one, like a giant Medicare that offers different kinds of "plans" through its contracted insurance companies. All that happens is that your employer pays into Medicare instead of Aetna or something and your claims run through the contracted state insurance company, like Blue Cross.
There are huge advantages to this regarding controlling costs, further best practices, eliminating lots of headaches for physician practices, simplifying everything, etc. ....
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 1:13:18 PM | Kanadah, you have your right to an opinion, but frankly the current non-system we have is incredibly wasteful and inefficient and the nationalized systems in other countries are far more efficient with little room for waste.
You have it completely backwards.
People need to understand something about nationalized health care.
Ummm I do understand it. I also have a family member that lives in Holland and is on that god forsaken system. When she comes to town we have to make appointments for her to see all the doctors she can while she is here.
Sorry you're the one that has it wrong. But hey if that's what you want Canada is right next door, go for it. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 1:37:34 PM | Well, Kanaduh, about the Netherlands:
"""Health care in The Netherlands is financed by obligatory health insurance and all insurance companies are obliged to provide a package with a defined set of insured treatments . This system came into effect in January 2006. For those who would otherwise have insufficient income, an extra government allowance is paid to make sure everyone can pay for their health care insurance. People are free to purchase additional packages from the insurance companies to cover additional treatments, like dental insurance, physiotherapy. These additional packages are optional.
A key feature of the Dutch system is that premiums are set at a flat rate for all purchasers regardless of health status or age. Risk variances between funds due to the different risks presented by individual policy holders are compensated through risk equalization and a common risk pool which makes it more attractive for insurers to attract risky clients. Funding for all short term health care is 50% from employers, and 45 percent from the insured person and 5% by the government. Children until age 18 are covered for free. Those on low incomes receive compensation to help them pay their insurance. Premiums paid by the insured are about 100 € per month (about US$145 in Jan 2008) with variation of about 5% between the various competing insurers.
Prior to 2006 (and since 1990) there were two separate systems of insurance finance, public and private. The public insurance system was paid for by a specific income tax. Everyone earning less than a certain threshold income could make use of the public insurance system. However, anyone with income over that threshold was obliged to have private insurance. Between 1947 and 1990 there had been no private health insurance operating in the Netherlands""".
This appears to me to be much closer to the American system of care than Canada's.
1. Doctors all in private practice
2. Private insurance companies operate, but one basic plan and one basic premium
3. No "public" insurance system
4. All citizens mandated to purchase insurance
If your " friend" needs to see doctors here in the US during their visits, it has more to do with them than any system of care in the Netherlands.
Another non-sequiteur ..... | |
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NERO1
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Joined: 3/8/2008
Msg: 114 | |
| So you think universal health care is good for America huh?
Posted: 6/27/2008 1:43:43 PM | Not only do I think it's good for America, I think it will be a great legacy of the Barack Obama administration, much like the legacies left by Woodrow Wilson (child labor, anti-trust, etc) and FDR (the New Deal, Social Security....).  | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 3:01:41 PM |
If your " friend" needs to see doctors here in the US during their visits, it has more to do with them than any system of care in the Netherlands.
Thats not true their system sucks and has waiting lists for things similar to Canada. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 6:12:39 PM | | Kanaduh, NO doctor is employed by the Netherlands. It is all PRIVATE MEDICAL FACILITIES and PRIVATE INSURANCE. It is NOTHING LIKE the Canadian system. It is the PHYSICIANS making the decisions about your "friend". | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 7:22:44 PM | Well, the Dutch model seems perhaps something that could be looked at - if one could resolve that all too typical battle of individual rights versus the ones of the collective there.
In the Literature
In 2006, the Netherlands launched a sweeping national health care initiative to provide universal health care coverage for its population. According to the authors of "Universal Mandatory Health Insurance in the Netherlands: A Model for the United States?" (Health Affairs, May/June 2008), it is a model that may be of particular interest to policymakers in the United States. Not a single-payer system—a policy approach often considered a nonstarter in U.S. policy circles—the Dutch approach combines mandatory universal health insurance with competition among private health insurers.
The Commonwealth Fund-supported article was authored by Wynand P.M.M. van de Ven, Ph.D., and Frederik Schut, Ph.D., of Erasmus University Rotterdam, the Netherlands.
A Work in Progress
The Dutch health care system is a work in progress. At its heart is a longstanding national desire to achieve universal health coverage. In 1941, the government introduced a mandatory health insurance plan for low- and middle-income people that provided most of the Dutch population with basic health insurance. Those with higher incomes typically purchased private insurance.
As access to health care increased, so did spending, arousing fears that rising medical costs would jeopardize access to health care, inflate labor costs, and increase unemployment. In 1982, the Health Care Prices Act authorized the Dutch government to control physicians' fees and total revenues. This legislation allowed the government, for example, to replace fee-for-service payments to hospital-based specialists with lump-sum payments to hospitals.
Managing Competition and Access
Growing dissatisfaction with "top-down" health care rationing policies—criticized for their inability to promote efficiency and innovation—led to broad support for incentive-based reform. In 1987, a government-appointed group of advisors proposed a national health care system based on market-driven reform.
Over the next two decades, the Dutch government worked to lay a foundation for merging competition with universal access to health care. For example, the new system required a system of risk equalization to prevent insurers from seeking only young, healthy customers. Additional reforms included developing a pricing system that would discourage physicians from providing inferior care; determining how to measure quality and outcomes; and arming consumers with more information about the price and quality of insurers and providers.
2006: The Health Insurance Act
The Health Insurance Act of 2006 was the culmination of several years of Dutch legislation and policy aimed at achieving universal health care coverage. It requires all people who legally live or work in the Netherlands to buy health insurance from a private insurance company. Insurers are required to accept each applicant at a community-rated premium regardless of preexisting conditions. In 2006, all but 1.5 percent of the population had purchased health insurance in accordance with the new legislation.
The plan is financed with individuals' annual income-based contributions to the tax collector. Employers are required to compensate their employees for these contributions. In addition, all adults are required to pay premiums directly to the selected insurer, which sets its own community-rated premium. Premiums are not required for children under age 18. About two-thirds of Dutch households receive an income-related subsidy from the government—a maximum of €1,464 (about US$2,200) per household per year.
The income-based contributions are transferred to a Risk Equalization Fund, which compensates insurers for taking on high-risk enrollees. In addition, insurers can use tools to protect their interests. These include managed care techniques, such as disease management. Insurers are also permitted to provide care in their own facilities with their own staff, to control costs better and may sell other products in addition to basic health insurance, like supplemental health insurance or car insurance. Increasingly, insurers ill be allowed greater leverage in negotiating prices, service, and quality of care.
Consumer Choice
As discussed, insurance companies are required to accept each applicant for basic insurance coverage. Individuals can choose from among 14 private insurance companies and several related subsidiaries. The Dutch government has set up a Web site where consumers can compare all insurers with respect to price, services, consumer satisfaction, and supplemental insurance, and compare hospitals on different sets of performance indicators.
Individuals who belong to a group—an employer, patient organization, labor union, or other legal entity—are eligible to receive a premium discount of up to 10 percent. In 2007, more than half of the population received group discounts averaging 7 percent.
Conclusions
The health care systems of the Netherlands and the United States offer complementary strengths and challenges. The Netherlands has implemented the infrastructure necessary to combine universal access with consumer choice of insurers, while the United States provides several examples of excellent integrated health care delivery systems.
As the Netherlands fine-tunes its health care system with an eye toward quality and cost, many questions loom, say the authors. Chief among them are "whether the insurers in the Netherlands are really able to function as good purchasers of care, which forms of 'managed care' will be acceptable to the public, and whether government will be prepared to give up its traditional tools for cost containment by reducing supply-side regulation." On these points, the authors conclude, "the jury is still out."
http://www.commonwealthfund.org/publications/
publications_show.htm?doc_id=685125
Knowing the Dutch, this should work rather well there. I'm not so sure about it being equally successful in the USA, however. | |
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| So you think universal health care is good for America huh?
Posted: 6/27/2008 11:07:55 PM | I don't claim to have any answers to current day healthcare problems. Just remember, the last solution was HMOs and look where we are. I advocate going back to the pre-HMO system, which did cost more money out of pocket to consumers. It was also a doctor controlled system.
Read up on any given country that has national health care. You'll see that there are a whole new set of problems, such as the Brits stopped providing bypass surgery to smokers because the wait list is so long. Guess who needs bypass the most? Germany has tax issues in relation to supporting their healthcare system. And that wonderful Canadian system? Canadians spend 1 billion dollars a year in the US for healthcare. Why, if their system is so much better? | |
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| So you think universal health care is good for America huh?
Posted: 6/28/2008 12:51:00 AM | ^^^ twas my grandpappy who said don't complain about something you got no reason to to give answers too...
ok, my grandfather was a jewish communist who helped start the FARC but he laid it on the line and paid for it.....and always had an answer..... help out those who couldn't help themselves..... | |
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| So you think universal health care is good for America huh?
Posted: 6/28/2008 1:38:24 AM |
Canadians spend 1 billion dollars a year in the US for healthcare.
Have you got a source for that ?
If you want to compare apples to apples, look at how much health care costs you ?
International comparisons
Among 23 countries with similar accounting systems in the Organisation for Economic Co-operation and Development (OECD) in 2005, the last year for which data are available, spending per person on health care remained highest in the United States (U.S.$6,401). The U.S. was followed by Norway ($4,364), Switzerland ($4,177) and Austria ($3,519). The lowest per capita expenditures were seen in Turkey ($586) and Mexico ($675). Health care spending in Canada (U.S.$3,326 per person) was relatively similar in range to seven other OECD countries, including France, Germany, the Netherlands and Australia.
http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_13nov2007_e
Yes, that's right.... Canadians spend about half as much as Americans do for their health care. Couple that as well with the problem that Canada faces with a much smaller population spread out across a vast landscape, with many small remote areas of population density. These add to costs , as distances must as a matter of course be factored into day to day expenses for things like health care or national defense.
We have a much smaller population, and the LARGEST city that they live in is only about five and a half million (that's Toronto, btw). people. Montreal, the second largest city has nearly four million or so. That's nine and a half million people that are grouped in two large centers. Those two population centers compose less than a third of Canada's population.
Scatter the other 2/3rd's across the breadth of Canada , like a farmer sowing wheat seeds across one very large field indeed.
In the USA, you've got some large advantages of population densities that allow for local hospitals , and in fact multiple ones.
Top Ten US cities by population
1New York New York 8,085,742
2 Los Angeles California 3,819,951
3Chicago Illinois 2,869,121
4Houston Texas 2,009,690
5Philadelphia Pennsylvania 1,479,339
6 Phoenix Arizona 1,388,416
7 San Diego California 1,266,753
8 San Antonio Texas 1,214,725
9 Dallas Texas 1,208,318
10 Detroit Michigan 911,402
http://www.citymayors.com/gratis/uscities_100.html
Now do the same for Canada :
City Population
Montreal 1,016,376
Calgary 768,082
Toronto 653,734
Winnipeg 618,477
Edmonton 616,306
North York 589,653
Scarborough 558,960
Mississauga 544,382
Vancouver 514,008
Laval 330,393
http://www.top-ten-10.com/science/demography/cities_canada.htm
Toronto, Scarborough, Mississauga, and North York are essentially " Toronto". In the same way, Montreal and Laval can be linked together as being "connected" to one another as one large "city".
So that's six out of the top ten cities here that are actually really two cities in any real sense of the world. Meaning that top ten list is actually a top six. 
After that those remaining cities and settlements are pretty small in any comparative sense to the rest of the USA for size of communities, meaning much less chance of easy access to things like a hospital, because the population density is lacking that could support it.
Don't forget, we provide the same medical care (at least potentially based on any diagnosis) for everyone in the country - no exceptions.  So if you happen to be in downtown Toronto when you collapse, that's a pretty efficient use of public funds.
If you happen to be in living outside of Nowhereville, in distant rural Canada you are not quite so efficient. In this case Mohammed is going to the mountain, this time around.
The other thing that has to be counted into the mix is that a majority of Canadians have some sort of supplementary private health insurance plan - typically through their work, or spouse's work.
About 30% of Canadians' health care is paid for through the private sector. This mostly goes towards services not covered or only partially covered by Medicare such as prescription drugs, dentistry and optometry. Some 65% of Canadians have some form of supplementary private health insurance; many of them receive it through their employers.There are also large private entities that can buy priority access to medical services in Canada, such as WCB in BC.
The Canadian system is for the most part publicly funded, yet most of the services are provided by private enterprises. Most doctors do not receive an annual salary, but receive a fee per visit or service. According to Dr. Albert Schumacher, former president of the Canadian Medical Association, an estimated 75 percent of Canadian health care services are delivered privately, but funded publicly.
"Frontline practitioners whether they're GPs or specialists by and large are not salaried. They're small hardware stores. Same thing with labs and radiology clinics …The situation we are seeing now are more services around not being funded publicly but people having to pay for them, or their insurance companies. We have sort of a passive privatization."
http://en.wikipedia.org/wiki/Health_care_in_Canada
Indeed that's one of the great dangers here to this concept of universal health care. There's a fear that this will create a separate sub-class of citizen, since those in any position of wealth or power will care less about the overall quality of health care here - since they no longer need it. That's a very real danger, too. Channeling the aristocracy through the main system is still the best way to keep that system functional at a higher standard.
If they slip off, in great enough numbers, into some health care version of a "gated community" then the system will deteriorate. Those with less power and money will get a lesser standard of care. The people most likely to be able to change things, that aristocracy, won't be exerting any pressure for any betterment of the general situation. It's kind of a Marie Antoinette syndrome, with the crumbs in this case going to the masses, if things are not overseen.
That's not what health care means to us here, however. It's everyone's right to be treated if they are ill, no matter what the weight of their wallet is.
Canadians sometimes forget the struggle for universal health care here, and the proposal and creation of the Medicare system. It's a fascinating look into how Canadians came to see Medicare as secondary only to the concept of Peacekeeping, in how we see and define ourselves - and our society.
So I see the American model, especially with it's population densities, as being actually a far better standard for efficient universal health care. The problem there is that doctors know they are making the most money on the planet doing exactly the same jobs others are doing in other countries for far less. They won't give that position up too readily.
If universal health care arrives in the USA one day, what happens to all of them ? All sorts of jobs are lost (rather good ones) working in those HMO's, if you start to have a central base of people doing the same job for the entire nation instead of separate companies.
Sure, it's more data entry, but you can get that done cheaply anyway. Computers and technology have also made medicine far less labor intensive in regards to medical information , and other medical forms that have to be manually processed.
So, in the end, if you look at the standard of medical care received throughout the entire nation - it's still done for roughly a half of what you spend.
Now compare our health statistics, nation to nation. Canada's meeting, or exceeding, any American advantages of all that additional money being spent there. Check into a site like Nationmaster.com, and punch up any of the health care stats charts on the numerous figures that will show that overall health here IS equal or better to anything you get in the USA. | |
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| So you think universal health care is good for America huh?
Posted: 6/28/2008 11:07:08 AM |
Toronto, Scarborough, Mississauga, and North York are essentially " Toronto".
They aren't "essentially" Toronto, MG. They are part of the city of Toronto and have been for a long time. The population of the city of Toronto is 2.5 million. Those numbers are really out of date. | |
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| So you think universal health care is good for America huh?
Posted: 6/28/2008 11:36:16 AM | Yearofthecat, HMOs were begun with Kaiser Permanate as the brainchild of Paul Elwood, whom I understand suffers from serious clinical depression from what capitalist did to the HMO concept.
The model was correct in that it aimed for wellness, reducing unnecessary surgery and a conservative approachto medicine which promoted better primary care and less specialist care. Harvard Health PLan here in Mass. is now a national leader among HMOs and a wonderful organization to get your health care from.
HMOs deteriorated under Nixon when the gates were opened to making a buck by providing less care to people.........hence, its bad rap.
Speaking of doctor-controlled, before HMOs there was a real problem with finding a primary care doctor, people used emergency rooms.........which were growing to palace-sized dimensions.....and you had a doctor for your nose, one for you legs, one for your liver, one for your butt, one for your little pinkie, etc.....specializing was where the money was and, if you could find a GP, well, with unlimited insurance and no incentive to control costs, he played it smart and send you to a pinkie doctor for a pinkie consult, to a butt doctor for a butt consult........and order a whole lots of tests to cover her own butt..........so, the system was set up basically to pay out $10,000 when someone caught a cold. Doctor-controlled is good only to a certain degree.....
The system, so-called, in America is a patchwork quilt and lots of good and lots of bad things.........my health plan.......well, I am over 50, I never hear from them for an annual check up or anything at all.......my insurance is $1,2oo a month for the family plan (I only pay 20%) ... and basically, it's set up for me as if I were a car or a boat, I am "insured" to the degree that I have a damaged organ that needs repair.
A REAL system would profile me, determine what preventive check-ups I need, bring me in, determine what lifestyle interventions are indicated such as diet, exercise, etc. and offer me those services ..........so far, just good, plain primary care..... but there is no such system in place, so what's offer is high tech interventions to salvage organs, which is getting more and more expensive because of a lack of a system, bad financial incentives, and people making their money from these things........there is no money for anyone to be made in preventive care.
It sucks, basically. It's stupid, just plain stupid....
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| So you think universal health care is good for America huh?
Posted: 6/28/2008 1:03:04 PM | As far as I've heard, there's no proposal for universal health care. That's newspeak for illness management. The focus is still on treating ill people. For the most part, doctors treat symptoms and people cure themselves. Wellness is starting to peak through where costs of treating the consequences are horrendous and people see an opportunity to save money. Obesity comes to mind. Of course, the other side of that is the huge profits to be made by appearing to treat it. Fad diets and 'fitness centers' come to mind. How many people drive SUV's to the gym to ride a stationary bike for about the same time as the duration of their commute?
Is there any value in the notion that a healthy workforce is probably more profitable than an unhealthy one? Companies probably don't need to subscribe to the idea since they can fire and hire pretty much at will. The burden of poor health moves on to someone else. Ultimately, the entire nation loses out with no particular group capable of correcting the problem. Doesn't that make the goal of universal health a national priority? It seems as much a national economic issue as one of conscience but I don't see it recognized as such.
If you don't want the government in charge, figure out some way of doing it privately, but make good health a priority! | |
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| So you think universal health care is good for America huh?
Posted: 6/28/2008 5:29:50 PM | "Anyway, this is basic economics: Remove the profit motive from health care and it will cost less to provide. It's very simple"
Actually it's simple minded. People, at least in the US anyway, now live longer and are in better health longer because of the advances in drug theraphies, medical devices, diagnostic equipment, etc. etc. Just where would all that have come from, if not from those ugly profits??
You want to drive healthcare costs down? Here's how you can do your part. Next time you or one of your loved ones goes to the doctor tell him you don't want him to use any diagnostic equipment not available 20 years ago. And if by chance one of you is diagnosed with a life threatening illness (I hope it doesn't happen) tell the doctors and hospital you don't want any treatments, drugs or theraphies not available 20 years ago. | |
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| So you think universal health care is good for America huh?
Posted: 6/28/2008 6:08:18 PM | we live longer than 20 years ago, but less than the rest of the world?
it's all relative..
we're less healthy,
have higher mortality rate,
and those who have coverage pay more than ever, and certainly more in multiples of what people in other nations pay. | |
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