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Discuss the US Presidential Election & Health Care
Posted by
CmdrTaco
on Fri Oct 31, 2008 10:00 AM
from the we're-on-the-homestretch-now dept.
from the we're-on-the-homestretch-now dept.
Yesterday we discussed the war and how foreign policy will matter in your decision next Tuesday. Today our series of election discussion pieces continues with Health Care. With an obesity epidemic, a failing economy, and ballooning health care costs, which candidate has the best answers to making sure that Americans are able to stay healthy without America being bankrupted in the process?
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Politics: Discuss the US Presidential Election & Education 1515 comments
In 24 hours, many of you will be able to vote. So as we come down to the wire, this is really our last chance to talk about the issues. We've already discussed Health Care, the War, and the Economy. Today I'm opening up the floor to discuss education. Perhaps no other issue will matter more in 50 years. Which candidate will make the next generation smarter?
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One of the better ideas to fix health care... (Score:5, Insightful)
One of the better arguments I've seen for fixing the current health care crisis can be seen here [anntorrence.com]
Of course, the insurance companies (who have very powerful lobbies) will attempt to shoot this plan down as they stand to lose. Though it really can be forcefully argued that insurance companies really do bring nothing to the table in terms of health care. Fundamentally, the idea is a good one when constrained. However, insurance companies have become too powerful and they now function as parasites on the system, making it less efficient and more expensive for the end user. Ask yourself: "what product do insurance companies offer in terms of health care?" What do they create? How do they contribute to health care? When it comes down to it, health insurance companies are not in business to provide health care or help you pay for health care. They are in business to provide insurance, collect money, minimize any payout and answer to their shareholders who expect the system to turn a healthy profit. Any reduction in what they have to pay out is money earned for them.
Which candidate will be better positioned to answer the problem? It will be the one who is able to make some hard decisions and stand up to powerful lobbyists. It will be the candidate who is able to apply creative thought and novel solutions to problems that we've been creating for ourselves for decades now. it will be the candidate who is able to rationally apply logic and recruit, retain and manage in their administration, unbiased and reasoned people who are willing to work hard on solutions that will benefit Americans and the wider global population.
Re:One of the better ideas to fix health care... (Score:5, Insightful)
Which candidate will be better positioned to answer the problem? It will be the one who is able to make some hard decisions and stand up to powerful lobbyists. It will be the candidate who is able to apply creative thought and novel solutions to problems that we've been creating for ourselves for decades now. it will be the candidate who is able to rationally apply logic and recruit, retain and manage in their administration, unbiased and reasoned people who are willing to work hard on solutions that will benefit Americans and the wider global population.
So in other words, we're completely screwed.
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Re:One of the better ideas to fix health care... (Score:5, Insightful)
They are a parasite which uses advertising to cover for the fact that when you really need coverage they are rarely there to help you. The power imbalance is such that 1 on 1 coverage is pointless for any major issues. If they where unable to know what your medical conditions where and had to separate coverage and cost from your medical conditions it might work but that's what government heath care is and what they are so afraid of. Basically, they are all to willing to sell coverage to healthy people like me but as long as they can drop you once something bad happens.
As I young person I don't really use my heath care plain and I am pure profit for now, but I know the system is not designed to help me as I age. We need to fix this and fix it now.
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Re:One of the better ideas to fix health care... (Score:5, Interesting)
Insurance compaines make their money by selling a service they don't intend to deliver, or deliver only part of. Banks make their money by stealing from you in small ammounts from all accounts.
Neither should be in a position to make decisions relating to the health needs of an individual.
I live in a country that has both Govt health care and private. However, the private insurers have no say in what treatment is given that is and should be the decision of the treating doctor.
It always amazes me that in the US accountants are allowed to decide a patients treatment.
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Re:One of the better ideas to fix health care... (Score:5, Insightful)
Nothing short of price controls across the entire medical industry can succeed.
Price controls inevitably lead to either rationing or shortages, period. So what you propose may bring "universal" healthcare to the masses, but it will be both lowest-common-denominator healthcare, you'll have to wait on a list to get to it, and the government will decide who you get to see despite any preferences you may have to the contrary.
No thanks. I'll pay my own way, thank you.
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Re:One of the better ideas to fix health care... (Score:5, Insightful)
There's no shortage of health care? I thought millions of people who want it don't have it? Am I missing something?
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Re:One of the better ideas to fix health care... (Score:5, Insightful)
Yeah, I love the idea that poeple will use 'too much' health care if it's free.
People barely drag themselves to the doctor when actually sick, it doesn't matter how much it costs, people simply do not like to go. The best way of reducing health care costs in this country would be regular checkups, but people don't go to them even if they're free.
The only people who would 'abuse' the system are hypochondriacs, which are quickly recognized by doctors and ignored, and new parents, who already use 'too much' health care for their children anyway.
And considering the 'shortages' people are talking about are for surgery and MRIs and whatnot, none of which you can visit without a reason, it's not like those people will be using them up.
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Re:One of the better ideas to fix health care... (Score:5, Interesting)
Let me give you an anecdote to help to make your point and show how much of a parasite the insurance companies really are.
I took my grandfather to his general doctor the other day. On the window is a sign, "Pay in full at time of service with cash and get 30% off." So basically if you skip the whole insurance process you get 30% off on the spot at this doctor. Insurance isn't the only problem, but is a big part of why healthcare costs so much.
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Re:One of the better ideas to fix health care... (Score:5, Insightful)
if I got cancer, tomorrow, I would be able to pay bills that I could otherwise not pay... *IT AN INSURANCE POLICY*
Or so you think until you check the fine print or they claim a pre-existing condition. And should you survive, good luck getting coverage ever again.
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Re:One of the better ideas to fix health care... (Score:5, Insightful)
If car insurance companies were large enough and powerful enough that almost all car repair happened under their banner, letting them force repair shops into setting prices low for them and high for everyone else, you might have a point.
As it is, a very small percentage of the population actually has that sort of car insurance, and a tiny fraction of car repairs happen under it.
And, just as more importantly, car insurance payouts happen between a few consenting car insurance companies, and denying claims will cause other companies to deny their own claims back.
That said, there are plenty of us who think that mandatory insurance on cars is stupid too, and that mandatory insurance is inherently a scam...if they government wants to collect money from a group of people to cover large costs they might incur later, it should just collect the damn money and do it itself. (This would not stop companies from providing the optional insurance that banks require on new cars and whatnot.)
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Er (Score:5, Insightful)
With an obesity epidemic... which candidate has the best answers?
That isn't something that the government should be dealing with, or even give a damn about. If people (and this includes me, I'm a big guy, so I'm not just picking on others here) are too damn stupid or lazy to manage their weight properly, that's their own fault. Our government has WAY more important issues to deal with than trying to coax some fat Americans into improving themselves.
Re:Er (Score:5, Insightful)
The obesity epidemic can be partially blamed on government subsidies to the production of high fructose corn syrup, and tariffs on imported (more healthy) roe or cane sugar. On top of that if you nationalize healthcare you also nationalize the costs of obesity, therefore such a lifestyle should be taxed higher to cover their added cost to society.
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Re:Er (Score:5, Insightful)
A similar argument was had a long time ago over automobile safety, wearing seatbelts, crash helmets etc. The bottom line is that what you do has an effect on others. Who will pay for your emergency care when you have a heart attack and no insurance? What is the cost on society of allowing, or even encouraging through fancy adverts, young people to develop all kinds of unhealthy lifestyle related long term illnesses? A libertarian might say that's great, as these people will die earlier, thus requiring less medical care - but the truth is that somebody will end up paying for that medical care, either the tax payer through some government program, or the healthy insurance buyer who never claims.
To paraphrase your answer:
"That isn't something that the government should be dealing with, or even give a damn about. If people (and this includes me, I drive an unsafe car, so I'm not just picking on others here) are too damn stupid or lazy to drive a safe car, that's their own fault. Our government has WAY more important issues to deal with than trying to coax some fat Americans into improving their cars."
Woohoo, car analogy!
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Re:Er (Score:5, Insightful)
4/5 may come into existence, but it will ANYWAY. My employer has already started offering $15/mo off for employees who sign a contract (with penalties) stating that they do not smoke. They offer up to $400/yr for people who take a company provided health exam and agree to follow a "health program" prescribed from whatever quack nutritionist they have on staff.
That's how it will go down at the national level too. You can't punish people for being fat or for smoking, but you can offer "incentives".
On the other hand, neither McCain's nor Obama's are any better. McCain's plan will have you get your own insurance, which likely will require a health examination to calculate your premium. If you're fat, it will be higher. If the doctor believes you smoke...it will be higher. etc. Obama's plan basically will boil down to "status quo". Allowing corporations to do as they are presently doing.
So while I agree with your statement, this is not avoidable. Insurance, by nature, is socialist, and insurance, by nature, determines your premium based on risk factors. I hate it, but it's not changing.
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Health care could help save the US economy (Score:5, Insightful)
Yet our country spends more per capita on health care than just about any other country on the planet, thanks at least in part to our for-profit system. In other industrialized countries, the workers are still paying for health care, but it comes out of their paychecks in the same way taxes come out. And in the end those other countries can make similar products at a lower final manufacturing cost (even after paying to export to the US).
If people are so certain that the US system is great, then please answer one question. How can we make American manufacturing competitive on the world market again while paying the highest health care costs in the world?
If you look at our top trading partner (that would be Canada), you'll see that their workers make comparable wages for equivalent jobs to those in the US. Yet numerous auto manufacturing facilities have been moved to Canada to save money. Where is the savings if the workers make similar wages? It is in health care and pensions, both managed by the state.
Re:Health care could help save the US economy (Score:5, Insightful)
I don't understand. If you have health insurance then the same is true. The people who don't claim subsidise the ones that do. The only difference is that the insurance company is skimming a big chunk off the top and trying to avoid paying anyone if they can possibly avoid it.
And, yes, I do live in Europe. My total tax burden (counting all forms of tax, not just income tax) was slightly below the US average last time I found a detailed comparison study (around 2004 - there may be more recent ones, so if you find one I'd be interested in seeing it), and it includes healthcare.
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Misconception (Score:5, Insightful)
There seems to be something of a misconception amongst most Americans that I speak to, that your only options are the current system or some kind of filthy commie healthcare system where government employees carry out open heart surgery with rusty cutlery.
The current system in the UK, for example, offers both private and state healthcare, with the NHS free for all and private healthcare available if you want to pay a bit of money for a TV in your hospital room and a shorter wait for your elective surgery.
If you don't want or can't afford private healthcare then you can use the NHS, which is perfectly adequate for most people and certainly doesn't have huge waiting lists for essential treatment as some people seem to believe. Yes, there are the fringe cases, but for the mostpart the NHS is no worse than any of the private medical services when it comes to patient care.
As a result of this system, the private healthcare providers have to charge reasonable rates, because they know that people will simply abandon them for the NHS if they don't appear to be offering good value for money any more.
Americans seem to be terrfied of any kind of government provided or subsidised healthcare at any level, almost as if they see it as a "gateway drug" to communism - as comical as that appears to the rest of the world.
Disclaimer: I currently contract for the NHS, making me far more cynical about it then I might otherwise be.
Re:Misconception (Score:5, Insightful)
Where's my choice not to pay into your system, though?
The same place as your choice not to pay for schools, police, the fire service and the military. It's the choice not to participate in society. If you want to live in the country, grow your own food, and not use money then you don't have to pay any taxes. The rest of us think being a member of society has more benefits than costs.
Or, my choice to use treatments not permitted by the government
You can go private for treatments not funded by the government, or you can go abroad for treatments deemed unsafe.
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Why do you hate the Constitution? (Score:5, Insightful)
Huh? Since when it it a Constitutionally delegated power of the Executive branch to "make sure" that Americans are "able to stay healthy," while also meddling in their finances?
Re:Why do you hate the Constitution? (Score:5, Insightful)
Because it was written 200 years ago by a small elite of white male landowners with no input from the actual majority of the population, and it is keeping the US stuck at a low standard of living while so many other developed countries have moved ahead.
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National health care will come from the Right (Score:5, Insightful)
I'm a health care provider. I've been in the field in various capacities since 1981 and as a licensed professional since 1990.
When we talk about the "health care system" in America we have to be very clear about what we are talking about. There are two halves to this system- health care providers and health care finance. The main problems in the US health care system are in health care finance, since this is what determines access to health care.
National health care insurance is an inevitability and IMHO will be driven from the Right not the Left. The driving force will be lobbying from large businesses (GM, for example) that will be rendered noncompetitive by health care costs; they will either go bust or leave the US for countries with a national health care plan. IIRC nearly $1500 of a GM auto's sticker price is health care costs for current and pensioned employees. The creation of a national health system would allow GM and other large companies to offload much of the cost of health care insurance for current employees but also for retirees. This would be a major gain in the bottom line for companies struggling under these costs and other market forces, and would put them on a more-equal footing with most European and some Asian competitors. It would also be a major gain for small businesses (like my Dad's, like the company I work for, etc.) as it would reduce payroll costs. The losers, of course, would be private insurance companies and their CEOs, employees and shareholders.
For the individual, national health care coverage would mean greater freedom to move between jobs to improve one's lot in life and greater flexibility in managing care for children or dependent adults (e.g., aging parents).
The creation of a national health care finance plan would be able to leverage economies of scale unavailable to private insurance companies. The removal of the profit motive would reduce overhead from an industry average of 10-30% to closer to Medicare's 2%- a savings of hundreds of billions of dollars per year right there. With universal coverage, every person in the US could obtain preventive, clinic based care (which is the least expensive way to receive care) rather than letting problem go unaddressed and eventually seeking care in an emergency room (the most expensive way to receive medical care). With universal coverage, health care providers would not face defaults on payments for services which would allow a reduction in the cost of care. Rationing of health care would be reduced through the elimination of provider networks and access restrictions imposed by insurance companies. And finally, authorizations for services would not be influenced by the need to protect the profit margin.
From the provider side, it costs money to get paid. Someone has to prepare a bill and send it out. For many of my patients, payment comes from two to four sources and I have to send a bill to each in turn according to an order of precedence. Each bill costs $3-5 to send, and then there are the costs of tracking reimbursement to collate all the payments, figuring out who gets money back if the bill gets overpaid (which happens frequently because the insurance companies don't understand their own systems very well). Being able to do single payer billing would save an average of $10 per patient in my clinic, which means either more profit or the ability to lower costs for services. Imagine the cumulative savings if the cost of every health care service in America could be reduced by an average of $10.
That all sounds like a panacea and of course no such thing exists. Every health care finance system would have problems. People worry about where the money would come from and the only possible answer is taxes, since that is the only source of government revenue. However, we already pay that tax and then some. Like most people, I get my insurance through my employer. I chose the cheapest plan, which is a high-deductible plan. It costs $512 per month, 50% out of my po
Re:Cuba? (Score:5, Informative)
Got some numbers on Cuba's healthcare being a failure?
Wikipedia: http://en.wikipedia.org/wiki/Health_care_in_Cuba [wikipedia.org]
References the World Health Organisation.
Despite the US embargo on Cuba.
Dude, you just fucked up. Cuba's health system is the best in "Latin" America, and is in many ways better then the USA's. Tell me how that is a failure?
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My Own (Extremely) Biased Take on Their Plans (Score:5, Informative)
Wow - you criticize Obama for not providing the details, but when you remark that he has lengthy PDFs you don't want to bother to read. Either you've already made up your mind and are just rationalizing your opinion, or you don't really care enough about the topic to do your research.
At least you admit to having bias, but then I fail to see anything meaningful at all in what you wrote. At the very least, you should said that you don't have enough information to make a sound judgment on the topic, which is fine. Unfortunately, the norm is that people don't want to admit that, and would rather just make up some reasons for their opinions rather than admit they don't know.
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Re:We HAVE universal free health care (Score:5, Insightful)
Walk into any Emergency Room lobby and you'll see a sign saying "you will be treated regardless of your ability to pay"
Which encourages a mentality of waiting for health problems to become emergencies and discourages any sort of preventive measures to maintain health.
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Re:Please tell me... (Score:5, Insightful)
"My personal health is my responsibility. If I want to smoke, drink, and eat fatty foods until I die of a massive heart attack, that's my business. Nobody else should be concerned with it. If it can't afford to pay for the health problems I've brought on myself, nobody else should be required to pay one red cent to cover me."
I agree. But what if the heart condition is hereditary and you can't afford to pay? Then you have a serious problem.
Look, I hate the thought I my money going to people who don't want to work, who don't want to take care of themselves, etc. There will always be people gaming the system because they're deadbeats and lazy and scammers, etc.
The the reality is, if I were to become homeless, I would want food, shelter, treatment until I got back on my feet. If I were unemployed, I would want food, shelter, medical treatment until I found a job. If I got some disease and couldn't afford it, I would want treatment. Just because some people refuse to find a job, or pick themselves up by the bootstraps doesn't mean the system is completely out of the question.
That costs money. At some point, you have to suck up the fact that some people game the system and will get my something for their nothing. That's life. That's taxes. That's school levys. That's fire/police. That's Social Security. In the end, YOU will need those things.
This country, including myself, needs to change it's me me me me me me me me attitude, or we're not going to make it long term. I'm a firm believer that karma is one hateful mistress when you ignore her.
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