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United States Government Medicine Politics

Discuss the US Presidential Election & Health Care 1270

Posted by CmdrTaco
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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Discuss the US Presidential Election & Health Care

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  • by BWJones (18351) * on Friday October 31, 2008 @10:01AM (#25582567) Homepage Journal

    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.

    • by pak9rabid (1011935) on Friday October 31, 2008 @10:12AM (#25582707)

      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.

      • by Anonymous Coward on Friday October 31, 2008 @10:17AM (#25582787)

        Exactly. People of that caliber are smart enough not to get into politics in the first place. They don't desire the power nor do they want to deal with the corruption.

        • by Retric (704075) on Friday October 31, 2008 @10:26AM (#25582955)
          It's all about corruption not heath care. 44% of all health care in the US is paid for by the government. This might seem odd considering how many people lack heath insurance and how much people need to pay out of pocket when they already have insurance but the simple fact is heath care is an expense to insurance companies which they try and reduce. They are not in the business of providing heath care at an affordable rate they are in the business of denying coverage.

          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.
          • by Falconhell (1289630) on Friday October 31, 2008 @10:50AM (#25583367) Journal

            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.

            • by mhollis (727905) on Friday October 31, 2008 @12:08PM (#25584737) Journal

              Insurance companies are almost exactly like bookies where you are essentially betting against yourself. They are particularly good bookies in that they very carefully build actuarial tables to help them with the odds.

              While gambling in many states is not legal or not legal outside of an Indian reservation, or not legal outside of a particular city, Insurance companies seem to not be considered quite the same thing. They are regulated, with the government (appropriately) requiring that they be able to pay out in all but the most extreme situation (like nuclear war or natural catastrophe).

              Part of the "gamble" here is that young people are generally healthy and older people tend to get sick more. Now there are older people who stay very healthy for a long time. My father is a great example, as he lived well into his seventies before he ever saw the inside of any hospital, save to visit someone. Then he had a heart attack that required a stent and is requiring that he take certain medications. His health has declined somewhat, but with proper exercise and as he continues to take prescribed medicine, he should see his 90s.

              But this results in a problem. Persons over 65 are not wanted by health insurance companies because their actuarial tables tell them that my father is an exception. They would tend to refuse to cover him and anyone his age because they don't want to lose money.

              Enter the government.

              The United States decided to take this class of person off the hands of the health insurance companies. They did this for two reasons: Firstly, it is considered a right that you will be able to live your life with some semblance of dignity. In order to create that, the government, in the 1930s created an insurance system that would pay out to persons (then) over 65, a consistent income that would enable them to live with some degree of dignity until they passed away. This is called Social Security. Today, Republicans call it an "Entitlement," and they are trying to make that word into a "dirty word," like they did with "welfare," another insurance program created in the 1930s to give poor people some dignity.

              Dignity seems to be a problem with the Republicans nowadays. they would rather make everyone in the Middle Class struggle harder. because when the Middle Class struggles, they occasionally look for someone to blame. And Republicans have learned that, since they only serve large corporations and very rich people, they have to create a pattern of blame so that they can divide the Middle Class. After all, the Middle Class does most of the work (for the large corporations that the Republicans serve) and pay most of the taxes (as a percentage of their income and as an aggregate total of the revenues received by the government). And if they can divide the Middle Class and get them to vote for Republicans, Republicans can serve this minority in the American population (the very wealthy).

              So, along come the Democrats, who look at all of the other top economies of the world and they say, "Why don't we have a nationalized system of healthcare that offers Americans some dignity like the other top economies?" And the Republicans launch their "Smoke and Mirrors" campaign to confuse and divide the Middle Class. Because they don't like the Middle Class (or anyone else, save the rich) having any dignity. It goes against the grain. When you have dignity, you can think about how Republican policies will actually affect you. So they launch a campaign, calling this "class warfare," and "Socialism." The hysterics they put on are laughable -- by those with dignity who actually think.

              Republicans call this "Big Government" while they want you to ignore the fact that a totally Republican Congress and the Bush Administration just presided over the largest expansion in the Federal Government since FDR with the creation of the "Department of Homeland Security" which is the only civilian federal government agency that is having trouble recruiting people

    • Re: (Score:3, Interesting)

      by MarkusH (198450)

      I have long thought that having a national health insurance system that anyone can buy into makes a whole lot of sense, especially if you roll in medicare/medicaid and the VA program costs into it. I also wonder how much of a discount doctors would be willing to give if you provide them with free malpractice insurance for accepting patients in the national health insurance program.

    • by FireStormZ (1315639) on Friday October 31, 2008 @10:22AM (#25582875)

      Health insurance companies are not health care companies? really? no kidding? Here is a question:

      What do auto insurance companies offer drivers? Do they help pay for cars? do they change your oil? They actually bring nothing to the table... oh yea except if you total your car and need it replaced.. Health insurance companies provide that, if I got cancer, tomorrow, I would be able to pay bills that I could otherwise not pay... *IT AN INSURANCE POLICY*

      • by Anonymous Coward on Friday October 31, 2008 @10:56AM (#25583501)

        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.

      • by DavidTC (10147) < ... > <neverbox.com>> on Friday October 31, 2008 @10:59AM (#25583559) Homepage

        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.)

      • by SydShamino (547793) on Friday October 31, 2008 @11:09AM (#25583745)

        Auto insurance companies don't offer plans that pay for 80% of your oil changes and brake services, but then decline to pay for your work at Jiffy Lube because, while they location is "in the plan", your work was performed by Bill, who's not a covered mechanic.

        In fact, laws (at least in my state) require that auto insurance companies pay for repairs no matter who performs the work; they can't force you to use "their" mechanics in "their" approved facilities.

        Catastrophic insurance is fine and good for both situations - if they pay out. Maybe the restructuring of health insurance should get those companies out of the routine care & maintenance - driving down the prices for the sort of care that prevents serious conditions - and leave the insurance companies to fight for that catastrophic coverage.

    • by EastCoastSurfer (310758) on Friday October 31, 2008 @10:43AM (#25583245)

      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.

      • Re: (Score:3, Informative)

        by MrMunkey (1039894)
        I would have to agree. I work for a hospital coding the electronic forms for the insurance carriers. That's all I do, and I'm not the only person. The carriers change their requirements all the time, which causes claims to be denied. Then we have to change how we submit those claims and re-submit them and hope they aren't denied again. Sure we get paid, but it costs the hospital quite a bit to have all of us employed to get that money in the door. I can't say if the carriers purposefully change their
    • Re: (Score:3, Insightful)

      by mc6809e (214243)

      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 pay

    • Re: (Score:3, Insightful)

      by jcr (53032)

      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.

      Well, that rules McCain and Obama out.

      -jcr

    • by hey! (33014) on Friday October 31, 2008 @11:32AM (#25584141) Homepage Journal

      The plan you link to is not really all that different from the Obama plan, except that Obama's plan tries to make it possible for private insurance companies to survive.

      Basically, Obama's plan gives individuals the ability to either (a) buy into a public plan if they aren't covered by any other insurance; (b) purchase private insurance through the kind of group insurance commission that would aggregate their buying power to lower prices or (c) continue to get health care through their employer.

      Since many small employers will choose to offer insurance through the government program, and many individuals will buy insurance at group rates, Obama's plan keep the insurance industry viable by having the government take over insuring catastrophic health care. This of course, is a budget buster.

      McCain's strategy is quite interesting. He wants to move away from employer supported health care, encouraging individuals to pay for their own insurance. He creates tax based disincentives for receiving employer supported health care, and gives tax breaks for seeking privately purchased health care. The idea is that people will make shrewder decisions if they have the money in their own hands, which is true. Unfortunately what seems shrewd for the individual is not necessarily shrewd for society. Nobody is going to opt for a plan without catastrophic care, so the cheapest plans will skimp on routine care, Nobody wants to get sick, but an individual might find a bet that he won't need care until his insurance kicks in favorable. The cumulative cost of those bets would be staggering and, of course, drive the cost of health insurance and care up for everybody. This, of course, is a budget buster; not for the federal government, but every household that has to buy insurance.

      It's not as simple as saying "McCain wants to tax health care benefits", which while technically true is really a clever fib. The problem is that McCain's plan doesn't believe that there is a shared interest in this problem that is distinguishable from the net effect of individuals pursuing their self interest. This is what Republicans mean when they talk about "freedom", and in fact, this kind of shared pursuit of individual gain is often for the best. But the logical end point of the view that this is best in every case is not a program of government incentives and disincentives. It's for the government to have no health policy at all. Introducing a government health policy is tacit admission that cumulative self-interest is not optimal in this case. This is not to say his plan can't work, but you can't argue it has to work from the ideological standpoint that pure market solutions are always best.

      McCain is right on this at least: it makes sense to take health care out of the hands of employers. Obama plan flirts with single payer, but doesn't go all the way. It wouldn't want to get a reputation as a hussy ... er... socialist. I think Obama's plan is over complicated. A straightforward offer of government backed health insurance would be simpler and get the job done. However, as you point out, the insurance companies would go ape-shit over single payer, which would be a death sentence for them. It isn't enough for the President to stand up against the lobbyists, congress will have to also. This introduces ... complications.

  • Alright, after reading a bit on both their websites, I'm going to try to state the facts and my opinion.

    McCain [johnmccain.com] : Actually puts numbers out there on how much you're going to "save" according to your tax bracket. But it's confusing to me how one column is showing a flat tax credit of $5,000 for this and then another column (after factoring something called "Income Tax Liability") showing what you save. He concentrates on guaranteeing me a "Better than Congressman" health care plan when I have no idea in hell what kind of health care they get. He also spends more time talking about Obama's health care plan than his own--which I would prefer to read myself and draw my own conclusions. I guess he focuses more on "net tax benefit" to each tax payer which sounds very enticing from a utilitarian standpoint.

    Obama [barackobama.com] : First off, his health care page has a lot of really bland generic bullshit slurry--quite different from his Iraq withdrawal plan. While he doesn't spend anytime attacking McCain's plan, I don't see how some of these bullets are going to do anything for Health Care. Every talking point sounds good but nowhere do I see a plan of A) how/when this will be implemented or B) what the net effect will really be. For example: "Reduce the costs of catastrophic illnesses for employers and their employees." What is a "catastrophic illness"? Reduce by how much? Who's footing this bill? What percentage is going to the employer Vs the employee? While he offers some lengthy PDFs on his site (that I don't have a lot of time to read), I'm skeptical he has any objective, measurable, attainable goals.

    So that's my quick take on this topic. Honestly, I'm not impressed with either candidate. I give a nod to McCain for actually throwing some numbers out there and wonder where the $2,500 per family figure is coming from in Obama's promises. This isn't going to factor into my voting because the roots of this. I grew up on MinnesotaCare so I'm probably going to lean toward the plan that makes the most of providing basic health care to those who can't afford it. My parents never could have afforded vaccinations and I don't think I ever went to the hospital aside from that. Others aren't so lucky. Call me biased or misinformed but I don't see either candidate really doing anything creative/ingenious with health care to the point of it being worth arguing over.
    • by Atmchicago (555403) on Friday October 31, 2008 @10:21AM (#25582871) Homepage

      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.

    • Re: (Score:3, Insightful)

      by DrLang21 (900992)
      Any Presidential candidate who throws out a planned date on something that needs to first go through Congress is just blowing smoke. Detailed numbers on such plans suffer from the same problem. Congress holds the ultimate authority on writing the final plan.
    • Re: (Score:3, Insightful)

      by twostix (1277166)

      It seems to me, and I might be wrong (I'm not)....

      That John Mcain, a Navy brat, turned lifetime public servant who has had "socialist" government provided healthcare for his entire 72 years on this planet. Probably doesn't know sweet FA about an the average persons health care, outside of what he reads and the health insurance lobbyists tell him.

      It's kind of ironic that the guy who's suckled at the government teat for his entire life, calls other people socialists.

      Has he even ever been to a job interview? O

      • by Theolojin (102108) on Friday October 31, 2008 @11:23AM (#25583987) Homepage

        It seems to me, and I might be wrong (I'm not)....

        That John Mcain, a Navy brat, turned lifetime public servant who has had "socialist" government provided healthcare for his entire 72 years on this planet. Probably doesn't know sweet FA about an the average persons health care, outside of what he reads and the health insurance lobbyists tell him.

        It's kind of ironic that the guy who's suckled at the government teat for his entire life, calls other people socialists.

        Has he even ever been to a job interview? Or even had to ring an insurance company to get cover?

        After a career in the Navy and a career in the Senate, it is doubtful that Senator McCain has interviewed for a job, unless you consider reapplying for his job in the Senate every six years is an interview of sorts.

        But, seriously. "Suckled at the government teat"? Really? I'm not voting for McCain, but this is just unfair. Senator McCain's father served in the Navy, thus earning his pay and his benefits (including health care). Senator McCain served in the Navy, thus earning his pay and his benefits (including health care). After serving in the Navy for decades, Senator McCain has served in the Congress, thus earning his pay and his benefits (including health care). C'mon. Suckling at the government teat? That's just not a fair assessment of what Senator McCain has been doing for 72 years. Complain about his inability to offer an coherent, consistent message. Complain about his plan to freeze government spending levels. Complain about his plan to tax health care benefits. I'll even grant you that he doesn't know much about the health care insurance of average folk. Just don't deny that the man has earned his health care for 72 years.

  • Kodos! (Score:3, Funny)

    by gardyloo (512791) on Friday October 31, 2008 @10:03AM (#25582593)

    Kodos wants us all healthy, for various reasons.

    • Re: (Score:3, Funny)

      by dkleinsc (563838)

      Does it have anything to do with this book I just found entitled "How to Serve Man"?

  • Er (Score:5, Insightful)

    by bigstrat2003 (1058574) * on Friday October 31, 2008 @10:05AM (#25582617)

    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)

      by Carewolf (581105) on Friday October 31, 2008 @10:21AM (#25582867) Homepage

      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.

    • Re:Er (Score:5, Insightful)

      by chrb (1083577) on Friday October 31, 2008 @10:54AM (#25583441)

      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:

      With a vehicle crash fatality 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 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!

  • by MindlessAutomata (1282944) on Friday October 31, 2008 @10:05AM (#25582619)

    All I can really say is the obvious: That people don't believe that government is there mostly to just protect rights anymore (if that ever was really the case), so socialized healthcare will be a reality whether we (or I) like it or not,

    and that once you get government in healthcare, the incentives to cut costs in places that aren't immediately visible and to pass laws that limit what we can do (and eat, and so forth) are even more likely to go into effect to keep costs low. Expect more restrictions on things like fast food if this goes into effect. People, apparently, cannot take care of themselves, so we need "Democracy" and mass opinion to do it for us. Some people might get the shaft and lose things they love, but in a democracy you sometimes gotta break a few eggs to make an omlette, right?

    • Re: (Score:3, Insightful)

      by brian0918 (638904)

      All I can really say is the obvious: That people don't believe that government is there mostly to just protect rights anymore (if that ever was really the case), so socialized healthcare will be a reality whether we (or I) like it or not.

      The problem with concocting "rights" to healthcare, gasoline, a car, a home, a tax break, though, is that the promotion of such "rights" requires the violation of rights - life, liberty, property, privacy, etc. You can't have both a "right" to other people's property and a right to your own property. It only serves to strip the word "right" of all meaning.

    • Re: (Score:3, Insightful)

      by CRCulver (715279)

      and that once you get government in healthcare, the incentives to cut costs in places that aren't immediately visible and to pass laws that limit what we can do (and eat, and so forth) are even more likely to go into effect to keep costs low. Expect more restrictions on things like fast food if this goes into effect.

      That's funny, there are fast food places everywhere in countries that have generous socialized medicine. Within less than a kilometer from where I write this in Finland, there are four McDonald

    • Re: (Score:3, Insightful)

      by smidget2k4 (847334)
      Is there evidence of that in other government health-care systems? As far as I know Great Brit, Canada, etc haven't banned McDonalds yet or stopped selling pop and cigarettes...

      I hear this argument a lot but I am unaware of any evidence of it actually happening anywhere. Sure, it makes sense, if we lived in a society that would allow it. But starting a government health care system isn't giving the government carte blanche control over everything we do. They pass a law banning McDonalds? Vote those
  • If we take a look at the costs of manufacturing in the US, there is one expense that manufacturers (such as the auto makers) pay here that they don't pay pretty much anywhere else - health insurance. For every new American-built car sold, a staggering portion of the price of the car goes to cover health insurance.

    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.
    • by brian0918 (638904) <brian0918 AT gmail DOT com> on Friday October 31, 2008 @10:41AM (#25583209)

      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.

      Do you really believe we have a private system in the US? It was the complete lack of competition that started with the government-sponsored monopoly of Blue Cross/Blue Shield, which in turn led to the complete distortion of the structure and purpose of insurance and healthcare, that has brought about the current system.

  • Misconception (Score:5, Insightful)

    by Spad (470073) <slashdot@nOspaM.spad.co.uk> on Friday October 31, 2008 @10:18AM (#25582807) Homepage

    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: (Score:3, Interesting)

      by wild_quinine (998562)
      The NHS is bloated, failing, inefficient. I am also more cynical than I should be.

      Because the NHS is also one of the best healthcare systems in the world. There are maybe five countries in the world that can boast better healthcare, across the board. A lot of places do things better, but not many do so as consistently.

      The US is most decidedly not one of the top five. I can't think of ANYTHING it does better than the UK.

      Sure, you can see the top specialist in a given field within days in the US. But you

    • 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.

      They sure do, yet Medicare (a federal organization) already spends the same $ per capita on health care in the US serving only some of the population as the NHS does on serving an entire country!

      Americans might be scared of subsidies, yet they're already wasting as much as we do and get very lit

  • by MSTCrow5429 (642744) on Friday October 31, 2008 @10:21AM (#25582861)

    "...which candidate has the best answers to making sure that Americans are able to stay healthy without America being bankrupted in the process?"

    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?

  • Efficiency (Score:4, Insightful)

    by twostix (1277166) on Friday October 31, 2008 @10:32AM (#25583065)

    Here in Aus we have both nationalised AND privatised healthcare. Yes we are the country of moderation, never going to one extreme or the other.

    I've made use of our public hospitals in my life for:
    1. A severely broken leg (emergency).
    2. A radio frequency ablation (serious but not urgent) in and out in a day, by one of the leading heart specialists in the world.
    3. My sons birth...single room for the Mrs, very quiet, great midwives and a nice experience. Funnily my other half is from the UK and MUCH prefers our system and hospitals. Though more stuff is covered over there apparently.

    All of these cost me nothing up front, service in all cases was great.

    That includes the midwives, the bulk billed GP visits, etc.

    Now the cost. I pay ~$600 a year on the 'medicare levy', that's how much it costs me in taxes. That's full cover (except dental, public doesn't cover most of that) for $600 a year for top notch service. There's more than that, but as a tax paying citizen, I'm happy for a portion of my taxes to be alloted to public healthcare.

    My mate pays a little more than that for private health insurance. He fell off his ladder a few years ago and totally mangled his wrist, nasty business, many breaks. After years of putting into his private insurance...he ends up in the public system anyway. There was nobody available to operate on him in the private hospital we took him to. Total waste of money.

    My father had his ankle fused in the private system, his treatment was no better than the public system. Except he got to pay a $3000 premium for the effort.

    I'm happy to pay ~600 a year to the government for 'health insurance', it's money well spent.

    I hear of Americans paying in the thousands a year for cover, I have to ask...why? Surely your hospitals can't be that inefficient, or are you all just very sick?

    I like our system, it works well. You can have the best of both worlds if you find the right balance point, going to one extreme or the other with total nationalisation or total privatisation seems silly.

  • by peter303 (12292) on Friday October 31, 2008 @10:38AM (#25583157)
    However their governments regulates they must offer a single price without age or pre-existing considition differentials. This pretty much how US employer insurance operates. Seems to work OK.
  • by cunamara (937584) on Friday October 31, 2008 @10:47AM (#25583321)

    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

  • by Kintanon (65528) on Friday October 31, 2008 @10:49AM (#25583363) Homepage Journal

    Insurance companies suck, I'd love to find one that acknowledges that there is a difference between a 2 person family and a 6 person family.
    As of right now if I wanted employer healthcare for me and my spouse it would cost me exactly the same as my co-workers healthcare for him, his spouse, and his 3 children.
    As two generally healthy adults we cost a lot less to cover than 3 children. But we pay the same amount. That sucks.
    Of course, healthcare isn't the governments business any more than housing, cars, or clothes are. If you believe the government should be providing you healthcare then you should also believe that the government should feed, clothe, and house you since those are more fundamental needs than healthcare.
    So, please stop your dirty socialist whining.

  • Simple (Score:3, Insightful)

    by BCW2 (168187) on Friday October 31, 2008 @10:51AM (#25583389) Journal
    Based solely on performance: Does anyone want the morons in Washington to have a say in your health care? That is one scary thought and very appropriate on Halloween.

    Remember, I have renamed Congress the "Thundering Herd of Dumbass" for a reason (19% approval rating shows I'm not alone).
  • by Kaldesh (1363017) on Friday October 31, 2008 @11:03AM (#25583617)
    This topic is one close to my heart... in several ways. I have very personal experience with Socialized Medicine. You see, I'm Canadian, for those of you not familiar with your neighbours to the north, we have a Socialized Medicine system. I've lived under it's jack boots all my life. I have too many stories to cover in this one post. In Canada socialized medicine is an unmitigated disaster. Unless you live in a large population center or in one of the richer areas in Canada you won't get good care. Myself I live in a rural area in New Brunswick, and the 'health care' that Canada offers hear is unacceptable. I actually got a job in the US 'just' to get health insurance. Where I live the closet Canadian hospital is over an hour and fifteen minutes away, there is 1 medical center in my area, open 2 days a week. Only one of those days does a doctor actually operate out of the clinic. I'll give you my own most recent experiences with that system. I was rushed to the near by US Hospital (thank you US Health Insurance), with heart issues a while back. Treated and released for my condition (Aterial Fib as it's called) a day later. I was instructed to see a Cardiologist ASAP to figure out what causes the issue. I contacted Canadian medicare and was told that the closest appointment they could give me was EIGHT MONTHS away. It would be another SIX MONTHS after the consult to have any testing I needed done then another SIX MONTHS to see the doctor for my results. Realize at this point I had no idea what was wrong with me... I could've been dead the next day from it. I promptly hung up the phone and contacted the nearest Cardiologist in the US. This was a Thursday... I was scheduled for the following Monday @ 8:30. I was taken care of and all prudent testing was done over the span of that week, and the week following. My condition identified and treatment was rendered. I encourage people to debate me on Socialized Medicine, I'm all too well versed in it's use. Frankly I can see how on the surface Socialized Medicine would look appealing to people, but once you get underneath to the meat of the matter... it becomes a scary reality. The simple fact of the matter is in a socialist health care system you are at the mercy of the government in terms of your overall health care. I know too many friends and family that have been mistreated, and some killed by negligence on the part of the state in these matters. It is NOT a good system, in practice.
    • by grub (11606) <slashdot@grub.net> on Friday October 31, 2008 @11:28AM (#25584091) Homepage Journal

      I contacted Canadian medicare and was told that the closest appointment they could give me was EIGHT MONTHS away. It would be another SIX MONTHS after the consult to have any testing I needed done then another SIX MONTHS to see the doctor for my results.

      This whole post reeks of US FUD.

      First off: you don't contact "Canadian medicare", there is no such thing. You contact your doctor who schedules you with a specialist.

      Fact:I went to my doctor on a scheduled check up and because of some minor thing he wanted me to see a cardiologist. It wasn't an emergency and I was there in about 2.5 weeks. An emergency (your "ASAP" situation) certainly would have gotten you in faster.
    • by hyades1 (1149581) <hyades1@hotmail.com> on Friday October 31, 2008 @02:27PM (#25587131)

      This is unmitigated bullshit. I've spent a good part of my life in Northern Ontario in a tiny town far from any major population centre. I had some health challenges, including experimental reconstructive surgery. I received superb care every time and have no complaints. Similarly, my friends and family have had much better luck than yours. One friend was released, in the opinion of his family, too soon. Providing a sufficient level of care for him at home for a couple of weeks cost his son and daughter some holidays. A longer-term disability would have qualified for home care.

      Anecdotal evidence, both mine and yours, count for very little in the overall scheme of things. The numbers prove, time after time, that the Canadian system works. Among other things, it puts about twice the amount of constant dollars (US or Canadian) that go into the system into doctors, nurses, equipment and facilities as the American system. In other words, it uses a lot less of the money in administration and paperwork.

      If you'd like to get some idea of how it works, check out infant mortality in Canada and the United States. That's a good, objective statistic that it's hard to manipulate.

  • 1 opinion (Score:4, Interesting)

    by rev_sanchez (691443) on Friday October 31, 2008 @11:07AM (#25583709)
    Until very recently health care costs were growing at several times the rate of inflation (inflation has increased a lot) and the US is spending much, much more per capita on health care than other western countries while covering a smaller portion of its population. The uninsured still receive care but they get emergency care and that is a very expensive way to treat most conditions. The cost of that is ultimately passed on to the insured and/or taxpayers so we're currently paying for insuring the rest of the country but at an inflated price and getting poor results now.

    There are serious problems with care for the insured. Contracts and billing between hospitals and payors are a terrible mess and administrative costs are a big part of hospital bills with private insurance. Medicare and the medicaids cost a lot less to administer so more of the public health care dollar goes to care than the private counterparts.

    I don't think the Canadian or British models would fit America very well but the German system with multiple non-profit payors or the Australian system with national health care and an option for a private premium insurance is something I think we should explore as they tend to keep choice in the equation.

    Obama's plan seems like it would be expensive but we're already paying for everyone to get health care now in some form so for the most part this is just shifting money around in an effort to provide better care. I think a lot of the savings with this plan from increased efficiency of care and cutting some of the cost of caring for the uninsured that is currently passed on to the insured is going to be eaten up by the hospital and insurance companies. It doesn't fix problems with private insurance but that's too big of a problem to tackle now.

    McCain's plan will cause some employers to drop insurance and make modest increases in cash wages for their workers because it will cost more to insure them and they can just let their employees buy insurance with a tax credit paid by other employers who provide insurance to their workers and some of their fake raise. It creates a competitive disadvantage to offer insurance because you'll be paying more to insure your employees and your competitors while they are probably paying a bit less than they were before. The insurance they'll be able to buy probably won't have group risk built into it so you'll see a lot more medical underwriting so healthy people can get good insurance cheaply and sick people will still have problems getting insurance.

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