Right now we have N people with insurance and Y doctors.
Obama’s plan would be N+40 million with the same number of doctors.
That doesn’t sound like a good deal to me.
The counter argument is always that we’re already paying for those 40 million people. Well, if that is truly the case, then problem solved we don’t need to provide them with health insurance. But in reality, no, those 40 million uninsured don’t have even remotely the same access as those with health insurance. They may get emergency care abut not much beyond that.
So what do you do if you don’t increase the supply of health care providers but do increase the supply of health care consumers? You get rationing.
The second big problem has to do with who is paying for it.
Right now, people who have health insurance are overwhelmingly paying for it themselves – either through their employer or on their own.
But if we hand over this to the government, then we get back to the top 1% paying for 40% of it. Sure, it’s a good deal for people who barely pay taxes but for the rest of us, do we really want to get into a situation where “society” is deciding what care we need or don’t need and paying for fundamental personal responsibilities? What’s next? Housing? Food? Clothing? Why stop at health care?
There are so many other reasons to object to universal health care but those are a couple of the most basic reasons I oppose any government involvement in health care.
I haven't had much interaction with the health care system in the US yet (and would like to keep it that way!), so I can't really make any meaningful comparison between a "government" run healthcare system and a private insurance system.
The one system I have experience with is the French one (not really a perfect example of how to run things, but an useful source of data nonetheless). It's kind of an hybrid system: basic healthcare is provided by the government and there are insurance companies (and quite wealthy ones) if you want more reimbursement for certains items or specific coverage. Most big companies provide that additional coverage so you are basically reimbursed 100% for all your medical needs.
It's financed through people salaries and taxes on interests. Basically everyone with a salary or a saving account pays something. Granted, it's still the top 1% that pays the more, but when you do look at how much it costs per person in the end, it's not only a good deal for people that do not work or get the minimum wage, it's also very interesting for those with salaries up to probably the top 5%, which is most of the workforce.
It's hard to tell whether a 100% privately run healthcare system would be better. In some cases, the state ends up having to spend huge sums of money to prevent healthcare problems with certain populations (illegal aliens usually do not get healthcare), which could have negative repercusions on the rest of the population. If there was no basic healthcare for jobless of low-wage people, that kind of thing might be worse and end up costing more than the cost of providing basic coverage. Unfortunately, it's quite hard to get numbers (especially since it's mostly theorical and we only have data on a very small part of the population).
As for rationing and the government deciding what you can do, that's not the case at all. You can go see any doctor you want (and there are no line or significant waiting involved for a majority of cases) and if you don't like it, nobody is preventing you from getting a second opinion. If you happen to need some sort of operation and do not want to go to a public hospital you can also decide to go to a private clinic and have it there (it's going to cost you more, but you have the choice). For some stuff, you get only reimbursed the basic stuff (dental & optic work comes to mind), but if you want something better you can either have one the private insurance I talked about earlier or pay the bill directly from your own pocket.
In the end, there are problems with this system too and it's not all nice and rosy, but it's nowhere near the apocalyptical hell some people are describing.
(sorry about the "double" post, I get a bad auth error when trying to edit)
I forgot to add that Europe is mandating that you should be able to choose your healthcare provider so it's possible to get out of the government run system (it's actually not that easy yet, but it's getting better and should be a breeze once France is fined for not respecting his obligations - which happens a lot ). That should get you back probably 80 to 90% of the money you pay to the state. Few people do it though and some of them have gone back when facing the real costs (pre-existing condition, anyone?)
The demand for doctors may increase, but so too would the supply over time, meaning it would only be a short-medium term problem.
I actually think the supply of Doctors will decrease... it's been on the steady decline for over a decade now.
People aren't majoring in Medicine anymore... they're not putting in the 9+ years of school so they can be sued a dozen times a year for malpractice the second anybody's cough isn't cured over the weekend. They're majoring in "Business" and "Technology", not Medicine.
Ask any (Medical) doctor how long they went to school, likely the least amount you'll hear is "7 years", that doesn't include Residency or anything... which is easily another 3-5. During which time, the person is poor and near lifeless because of the amount of studying and time they have to put into work.(And that's just a general practicianer, try asking a Neuro or Heart Surgeon how much time THEY put in!)
The only way this "plan" would work is if the Government gave some sort of extra incentive to actually BECOME doctors... such as protection from frivolous malpractice suits or discounts on malpractice insurance, which any (Surgical) Doctor's Office will tell you is near half their Operating Cost... and rising!
to recap:People aren't becoming Doctors. (and giving them healthcare isn't an incentive to start)Doctors spend a decade + in training. (and today's society doesn't care for that length of time)There's no reason for people to desire to become Doctors. (and plenty of reasons for them to desire not to)
A few years ago I had two teenagers in my care from Bulgaria. They were in the states going to our local High School and they would stay with me over the course of two years on school vacations and weekends because they couldn't go home.
One of the girls, extremely bright has a father who is a Doctor. She's now been accepted to Harvard (free of course) after obtaining and fullfilling a 4 year scholarship for an undergrad degree in Oregon.
She told me that during their years under communism he had to go to Africa to work because Doctors were so underpaid. They were very very poor. She said the only ones making any money were the ones in the goverment. Everyone else were extremely underpaid including doctors. So he would travel for a year or so at a time to Africa using his profession as a doctor. He would send money home to the family in order to support them.
Is that where we are headed?
Obama says the cost of healthcare is what's bankrupting our country, that we must reduce the cost of healthcare.
He claims that the proposed government takeover of healthcare is the answer to that problem, that 'greater efficiency' will reduce the cost enough to save us from collapse. However you slice it, he's wrong. Increased efficiency is the equivalent of increased productivity - greater output with less labor. Increased productivity is universally accepted as a good thing, increasing the standard of living. Not so with healthcare. An increase in productivity is the last thing they are looking for.
Government believes that in healthcare, efficiency is the enemy of cost control. That is the only conclusion that can be drawn from what the government has actually done over the past 40 years, as opposed to its rhetoric. It was simple, straightforward and easy to deliver care in the 60's and 70's and relatively cheap in GDP terms. The more the government has insinuated itself into healthcare, the faster the cost of healthcare has risen, which has, of course, been blamed on insufficient government insinuation into healthcare and its subsequent expansion. Rinse, repeat, rinse, repeat, here we are at 20% of GDP (set aside the debate over whether that is a good or bad thing, whether there is a 'right' percentage).
When my father was ill and hospitalized with pneumonia in 1971, our family doctor was able to get an experimental antibiotic flown in from England within 24 hours. A family doctor, not a specialist, and all he had to do was pick up a phone and request it. No authorization forms, no 'certification,' nothing more than his judgment about what his patient needed, based on his laborious training and acquired knowledge. That was efficient, and it simply wouldn't, couldn't, happen now. Barriers have been erected systematically, relentlessly and with intent to prevent just such efficiency, all in the name of saving money, especially in Medicare. Private insurers, once they saw how effective 'efficiency control' was for the feds, went & did them one better, with a little subsidy from the feds to be sure they got the market share the feds wanted them to have (you may remember HMO's were paid more because they were 'more efficient' - look how well that worked out).
Lets assume for a moment you're correct, that even with an increasing demand for doctors, the number of doctors decreases. What would that mean? Well since healthcare is typically something you need (and hence can't cut back on as easily as various luxuries), you will have an excess demand where a doctor has say 2 people they need to treat, but only time to treat 1. In a private system that means those people can get charged more money until there is no longer an excess demand. This happens both from the effect of the increase in cost making people put off treatment, and also because if they raise money, the money doctors earn will in turn increase. This means that rather than a fall in the number of doctors you'd expect a rise, because they would earn more and more money, making it more attractive to become one. With a public system meanwhile you would have to impliment a system of queueing to control the excess demand. The longer the waiting time, the worse it becomes for the politicians, as people demand access to necessary treatment quickly, forcing them to raise wages for the doctors so that more people will want to train.
The time lag between wages rising for doctors causing new people to train as doctors as a result, and then becoming doctors is quite significant, hence why I refered to it as a short-medium term problem, but it is certainly not a long term one.
Littleboy, I'm glad you live there because I have been stating that France has one of the better UHC systems. Go here and scroll down ( https://forums.joeuser.com/358734 )
In France the tax rate is 30% for anyone who makes 25,233 to 67,555 (Euros, I if you go to the link and scroll down I converted everything to dollars) while if you make more than 67,555 your taxs are 40%. In reality you guys are paying for it and like you stated most of the population is paying for it which is only 62 million people. (On an unrelated topic, I do like how France is using Nuclear power and I wish the U.S would follow France in this because 3 Mile Island and Chernobel were all human error/ignorance. The systems are stronger and more secure. We are able to get a butt load of more enegry now than we could from the older Nuclear power plants. Nuclear power is cleanier and the waste, which is an extreme negative, has become more manageable. Why can't the States do this instead of the UHC?).
The United States is almost 5 times larger than Frances' population for the population in the States is either just about 300 million or a little over that.
If you go to that link, you'll see that. When I was in Grad School some time ago, I would ALWAYS hear how the U.S is the only industrial nation that does not have a UHC system. Most people that make that agrument think that some how Canada, U.K., and European countries have the same population size as the U.S. or vice versa. Truth of the matter is that the States are by far much larger than all of those other countries.
Then I also hear the usually statement: 'think how many people are all unisured in the States.' I never said this but I thought this (for it is an extreme thought) think of all those unisured in China and India. I'm not sure about China, but in India I know there is a ton of unisured (yes I know that India isn't on the same level as the other countries we're discussing) yet I'm sure neither of those two countries will ever adopt a UHC system due to the fact people will agree that their population size is too big.
UHC is more geared to smaller populations. ON top of that you're almost guranteed to be paying higher taxes. Just go to that link and scroll down. The U.S tax rate is lower than the usual suspects that get lined in the comparison of UHC systems. I'm guessing that our tax system is more complex and more imbecilic, though. Also, our system was probably made from a room full of neonates and anything that they said was put into the tax code hence why its so long and confusing.
On a final note, why is it necessary for the entire population to be insured? If people in the U.S would realize is that what is more important than everyone getting insured is that if we had a better system of preventive medicine/health. This would drastically cut down cost because usually illnesses/diseases ect ect tend to get more expensive to treat in the later stages as that they go undetected compared to if they are caught earlier.
I feel that people including the President are missing the whole reason why the health care system is if you want to call it 'out of control'. Most people in the U.S only go to the doctor when it is EXTREMELY necessary: ex. I'm coughing up blood now when I've had this prolonged chest pain for about 2 months or something to that nature (again the coughing up blood/chest pain was only an example).
A final example is Supreme Court Justice Ruth Ginsburgh being diagnosed with pancreatic cancer in the very early stages. Which if you know anything about pancreatic cancer it is VERY rare that they find it in the early stages and if it goes undetected (which it most oftenly does) proves to be very fatal and very expensive to treat in the later stages. How did they find it, Supreme Court Justices all have monthly (or there about) checkups at the U.S. tax payers expense. This is a prime example of the effectiveness of preventive care/medicine.
Under Obamacare, she'd be determined 'too old' and denied treatment. After all, 'we can't continue to pay for things that don't make us well'. The facts about pancreatic cancer survival, no matter how early it is diagnosed, are grim. The characteristics of the rare 'long-term' survivors are completely unpredictable and, were she not a Supreme Court Justice, she wouldn't make the cut when her case came up before the 'panel of experts' - not at 76, only 3 years away from her life expectancy, especially once the Federal Coordinating Council for Comparative Effectiveness Research renders a ruling on the management of pancreatic cancer (the FCCCER has already been created, thanks to HR1, the 'stimulus' bill).
Furthermore, the assertion presupposes that all montly checkups would detect a pancreatic cancer at an early stage, and they wouldn't. It would be great if everyone got Supreme Court Care with monthly checkups paid for by somebody else, but that ain't what's being proposed. The amount of money expended to detect one case of pancreatic cancer using that approach would be astronomical.
I believe some aspects of health care can be more efficient, such as the administrative areas. I like the electronic medical record concept (though I firmly believe the government and private insurance should not have their hands on this). Go to the doctors office, punch in a pin (or a biometric for emergency service).
When has the government provided exceptional value on anything? The few health services they now provide are either wasteful, inefficient, or corrupt (VA, Medicaid, Medicare). Who in their right mind can possibly believe they will get a national plan right?
I hear a lot of talk about being able to keep my current health plan. Gee thanks! Does that mean that I then don't have to pay for my plan and again via taxes for someone else? Good deal for them I guess. So where is the incentive to pay your own way, when you MUST pay anyway via your taxes? We live in a slackers paradise.
I'm not going to even get into reduced health care for the elderly. Groups like AARP are so glued to Obama's member, sort of like the media, that they are selling out their constituents by supporting this travesty. Remember the not too distant screams when Bush proposed private retirement savings accounts along side social security? Funny how quiet it is now.
There isn't a day that goes by that I don't see some company hawking health insurance for people that are self-employed or want something other than what their work place provides. Insurance is available. I wonder how many people just are too cheap, or think they are invulnerable to buy it? When I was younger I probably would have forgone coverage just to make my paycheck a little larger, had I not been under military health care. I get that, but it is a personal choice to take it or not. Look at your pay stubs folks, Medicare taken out of your paycheck is not refunded when tax returns are submitted, If if you effectively pay nothing. What are you going to save if this amount increases? Then the choice to risk it is moot, you will pay, and you won't pocket the extra few bucks each payday. Let the people decide.
How/why?
I think that in this case the facts speak for themselves. In Canada, we have universal healthcare -and-
So what is the benefit of having a privatized healthcare system? Those with the means to pay for the "Platinum" package get amazing treatment. Admittedly much better than that offered by a socialized system. However, those who can only pay for the Silver package might be in trouble if they start making too many claims (how dare they!) or run into a problem not covered by their plan.... which really is absolutely ridiculous. How can anyone realistically anticipate what number of possible medical conditions they might run into in a few decades?!? And, if you're like most average joes in the world, you can't even afford the silver package but instead have to shell out dough for the Bronze package, which could be called "Best Effort"
I will maintain to my grave (which statistically I will visit after living more years on this earth than an American) that to include the profit motive in healthcare is simply wrong for several reasons. Yes, healthcare has a cost, as does everything, but that cost should be covered by a public system whose primary motivation is to deliver effective service to everyone -rather than- turning a profit. In short, healthcare should be a service, not a business. And it is for that reason that it should be public, which, it already is in every single industrialized country except for the United States.
These would be good points if there were any evidence of a cause-and-effect relationship betweeen them. Sometimes (in fact, much if not most of the time) bare facts don't speak for themselves. Understanding the facts requires thought & effort.
They already have healthcare paid for by the taxpayers - it's called Medicaid.
Niavete, thy name is idealism. Food has a cost, but shouldn't everyone eat, without 'profit' being taken out by the food industry? Shelter has a cost, but shouldn't everyone have a house, without 'profit' being taken out by the housing industry? Cable TV has a cost, but shouldn't everyone be able to watch American Idol, without paying Simon Cowell $22mil?
Great points! Enjoy that 1.83 years longer you have to live. You'll need it to pay your tax burden.
Example of Canadian earning 80K for 2008. http://www.pwc.com/en_CA/ca/tax/publications/tax-facts-figures-2008-en.pdf
Federal Income Tax: 13,677.00
Provincial/Territorial tax (range highest to lowest): 24, 078.00 (Quebec) 17,771.00 (Nunavut)
Nonresident Federal: 22, 374.00
Unadjusted taxes for person making 80K and living in Quebec 47.19375%
The US earning 80K for 2008
Federal Income Tax: $16,385 single $ 12,694 married http://www.irs.gov/pub/irs-pdf/i1040ez.pdf
State Taxes: California (Used highest rate of 10.3%) $8240.00 http://www.bankrate.com/yho/itax/edit/state/profiles/state_tax_Cal.asp
BTW my state of Virginia the tax burden on 80K is $ 4343.00 in contrast.
Unadjusted taxes for single person making 80K and living in California 30.78125%
Today's currency rate: 1.00 USD = 1.08601 CAD or $24,625.00 USD = 26,742.75 (in case anyone was wondering), percentages are unaffected.
So if your paying $11,012.25 (CAD) more (in comparison to California) in taxes for the economical, scientific, industrial. military, and cultural power house that is Canada, your health care should be top notch, right? In fact it must be the "Platinum" level you alluded to in your comments. So tell me why do some Canadians come to the US for treatment? Keep your Canadian national heath care, peddle crazy somewhere else.
BTW even fast food outlets (McDonald's, Hardy's, etc.) offer health care for their "minimum wage" employees.
Could you provide the company that charges that amount for basic health care? The most expensive my employer offered was in the neighborhood of $3500.00 per year (after their contribution of course).
Nitro-
You're absolutely right. My tax burden is excessively higher than a counter-part in the States would have. And it needs to be.
Let's take a look at the details. Canada has 1/10th the population of the States and geographically, is larger. So, we have far fewer people spread out over a much larger area. And, if our tax rate wasn't what it is, we couldn't function as a nation. We have remote communities of a few hundred people for which -no business case exists-
In order to have potable water, phone system, internet and power grid for one of these towns that is fly in access only (so remote that there are no roads to it) subzidization is necessary to provide those services. So, why do we even keep a town there?
1) History has proven that forced relocation of an entire population rarely has a good end-outcome
2) The community is usually nearby a very large mineral deposit of say, uranium. Or in the case of where I live, a few hundred miles north there are three large diamond mines and less than sixty miles south they've found a whole bunch of rare earth elements that currently are only being mined in quantity in places like China and Congo (Lithium, Tantalum, etc, etc)
So while there is no direct reason to have a community there, indirectly there are a thousand reasons that benefit the whole nation, so it makes sense to keep it alive via subsidization. Therefore higher taxation required.
But the real bonus? Higher taxation means there are more opportunities for everyone that otherwise, wouldn't have those opportunities. I went through college on federal student loans which are pretty much better than anything I could ever dream of getting from a bank. It's a loan which cannot be defaulted on, if I have trouble re-paying....and can prove I'm not trying to bilk the system.... they'll drop my interest rate to zero and the monthly payment to 10 dollars a month. Or even temporarily suspend re-payment depending on my situation.
Here's another incentive. If I start a family and raise my kids in the northern part of the country, they will be able to go to any university or college they want to in Canada, and the government pays the way, as well as providing living costs for them while they're there. This is a government incentive to keep population in the north, so that one day we may realize our dream of conquest and invade Alaska (kidding)
Seriously though, this is a huge burden that my kids wouldn't have to worry about. Quality post-secondary education costs tens of thousands of dollars which puts young people in a severely disadvantaged situation when they graduate. Unless, of course you're going to become a doctor or lawyer and then it's not such a big deal. My brother is going to have approx 90-100K in debt once he graduates, but he's then going to be an optometrist and make enough income to be able to repay that.
Anywho, off-topic I know. Yes, we pay much higher taxes. But the trade-off is that I'll never have to worry about medical bills or coverage.
Indeed. And I wonder what exactly that coverage offers? I wonder what kind of claims they can make and get coverage for, what the deductibles are and so forth? It is a documented fact that many of the folks who declare bankruptcy due to medical bills actually -had- coverage, just not very good or complete coverage. And I highly doubt that McDonald's springs for the gold package for it's employees.
I do believe that 13,200 dollar figure I got was for the average rate someone would pay if they approached an HMO directly as an individual. It does make sense that a company would get a "group" rate that would be much better than individual, just like buying in bulk. However, if enough employees of a company make claims that start hurting the HMO's bottom line it can (and has in the past) told the company it's going to up the premiums, or tighten the criteria, etc etc.
I didn't use the ALL statement where you have a contention. If I had your assessment would be correct. Just looking at facts you can tell treatment of diseases in the later stages is usually more expensive than if it could be caught in the earlier stages. I was just using her as an example.
Research has shown that preventive medicine could possible lower health cost due to the fact that it tries to catch illness/diseases in the early stages. Since there are humans involved there is going to be exceptions to that.
Hold on there with the bonus. I was able to get ton of grants for Undergrad and I didn't do much of anything to obtain them. In fact, it was my high school guidance couselor who got me most of them. No, I didn't go to a rich upper class high school nor did I go to a private school. I went to a high school that was right on the border of the urban/suburbs. On top of that , you're assuming that everyone should go to college. Which is not the fact of the matter or should just go to college just because you can take the money out (which I've seen a lot of people do). Any debt that I did accumulate I was able to pay it completely off when I went to grad school due to the fact that I had my tuition waived and got a stipend. So there are other ways to go about it then taking out huge honkin loans.
Do you actually trust other people with all that money? I have little trust in people anymore. This by no means means that I don't trust people. The States would be the largest country to get UHC, when you just look at the UK system they've recently had to inject several billion pounds (they've done this several times) Furthermore, In the States taxs were not necessarly intended for those purposes. I am glad that you are really happy to be paying high taxes. GOOD FOR YOU!
I'm not against people getting cheap affordable health care and I know circumstances do happen when you could use health care.
Our government has shown time in and time out that it does not know how to handle large sums of money properly or resourcefully.
I'm an advocate for effective preventive care and early detection as well, but not for the same reason. There have been several actuarial studies which have posed that widespread prevention & early detection programs would actually be more expensive when the costs of the programs and the costs of subsequent healthcare consumption over a longer lifetime are considered, even allowing for the 'continued productivity of the patient.' The fact is, even if your pancreatic cancer is detected early and 'cured' you will die from something else and the cost of care for your final year of life will be just as high as it would otherwise have been, on average. It'll just occur in a different year.
Since I approach the moral question from the standpoint of the individual, I favor preventive measures & early detection efforts, but from a public health perspective and societal cost perspective, it is a problematic issue. If the decisions are being made at the level of the federal government based on what the tax base can afford, anonymous individuals will suffer the consequences. If the decisions are being made by individual patients and their physicians, the market with 'suffer the consequences'. It all boils down to what you value more: individual freedom of choice or sacrificing individual freedom of choice for the 'greater good' with the greater good being determined by self-designated elites. It's one thing to choose the latter approach voluntarily, which is the case with our military for example, but another to be forced to do so.
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