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This is from my country, Norway.
Not so much. The US is currently one of the top (if not *the* top, no figures handy this moment) oil consumers in the world. Turning that around to a point where we can survive on our own oil production--let alone to a point where we can export--would literally destroy the oil market.
As a consequence, Norway would suffer a significant blow to its income as the price of oil fell through the floor, and you'd be unable to sustain your own system. Meanwhile, as oil production here is pretty much entirely private (Alaska does give yearly stipends to its residents for oil exploitation, but it's not much), it would not have near the impact on the federal budget you seem to expect.
Bottom line: there's no simple solution. What works for one country may not work for another, even when you're comparing similar nations--let alone ones as disparate as Norway (very small, very homogenous, massive exports) and the US (very large, very diverse, net importer).
Another problem is that we are getting rid of "good jobs" in America and exporting it to India and other places like that.
That's my expectation of how the process will actually work because that's how politics works. I believe that the entirety of the current US health insurance industry needs to go. That can never happen in a political process where powerful (and wealthy) insurance lobby interests put political pressure to keep as much of their power and wealth intact as possible. Same with doctors. Doctors simply make *way* more money than they deserve. We could have some kind of wage controls, or we could have them work for the government or many different options all of which the AMA lobby will be fighting tooth and nail every inch of the way. Same with the pharmacutical companies, same with any of the powerful interests with a vested position in the current status quo. That's how politics works, negotiation and compromise. Who can predict the functionality of a system that results from a compromise between the AMA, the insurance companies and the pharmacuticals. How it worked would be dictated by who negotiated better or who applied the most pressure or who had the better ad campaign.
Who could ever predict what kind of system would emerge let alone anticipate the efficiency of such a system.
There is a big benefit in starting with a system that as a unified whole actually works albeit with a few warts then hoping that whatever we come up with won't be a total and complete disaster.
I believe the US healthcare system is going to hell in a handbasket and it's going there rather quickly. I still believe that a random selection of the worlds top ten best systems will yield something better than we could come up with even if we negotiated and legislated and committee'd ourselves to death for the next 20 years because that's how long it will take. You think the Global Warming discussion is contentious, just wait, the healthcare deniers will blot out the sun with their numbers. Just throw a dart and pick a system sometime before I die of old age in the next 20 years and I'll be happy.
Whether we like it or not, incrementalism is a fundamental feature of U.S. public policy. As is interest group influence. Taking down PhRMA would be a generational task, far beyond the power of a single presidency or even several Congresses. And they are just one powerhouse at the table when it comes to defending the U.S. status quo. So all I'm hoping for this round is that we can get something like an option for anyone who wants it to buy into Medicare.
The real 'cost factor' that most U.S. folks are not willing do discuss directly is the question of whether most medical care should be for-profit or nonprofit. I have no objection to upper middle-class people being able to pay for a fancy, private complement to the 'real' health care system.
But as a child of a dedicated health care professional who watched and bemoaned the rise of "the business model" in hospitals, I would very much prefer to receive my care from people who want to be in public service, not people who want a big and rapidly growing paycheck. There's a reason nurses used to wear those funny hats. Their profession's roots are in nunneries. As in gangs of women sworn to serving a higher purpose, not cleaning up after arrogant, profiteering doctors whose white coats make them feel godlike, or worse, pushing paper for faceless technocrats stacked nine deep in a private bureaucracy.
it would be impossible to implement a health care system which has much lower cost per capita than the current one you have in the USA?
The Annual rise of expenditures has been higher in the USA than for france in the last decades, both with a trend in slowing down the cost rise. the one of UK had a higher rise but it probably will them still take a few decades to catch up.
http://www.kff.org/insurance/snapshot/chcm010307oth.cfm
(take a look at the exhibits, its very interesting to see the development of health care costs from 1970 on, a lot countries which were roughly on the same level as the USA in 1970 are now at only about half the costs the USA are)
Yes, Norway is a very good country to live in, maybe the best one in the world if you can use such a sweeping statement like it's an objective truth. That doesn't mean the country doesn't have its share of problems, although you could argue that we aren't worse off than any other country out there. The video was nice, but it felt kinda artificially utopian ^^; If you look around the country, you won't have problems finding people who aren't having a very "good" life, be it emotionally or in the actual fulfilment of physical needs. Likewise, I'd be surprised if you couldn't find people in most countries in the world who are very happy with their country and their lives in general.
As has been mentioned, if you have a condition that needs medical treatment, it doesn't cost you anything, but some specialised treatment can take months or even years to actually receive because of the queues in the medical system. If you can afford it, there's always private clinics you can go to instead, although there aren't any private major hospitals so the seriousness and range of conditions you can treat privately are relatively limited. Medicine can either be partially paid for by the state or not, but even with partial coverage from the state an elderly person with mulitple conditions that needs treatment can use a large amount of his or her pension on medication per month, and that's on top of other costs of living in one of the most expensive countries in the world. For a person who can work full time though, medicine expenses are usually very manageable. There is a limited scope of medication available; not all medicine available in the world is approved for use here, and due to government funding of some meds, they will often opt for a cheaper medication than one that is more expensive but has less side effects or better symptom relief, sometimes completely barring the "better" medicine from being sold here at all or demanding that the person who wants it has to bear the full cost themselves.
We're also using waaaaaay too much money on our medical system at the moment without getting enough in return for it. The government is currently trying to turn the system around a bit, as we're pouring in more and more money but not actually seeing an appreciable increase in effciency from it.
Some problems are less immediate, but are also pretty much the same all over the world, like the "worrying" trend that people gradually live longer and longer and we might end up with too little labour force to adequately take care of them all a few decades from now. Not to mention the increase in pension expenses when such a time comes. This is one of the main reasons we have our "Norwegian Government Pension Fund", a Sovereign Wealth Fund that is meant to cover a large part of those expenses a couple of decades from now when income from tax and exports can't handle all the expenses that comes with an aging population. Ideally the fund would accumulate enough wealth that the interest and returns alone could cover this, but that is (in my opinion) unlikely to happen.
That our main export income comes from Oil and that it won't last forever isn't something that has gone unnoticed by ourselves either. The standards of our education has been criticised for years because of poor results internationally (yes, we got a high rate of literacy, but knowing how to read isn't exactly enough). There's also a fairly common opinion that we aren't using enough money on research and development in order to give ourselves more legs to stand on in the future, since reliance on fossil fuels isn't viable in the long term as far as income is concerned, and there's also a limit to how much renewable energy we can produce without completely ravaging the entire country's nature and wildlife.
Anyway, I could rant for hours about things that aren't all that good in this country, but it doesn't really matter. Let's just say that while what was shown in the movie clip is entirely true, it's also a very simplified and somewhat one-sided portayal of Norway. I love living here, it's a great country, but not quite as perfect as that movie might make it seem ^^ We don't have all of your problems, but we certainly have our own I would suspect that the same goes for most countries out there. And yes, we feel the credit crunch here as well (Stardock games are around 50% more expensive now in Norwegian Kroner than they were at the cheapest last year! )
Oh, and speaking of oil:
In Norway, the government has something it calls "Handlingsregelen" (not sure how to translate that... Emm, The Act/Action Rule?). It governs how much money the government should spend of the oil income we have. Currently it is set to be the expected yield/returns on the pension fund (after adjusting for inflation etc), which is set to be 4% of the fund. In this way, the fund will theoretically never shrink even if there's no actual new oil income being added to it (provided the fund actually achieves a 4% return), and it allows for use of more money as the oil income added to it makes the fund bigger. This is in theory though; the rule was put in effect by the government in 2001 and they never actually managed to use that little until the budget suggestion that was put forth in 2007, which was based on using slightly less than the 4% set by the rule. I can't at a cursory search find out how much money that actually was, but I think it was around 11-13 billion dollars (by today's exchange rate).
Naturally, the fund has been affected by the current economic state that came from the credit crunch, so next year I assume they'll have to use more than 4% in order to get a balanced budget.
Wow you guys make for an interesting read.
I lie in Quebec canada, and our healthcare is not perfect in any way. There are long waits for some things and when you want to go to the emergency room sometimes you can wait up to 24h before you get service. Of course when you have to wait that long it's usually ebcause you have nothing serious and you could of stayed home and tough it out. That is what I think our bigest problem is with "free" healthcare. People get a papercut and run run run they go to the emergency room.I've been to the emergency room, about 5 times in my life: I'm 34 and 3 times I had to be operated the other 2 times thought me to stay home and tough it out until it passed or I passed out LOL
The fun part about my healthcare is having a family doctor that I can see pretty much when I want (keep in mind that I usually have to wait 1 to 2 month for my appointment) but I do get to see her regularly which means I get my normal checkups. All this included in my taxes. I earn 40K a year here and I am taxed at 35% When you make more then 55K here you are taxed 52%. That's more then half of your ernngs for taxes. Ouch. But then again I would not give it up for anything in the world. Another thing in canada the healthcare and taxes are done differently in each province. They all have they way of handeling theur "free healthcare" and taxes. In alberta for exemple they have less then half of my taxes. They also have lots of oil!
That's the big lines of our free healthcare.
Then there is medication issurance... that's another story!
This is why most countries do not have a 100% socialized healthcare system. It is very common that the state dictates a high standard minimal coverage level for each of its citizens regardless how much money they have. This the socialized part of the system. On the other hand, there is little issue of having pharmacies compete with each other, this may reduce the price of drugs and thus keep the costs of the healthcare system under control. Or you could for example have drug manufacturers fight each other for the lowest prices in public tenders. Market mechanisms are a proven mechanism to keep costs under control. Whatever competition is introduced, it is always done in such a way that everyone has equal access to health care facilities.
When Michael Moore shows the situation in France, he "forgets" to tell you that many healthcare services in France do cost money. Not anything unreasonable, it is simply that not everything is available for free. Yes, it is true every French citizen has access to high quality health care, his main point is fully correct. But if you want the services Michael Moore shows you, you need to pay extra.
Norway has one of the most expensive healthcare systems out there besides the US, plus it has massive oil revenues, plus one of the highest tax rates in the world with which to sustain it. And as kryo pointed out, adopting an identical system in the US would be even more expensive due to the size and population of the US and other factors such as our horrible lifestyles. If we switch over to any form of socialized healthcare, taxes will have to go up - but there is going to be massive resistence to it; it'll be a real long time if ever before Americans will settle for taxes remotely near what Norwegians pay.
Frankly I think the most telling thing about that table has nothing to do with comparisons between different countries; no, it's that healthcare costs everywhere are going up at unsustainable rates. I wasn't saying that the problems I mentioned about all those countries' healthcare systems aren't also present (and usually worse) in the US system. But I just think it's a terribly dumb idea to make our goal to copy a system that's just as doomed to failure as our own, just in a few extra years.
Much of the american population already can't afford our healthcare, and that group of people grows every year. The rising costs prevent poorer people from getting decent healthcare and strains the rest of the population's budgets. In places like France and the UK, the rising costs means that the governments are starting to be unable to maintain their healthcare systems' overall quality - in terms of both the quality of the actual care and treatment, and timeliness. What I'm saying is, in the US individuals are becoming unable to afford healthcare from the bottom of the financial structure up. In most other countries, the healthcare systems themselves are beginning or going to begin degrading. I don't want to trade one for the other - I want to solve our relatively unique problem without causing the other.
I was looking for information (hopefully without an obvious bias) that objectively compared the US healthcare system to that of the rest of the world. The most comprehensive source that I found was a report entitled The U.S health Care System: Best in the World, or Just the most Expensive? which was published by the Bureau of Labor Education which is part of the Division of Lifelong Learning which is itself a part of the University of Maine.
The downside of this data is that it was published in 2001 and so is somewhat dated. However if anything I think this underestimates the issue. I highly doubt the US healthcare system has gotten *more* competitive within the last 7 and 1/2 years. But if anyone can find more recent data that's reasonably unbiased then I would definitely like to see it.
The first point of the report is a cost comparison. The following data is excerpt from a chart on page 3 of the linked report and lists the per capita health spending of a number of countries in 1998 U.S. Dollars.
$4178 U.S.A$2794 Switzerland$2425 Norway$2424 Germany$2312 Canada$2215 Luxembourg$2133 Denmark$2077 France$2043 Australia$1822 Japan$1783 Italy$1746 Sweden$1502 Finland$1461 U.K.
Based on this data the US per capita spending sticks out like a sore thumb. If you take the average of all countries listed except the US and average them you get $2057. So on average the US costs are more than *twice* those of the rest of the developed world. Clearly we're doing something drastically wrong that most everyone else has managed to avoid.
The report goes on to compare the quality of various healthcare systems. This information is exerpt from a table on page 4. Basically the US is last in infant mortality, 2nd to last in life expectancy, last in health system overall performance and 2nd to last in percent satisfied with health system. The only thing that the U.S. ranks near the top is in responsiveness. So at least we don't have to wait very long to get essentially the worst care in the developed world.
Another point I want to respond to is a few folks have commented that some countries healthcare systems are "unsustainable". Not really sure what this means. If a $2000 per capita system is unsustainable then how can a $4000 per capita system be sustainable?
Sustainable to me implies that there is some balance between income generated versus costs of a specific endeavor. But that makes no sense whatsoever. What difference does it matter where the funds used to provide healthcare come from. Whether it's taxes, or some magic source of income, it's all money. The question is not sustainability, the question is one of priority. Spending $500B a year on our military budget seems sustainable in that we've been doing it for quite some time with no end in sight. Last I heard we don't rent out our military to other countries for side jobs to offset expenses (this might not be a bad idea though). If we can afford 1/2 trillion dollars a year on a military we can afford to fix healthcare.
You're implying that the per capita cost of Norway's healthcare system does not count the oil revenue. Like I said the per capita cost is per capita cost, whether the money comes 100% from taxes or partially from taxes and some nationalized oil income or any other combination, it's not that the per capita cost is calculated by taking the cost and subtracting oil revenue and then dividing by population, it's just the costs divided by population. The oil income just makes their taxes lower than they might otherwise be, but it doesn't change the per capita cost.
Note that I didn't chase down TheBigOne's link before posting my own chart although the data *is* pretty much similar.
[edit] Also when extrapolating a small countries system to a larger country like the US I would expect that per capita costs could be lower due to economies of scale. A number of things are "sunk" costs that get amortized over the total population. The larger the population the lower fixed costs are on a per capita basis. [/edit]
My health insurance burden is very close to approaching the amount I pay in federal taxes. We're paying for it one way or the other. Pay 1X taxes and 1X healthcare or pay 2X taxes, it's all the same except the higher taxes option makes US labor cheaper to employ. Other countries that fund healthcare by taxes instead of putting the burden on their companies are essentially giving their businesses a subsidy compared to US companies.
Nice to say, but assuming the $4178 per capita spending is correct, we're already spending roughly $1.25 trillion a year on health care. Addressing the efficiency of our money seems far more important than throwing more money at the total system. Apparently, other countries are getting more that twice the level of health service for what they spend.
Much of our problem is the distribution of care; obviously, it is the uninsured and economically disadvantaged that contribute to most of the statistics that make us come in last in all those categories. The challenge is including those people in the system without decreasing the high-end care available to those already in the system. From a most-good-for-most-people standpoint, it would make sense to take what we currently spend on cancer treatment for a relative few and use it to cover primary care for everyone; something tells me the people currently needing those services wouldn't go for that.
It isn't. But just because $4000 isn't sustainable doesn't mean $2000 is. But really the current costs aren't what are unsustainable - even in the US system - it's the ever rising costs. And they are rising extremely quickly, all across the board. I just don't see the point in initiating a massive, titanic, overhaul of our healthcare system just to replace it with something that's going to fall apart soon anyway. In fact, I think it would be harmful in the long-run, due to the costs of the transition and infrastructure changes. All I'm saying is that I think we'll be much better off if we try to switch to a system that might actually last, rather than copy a better system in use somewhere in the world that, despite its superiority, won't.
Actually, there's a big difference. Americans like to choose how to spend their money, not let the government tell them how they're going to spend it. And it makes sense, really. Responsible individuals can allocate their money much better than the government can for them. Obviously there are places where we've had to give ground or there couldn't be a functional government, and healthcare now appears (to me) to be one of those places. Nonetheless, there is a big difference between whether healthcare is payed for by the government using your taxes, or directly by you.
It is a question of both priority and sustainability. If people's priorities are such that the cost of a healthcare system is too high, then that system is unsustainable. Not to mention that healthcare around the world are requiring larger and larger fractions of budgets. It's not so much a problem in the US because the burden is placed mostly on individuals and not the government (which means it's still at least as big a problem, just realized differently); but it's a major problem in every country with largely socialized healthcare.
And $500 billion is pennies. Using the $4700 per capita figure from TheBigOne's table, that means the US currently spends more than $1.65 trillion on healthcare (US pop is ~350 million). Though I'll be one of the first to agree that our military's budget is bloated, and its spending is one of the least efficient of all government agencies. That said I believe that maintaining a huge military budget is a good idea, considering that the US is pretty much the only power left that can actually project power to anywhere in the world where it's needed. (Even if lately we've been projecting it in all the wrong places - but that's a certain President's and Sec Def's fault than the military's) The world would've been a much better place if we'd gone into land-of-the-genocide Sudan instead of Iraq.
Actually, we pretty much do that for free. We maintain military presences in all sorts of stupid places around the world. One good thing I think Bush actually did was shut some of them down. Also, whenever there's been a crisis anywhere in the world it tends to be American troops that do the lions share (again, this has recently not been the case due to a certain misadventure in the middle east).
But the point is that we *already* are spending this much money right now by hook or crook one way or another. The burden is also disproportionaly shared by those that have insurance but the bottom line is we pay this one way or another. Now if we can replace our $5711 per capita system with a $3000 per capita system we can actually save almost $800 billion of what we're *already* spending.
But even granting that they can, responsible individuals cannot eliminate the parasitic health insurance industry nor can they use leverage to reduce doctors huge salaries nor can they legislate against spurious malpractice suits nor can they stop the pharmacuticals from using the US population to essentially fund future drug research while charging rest of the world per unit production costs. The government *can* in fact do these things even if in reality they won't.
Anyway, like the global warming issue I at least have the solace that I and everyone I care about will probably be dead within the next 20 years. After that it's your problem, you'll be the ones that suffer the consequences of inaction.
How can police enforce the law if they're unarmed?
A show of hands please.
How many folks on this forum that live outside the US would be willing to trade their healthcare system for that of the US?
Don't all answer at once.
How many folks on this forum that live outside the US would be willing to trade their healthcare system for that of the US?Don't all answer at once.
I would. If i lived in Albania.
Sorry. They actually have free nationalized healthcare as well.
No thanks
Many of the worst criminals in the U.S. wear a badge and carry a gun.
The poor emergency care and wait lists in most countries certainly have that effect, even if it is not announced policy. That's one more part of the disparity of US healthcare; if you need major care (heart surgery, cancer, etc) and can afford it, it's the best in the world. If you can't, you'd be better off in a system where you might need to wait a few weeks for a surgery you'd get in days in the US.
The vast majority of criminals have guns, but not badges. There are always some bad cops; most of them are not. Or are you one of those (paragraph of expletives deleted) liberals who assume anyone who wears a uniform is an SS wannabe?
Well, seeing as a lot of criminals are unarmed as well, they simply subdue them, by brute force, pepper spray or police dogs (no, not poodles like in the video ) . If the criminals are carrying firearms, then the police arm themselves as well. The police have weapons at their disposal, they just don't need to carry them around, so they don't. I mean, really, it's a small country. There aren't that many places to hide. If they know who you are or what you look like, they'll find you. You won't get away, and if you arm yourself, the police will too and plug you in the kneecaps if you absolutely refuse to surrender.
Also, as seen in the video, the maximum sentence you can get here is 21 years unless you're criminally insane. Most sane criminals aren't going to fight to the death if the alternative is 2-3 years in prison. If the alternative was 20-30 years+ like it often would be in the US, then they'd be more inclined to fight it out.
Harsh prison sentences do not prevent crime, they just keeps criminals off the street longer if/when you catch them and make them more desperate to avoid it. Criminal rehabilitation is a lot easier when you're not locking people up for the majority of their lives before releasing them again. That doesn't mean we don't have repeat offenders and people who never leave the criminal lifestyle, of course, but we try not to unduly ruin the lives of people who've made a mistake (even a serious one). We do have normal prisons and maximum security prisons for people who are considered dangerous to the general public. "Open" prisons like the one in the clip are the exception, not the rule.
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