Man I feel sorry for you guys.
I am very lucky to be living in Australia. We seem to have the best health care system in the world.
Need a root canal? Done!
Appendix need to come out? Done!
Daughter broke her arm? Fixed!All these happened to my family with only a day or so wait and 0 out of pocket cost!
I got a workmate who has cancer and gets chemo on the public system.Private health here really only means a private room and you pick your doctor.
Oh and our public system won't pay for cosmetic surgery.Anything else and you are sweet.
Our nurse to patient ratio is 1 to 4.I have had American friends visit who marvel at our health care.
The downside?
We are about the highest taxing nation in the world!!!
He said Americans would riot over our taxes.I'll admit I hate tax time. But I was so happy when the doctors fixed my daughters turning eyes. She would be blind otherwise.
Arrrgh. We are not "about the highest taxing nation in the world". That's just yet another simple Liberal party slogan meant for the masses whose political understanding goes as far as the words of the loonie right wing talkback hosts will penetrate their memory (and for US friends - our Liberals are actually the conservative party in our system). Look at comparisons with OECD countries to get an idea of who we compare with other countries.
Our public health system is fantastic but wait times do vary a lot depending on where you live. Private means you don't have to wait - and in a life-threatening emergency the public health system is fantastic (from personal experience twice).
Agree with you on the public health bit.
My wife is a nurse. Her biggest gripe is how long it takes to get an orderly to come help change out a patient when they discharge somebody. She is a Clinical Nurse and often shift coordinator. Not a bad system when that's the main gripe.As for the whole liberal/labor thing, I honestly vote for liberal because I was army for 10 years and feel we don't spend anywhere near enough on defence. Defence was actually building some capability when Howard was PM. Now labor guts it in one term. 20 million people and only 5 infantry battalions? Mechanised Grunts still driving Vietnam era apc's and now we don't have para in regular infantry anymore? I'll stop now cause this is a WHOLE other topic and will likely bore our American comrades here.
Unions are getting f~@+ed by employers, and this is somehow Obama's fault?
Yes. According to the article that I linked from the site that you always link, "The goal is twofold: to generate revenue to help pay for covering the uninsured; and to make the most expensive plans — which some argue encourage overuse of medical care — less attractive. "
Are we Taldor, or is Taldor us?We started out as Andorran, and somehow ended up being Cheliax.
The road to Hell is paved with the bricks of good intentions. Don't step on the gold ones.
Bears repeating:
But Obama left out a few points. First of all, what about the millions of workers who--after years of companies shifting the burden of health care costs onto employees through contributions, co-pays and deductibles--don't like their health care plan? They're stuck with what they have--the health care law doesn't give them an option to seek better coverage.
Moreover, the PPACA will directly contribute to the long-term trend of employer-provided health care becoming more expensive for workers and less adequate in providing access to care.
One way is a steep new tax on so-called "Cadillac" health care plans. Starting in 2018, insurers will have to pay a 40 percent tax on health insurance where the policies are "too good"--plans where the value exceeds $10,200 a year for individuals or $27,500 a year for families. Lawmakers consciously intended for insurance companies to pass this huge cost on to employers--as an incentive for companies to switch to a lower-cost plan that comes in under the excise tax threshold.
But "lower-cost" means more restrictions on benefits, higher co-pays and higher deductibles. In other words, the authors of the health care law want companies to continue shifting the health care burden onto workers.
The justification for this is that the excise tax would help control the rise in health care costs, which grow far faster than the overall inflation rate each year. But instead of putting restrictions on insurance company super-profits or spending on internal bureaucracy, Washington's method for controlling health care costs is to make workers pay.
The plans that will be hit by the excise tax aren't all that exceptional, either. One research study conducted as the health care law was being written found that Blue Cross/Blue Shield standard plans--which cover nearly half of all federal employees--would cross the "Cadillac tax" threshold in the first year for individuals and the third year for families.
The effect of all this will be to shift more and more people away from halfway decent health insurance--and into the inadequate, bare-bones plans that are so frustrating for anyone covered by them, but so profitable for the insurers.
From communist propaganda article #2 above
Two words for you: Lumber. Consortium.Well no, we whitewashed the history to make cheliax look like Andor.Are we Taldor, or is Taldor us?We started out as Andorran, and somehow ended up being Cheliax.
Perhaps a few more words?
Yes. According to the article that I linked from the site that you always link, "The goal is twofold: to generate revenue to help pay for covering the uninsured; and to make the most expensive plans — which some argue encourage overuse of medical care — less attractive. "
And that article was written before the clause banning co-pays on preventative care was added to the final bill. There is no effort being made to reduce use of medical services. Some unspecified speakers can insist that cafillac plans encourage overuse, but with medical loss ratios (the percentage of premiums/copays/deductibles going to medical services, instead of insurance admin or profit) often less than .50, they are a scam. Insurance companies are massively overcharging relative to medical costs, relying on the lure of superior service to tempt employees into pressuring employees to pay the premiums.
Your "communist" articles have the incentives upside down. High-premium plans have excellent margins, while lower-cost plans are trying to recoup costs by imposing onerous (but not actually very profitable) terms like co-pays and caps. It's backwards to think that a tax made to eliminate an insurance company cash cow is somehow the result of insurance company lobbying.
Cadillac plans are a scam that insurance companies pull to take advantage of the fact that employees do the wanting and the paying, but only employers do the shopping or see the bill.
Well, I don't understand how one insurance charges me $1000 for an emergency room visit and another costs $75 and the latter is a scam.
As for the fact that the insurance companies make bank off of them, well I can't say I'm surprised. I'm sure that after they get "screwed" by the ACA they'll console themselves with all of the money coming from the new customers whom they'll be getting because they wrote the law.
Perhaps a few more words?Two words for you: Lumber. Consortium.Well no, we whitewashed the history to make cheliax look like Andor.Are we Taldor, or is Taldor us?We started out as Andorran, and somehow ended up being Cheliax.
Evil capitalist enterprise in Darkmoon Vale. Lurking enemy in the Kobold King series of modules.
Considering the role that unions had in creating our current screwed up system it's a little late for them to complain.
The Axis powers had a lot to do with it too.
They're not complaining. I am. Most of them are thrilled shiznitless at Obamacare.
Cadillac plans are a scam that insurance companies pull to take advantage of the fact that employees do the wanting and the paying, but only employers do the shopping or see the bill.
This also doesn't make any sense to me because the employer pays for, but the union does the shopping. In my workplace, anyway.
Well, I don't understand how one insurance charges me $1000 for an emergency room visit and another costs $75 and the latter is a scam.Well, it's better for you, obviously.
What's harder to see is the total cost of the two plans. Both the out of pocket and premium costs you pay and the part your employer pays. That part is also helped by size, larger employers can negotiate better deals.
Old insurance--I paid $40/week.
Cadillac insurance--I pay nothing--for now.
I'm sure the price tage is large for UPS, but I don't care. They're making record profits.
CalCPA ProtectPlus: "1. Why was “The Cadillac Tax” included in the Health Care Reform Act?
There are two primary reasons for the inclusion of The Cadillac Tax in the Health Care Reform Act. The first is to stem the rise of health care costs. One belief is that excessively benefit-rich plan designs encourages higher utilization, even overuse, of health care services by the plan participants and, as a result, have a greater influence in driving escalating health care costs.
The second reason is to generate revenue to help pay for covering the uninsured. The Congressional Budget Office (CBO) estimates that The Cadillac Tax will generate $149B over a 10-year period."
Some dude on The Incidental Economist: "MacGillis" [Washington Post reporter] slipped quickly passed something. That tax on “the most expensive insurance plans to restrain consumers’ superfluous use of health care”–the excise or Cadillac tax–does target the growth of private insurance rates. In fact, that’s its very purpose. It will gradually erode the employer-sponsored tax subsidy that the vast majority of health economists believe contributes to overuse of health care and labor market distortions."
Time Magazine: "One provision in Chairman Max Baucus’s original Chairman’s Mark is a new tax on so-called “Cadillac” health insurance plans. The original Baucus mark calls for insurers to pay a 35% tax on plans that cost more than $8,000 for individuals and $21,000 for families. The logic here is that very expensive plans that require little or no out of pocket spending encourage overuse of health care services. The excise tax would also, of course, raise billions to help pay for the spending in the Baucus bill. The new tax would kick in in 2013 and the thresholds for plan costs would be pegged to the consumer price index, which grows significantly slower than medical spending inflation. Several senators on the committee, including Republican Olympia Snowe, have expressed concern that this excise tax would eventually encompass too many health insurance plans, affecting much of the middle class."
Some dude from Health Care Blog: "The debate over proposals to tax health insurance plans is confusing and frustrating. The proposals are usually described as a tax on “gold plated” or “Cadillac” health coverage. According to the media and many spokespeople on the Hill, these health plans with “overly generous benefits” supposedly encourage overuse of medical services and drive up the overall costs of health care. "
This "Cadillac-plans-encourage-overuse" argument seems to be pretty common.
And what is this poverty line that the gov't will help you out at if you are 133% above or below?
'Cos I'm getting $11,170. Times 133% = $14,000ish. 'Cos even I make more than that and I only work 25 hours a week at $12/hr.
Agree with you on the public health bit.
My wife is a nurse. Her biggest gripe is how long it takes to get an orderly to come help change out a patient when they discharge somebody. She is a Clinical Nurse and often shift coordinator. Not a bad system when that's the main gripe.As for the whole liberal/labor thing, I honestly vote for liberal because I was army for 10 years and feel we don't spend anywhere near enough on defence. Defence was actually building some capability when Howard was PM. Now labor guts it in one term. 20 million people and only 5 infantry battalions? Mechanised Grunts still driving Vietnam era apc's and now we don't have para in regular infantry anymore? I'll stop now cause this is a WHOLE other topic and will likely bore our American comrades here.
I was in the army for 12 years and wouldn't vote Liberal if Australia were a one-party state! I do think the Army always gets the short stick when it comes to equipment compared to Navy and Air Force - do we seriously need 12 subs when we can't even keep 2 of our current 6 ready for sea. Our M113s have been refitted so many times they barely have a Vietnam-era component left in them. A Para batallion is all well and good but we do have a range of para-capable units and do we actually have the airlift capacity to lodge and maintain a battalion size force anyway?
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Well, I don't understand how one insurance charges me $1000 for an emergency room visit and another costs $75 and the latter is a scam.Well, it's better for you, obviously.
What's harder to see is the total cost of the two plans. Both the out of pocket and premium costs you pay and the part your employer pays. That part is also helped by size, larger employers can negotiate better deals.
Old insurance--I paid $40/week.
Cadillac insurance--I pay nothing--for now.
I'm sure the price tage is large for UPS, but I don't care. They're making record profits.
I miss the nice insurance i had at UPS, paid less for it and it did better for me
I miss the nice insurance i had at UPS, paid less for it and it did better for me
Actually, UPS has increased employee contributions substantially--for supervisors and other non-bargaining unit members. I don't often groove off of the misfortune of others, but this always makes me smile.
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I miss the nice insurance i had at UPS, paid less for it and it did better for meActually, UPS has increased employee contributions substantially--for supervisors and other non-bargaining unit members. I don't often groove off of the misfortune of others, but this always makes me smile.
Well i hate unions for a reason, you are demonstrating one. how dare we not want to pay protection money to have a job. And the union mobs love to screw other workers for their own benifit
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Why should we pay to be insured or pay to be uninsured?
If we are going pay anything because of medical then it should be for a pair of tax funded health providers otherwise it should be a straight free market. Nothing in between is worth it, except to those few that make more money by making it harder for others to survive (which takes a lot more then healthcare). The government should not ever force the people to pay private organizations, ever, that is a breach of the purpose of the government.
I say a pair of providers, because then they have to compete service wise to make the people happy. The incentive is one gets 60% of the funding and that would be the that gets better "customer" satisfaction. This puts crimp on laziness.
What about Cuba, do they count?
Vive le Galt!!
And if not that, employer-paid "Cadillac" plans for all!
Except UPS supervisors!
Anyone ever read Journey to the End of the Night? Where the doctor is running around taking care of the poor of Paris and he doesn't have enough, I don't know, balls to actually make them pay their bills? I think we should do it like that.
Anyone ever read Journey to the End of the Night? Where the doctor is running around taking care of the poor of Paris and he doesn't have enough, I don't know, balls to actually make them pay their bills? I think we should do it like that.
So you wind up with a doctor that can't do surgery to fix anyone, goes to jail for not being able to pay off their education, and de incentivises anyone else from becoming a doctor?
None of that happens in JttEotN.
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A major part of the problem is that money is a major motivation and those in charge make more money off these systems and many suggested fixes even by those with good intentions don't address that issue. To fix the problem requires fixing the source.
Either remove profits from the equation or cut and remove any connection between the law and the making of profits (free market).
In the first option there is little motivation to make laws that benefit just the few, so most laws will benefit everyone or hinder everyone.
In the second option, the law makers have no say and can do nothing to help or hinder (except in the case of illegal vs legal drugs) and thus competing for customers drives up service and drives down costs, however this requires there to be competition.
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Free market can work, to a point (mostly saying it is much better then having a forced to pay someone law). but the government has to allow the failing companies to fail instead of bailing them out (The recent bailouts to car manufacturers for example) and prevent crimes from one company against another without singling anybody out. True with hospitals things are not as simple as with products but in free market people will avoid bad doctors or clinics, hospitals, and insurance companies when they are unsatisfied, whenever they have the opportunity, thus driving those companies to try to maintain customer satisfaction.
The VA shows why having doctors automatically paid for with no competition is bad. My dentist was so bad he "forgot" to clean the crunchy stuff from my mouth after making a temp (stuff was stuck to the roof of my mouth and everything, messiest dentist ever), and then used his thumb to shape my fillings which left them with a ridge against my gums that caught food a lot, all because he wanted to be done before his show started and it took me a bit of effort and complaints to get a new dentist.
In the civie world even now that would never happen because I could simply walk away and refuse to pay from dissatisfaction. Whether I got away with it for long or legally doesn't matter, the dentist would not want to have to fight to get his money and knows that I will be telling others of his service, or lack of it. AKA he would want me to be absolutely satisfied so I come back to him for my cleanings and recommend him to others, so that he will get money to pay his bills, a worry the VA dentist doesn't have.
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The customer's don't care about risk pools, the risk pool doesn't help or hinder the people. That consideration is only valuable to those who own and run the places, which are the people we want to stop wanting money.
Modern technology plays right into the weaknesses of Capitalism on a national and global scale, if we want to improve the system and fix the problems being discussed, we have to remove capitalism from the equation as much as possible.
The free market model while not perfect, prevents the minority from constantly trading favors, making the market ever more difficult to enter, and making things ever more expensive for the consumer. If the government had no ability to impose such things, we would be discussing a much smaller problem then what's facing us, not just in the next few years but a few decades down the road, our children are going to scoff at our claims of how much better it was in "our day".
As for the dentist, requiring money upfront doesn't foil my plan, it just forces different tactics and any such "fighting" takes him away from serving patients (thus a big dent in his pay) and reduces his pool of potential patients (a bigger dent in his pay). With the VA system, action on my part will not likely affect him in any meaningful way, after all, he doesn't get paid by me or my insurance anyway. The idea of not being able to pay his kids way through college doesn't occur to him.
So you wind up with a doctor that can't do surgery to fix anyone, goes to jail for not being able to pay off their education, and de incentivises anyone else from becoming a doctor?Anyone ever read Journey to the End of the Night? Where the doctor is running around taking care of the poor of Paris and he doesn't have enough, I don't know, balls to actually make them pay their bills? I think we should do it like that.
Celine wrote this book (and was a MD) in the thirties, BEFORE social security.
My grandfather was a MD too in the same timeframe in a rural area, and did the same. He took his oaths seriously and had rather treating somebody for nothing, or for a mere poultry, than doing nothing.
It's quite obsolete now. A magic plastic card takes care of all the money issues.
@Comrade Anklebiter: as you are interested in social upheavals, did you read about the french liberation in 44-45, and particularly about the work of the Conseil National de la Resistance ? It was about as great a social change as the end of royalty...
Obamacare is a step in the right direction, but won't dispel all your healthcare woes until something is done to control medical costs in the USA. The patent system on drugs is particularly rotten (add some useless bit of molecule, and wazam, another decades-long monopoly on a molecule, with full freedom to fix prices! Yummy!).Though, unless I'm missing something, that doesn't extend the patent on the original drug, it just gives them a brand new drug to market as new and improved.
The bigger problem is consumer advertising for prescription drugs. When that ban was lifted is when things started to go crazy.
Yep, that's it. Add a little something and get a new patent, cease production of the old molecule and spend millions in marketing to teach to the masses how your mint-fresh neo aspirin is so much better. Throw in some nice semanaries for MDs in sunny, beachy countries. Forget the little part about added medical efficiency, as there is none.
@Comrade Anklebiter: as you are interested in social upheavals, did you read about the french liberation in 44-45, and particularly about the work of the Conseil National de la Resistance ? It was about as great a social change as the end of royalty...
I haven't read all that much on the subject, no. I do know that there were pretty good opportunities for international proletarian socialist revolution throughout southern Europe (more so Italy and Greece, but France, too) but the Cachins and Togliattis, et al. were counterrevolutionary lapdogs of that murderous Thermidorian hack Stalin.
But at least they weren't Nazis like Celine.
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@ A Man In Black
There will always be a barrier to entry, the question is the size of that barrier (This is one of the weaknesses of capitalism made worse by modern technology anyway).
Insurance, you can enact price controls or you can remove the need for price controls. I prefer the latter.
There is more then just straight hospitals, there are clinics and small practices of all sorts, not all healthcare is the "emergency has to be done now" kind. There are plenty of stand alone practices even now when what you are saying is more true then what I'm suggesting. Hospitals can be competitive with the exception of the emergency room which is covered in part by the profits made elsewhere, particularly when they uninsured patients.
Our current system started out as free market and the only changes made to that were made by the rich business owners paying off politicians or becoming politicians to make laws that increase their profits, lower their costs, make a bigger barrier to entry, and lets not forget the billions in payouts to keep the companies afloat.
Dentists are visited rare enough that someone who doesn't like their dentist can go to the next town over for one, and two, in small towns such problems are reduced because almost all people feel the need to help out their neighbor and friend more then a stranger. Small towns are in general made up of a close knit group of people who end up acting like extended family which makes such behavior by the dentist far less likely then in a city.
Many countries with universal health care, do allow for-profit medical providers, and some even allow for-profit insurance. The main difference between their system and the US system is that costs are almost always fixed, both for core medical insurance and per-service. Nobody has yet come up with a working alternative to having the government step in and quash rising medical costs (or simply nationalizing the health care system, which is more drastic but does the same thing).
Well, as one example, Germany has mandatory universal health care, and for-profit providers. But you are only eligible for the latter if you are either earning enough money or are self-employed (with a few other obscure possibilities as well). The costs of health insurance are taken as a percentage from your pre-tax income, it is like another income tax. The mandatory health care costs are on the rise, and there are rather fruitless attempts to put a lid on these costs (small wonder, considering that medication is in general very expensive here, kept that way by pharmaceutical companies, and lots of hospital companies want to make a tidy profit as well. It is surely not due to the wages the nurses etc. are paid.) The mandatory health care is provided by a number of insurance companies as well, but these are more something like a public company. We´ve seen the smaller of these to either go broke or merge into larger ones the last decade. The for-profit insurance gets ever more expensive from what I hear these days. So, it not all that well either, but in general, it is ok if expensive.
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Our current system started out as free market and the only changes made to that were made by the rich business owners paying off politicians or becoming politicians to make laws that increase their profits, lower their costs, make a bigger barrier to entry, and lets not forget the billions in payouts to keep the companies afloat.REGULATIONS EXIST TO LINE THE POCKETS OF CORPORATE FATCATS, amirite? This is libertarian claptrap.
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What is the point behind those bailouts? If those companies failed, it would have left room open for new companies to be made, to fill the need, but instead bailouts were made that kept these big companies on top and in control.
Rules and regulation that are not needed and that are easy or unnecessary for big companies to implement but make start-up costs for new business much higher. What is the point behind those?
And FDA has government support but is very misused. A guy had some bread recipe that he said would improve your health, the FDA made a rule that basically anything that had a positive effect on ones health is a drug under their jurisdiction and went and shut the guy down. Because the FDA has such control over drugs, they decide who can sell and that would be those in charge.
How many government officials are there that are not business owners? If you owned some major company and you had the power to make rules that would make your company more successful and prevent competitors, wouldn't you use that power? And even if you are goody-to-shoes enough to not, can not see the opportunities they see? What makes you think they wouldn't use that power like that?