Hmm You want me to pay for what?

Daryl wrote:This seems to be an example of very different cultures, in that I find the concept of businesses being Christian based and thus ethical to be bizarre.

In our culture it is not normally done for an individual or organisation to publically discuss their religious affiliation. That said some of our worst employment scandals have occurred from such organisations as the Catholic Church, Hillsong revival, and US based multinationals that espouse Christianity. Why should Christianity have a monopoly on ethics anyway? Many good people are Islamic, Hindu, Buddhist and secular.
...

Anyone who needs religion to be ethical, has a BIG problem.

PeterZ wrote:On top of that they want one of the least efficient organizations in any society to manage that transfer of wealth. When efficiency means providing a service for the least amount of resources, why on earth would any sane and caring individual want ANY government near running healthcare? Regulate? Certainly. Manage and operate? Hell no!

Why dont you check around different healthcare systems around the world?
Look at where you get the most for the money spent. Then look at how it´s being run.
Government run healthcare is mostly more efficient than private run.
Here, the introduction of generalised private healthcare has raised overall costs something like 25-50%.

But of course, "everyone knows" governments cannot run things efficiently. Despite the massive evidence to the contrary.

Government paid heathcare isn't free. The services have to paid for regardless of who is sponsoring the healthcare plan in question. The proponents of publicly fund healthcare simply want the more well off and healthy to pay for the less well off and sick.

I think i´ll use someone elses quote to describe what i think about that egotistic stupidity.


"their are 2 types of ppl in this world, the sick and the ones who will be sick...... yet so many stupid idiots think they will live forever ailment free and why should they have to pay for any type of health care when they aren't currently using it."

Michael Riddell wrote:

biochem wrote:They never had it. The employer system is a legacy of WWII. Basically the government put in place wage controls so employers couldn't raise wages to compete for workers and the labor supply was exceptionally low since most working age males were in or working for the military. So to bid for the very few available workers the companies started offering benefits such as health care which didn't count toward the wage controls.

At the same time, to use the UK as an example, allowing private individuals to have their own health insurance? We have "National Insurance" automatically deducted from our wages to help pay for the NHS and the State Pension, but we're also allowed to pay into our own, private, health insurance plans - I do.

Mike.

I'm not an expert on this, but the provision that people could not buy their own medical care decided me that Obamacare was a control system rather than a medical health system.

To be blunt about it, what is wrong with letting people who can afford experimental treatments act as guinea pigs for the rest of us? If it works, it is probable that prices will be brought down to where more can afford it.

Per Germany:

A huge part of this is that preventative care is covered, and so seeking such care doesn't carry any particular stigma;

Preventive care should be covered under any sensible insurance. At the same time, people need to be educated about it. BJ & I use some preventive means that many don't seem to know. Linus Pauling, who got his first Nobel Prize for improving chemistry and spent the last half of his life working in biochemical research stated that Vitamin C supplements reduce the risk of heart attacks. I only found this by searching the net, AFTER my heart attack. There was also a research study on the net reporting a 40% risk reduction with 500 mg/day supplement. Pauling suggested 2,000 mg/day for those who are not vitamin C intolerant.

DDHv wrote:...

Preventive care should be covered under any sensible insurance. At the same time, people need to be educated about it. BJ & I use some preventive means that many don't seem to know. Linus Pauling, who got his first Nobel Prize for improving chemistry and spent the last half of his life working in biochemical research stated that Vitamin C supplements reduce the risk of heart attacks. I only found this by searching the net, AFTER my heart attack. There was also a research study on the net reporting a 40% risk reduction with 500 mg/day supplement. Pauling suggested 2,000 mg/day for those who are not vitamin C intolerant.

That tend to be a common problem, that information is rarely found easily.

If you´ve had/have heart issues i suggest you add a daily dose of magnesium, preferably magnesium citrate.
Nothing ever guaranteed, but it is often beneficial.

Wow... it's really difficult to read this thread and even know where to begin, but might as well start somewhere. So...

namelessfly wrote:The point is that the US already had an extremely effective healthcare system based on employer financed insurance with Medicaire to insure the high risk elderly and Medicaid to fund the indigent. I myself was enrolled in a government organized high risk insurance pool. Itcost me $1,000 per month for a high deductible, but I had insurance.

You know, when I first moved to the U.S 15 years ago the fact that anyone could have made the two statements you just made in those 2 sentences with a straight face would have left my mind boggled. I've since come to realize however that it's simply that the vast majority of the people in the States have absolutely no degree of accurate exposure to the health insurance systems of other developed nations and thus have no idea how badly they're being screwed over.

Instead, they have exposure to a vast sea of absurd caricatures of other nations systems backed by an unrelenting drumbeat that the US has the best system in the world. (Spoiler, it doesn't. And it's not number 2. Or number 5. Or even number 10.)


Speaking purely anecdotally, when I first arrived and was going through orientation at the company that had hired me (engineering company in Silican Valley that has, for the US, what is considered an excellent health insurance benefits package) my initial reaction was something along the lines of "you've got to be joking, this is what passes for a health insurance system in the United States of America?"

I second guessed my decision to move. Seriously.


Don't get me wrong, the quality of medical care in the U.S. is great. Skilled doctors, first rate equipment, blah, blah, blah... If, you know, you can access it without bankrupting your family.

But the health insurance system? That's pretty much always been horrendous. It is slightly less horrendous now, but only slightly. It's still put to shame by the health insurance systems of almost any other developed nation on earth.

With few exceptions, the only people who had no insurance at all were illegal aliens.

Ummm, no. That statement and reality are not only not close to each other, when they look in the night sky they see different constellations.


Illegal immigrants make up in the neighborhood of 3-4% of the population of the country.

~15% of the US population was completely uninsured in 2008.

You're off by about 35 million of your fellow citizens there. And that's only counting the totally uninsured. If you count the hopelessly inadequately insured who would be completely and totally screwed by any serious medical emergency you can double that number. I have a sneaking suspicion you yourself may have been one of those, the fine print on those high deductible plans can be really nasty and insurance companies had a history of being extremely skilled at dumping your coverage if you became too large a financial burden on their bottom line... at which point you would have joined the very large ranks of the people who were treated as un-insurable due to "pre-exisiting conditions".

Obama and the Democrats deceitfully promoted a dysfunctional healthcare system then executed it with extreme, gratuitous incompetence. Millions of people are getting screwed financially because of this FUBAR and thousands are dying uneccesarily from the disruption in medical care.

The only places I'm aware any serious study has shown thousands dying unnecessarily is in states where Republican governors refused Medicaid expansion.

http://healthaffairs.org/blog/2014/01/3 ... l-impacts/

I have yet to see any study that says there have been increased mortality as a consequence of the ACA as opposed to as a consequence of certain states doing everything they can not to implement it's provisions.

Additionally, health care costs have been growing at historically slow rates since ACA implementation.

So you appear to have the facts here exactly backwards. You may want to reconsider your preferred news sources.

PeterZ wrote:
Any other organization(s) that isn't a monopoly or oligopoly can do the job more efficiently. That means more healthcare for any given level of resources.

That is just so wrong that it's hard to think of even one specific example where it could be right.

Agree completely. Proof abounds internationally that a properly run government universal health service is more efficient, more effective and more ethical. Not surprising when you consider that adding a new layer of profit oriented businesses must mean more expense.

Annachie wrote:

PeterZ wrote:
Any other organization(s) that isn't a monopoly or oligopoly can do the job more efficiently. That means more healthcare for any given level of resources.

That is just so wrong that it's hard to think of even one specific example where it could be right.

I've been trying to think of one
Organization that does do the job more efficiently, or cheaper. There's not many that don't screw something over. Assuming of course the government runs things properly in the first place. At least the government isn't screwing everything down in the hunt for the god almighty dollar and it's bastard offspring the executive bonus.

Daryl wrote:Agree completely. Proof abounds internationally that a properly run government universal health service is more efficient, more effective and more ethical. Not surprising when you consider that adding a new layer of profit oriented businesses must mean more expense.

Profits offer an incentive to use assets efficiently. Screwing over customers decreases profits as customers stop being customers over time. So long as customers have a choice, businesses of any sort must provide services of sufficient quality to keep and gain customers.

Every system has built in incentives. The US government provides a huge incentive to expand its departments. Efficiency is a disincentive to that growth. The public employees' union provides more disincentive for efficient operations. Because this tendency is pretty strong, some competing element must be applied. Regarding health care providiled by the government there is a example of how those incentives play out over time, the VA. In Colorado they spent 500 million building a hospital designed in such a way that it will cost 1 billion to build. A judge ruled the contractors don't have to build it for the $500 million the VA contracted for. As I said not very efficient use of assets.

I prefer to have a private enterprise regulated by a slightly antagonistic agency. Can pure government sponsored programs elsewhere provide good services? Certainly, they can. My point was that being a monopoly reduces the incentive to becoming optimally efficient in the use of assets.

PeterZ wrote:

Daryl wrote:Agree completely. Proof abounds internationally that a properly run government universal health service is more efficient, more effective and more ethical. Not surprising when you consider that adding a new layer of profit oriented businesses must mean more expense.

Profits offer an incentive to use assets efficiently. Screwing over customers decreases profits as customers stop being customers over time. So long as customers have a choice, businesses of any sort must provide services of sufficient quality to keep and gain customers.

In very generalized theory. In practice not so much. Which we know because we have decades of real world data from nations across the world that says so unequivocally. Universal public sector managed health insurance systems reliably crush private sector systems for efficiency.

Here's the problem, is a private-sector profit-motivated approximately-free-market system (allowing for a degree of common sense regulation) the most efficient way to handle a lot of markets? Absolutely. Want to provide your population with produce? Private sector is great at that. Consumer electronics? Ditto. Automobiles? No problem.


Health Insurance? HELL. NO. It is a market custom designed to be abused horrifically by the private sector. All the incentives are exactly backwards from anything you want the private sector touching with a 100 foot pole.


If you're selling someone, say, a TV, then you want customers who love to use their TVs. Who want to use your product. They make great customers. And so all your incentives are to do everything you can to attract those customers who really want and need what you're selling. So your incentives are all geared towards fulfilling that need in society.


If you're selling insurance the last people on earth you want as customers are people who actually use what you're selling them. Those people are horrible customers. They cost you money. You want people who will write you a check and then they never ever use your services. You want to attract those customers and you want nothing to do with the people who actually need your services. So all your incentives are geared to making you do everything in your power to AVOID filling the need you're supposed to be fulfilling. Do private sector health insurance companies want to insure all the young healthy people in the US? Absolutely. Do they want to insure the elderly or military veterans who generally require a lot of high cost care? They will do everything in their power to avoid doing so, which is why they're generally completely thrilled with the idea of medicare or the VA. Let the government take all the problem patients off their hands while they siphon the bank accounts of everyone else.



Beyond that, there's just the basic structure of insurance and the natural consequences of how it works. Competition in a market for cars? Good thing! Totally works in favor of the consumer. Makes suppliers try harder and do better to make sure as many of those customers they're fighting over come to them.

Now that's true to a degree in insurance as well, but it's cancelled out by the complicating detail that insurance is more efficient the larger the risk pool is. And the more competition you create the more pieces you're dividing that pool into, tanking the efficiency of every party involved.


Then there's the other massiv inefficiencies in the private sector insurance approach. Advertizing budgets. Universal public sector systems don't need to blow 10 or 15 percent of their operating costs trying to get people to sign up. Profit requirements. Public sector insurance is a service, not a business. They only need to charge people enough to break even after costs of paying for care and administration, private sector needs to charge that plus a profit margin. Oh right, speaking of administration. Universal public sector systems have extremely simple administration that additionally get to take advantage of a pre-existing revenue collection apparatus. That doesn't just save the insurance system money that saves medical care providers money.

The billing and collections departments of major hospitals in Canada tend to be a couple people in an office. Everything is extremely simple. It's understood what's covered, what's not, how to collect. The billing and collections departments of major hospitals in the US tend to be their own entire wings of buildings with armies of accountants pouring over the hundreds of different policy details of every single different patient they have and arguing with a hundred different insurance companies about whether any one thing is covered or not and who's going to pay for it. That costs crazy amounts of money that drives efficiency down even more.


Private sector health insurance systems simply cannot compete with the efficiency of universal public sector systems.

Here's a recent experience I had with our privately run system. I went to an Urgent Care center a week and a half ago with abdominal pain. They took my temperature and blood pressure, had me fill out some paperwork and describe my symptoms. Rather than doing any other tests, they sent me to the emergency room 5 miles down the road, which diagnosed me with a kidney stone (for around 1600 after my insurance, though most of that was my annual deductible).

Then this Friday, I got an e-mail from my insurance company that the urgent care center sent them an invoice for $190. I also found out that the urgent care center was owned by the hospital they sent me to, giving them an incentive to refer me there. While I am following the free market in terms of not going there again, due to my pain, I couldn't exactly shop for different options at the time.

For preventative and non-urgent stuff, shopping around is an option, but for too much, you don't know the cost until after the services have been provided. Maybe single-payer isn't the best option, but at the very least, the medical facility should provide an up-front estimate (much like auto mechanics).