Campaign for Liberty: America's Socialized Medicine

[SnyderShrugged]

http://www.campaignforliberty.com/article.php?view=172

somewhat long, but very insightful article from an MD. Does well in describing how Federal Involvement in health care since the late 60's had a large impact on the accelerated costs.

America's Socialized Health Care
By Lawrence Wilson, M.D.
Published 08/17/09


Health-care systems in most developed nations are in financial trouble. Health benefits are being cut back because of exploding costs. Degenerative illnesses such as diabetes and cancer are at epidemic levels in spite of new drugs and treatments. While doctors, politicians, and insurers blame each other, they rarely mention the real problem.

Skyrocketing costs are due to the structure of health care in all these nations. All are mainly socialized, including America's. This means they operate as top-down bureaucracies, out of touch with people's real needs. Almost no market forces are allowed to operate for rational decision-making and cost control.

The results are predictable. In 2002, America spent $1.6 trillion on health care, up 9.3 percent from 2001. Drug costs increased 15.3 percent while hospital costs increased 9.5 percent. Out-of-pocket costs, the most market-related, declined.

A graph plotting the percentage of government payment for health care with the total cost of health care would turn almost vertical after the passage of Medicare and Medicaid in 1967.

America really has three health-care sectors. The socialized part or government sector comprises about 65-70 percent and includes Medicare, Medicaid, and the Indian Health Service. It also include the Department of Veteran Affairs, the Public Health Service, programs such as KidCare, and the bulk of medical research. The latter includes the National Institutes of Health, National Cancer Institute, National Heart Institute, and about 30 other government institutes. The "donors" for research in these institutes have little say over what or how wisely their health-research dollars are spent.

All the above are funded from taxes confiscated from the people at the point of a gun, making this a less-than-compassionate system. All are insulated from the health-care marketplace and thus from rational decision-making. All are run as huge bureaucracies, with their inherent problems of fraud and high administrative overhead. Medicare rules alone are 133,000 pages in length. This makes the 10,000-page income-tax code look like a model of simplicity.





**click link for rest

[Thiebear]

i have no issue with what he says...



Personal responsibility

The biggest problem with the drug-medicine cartel is that drugs and surgery do not prevent disease, do not address deep causes of disease, and do not make people healthy. They mainly suppress symptoms. According to the American Public Health Association, 48 percent of the determinants of disease are now due to "behavioral lifestyle," 25 percent are due to genetic constitution, 16 percent to the environment, and only 11 percent are due to lack of access to medical care. Often drugs make people sicker, which only adds to the cost. Malpractice lawsuits due to harm from the system add even more cost.

According to a recent article in the Journal of the AMA, modern medicine is the fourth leading cause of death in America, just behind cancer, heart disease, and strokes. This study only included deaths that occurred in hospitals. The Nutrition Institute of America just completed the first broad survey of the side effects of drug medicine.

It found that adverse drug effects and medical errors account for some 669,000 deaths, making drug medicine the leading cause of death in America. (See www.nutritioninstituteofamerica.org.) Instead of giving poisons, other healing systems balance body chemistry, correct spinal abnormalities, detoxify the body, or alter subtle electrical or vibrational imbalances in the body.


that seems really high.

[PokerPacker]

breaking up the cartel is a tough thing to do.

[alexey]

Market forces will try to maximize profit. Maximizing profit will not necessarily lead towards acceptable health care system unless incentives are set up specifically to that end.

[SnyderShrugged]

Market forces will try to maximize profit. Maximizing profit will not necessarily lead towards acceptable health care system unless incentives are set up specifically to that end.

In a true free market (which is nothing close to what we have now, as referenced in the article), profit maximization will only come through customer satisfaction. The balance between those two is what helps a market self regulate. The companies that can maximize that satisfaction and quality will therefore draw and retain customers from those that dont.

[Prosperity]

You are going to have a very hard time convincing me that "the National Institutes of Health, National Cancer Institute, National Heart Institute, and about 30 other government institutes" should be desposed of out of some generic taxation is slavery argument. Furthermore the ONLY evidence it cites against these research institutions is that they are bureaucracies (without actually detailing why those bureaucracies fail in the NIH for example) and the fact that cancer rates have gone up, and the title of one AMA journal. It ignores all the basic research that those institutions do which are then allowed to be used by any other institution including the private sector. I'm sorry but that's just ideological hackery. And to claim that none of the decisions made in those institutions is rational is just ignorant. There are pretty stringent reviews of grants given out, and they aren't just given out willy nilly, scientists have to compete for those grants with each other by writing the best research proposals and proving they are capable of solid research. Out of the things government funds this is by far one of the most beneficial things.

[SnyderShrugged]

You are going to have a very hard time convincing me that "the National Institutes of Health, National Cancer Institute, National Heart Institute, and about 30 other government institutes" should be desposed of out of some generic taxation is slavery argument. Furthermore the ONLY evidence it cites against these research institutions is that they are bureaucracies (without actually detailing why those bureaucracies fail in the NIH for example) and the fact that cancer rates have gone up, and the title of one AMA journal. It ignores all the basic research that those institutions do which are then allowed to be used by any other institution including the private sector. I'm sorry but that's just ideological hackery. And to claim that none of the decisions made in those institutions is rational is just ignorant. There are pretty stringent reviews of grants given out, and they aren't just given out willy nilly, scientists have to compete for those grants with each other by writing the best research proposals and proving they are capable of solid research. Out of the things government funds this is by far one of the most beneficial things.




Well it sure doesnt appear that the government financing on the backs of the taxpayer has helped though, does it?

"It has cost taxpayers some $30 billion over a 35-year period. After adjusting for a longer life span, between 1950 and 1989 the incidence of cancer rose by about 44 percent. Breast cancer and colon cancer in men have risen about 50 percent, while some others have risen 100 percent"

[JMS]

Propaganda. The "acceleration" in healthcare costs correspond with Ronald Reagan deregulations of the early 1980's and inviting big business involvement into what was largely a non profit segment of the economy. Reagan did this because he believed big business could run things more effciently than non profits or government agencies. History has proven Reagan was wrong. Big Businesses gift isn't running things more effciently, their gift is making profits, which they have done. Profits by charging more, not by making things work better, did not turn out to be a net benifit for the economy or America. When Reagan turned over our health insurance industry to big buisness healthcare consumed 8% of the economy and was considered out of control. Today it consumes 17% of our economy and is on the verge of bankrupting us.

Looks like there won't be meaningful healthcare reform in Obama's first term in office. That's a tactical victory for the insurance companies. But the winner of the war is still certain. You can fool most of the people some of the time, and some of the people all the time, but you can't fool most of the people all of the time. Insurance companies are parisites on the economy and parisites on American industry. We are either going to reform them, or go bankrupt. We are either going to reform them or loose what little remains of our manufacturing base. Their is no other option.

[SnyderShrugged]

Propaganda. The "acceleration" in the raise of healthcare costs correspond with big business involvement in the insurance agencies.

Looks like there won't be meaningful healthcare reform in Obama's first term in office. That's a tactical victory for the insurance companies. But the winner of the war is still certain. You can fool most of the people some of the time, and some of the people all the time, but you can't fool most of the people all of the time. Insurance companies are parisites on the economy and parisites on American industry. We are either going to reform them, or go bankrupt. Their is no other option.


:doh: still claiming its the insurance companies?

[alexey]

In a true free market (which is nothing close to what we have now, as referenced in the article), profit maximization will only come through customer satisfaction. The balance between those two is what helps a market self regulate. The companies that can maximize that satisfaction and quality will therefore draw and retain customers from those that dont.
Yes, customers that can be served for a profit will indeed be kept in a state that will help maximize their profitability. Unless incentives are set up properly, I do not think that would not lead us to an acceptable situation.

[SnyderShrugged]

Yes, customers that can be served for a profit will indeed be kept in a state that will help maximize their profitability. Which is not going to lead to an acceptable HC system.

you're going in circles.

We are now back to the starting point.

80% of people with active health insurance plans are satisfied with their coverage and plan.

We have an acceptable system, just with some unacceptable details within. All of which do not need to be addressed with a public option and more federal control over our lives.

[JMS]

:doh: still claiming its the insurance companies?

:doh: Still claiming it's not.

[SnyderShrugged]

:doh: Still claiming it's not.


yes. You still havnt provided evidence beyond some loose freedomworks connection that doesnt even exist in reality.

carry on with your myths and fantasy sir!:)

[JMS]

80% of people with active health insurance plans are satisfied with their coverage and plan.

Actualy that's 75%, roughly equivelent to the number of folks who have never had to rely on their health insurance for any kind of serious disability or injury.




We have an acceptable system, just with some unacceptable details within. All of which do not need to be addressed with a public option and more federal control over our lives.

We do not have an acceptable system. We have a horrable system ranked 37th in the industrialized world comparable to some third world country's like Cuba which ranked 39th. We spend twice what the best systems in the world spend and about 100x as much as a comparable system like Cuba.

We do all of this while leaving roughly half the population of the country outside of our commercial healthcare system. 100 million the insurance companies can't make profit off of go to medicaid and medicare, and another 50 million working poor who have no coverage what so ever.

[Prosperity]

Well it sure doesnt appear that the government financing on the backs of the taxpayer has helped though, does it?

"It has cost taxpayers some $30 billion over a 35-year period. After adjusting for a longer life span, between 1950 and 1989 the incidence of cancer rose by about 44 percent. Breast cancer and colon cancer in men have risen about 50 percent, while some others have risen 100 percent"

It is actually very clear that it has helped.

We now have much more information on what causes cancer, and treatments for those that have it. BUT, information on what causes cancer doesn't stop people from smoking cigs, becoming obese, or be any less exposed to cancer causing agents as before. but this is a minor point in the evidence for this authors hack status. Furthermore what about 1989-2009, a 20 year period (the data IS available). If we have been paying for the past 35 years, wouldn't the benefits start appearing later... like I don't know... the past 20 years when the past 35 years of basic research could be applied? You understand that basic research is only applied years after the new information has been understood right? But there is even more obvious bull**** data he includes. Why should we expect any effect in the 24 years after 1950? If we have been funding for the last 35 years the funding wouldn't have started till 1974... 24 years after the start of the data he cites for saying cancer has increased. Why are the past 20 years ignored, and the 24 years before the last 35 included? It reeks of intellectual dishonesty. And I know why he didn't include that data. Since 1930 cancer rates were steadily rising, but starting in the early 1990's the rates for lung, colon and rectal, prostate cancer have steadily decreased (cancer.org). It's pretty obvious why he left those years out... Very intellectually dishonest, but it is not veiled very well so none should be so easily fooled by it.

Frankly, this obvious attempt to hoodwink his readers destroys all his credibility.

[JMS]

yes. You still havnt provided evidence beyond some loose freedomworks connection that doesnt even exist in reality.

carry on with your myths and fantasy sir!:)

You are a dishonest person on this topic. someone who openly lies in the healthcare debate.

It is possible to have an honest disagreement on the value of the evidence, but to continously claim no evidence has been brought to your attention which opposes your position is funidentally untrue, and dishonest.

[Thiebear]

xray technician.

put this on
click
next.

[alexey]

you're going in circles.

We are now back to the starting point.

80% of people with active health insurance plans are satisfied with their coverage and plan.

We have an acceptable system, just with some unacceptable details within. All of which do not need to be addressed with a public option and more federal control over our lives.
Do you acknowledge that there is a conflict of interest between profits and public good in health care?

[skinfan13]

Yes, customers that can be served for a profit will indeed be kept in a state that will help maximize their profitability. Unless incentives are set up properly, I do not think that would not lead us to an acceptable situation. you realize you just argued against capitalism right? what are you, a communist?

either that or your understanding of capitalism is very shaky

[SnyderShrugged]

It is actually very clear that it has helped.

We now have much more information on what causes cancer, and treatments for those that have it. BUT, information on what causes cancer doesn't stop people from smoking cigs, becoming obese, or be any less exposed to cancer causing agents as before. but this is a minor point in the evidence for this authors hack status. Furthermore what about 1989-2009, a 20 year period (the data IS available). If we have been paying for the past 35 years, wouldn't the benefits start appearing later... like I don't know... the past 20 years when the past 35 years of basic research could be applied? You understand that basic research is only applied years after the new information has been understood right? But there is even more obvious bull**** data he includes. Why should we expect any effect in the 24 years after 1950? If we have been funding for the last 35 years the funding wouldn't have started till 1974... 24 years after the start of the data he cites for saying cancer has increased. Why are the past 20 years ignored, and the 24 years before the last 35 included? It reeks of intellectual dishonesty. And I know why he didn't include that data. Since 1930 cancer rates were steadily rising, but starting in the early 1990's the rates for lung, colon and rectal, prostate cancer have steadily decreased (cancer.org). It's pretty obvious why he left those years out... Very intellectually dishonest, but it is not veiled very well so none should be so easily fooled by it.

Frankly, this obvious attempt to hoodwink his readers destroys all his credibility.


He didnt leave those years out, and he didnt cherry pick stats either, like you just did. He referenced all cancer stats and compared them to the costs of Federal funding.

Sorry you dont like it, but thats the way it is. Lots of money thrown at the problem in the traditional way of Federal spending, all to yield little results.

[SnyderShrugged]

Do you acknowledge that there is a conflict of interest between profits and public good in health care?

No, since health care is a product and not a right.

[SnyderShrugged]

You are a dishonest person on this topic. someone who openly lies in the healthcare debate.

It is possible to have an honest disagreement on the value of the evidence, but to continously claim no evidence has been brought to your attention which opposes your position is funidentally untrue, and dishonest.


Oh. OK! LMAO! I'm dishonest now??? whatever jackarse:doh:

[alexey]

you realize you just argued against capitalism right? what are you, a communist?

either that or your understanding of capitalism is very shaky
Capitalism needs to be regulated.

[alexey]

No, since health care is a product and not a right.
Just want to make sure we're on the same page... You'd be okay with people who cannot afford health care to be dying on the streets and such? What about people who thought they were covered but were refused treatment based on fine print?

[JMS]

you realize you just argued against capitalism right? what are you, a communist?

either that or your understanding of capitalism is very shaky

It's like saying you are against capitalism because you think the federal government does a better job of feilding an army paid for out of taxes rather than raising one from scratch when it's needed through local communities and business leaders like we use to do. Our capitalistic society decided it was better to handle defense collectively out of taxes because it was superior than rellying on busness folks like George Washington or Benidict Arnold to raise outfit and field their own units.

Its more like what you understand of the healthcare industry is shakey. The commerical healthcare industry in this country is not capitalism. It's a monopoly. It's a trust which has enjoyed anti trust exemption from the Sherman Act since 1947...

It's a network of 1300 companies which legally calude with each other to avoid competition and ensure raising costs and profits across the industry.

Healthcare isn't an industry which can be effectively served through capitalism, never has been. This is because the machines and expertise are so expensive to accumulate that the folks who benifit directly from them are not able to reimburse the cost of aquiring them, not with or without insurance. So this cost is spread out throughout the entire community, always has been. Hospitals with dialisys machines, MRI machines, heart transplant teams etc are seen as a benifit for the community, not simple a benifit narrowly to their patients. The community pays for these things. We do so in taxes, in $100 bills for asprins, in federal, state, local loans and grants.

The debate is not between capitalism and socialism. The debate is between a heavily regulated federal system geared to benifit big buisness, or a heavily regulated federal system geared to benifit the consumer.

[December90]

Well if health care should be "free" because it is a basic necessity, then what else is a basic necessity? Should we provide free food and clothes and housing to everyone in the U.S.? At what point do we allow for people to be responsible for themselves (in both a positive and a negative way) to the point that they have to pay for the things they want or need.

The biggest problem we have with our Government in general right now is the fact that we have set up so many entitlement programs that we have NO politicians with the ability to stand up and say "NO MORE" if anyone has tried then they stand zero chance of winning an election.

Simply stated: for better or worse, every individual and/or family should be responsible for themselves. It should not be up to the public at large to take care of everyone.

[JMS]

Just want to make sure we're on the same page... You'd be okay with people who cannot afford health care to be dying on the streets and such? What about people who thought they were covered but were refused treatment based on fine print?

Or people who were covered but after they got sick had their insurance premiums raised to a rate which wasn't affordable, or simeple dropped all together.

The system described benifits the insurance agencies, It just doesn't benifit the public.

[alexey]

Well if health care should be "free" because it is a basic necessity, then what else is a basic necessity?
For me a basic necessity is not to have rotting corpses of poor sick people on streets :whoknows:

[Koolblue13]

:doh: Still claiming it's not.

I'm with you, I have no interest in taking responsibility of myself.

Why would I diet and exercise, when I can just take a pill.

[TheLongshot]

Well if health care should be "free" because it is a basic necessity, then what else is a basic necessity? Should we provide free food and clothes and housing to everyone in the U.S.? At what point do we allow for people to be responsible for themselves (in both a positive and a negative way) to the point that they have to pay for the things they want or need.

The biggest problem we have with our Government in general right now is the fact that we have set up so many entitlement programs that we have NO politicians with the ability to stand up and say "NO MORE" if anyone has tried then they stand zero chance of winning an election.

Simply stated: for better or worse, every individual and/or family should be responsible for themselves. It should not be up to the public at large to take care of everyone.

Has anyone argued that healthcare should be free? I think the main thrust of the argument is that healthcare should be within reach of everyone. Considering the way the system currently works, it is a necessity. Arguing that it shouldn't work this way is having your head up in the clouds.

[JMS]

Well if health care should be "free" because it is a basic necessity, then what else is a basic necessity?


That's not the argument. The argument is should you pay for insurance to cover you in case you get sick, or should you pay for insurance because it's profitable for the insurance companies, who can then raise your rates or drop you all together in case you get sick.

The quesiton is, is capitalism / free market a jingoistic concept which we write an a flag and ride off a cliff under, or is it a system of using competition to ensure the consumer gets the best value for his dollar spent.



Simply stated: for better or worse, every individual and/or family should be responsible for themselves. It should not be up to the public at large to take care of everyone.

And again that's not the argument. The poor and elderly have socialized medicine in this country. Medicare and Medicaid. The question is how to contain the costs of a commecial system which services about half the population and which is divoid from competition. Costs in the commerical system, which have been raising at 2.5 times the rate of wages for 30 years.

I would argue this is done by introducing competition into the system. The insurance companies would argue this is done by the federal government sucking up a higher percentage of their expenses.

That's the argument, how best to control costs; and reform an out of control industry.

[JMS]

Capitalism needs to be regulated.


The responsible role of government in a capitalistic marketplace is to ensure competition and safeguard the free market. Since the industrial revolution we have known unregulated markets break down into trusts, and trusts devoid of competition do not benifit society or the nation.

But that's not even what we are talkinga bout here cause the insurance companies aren't capitalism or a free market. They are already a heavily regulated industry which enjoys anti trust exemptions to limit competition and has for more than 60 years.

[JimboDaMan]

you realize you just argued against capitalism right? what are you, a communist?

either that or your understanding of capitalism is very shakyUnrestrained capitalism has never been an unmitigated good. In many areas it MUST be regulated. Profit is a powerful motivator, but we have always regulated it in some ways. We can differ as to the proper amount or methods of that regulation, but regulate we must.

If you're going to sell cupcakes on the street corner, its OK for the market to adjust itself to the comparative value of your cupcakes vs. the guy down the block.

Its not OK to do that with cancer treatments. Its not OK for dead bodies to line up because of worthless meds until the patient community figures out which ones work and which ones do not. Its not OK in a hundred other situations involved with health care.

I'm hoping your "communist" comment is largely in jest, or else your understanding of things is lacking.

[JMS]

I'm with you, I have no interest in taking responsibility of myself.

Why would I diet and exercise, when I can just take a pill.


If I turn on the water fountain and drink from the focite am I not taking responsiblity for myself because I believe the federal regulations protecting the quality of that water are a good thing? Am I a communist or merely a socialist because I believe meaningful regulations play a valuable role in our economy, and industries and have done so for my entire lifetime....

Let's say I take that pill you mentioned in order to loose weight or maintain my health. Am I a communist or a socialist for favoring regulations which ensure that pill will do what I expect it will do and is not be full of dirt, or worse poison?

That's the debate here. If I pay for insurance all my life, should I be able to expect that insurance won't drop me if I get sick, won't raise the rates so I can't afford it if I get sick? Won't raise the rates on my entire small buisness employer to make them fire me if I get sick? Does insurance really serve it's purpose if it doesn't protect one from the financial costs of sickness or injury? These things all happen today. That's what the reform is partially about.

Another part is about competition. Introducing competition to ensure the consumer get's the best value for his money spent. Do we introduce competition by creating a new revenue neutral government entity to draw a line under the insurance companies which will take market share away from them if they raise rates unfairly or drop their services? Or do we introduce competion by relying on branches of the same trust which have been colluding with itself for 60 years to control our marketplace without competition to wake up and actually compete?

Lastly what is a reasonable cost for introducing competition in a segment of the economy which is expected to consume 35 Trillion dollars over the next ten years? Is a trillion dollars too much to pay over a decade to introduce competition into such a industry? or is any price too high? Note we pay $2.4 trillion a year or 17% GDP, and over ten years we are expected to spend $35 Trillion. If the competition effects the growth of healthcare costs even by taking 10% off the growth, it will have paid for itself.

None of that sounds like things an empowered individual could accomplish on his own. Sounds like a good job for the government to involve itself in. After all it's the government involvement which established the anti trust execmptions which created this monster system we have in the first place.

[Prosperity]

He didnt leave those years out, and he didnt cherry pick stats either, like you just did. He referenced all cancer stats and compared them to the costs of Federal funding.

Sorry you dont like it, but thats the way it is. Lots of money thrown at the problem in the traditional way of Federal spending, all to yield little results.

This is blatantly dishonest, or mistaken, or deceitful, or whatever word you want to describe for flat out different than the truth


here is what he said:


An example of the dismal failure of the government sector in America is the "war on cancer," which is administered by the National Cancer Institute. It has cost taxpayers some $30 billion over a 35-year period. After adjusting for a longer life span, between 1950 and 1989 the incidence of cancer rose by about 44 percent. Breast cancer and colon cancer in men have risen about 50 percent, while some others have risen 100 percent. A recent article in the Journal of the AMA was entitled "Are Increasing Five-Year Survival Rates Evidence of Success against Cancer?" The answer was "No."

He cherry picked the only years in which it was rising. He ignored the last 20 years in which the rates have been dropping. If you don't think that is cherry picking you either don't know what cherry picking is, or you are lying about what cherry picking is. Either way next time you want to refute a point give some explanation. Giving no explanation while at the same time saying another person's reasoning, which is explained in detail, is wrong, makes you look either ignorant or dishonest.

The incidence of cancer has dropped since 1989
The exact years that he leaves out

[JimboDaMan]

I'm with you, I have no interest in taking responsibility of myself.

Why would I diet and exercise, when I can just take a pill.Not sure what that means. If there really was a pill that would take the place of diet and exercise I'd be there in a heartbeat, free up that time and effort to do other things.

[Mad Mike]

In a true free market (which is nothing close to what we have now, as referenced in the article), profit maximization will only come through customer satisfaction. The balance between those two is what helps a market self regulate. The companies that can maximize that satisfaction and quality will therefore draw and retain customers from those that dont.

In a true free market as you would have it , insurance companies would be charging whatever they want and denying coverage because there would be no choice when all of the insurers are doing the same thing.

SS has admited he works for an insurance company. We also know he is willing to blindly follow his ideology off of any cliff. He has three threads on the subject on the first page. At what point does it become spamming?

Oh, and back in the real world where not everyone who is sick brought it on themselves.... :doh:

I found this letter on another site:


Let me give you this one from a UK citizen perspective. I am a Type 1 Diabetic and was diagnosed 7 years ago. Here is the care that is provided to me. *Free prescriptions for the 8 different medications & supplies I need. Phone up Doctor,ask for Prescription, pick up from Pharmacy - Done. *About 4 visits to my Doctor each year (who I was able to choose, based on his experience with Diabetic patients) plus telephone calls whenever I need to. *Check ups with a consultant at local Diabetic & Endocrinology centre every 6 months. Also available by telephone or email any time I need them. *Last month I had an MRI scan for evidence of peripheral neuropathy. Last year I was hospitalised on a precaution with severe Tonsillitis, I was immediately given a private room with a TV, stayed for a week and was very well looked after. Not one penny changed hands at any point in all the care I have received, at every level the facilities have been excellent, the staff courteous, and they listen and are responsive. Contrast this with my one experience of private insurance. After I was diagnosed, I called BUPA, a UK private insurer, to see if it would be worth taking out a policy. I was told that they would not cover my pre-existing condition, but would cover everything else. Knowing that they would do everything in their power to prove that any problem I had would be linked back to diabetes, I said thanks but no thanks. The opposition to socialised medicine, as seen from this side of the Atlantic, is so absurd I barely know where to start. Yes I pay taxes to get this care, but better that than putting it through some faceless corporation that values it's shareholders more than me. You pay taxes for police, fire department, roads, schools, why on earth is healthcare, a basic necessity for everyday life, the exception? The only reason is entrenched interest and ignorance. By all means argue about how it's run (it's not like the NHS doesn't have problems, it does) but don't argue that it doesn't work when every other major industrialised nation does it, and wouldn't swap systems with the US in a million years.

Bottom line. Insurance companies are "death pannels" who decide who live and dies, who is covered, who is not, and how much it costs... ALL ACCORDING TO PROFIT.

[Baculus]

Skyrocketing costs are due to the structure of health care in all these nations. All are mainly socialized, including America's. This means they operate as top-down bureaucracies, out of touch with people's real needs. Almost no market forces are allowed to operate for rational decision-making and cost control.

**click link for rest

I found this paragraph difficult to swallow, because all other nations are controlling costs better than the US. If cost "skyrocketing" in other nations, it is absolute exploding here in the US. Also, all other nations do NOT have a socialized health care structure. The UK? Yes. France, Germany, Switzerland? No, they do not. A single-payer system itself does not signify socialized medicine (even if that term is very loosely used in many circumstances), and a publicly funded universal system does not always mean as much. Right off the bat, the "socialized medicine" bugaboo is wielded. "Socialized medicine" is blamed when the private sector has been primarily responsible for such cost increases. That's why the US's per-capita spending has risen by more than 2x compared to our "socialized" neighbor, Canada.

It doesn't help his case when he uses hyperbole such as, "All the above are funded from taxes confiscated from the people at the point of a gun, making this a less-than-compassionate system." No, in fact, taxes for "all of the above" are NOT confiscated at the point of the gun. We may all resist taxes to a degree -- at one point, I supported the dismantling of the IRS -- but the provisioning of a public function is not an Orwellian paradigm.

His section on cancer isn't very convincing when he attempted to imply that cancer research is somehow related to increased rates. There are a lot of reasons for increased cancer rates, but the research itself isn't one of them (unless a certain unnamed procedure is responsible for these increased rates).

Continuing in the article, this section was a bit befuddling: "The so-called private sector of American health care is better termed the regulated sector. It includes insurance companies, HMOs, and licensed pharmacists and physicians. To receive any government reimbursement they must "play by the rules" imposed by the socialized sector. As a result, this sector is mainly an extension of the socialized sector." This is not a very strong argument: Most physicians are private physicians, but of course they will have to play by government rules when it comes to Medicare and Medicaid.

This author, with the following paragraph, provides us with a hint of his anarcho-capitalist tendencies: "Medical schools also receive government subsidies and grants. This means that what is taught is influenced if not dictated by these funding sources. Physicians are regulated by state licensing boards and, of course, must abide by Medicare and HMO regulations if they choose to work in those settings. To call any of these aspects of the health-care system 'private' is a joke." So, in his esteem, medical schools should not receive any grants; if medical students thought educational costs were high now, just think of the costs if federal grants were not used. Furthermore, color me unconvinced that medical licensing is unneeded; I just do not believe that a wild and woolly unregulated and unlicensed medical sector is the fix for our problems. Do we want to deregulate other fields as well? What about plumbers, electricians, or anyone in a host of other sectors?

In the next breathe, though, he is condemning the AMA as a controlling cartel (while mentioning that "thousands of Americans flee each year to Mexico and Europe to obtain products and therapies banned in the United States but in use for as many as 50 years elsewhere"). His criticisms of the AMA may be justified, but that particular organizations it is not a government agency.

So what is his cure for all the problems he touches upon this article? Deregulation. Yes, he complains about a monopoly by the AMA, so his suggestion is to make it easier for monopolies to form by the means of deregulation. From the start, I am not sure if I agree with his main premise: "Whenever an industry becomes mired in special-interest rules, deregulation is the answer." Yes and no. Government can certainly become a conduit for business via special interest groups, i.e., lobbyists, PACs, and so forth. We see this problem in many industries. But deregulation will not eliminate this -- in fact, from what we have seen from the experience of deregulation, it can make it worse. What do you think affected the housing market? What led to the the California energy crises, which involved Enron?

Now, I agree that "for her first 120 years, America had a true free-market health-care system free of government interference" and "competition between many kinds of practitioners kept prices low -- people paid for exactly what they wanted. Our health statistics ranked first in the world," but this was true even after some regulations were implemented. And in spite of such regulations, health care profiteering has skyrocketed while American health care rankings has dropped.

How is the market going to restore order and why, then, are these aforementioned problems the fault of the US government? How come I get the feeling that he is avoiding the elephant in the room, which is a for-profit industry which is more concerned with the bottom line as opposed to "whoever helped people the most prospered," as he says in his article?

So what is the cure to his diagnosis? "Deregulation in health care would have to be a two-part affair of (1) eliminating government regulation and government involvement; and (2) eliminating the control of the medical cartel."

More deregulation. Even though such deregulation, in the modern age of corporate power, will not decrease their power. Returning to the 19th century, if you ask me, is not a salve for the problems which he outlined. Especially when he declares, in the next breath, "It found that adverse drug effects and medical errors account for some 669,000 deaths, making drug medicine the leading cause of death in America."

Yeah, so what is the response? DEREGULATE!

¡Ay, caramba!

Now, I don't totally disagree with his solution, which is that "prevention is hundreds of times less expensive than treating a condition when it has fully developed," along with his assertions that personal responsibility and our lifestyles must be addressed. That is fine, and all of this can be assumed without regulation or deregulation. And that "health is never a commodity that can be bought and sold, doled out to the poor or guaranteed by a government agency," even though it is "bought and sold" and "doled out" by the anarcho-free market which he espouses.

What is his final, end-game analysis? "There is no market failure." Of course, I must add that this article was written in 2004, so I am not sure how he feels about today's market, but there is evidence of a "market failure" in this decade. And he again espouses the virtues of deregulation while asserting that "the American people would be much better off" with such deregulation.

Would we? What is his evidence? From examples of medicine from over a century ago, from the good old days of the 19th century? He adds to his analysis with, "Instead of the FDA, several competing consumer rating groups would do far more to protect the American people than the current system." So we would depend on "consumer rating groups" to ensure our food and drugs are safe?

That doesn't make me feel more secure.

And finally, in the end, he re-asserts that "American health care is only slightly less socialized than the single-payer systems of Europe and Canada. No wonder costs are out of control. Deregulating health care would benefit all Americans and restore a crippled system to sanity." The problem is, this doesn't jive with the reality of the three systems -- the US system has little in common with those single-payer systems, all of which are able to deliver health care at a more efficient rate.

I just fail to see how deregulation, across the board, is going to help the situation.

[Baculus]

In a true free market as you would have it , insurance companies would be charging whatever they want and denying coverage because there would be no choice when all of the insurers are doing the same thing.

Exactly.


Bottom line. Insurance companies are "death pannels" who decide who live and dies, who is covered, who is not, and how much it costs... ALL ACCORDING TO PROFIT.

Spot on analysis.

[TheLongshot]

So what is his cure for all the problems he touches upon this article? Deregulation. Yes, he complains about a monopoly by the AMA, so his suggestion is to make it easier for monopolies to form by the means of deregulation. From the start, I am not sure if I agree with his main premise: "Whenever an industry becomes mired in special-interest rules, deregulation is the answer." Yes and no. Government can certainly become a conduit for business via special interest groups, i.e., lobbyists, PACs, and so forth. We see this problem in many industries. But deregulation will not eliminate this -- in fact, from what we have seen from the experience of deregulation, it can make it worse. What do you think affected the housing market? What led to the the California energy crises, which involved Enron?

Or telecom companies.

http://news.cnet.com/8301-1035_3-10307726-94.html

[JMS]

It doesn't help his case when he uses hyperbole such as, "All the above are funded from taxes confiscated from the people at the point of a gun, making this a less-than-compassionate system." No, in fact, taxes for "all of the above" are NOT confiscated at the point of the gun. We may all resist taxes to a degree -- at one point, I supported the dismantling of the IRS -- but the provisioning of a public function is not an Orwellian paradigm.


I think the point was that what was being called a free market solution is itself a heavily regulated solution.



Continuing in the article, this section was a bit befuddling: "The so-called private sector of American health care is better termed the regulated sector. It includes insurance companies, HMOs, and licensed pharmacists and physicians. To receive any government reimbursement they must "play by the rules" imposed by the socialized sector. As a result, this sector is mainly an extension of the socialized sector." This is not a very strong argument: Most physicians are private physicians, but of course they will have to play by government rules when it comes to Medicare and Medicaid.


Well think of that for a moment. States say who can call themselves a doctor and who can't. Being a doctor in Virginia doesn't mean you can call yourself a doctor in Texas, Florida, or California. There are steep and artificial barriers for doctors to move their practices. Again the point is our current system is heavily regulated.




Now, I agree that "for her first 120 years, America had a true free-market health-care system free of government interference" and "competition between many kinds of practitioners kept prices low -- people paid for exactly what they wanted. Our health statistics ranked first in the world,"


I don't think that coorolation existed. from 1776-1900 medical science could be effectively practiced from a horse drawn wagon. They didn't have anesticia for medical operations, they didn't have antibiotics, and they barely had a concept or what caused infections.

I wouldn't catagorize the US system in this time period as the model for the world, or first in the world by a long long measure. We were a third or second world country for most of this period.

We got the best medical system in the world after WWII when Europe was trashed and frankly we advanced. We federally funded an entire generation of doctors via the GI bill and other federal programs; and we were on the cutting edge of innovation too in how governments could help partner with private industry to create good healthcare.

This all changed in the early 1970's when scandinavian countries started experimenting with universal coverage systems. Since that time we have lost our #1 ranking and today we rank down near 37th in the world in healthcare delivery.



I just fail to see how deregulation, across the board, is going to help the situation.

Some folks believe the government is the root of all evil. Minimize the Government and you minimize the evil. What these folks don't understand is the government minimizaiton isn't really an option. The government already plays a central role and if you don't make use the the gov tool, then the other side will.

Which is exactly what has happenned in healthcare since the smaller government folks have come to power.

[SnyderShrugged]

Just want to make sure we're on the same page... You'd be okay with people who cannot afford health care to be dying on the streets and such? What about people who thought they were covered but were refused treatment based on fine print?

There arent people "dying in the streets" Thats a typical fear tactic that adds no value to the debate.

For people who thought they were covered because they didnt understand their coverage, I feel sad for them, but in the end it was their responsibility to understand their coverage before they agreed to purchase it.

now that said, I think it's the insurance company's responsibility to provide as much clear information about coverage to their suscribers as human;y possible. I can only speak for the company i work for, but we have had a 5 year push to provide easy guidance to the consumer in order to help them make the best insurance decisions possible. We provide explanations of benefits documents at inception as well as along the way to our members. We also set up booths in stores to explain how things like medicare advantage works and hold monthly forums and Q & A's for our members who have ongoing questions. These things, coupled with a rigorous consierge service, customer service hotlines and other projects provide the members with much more information than was typical in the years of the past. There really isnt any reason a consumer must go uninformed in this day and age.

[SnyderShrugged]

In a true free market as you would have it , insurance companies would be charging whatever they want and denying coverage because there would be no choice when all of the insurers are doing the same thing.

SS has admited he works for an insurance company. We also know he is willing to blindly follow his ideology off of any cliff. He has three threads on the subject on the first page. At what point does it become spamming?

Oh, and back in the real world where not everyone who is sick brought it on themselves.... :doh:

I found this letter on another site:



Bottom line. Insurance companies are "death pannels" who decide who live and dies, who is covered, who is not, and how much it costs... ALL ACCORDING TO PROFIT.

Mike, you obviosuly do not understand the fundamentals of a free market. If it's insurance company collusion that you fear, well thats understandable. But collusion is illegal already and if that fear is true, then wouldnt simply enforcing collusion and price fixing laws be the best manner to protect the consumer?

I want to try and stay civil with you, but I don't give a rats behind if you are upset at threads i take part in or start. take it up with a mod if you feel I have acted outside the boundaries of the rules.

Not sure where you believe I have ever believed the sick "brought it on themselves". I formally challnge ypou to show where I have said anything of the sort.

lastly, Please note, i havnt been involved in any of the "death panel" discussions. I honestly think thats a distractor debate point from both sides of the debate. Please steer your points regarding that towards someone who actual;ly took part in the discussion about it.

[alexey]

There arent people "dying in the streets" Thats a typical fear tactic that adds no value to the debate.
I asked you a question that you failed to answer. Let's try again.

1) What do you think should happen to people who cannot afford health care?

2) What do you think should be done about people that have a chronic condition that would prevent them from being able to purchase health insurance?

[SnyderShrugged]

I asked you a question that you failed to answer. Let's try again.

1) What do you think should happen to people who cannot afford health care?

2) What do you think should be done about people that have a chronic condition that would prevent them from being able to purchase health insurance?


people who cannot afford health care are elligible for midicare currently, I believe.

I have no problem with the truly poor and unable to afford insurance using the tools already available.

What I do have aan issue with is that many of the so-called uninsured are that way out of personal choice and priorties. I don't beleive they should be covered by the taxpayer, yet I also believe that we should respect their choice, as is their right.

believe it or not, I actually support covering of pre-existing conditions. And to be blunt, so does the health insurance industry who is not fighting that provision at all.

[JMS]

There arent people "dying in the streets" Thats a typical fear tactic that adds no value to the debate.


There are literally millions of people who die because they can't afford or are denied healthcare in this country. That's reality.



For people who thought they were covered because they didnt understand their coverage, I feel sad for them, but in the end it was their responsibility to understand their coverage before they agreed to purchase it.


Problem with that statement is the terms of your coverage can be changed as quickly as your health can change. If you work for a small business like Most Americans do you are at the mercy of the health insurance company to cover your bills if you get sick.




now that said, I think it's the insurance company's responsibility to provide as much clear information about coverage to their suscribers as human;y possible. I can only speak for the company i work for, but we have had a 5 year push to provide easy guidance to the consumer in order to help them make the best insurance decisions possible. We provide explanations of benefits documents at inception as well as along the way to our members. We also set up booths in stores to explain how things like medicare advantage works and hold monthly forums and Q & A's for our members who have ongoing questions. These things, coupled with a rigorous consierge service, customer service hotlines and other projects provide the members with much more information than was typical in the years of the past. There really isnt any reason a consumer must go uninformed in this day and age.

And when folks get really sick or age your company raises their rates until they can't pay, or just drops them all together. Then they loose their insurance and when that happens all their conditions become pre-existing and won't be covered by any insurance company even if they can find a new policy.

Information only helps if the system isn't already stacked against the consumer.

[Baculus]

I think the point was that what was being called a free market solution is itself a heavily regulated solution.

It is two sides of the coin: Both an regulated and unregulated market can lead to bureaucratic power structures and monopolies. We often have a fetishized ideal of the free market which may not resemble reality, especially with the rise of larger corporations in health care insurance provisioning.

What he doesn't really address, in this article, is the problem with people's ability to pay for the costs of health care.


Well think of that for a moment. States say who can call themselves a doctor and who can't. Being a doctor in Virginia doesn't mean you can call yourself a doctor in Texas, Florida, or California. There are steep and artificial barriers for doctors to move their practices. Again the point is our current system is heavily regulated.

Sure. That seems like the sort of area where deregulation may be needed. It makes sense. Of course, that is probably a better example then anything he described in he article.


I don't think that coorolation existed. from 1776-1900 medical science could be effectively practiced from a horse drawn wagon. They didn't have anesticia for medical operations, they didn't have antibiotics, and they barely had a concept or what caused infections.

Right. That's why our modern interweb of medicine is needed. Regulation unto itself doesn't create a modern medical "superstructure," but government assistance, in the form of funding, can certainly help.


I wouldn't catagorize the US system in this time period as the model for the world, or first in the world by a long long measure. We were a third or second world country for most of this period.

We got the best medical system in the world after WWII when Europe was trashed and frankly we advanced. We federally funded an entire generation of doctors via the GI bill and other federal programs; and we were on the cutting edge of innovation too in how governments could help partner with private industry to create good healthcare.

All good examples of federal involvement in the American health industry, especially post-1945.


This all changed in the early 1970's when scandinavian countries started experimenting with universal coverage systems. Since that time we have lost our #1 ranking and today we rank down near 37th in the world in healthcare delivery.

It reminds me of the decline of our educational system.


Some folks believe the government is the root of all evil. Minimize the Government and you minimize the evil. What these folks don't understand is the government minimizaiton isn't really an option. The government already plays a central role and if you don't make use the the gov tool, then the other side will.

Which is exactly what has happenned in healthcare since the smaller government folks have come to power.

Precisely. Progressives want good governance, to make it effective if we're going to have it. Some conservatives complain of bad government, do little to improve it, and wonder why it's a self-fulfilling prophecy. "Government is evil!" OK -- so why are you in it? Are you part of the problem or the solution?

I now consider myself to be a progressive libertarian -- if we are going to have government, let's make it as effective as possible, whatever its size. Whether it is on the local, county, state, or federal level, let's make it work. Simply agitating for its demise does none of that.

[SnyderShrugged]

There are literally millions of people who die because they can't afford or are denied healthcare in this country. That's reality.



Problem with that statement is the terms of your coverage can be changed as quickly as your health can change. If you work for a small business like Most Americans do you are at the mercy of the health insurance company to cover your bills if you get sick.




And when folks get really sick or age your company raises their rates until they can't pay, or just drops them all together. Then they loose their insurance and when that happens all their conditions become pre-existing and won't be covered by any insurance company even if they can find a new policy.

Information only helps if the system isn't already stacked against the consumer.


1. I have never seen actual stats that support your claim the "Millions die because they cant afford insurance or are denied care". Why havent they enrolled in medicare or medicaid? No health care provider is legally allowed to deny care due to inability to pay, its a fact.

2. Coverage cant be changed legally in the middle of a plan year, another fact. rates also cannot be raised in the middle of a plan year. Another fact. People arent randomly "dropped" from coverage unless they lied at inception or broke the rules via fraud attempts. it's illegal.

3. Obviously, the average consumer doesnt agree since 80% like their plans. Also, I already pointed out that covering pre-ex was actually part of the reform proposals that the industry itself put forth. There is nothing to be angry about in regards to reforming pre-ex coverage. Everyone agrees already.

[TheLongshot]

people who cannot afford health care are elligible for midicare currently, I believe.

I don't think so. I just went through the eligibility quiz on their web site and tried to give the right answers to trigger that and it pretty much says that I'm eligible when I get to retirement age.


I have no problem with the truly poor and unable to afford insurance using the tools already available.

Well, the tools that seem to be available are non-profit clinics that cater to that demographic and emergency rooms. That doesn't exactly give me the warm-and-fuzzies if I'm uninsured.

Interesting in my search that I found articles saying that some stimulus money went to some of these clinics:

http://seattletimes.nwsource.com/html/nationworld/2009396339_apstimulushealthclinics.html?syndicatio n=rss


What I do have aan issue with is that many of the so-called uninsured are that way out of personal choice and priorties. I don't beleive they should be covered by the taxpayer, yet I also believe that we should respect their choice, as is their right.

Course, if a pandemic happens because of something like this, it doesn't affect you, right? :silly:

To back down slightly to something a little more every day, you don't mind paying the bill for Emergency Room care for the uninsured? Not to mention that if you have a real emergency, you still have to deal with the crowds that don't have an emergency.

http://www.nytimes.com/2008/12/09/business/09emergency.html

[SnyderShrugged]

I don't think so. I just went through the eligibility quiz on their web site and tried to give the right answers to trigger that and it pretty much says that I'm eligible when I get to retirement age.

So there already is a mechanism to protect those that cant truly afford health insurance in place. Why not work with that system to reform rather than these costly proposals?



Well, the tools that seem to be available are non-profit clinics that cater to that demographic and emergency rooms. That doesn't exactly give me the warm-and-fuzzies if I'm uninsured.

warm fuzzies or not, it cant be debated that the uninsured have an avenue for care. Not exactly forced death in the streets.

Interesting in my search that I found articles saying that some stimulus money went to some of these clinics:

http://seattletimes.nwsource.com/html/nationworld/2009396339_apstimulushealthclinics.html?syndicatio n=rss



Course, if a pandemic happens because of something like this, it doesn't affect you, right? :silly:

havnt seen a lot of pandemics around here, and honestly, I doubt any proposed refrom would address the hell that would happen should one occur.

To back down slightly to something a little more every day, you don't mind paying the bill for Emergency Room care for the uninsured? Not to mention that if you have a real emergency, you still have to deal with the crowds that don't have an emergency.

http://www.nytimes.com/2008/12/09/business/09emergency.html

I'd rather foot the bill for occasional ER visit and clinic use than absorb the high costs of the proposed plans and the loss of liberty and choice that will ultimately be present.

[JMS]

It is two sides of the coin: Both an regulated and unregulated market can lead to bureaucratic power structures and monopolies. We often have a fetishized ideal of the free market which may not resemble reality, especially with the rise of larger corporations in health care insurance provisioning.

What he doesn't really address, in this article, is the problem with people's ability to pay for the costs of health care.


Agreed.




Sure. That seems like the sort of area where deregulation may be needed. It makes sense. Of course, that is probably a better example then anything he described in he article.


Yeah but nobody is talking about that type of deregulation because that works for all parties concerned. If you deregulated the state enclaves and let doctors live and practice anywhere in the country you would have 1/3 of all the doctors in Florida and Southern California and nobody in the midwest.

Probable one reason why they created the state enclaves in the first place. Doctors are an important resource everybody needs them.




Right. That's why our modern interweb of medicine is needed. Regulation unto itself doesn't create a modern medical "superstructure," but government assistance, in the form of funding, can certainly help.


[quote=Baculus;6643025]
It reminds me of the decline of our educational system.


Yep I agree, Americans in the 1960's and early 70's expected to be the best in everything. Best elementary education, best highway system, best train system, best air trafic control system and best Healthcare system....

What happenned? We got arrogant. We decided we had all the answers and couldn't benifit from anybody elses ideas. So we began slipping behind other more innovative countries and then failed to reform ourselves as the rest of the world has done. That's how we went from best in the world to second/third world programs in many of these segments. We stopped learning and we dismiss proven ideas which could help us just because other folks thought of them first.



Precisely. Progressives want good governance, to make it effective if we're going to have it. Some conservatives complain of bad government, do little to improve it, and wonder why it's a self-fulfilling prophecy. "Government is evil!" OK -- so why are you in it? Are you part of the problem or the solution?


Agreed.




I now consider myself to be a progressive libertarian -- if we are going to have government, let's make it as effective as possible, whatever its size. Whether it is on the local, county, state, or federal level, let's make it work. Simply agitating for its demise does none of that.

As a conservative republican most of my adult life who first voted democratic in the 2004 Presidential election; I agree with you. We need new Ideas and we need to demand we get value for all the money our governemnt spends. We also need to hold our elected leaders accountable. I don't even call myself a conservative anymore. I'm definitely a liberal. A progressive Liberal.

[MurrayH81]

There arent people "dying in the streets" Thats a typical fear tactic that adds no value to the debate.
.

How about the phrase - People who are denied care they need because they cannot afford it or it costs too much, who are having to deal with treatable, correctable conditions on their own because of the cost or "fine print" or finding of "a pre-existing condition" by an insurance company.

I freely admit that the US is not overpopulated with wave after wave of people dying in the street due to lack of medical care. However, since people are certifiably meeting the above criteria in larger numbers -- how many is too many?

If the source of medical insurance is lost when a job is lost (post Cobra coverage as well), an existing condition becomes a "pre-existing" condition.

I will also acknowledge that many people do not read the fine print of their health insurance. Didn't we go through this same scenario with home purchases and other contracts?

Here is the core issue for me. The contract should be simple and one page in length. The contract should state what is provided, what costs are associated, and how costs will be raised to account for expenses.

Health care for me is the same as a Fire Department. Taxpayers pay to maintain that whole service of prevention and on need mitigation. I suppose that makes people who participate in that service via their taxation or upon need "socialists" or some such. Why aren't people told they need to be responsible for putting their own fires out? Why doesn't the community come together and work to put out the fire? Worked in the old days, didn't it? Those evil, tax funded, government run Fire Departments have for the most part driven out competing private enterprise and made hard working American citizens into socialist slaves, haven't they?

Bottom line -- as bad as it currently is, I have more faith that a government controlled, tax-payer funded health system will benefit society over an corporation motivated only by profits. One need only look to the recent Wall Street problems to understand that corporations are driven solely by greed, and don't even have a sense of self-preservation any longer.

[SnyderShrugged]

How about the phrase - People who are denied care they need because they cannot afford it or it costs too much, who are having to deal with treatable, correctable conditions on their own because of the cost or "fine print" or finding of "a pre-existing condition" by an insurance company.

I freely admit that the US is not overpopulated with wave after wave of people dying in the street due to lack of medical care. However, since people are certifiably meeting the above criteria in larger numbers -- how many is too many?

If the source of medical insurance is lost when a job is lost (post Cobra coverage as well), an existing condition becomes a "pre-existing" condition.

I will also acknowledge that many people do not read the fine print of their health insurance. Didn't we go through this same scenario with home purchases and other contracts?

Here is the core issue for me. The contract should be simple and one page in length. The contract should state what is provided, what costs are associated, and how costs will be raised to account for expenses.

Health care for me is the same as a Fire Department. Taxpayers pay to maintain that whole service of prevention and on need mitigation. I suppose that makes people who participate in that service via their taxation or upon need "socialists" or some such. Why aren't people told they need to be responsible for putting their own fires out? Why doesn't the community come together and work to put out the fire? Worked in the old days, didn't it? Those evil, tax funded, government run Fire Departments have for the most part driven out competing private enterprise and made hard working American citizens into socialist slaves, haven't they?

Bottom line -- as bad as it currently is, I have more faith that a government controlled, tax-payer funded health system will benefit society over an corporation motivated only by profits. One need only look to the recent Wall Street problems to understand that corporations are driven solely by greed, and don't even have a sense of self-preservation any longer.


please see all of my above posts on how I and the Insurance industry support covering pre-exsisting conditions as a part of reform.

[JMS]

1. I have never seen actual stats that support your claim the "Millions die because they cant afford insurance or are denied care". Why havent they enrolled in medicare or medicaid?


Medicare is for the old over 65. Medicaid is for the poor. The 50 million uninsured in this country aren't old, and make too much money to be considered poor.....

Obama in his Op-ed Piece in the NY Times Sunday said there were an addional 12 million Americans who were discriminated against by their health insurance companies, denied treatment, charged higher rates, or had medical bills which were not covered.



No health care provider is legally allowed to deny care due to inability to pay, its a fact.


It's not a fact. It's a fantisy from a bygone era. Hospitals are only required to stabilize you. Literally if you showed up with an arrow through your neck they could deny you care as long as they could make the claim you were not in immediate danger of dieing.




2. Coverage cant be changed legally in the middle of a plan year, another fact. rates also cannot be raised in the middle of a plan year. Another fact. People arent randomly "dropped" from coverage unless they lied at inception or broke the rules via fraud attempts. it's illegal.


So your point is they can't drop you immediately? They can't raise your rates immediately if you get sick?

Your rates certainly can be changed and are when folks get sick.



3. Obviously, the average consumer doesnt agree since 80% like their plans.


75% are satisfied with their plans. Satisfied is not the same as like. Also that statistic roughly corresponds to the % of folks who have never needed their plan for serious illness or injury.

Ignorance is truely bliss.



Also, I already pointed out that covering pre-ex was actually part of the reform proposals that the industry itself put forth. There is nothing to be angry about in regards to reforming pre-ex coverage. Everyone agrees already.

Why didn't they agree 20 years ago, or 10 years ago? They agree today cause folks are getting pissed. It's compromise or get steam rolled. You are correct though the insurance companies are actually on board with about 80% of the reforms. It's the public competition option which they are trying ot fight tooth and nail. The insurance companies are fine with "reform" as long as they can pass the cost to the consumer.

[SnyderShrugged]

Medicare is for the old over 65. Medicaid is for the poor. The 50 million uninsured in this country aren't old, and make too much money to be considered poor.....


Obama in his Op-ed Piece in the NY Times Sunday said there were an addional 12 million Americans who were discriminated against by their health insurance companies, denied treatment, charged higher rates, or had medical bills which were not covered.

Just because the President says it, doesnt mean its true. Ummm, if "they make too much money" to be on medicaid, then they arent poor!


It's not a fact. It's a fantisy from a bygone era. Hospitals are only required to stabilize you. Literally if you showed up with an arrow through your neck they could deny you care as long as they could make the claim you were not in immediate danger of dieing.

No, it's a fact. Look it up.




So your point is they can't drop you immediately? They can't raise your rates immediately if you get sick?

Your rates certainly can be changed and are when folks get sick.

Rates cant be raised if you get sick. They can only be raised in a new plan year, that you must agree to before purchasing your insurance. Most companies use midicare reimbursement rates as the bar anyway, so get mad at the feds for that.


75% are satisfied with their plans. Satisfied is not the same as like. Also that statistic roughly corresponds to the % of folks who have never needed their plan for serious illness or injury.

Ignorance is truely bliss.

I think the figure was actually 79%(but I'd have to double check). Satisfied is the same as like (as opposed to dislike).


Why didn't they agree 20 years ago, or 10 years ago? They agree today cause folks are getting pissed. It's compromise or get steam rolled. You are correct though the insurance companies are actually on board with about 80% of the reforms. It's the public competition option which they are trying ot fight tooth and nail. The insurance companies are fine with "reform" as long as they can pass the cost to the consumer.

so whats the problem? Are you looking for actual reform or just a mechanism to "punish" insurance companies who have all worked within federal regulations for many decades.

Sounds more like you just have a grudge to cast and arent really interested in reform unless it "punishes" an industry.

reform can happen and it can happen fairly to all involved. It doesnt have to punish anyone.

[techboy]

If you deregulated the state enclaves and let doctors live and practice anywhere in the country you would have 1/3 of all the doctors in Florida and Southern California and nobody in the midwest.

That hasn't happened with plumbers, auto mechanics, truck drivers, or hair stylists. Why would it happen with doctors?

[SnyderShrugged]

That hasn't happened with plumbers, auto mechanics, truck drivers, or hair stylists. Why would it happen with doctors?


Thats a good point, and I know that if I were a Dr in the north east that suddenly lost most of his competition, I wouldnt think once about leaving!

[TheLongshot]

Yeah but nobody is talking about that type of deregulation because that works for all parties concerned. If you deregulated the state enclaves and let doctors live and practice anywhere in the country you would have 1/3 of all the doctors in Florida and Southern California and nobody in the midwest.

Probable one reason why they created the state enclaves in the first place. Doctors are an important resource everybody needs them.

Actually, what is happening right now is a lot of doctors are moving from the east coast out west because the cost of doing business is getting too high out here. Many are going into managed care because they don't want to deal with the BS of insurance companies any more.


That hasn't happened with plumbers, auto mechanics, truck drivers, or hair stylists. Why would it happen with doctors?

For one, the education requirement isn't nearly as high, so the barriers for entry isn't as high. Second, I have seen the effects when it takes a couple of months to get an appointment with your doctor.

[SnyderShrugged]

Actually, what is happening right now is a lot of doctors are moving from the east coast out west because the cost of doing business is getting too high out here. Many are going into managed care because they don't want to deal with the BS of insurance companies any more.

Not to be nitpicky, but who do you think manages "managed care " if not insurance companies?

[JMS]

Just because the President says it, doesnt mean its true. Ummm, if "they make too much money" to be on medicaid, then they arent poor!


So if a family of four makes like 24k technically they aren't eligible for assistance, but they still can't afford 12k a year to buy insurance on their own. ( 12k is a typical health insurance policy where an employer pays 9k and the indivual pays about 3k ).



No, it's a fact. Look it up.


It's called EMTALA or the Emergency Medical Treatment and Active Labor Act. It doesn't say the hopital has to treat you. It says the hospitals have two responsibilities. (1) to perform an exam to determine if an emergency situation exists. (2) to stabalize you if an emergency situation is found.

You don't have the right to get treatment at any hospital as you did at one time in this country.

Hospitals are not required to treat everybody who walks through their doors. That's pure fiction. They are only required to stabilize you. Sometimes they don't even do that much.

http://www.emtala.com/faq.htm



Rates cant be raised if you get sick. They can only be raised in a new plan year, that you must agree to before purchasing your insurance. Most companies use midicare reimbursement rates as the bar anyway, so get mad at the feds for that.


you have zero protection against raising rates if you have a single policy or work for a small business. your ownly protection is if you have a group policy and state and federal laws apply to you. single policies are only covered by state laws.

[TheLongshot]

Not to be nitpicky, but who do you think manages "managed care " if not insurance companies?

Some are, but not all. Some are MSOs, which provide a larger organization to get the benefits of the economics of scale and being a single payer.

[JMS]

Actually, what is happening right now is a lot of doctors are moving from the east coast out west because the cost of doing business is getting too high out here. Many are going into managed care because they don't want to deal with the BS of insurance companies any more.


Yes but their is a barrior to doctors moving from one state to another. They have to be re-certified which represents a significant barior to entry for many states...

Doctors get certified when the graduate medical school and even fine doctors would have a hard time taking that test again 20 years latter if they decided to move from say Virginia to Florida or California.

[SnyderShrugged]

So if a family of four makes like 24k technically they aren't eligible for assistance, but they still can't afford 12k a year to buy insurance on their own. ( 12k is a typical health insurance policy where an employer pays 9k and the indivual pays about 3k ).



well, sounds more like a study on medicaid eligibility is in order than health care reform. I think a family of 4 on 24k can find affordable health insurance. I did when I was earning that level. It was difficult, but I sacrificed luxuries because health care was improtant to me.



It's called EMTALA or the Emergency Medical Treatment and Active Labor Act. It doesn't say the hopital has to treat you. It says the hospitals have two responsibilities. (1) to perform an exam to determine if an emergency situation exists. (2) to stabalize you if an emergency situation is found.

You don't have the right to get treatment at any hospital as you did at one time in this country.



There is a bit more that you need to read. yes, they have to stableize the patient, but they cant refuse care due to inability to pay and they cant sue for payment later under the act.

If "stable" the hospital can treat or transfer to somewhere that can treat. They cannot simply send them away.

from Wiki:

[edit] Hospital obligations
Hospitals have three obligations under EMTALA:

Individuals requesting emergency care, or those for whom a representative has made a request if the patient is unable, must receive a medical screening examination to determine whether an emergency medical condition (EMC) exists. Examination and treatment cannot be delayed to inquire about methods of payment or insurance coverage, or a patient's citizenship or legal status. The hospital may only start the process of payment inquiry and billing once the patient has been stabilized to a degree that the process will not interfere with or otherwise compromise patient care.
The emergency room (or other better equipped units within the hospital) must treat an individual with an EMC until the condition is resolved or stabilized and the patient is able to provide self-care following discharge, or if unable, can receive needed continual care. Inpatient care provided must be at an equal level for all patients, regardless of ability to pay. Hospitals may not discharge a patient prior to stabilization if the patient's insurance is canceled or otherwise discontinues payment during course of stay.
If the hospital does not have the capability to treat the condition, the hospital must make an "appropriate" transfer of the patient to another hospital with such capability. This includes a long-term care or rehabilitation facilities for patients unable to provide self-care. Hospitals with specialized capabilities must accept such transfers and may not discharge a patient until the condition is resolved and the patient is able to provide self-care or is transferred to another facility.

[edit] Amendments
Since its original passage, amendments to this act have been passed by U.S. Congress that either add or remove various obligations. Additionally, state and local laws in some places have imposed additional requirements on hospitals. These amendments include:

A patient is defined as "stable," therefore ending a hospital's EMTALA obligations, if:

The patient is conscious, alert, and oriented

The cause of all symptoms reported by the patient or representative, and all potentially life-threatening, limb-threatening, or organ-threatening symptoms discovered by hospital staff, has been ascertained to the best of the hospital's ability.

Any conditions that are immediately life-threatening, limb-threatening, or organ-threatening have been treated to the best of the hospital's ability to ensure the patient does not need further inpatient care.

The patient is able to care for themselves, with or without special equipment, which if needed, must be provided. The required abilities are:
Breathing
Feeding
Mobility
Dressing
Personal hygiene
Toileting
Medicating
Communication

Another competent person is available and able to meet the patient's needs following discharge.

All patients have EMTALA rights equally, regardless of age, race, religion, nationality, ethnicity, residence, citizenship, or legal status. If patient's status is found to be illegal, hospitals may not discharge a patient prior to completion of care, though law enforcement and hospital security may take necessary action to prevent a patient from escaping or harming others.

Treatment may only be delayed as needed to prevent patients from harming themselves or others.

Overloaded hospitals may not discharge a patient unable to pay to make room for a patient who is able to pay or is otherwise viewed by society as a more valued citizen. If the emergency room is overloaded, patients must be treated in an order based on their determined medical needs, not their ability to pay.

Hospitals may not deny or provide substandard services to a patient who already has outstanding debt to the hospital, and may not withhold the patient's belongings, records, or other required services until the patient pays.

Hospitals and related services cannot receive a judgment against the patient in court filings made more than 36 months after the date the patient was discharged, or the last partial payment the patient made to the hospital, contractor, or agent. After that period, the patient may not be threatened with legal action if payment is not made, and may not be denied future outpatient services from the same company/agency that a patient is able to pay.

If a patient has been awarded monetary damages against the hospital or any related or affiliated services by a court of law, or has settled out of court on damages, the hospital and related/affiliated services may not withhold monies due to lack of payment, or count the money toward the bill in lieu of making payment to the patient. Voluntary consent for such an arrangement is permitted only if initiated by the patient. Hospitals may not threaten or coerce a patient into such a settlement, or mislead the patient into believing such an arrangement is required or recommended.

Patients cannot face criminal prosecution for failure to pay, even if the patient came to the hospital aware of inability to pay.

Hospitals and third-party agents may not threaten patients with prosecution as a means of scaring the patient into making payment. Patient can be prosecuted under existing federal, state, or local laws for providing false name, address, or other information to avoid payment, receiving bills, or to hide fugitive status.

A hospital may not perform a credit check on a patient either before, during, or after stay. The patient cannot receive a negative credit mark for failure to pay the hospital or any related services, or any third-party agent collecting on their behalf. Such services may not threaten patient with credit reporting to scare them into paying.

Hospitals are prohibited from discriminating against or providing substandard care to those who appear impoverished or homeless, are not well-dressed or groomed, or exhibit signs of mental illness or intoxication. If the hospital fears a patient may be a threat to others, the hospital may delay care only as necessary to protect others.

Hospitals are required to sufficiently feed patients unable to pay at a level equal to those able to pay, while meeting all physician-ordered dietary restrictions.

Hospitals are not required to provide premium services to the patient not related to medical care (such as television) when failure to provide this service does not compromise patient care.

Hospitals and affiliated clinics are not required to provide continued outpatient care, drugs, or other supplies following discharge. In the event such services are recommended, but a patient is unable to pay, the hospital is required to refer the patient to a clinic or tax-funded or private program that enables the patient to pay for these services, and to which the patient has reasonable access. Hospitals must reasonably assist patients as necessary to obtain these services by providing information the patient

http://www.emtala.com/faq.htm



you have zero protection against raising rates if you have a single policy or work for a small business. your ownly protection is if you have a group policy and state and federal laws apply to you. single policies are only covered by state laws.

You certainly do have protection if you have a single policy or small business. Size of the policy doesnt matter, the plan year negotiated rates and coverage levels are in place until the plan expires. Once it does, and they cant agree on the new rates, it's simply time to find another carrier. Choice.

[SnyderShrugged]

Some are, but not all. Some are MSOs, which provide a larger organization to get the benefits of the economics of scale and being a single payer.


My company adminsters MSO's too?

[JMS]

There is a bit more that you need to read.

I am very familiar with the act, I'm the one who brought it to your attention. You were wrong, Hospitals can definitely deny you treatment. Like I said if you had an arrow in your neck, they could deny you treatment as long as they could claim you were stable.. They could stick you back in the ambulance and send you an hour down the road to a different hospital.

And remember too EMTALA only applies to “participating hospitals” – those hospitals that receive federal funding under Title 42. If the Hospital is a private hospital they don't even have to stabalize you. Literally the only problem in letting you die on their door step would be the bad PR if they were unfortunate enough to have it reported on.

You do not have a right to healthcare at hospitals like you said. Indeed like we used too.





You certainly do have protection if you have a single policy or small business. Size of the policy doesnt matter,


Size of the policy certainly does matter. For two reasons. (1) group policies over a certain size are covered by federal law as well as state laws. (2) Insurance companies are less likely to screw with a large group policy because companies hire professional HR folks to deal with the insurance companies, and if you are buying hundreds or thousands of policies you have significantly more leverage than if you are buying one policy.

Folks with individual policies or who work for small businesses ( read most Americans ) have no leverage when dealing with insurance companies.

And again.... You aren't arguing I'm wrong. that insurance companies can raise your rates, drop you all together, or deny coverage for a number of reasons. You're arguing only that they can't do it immediately, and even that isn't true. It depends on the state.





the plan year negotiated rates and coverage levels are in place until the plan expires. Once it does, and they cant agree on the new rates, it's simply time to find another carrier. Choice.

you are talking like their is a federal law which states that, or that it's some sort of universal truth. That isn't true. There are states which companies can raise your health insurance rates as easily as they raise your auto insurance rates and they do.

Likewise you are not arguing they can't raise your rates, only that in some instances they can't do it immediately but have to wait a few months. Either way if you use your health insurance for a serious costly illness, and your not in a group plan, your rates are going up dramatically and in today's United States that means most Americans with Coverage won't have coverage very long if they actually have to depend upon it.

[JMS]

well, sounds more like a study on medicaid eligibility is in order than health care reform. I think a family of 4 on 24k can find affordable health insurance. I did when I was earning that level. It was difficult, but I sacrificed luxuries because health care was improtant to me.


Yeah somehow I don't think it's in the rhelm of possibility that you were supporting a family of four on 24k and could afford a 12k policy. Not while eating three meals a day and living indoors anyway. Maybe you afforded the 3k co-pay because your job offered insurance and you were single.

There are tons of working poor who are left out of our healthcare system both the public medicare medicade cause they are too young or make too much, and the private one cause they don't make enough .

Even if they did have find some way to streatch and afford insurance, the insurance company would no no requirement to pay if they actually had despirate need of the insurance.

That's the way our system works.

[GoSkins561]

you realize you just argued against capitalism right? what are you, a communist?




I laughed, :CaptainObvious:

[PokerPacker]

That hasn't happened with plumbers, auto mechanics, truck drivers, or hair stylists. Why would it happen with doctors?

Exactly. Supply and Demand. If all the doctors went to Florida and Cali, there would be an overabundance of doctors in those areas creating excessive supply while demand remains stagnant. That's no way to pick up business.

[MurrayH81]

please see all of my above posts on how I and the Insurance industry support covering pre-exsisting conditions as a part of reform.

Well, that's nice, and I am glad that the industry that created the problem in the first place, is now onboard with fixing it as they fight for their current existence.

I know it's hard to see from the inside, and I am not calling you out as a human being or trying to lump "the company you work for as being as bad as others". However, taken as a whole, the "industry" has (of late) served only their greed/self-interest. Which is why health care needs to be changed.

Do you really believe that changes that you allege your industry are willing to consider implementing now would be happening if that very industry hadn't created a mess to begin with?

I am not out to punish anyone. I just can't trust a corporation to provide for me any longer (the same way I can't trust AIG or Enron). Recent events are exposing corporations for what they are (vehicles for maximizing investor and executive profits).

[Mad Mike]

1. I have never seen actual stats that support your claim the "Millions die because they cant afford insurance or are denied care". Why havent they enrolled in medicare or medicaid? No health care provider is legally allowed to deny care due to inability to pay, its a fact.

Bull****. Emergency rooms can't turn you away. Doctors who could help prevent the issue from becoming an emergency can and do. THAT IS A FACT.


2. Coverage cant be changed legally in the middle of a plan year, another fact. rates also cannot be raised in the middle of a plan year. Another fact. People arent randomly "dropped" from coverage unless they lied at inception or broke the rules via fraud attempts. it's illegal.

So at the end of the "planned year" when they bump rates or drop coverage, it's OK, right?


3. Obviously, the average consumer doesnt agree since 80% like their plans. Also, I already pointed out that covering pre-ex was actually part of the reform proposals that the industry itself put forth. There is nothing to be angry about in regards to reforming pre-ex coverage. Everyone agrees already.

Which explains why my pre-existing conditions are covered since it's in the power of insurance companies to do that now. Oh wait.

You dont know **** about what it's like to be uninsured. Don't act like you do.

[TheLongshot]

My company adminsters MSO's too?

I'm sure they do, but not all are part of insurance companies.

[SnyderShrugged]

Yeah somehow I don't think it's in the rhelm of possibility that you were supporting a family of four on 24k and could afford a 12k policy. Not while eating three meals a day and living indoors anyway. Maybe you afforded the 3k co-pay because your job offered insurance and you were single.

There are tons of working poor who are left out of our healthcare system both the public medicare medicade cause they are too young or make too much, and the private one cause they don't make enough .

Even if they did have find some way to streatch and afford insurance, the insurance company would no no requirement to pay if they actually had despirate need of the insurance.

That's the way our system works.


I didnt have to afford a 12k policy, as you said employers covered 9k of it. In my case, the policy wasnt anywhere near 12k anyway (I have a hard time believing many are)

[SnyderShrugged]

I'm sure they do, but not all are part of insurance companies.


Actually, I dont think any are, but most often a private insurance company administers them in an agreement together.

[SnyderShrugged]

Bull****. Emergency rooms can't turn you away. Doctors who could help prevent the issue from becoming an emergency can and do. THAT IS A FACT.

then go to a free clinic!


So at the end of the "planned year" when they bump rates or drop coverage, it's OK, right?

It's plan year (as in insurance policy plan). They dont willy nilly "bump" rates or drop coverage. It's a negotiation near the end of the current plan year, a customer or group can opt to go another way if the rates or coverage levels are not attractive to them. It's a choice.

Which explains why my pre-existing conditions are covered since it's in the power of insurance companies to do that now. Oh wait.

You dont know **** about what it's like to be uninsured. Don't act like you do.


I think I already mentioned that I also agree that Pre-ex should be covered and the industry has already conceded and even proposed to reform and cover them.

No, I dont know because I chose to buy insurance, shopped for a plan my family could afford and sacrificed luxuries to get it.

You could too. A week or so ago, I posted some links for you to help find affordable coverage in your state. Didnt you see that?

[JimboDaMan]

I didnt have to afford a 12k policy, as you said employers covered 9k of it. In my case, the policy wasnt anywhere near 12k anyway (I have a hard time believing many are)You're in the industry? You have trouble believing policies cost 12K? Everything I read says that's the average.

btw, congrats to you, if you made 24K and spent 3K for health insurance. But do you understand the point that a huge percentage of 24K jobs don't come with any employer insurance? That it literally would cost half the paycheck to buy reasonable insurance, and therefore is not really a choice at all?

[Hubbs]

Well it sure doesnt appear that the government financing on the backs of the taxpayer has helped though, does it?

"It has cost taxpayers some $30 billion over a 35-year period. After adjusting for a longer life span, between 1950 and 1989 the incidence of cancer rose by about 44 percent. Breast cancer and colon cancer in men have risen about 50 percent, while some others have risen 100 percent"

SS, I think I have a pretty simple explanation for that one - people didn't live long enough to get too many types of cancer back in the day. When life expectancy increases, so does expected number of ailments.

[Hubbs]

Propaganda. The "acceleration" in healthcare costs correspond with Ronald Reagan deregulations of the early 1980's and inviting big business involvement into what was largely a non profit segment of the economy. Reagan did this because he believed big business could run things more effciently than non profits or government agencies. History has proven Reagan was wrong. Big Businesses gift isn't running things more effciently, their gift is making profits, which they have done. Profits by charging more, not by making things work better, did not turn out to be a net benifit for the economy or America. When Reagan turned over our health insurance industry to big buisness healthcare consumed 8% of the economy and was considered out of control. Today it consumes 17% of our economy and is on the verge of bankrupting us.

Looks like there won't be meaningful healthcare reform in Obama's first term in office. That's a tactical victory for the insurance companies. But the winner of the war is still certain. You can fool most of the people some of the time, and some of the people all the time, but you can't fool most of the people all of the time. Insurance companies are parisites on the economy and parisites on American industry. We are either going to reform them, or go bankrupt. We are either going to reform them or loose what little remains of our manufacturing base. Their is no other option.

Same goes for you, JMS. You're looking for a political reason when it's a demographic one. The Baby Boomers hit their 40's under Reagan - that's a big number in terms of health care costs.

The whole "health costs are accelerating faster than GDP" argument is inane. Of course they are. That's what happens when you have a distorted population breakdown, and the biggest age group is getting older and older. Their care costs more and more.

[JMS]

Same goes for you, JMS. You're looking for a political reason when it's a demographic one. The Baby Boomers hit their 40's under Reagan - that's a big number in terms of health care costs.


The baby boomers weren't just an American Statistic. IT was a global statistic. And the world didn't see their healthcare costs go up like the US did. The United States actually has a pretty young population compared to all the folks kicking our butts in healthcare delivery costs.

America's increasing healthcare costs are definitly political. IT's the system we've chosen which consistantly has under performed and over charged us for decades.




The whole "health costs are accelerating faster than GDP" argument is inane. Of course they are. That's what happens when you have a distorted population breakdown, and the biggest age group is getting older and older. Their care costs more and more.

Most European countries and Japan have older populations than the United States does.
http://www.photius.com/rankings/population/median_age_total_2008_0.html

Yet their healthcare costs are at most half what ours are, and their costs are rising at a much smaller rate too. Our problem goes way beyond age of the population.

[Hubbs]

Well, I mis-spoke in my earlier post - demographics aren't the only factor in rising health costs, although I'd say that they'd be more prominent here than anywhere else, simply because we had more Baby Boomers than any other country (except perhaps China... I don't know off the top of my head). Tort reform would be another big factor, in my opinion. Which, again, tends to be a problem only when people have to see the doctor for a certain ailment in the first place - e.g., when they are older.

Look, JMS, despite my libertarian-ness, I'm actually more on your side when it comes to this issue. I believe it has moral value that trumps any sort of economic question, similar to paying for cops, or for fire fighters. But I do think it's important to analyze the data properly and say, "Huh, looks like we probably would have paying out the ass anyway, since Aunt Jessie and Uncle Murray and Uncle Fred and Aunt Sarah and Uncle Phil all have conditions that require extensive testing. Welcome to being late-middle-aged."

[Prosperity]

SS, I think I have a pretty simple explanation for that one - people didn't live long enough to get too many types of cancer back in the day. When life expectancy increases, so does expected number of ailments.

When cancer knowledge has really started to be applied, and I don't just mean new drugs and treatments, but also knowledge about how some things cause cancer, cancer rates started to go down... From 1990-2009 cancer rates HAVE gone down, without a lower life expectancy. The research HAS paid off. It's just that with something like cancer, which can take many years to break out, that just because funding started in the the early 50's that the rates where going to go down by the end of the 50's. When that research started very little of the knowledge could be immediately applied, and even if it could the population had spent many years before that not even knowing simple things like cigs causing cancer. Now that those older generations have passed away the newer ones have for the most part had access to this research and we have seen a corresponding decrease in cancer rates. Though you are probably getting at one of the reasons cancer rates had gone up during that time period, another reason being the number of toxins humans started releasing since the industrial revolution and other increases in environment, and or person habits.

That article is pure bull**** on this point. THE ONLY evidence he gives for public funded biomed research hurting healthcare is completely debunked by what I just said.

[Hubbs]

When cancer knowledge has really started to be applied, and I don't just mean new drugs and treatments, but also knowledge about how some things cause cancer, cancer rates started to go down... From 1990-2009 cancer rates HAVE gone down, without a lower life expectancy. The research HAS paid off. It's just that with something like cancer, which can take many years to break out, that just because funding started in the the early 50's that the rates where going to go down by the end of the 50's. When that research started very little of the knowledge could be immediately applied, and even if it could the population had spent many years before that not even knowing simple things like cigs causing cancer. Now that those older generations have passed away the newer ones have for the most part had access to this research and we have seen a corresponding decrease in cancer rates. Though you are probably getting at one of the reasons cancer rates had gone up during that time period, another reason being the number of toxins humans started releasing since the industrial revolution and other increases in environment, and or person habits.

That article is pure bull**** on this point. THE ONLY evidence he gives for public funded biomed research hurting healthcare is completely debunked by what I just said.

Dude, I'm largely on your side on this one, you don't need to worry very much. My main point was that cancer rates and costs were bound to increase anyway, not that corresponding treatments couldn't counter-act the demographic changes. Hell, I have a father and an aunt who have faced cancer, I like to think that I would know. Both of them have done fine - but both are included in cancer statistics, because they lived long enough.

It's a percentage game. Right now, the largest percentage of our population os vulnerable to all sorts of cancers. Any poker player will tell you that going all-in with Jack-5 off-suit will usually lead to losing money. This really isn't all that different, mathematically speaking.

[JMS]

Well, I mis-spoke in my earlier post - demographics aren't the only factor in rising health costs, although I'd say that they'd be more prominent here than anywhere else, simply because we had more Baby Boomers than any other country (except perhaps China... I don't know off the top of my head). Tort reform would be another big factor, in my opinion. Which, again, tends to be a problem only when people have to see the doctor for a certain ailment in the first place - e.g., when they are older.


Age was a good thought. I had to look that up. Unfortunately America has one of the youngest populations in the industrialized world and has the highest healthcare costs and growth by a factor of 2. So it doesn't seem to be a factor. If it was a factor everybody else like Canada/ Europe/Japan/Russia would be lagging behind us rather than doing better than us on cost.

Tort reform isn't really an issue. It aco****s for 3% of medical costs which is significant, but meaningless when you have industries like the insurance companies, drug companies, and hosptials which are overcharging by 50%, and getting subsidies too boot.

The real issue with Tort Reform is the malpractice insurance premiums which doctors have to pay, which are outragous. But that goes back to reforming the insurance agencies not the legal system.



Look, JMS, despite my libertarian-ness, I'm actually more on your side when it comes to this issue. I believe it has moral value that trumps any sort of economic question, similar to paying for cops, or for fire fighters. But I do think it's important to analyze the data properly and say, "Huh, looks like we probably would have paying out the ass anyway, since Aunt Jessie and Uncle Murray and Uncle Fred and Aunt Sarah and Uncle Phil all have conditions that require extensive testing. Welcome to being late-middle-aged."

I agree however the rest of the world is older than we are. We are among the youngest industrialized nation not the oldest (south korea, Mexico, South Africa and Israel are younger). Our median age(36.6) is almost a decade younger than that of Japans(43.5), Germany(43), and Italy(42.5); yet our costs are twice as high as these countries.
http://www.photius.com/rankings/population/median_age_total_2008_0.html

Age isn't the deterministic factor in healthcare cost. Neither is health of the population as the healthcare industry would have us believe. It's just our system.

I agree with you too that healthcare could be like fire departments, libraries, National Defense, and police. We certainly have never believed a free marketplace was the ideal delivery mechanism for healthcare. The question is do we support a beurocracy which benifits the corporations or do we create a beurocracy which benifits the consumers.

[PeterMP]

Age was a good thought. I had to look that up. Unfortunately America has one of the youngest populations in the industrialized world and has the highest healthcare costs and growth by a factor of 2. So it doesn't seem to be a factor. If it was a factor everybody else like Canada/ Europe/Japan/Russia would be lagging behind us rather than doing better than us on cost.
Actually, the number you need to look at is the change in the age of the population w/ respect to the change in medical costs

It is possible we started much younger than them and have aged at a faster rate as an entire population.

**EDIT**
As an example, it is possible that their immigrant pool over the relavant time period has been younger than ours.

[The Robert Griffin Experience]

help

why are we accepting the premise that the government-run healthcare systems of Europe and Japan have better healthcare delivery than the USA?

First off, the WHO has given up attempting to quantify healthcare delivery, and the factors that were used to determine the original ranking (and many subsequent rankings) are heavily biased towards government-run, socialized systems. For example, the "financial fairness" part reflects the idea that wealther persons should pay an equal proportion of their income on healthcare as poor persons - an absolutely inane and ridiculous premise. Furthermore, the idea of measuring healthcare equality as a determinant of quality of care is silly - it not only assumes that good care for the wealthy can only occur at the expense of care for the poor (an assumption that underlies the entirety of the socialistic mindset), but that it is more desirable to have average care for everyone, instead of above-average care for the non-rich and excellent care for the rich.

Furthermore, it's rankings seem to imply that health systems are responsible for social factors that impact health, which again strongly favors more state-run systems.

The WHO rankings should have absolutely zero credibility in a discussion of health care.

What we do know is that there at least some evidence that those systems artificially stimulate demand (if it's free, why worry about the cost of what I'm buying?), similar to how our health insurance system does here, except there are at least some market barriers to infinitely increasing demand. In single-payer systems, these are virtually non-existent. This is what leads to rationing, similar to how an oversupply of money leads to price controls.

Futhermore, humans operate on rational materialist lines for the most part, and respond to incentives. Those incentives are reduced or eliminated in the case of government-run systems, and therefore, there is a lack of innovation (which the U.S still does relatively well).

Also, using mortality rates is about the worst determinant for health-care coverage you could possibly use. There are far too many variables in mortality rates to tie it to health coverage (diet, income, etc).

But in the areas where health care actually does have an impact (like treating specific diseases), the U.S. crushes single-payer systems. We survive cancer and heart disease better, while being more at risk for it because of our unhealthy lifestyles.

[JimboDaMan]

help

why are we accepting the premise that the government-run healthcare systems of Europe and Japan have better healthcare delivery than the USA?

First off, the WHO has given up attempting to quantify healthcare delivery, and the factors that were used to determine the original ranking (and many subsequent rankings) are heavily biased towards government-run, socialized systems. For example, the "financial fairness" part reflects the idea that wealther persons should pay an equal proportion of their income on healthcare as poor persons - an absolutely inane and ridiculous premise. Furthermore, the idea of measuring healthcare equality as a determinant of quality of care is silly - it not only assumes that good care for the wealthy can only occur at the expense of care for the poor (an assumption that underlies the entirety of the socialistic mindset), but that it is more desirable to have average care for everyone, instead of above-average care for the non-rich and excellent care for the rich.

Furthermore, it's rankings seem to imply that health systems are responsible for social factors that impact health, which again strongly favors more state-run systems.

The WHO rankings should have absolutely zero credibility in a discussion of health care.You are overstating your premise, but I'll bite. Since its impossible to compare quality we'll have to compare cost. I think in that case we rank dead last.

[Thiebear]

I would disagree that all other countries are doing better at cost..
If you go look at Canada and France they are saying the same things... unsustainable with current setup.
I believe Germany is doing the best??? not sure.

[Prosperity]

Dude, I'm largely on your side on this one, you don't need to worry very much. My main point was that cancer rates and costs were bound to increase anyway, not that corresponding treatments couldn't counter-act the demographic changes. Hell, I have a father and an aunt who have faced cancer, I like to think that I would know. Both of them have done fine - but both are included in cancer statistics, because they lived long enough.

It's a percentage game. Right now, the largest percentage of our population os vulnerable to all sorts of cancers. Any poker player will tell you that going all-in with Jack-5 off-suit will usually lead to losing money. This really isn't all that different, mathematically speaking.

sorry my man, I just thought people were ignoring my well thought and reasonable thinking, I hate when that happens :D

[The Robert Griffin Experience]

You are overstating your premise, but I'll bite. Since its impossible to compare quality we'll have to compare cost. I think in that case we rank dead last.

Actually we have significantly better quality. (I edited my post after you posted). Reread my post to see where the costs stem from (a part of that is from having better medical technology than other nations as well)

[PeterMP]

But in the areas where health care actually does have an impact (like treating specific diseases), the U.S. crushes single-payer systems. We survive cancer and heart disease better, while being more at risk for it because of our unhealthy lifestyles.
Just to add:

"In the UK there may be up to 15 000 avoidable deaths from cancer every year in people over the age of 75 years. A study presented last week at the National Cancer Intelligence Network (http://www.ncin.org.uk/) annual conference highlights the disparity in cancer mortality rates between the UK and 11 European countries and the USA. Using data from the WHO mortality database, Tony Moran and colleagues showed that between 2003 and 2005, cancer mortality rates in the UK were 23% higher than in six western European countries among those aged 75—84 years and 31% higher than in the USA among people over the age of 85 years. From 1995—97 to 2003—05, there was a 2% increase in cancer death rates in people older than 85 years in the UK; in western Europe, there was a 16% decrease. The UK's National Health Service has some of the world's top researchers and physicians. So why is the UK lagging behind its neighbours in delivering cancer care? There is scant research in this area, but limited access to effective state-of-the-art treatments, with policy makers placing much emphasis on cost-effectiveness for cancer drugs, might play a part."

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61214-9/fulltext

Our numbers are better than the UK or western Europe.

http://jnnp.bmj.com/cgi/content/full/77/3/288
"Interestingly, there were large variations in outcome among the countries in this study. In absolute percentages the risk of death and dependency ranged between 44% and 67%, and this variation did not seem to be caused by chance. After adjustment for a wide range of prognostic factors, and after grouping the countries into regions, a significant difference remained between Britain on the one hand and the USA and Scandinavian countries on the other, but the difference between Britain and north western Europe had disappeared. Variations in mortality were even more impressing than variations in the combined outcome: the authors noted that when grouped by geographical region, death rates were 40–50% lower in North America and Scandinavia than in Britain (p = 0.0001). The significant variation in case fatality remained after adjustment for case mix variables."

North America faired the best (better than Scandinavia).

What about Canada?

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080716/cancer_statistics_080716/20080716/


"The U.S. has a five-year survival rate in all the cancers studied of 91.9 per cent, while Europe's is much lower at 57.1 per cent. However, survival rates within the U.S. can vary. In Canada, the five Canadian provinces included in the study had almost identical results.
"For those five provinces, the survival rate does not differ very greatly from one to the other," said British cancer researcher Prof. Michel Coleman. "That probably indicates the overall effectiveness of universal health care for setting a high standard."
The range of survival rates across the five provinces was quite narrow, from a low of 79.3 per cent in Nova Scotia to a high of 85.4 per cent in British Columbia."


So we are at 91.9%, and they don't give an exact number for Canada, but since it varies by province from 79.3 to 85.4, we can conclude they are somewhere in the mid to low 80's.

(it does go on to point out that the rate varies across the US by geography and race).

http://www.archives-pmr.org/article/S0003-9993(07)01754-6/abstract

"Elements of our vision for a better system of stroke rehabilitation may have already been realized in other countries. The Post-Stroke Rehabilitation Outcomes Project (PSROP) was a large, prospective multicenter study that included data from a total of 1291 patients located in 6 hospital-based rehabilitation centers within the United States and 1 in New Zealand.13 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#bib13), 14 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#bib14), 27 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#bib27), 30 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#bib30), 31 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#bib31), 32 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#bib32), 33 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#bib33), 34 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#bib34), 35 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#bib35) The results from this comprehensive study provide a basis for comparison with the current Canadian stroke system by using data from the Canadian Institutes of Health Information, which captured data from all stroke rehabilitation centers within Canada. Although statistical inferences were not possible, it is evident that patients participating in the PSROP study were treated with greater efficiency (table 1 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#tbl1)). Rehabilitation facilities in Canada typically admitted less impaired patients at a later point after stroke onset, where they remained for longer periods of time. Patients were also more likely to be sent to a long-term care facility after discharge.

In contrast, patients included in the PSROP study were treated on specialized units, admitted soon after stroke onset, and received intensive task-specific therapies that simulated real-life tasks.13 (http://www.archives-pmr.org/article/PIIS0003999307017546/fulltext#bib13) These observations suggest that the Canadian system, much like stroke rehabilitation systems in other countries, can be improved and would benefit from reorganization and reinvestment. Although the American PSROP centers tended to admit younger patients, and at an earlier stage after stroke, these factors alone were unlikely to account for such vast differences in outcomes, particularly with respect to the FIM instrument efficiency scores. As shown by the results from the PSROP study, when evidence-based treatment approaches were applied, the apparent differences in efficiency of care between the 2 systems were dramatic."

Remember, PSORP is the US (and one hosiptial in New Zealand).

Their conclusion:
"A thoughtful reorganization of stroke rehabilitation services coupled with modest additional investment would improve the state of stroke rehabilitation care in Canada substantially. Increased access to specialized interdisciplinary stroke rehabilitation units will help to decrease the level of disability for the stroke survivor and reduce the requirement for institutionalization. Other elements of care including early access to rehabilitation, increased intensity of therapies that simulate real-life tasks, and adequate outpatient therapies could improve patient outcomes with greater efficiency of care."

If you are sick, you are still better off here over any other western country.

[gbear]

What I find interesting in all of this is the assumption that no country with socialized care would copy what is working in the U.S. in terms of treatment plans.

For example, my mom works developing palliative care guide lines for different types of cancers. Her work, done here in the U.S. and primarily for a U.S. audience, is now being used by China to develop their guidelines. I think the assumption that other countries will turn away from something that works simply because it is too expensive is perhaps an assumption based on a faulty premise that socialized medicine can never progress.

[skinfan13]

Here's what it comes down to for me:

health is not a gaurenteed right in the constitution. access to healthcare is not a guaranteed right in the constitution.

so, why is nobody talking about a constitutional amendment to make this mess legal? I would oppose such an amendment, but nobody, and I mean NOBODY wants to take the route that the framers intended the country to take when a giant question on the role of government surfaces, such as now...

I oppose this healthcare bill on an economic and constitutional premis. I would be more inclined to accept reform if we first passed an amendment to the constitution. (doesn't mean i wouldn't campaign against such an amendment ;))

[Prosperity]

Here's what it comes down to for me:

health is not a gaurenteed right in the constitution. access to healthcare is not a guaranteed right in the constitution.

so, why is nobody talking about a constitutional amendment to make this mess legal? I would oppose such an amendment, but nobody, and I mean NOBODY wants to take the route that the framers intended the country to take when a giant question on the role of government surfaces, such as now...

I oppose this healthcare bill on an economic and constitutional premis. I would be more inclined to accept reform if we first passed an amendment to the constitution. (doesn't mean i wouldn't campaign against such an amendment ;))

Are you against the government providing other services that are not specifically listed as rights in the constitution? Education, roads, and defense aren't really rights either.

[JMS]

Here's what it comes down to for me:

health is not a gaurenteed right in the constitution. access to healthcare is not a guaranteed right in the constitution.

so, why is nobody talking about a constitutional amendment to make this mess legal? I would oppose such an amendment, but nobody, and I mean NOBODY wants to take the route that the framers intended the country to take when a giant question on the role of government surfaces, such as now...

I oppose this healthcare bill on an economic and constitutional premis. I would be more inclined to accept reform if we first passed an amendment to the constitution. (doesn't mean i wouldn't campaign against such an amendment ;))

Doesn't the constitution still allow for slavery? Anti trust laws aren't in there. How about space exploration? How about a standing army over and above "common defense". How about the national park service, interior department or Department of Education?

There are lots of stuff that aren't in the constitution which we take for granted. We don't need not amendment to the constitution to desegregate the school system or the military. We don't need one for healthcare reform.

[JMS]

help

why are we accepting the premise that the government-run healthcare systems of Europe and Japan have better healthcare delivery than the USA? .

We created and largely pay for a United Nations effort for countries to collaberate on healthcare. That's called the World Health Organization and it's been in existance since just after WWII.

The WHO currently ranks the US healthcare system between Costa Rica and Slovinia.

Also by many metrics the US healthcare system is not up to par. Child Mortality, secondary infectioins, mis diagnoses leading to death, errors in crossing perscription medication leading to death are all metrics of quality of care. All metrics which the United States does not fair well against the rest of the industrialized world.

[Predicto]

Here's what it comes down to for me:

health is not a gaurenteed right in the constitution. access to healthcare is not a guaranteed right in the constitution.

so, why is nobody talking about a constitutional amendment to make this mess legal?

Because the argument is based on the flawed assumption that the government may not do anything unless it is specifically enumerated in the Constitution.

The argument assumes that the Constitution was written as a complete "positive" blueprint for governmental power. I would argue that the Constitution was really written as a "negative" expression of limitation on governmental power. Thus, unless the Constitution says: "The government shalt not provide for healthcare," then the government may choose to provide for healthcare if the popular will permits it to do so.

[skinfan13]

Are you against the government providing other services that are not specifically listed as rights in the constitution? Education, roads, and defense aren't really rights either. Education is a state issue, so yes I'm against the federal government being involved in education. That's a fairly unpopular view, but the 10th Amendment reserves education as a state issue. Free public education is not a right of the United States citizen. It is a right however of every citizen of the several states as legislated by those states.

The elastic clause covers roads in that Congress has the power to establish post roads, and has the power to enforce and carry out that provision. Even so, roads are maintained (for the most part 98% of the time) by the states anyway.

How is defense not a right? That's one of the pillars of government, to provide for the common defense, to maintain and army and navy!


Doesn't the constitution still allow for slavery? Anti trust laws aren't in there. How about space exploration? How about a standing army over and above "common defense". How about the national park service, interior department or Department of Education?

There are lots of stuff that aren't in the constitution which we take for granted. We don't need not amendment to the constitution to desegregate the school system or the military. We don't need one for healthcare reform. You're assuming I agree with those things you listed ;)

Unpaid labor is constitutional within the penal system. There has to be due process though. Slavery, as we knew it pre-1865, is unconstitutional via the 13th Amendment. Anti-trust laws I whole-heatedly believe are unconstitutional. Doesn't mean that they aren't entirely a bad idea however. While the spirit of the constitution is against a standing army, correct me if I'm wrong, but nothing actually prohibits maintaining the military in peacetime. Yes, NASA is in fact unconstitution, as are the NIH, etc. A fix for that is to amend the constitution to give Congress the power to appropriate money or establish departments for scientific endeavors.

the point is, there are many departments and agencies that are unconstitutional but serve good purposes. The fix to all this is pass constitutional amendments in order to grant congress more power. Article 1 Sec. 8 was meant to restrict congresses power, and the idea was that in order for congress to be givn more power, the states would have to cceade that power to Congress. Just because for the last century we haven't been following the constitution isn't justification for not doing so now :2cents:. A good example of Constitutional understanding taking a big slide is the issue of prohibition. How come alcohol prohibition needed a constitutional amendment, but drug prohibition does not???


Because the argument is based on the flawed assumption that the government may not do anything unless it is specifically enumerated in the Constitution.

The argument assumes that the Constitution was written as a complete "positive" blueprint for governmental power. I would argue that the Constitution was really written as a "negative" expression of limitation on governmental power. Thus, unless the Constitution says: "The government shalt not provide for healthcare," then the government may choose to provide for healthcare if the popular will permits it to do so. actually, you have the intention flipped quite 180 degrees from where it should be. Unless it is numereted in Article I sec. 8, it is a function of the states rather than congress. that's why they are called enumerated powers. The 10th amendment reserves all functions not listed in I Sec. 8 to the state governments. that's a pretty clear indication of the framers intents.

[PeterMP]

We created and largely pay for a United Nations effort for countries to collaberate on healthcare. That's called the World Health Organization and it's been in existance since just after WWII.

The WHO currently ranks the US healthcare system between Costa Rica and Slovinia.

Also by many metrics the US healthcare system is not up to par. Child Mortality, secondary infectioins, mis diagnoses leading to death, errors in crossing perscription medication leading to death are all metrics of quality of care. All metrics which the United States does not fair well against the rest of the industrialized world.
But his point is that the "ranking" by WHO isn't cut and dry. Part of their ranking is "fairness".

What happens if I disagree w/ their method of measuring what is "fair"?

The other thing is that things like life expectancy are somewhat nebulious.

For example, we had significantly more people die of HIV than Canada in 2004. Is that a failure of our health care system or a result of our behavior?

How about car accidents?

The male US death rate due to car accidents was 20.5%. The Canadian was 11.7. The US female rate was 9.2. The Canadian was 4.9.

We do worse in accidental posionings, fires, drownings, machienry and cutting and piercing equipment, firearms/missles (in fact, we do worse in all accidental categories, except falls and the other category).

Is that a failure of our healthcare system?

I will also note that we do worse in the 'Drugs, medicaments causing adverse effects in therapeutic use', but we also take more prescription drugs.

http://apps.who.int/whosis/database/mort/table1.cfm

so by nature you'd expect more adverse reactions, and they don't appear to supply any corrective mechanism.



Do you have a link for the stuff about us ranking poorly from things like misdiagnosis?

I know we do better in terms of treating stroke than most western countries, and I know that a big part of treating a stroke is to diagnosis quickly and starting treatments, AND stroke is still a significant killer.

[Predicto]

actually, you have the intention flipped quite 180 degrees from where it should be. Unless it is numereted in Article I sec. 8, it is a function of the states rather than congress. that's why they are called enumerated powers. The 10th amendment reserves all functions not listed in I Sec. 8 to the state governments. that's a pretty clear indication of the framers intents.

If you were writing this post in the 1790s, you might have an arguable point. However, 200 plus years of constitutional jurisprudence have taken place since then. The federal government's powers to promote the general welfare, regulate commerce and do acts necessary and proper in support of its goals (all contained in Article I, section 8) have been construed broadly, while the Tenth Amendment has been construed narrowly (and mostly ignored).

Talking about original framers' intent in a vacuum is interesting, but unlikely to lead to any real, practical results.

[PokerPacker]

Because the argument is based on the flawed assumption that the government may not do anything unless it is specifically enumerated in the Constitution.

"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people." - 10th Amendment

Hmm... guess the Constitution doesn't understand itself, does it?

[Baculus]

Here's what it comes down to for me:

health is not a gaurenteed right in the constitution. access to healthcare is not a guaranteed right in the constitution.

That is irrelevant. Women or blacks didn't have any voting (or citizen rights) either in the original Constitution.


so, why is nobody talking about a constitutional amendment to make this mess legal? I would oppose such an amendment, but nobody, and I mean NOBODY wants to take the route that the framers intended the country to take when a giant question on the role of government surfaces, such as now...

Because it is not necessary. People often ignore the Ninth Amendment and what it means:

"The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people."

Basically, this amendment says, "if it isn't outlined in the Bill of Rights doesn't mean it is not a right." The Bill of Rights touches upon some rights, but not all of them.


I oppose this healthcare bill on an economic and constitutional premis. I would be more inclined to accept reform if we first passed an amendment to the constitution. (doesn't mean i wouldn't campaign against such an amendment ;))

I probably would not agree with you on this point. There is nothing unconstitutional about H.R. 3200. Congress can pass national laws -- this is a federal union not a confederacy. Constitutionally, Congress has the power to regulate commerce, via the Commerce Clause, which would include the health care industry since it operates amongst the states.

I can understand why a fiscal conservative would have an opposition viewpoint, but I would probably have a hear more Constitutional arguments to be convinced that this is an issue.

[Baculus]

"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people." - 10th Amendment

Hmm... guess the Constitution doesn't understand itself, does it?

That doesn't mean that Congress cannot create laws which are not specified in the Constitution, which is an outline of government and not a list of Congressional laws.

The Founding Fathers knew that future laws would be created, which is why Congress has those powers.

[Baculus]

Just to add:

"In the UK there may be up to 15 000 avoidable deaths from cancer every year in people over the age of 75 years.

Our numbers are better than the UK or western Europe.

Cancer treatment is one of the areas in which we lead other areas of the world. But, it must be noted that the US also has a higher rate of incidents compared to Europe, too. We lead cancer research because we have a lot more people inflicted with this ailment.


http://jnnp.bmj.com/cgi/content/full/77/3/288
"Interestingly, there were large variations in outcome among the countries in this study.

North America faired the best (better than Scandinavia).

See above.


"That probably indicates the overall effectiveness of universal health care for setting a high standard."
The range of survival rates across the five provinces was quite narrow, from a low of 79.3 per cent in Nova Scotia to a high of 85.4 per cent in British Columbia."

So we are at 91.9%, and they don't give an exact number for Canada, but since it varies by province from 79.3 to 85.4, we can conclude they are somewhere in the mid to low 80's.


It appears Canada is able to deliver good care, in spite of the criticisms that some Americans have leveled against it.


If you are sick, you are still better off here over any other western country.

That is still not true at all. How are you better off here if you cannot even afford to receive the treatment? Can you explain that? Can you explain why the US is behind in some of the most important health care metrics if we are still "better off here over any other western country"?

I thought the other day you denied every saying the US has the best health care system in the world? Now, you seem to be reversing yourself.

[skinfan13]

That is irrelevant. Women or blacks didn't have any voting (or citizen rights) either in the original Constitution. perhaps I'm not being clear because you just made my point for me: we changed the Constitution. That is a perfect example of my point: such legislation was not permitted by Article I Sec. 8, so what did we do? Ignore the Constitution because the legislation was a good idea? NO! we changed it for the better!!! That is how our country works, we are ruled by laws! Congress has laws that regulate it handed down by the People, why should they not obey the laws that regulate them?




Because it is not necessary. People often ignore the Ninth Amendment and what it means:

"The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people."

Basically, this amendment says, "if it isn't outlined in the Bill of Rights doesn't mean it is not a right." The Bill of Rights touches upon some rights, but not all of them. You are mostly correct in the meaning of this amendment. This amendment was passed in order to encompass English common law, which was unwritten but had legal precedence in America prior to the revolution. If you wish I will find a scholarly source on this.

The Amendment was also to prevent congress from taking rights away from the People, but I'm 100% positive we both agree on this point, so it really is irrelveant, I merely say that for the benefit of others.




I probably would not agree with you on this point. There is nothing unconstitutional about H.R. 3200. Congress can pass national laws -- this is a federal union not a confederacy. Constitutionally, Congress has the power to regulate commerce, via the Commerce Clause, which would include the health care industry since it operates amongst the states.

I can understand why a fiscal conservative would have an opposition viewpoint, but I would probably have a hear more Constitutional arguments to be convinced that this is an issue. The underlined portion is an incredibly, incredibly bold statement.

The commerce clause is a cop-out argument. The commerce clause was not intended to be so broadly interpreted. I think it was during the depression years that SCOTUS ruled that A farmer who buys, grows, and sells his crops in-state is subject to the commerce clause because people buying his crops have to make a choice between buying his crops, and buying out of state crops, thus effecting prices across state lines. :wtf: I hope you can see that for a strict constructionist like me, the commerce clause isn't going to cut it for such legislation.

[skinfan13]

That doesn't mean that Congress cannot create laws which are not specified in the Constitution, which is an outline of government and not a list of Congressional laws.

The Founding Fathers knew that future laws would be created, which is why Congress has those powers. not entirely true. I quote Article I Sec. 8 Clause 18 USC:

"To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof."

That is the entire clause down to the punctuation, I did not copy paste that, I wrote it out from my personal copy.

Everyone forgets the part that says "foregoing Powers". It's fairly obvious that this only means Article I sec. 8's list of congress's powers and other articles concerning the powers of congress, such as the rest of article I and other bits later on concerning congress, such as the power to grant permission of private citizens to accept titles of nobility from foriegn states. This also includes the amendment by proxy (the constitution allows amending and the amendments are part of the constitution). It is not meant to mean: "It's a good idea for legislation and since the constitution does not prohibit it, its ok." it means: " In order to carry out the powers of congress effectivly, congress may make laws that allow it to excersice the specific powers granted to it."


edit: I realize that my tone in the last two posts may seem angry or confrontational, but I assure you, I mean only the best and am interested in pursuing this debate on a purely intellectual level :)

[Predicto]

The commerce clause is a cop-out argument. The commerce clause was not intended to be so broadly interpreted. I think it was during the depression years that SCOTUS ruled that A farmer who buys, grows, and sells his crops in-state is subject to the commerce clause because people buying his crops have to make a choice between buying his crops, and buying out of state crops, thus effecting prices across state lines. :wtf: I hope you can see that for a strict constructionist like me, the commerce clause isn't going to cut it for such legislation.

Yes. For a strict constructionist like you.

[Baculus]

perhaps I'm not being clear because you just made my point for me: we changed the Constitution.

The Constitution can be modified -- that is built into the document. That being said, to what are you referencing when you say, "We changed the document"?


That is a perfect example of my point: such legislation was not permitted by Article I Sec. 8, so what did we do?

Specifically, what legislation and what part of Sec. 8?


Ignore the Constitution because the legislation was a good idea? NO! we changed it for the better!!! That is how our country works, we are ruled by laws! Congress has laws that regulate it handed down by the People, why should they not obey the laws that regulate them?

Again, I am unsure to which legislation you are describing.


You are mostly correct in the meaning of this amendment. This amendment was passed in order to encompass English common law, which was unwritten but had legal precedence in America prior to the revolution. If you wish I will find a scholarly source on this.

I don't think isn't quite the entirety of this amendment nor its objective, per se.

The Founding Fathers were worried about this issue, that is, the government basically taking away rights because they were not enumerated in the Constitution.

As James Madison said:

"It has been objected also against a Bill of Rights, that, by enumerating particular exceptions to the grant of power, it would disparage those rights which were not placed in that enumeration; and it might follow by implication, that those rights which were not singled out, were intended to be assigned into the hands of the General Government, and were consequently insecure. This is one of the most plausible arguments I have ever heard against the admission of a bill of rights into this system; but, I conceive, that it may be guarded against. I have attempted it, as gentlemen may see by turning to the last clause of the fourth resolution."

http://press-pubs.uchicago.edu/founders/documents/bill_of_rightss11.html

Here is a snippet of information about it:

http://civilliberty.about.com/od/equalrights/p/9th_amendment.htm


The Amendment was also to prevent congress from taking rights away from the People, but I'm 100% positive we both agree on this point, so it really is irrelveant, I merely say that for the benefit of others.

Sure, I agree. And that is why I believe health care is a right, and the argument, "It's not in the Constitution," is irrelevant.


The underlined portion is an incredibly, incredibly bold statement.

The commerce clause is a cop-out argument. The commerce clause was not intended to be so broadly interpreted. I think it was during the depression years that SCOTUS ruled that A farmer who buys, grows, and sells his crops in-state is subject to the commerce clause because people buying his crops have to make a choice between buying his crops, and buying out of state crops, thus effecting prices across state lines. :wtf: I hope you can see that for a strict constructionist like me, the commerce clause isn't going to cut it for such legislation.

As a Constitutionalist, you would have to provide examples to how such legislation would exceed the boundaries of the Commerce Clause. The Founding Fathers knew regulation would grow, and, in fact, even at that time, they were starting to regulate it between the states, partially to remove tariffs between the developing regions.

Federal regulation of commerce is not new -- it dates back to the 18th century, when this nation was young, and commerce between the colonies, its roads and ports, were regulated. Such centralized regulation, in fact, is one of the reasons why we became a rising economic power.

Thus, I think the argument isn't a matter of "can the government regulate health care?" as opposed to "should the government regulate health care?"

[PokerPacker]

That doesn't mean that Congress cannot create laws which are not specified in the Constitution, which is an outline of government and not a list of Congressional laws.

The Founding Fathers knew that future laws would be created, which is why Congress has those powers.

It means they cannot create laws that are outside of their realm of jurisdiction as defined by The Constitution without first passing an amendment to The Constitution itself redefining their jurisdiction.

[skinfan13]

Yes. For a strict constructionist like you. Thank you for making clear that I was talking about my personal beliefs :silly:

[Baculus]

It means they cannot create laws that are outside of their realm of jurisdiction as defined by The Constitution without first passing an amendment to The Constitution itself redefining their jurisdiction.

Right. Thus, an argument would have to be made to what is outside of their jurisdiction. Commerce isn't that -- it is a specific Congressional power.

[PeterMP]

That is still not true at all. How are you better off here if you cannot even afford to receive the treatment? Can you explain that? Can you explain why the US is behind in some of the most important health care metrics if we are still "better off here over any other western country"?



I thought the other day you denied every saying the US has the best health care system in the world? Now, you seem to be reversing yourself.

The above statistics take into account ones ability to pay. People here w/ cancer when taken accross all people's ability to pay recover better than in other countries. Unless a priori you know something about somebody's ability to pay, you would conclude a cancer patient is better off here.

Samething with stroke. I can post data on other pretty general, but serious health issues if you'd like.

You missed an important point. IF you are sick. Other systems, probably at least partly (if not mostly) due to their preventative care measures (and also at least partly likely do to societal differences), have fewer people that actually have these types of issues.

Going back to your study the other day about aspiring and stroke prevention. If you are in Canada, you are more likely to get proper guidance via preventative care about avoiding a stroke and so are less likely to have a stroke (vs. the same person that doesn't get that same info). If however, you are one of those that don't follow the guidance so you get a stroke (some won't follow the guidance and won't get a stroke) or are going to get a stroke despite following preventative care, you are better off here in general (that might not be true for all depending on their income/insurance status).

(As a footnote, I'd love to see a study comparing the effect of preventative care in vs. Canada (i.e. how many more Canadians follow their doctors advise than Americans). If you remember, only 50% of Americans that were told to take aspirin followed their doctors advice.)

In addition, I'd argue that BEST should also be a function of costs considering the conversation. In terms of helping the sick, we do an excellent job, but it could be easily argued we spend to much for the superior job we do.

[PokerPacker]

I also think we should make the distinction between freedoms and entitlements. Equating the right to free speech and the supposed right to health care doesn't work, because one is preventing abridgment of one's personal freedom, while the other is providing a service. two very different beasts.

[Baculus]

This is nice. Here is a video of a Jewish man talking about Israel's health care system, which is a nationalized system (did you hear that? Our Israeli allies are COMMUNISTS!), and this woman says "heil Hitler" to the gentlemen. She then proceeds to act obnoxiously when the man admonishes her for her words, claiming that "he should be the most against Obama," because, you know, Obama is a Nazi. And universal health care systems are fascist, right?

:doh:

The Jewish fellow talks about having to spend $8,000 dollars at a nearby hospital because he didn't have insurance, and she mocks him as if he is "crying."

http://thinkprogress.org/2009/08/18/hitler-israel/

This woman is asinine -- people have lost their minds over this issue. This is what we get from all of the fear mongering from the right-wing: People that do not know what they are talking about.

[Predicto]

Thank you for making clear that I was talking about my personal beliefs :silly:

Well, be fair. You were asking in your original post: "why is nobody talking about a constitutional amendment to make this mess legal?"

The answer is because "this mess" currently is not illegal. A strict constitutionalist such as yourself might want the constitution interpreted such that a law like this would be deemed illegal, but under actual constitutional law as it has developed for 220 years, it is not illegal.

Which explains why no one is bothering talking about amending the constitution to make it legal, except for you.

[Predicto]

In addition, I'd argue that BEST should also be a function of costs considering the conversation. In terms of helping the sick, we do an excellent job, but it could be easily argued we spend to much for the superior job we do.

I agree, but I would add that it is at least a legitimate question to ask about reaching the uninsured and underinsured.

After all, Iraq used to have a fantastic health care system - if your name was Saddam Hussein. A system that is great for the rich, mediocre and overpriced for lower incomes, and essentially nonexistent for the poor except in emergencies - I find that system difficult to defend.

[Baculus]

I also think we should make the distinction between freedoms and entitlements. Equating the right to free speech and the supposed right to health care doesn't work, because one is preventing abridgment of one's personal freedom, while the other is providing a service. two very different beasts.

You are talking about the difference between negative and positive rights. Free speech can be seen as a negative right (meaning, you are free NOT to be suppressed), while health care is seen as a positive right. We have police departments and public education due to negative rights as well.

You have a right to be protected by the police. You have a right to a public education.

[Predicto]

This is nice. Here is a video of a Jewish man talking about Israel's health care system, which is a nationalized system (did you hear that? Our Israeli allies are COMMUNISTS!), and this woman says "heil Hitler" to the gentlemen. She then proceeds to act obnoxiously when the man admonishes her for her words, claiming that "he should be the most against Obama," because, you know, Obama is a Nazi. And universal health care systems are fascist, right?

:doh:

The Jewish fellow talks about having to spend $8,000 dollars at a nearby hospital because he didn't have insurance, and she mocks him as if he is "crying."

http://thinkprogress.org/2009/08/18/hitler-israel/

This woman is asinine -- people have lost their minds over this issue. This is what we get from all of the fear mongering from the right-wing: People that do not know what they are talking about.


Holy Smoke!

Why do I doubt that this will be discussed on Fox News tonight?

[Baculus]

The above statistics take into account ones ability to pay. People here w/ cancer when taken accross all people's ability to pay recover better than in other countries. Unless a priori you know something about somebody's ability to pay, you would conclude a cancer patient is better off here.

Sure. But you have to be able to pay in the first place, so it isn't as easy as "our system is the best because we have great cancer treatment." If you cannot pay for this treatment, then it is a moot point. We may as well have the worst treatment in the world, and some treatment in a universal system is better then none. Wouldn't you agree?


You missed an important point. IF you are sick. Other systems, probably at least partly (if not mostly) due to their preventative care measures (and also at least partly likely do to societal differences), have fewer people that actually have these types of issues.

Sure. That is true, and one advantage of those sort of systems. Plus, these days, Americans just aren't as health as other populations (which helps with the performance of their systems, which you are basically arguing).


Going back to your study the other day about aspiring and stroke prevention. If you are in Canada, you are more likely to get proper guidance via preventative care about avoiding a stroke and so are less likely to have a stroke (vs. the same person that doesn't get that same info). If however, you are one of those that don't follow the guidance so you get a stroke (some won't follow the guidance and won't get a stroke) or are going to get a stroke despite following preventative care, you are better off here in general (that might not be true for all depending on their income/insurance status).

I can agree that, statistically, the US is ahead of Canada in that regards. Of course, it still depends on the region -- some areas of Canada do outperform some American regions, and vise-versa.


(As a footnote, I'd love to see a study comparing the effect of preventative care in vs. Canada (i.e. how many more Canadians follow their doctors advise than Americans). If you remember, only 50% of Americans that were told to take aspirin followed their doctors advice.)

That would be an interesting study. I am not sure how far back some of these preventive medicine studies go, since it seems to be a more recent trend in medicine.


In addition, I'd argue that BEST should also be a function of costs considering the conversation. In terms of helping the sick, we do an excellent job, but it could be easily argued we spend to much for the superior job we do.

In some areas, yes, we do a decent job when a patient is able to receive treatment. But that cuts to the heart of this debate, doesn't it?

[Baculus]

Holy Smoke!

Why do I doubt that this will be discussed on Fox News tonight?

The changes are pretty slim, IMO. I suspect Shepard Smith would be the person who shows this video, if anyone.

[PokerPacker]

You are talking about the difference between negative and positive rights. Free speech can be seen as a negative right (meaning, you are free NOT to be suppressed), while health care is seen as a positive right. We have police departments and public education due to negative rights as well.

You have a right to be protected by the police. You have a right to a public education.

Police and Schooling are State issues, not Federal (Department of Education is unconstitutional).

If a State wishes to give out universal health care for its citizens, that is that State's issue to deal with.

[skinfan13]

The Constitution can be modified -- that is built into the document. That being said, to what are you referencing when you say, "We changed the document"?



Specifically, what legislation and what part of Sec. 8?



Again, I am unsure to which legislation you are describing. I was referring to this:


That is irrelevant. Women or blacks didn't have any voting (or citizen rights) either in the original Constitution. the 15th and 19th amendments (I thought it was more obvious that I was referring to those, perhaps I should have been clearer. The thought was, such hypothetical legislation encompassing what became both of those amendments was unconstitutional, and thus, they were added via amendments in order to make it so. They changed the constitution instead of sidestepping it, which is still what we should do. The founders made amending difficult so that each amendment would be treated with much gravity and that only one's we were dead sure about would be passed.

prohibition of alcohol was the same way. At least prohibitionists knew that they needed an amendment in order for their aims to be constitutional. (unlike our current drug prohibition).




I don't think isn't quite the entirety of this amendment nor its objective, per se.

The Founding Fathers were worried about this issue, that is, the government basically taking away rights because they were not enumerated in the Constitution.

As James Madison said:

"It has been objected also against a Bill of Rights, that, by enumerating particular exceptions to the grant of power, it would disparage those rights which were not placed in that enumeration; and it might follow by implication, that those rights which were not singled out, were intended to be assigned into the hands of the General Government, and were consequently insecure. This is one of the most plausible arguments I have ever heard against the admission of a bill of rights into this system; but, I conceive, that it may be guarded against. I have attempted it, as gentlemen may see by turning to the last clause of the fourth resolution."

http://press-pubs.uchicago.edu/founders/documents/bill_of_rightss11.html

Here is a snippet of information about it:

http://civilliberty.about.com/od/equalrights/p/9th_amendment.htm That's all fine and dandy, but the amendment isn't meant to make everything a right. It only prevents congress from prohibiting rights or taking rights from the People, and incorporating common english law at the birth of the nation into the constitution. That is how most constitutional scholars look at the 9th amendment.




Sure, I agree. And that is why I believe health care is a right, and the argument, "It's not in the Constitution," is irrelevant.
again, you're taking it too broadly. If this were the case, then there would be no need for the 13th, 14th, 15th, 17th, or 26th amendments.



As a Constitutionalist, you would have to provide examples to how such legislation would exceed the boundaries of the Commerce Clause. The Founding Fathers knew regulation would grow, and, in fact, even at that time, they were starting to regulate it between the states, partially to remove tariffs between the developing regions.

Federal regulation of commerce is not new -- it dates back to the 18th century, when this nation was young, and commerce between the colonies, its roads and ports, were regulated. Such centralized regulation, in fact, is one of the reasons why we became a rising economic power.

Thus, I think the argument isn't a matter of "can the government regulate health care?" as opposed to "should the government regulate health care?" See I think we were talking about different things here. I was refering to public option. Congress certaintly has the right to reasonably regulate the industry. Now I believe such regulation should be limitted. I do not dispute reasonable regulations.

[skinfan13]

Well, be fair. You were asking in your original post: "why is nobody talking about a constitutional amendment to make this mess legal?"

The answer is because "this mess" currently is not illegal. A strict constitutionalist such as yourself might want the constitution interpreted such that a law like this would be deemed illegal, but under actual constitutional law as it has developed for 220 years, it is not illegal.

Which explains why no one is bothering talking about amending the constitution to make it legal, except for you. This would not have been the case 100 years ago. The progressive movement did much damage to this country in terms of federalism. (progressive in this sense being the movement, not today's liberals since they call themselves progressives for some reason).

[Baculus]

Police and Schooling are State issues, not Federal (Department of Education is unconstitutional).

If a State wishes to give out universal health care for its citizens, that is that State's issue to deal with.

First, let's remember what we are discussing here: The right to health care. Once we establish if it is a right, then we can argue to how such a right is delivered. In the case of H.R. 3200 and regulating health care, I see no Constitutional issues.

As far as the Dept. of Education, Article Two of the Constitution has long been used to appoint and create Cabinet level positions. George Washington, after all, was the first to do so.

[Baculus]

This would not have been the case 100 years ago. The progressive movement did much damage to this country in terms of federalism. (progressive in this sense being the movement, not today's liberals since they call themselves progressives for some reason).

I would argue the opposite, in that the Progressive era was one of the most important periods in US political history. Also, liberals call themselves "progressives" because they are the modern heirs to the Progressive movement from that time period and extending into the 21st century. Progressives such as Robert "Fighting Bob" La Follette is still admired by modern liberal progressives. ("Fighting Bob Fest" is one of the largest yearly gatherings for such progressives.)

What did the progressives accomplished? They passed child labor law, supported women's suffrage (which resulted in the 19th Amendment), sponsored anti-trust laws (Sherman Anti-trust Act), pushed for food and meat inspection (Socialist Upton Sinclair was influential with his book, "The Jungle").

Progressives were also successfully responsible for pushing for more government transparency and direct democracy within the states. The 17th Amendment is example of this direct democracy -- that is why we can now elect our senators instead of having the state legislate choose them. (Most people do not realize this, I might add, too.)

As far as federal regulation, it was needed at that time, especially in regard to the railroads and other corporate interests.

[skinfan13]

I would argue the opposite, in that the Progressive era was one of the most important periods in US political history. Also, liberals call themselves "progressives" because they are the modern heirs to the Progressive movement from that time period and extending into the 21st century. Progressives such as Robert "Fighting Bob" La Follette is still admired by modern liberal progressives. ("Fighting Bob Fest" is one of the largest yearly gatherings for such progressives.)

What did the progressives accomplished? They passed child labor law, supported women's suffrage (which resulted in the 19th Amendment), sponsored anti-trust laws (Sherman Anti-trust Act), pushed for food and meat inspection (Socialist Upton Sinclair was influential with his book, "The Jungle").

Progressives were also successfully responsible for pushing for more government transparency and direct democracy within the states. The 17th Amendment is example of this direct democracy -- that is why we can now elect our senators instead of having the state legislate choose them. (Most people do not realize this, I might add, too.)

As far as federal regulation, it was needed at that time, especially in regard to the railroads and other corporate interests. Interesting you bring up these points. This really isn't the thread to discuss this stuff in. I personally despise the 17th amendment. it is by FAR the part of the constitution I like the least. I even started a thread on it. I suggest we stop derailing the healthcare debate and discuss those sorts of issues in that thread. I know what progressives accomplished and I think the damage they did outweighs the good they accomplished.

[PeterMP]

I agree, but I would add that it is at least a legitimate question to ask about reaching the uninsured and underinsured.

After all, Iraq used to have a fantastic health care system - if your name was Saddam Hussein. A system that is great for the rich, mediocre and overpriced for lower incomes, and essentially nonexistent for the poor except in emergencies - I find that system difficult to defend.


Sure. But you have to be able to pay in the first place, so it isn't as easy as "our system is the best because we have great cancer treatment." If you cannot pay for this treatment, then it is a moot point. We may as well have the worst treatment in the world, and some treatment in a universal system is better then none. Wouldn't you agree?
Even poor people are diagnosed w/ cancer in this country. Those that can't access healthcare treatment due to costs will factor into the caculation of percentage that recover.

We do a better job in terms of people recovering than essentially every western European country (all of those that I know of) and Canada, when everybody is concluded.

[Baculus]

Interesting you bring up these points. This really isn't the thread to discuss this stuff in. I personally despise the 17th amendment. it is by FAR the part of the constitution I like the least. I even started a thread on it. I suggest we stop derailing the healthcare debate and discuss those sorts of issues in that thread. I know what progressives accomplished and I think the damage they did outweighs the good they accomplished.

Why do you detest an amendment which allowed for direct democracy? This may indeed be a little OT, but I admit I find your position to be a bit puzzling.

America is simply a better nation for progressive policies, but, as you said, that is neither here nor there in this debate.

[Baculus]

Even poor people are diagnosed w/ cancer in this country. Those that can't access healthcare treatment due to costs will factor into the caculation of percentage that recover.

Being diagnosed with cancer is entirely different then being treated for cancer.


We do a better job in terms of people recovering than essentially every western European country (all of those that I know of) and Canada, when everybody is concluded.

Patient recovery is only one part of health care, and I would venture to guess that for many procedures, Canada and Europe has similar statistics in this area.

[PeterMP]

Being diagnosed with cancer is entirely different then being treated for cancer.
Is this really that hard?
If you are not treated and you don't recover on your own, then you will be part of the calculation in terms of those that didn't recover.

You will pull down the percent recovery of the nation that you live in. If large amounts of people had cancer, weren't getting treated, and then died (as compared to other countries), we'd have a low percentage of recovery.

We don't. Compared to the rest of the western world we do very well.

I picked cancer and stroke because they are to representative diseases. Sometimes other western countries do as well w/ other diseases, but accross the board for things like these we do better in terms of recovery (we do have higher numbers of incidents, which is likely at least partly due to our preventative care issues).


***EDIT***
Look, my general point is that people love to absolutely trash our medical system. If you listened to JMS and some others, they'd have you believe we didn't do anything right.

We have serious issues, but there are things we do VERY well.

To ignore that is dumb.

[Baculus]

Is this really that hard?
If you are not treated and you don't recover on your own, then you will be part of the calculation in terms of those that didn't recover.

You will pull down the percent recovery of the nation that you live in. If large amounts of people had cancer, weren't getting treated, and then died (as compared to other countries), we'd have a low percentage of recovery.

We don't. Compared to the rest of the western world we do very well.

It didn't take me long to find this article:

http://latimesblogs.latimes.com/booster_shots/2009/02/breast-cancer-p.html

This was soon followed by this:

http://www.theheart.org/article/952289.do

We do have issues with cancer treatment. I know -- my father died from cancer. And not only that, but he was misdiagnosed with it. If his physician had demonstrated a bit more competency it is possible he would be alive today. Now, this is not an appeal to emotion to my position, but there is a personal reason to why I am a bit skeptical in regard to this particular line of discussion.

And we are not even addressing the issue to why the US has so many incidents of cancer compared to other nations.


I picked cancer and stroke because they are to representative diseases. Sometimes other western countries do as well w/ other diseases, but accross the board for things like these we do better in terms of recovery (we do have higher numbers of incidents, which is likely at least partly due to our preventative care issues).

***EDIT***
Look, my general point is that people love to absolutely trash our medical system. If you listened to JMS and some others, they'd have you believe we didn't do anything right.

We have serious issues, but there are things we do VERY well.

To ignore that is dumb.

Yes, on the other hand, to ignore our problems is even worse. That's exactly what anti-reformers do: They proclaim our system the best in the world, nothing needs to be done about it, and we can learn nothing from other nations. They loudly proclaim, "Our system is the best in the world!" as they agitate to preserve the status quo.

This is a fact -- we simply do not have the best system in the world. As you have indicated, we are good in some stuff, but we have poor results in other.

[PeterMP]

It didn't take me long to find this article:

http://latimesblogs.latimes.com/booster_shots/2009/02/breast-cancer-p.html

This was soon followed by this:

http://www.theheart.org/article/952289.do

We do have issues with cancer treatment. I know -- my father died from cancer. And not only that, but he was misdiagnosed with it. If his physician had demonstrated a bit more competency it is possible he would be alive today. Now, this is not an appeal to emotion to my position, but there is a personal reason to why I am a bit skeptical in regard to this particular line of discussion.

I don't doubt that we have issues, but the stats repeatedly show in multiple studies on multiple diseases on average that you are more likely to survive here than over seas.

[Baculus]

I don't doubt that we have issues, but the stats repeatedly show in multiple studies on multiple diseases on average that you are more likely to survive here than over seas.

At the same time, you are more like to develop cancer and other chronic illnesses here in the US. Also, it must be restated that, in overall critical stats, we're still behind other natiions.

It's simple -- we keep what we do well. Any such new system does not mean we won't.

[PeterMP]

At the same time, you are more like to develop cancer and other chronic illnesses here in the US.
But how much of that is due to our health system vs. society/culture.

I'll admit that some are related to other countries more extensive primary care, but there is no guarantee that going to another healthcare system will bring us down to their levels.

[skinfan13]

Why do you detest an amendment which allowed for direct democracy? This may indeed be a little OT, but I admit I find your position to be a bit puzzling.

America is simply a better nation for progressive policies, but, as you said, that is neither here nor there in this debate. I'll respond to this, because you seem genuinely curious, and then I'll take my leave from talking about theories on government not pertaining to health care. I would be happy to move this conversation to one of my old threads on the 17th amendment however if you feel like responding.

First and foremost, I must point out that our Republic was never intended to be a democracy, especially a direct democracy. We are a constitutional, federal, republic. Representative democracy on the whole is much better suited to our country. Jefferson despised direct democracy, because in such a system 51% can terrorize and strip away the rights of the other 49%. It is for this reason we have federalism.

The genius of checks and balances did not only extend to the federal government, but also formed a nice triangle of power between the national government, the state government, and the people. This was attained through the election of candidates by the people to the House of representatives and the Presidency, the federal government represented themselves of course in whatever they did, and the senate was the states' check upon federal power by having state legislators appoint senators. I am well aware of the corruption involved in later years surrounding the appointment of senators, but something has to be said for the destruction of the system of checks and balances as it was created. It is no coincidence that special interest politics exploded after the passage of the 17th amendment. I whole-heartedly believe that. Now, I am not saying that what we had in place prior to the 17th amendment was fantastic, but the complete exclusion of the states' representation in the federal government has weakend the states to the point that their soverignty barely exists, which is not good for the People.

I have sent numerous petitions to my congressman (who my grandfather actually knows. I know he's actually considered what I said before) and my senators asking that they listen to what I have to say on the issue. I believe we should repeal the 17th amendment. We should replace it however with a new system of representation for the states. I've always thought that perhaps one senator should be appointed by the legislature their state and the other popularly elected by the People. Likewise, I believe the State's should be given one representative in the House. perhaps an non-voting one. I would be fine if that second part didn't happen at all.

A restoration of the states' check upon the federal government would be nice. A reduction in special interest politics in the senate would likewise be nice.

like I said, I would be happy to continue such a conversation in a different thread, perhaps mine on the 17th amendment: http://www.extremeskins.com/showthread.php?t=211620

[PeterMP]

It's simple -- we keep what we do well. Any such new system does not mean we won't.
I wanted to come back to this. It isn't that simple. It isn't like the Canadians and Europeans WANT to have a smaller percentage of people recovering from cancer and other serious illnesses than us.

They know there are differences, but closing the gap IS NOT simple (while keeping in the cost structures they've established). The study I posted suggested changes to the Canadian system to improve their stroke recovery. All of the things they mentioned cost money.

So the question becomes how do we keep what we have that works, whle moving to a lower cost system (and ideally a system where costs aren't increasing faster than inflation)?

And since the plan under consideration is Obama's, the question really becomes does Obama's plan do that for you?

I think the answer is pretty clear that it does probably allow you to keep much of what we have, but it doesn't really do much to actually create a system w/ lower cost.

As an example, in the other study you posted, they pointed out one big benefit in the Canadian system is they don't even track costs by patient. The government doesn't know what person got what procedure for hosipitials. They just set a global budget for the hosipitial. This obviously reduces paper work. There is nothing in Obama's plan that is going to allow for that kind of reduction in over head costs.