The Future of US Healthcare

[Autumn Demon]

Universal health care does bring down the cost of health insurance. If a mandate to buy health insurance passes two important things will happen. More people will put money into insurance pools which will spread the costs of the sick over a larger group, which should in theory drive costs down. The problem in America is that the market for health insurance is so uncompetitive because most people get insurance from their employers and have no say in what they receive or how big of a wage cut they take for insurance. This is why creating exchanges and allowing people to buy insurance over state lines is so important for increasing competition.

Secondly, once a mandate is in place people who don't have insurance will be forced to buy insurance or pay a fine. If people decide insurance is too expensive and don't purchase any they are going to be mad as hell at their politicians for fining them. Democrats will then have a choice: lower the costs of health insurance so people can afford it, get rid of the mandate, or get voted out of office. When the mandate sticks it is the most effective tool at bringing down health care costs because voters will actually care about costs (vmost people with health insurance don't care because they get it through their employer and thus don't know how much they're paying).

[Xellos-_^]

Originally Posted by Joojoobees

Now, once you have identified a societal problem (too few doctors) do we just throw our hands in the air, and give up, or do we find concrete steps that lead to a resolution of the problem? It may not be as easy as chunking out cars, but to say humans are collectively incapable of affecting the number of doctors produced by society is too much, right? That is where Congress needs to get involved.

just how do you plan to increase the number of doctors? it takes 10 yrs of school and training and a million dollars in student loans to produce one doctor. Add in the hours, paperwork and malpractice insurance, if the pay isn't there, you won't get enough qualify people to be doctors.

[Anh_Minh]

Make of that what you will, but there are fewer patients per doctor in the US than in the UK or Canada. Admittedly, there are more than in most European countries.

[Nosauz]

Originally Posted by Cinocard

BECAUSE their social, economic, legal, political conditions are different from the U.S. If you want to compare, you have to take a country with the same conditions as the U.S.

They may pay a fraction of what you do because of subsidies, of lower living costs, of lower medical quality, of more supply of doctors, of fewer legal risks involve, of medical universities there are cheaper...Because of tons of things that require case studies to clarify.

Now, tell me instead, how does forcing everyone to get insurance bring down the price?

Again... cite your sources, prove that their expenditures do lower they health costs and not that their system is more efficient than this private health industry we have. When the for profit insurance industry maximizes their revenue by dropping people who have paid premiums when they get sick, isn't one that promotes health care at all, it's a call to greed, and if you can't see it then your blind. How can you ensure less and make more money. Then again reform is a pipe dream.

If it was SINGLE PAYER, you could eliminate a lot of overhead you would consolidate the hosipital administrators with the insurance admins since doctors know they would be reimbursed for their services, and since your removing parts to have a more slim down system it inherently requires less money less upkeep, simple math.

Originally Posted by Xellos-_^

just how do you plan to increase the number of doctors? it takes 10 yrs of school and training and a million dollars in student loans to produce one doctor. Add in the hours, paperwork and malpractice insurance, if the pay isn't there, you won't get enough qualify people to be doctors.

Apparently killing those that provide abortions is a way to get more people to be doctors since god said it was ok!

@synasethic,

honestly I could care less what you think, but it's been proven that single payer systems are cheaper and offer better care for the amount of money spent, because there are successful examples, he's asking something counter to that, so I say PROVE IT, clearly health reform shouldn't take place because we're 'spending too much' on something that we haven't touched in nearly 20 years because republicans choose to not address the problem because the status quo is soooooooooo great.

[synaesthetic]

Nobody is claiming the status quo is great.

We're just skeptical (very skeptical) that allowing the US government (which has a history of being fucking worthless) to control our healthcare utterly and completely is the best course of action.

Actually I know it's stupid in the extreme. The US government has the reverse Midas touch. Instead of gold, everything it touches turns to stinking, steaming shit.

[Nosauz]

Originally Posted by synaesthetic

Nobody is claiming the status quo is great.

We're just skeptical (very skeptical) that allowing the US government (which has a history of being fucking worthless) to control our healthcare utterly and completely is the best course of action.

Actually I know it's stupid in the extreme. The US government has the reverse Midas touch. Instead of gold, everything it touches turns to stinking, steaming shit.

In SINGLE PAYER THE GOVERNMENT DOESN"T CONTROL HEALTH CARE. They control HEALTH INSURANCE, health care providers are still privatized the only difference is that their paid by the government instead of insurance industry who's bottom line is to deny you coverage of the plan you've paid premiums on.

[Kyuusai]

Originally Posted by Mentar

Isolated examples, maybe. But as a general rule, I'm positively sure that countries with universal healthcare are indeed much more inclined to help you FIRST, and worry about paperwork later.

They can be. But it's really a very easily fixable issue in the grand scheme of things.

Originally Posted by Mentar

But would that be a proper solution? Essentially, this only puts financial extra strain on the various hospitals instead of properly fixing the underlying problem.

Somehow, though, there was less strain before. If we judge by the history of medical care in the US, the problem isn't "not having universal health care". (Note: I also have no objection to taxpayers providing a safety net to cover gaps in a more robust system.)

Originally Posted by Mentar

And besides, it's unreasonable to optimize saving the kid that has just fallen into the well. I'm sure you'll agree that the smarter approach is PREVENTION, not efficiency in the ER.

Agreed, but again, judging by a prior history of medical care being subsidized for the poor and still being affordable for everyone else, something used to be right. It wasn't perfect, but it wasn't the horror we have today, and it had an inherent flexibility and tendency to innovate.

Originally Posted by Mentar

But your political system and especially political climate is totally unsuited to create reasonable baby-steps. It's near impossible to start with some measures to then see if they yield the desired result. Anytime a measure is introduced with which the government could make a REAL difference (like negotiating drug prices directly, or like removing the ridiculous "only in-state insurances" monopoly protections), it's immediately shouted down as the coming of the antichrist, leading to behavior like perpetual civil war, and enough senators that had been bought with contributions have their balls squeezed until it's dead again. Unless there are true paradigm changes, there can't be a reasonable step-by-step approach because your system PRECLUDES reason. And the media are complicit in the cover-up, before people start wondering what the hell is going on because nothing ever gets done.

No, every once in a few decades, you have a chance to force an entire new block through. Or you fail.

You've mentioned two excellent examples from both sides of the political spectrum that were both utterly opposed by the other side. It's an excellent illustration of the political problems here. Both camps in congress seem more interested in squabbling than fixing things when there is a suggestion by the other side.

We did get into this mess step by step. Every time the system was broken further, the solution was just to do more of what broke it. I doubt we'll get out of it step by step. But regardless of whether it's done in one sweeping change or bit by bit, I don't want the US to get stuck with a poor system that it can't get itself out of. Done right, I think universal healthcare is OK, but I have zero hope of it being done right (due to the political climate), and even if it were there's simply little recourse for the individual once it's in place. Once you have it, you're stuck with it, and all you can do is hope that the people voting don't screw things up or use it to extend power... And I think that hope is in vain almost anywhere (all being a matter of time).

I think there is a better solution that is more flexible and more fixable when things go awry, with a natural tendency to limit the area of influence when mistakes are made.

Regardless, we don't have the leadership to do either of those things. Right now we are faced, again, with a few sensible fixes mashed up inside a lot of More Of What Broke It In The First Place.

Originally Posted by Mentar

Says who? With all due respect, but medical advancements are made throughout the world, not just in America. Many of them in countries with universal healthcare. In fact, I see little to no correlation between healthcare _insurances_ and medical science. Advancements are made in leading clinics, universities, medical societies and the likes. A smaller part from drug companies, maybe. But insurances, no way.

Major medical advancements are made all over the world. But the bulk of them seem to come from countries which are willing to make use of commercial potential.

Insurance companies don't pay for it directly, but they certainly do indirectly. Research and development takes resources, but without the ability to begin by charging what the market will bear, there is simply less investment. And "what the market will bear" is what brings prices down in the long run in commercial or social healthcare. Government-led corruption of the insurance market has been one of the biggest reasons for prices not coming down, and I'm not personally not interested in further institutionalizing that system.

Originally Posted by Mentar

And I consider this an ethically troublesome train of thought, at least when it's being used as a pretext to deny coverage to the poor. So the development of top-of-the-list prosthetics is supposed to be prioritized over life-saving/prolonging treatment of someone who lost his job and can't pay his health insurance anymore?

Really?

Again, you are putting words into my mouth. Both sides of the equation have to be balanced.

Originally Posted by Nosauz

In SINGLE PAYER THE GOVERNMENT DOESN"T CONTROL HEALTH CARE. They control HEALTH INSURANCE, health care providers are still privatized the only difference is that their paid by the government instead of insurance industry who's bottom line is to deny you coverage of the plan you've paid premiums on.

If health insurance had no way of influencing the health care market, the US wouldn't have its current problems. The control is there, though it is indirect.

In a single payer plan, it simply becomes the government's job to deny coverage rather than a company's. If you think they're not providing satisfactory service... Oh, well, too bad.

[Nosauz]

Originally Posted by Kyuusai

In a single payer plan, it simply becomes the government's job to deny coverage rather than a company's. If you think they're not providing satisfactory service... Oh, well, too bad.

If government run health care is so garbage tell our congressmen, and the federal employees to go private since the government can't do jack shit right? There is some control on what is and what isn't covered, but there comes in the supplement plans that cover vanity crap like plastic surgery etc. Anyway ask your local federal employee if he wants to give up his health care for a standard Aetna plan... I'll bet you it's a RESOUNDING no.

[Lio]

Originally Posted by Nosauz

In SINGLE PAYER THE GOVERNMENT DOESN"T CONTROL HEALTH CARE. They control HEALTH INSURANCE, health care providers are still privatized the only difference is that their paid by the government instead of insurance industry who's bottom line is to deny you coverage of the plan you've paid premiums on.

Hey, come to Canada. The US healthcare will never be as good as ours. Besides, it'll probably cost you less to move up here than paying for healthcare in the US.

Really.

[Nosauz]

Originally Posted by Lio

Hey, come to Canada. The US healthcare will never be as good as ours. Besides, it'll probably cost you less to move up here than paying for healthcare in the US.

Really.

I'm actually a canadian citizen, but I have a green card here and am attending school here. I acutally kind of wish I went to UBC or McGail instead of my school, apparently the common good and basic human rights are not as important as corporate bottom lines

[synaesthetic]

If the government pays for healthcare, they control it.

When you pay for something, you own it.

[Nosauz]

Originally Posted by synaesthetic

If the government pays for healthcare, they control it.

When you pay for something, you own it.

Again tell those senators and representives and other federal employees to give up their shitty government run health care....

are those crickets? Yea you just got laughed out of the federal government by people who are very much pleased with the service they receive.

[OceanBlue]

I'll say it now. I don't know much about health care, but this struck me as odd:

Originally Posted by synaesthetic

If the government pays for healthcare, they control it.

When you pay for something, you own it.

That's a catchy phrase, but does it honestly work in such extremes? In my opinion, paying people for the services they offer is different from paying for products. You'll never be in complete control of what you're paying for [and depending on the service, you might not even have much control at all]. I'm not saying that you have no control, or that the government will NOT take away all of your rights and choices [but I doubt that will happen], of course.

Or rather, I don't understand what you mean when you say that you can 'own' health care.

[Kyuusai]

Originally Posted by Nosauz

Again tell those senators and representives and other federal employees to give up their shitty government run health care....

are those crickets? Yea you just got laughed out of the federal government by people who are very much pleased with the service they receive.

Are you seriously suggesting that the level provided to normal citizens under a universal plan would rival the level of service that the taxpayer currently provides to senators and representatives?

Originally Posted by OceanBlue

I'll say it now. I don't know much about health care, but this struck me as odd:

That's a catchy phrase, but does it honestly work in such extremes? In my opinion, paying people for the services they offer is different from paying for products. You'll never be in complete control of what you're paying for [and depending on the service, you might not even have much control at all]. I'm not saying that you have no control, or that the government will NOT take away all of your rights and choices [but I doubt that will happen], of course.

Or rather, I don't understand what you mean when you say that you can 'own' health care.

It's true that you can't control the particulars of a service provided by an institution, but if you're unhappy with it, ideally you can go to some one that better caters to you. One of the biggest factors in rising health care cost in the US is the fact that there is collusion and reduced choice.

[OceanBlue]

Originally Posted by Kyuusai

It's true that you can't control the particulars of a service provided by an institution, but if you're unhappy with it, ideally you can go to some one that better caters to you. One of the biggest factors in rising health care cost in the US is the fact that there is collusion and reduced choice.

So what's wrong with the government public option [which I know isn't the topic of discussion right now, but seeing how paranoid people are about universal health care...]? It doesn't eliminate competitors and creates more choice for the consumer. I don't understand why people rally against it so much.

In my opinion, it's not likely, with the way things are now, that the government can completely control health care. There are too many people against it. But, again in my opinion, people polarize the argument too much. Just because the government is going to have more options in monitoring health care [similar to the FDA or anti-trust], doesn't mean that it'll completely take it over. I'm just trying to figure out why the point of the debate is complete government takeover rather than purely government supervision.

[Cinocard]

Originally Posted by OceanBlue

So what's wrong with the government public option [which I know isn't the topic of discussion right now, but seeing how paranoid people are about universal health care...]? It doesn't eliminate competitors and creates more choice for the consumer. I don't understand why people rally against it so much.

There has never been any real competition in medical services in the U.S. We lack doctors. Universal health care won't change the fact. Heck, the take out of education and higher taxation may make it worse.

Neither does it create more choice for customers. You still have the same old hospitals and clinics. Only that now you don't have a choice of what insurance plan to follow. And that because the un-sick pay for the sick, and the rich pay for the poor as well, demand will increase. And because of the cut in education and the increase in taxation, the supply of doctors and nurses will go down. Supply down, demand up, hospitals will happily charge even higher to increase their profits.

Originally Posted by Nosauz

Again... cite your sources, prove that their expenditures do lower they health costs and not that their system is more efficient than this private health industry we have. When the for profit insurance industry maximizes their revenue by dropping people who have paid premiums when they get sick, isn't one that promotes health care at all, it's a call to greed, and if you can't see it then your blind. How can you ensure less and make more money. Then again reform is a pipe dream.

Do you even know how to compare 2 things? It's unintelligible to compare any country to the U.S, because beside health care being universal or not, other conditions are also so different. That's why I never made any claim about those country to have to cite anything for you.

I never said government expenditures do lower health costs either. I said expenditures INCREASE health costs, sir. And universal health care doesn't mean the abolishment of private health industry either. If the bill is to go through, we still have a private health industry.

Do you also even understand the difference between the actual cost and the cost to one patient? Insurance never has any significant impacts to medical services' prices. It only spreads out the payment between customers.

Originally Posted by Nosauz

If it was SINGLE PAYER, you could eliminate a lot of overhead you would consolidate the hosipital administrators with the insurance admins since doctors know they would be reimbursed for their services, and since your removing parts to have a more slim down system it inherently requires less money less upkeep, simple math.

Lol, high medical cost in the U.S isn't because of such "overheads."

honestly I could care less what you think, but it's been proven that single payer systems are cheaper and offer better care for the amount of money spent, because there are successful examples

What examples? Source please. And please pick a country that is SIMILAR to the U.S. Don't pick things like Finland or Canada...

[Nosauz]

Originally Posted by Kyuusai

Are you seriously suggesting that the level provided to normal citizens under a universal plan would rival the level of service that the taxpayer currently provides to senators and representatives?

synathestic's argument is based on the premise that what ever the government touches turns to shit... here is one of many cases where the federal government does something that benefits the people it serves. You can cry about libertarian battle cries but the fact of the matter is many things would not be done under a libertarian society.

@cincocard

I'm going to keep pointing to Canada because it does work, just because GDP aren't the same doesn't mean that the systems are intrinsicly different. If not Canada then France, Great Brittan or Germany would suffice? Japan too also has your boogey man 'socialized medicine' and actually health care prices are high in the us due to the "overhead" required to determine "fraud" as stated by one wellpoint executive during the health reform sub committe chaired by Stupak. Their claim for inefficiencies compared to medicare was that they had a more rigerous claims denial department. If we are going to have private insurance then insurance companies should damn well insure the most risky, the eldery which the government nicely takes care of for them. Of course in your world the system is perfect and premium aren't increasing annualy and the insurance companies are out there to offer better service to compete against their competitors... Oh wait that's not the case.

[OceanBlue]

Originally Posted by Cinocard

There has never been any real competition in medical services in the U.S. We lack doctors. Universal health care won't change the fact. Heck, the take out of education and higher taxation may make it worse.

Neither does it create more choice for customers. You still have the same old hospitals and clinics. Only that now you don't have a choice of what insurance plan to follow.

I guess this is going to be my 'blatant opinion' post instead of my 'trying to understand the situation' post.
I was talking about the public option. The lack of doctors, etc. have nothing to do with the public option. Also, the entire point of the public option is that people who don't have a choice do, because it isn't supposed to replace private insurance. I don't see what having the same hospitals and clinics have to do with insurance options.

[Cinocard]

Originally Posted by Nosauz

@cincocard

I'm going to keep pointing to Canada because it does work, just because GDP aren't the same doesn't mean that the systems are intrinsicly different. If not Canada then France, Great Brittan or Germany would suffice?

Nowhere in the world is the legal system as harsh to health related problem as the U.S. Income disparity, medical education costs in Canada are also much lower than the U.S. You can't do comparison that way. Canada universal health system is good, okay. But what if it would be even better if it were not universal?

The problem is that the U.S is too unique to even try to compare.

Of course in your world the system is perfect and premium aren't increasing annualy and the insurance companies are out there to offer better service to compete against their competitors... Oh wait that's not the case.

I never said that. My arguments never aim at how much on average a patient pays, but at HOW MUCH hospitals charge patients. Obviously, universal health care doesn't make hospitals charge less.

Originally Posted by OceanBlue

The lack of doctors, etc. have nothing to do with the public option. Also, the entire point of the public option is that people who don't have a choice do, because it isn't supposed to replace private insurance. I don't see what having the same hospitals and clinics have to do with insurance options.

You mean the people who can't afford any private insurance options. Then I agree, universal health care may make a way out for them. But in the long run, supplier of medical services may increase the prices and make the effort naught. Why they can increase the prices, I think I already give some demonstration.

I believe universal health care doesn't touch the root of the problem.

[OceanBlue]

Originally Posted by Cinocard

You mean the people who can't afford any private insurance options. Then I agree, universal health care may make a way out for them. But in the long run, supplier of medical services may increase the prices and make the effort naught. Why they can increase the prices, I think I already give some demonstration.

I believe universal health care doesn't touch the root of the problem.

Calling it universal health care gives it a different connotation and tends to lump it with other arguments that don't involve the public option [In fact, it's not even health care. It's health insurance]. Do you mind using the different term, considering when people think of universal health care, they think of government-mandated health care, and that's not what the public option is.

If I understand things correctly, suppliers of medical services can always increase prices, regardless of the insurance. Plus, even if it doesn't touch the root of the problem, if it helps, why is it a problem? I'm not sure fixing health care [if you believe it needs to be fixed] can be solved with one effort.

Edit: Actually, looking at your response to Nosauz, it seems you aren't really considering the insurance costs, and instead are focusing on health care costs. We might be arguing different points.