complord
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Posts posted by complord
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The 'community' doesn't always have the resources, skills, people, etc. to counteract most problems. This is why governments exist: to help communities get the resources, skills, people, etc. that they need to function. What you are basically proposing is anarchy, which I'm not against actually, in that the people of each community should decide how they are governed. The problem with this is that the community can only use what the community has thus no money from county, state, and/or federal sources. If you want to have your slice of regressive, theocratic, byzantine America, go right ahead, but be ready to support it all with your own community's money, skills and people.
Also, Casey said what I always wanted to say: Artaban, you are a ridiculous person. Your fundamental lack of understanding of logic, morality, laws, government, etc. is astounding. Also, your reading comprehension is quite poor as well.
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I agree that 100% of the blame doesn't lie at the feet of providers. I focused on them because you were defending them, I apologize if that is the impression I gave. I totally understand that insurance providers are very complicit in this endeavor to constantly shoot for the moon when it comes to profits. Insurance companies are part of the problem mainly when it comes to medical bankruptcies. 8 out of 10 medical bankruptcies are for someone with insurance. Wall Street actually rates insurance companies with lower claim rates as better insurance companies and thus get more money to their share holders. This is all a vicious cycle though. Insurance companies deny coverage and thus the provider is left with a patient that got service but doesn't pay. So now the providers jack up all the prices on procedures to pay for these people who are going bankrupt on them. Now, the insurance companies see that prices have gone up so the premiums go up and less services are now covered because how expensive they are. On top of that private hospitals want to make a profit so they will deny patients and jack up prices to get more money from insurance/government. These patients then get dumped at county hospitals which the taxpayer has to pay for. It keeps going until the critical mass you mentioned. I feel no sorrow for private providers or insurance companies.
I was directing that last part to the thread as a whole and I noticed I put a 'you' in there. Sorry about that. Yes, single payer is and probably never will be an option because of all the money that will be lost an entire sector of the economy destroyed. Politics as usual, we get what the lobbyists want and not what the people want.
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You can't equate the civil rights movement to health care reform because there is way too much money to lose. The reason we have the crappy plan offered to us that we do is because of lobbyists and politics as usual. Single payer is the only option that makes sense and will actually work but it won't happen because of all the money to be had. If Obama doesn't get some sort of health care reform though, no matter how useless, his entire first term will be deemed a failure and will have a tough time in 2012 let alone the rest of this term.
An offer that can't refuse you say? How about the insane amount of medical bankruptcies? How about the deaths caused by denial of care from insurance companies and lack of care after emergencies for uninsured? How about the bankrupting of the country caused by rising medical costs? What else has to happen?
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All those examples you gave were amoral. I obviously have to agree that the people don't always want what is best for them. I hardly think you can make the same argument with universal health care though.
The way Obama is running the country right now shows his political naivety. He doesn't understand that political opponents will attack him even if it doesn't make logical sense. He also doesn't understand that reaching across the aisle usually hurts legislation more than makes it better because it doesn't make anybody happy. Obama needs to start spending that political capital he has.
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If you don't agree that people have the right to at least basic medical care so that they don't have to worry about accidents out of their control I'm not sure you are morally suited to be in a society. Society is much more than following rules, working and spending.
Kevin, you are retreading ground I already covered. The problem is that hospitals, clinics and pharmaceuticals charge way too much for their services because they are trying to make more profit than last quarter. If you take the profit out of it the system doesn't reach that critical mass you are talking about. Also, if everyone is covered costs can, and will, go down because there will be no more excuses for uninsured patients (illegal immigrants will always be an issue). Also, with profit out of the mix the only reason to raise rates on procedures and medicine is because it costs more.
Single payer works. All countries with single payer health care in the Western world have lower health care costs and better health care overall. Nobody in this thread has denied this yet you keep railing against the solution to our problems. The reason single payer won't pass is because, like has been said in this thread, people don't understand it. I'm not sure how simpler I can make it....
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This is from wikipedia and the source link follows the quote:
By the design of the program, the federal government is not permitted to negotiate prices of drugs with the drug companies, as federal agencies do in other programs.
http://www.azstarnet.com/news/163911
That is for Medicare Part D. Now for hospitals and clinics. I think I see the disagreement we are having. Yes, Medicare only pays for part of the cost for health care and yet Medicare still keeps rising in price since its inception. Now, part of this is the aging population but the other factor to this is that hospitals and clinics can charge whatever it pleases. I'm saying the problem starts with you, the hospitals and clinics, and the government does nothing to stop this. In a health care system that makes sense the government would say that if a CAT scan is needed, fine, you can only charge X and we will only pay X and no run over costs will go to the patient. That doesn't happen in the US. Medicare pays a percentage up to a total dollar amount and the rest gets charged to the patient. So their Medicare gets vaporized by a CAT scan that costs way too much and they have to pay for the nurses, doctors, and drugs used themselves. This is insane. Even with this insanity people on Medicare/Medicaid like the service they are getting from the government which shows how messed we are culturally when it comes to health care.
The bottom line, which I believe everyone can agree with, is that making money from illness is amoral and illogical.
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jmccarthy said:
Which brings up an interesting point. What exactly is the goal of healthcare reform? Sure we can lower GDP spent on healthcare by switching to socialized medicine, but we could accomplish the same feat outlawing all medical treatments that cost more than $50. But it won't improve the quality of care.
You are operating under the assumption, as lots of Americans do, that we have the best health care. Well, we don't. We are on the bottom when it comes to health care concerning developed countries. The worst that would happen is the level of care stays the same and we don't bankrupt the country by reducing the cost of health care through reform.
ktom said:
Which private insurance companies have been trying to do for decades - although in an attempt to increase profits. Insurance companies, including Medicare, already pretty much dictate what they will pay the provider. This obviously has led to ever increasing cost of care here in the US, not the opposite. The providers compensate by pushing high-margin procedures, not by bringing down overall costs or prices. So how is another insurer, even a government sponsored one, entering this going to change things? What will be different?
If you read what I wrote you would realize what you stated is false. Medicare/Medicade does not dictate prices which is the problem. Hospitals, clinics and pharma dictate prices which makes the cost go through the roof because they are in it for profit. The more procedures they do and the more expensive they make them the more money they get. They argue they would go bankrupt if they didn't do this because they have to cover the cost of malpractice lawsuits and non-insured patients but that again is a lie. Most doctors get paid commission on how much money they can bring in through expensive unnecessary procedures.
ktom said:
But as I also touched on, if the providers know what the government is going to pay, there is an incentive to push the high-margin procedures and encourage overutilization. (One of many reasons, including that the patient often wants everything.) The balance is not necessarily struck by insuring everyone, particularly if the government is not the only payer.
Again, false. Hospitals, clinics and pharma dictate what they are going to charge and the government says fine.
ktom said:
Right, but how does the government influence this in our culture, which does not practice as much preventative medicine? The lack of preventative care in this country has as much, if not more, to do with social and cultural factors than it does with doctors not trying to get their patients to take more personal responsibility for their health before the problem arises. In fact, a good chunk of doctors are all for preventative measures, even though they don't get paid for them.
The reason this is prevelant in our culture/country is that insurance/health care is expensive. If health care was free or very cheap more people would go to the doctor to get preventive medicine but right now people wait to the last minute because they can't afford to go to the doctor for little visits. Also, the uninsured won't go at all because it would be much more expensive than someone with insurance and they don't go to the hospital until they are dying.
ktom said:
Yes, but they also "ration" care and/or refuse certain treatments to different people (the government doesn't pay for dialysis for someone over 65, for example). Will that fly in the US?
Sounds like you advocate pure socialized medicine with a single government payer? If so, that essentially comes down to all healthcare providers being employed by the government (perhaps not directly, but essentially). Not saying it's a bad thing, only that to do that here, we wouldn't be "reforming;" we'd be "demolishing and rebuilding."
Since when has rationing become a dirty word? The word I prefer to use is triage but even that has become a negative term. I have no problem with health care being smart and focusing resources on people who actually need it.
Yes, I think single payer is the way to go. Our current health care system in the US sucks...hard. I see no reason to keep it in its current state. Reform would be good but as always not much would change.
Stag Lord said:
The problem with the insurance for rpofit model is that there is often a conflict between the best interest of the insuracne companies shareholders and the best interest of their patients.
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Kevin, you bring up some good points but there is a lot you are missing which is part of which I talked about earlier in that the government can't use it's influence to bring down prices. It is basically the Wal-Mart model where the seller decides how much the producer is going to charge. The other thing is that hospitals, pharma, and clinics know the government is going to pay so it doesn't have to worry about padding prices and what not which you touched on. Another thing that other socialized medicine countries do, especially the UK, is practice preventative medicine. This lowers cost substantially since shorter frequent visits and/or procedures is better than long infrequent ones. Also, the facts speak for themselves in that socialized medicine countries spend less of their GDP on health care than we do by a large margin.
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ktom said:
I'm still not sure how a government run option is supposed to drive costs down.
The operating costs for Medicare and Medicaid are very low, around 3%. Private insurance companies operating costs are in the high single digits or low teens. The main reason why Medicare and Medicaid cost so much is that when they were created the government purposely crippled them on behalf of pharma and hospitals. There is language in the Medicare/Medicaid bylaws stating that the United States government cannot used its huge influence to drive down the cost of services and medication provided by hospitals and pharma respectively. The whole point of socializing medicine is the fact that the government can leverage down the cost of services and medicine. That is one of the reasons other countries with socialized medicine pay much less than the US does for health care costs.
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The United States spends the largest percentage on health care in the developed world and has one of the worst ratings from the WHO on health care in the developed world. Something is wrong here. I agree that costs need to go down but I don't think private insurance is a way to do this. I also agree that health care is a right and thus the point made that market forces shouldn't be involved in something that is a necessity is a valid one. Other countries with socialized medicine for lack of a better term have people that are healthier, live longer and generally happier. Yes, you could argue part of this is culture but I think not having medical bankruptcies and denial of service is a large contributing factor to their in general positive health care system.
I believe three things need to happen in America to make health care work:
1. Insurance companies need to become non-profit and thus they compete for the service they give and not their share holders' portfolio.
2. Everyone gets the same level of basic care and people can pay more for more specialized care like guaranteed private rooms, etc.
3. A non-interested party needs to set the costs of all procedures so that getting an aspirin in the ER doesn't cost $10 a pill.
In general I think these resolutions would reduce health care operating/administration costs and provide everyone with at least the same level of not so great health care they are getting now. A single payer model has its ups and downs and I think it would work in the US. Just because we have the fourth largest population doesn't mean that a single payer model isn't feasible.
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That article is so bipolar. It complains about government, specifically the execute branch, gaining too much power. At the same time it complains that the people want the executive power to gain more power to fix all these problems. I'm not sure what the point is of the article. The article doesn't explain a better way to fix these problems without government involvement or supposed expansion of executive powers which are mostly kept in check by the legislative passing laws. I'm not sure the author knows how a republic works or what a government is for.
US Health Care reform
in 8. AGoT Off Topic
Posted
I'm not sure what having more people means when we are talking about percentages and not total money spent. Also, comparing a third world dictatorship on a Caribbean island to America is a joke. One thing Cuba does have over us is happier people but that could also be that the secret police have killed all the unhappy people.
Stag Lord, I probably shouldn't bring this up but it is just so tempting: If we are a nation founded on Judeo-Christian principles how come universal health care isn't in the Constitution considering Jesus talked about helping the sick?
On another note, Ted Kennedy died today which is sad even though he was a controversial figure to put it lightly. One of the major proponents of health care reform died before he could see it come to light which is unfortunate.