Do people 'deserve' universal health care?

[SadisticNature]

The lowest medical costs occur in countries with single-payer government run systems. These countries also score among the highest in the world for quality of care.

The US system is the most expensive in the world. The problem is the private insurance companies. Medicare and Medicaid are run with a 2-3% administrative cost (including salaries) whereas the typical insurance company has administrative costs around 40%. This is before you even look at the amount of profit the companies take out of the system (typically massive as well). The problem is even the small to medium insurance companies end up with a board of directors and a not insignificant executive board either. Those salaries have a huge impact on insurance cost. All said and done about half of what you pay for insurance actually covers the cost of the insurance plan, and most deals with profit and the bloated administration that medicare and medicaid prove is not needed.

In addition the current system has insurance costs rising faster than health costs as companies attempt to pad the bottom line.

[steelish]

The lowest medical costs occur in countries with single-payer government run systems. These countries also score among the highest in the world for quality of care.

Yeah, sure. Which is why, I suppose, my dual citizenship (Canada and US) aunt and uncle are appalled that we are contemplating a National Health Care system. They claim that the Canada system is great for minor health care problems, but for the more serious stuff, they rely on the private health care that the US provides, stating that it has much higher quality health care.

[DuncanONeil]

I hear it's one horse-power! (but requires more frequent maintenance)

I suppose! If you want to consider fueling and washing as maintenance.

[DuncanONeil]

A government large enough to give you everything you need is a government large enough to take everything you have.

former President Gerald Ford

I heard that today and it is so true and perfect to this situation. We are going to slowly empower our government and this health care bill lays down the foundation by which they will eventually have that power over us.

Slowly?!?!

[DuncanONeil]

The lowest medical costs occur in countries with single-payer government run systems. These countries also score among the highest in the world for quality of care.

Define quality? When time is a component of quality you can not rate these Government runs systems as high quality. Were these plans so effective there would be no reports from these countries of the poor care and other quality issues.
Also you are confusing costs with payment. For example a procedure that costs $3,000 does not have its costs reduced because Medicare pays only $1,000!

The US system is the most expensive in the world. The problem is the private insurance companies. Medicare and Medicaid are run with a 2-3% administrative cost (including salaries) whereas the typical insurance company has administrative costs around 40%.

To some extent you are correct. But that is not the only component. There are requirements in place, from the Government, that raise their costs. Artificial restriction on the area provider can seek clients, for one. Another issue is the customer not paying anything, that leads to "who cares the cost I don't have to pay". That is a big fault in all pervasive insurance. In the past I at least got a copy of the bill that went to insurance, now I see nothing. Comparison of administrative cost between Medicare programs and commercial programs is also an unfair comparison as that do not follow the same rules. Medicare does not REQUIRE a profit. Medicare gets to decide, on its own, how much it will pay. The medical provider is prohibited from asking the patient for the difference.
"Administrative costs account for 25 percent of health care spending, but little is known about the portion attributable to billing and insurance-related (BIR) functions. We estimated BIR for hospital and physician care in California. Data for physician practices came from a mail survey and interviews; for hospitals, from regulatory reporting; and for private insurers, from a consulting company. Private insurers spend 9.9 percent of revenue on administration and 8 percent on BIR. Physician offices spend 27 percent and 14 percent, and hospitals, 21 percent and 7–11 percent, respectively. Overall, BIR represents 20–22 percent of privately insured spending in California acute care settings. Single-payer analysts Steffie Woolhandler, David Himmelstein, and their colleagues have argued that moving to a Canadian-style system would reduce U.S. administrative costs by 10–15 percent of total health spending." That means instead of 20% it would be 18%, big savings!

This is before you even look at the amount of profit the companies take out of the system (typically massive as well).

Define massive? The insurance provider with the greatest amount of profit is only at 8%

The problem is even the small to medium insurance companies end up with a board of directors and a not insignificant executive board either. Those salaries have a huge impact on insurance cost.

How do you propose that these companies run? As a point of interest Boards of Directors often are some of the least paid persons in the company.

All said and done about half of what you pay for insurance actually covers the cost of the insurance plan, and most deals with profit and the bloated administration that medicare and medicaid prove is not needed.

Again a comparison of private company with a organization that does not have the same rules and restrictions. They are not comparable! How much of the costs of running the insurance company is driven by the Government rules that they are forced to follow.

In addition the current system has insurance costs rising faster than health costs as companies attempt to pad the bottom line.

You really think the only reason the prices are going up is to increase the profit earned? That is ridiculous! Though you would likely not believe it you would likely be surprised to lean which companies have the highest profit rates.

[DuncanONeil]

Oh Yeah I forgot about the survival rates that are greater in US medical treatment than under "Single Payer".

The lowest medical costs occur in countries with single-payer government run systems. These countries also score among the highest in the world for quality of care.

The US system is the most expensive in the world. The problem is the private insurance companies. Medicare and Medicaid are run with a 2-3% administrative cost (including salaries) whereas the typical insurance company has administrative costs around 40%. This is before you even look at the amount of profit the companies take out of the system (typically massive as well). The problem is even the small to medium insurance companies end up with a board of directors and a not insignificant executive board either. Those salaries have a huge impact on insurance cost. All said and done about half of what you pay for insurance actually covers the cost of the insurance plan, and most deals with profit and the bloated administration that medicare and medicaid prove is not needed.

In addition the current system has insurance costs rising faster than health costs as companies attempt to pad the bottom line.

[DuncanONeil]

Yeah, sure. Which is why, I suppose, my dual citizenship (Canada and US) aunt and uncle are appalled that we are contemplating a National Health Care system. They claim that the Canada system is great for minor health care problems, but for the more serious stuff, they rely on the private health care that the US provides, stating that it has much higher quality health care.

Tantricsoul has me confused!? Thanks you for what you say and thanks Sadistic for what they say!?

[steelish]

Slowly?!?!

lol. Well, it has been happening since before I was born. It's just been gaining speed lately.

[steelish]

Tantricsoul has me confused!? Thanks you for what you say and thanks Sadistic for what they say!?

I think as the moderator (and correct me if I'm wrong on this TantricSoul) is that he is thanking each poster for attempting to educate the opposing viewpoints without using flaming comments.

[steelish]

Yeah, sure. Which is why, I suppose, my dual citizenship (Canada and US) aunt and uncle are appalled that we are contemplating a National Health Care system. They claim that the Canada system is great for minor health care problems, but for the more serious stuff, they rely on the private health care that the US provides, stating that it has much higher quality health care.

I forgot to add that they also commented that our health care system is timely, in that if something needs to be looked at/tested/etc., it's done much quicker here than in Canada. (Their words, not mine)

[TantricSoul]

Thank you steelish for addressing Duncans comment.

The reason I thank most every post in this section is ... I just want to have an astronomical "thanks" count for my statistics (see I'm trying to cultivate a "sense of gratitude" in my life.)

Actually I do this for several reasons, as steelish suggested above, one of them is to thank posters for participating in threads and contributing different views without resorting to attacks.

Another reason I'll admit to is that it helps me to keep track of which posts I have read in a particular thread previously.

And as shown by Duncans post, to keep you all guessing as to what viewpoint I may have on a particular issue, I wouldn't want any accusations of unfair moderation based upon perception of my beliefs around the issues discussed.

Respectfully,
TS

[SadisticNature]

You really think the only reason the prices are going up is to increase the profit earned? That is ridiculous! Though you would likely not believe it you would likely be surprised to lean which companies have the highest profit rates.

I actually said "The costs are rising faster than the health care costs." This in itself says that health care costs are rising, but costs to the end user are rising. Your claim that I am saying profits are the only reason is outright wrong. It's not even my claim of the main cause of problems, administrative overhead.

However, even using your source for the numbers we have 43% of revenue in administrative overhead and 8% of revenue in profit so the private system is taking up half the money used.

As for your claims of $3000 cost on a $1000 procedure these are wrong as well. What typically happens in the public system is something along the lines of $1200 to $1500 on a $1000 procedure which actually makes money when the administrative overhead is 3% instead of 43%. What happens in the private system is the insurance companies to treat a $1000 procedure as a $2000 one for the purpose of assessing risk as they need that 2 to 1 mark-up to get profits with their huge administrative overhead.

As for wait times, its an issue in a public system, but they are being worked on and are far lower than they were a few years ago. Most procedures have good times now. Also the implication that the US does better on all big issues is outright wrong. The US system if you have money to pay for it does better on some types of cancer, but is near the bottom on all emergency services. Your system does terribly for heart attacks, car accidents and pretty much everything else that requires a quick efficient response. Inability to take people to the fastest reachable hospital causes huge problems, no doubt explaining the fact that the US has one of the highest rates of people dying while on the way to the emergency room.

[steelish]

Your system does terribly for heart attacks, car accidents and pretty much everything else that requires a quick efficient response. Inability to take people to the fastest reachable hospital causes huge problems, no doubt explaining the fact that the US has one of the highest rates of people dying while on the way to the emergency room.

Wow. Not sure where this tidbit of information comes from, but it's terribly incorrect. Ambulances respond very quickly to accident scenes and to other emergencies. The national average response time for an ambulance is 10 minutes. It's usually even quicker than that and they do not check to see if you have insurance when they transport you. They simply take you to the NEAREST hospital and then you are stabilized. ONLY AT THAT TIME does your insurance information get checked for coverage. If your insurance company requires you to attend a different hospital, they transport you AFTER it is safe to do so.

[steelish]

They simply take you to the NEAREST hospital and then you are stabilized.

Sorry, I should have said, "They simply take you to the NEAREST hospital WHILE they stabilize you.

[DuncanONeil]

I forgot to add that they also commented that our health care system is timely, in that if something needs to be looked at/tested/etc., it's done much quicker here than in Canada. (Their words, not mine)

I have heard the same thing from Mark Steyn, a Canadian citizen!

[DuncanONeil]

As for your claims of $3000 cost on a $1000 procedure these are wrong as well.

Sorry to disabuse you. But the numbers came from a doctor and a recipient of the procedure. The recipient, without using insurance paid $3,000 for the procedure, for which Medicare pays only $1,000.

What typically happens in the public system is something along the lines of $1200 to $1500 on a $1000 procedure which actually makes money when the administrative overhead is 3% instead of 43%. What happens in the private system is the insurance companies to treat a $1000 procedure as a $2000 one for the purpose of assessing risk as they need that 2 to 1 mark-up to get profits with their huge administrative overhead.

What everyone refuses to acknowledge is that a large part of said overhead is costs that arise as a result of Government leveled requirements. It is estimated that, in total, the cost of everything in this country is 30% due to Government taxes and regulation.

As for wait times, its an issue in a public system, but they are being worked on and are far lower than they were a few years ago. Most procedures have good times now. Also the implication that the US does better on all big issues is outright wrong. The US system if you have money to pay for it does better on some types of cancer, but is near the bottom on all emergency services. Your system does terribly for heart attacks, car accidents and pretty much everything else that requires a quick efficient response. Inability to take people to the fastest reachable hospital causes huge problems, no doubt explaining the fact that the US has one of the highest rates of people dying while on the way to the emergency room.

That is not an issue of health care but an issue of the preferred provider system. That is to say the insurance provider and who accepts them is the driving factor. Hence the reason I assert that the all pervasive cover everything insurance is a detriment to the price of health care.

[DuncanONeil]

Your system does terribly for heart attacks, car accidents and pretty much everything else that requires a quick efficient response.

The world wide death rate from heart attack is a whopping .2%. So based on what you claim the US should do much worse than this. The comparable figure for the US is a staggering .17%!

[SadisticNature]

Obviously if you include everywhere with bad data your numbers are wrong.

As for Mark Steyn, he has a long journalistic history of bad sources, so I have trouble accepting something he says. His numbers tend to be wrong.

Again, if Medicare is paying $1000 for a $3000 procedure the ratio of costs of administration to costs of treatment would go up! Basically, administrative costs are the non-procedure costs, if your total costs go down by reducing procedure costs the administrative costs would go up, so if they are paying far too little on procedures administrative costs should be a higher % but they are 3%. Your example basically proves my case.

The .2% vs .17% includes a lot of countries with pretty atrocious health care. I think a country that has the worlds largest economy and spends triple what anyone else does on healthcare should be doing far better than a .03% improvement! I'd be happy to take a look at your data if you provide a link.

Here are some other statistics:

http://en.wikipedia.org/wiki/List_of..._by_death_rate ->
US 8.38 does worse than Canada's 7.74

http://en.wikipedia.org/wiki/Infant_mortality_rate ->
Infant Mortality by state

http://en.wikipedia.org/wiki/List_of...mortality_rate ->
Infant Mortality by Country

Canada does much better than the US, the only state in the entire US with a number better than Canada's national average is Utah.

[SadisticNature]

I thought you were comparing what Canada's public system is doing, I'm not surprised the current US system is messed up.

As for $3000 cost to user vs Medicare pays $1000, I'd like to see actual data on what the procedure costs, compared to what the doctor is deciding to charge for it. This could easily be an example of price inflation that is typical when people's costs are covered by private insurance.

[Lion]

I have heard the same thing from Mark Steyn, a Canadian citizen!

Here's another Canadian citizen who is happy with his healthcare system. Who has seen a family relative admitted almost immediately when something seemed wrong, and was monitored all night, and then admitted when the doctors were concerned.

And once it was all over, we walked out of the lobby, the only expense was the parking, our concern was to move on, not to look back.


I don't know what your point was by saying that there is an upset Canadian regarding the healthcare system, but I can tell you that I've met a lot of Canadians, a lot who are happy, and a few, understandably, that are annoyed with problems that plague our system.

It works for us, we don't have a huge military budget, that is proportionatly about 8 times larger then ours, we care about different things.


There has been such a huge noise about public healthcare recently, and it would be nice for the people so opposed to it to give some sort of solution to the problem of so many uninsured, rather then talk about how the government is turning some sort of communist regime. Public healthcare might not work for US, but now that the debate is on the table, the only thing I've heard from the right is why it can't be done, and nothing else.

What's the point of spending billions to protect Americans through military means if Cancer, heart disease, or some other sickness can kill them at higher rates then terrorism ever could?


Some conservatives say that the number is 11 million, but the number of uninsured, either by choice or due to lack of money is around 30 million. Taking the conservative guess of 11 million, what is your solution for their healthcare? Do they deserve help even?

[steelish]

There has been such a huge noise about public healthcare recently, and it would be nice for the people so opposed to it to give some sort of solution to the problem of so many uninsured, rather then talk about how the government is turning some sort of communist regime. Public healthcare might not work for US, but now that the debate is on the table, the only thing I've heard from the right is why it can't be done, and nothing else.

Here's an idea...how about if the government covers ONLY the uninsured? As with welfare, once you have employment and can be covered that way, they can take the person off the government run program. That way, those of us who are happy with what we have can be left alone.

What's the point of spending billions to protect Americans through military means if Cancer, heart disease, or some other sickness can kill them at higher rates then terrorism ever could?

You make it sound as if you believe America has the highest rate of deaths from cancer, heart disease, or other sicknesses. Nothing could be further from the truth.

Some conservatives say that the number is 11 million, but the number of uninsured, either by choice or due to lack of money is around 30 million. Taking the conservative guess of 11 million, what is your solution for their healthcare? Do they deserve help even?

You just said it yourself...by CHOICE! That is the only reason the number jumps higher. Why include that number? Why force someone to get health insurance if they don't want it?

I know what you will say. It's for their own good. It's for the good of others because if they had health insurance, they would get care when needed, etc. However, how is that any different than forcing someone to stop smoking? How about if you stood behind someone who was overweight and forced them to run on the treadmill and monitored their eating? That would be well and good if someone WANTED that done to them, but if they didn't, it would be akin to slavery.

[MMI]

From the BBC: The government in Finland has become the first in the world to say it intends to phase out smoking completely.

Anti-tobacco laws are being tightened in what anti-smoking campaigners have called a war on the cigarette industry.

Paul Henley reports from Helsinki: http://news.bbc.co.uk/1/hi/world/europe/8458347.stm

[MMI]

Scenario 1: Mr Blobbo and I belong to a state run healthcasre system. We both pay our compulsory contributions. Mr Blobbo has a heart attack. The healthcare system treats him while his contributions and mine go towards defraying the cost.

Scenario 2. Mr Blobbo and I live in a country with no compulsory healthcare provision. Blobbo chooses to have expensive health insurance because he knows he runs a high risk of heart disease. I, being more confident and apparently more healthy, exercise my choice not to make any provision. One day, while out jogging, I am hit by a truck and am badly injured. Not only do I need immedate surgery requirning shattered bones to be pinned, blood transfusions and a long period of recouperation, but I must pay visits to hospital for the rest of my life for checkups and painkilling injections. I've got no money, so who pays?

Wonder how Mr Blobbo feels about that.

[steelish]

Sorry MMI, I'll still go with scenario #2.

I have my beliefs and my values, and I won't change on that. I foresee an America in which the government tries to control every aspect of our lives, because they will be "responsible" for our healthcare. Things might not have gone like that in your wherever you live, but in the U.S., with the corruption we have and the politicians making statements like; "We know what is best for them. They don't know what they want." Things will get really bad, very quickly. Anyone who thinks otherwise has their head in the sand...in my opinion.

[MMI]

I don't believe US politicians are any more corrupt than those of any other Western country, and neither should you.

I'm left wondering whether it's worse to have my head in the sand (in your opinion) or to suffer from paranoid distrust of the people you put in power by virtue of a democratic system you cleave to (in my opinion).

I belong to the first category of people because I consider that we have sufficient checks and balances in the UK to make sure that the "very bad" situation you dread is almost certain never to come about, and that's in a class-ridden country with an aristocracy which still controls the nation through its economy, regardless of what Parliament thinks, and where corruption is sanitised through the "Old Boy Network". If we have sufficient checks, then so have you.

[steelish]

I belong to the first category of people because I consider that we have sufficient checks and balances in the UK to make sure that the "very bad" situation you dread is almost certain never to come about, and that's in a class-ridden country with an aristocracy which still controls the nation through its economy, regardless of what Parliament thinks, and where corruption is sanitised through the "Old Boy Network". If we have sufficient checks, then so have you.

But we DON'T have sufficient checks. Our Congress right now is not a balanced mix, it is heavily left wing. We need a equal number of left and right to maintain a balance.

[Thorne]

But we DON'T have sufficient checks. Our Congress right now is not a balanced mix, it is heavily left wing. We need a equal number of left and right to maintain a balance.

The constitutional checks and balances are between segments of the government, not between political affiliations. I would say, though, that the right didn't have any concerns about maintaining balance when the Congress was heavily right wing. Let's face it. Neither side will be happy if the other side has control. What frightens me is when, like now, the Congress and the President are from the same side. That tends to corrupt one of the constitutional balances.

[steelish]

Ah, but there is very much a balance between political affiliations.

Our government was founded on the idea of People's Law and our founders struggled hard to find the balanced center. In fact, the wings on the eagle which is the seal of the United States of America symbolizes the balance. The left wing refers to the Problem-Solving Wing (the Democrats) while the right wing refers to the Conservation Wing (the Republicans).

Those who represent the left wing of the eagle (i.e., the Democrats) are sensitive and compassionate to the unfulfilled needs of the people. They dream of elaborate plans to solve these problems.

Those who represent the right wing...or the Republicans, have the responsibility of conserving the nation's resources and the people's freedom. Its function is to analyze the programs of the left wing with two questions; First, can we afford it? Second, what will it do to the rights of the people?

So you see, political affiliations have a lot to do with the balance of our nation.

[DuncanONeil]

The patient in question, who paid cash not insurance, reported the charge for the procedure was $3,000. A doctor conversing with the patient reported that said procedure is reimbursed by Medicare at $1,000. Actually the doctor person inferred $3,000 based on a cash patient, confirmed by the patient, and then followed up with the Medicare payment.

Again in this case there was no insurance involved!

I thought you were comparing what Canada's public system is doing, I'm not surprised the current US system is messed up.

As for $3000 cost to user vs Medicare pays $1000, I'd like to see actual data on what the procedure costs, compared to what the doctor is deciding to charge for it. This could easily be an example of price inflation that is typical when people's costs are covered by private insurance.

[DuncanONeil]

Here's an idea...how about if the government covers ONLY the uninsured? As with welfare, once you have employment and can be covered that way, they can take the person off the government run program. That way, those of us who are happy with what we have can be left alone.
You just said it yourself...by CHOICE! That is the only reason the number jumps higher. Why include that number? Why force someone to get health insurance if they don't want it?

I can see that you understand the fallacy here. Many of the uninsured CHOOSE to not have insurance. A significant portion do not need insurance. Even the plans Congress is demanding only solve the insurance problem for less than half the people THEY say are uninsured.

Why does everyone that supports this mess of a plan think this is the only way to change the status quo? Why is it that these same people have not heard of the other options?