Questions for Americans: Socialised Health Care


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The Exchange

Actually what you are seeing is the vested interests being challenged and arraying their forces. The NHS wasn't greeting with whoops and cheers from the medical profession (we didn't really have much of a medical insurance industry to replace) when it was set up. The doctors were horrified. Of course, the NHS has set up new vested interests and now the doctors howl about every proposed change as threatening the NHS's values. It's just politics, and that is simply part of the human condition.


Anyone looking for some anecdotal about how borked American health care is can look here for a rather large collection of some examples of what, exactly, we've gotten wrong.


Zombieneighbours wrote:
we also don't have scenes like this.

"I can't afford healthcare", as they are driving an SUV (was that a hummer?). Screwed up priorities.


pres man wrote:
Zombieneighbours wrote:
we also don't have scenes like this.
"I can't afford healthcare", as they are driving an SUV (was that a hummer?). Screwed up priorities.

I knew a couple like that. They told me they went two days without eating because they didn't have the money, but yet they mysteriously had the money to get beer and pot.


Garydee wrote:
WormysQueue wrote:
Zombieneighbours wrote:
Firstly, your politics is squeed out onto the right so far it can't see where the rest of the world lies. Your on the socially liberal(if memory serves) right, in a country that's left of where englands centre right sits.

I whonder where it makes us Germans sit. I guess, Karl Marx would be proud of his countrymen. :D

But I have to admit that I thought the same; if that is left-wing propaganda, then there's no right wing in Germany.

I would not have said that if the film was more balanced. They could have mentioned the good things about the American system with the bad or they could have mentioned the problems with national healthcare. No, it was all about bashing American healthcare. As I said before, we have conservatives who pull the same thing. There was a recent film about how slow ERs move in Canada and how you might die waiting. I condemn them as being irresponsible as well.

Firstly, it is aimed at an educated english audiance. We know the positive elements of your system already. Saying that it is unbalanced because it did not give equal time to the positive elements. It is like saying that a discription of a headside of a coin is unbalances, because it fails to do more than mention the existance of the other side of the coin.

Again, a documentry on a pressing and serious issue in your healthcare system has no need to touch on the problems with out healthcare system, especially when it does not say you should adopt our healthcare system and that evenb your most left wing politicians are not seriously entertaining changing your system to our system.

It isn't about bashing anything, it is about detailing a major failing in your system of healthcare. It is a failing that was one of your presidents major policies to do something about, which is why it was of such interest at the time.

Sovereign Court

wildly off-topic rant about the falling standards of BBC documentaries that is probably only relevant or comprehensible to Brits.

Spoiler:

Whilst still not having drooped to the level of the commercial channels it is sad to see how far Panorama has fallen since my youth (and I'm only 29!)

The language choices, the use of background music... there was an emotive edge - not with any real message, just a desire to squeeze a tear out of any susceptible watcher.

I remember watching reportage of the September 11th hijackings/attacks a few weeks after and being quite nauseated by the 'suffering/tragedy as entertainment' approach of some broadcasters and thinking with some relief that: "At least the BBC hasn't put maudlin strings over the plane crashes."

There's a prioritising of first-hand experience over expert analysis that bugs me; all built around an assumption that we're not interested in complex issues and would rather witness extremes of emotion.

Of course, the real subject of that documentary should have been the subject glossed over near the start when Obama informed the crowd that they had only created the opportunity for change by electing him and that real change was yet to come.

Please continue with the far more serious debate.


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pres man wrote:
Zombieneighbours wrote:
we also don't have scenes like this.
"I can't afford healthcare", as they are driving an SUV (was that a hummer?). Screwed up priorities.

Is it a screwed up priority, though? Depending on your current level of health and transportation needs, it may be a rational, if short term, choice. It all depends on how you rate the risks of not having health care compared to the benefits of having the SUV.

Of course, one has to wonder if the assessment of the payoffs was a good one, seeing as how it was probably affected by the consumption driver known as "advertising," the psy-ops program designed to get people to make emotional decisions rather than rational ones.


Garydee wrote:
pres man wrote:
Zombieneighbours wrote:
we also don't have scenes like this.
"I can't afford healthcare", as they are driving an SUV (was that a hummer?). Screwed up priorities.
I knew a couple like that. They told me they went two days without eating because they didn't have the money, but yet they mysteriously had the money to get beer and pot.

Is...is that the sweet stentch of hypocracy? I think it is...

When i try to say people don't 'need' SUV, you guys jump all over me, how i can make such a claim. Given that you know nothing about the backgrouds of these people, it might be wise not to jump to conclusions.

In the case of the woman who said she cant afford health insurance, she is not, as far as i can see shown with her vehicle. In other cases, who knows why specifically they have turned up with there machines of awesome stupidity? Perhapes a friend had driven them, perhapes they have borrowed the car, perhapes they can't get treatement for a pre-existing condition or perhapes the insurance company has wriggled it's way out of paying.

The Exchange

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Garydee wrote:
I would not have said that if the film was more balanced. They could have mentioned the good things about the American system with the bad or they could have mentioned the problems with national healthcare. No, it was all about bashing American healthcare. As I said before, we have conservatives who pull the same thing. There was a recent film about how slow ERs move in Canada and how you might die waiting. I condemn them as being irresponsible as well.

To be fair, I learn a lot about the U.S. in threads like this because I get both sides of the story whereas our media aren't really sympathetic to the republican view of things (especially after the Bush era).

I'm only amazed that this topic seems to be viewed as a right vs. left issue in America when in Germany our system is widely accepted over the whole political spectrum. We have our issues as well and there is constant strife about minutiae but at the end of the day there's (nearly?) no one doubting that our system's underlying principles are sound.


GeraintElberion wrote:

wildly off-topic rant about the falling standards of BBC documentaries that is probably only relevant or comprehensible to Brits.

** spoiler omitted **

Please continue with the far more serious debate.

I share some of this sentiment, but lets keep the critism of auntie where the yanks can't see it ;)


Bill Dunn wrote:
pres man wrote:
Zombieneighbours wrote:
we also don't have scenes like this.
"I can't afford healthcare", as they are driving an SUV (was that a hummer?). Screwed up priorities.

Is it a screwed up priority, though? Depending on your current level of health and transportation needs, it may be a rational, if short term, choice. It all depends on how you rate the risks of not having health care compared to the benefits of having the SUV.

Of course, one has to wonder if the assessment of the payoffs was a good one, seeing as how it was probably affected by the consumption driver known as "advertising," the psy-ops program designed to get people to make emotional decisions rather than rational ones.

It must be said, expecting most people to make a rational decision about any consumer good is pretty much laughable these days.


Kirth Gersen wrote:
So, having read every post, I now realize something: for Americans, health care is not the issue under debate. It's just more of the same old "us" vs. "them" Republican vs. Democrat crap. Anyone in favor is obviously a communist. Anyone opposed is obviously a right-wing extemist. There are no Americans anymore; just two mutually antagonistic camps, always happy to cut off a nose to spite the face.

Kirth, I disagree.

Many people opposed to health care reform aren't right-wing extremists; in fact, they have a point. That is, we have a huge budget (not to mention debt) problem, and if we don't fix it, it is going to be our undoing. So they're very conscerned about increased government spending, which I respect as a very valid point, and am happy to listen and consider their concerns.

On the other hand, many people opposed to healthcare reform do NOT have a point. Watch the video about the guy referenced up thread who disrupted the townhall meeting. He was totally unable to coherently articulate what he was opposing, beyond "it's socialist." He seemed more concerned about "exercising his rights" then he did about actually understanding what he was yelling about. Even worse, he apparently felt totally justified in shouting everyone else down, which of course was a violation of their rights.

On the flip side, there are people who won't listen to legitimate concerns. They're convinced that anyone raising them is a corporate shill, intent on sucking the last dime from everyone, no matter the cost. They also WILL NOT EVEN LISTEN to the other side.

Extremists of either stripe are dangerous; they're like attack dogs. You just tell them what they should think, point them in the right direction, and let go. Worse, they are being used to sabotage the political process on an alarming scale. Essentially, bringing the system to a grinding halt has become an accepted and legitimate political tactic (for both sides). The danger is that the more frustrated everyone gets with a system that can't DO anything, the more likely they are to eventually listen to anyone who can just MAKE SOMETHING HAPPEN. In short, the frustration borne of a system in gridlock has historically given rise to fascism.

Disagreement is good. Disagreement is healthy. Disagreement that involves shutting the other guy up at any cost isn't.


David Marks wrote:
Kirth Gersen wrote:
So, having read every post, I now realize something: for Americans, health care is not the issue under debate. It's just more of the same old "us" vs. "them" Republican vs. Democrat crap. Anyone in favor is obviously a communist. Anyone opposed is obviously a right-wing extemist. There are no Americans anymore; just two mutually antagonistic camps, always happy to cut off a nose to spite the face.
That is an uncomfortably close description of what it's like over here. Sigh.

Sadly, that's what it's like pretty much everywhere.


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Aubrey the Malformed wrote:
Actually what you are seeing is the vested interests being challenged and arraying their forces. The NHS wasn't greeting with whoops and cheers from the medical profession (we didn't really have much of a medical insurance industry to replace) when it was set up. The doctors were horrified. Of course, the NHS has set up new vested interests and now the doctors howl about every proposed change as threatening the NHS's values. It's just politics, and that is simply part of the human condition.

When the Labour government created NHS, it had a massive majority and had swept into power in a wartime election, turfing out a wartime icon of a Prime Minister. There was no way the Conservatives could claim, with any real credibility, that Labour did not have a mandate. That's pretty much a perfect storm for getting BIG things done, even over vested interests.

By comparison, though Obama did win handily and the Democrats widened their majorities including setting up a potentially filibuster free supermajority in the Senate, the American system is designed to gridlock. Bicameral legislature, executive branch involved in approving legislation, huge regional disparities in political views within the same party, weak central party authority and discipline. The status quo is hard to dislodge.


bugleyman wrote:

Disagreement is good. Disagreement is healthy. Disagreement that involves shutting the other guy up at any cost isn't.

True, but we have to remember, these aren't debates. Where each side gets an equal say. A citizen can ask a question of a politician and the politician can go off on some totally unrelated issue, totally ignoring the person's question. The citizen then often doesn't get a chance to challenge the politician because they are often limited to one question. In effect the politician is shutting the other guy up at any cost.

Many of these town hall meetings are situations where the politicians feel they have to "educate" the citizens, instead of listening to what the citizens actually want. The politicians should be going in with an open mind as well, and expect that their ideas might be changed. Sadly, this often not the case on either side (the politician's or the citizen's).


Bill Dunn wrote:


When the Labour government created NHS, it had a massive majority and had swept into power in a wartime election, turfing out a wartime icon of a Prime Minister. There was no way the Conservatives could claim, with any real credibility, that Labour did not have a mandate. That's pretty much a perfect storm for getting BIG things done, even over vested interests.

By comparison, though Obama did win handily and the Democrats widened their majorities including setting up a potentially filibuster free supermajority in the Senate, the American system is designed to gridlock. Bicameral legislature, executive branch involved in approving legislation, huge regional disparities in political views within the same party, weak central party authority and discipline. The status quo is hard to dislodge.

Agree 100%. Perhaps 1000%. America's government was designed to be inefficient and very prone to maintaining the status quo, due to the needs of the Founding Fathers at the time.

Things were different then, and the way we solved the problems of the time (creating this inertia driven system of government) are preventing us from solving our problems now. To say it is insanely frustrating doesn't even begin to describe it.


Submitted for consideration, without comment.


David Reutimann wrote:
Submitted for consideration, without comment.

Since you didn't leave a comment, I don't know what you wanted us to give us with your link. What you gave me, however, was this:

The link wrote:
Senate Finance Committee ranking member Chuck Grassley admitting that he probably wouldn’t vote for any type of bill -- even if he got everything he wanted in it.

That goes back to arguing in bad faith, something I briefly talked about earlier. The left wants health care reform. The right doesn't. Their position isn't that there are some reforms they want to see that are different from the left's; they simply want no reform to be passed at all.

Which in itself wouldn't be so bad except instead of saying so they pretend that there are concessions that will convince them to accept some amount of reform. But somehow that support just never seems to materialize, even after they get everything they want.

Sigh.


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pres man wrote:


True, but we have to remember, these aren't debates. Where each side gets an equal say. A citizen can ask a question of a politician and the politician can go off on some totally unrelated issue, totally ignoring the person's question. The citizen then often doesn't get a chance to challenge the politician because they are often limited to one question. In effect the politician is shutting the other guy up at any cost.

If the politician fails to answer the question, citizens can ask the question again. And again. And again, until he relents and answers it. You see that sort of thing at press conferences.

pres man wrote:
Many of these town hall meetings are situations where the politicians feel they have to "educate" the citizens, instead of listening to what the citizens actually want. The politicians should be going in with an open mind as well, and expect that their ideas might be changed. Sadly, this often not the case on either side (the politician's or the citizen's).

Educating the voters, via discussion and Q&A, is one of the points of holding town hall meetings. They're not just places to poll the constituents.


David Marks wrote:
David Reutimann wrote:
Submitted for consideration, without comment.

Since you didn't leave a comment, I don't know what you wanted us to give us with your link. What you gave me, however, was this:

The link wrote:
Senate Finance Committee ranking member Chuck Grassley admitting that he probably wouldn’t vote for any type of bill -- even if he got everything he wanted in it.

That goes back to arguing in bad faith, something I briefly talked about earlier. The left wants health care reform. The right doesn't. Their position isn't that there are some reforms they want to see that are different from the left's; they simply want no reform to be passed at all.

Which in itself wouldn't be so bad except instead of saying so they pretend that there are concessions that will convince them to accept some amount of reform. But somehow that support just never seems to materialize, even after they get everything they want.

Sigh.

Actually, I was more interested in what the individual posters would take away from it. You're right, Chuck Grassley is negotiating in bad faith. However, it could be argured that that is part and parcel of being a politician. (Yes, I have been told many times that I'm a cynic.) I guess I'm just curious (and cynical again) if the template through which protestors will be portrayed will change now that the ideology of the protestors is changing.


David Reutimann wrote:
Actually, I was more interested in what the individual posters would take away from it. You're right, Chuck Grassley is negotiating in bad faith. However, it could be argured that that is part and parcel of being a politician. (Yes, I have been told many times that I'm a cynic.) I guess I'm just curious (and cynical again) if the template through which protestors will be portrayed will change now that the ideology of the protestors is changing.

I suppose you could say it's part of being a politician, but I surely don't like it. Another example would be with all the talk of the "death" of the public option, I've already seen a few right-leaning publications talking about how the next possible option, a co-op, is still not acceptable. What would be acceptable? I suspect nothing, but by making it seem like one more compromise would get their approval any chance at reform can be slowly eroded away and torn apart. Sigh and sigh again.

As for the protesters, I went and re-read the link, but couldn't find anything about protesters. What protesters are you talking about?

My problems with the current spate of anti-reform protesters were twofold. One, they weren't actually protesting anything that existed. Death panels, forced euthanasia, socialized medicine, etc. None of that was proposed or has ever existed as possible reform, but they were still outraged about it.

Second, protesting outside is fine, and using signs or slogans that are tasteless or offensive isn't even a problem. But the threats of physical violence and the shouting down of dissenting opinions, the refusal to let anyone try to explain that what they were protesting didn't even exist, was wholly uncalled for.


David Marks wrote:
David Reutimann wrote:
Actually, I was more interested in what the individual posters would take away from it. You're right, Chuck Grassley is negotiating in bad faith. However, it could be argured that that is part and parcel of being a politician. (Yes, I have been told many times that I'm a cynic.) I guess I'm just curious (and cynical again) if the template through which protestors will be portrayed will change now that the ideology of the protestors is changing.

I suppose you could say it's part of being a politician, but I surely don't like it. Another example would be with all the talk of the "death" of the public option, I've already seen a few right-leaning publications talking about how the next possible option, a co-op, is still not acceptable. What would be acceptable? I suspect nothing, but by making it seem like one more compromise would get their approval any chance at reform can be slowly eroded away and torn apart. Sigh and sigh again.

As for the protesters, I went and re-read the link, but couldn't find anything about protesters. What protesters are you talking about?

This was what I was talking about:
MSNBC wrote:
*** Liberal backlash: So what’s worse for the Obama White House -- that Republicans are aiming all their fire to defeat health-care reform, or that liberals are now up in arms over the idea that the president isn’t 100% behind a public/government insurance option? Sen. Russell Feingold said that "without a public option, I don't see how we will bring real change to a system that has made good health care a privilege for those who can afford it.” Rep. Anthony Weiner, who made the expedient decision not to run against Mike Bloomberg for NYC mayor, is threatening that 100 House Democrats won’t support any health-care bill that doesn’t contain a public option. And liberal pundits are upset, too. Jon Stewart, in fact, used a sledgehammer last night, mocking the White House for its inability to stay on message, like the Bush White House was able to do in the run-up to the Iraq war. Here’s a fun little exercise: Find one, ONE, Republican (or even a conservative Democrat) who is publicly praising the White House's backtrack in any of the clips this morning.

While they are not marching with signs (yet), this is similar to how the right wing protests began. And they certainlt qualify as protestors in a traditional sense, as they are voicing their opinion in a manner that protests a proposed action.

David Marks wrote:

My problems with the current spate of anti-reform protesters were twofold. One, they weren't actually protesting anything that existed. Death panels, forced euthanasia, socialized medicine, etc. None of that was proposed or has ever existed as possible reform, but they were still outraged about it.

Second, protesting outside is fine, and using signs or slogans that are tasteless or offensive isn't even a problem. But the threats of physical violence and the shouting down of dissenting opinions, the refusal to let anyone try to explain that what they were protesting didn't even exist, was wholly uncalled for.

That is true, but unfortunately such behavior has existed on both sides. For example, one side is talking about forced euthanasia, death panels, etc, while the other side is talking about astroturf, rent-a-mobs, opposition being only motivated by racism, Nazis, the Ku Klux Klan, and so on. It seems that both sides have been reading rule #12 in Rules for Radicals.

The fact that no side can seem to get past the rhetoric and the hyperbole is more a function of the fact that each side feels that they have been personally attacked by the other and less by the fact that there is not common ground to be had.

Liberty's Edge

I think that as long as those responsible for providing health care concern themselves solely with their own profit (as every private insurance company does) as opposed to the health and well-being of their customers, the United States will lag behind other industrialized nations in the quality of care provided, and in every statistical measure (longevity, infant mortality, and so on).

Most people who have insurance in the United States only have the illusion of insurance. As long as they don't get too sick, the insurance companies will help foot the bill. Get something that's seriously dangerous (to you and your insurance company's bottom line), and they'll find an excuse to drop you. It's happened to tens of thousands of people here in the United States. You forgot to disclose to your insurance company that you were treated for acne as a teenager? Well, now that you're 50, and you have cancer, we'll just use that as an excuse to drop you as a patient. And you won't be able to get coverage elsewhere, because you have a pre-existing condition. The majority of the people in the United States who file for bankruptcy due to medical bills already had health insurance. Our system is the most soulless system in the the industrialized world.

As to paying for Universal Single-Payer Coverage, we're already doing that. We're paying more for health care than anyone else in the world, and we're getting less in return than anyone else in the world (well, unless you're "Dollar" Bill McGuire -- he seems to be doing okay).

As to our government being unable to administer health care, they're already doing that (and quite efficiently) for millions of people.


Heymitch wrote:

I think that as long as those responsible for providing health care concern themselves solely with their own profit (as every private insurance company does) as opposed to the health and well-being of their customers, the United States will lag behind other industrialized nations in the quality of care provided, and in every statistical measure (longevity, infant mortality, and so on).

Most people who have insurance in the United States only have the illusion of insurance. As long as they don't get too sick, the insurance companies will help foot the bill. Get something that's seriously dangerous (to you and your insurance company's bottom line), and they'll find an excuse to drop you. It's happened to tens of thousands of people here in the United States. You forgot to disclose to your insurance company that you were treated for acne as a teenager? Well, now that you're 50, and you have cancer, we'll just use that as an excuse to drop you as a patient. And you won't be able to get coverage elsewhere, because you have a pre-existing condition. The majority of the people in the United States who file for bankruptcy due to medical bills already had health insurance. Our system is the most soulless system in the the industrialized world.

As to paying for Universal Single-Payer Coverage, we're already doing that. We're paying more for health care than anyone else in the world, and we're getting less in return than anyone else in the world (well, unless you're "Dollar" Bill McGuire -- he seems to be doing okay).

As to our government being unable to administer health care, they're already doing that (and quite efficiently) for millions of people.

And there is people like my wife's father. Had something like 4 heart surgeries over the span of 12 years. He was a smoker. And even during the last time when he was dying and the hospital staff said that continuing treatment was probably a bad idea, was still willing to do so when the family decided to at least try mainly to avoid the guilt of not doing so. This family wasn't insanely rich. That is the problem with anecdotes. There are always enough on both sides, that it doesn't actually prove anything.


There's this episode of The West Wing, called 20 Hours in America. Josh and Toby are having an argument, and Donna asks, "What the hell are the two of you talking about?"

Toby responds, "I assure you neither one of us knows."

For some reason, this thread reminds me of that.


David Marks wrote:

Patrick, I did some looking into medical malpractice points you are making and found some interesting things.

(I have found the list tag, and it is good.)


  • The total of all malpractice insurance premiums amounts to 0.56% of health care costs.

Yes, but studies have shown that the actual cost when you add up the defensive CYA medicine and other factors is more like 5-10% Link

Would trial lawyers agree to a cut in their share of judgements in good faith, since everyone is being asked to sacrifice? Say, only getting 10% of any judgement payout rather than 33%?

David Marks wrote:
  • The CBO has examined the idea of defensive medicine. They found no difference in practice between states with limits on tort settlements and those with no limits.
  • There could also be variables to the equation. I looked for the CBO's information, but wasn't able to find it. A link would be helpful. This >article< in the NY Times seems to indicate Texas had a positive jump in health care quality after instituting tort reform. Perhaps costs in Texas stayed up even though more people were being seen since there were so many more doctors? I don't know the answer to that.

    David Marks wrote:
  • There is no correlation between the price of malpractice premiums and the amount given out in malpractice settlements.
  • The price of premiums does (anti) correlate with interests rates.
  • If you take all the money given out in malpractice settlements over $250,000 in NJ ( a state without caps) in a year and give it to physicians, each doctor would get $15.
  • Why do so many doctors feel like tort reform is an essential part of health reform if it wouldn't make a difference? I would imagine that they are the folks on the 'cutting edge', pun intended. No one is advocating wiping away damage judgements all together, but a cap on what can be asked for in a suit is surely not all that whacky if we are asking for such a major reform of the health care system.

    David Marks wrote:
    This link might provide you with more reading from a left PoV on the malpractice issue.

    I will peruse this article. Thanks for the link.

    David Marks wrote:

    Now for the fun (although terrifying) fact of the day. How many people die every year in traffic accidents? How many die in hospitals from preventable causes? Which do you think is bigger, and what do you think the relationship is?

    Ready? Car crashes cause 40000~50000 deaths a year. Preventable deaths within a hospital on the other hand are on the scale of 100000 for just infections caused by improper sterilization. That's over double the number for car crashes and five times the number of homicides. If you include blood clots post-surgery, the number increases by another 200000. Common wisdom is that medical malpractice insurance is a highly onerous burden, but my first look into the matter is suggesting common wisdom is wrong here.

    Well, this is a staggering number. However, it is not any different for folks with other types of health systems. This >Article< by the UK newspaper the Telegraph details how an estimated 72,000 preventable deaths occur in the NHS system annually, but that the incidents were underreported by the system itself. Considering the population difference, I believe that the UK actually has a higher per capita preventable death rate, if you trust the Telegraph's information.

    Also, there are limits to what car insurance will pay for accidents, including death-related ones. Why shouldn't malpractice have a system of similar caps?


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    Patrick Curtin wrote:
    Also, there are limits to what car insurance will pay for accidents, including death-related ones. Why shouldn't malpractice have a system of similar caps?

    That's a limit to what the insurance will pay out. That's not a limit to the insured driver's liability in a court case. If there are damage caps, those are a completely different issue from what the insurance companies will cover for any individual policy.


    My issues with socialized health care:

    1) As the party in power and the veiws of the nation change so will what is covered. I don't want what treatments are available controlled so completely by politics.

    2) I simply don't trust the government will run it efficently and fairly. The rate they loose money running the post office is amazing. Running health care will take even more skill and the ability to make tough life and death issues. Our government gets weak in the knees way to easy.

    3) Our current debt level is so high without it that I would rather see real progress on that be done before creating even more. Basically we are already being unfair to the next generation enough to bail out our own mistakes. I don't want them to have to pay for another huge government program that may collapse before they even get to benifit from it.

    4) There are many reforms that could be undertaken before it becomes needed for a complete government take over. Try them first before putting all our healthcare in one very risky government controlled try.


    Bill Dunn wrote:
    Patrick Curtin wrote:
    Also, there are limits to what car insurance will pay for accidents, including death-related ones. Why shouldn't malpractice have a system of similar caps?
    That's a limit to what the insurance will pay out. That's not a limit to the insured driver's liability in a court case. If there are damage caps, those are a completely different issue from what the insurance companies will cover for any individual policy.

    Does anyone have a statistical chart of how many lawsuits reach beyond what car insurance will pay for an accident? I will look among the intrawebz for any information on this and get back.


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    Thurgon wrote:


    My issues with socialized health care:

    1) As the party in power and the veiws of the nation change so will what is covered. I don't want what treatments are available controlled so completely by politics.

    Government is notoriously slow at changing anything requiring new laws or regulations that don't involve executive orders. Medicare is pretty insulated from politics with respect to medical practice. There's no reason to expect a public option would be any different.

    Thurgon wrote:
    2) I simply don't trust the government will run it efficently and fairly. The rate they loose money running the post office is amazing. Running health care will take even more skill and the ability to make tough life and death issues. Our government gets weak in the knees way to easy.

    USPS is largely autonomous and subject to decreasing demand due to changes in technology. Coverage of care decisions are made by Medicare all the time. Seems to be pretty successful.

    Thurgon wrote:
    3) Our current debt level is so high without it that I would rather see real progress on that be done before creating even more. Basically we are already being unfair to the next generation enough to bail out our own mistakes. I don't want them to have to pay for another huge government program that may collapse before they even get to benifit from it.

    The next generation will be eligible for coverage under a public option as soon as it is operational. A larger proportion of them may, in fact, be covered than any other age cohort given the number of kids living uninsured now.

    Thurgon wrote:
    4) There are many reforms that could be undertaken before it becomes needed for a complete government take over. Try them first before putting all our healthcare in one very risky government controlled try.

    Complete government takeover isn't even on the table.


    pres man wrote:
    And there is people like my wife's father. Had something like 4 heart surgeries over the span of 12 years. He was a smoker. And even during the last time when he was dying and the hospital staff said that continuing treatment was probably a bad idea, was still willing to do so when the family decided to at least try mainly to avoid the guilt of not doing so. This family wasn't insanely rich. That is the problem with anecdotes. There are always enough on both sides, that it doesn't actually prove anything.

    I think it was actually on a libertarian site that I first read "The plural of anecdote is not data." Which is why I must again point out that statistically, America pays more than anyone else yet receives worse health care (or at best, equivalent). This isn't anecdotal; I don't think I've even seen anyone try to explicitly refute the data.

    I'll repeat. We pay more, for less. Quite a bit more. This should bother you, since in this case that less results in lots of suffering and misery. Not talking about instances where insurance screws someone. I'm talking about instances where lack of insurance screws someone. Why is it America is the only industrialized nation great enough to bankrupt citizens for getting sick?


    David Reutimann wrote:

    This was what I was talking about:

    I had thought that might be what you meant, but since it didn't reference any actual protesters I wasn't sure. Thanks for clarifying.

    David Reutimann wrote:


    That is true, but unfortunately such behavior has existed on both sides. For example, one side is talking about forced euthanasia, death panels, etc, while the other side is talking about astroturf, rent-a-mobs, opposition being only motivated by racism, Nazis, the Ku Klux Klan, and so on. It seems that both sides have been reading rule #12 in Rules for Radicals.
    The fact that no side can seem to get past the rhetoric and the hyperbole is more a function of the fact that each side feels that they have been personally attacked by the other and less by the fact that there is not common ground to be had.

    I don't really think any of the things you listed violate either of the things I was complaining about re: the protests. After all, there was much more evidence of astroturfing or rent-a-mobs than there ever was for death panels or forced euthanasia. But I'd prefer this thread not get dragged off course into a which side is the bigger ass argument (although we know it was you guys! :P)


    Bill Dunn wrote:


    Thurgon wrote:
    4) There are many reforms that could be undertaken before it becomes needed for a complete government take over. Try them first before putting all our healthcare in one very risky government controlled try.
    Complete government takeover isn't even on the table.

    And to build on Bill's response, what we are trying to pass ARE the reforms that can be undertaken before a complete government take over is needed.

    If these reforms don't pass the system will remain badly broken, and the problem will get worse. Fighting health care reform now just means the battle will come back at a later date. Next time the proposed changes may not be so restricted.


    David Marks wrote:
    pres man wrote:
    And there is people like my wife's father. Had something like 4 heart surgeries over the span of 12 years. He was a smoker. And even during the last time when he was dying and the hospital staff said that continuing treatment was probably a bad idea, was still willing to do so when the family decided to at least try mainly to avoid the guilt of not doing so. This family wasn't insanely rich. That is the problem with anecdotes. There are always enough on both sides, that it doesn't actually prove anything.

    I think it was actually on a libertarian site that I first read "The plural of anecdote is not data." Which is why I must again point out that statistically, America pays more than anyone else yet receives worse health care (or at best, equivalent). This isn't anecdotal; I don't think I've even seen anyone try to explicitly refute the data.

    I'll repeat. We pay more, for less. Quite a bit more. This should bother you, since in this case that less results in lots of suffering and misery. Not talking about instances where insurance screws someone. I'm talking about instances where lack of insurance screws someone. Why is it America is the only industrialized nation great enough to bankrupt citizens for getting sick?

    I would be interested in seeing the median spent on health care as opposed to the average.


    David Marks wrote:
    Bill Dunn wrote:


    Thurgon wrote:
    4) There are many reforms that could be undertaken before it becomes needed for a complete government take over. Try them first before putting all our healthcare in one very risky government controlled try.
    Complete government takeover isn't even on the table.

    And to build on Bill's response, what we are trying to pass ARE the reforms that can be undertaken before a complete government take over is needed.

    If these reforms don't pass the system will remain badly broken, and the problem will get worse. Fighting health care reform now just means the battle will come back at a later date. Next time the proposed changes may not be so restricted.

    Somebody should talk to Barney Frank and set him straight, because he says that in fact it is on the table (just down on the desert part, i.e. down the road).


    Patrick Curtin wrote:


    Yes, but studies have shown that the actual cost when you add up the defensive CYA medicine and other factors is more like 5-10% Link

    Would trial lawyers agree to a cut in their share of judgements in good faith, since everyone is being asked to sacrifice? Say, only getting 10% of any judgement payout rather than 33%?

    I looked through the wiki and didn't quite see your number (although see my next section below).

    Can't speak for the lawyers (don't even know any) but I wouldn't wholly opposed to that. Maybe we could tax medical malpractice payouts and use them to fund universal health care! (Kidding, kidding ... mostly)

    Patrick Curtin wrote:


    There could also be variables to the equation. I looked for the CBO's information, but wasn't able to find it. A link would be helpful. This >article< in the NY Times seems to indicate Texas had a positive jump in health care quality after instituting tort reform. Perhaps costs in Texas stayed up even though more people were being seen since there were so many more doctors? I don't know the answer to that.
    http://www.justice.org/cps/rde/xchg/justice/hs.xsl/8681.htm wrote:
    The Congressional Budget Office called the evidence of defensive medicine “not conclusive,” and summarized, “On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small.”i Researchers at Dartmouth College echoed these conclusions, saying, “The fact that we see very little evidence of widespread physician exodus or dramatic increases in the use of defensive medicine in response to increases in state malpractice premiums places the more dire predictions of malpractice alarmists in doubt.”

    I believe this data is found here (PDF) but I can't claim I've actually been brave enough to download it and dive in.

    Patrick Curtin wrote:


    Why do so many doctors feel like tort reform is an essential part of health reform if it wouldn't make a difference? I would imagine that they are the folks on the 'cutting edge', pun intended. No one is advocating wiping away damage judgements all together, but a cap on what can be asked for in a suit is surely not all that whacky if we are asking for such a major reform of the health care system.

    Well, I think seeing as doctors have to deal with medical malpractice on a daily basis, and likely fear it (since it could lead to the loss of their license, after all). For the same reason I'd say take the above quote with a grain of salt, seeing as it comes from a law organization. Still, the CBO is vaguely reliable so ...

    I'm not sure I believe simply working in medicine gives you very deep insight into the medical industry either, although I'll admit it likely gives you some. Edit: I wanted to say this the first time but forgot (doh!) While I'm sure doctors would like tort reform, the AMA still backs the health care reform currently on the table. So they obviously think there is something to be gained for themselves here. I suppose it's tangential to the point here, but wanted to point it out.

    To be honest, were it me and you negotiating what kind of health care reform gets passed, I'd likely agree to trade you your tort reform for a strong public option and some good exchanges. More's the pity that we are not.

    Patrick Curtin wrote:


    I will peruse this article. Thanks for the link.

    For the record, I haven't read the book the article talks about; all my info on it comes second hand.

    Patrick Curtin wrote:


    Well, this is a staggering number. However, it is not any different for folks with other types of health systems. This >Article< by the UK newspaper the Telegraph details how an estimated 72,000 preventable deaths occur in the NHS system annually, but that the incidents were underreported by the system itself. Considering the population difference, I believe that the UK actually has a higher per capita preventable death rate, if you trust the Telegraph's information.

    Also, there are limits to what car insurance will pay for accidents, including death-related ones. Why shouldn't malpractice have a system of similar caps?

    Without reading the study they are referencing it's hard to say. The two numbers I gave were for two specific forms of "preventable death". What were they counting in that study? What I wanted to point out though, is that with the number of potential medical malpractice cases out there, the number brought to try is extremely low, not to imply that our system was deadlier than others.


    pres man wrote:


    I would be interested in seeing the median spent on health care as opposed to the average.

    As you can guess, that piece of data is a bit harder to find than the average. From here, though, I get a few things though:


    • A recent study found that 62 percent of all bankruptcies filed in 2007 were linked to medical expenses. Of those who filed for bankruptcy, nearly 80 percent had health insurance.
    • Over the last decade, employer-sponsored health insurance premiums have increased 119 percent.
    • Employees have seen their share of job-based coverage increase at nearly the same rate during this period jumping from $1,543 to $3,354.

    Lots of businesses are feeling the pain of increasing health care costs; I don't think I've seen any evidence suggesting the problem here is that a few are choosing to spend far more in health cost insurance than others (assuming that is what you were suggesting?)


    David Marks wrote:
    To be honest, were it me and you negotiating what kind of health care reform gets passed, I'd likely agree to trade you your tort reform for a strong public option and some good exchanges. More's the pity that we are not.

    Indeed. I understand that it sucks that many cannot afford insurance. I certainly don't enjoy laying out $130 a week for my family's healthcare. My main bone of contention is that there are a LOT of issues that need to be addressed to generate real reform, and I think that the Obama administration made several errors in how they framed the political debate. By approaching it as fait accompli legislation that had to be passed in three weeks, and by dismissing people who wanted more input in the process, now the entire debate is polarized. And the uninsured stay uninsured.

    I would be behind some sort of 'public option' as long as there was iron-clad assurances written into the legislation that people would not be forced to join it. Also, there is still the glaring cost. And while statistics show that Americans do pay more for health care, we are also a leader in biotechnology innovation, way ahead of any other nation.

    I still have not been convinced that any of the bills being debated in various forms in Congress will save any money, or give us better coverage. If they can figure that out without adding to our already onerous debt load, I am open to discussion.

    I just think that the doctor's opinions should matter more than the lawyers in this particular debate. They are the ones who will be most affected by the changes. I have not seen many doctors individually advocating the new system (although I do realize the AMA has endorsed it).

    Edit: The AMA posted a roundtable discussion between two senators, an AARP rep and the head of AMA. A long piece, but informative. The co-op model sounds more viable to my small-govt mindset. In all the various brou-ha-ha I didn't even know there was a bipartisan commission working on a version of reform. Go figure.


    Adventure Path Charter Subscriber
    pres man wrote:


    Somebody should talk to Barney Frank and set him straight, because he says that in fact it is on the table (just down on the desert part, i.e. down the road).

    "Down the road" pretty much anything is on the table. But we shouldn't fear that. Nor should we fear we can prove to work, whether "socialized" or not.


    One thing I would like to point out is insurance companies aren't the people setting the prices for services, doctors and hospitals are. I worked in the business office of a hospital, so trust me when I say they are VERY profit oriented. Nothing changes if we add 48 million people to the mix, and that is why the AMA is on board for the current plan, 48 million new customers.

    Everyone throws out the amount spent on health care, but most studies show we spend more simply because we charge more. We charge more because we are capitalists. Again, nothing changes. The hospitals with the worst problems financially are the ones MOST dependent on medicare and medicaid. They subsist, never expanding or improving. Our whole system will be that way. Take away the profits for drug companies and we have no new drugs.

    Also, most of those 48 million added won't pay a thing into the system, because they for the most part pay little in taxes. So we take a financial hit from the loss of private insurance, then throw in massive increase in patients, and we are set for total system failure. We need reform, but not massive overnight changes with no clear way to pay for or support them.

    The Exchange

    Pathfinder Adventure Path Subscriber
    Patrick Curtin wrote:
    I would be behind some sort of 'public option' as long as there was iron-clad assurances written into the legislation that people would not be forced to join it.

    This isn't probably the way this can be done, though.

    The health care system in Germany is organised around the solidarity principle basically meaning that all people pay and all people profit.

    Now we have private insurances as well and if you have a certain minimum income you have the choice to stay in the public insurance or to go to a private insurance. But as this minimum income is quite high I guess it's around 15% of the population actually having this choice. All others have to stay in the public insurance system.

    The good thing that even the public sector isn't organized as a monolithic entity. Even as someone who isn't able to take a private insurance I have plenty of choice between different insurances. And while those have to obey certain governmental restrictions, there is room for competition. Meaning that my choice isn't just an illusion the government tricked me into.

    The Exchange

    Bill Dunn wrote:
    Aubrey the Malformed wrote:
    Actually what you are seeing is the vested interests being challenged and arraying their forces. The NHS wasn't greeting with whoops and cheers from the medical profession (we didn't really have much of a medical insurance industry to replace) when it was set up. The doctors were horrified. Of course, the NHS has set up new vested interests and now the doctors howl about every proposed change as threatening the NHS's values. It's just politics, and that is simply part of the human condition.

    When the Labour government created NHS, it had a massive majority and had swept into power in a wartime election, turfing out a wartime icon of a Prime Minister. There was no way the Conservatives could claim, with any real credibility, that Labour did not have a mandate. That's pretty much a perfect storm for getting BIG things done, even over vested interests.

    By comparison, though Obama did win handily and the Democrats widened their majorities including setting up a potentially filibuster free supermajority in the Senate, the American system is designed to gridlock. Bicameral legislature, executive branch involved in approving legislation, huge regional disparities in political views within the same party, weak central party authority and discipline. The status quo is hard to dislodge.

    Absolutely. The arrangement whereby consultants are able to continue in private practice was a sop to stop them rebelling (yes, the Loyal Opposition were too damaged to do much about it). Bevin talked about stuffing their mouths with gold to keep them on-side. But the set-up in the UK is such that whoever is in power is in effective absolute power for the period they are in office - the so-called elective dicatorship. So a party with a big majority can more-or-less do what it wants, and the Labour government of 1945 was clearly a radically socialist one. The US system contains more checks and balances on executive power which means that really big changes on a national scale are much harder to pull off.

    The Exchange

    Thurgon wrote:


    My issues with socialized health care:

    1) As the party in power and the veiws of the nation change so will what is covered. I don't want what treatments are available controlled so completely by politics.

    Fairly unlikely. There is a degree of intereference, largely on the basis of cost-benefit, but arguably that is responsible government. ecisions in the NHS are basically down to the clinician.

    Thurgon wrote:
    2) I simply don't trust the government will run it efficently and fairly. The rate they loose money running the post office is amazing. Running health care will take even more skill and the ability to make tough life and death issues. Our government gets weak in the knees way to easy.

    Well, the US system seems to be less efficient that the UK system in that it is more expensive, offers less coverage, and life expectancy is lower.

    Thurgon wrote:
    3) Our current debt level is so high without it that I would rather see real progress on that be done before creating even more. Basically we are already being unfair to the next generation enough to bail out our own mistakes. I don't want them to have to pay for another huge government program that may collapse before they even get to benifit from it.

    There isn't actually that much difference between coughing for an insurance premium and coughing for tax. The US system is more expensive - it would be a saving to the nation if they adopted a cheaper system.

    Thurgon wrote:
    4) There are many reforms that could be undertaken before it becomes needed for a complete government take over. Try them first before putting all our healthcare in one very risky government controlled try.

    Agreed - the UK system is hardly the only model and there may be better solutions that suit the infrastructure and culture of the US.


    b j wrote:

    One thing I would like to point out is insurance companies aren't the people setting the prices for services, doctors and hospitals are. I worked in the business office of a hospital, so trust me when I say they are VERY profit oriented. Nothing changes if we add 48 million people to the mix, and that is why the AMA is on board for the current plan, 48 million new customers.

    Everyone throws out the amount spent on health care, but most studies show we spend more simply because we charge more. We charge more because we are capitalists. Again, nothing changes. The hospitals with the worst problems financially are the ones MOST dependent on medicare and medicaid. They subsist, never expanding or improving. Our whole system will be that way. Take away the profits for drug companies and we have no new drugs.

    Also, most of those 48 million added won't pay a thing into the system, because they for the most part pay little in taxes. So we take a financial hit from the loss of private insurance, then throw in massive increase in patients, and we are set for total system failure. We need reform, but not massive overnight changes with no clear way to pay for or support them.

    And herein lies one problem. In a normal market, the prices of goods or services are determined by how much they are worth to the customers. I want bread, but only for $X dollars. If no one is willing to give me bread at the price I'm willing to pay, I can just do without bread.

    Health care isn't the same. When you need treatment to avoid death, or (even worse) to avoid your child's death, no amount of money will even be too much. You will mortgage your home, you will sell your car, you will give everything you have. How can prices possibly be rationally determined by a free market in such a situation?

    Again though (and I feel like a broken record saying this again) these are reasons for a socialized or single-payer system, both of which are NOT even possibilities with the current proposed reform. People get hung up on the idea of a public option, but fail to realize that the proposed public option is VERY tiny and limited under most plans currently proposed. Few would qualify for it, and I think current estimates are only around 10% total enrollment in the public option in 10 years. That means the other 90% of the population would still have private insurance.

    The real jewels of the current reforms are the exchanges and the insurance reforms (I listed them earlier, will re-list if requested).

    The public option provides many valuable things (it is estimated to reduce costs close to $1000 a person, and will result in a less expensive insurance regulatory body) but as some have reluctantly admitted, it isn't all of health reform. Both sides focus on it and lose sight of the bigger picture. That said, if talk of dropping it energizes reform proponents enough to get it added in and passed, I'm a fairly happy person.


    As to end-of-life care on the NHS, from the experience of family members in their 90's I can say it's of very high quality

    Thinking of my grandmother, she had two bouts of significant treatment for debilitating conditions in her 90's. one of them involved 2 weeks on an Intensive Care unit, while she was put in a medicaly-induced-coma while a treatment on a nerve-condition was carried out. they could have just given her medication, at a MUCH lower cost, but her consultant chose the coma-based option, as it improved her quality of life significantly

    When she died, it was from a stroke, which left her with almost total paralysis. again, various treatment options were considered, and a surgical option was tried - sadly, it didn't work, but it did give her enough movement to express her wishes, to which she said she wanted treatment withdrawing, other than pain relief, and she died a few hours later

    so, there are two examples of a woman in her 90's getting treatment beyond Paliative care on the NHS.

    I'm also thinking of my aunt now, who has a very complex cancer. she is in her 60's and again is recieving a very expensive programme of life-extending treatment, and also a package of pain-management (including a nurse who visits her at home between chemo treatments, to see what medical support she needs) - it's expected to add a year or two to her lifespan

    Scarab Sages

    Link to an interesting piece from The American Prospect:

    THE HISTORY OF THE PUBLIC OPTION.


    I haven't finished reading it yet, but this (10 Reasons to Support Reform) was given to me today and I thought it would be of interest to anyone still following this thread.


    As I live in the UK I get free health care. I get taxed at source so I don't notice it. If anything happens to me I know that I will not be left on the shelf until I produce insurance papers or a credit card. If you are on a low income you pay nothing, not even the £7 or so for your perscription.
    If you need a new heart you get one if a doner is there. It doesn't matter if you have money or not.
    If you have long term sick your insurance doesn't run out, premiums don't go up.
    My partner developed double pnuemonia and spetacemia not so long ago. ICU unit for ten days, with her own personal nurse then another month on a ward then six months of physio. FREE.
    The NHS isn't perfect but no one slips through the net and no one dies because they are poor and can't afford treatment.
    Socialised health care is wonderful.


    Garydee wrote:
    Zombieneighbours wrote:


    Especially if you need to get to work, rather than faf about getting it road worthy. At the momment, the system seems to be utterly f&&#ed, i understand i speak as an outsider, but from what i can see it is the case.

    Not really. Our system has a lot of problems and faults but it's not nearly as bad as it shows on propaganda films. There have been conservatives that have made propaganda films that makes nationalized healthcare look like a total disaster as well.

    Sure...but you can bypass the propaganda and go to material thats basically fair and balanced like OECD country comparisons. I feel its here that the issues with the American system are most pronounced. When its clear that Americans, per capita, pay more then almost all other rich western countries and yet they receive health care thats statistically only comparable to countries that pay significantly less. You know that there is something wrong and that the system needs an overhaul.

    With what you guys pay American Healthcare should be pretty much the best in the world but its not even close to the Japanese or Swiss system in terms of results just in terms of cost. For the results your seeing you should be paying something more akin to what Canada or Britain pay which is close to half of what Americans spend on health care.


    It doesn't help when pharmaceutical companies start making money out of other peoples suffering.
    A company which produces a drug which stops the transfer of HIV accross the placenta refused to sell it to Africans at cost price but insisted that it they pay full wack for it.
    "We have to get our research money back" the caring spokesman said.

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