American Medical System Far Better For You Than The Socialized British Version
- Thread starter Fullosseousflap
- Start date
-
New SDN Article! Occupational Therapy Clinical Experiences
1) I'm sure the 45 million uninsured in the US agree with you.
2) You have to show how socialized medicine per se leads to shortages. Does the government simply elect to not offer the services? Are people unwilling to pay for additional services through taxes?
3) I will repeat my challenge to fiscal conservatives on SDN. Come up with a plan that protects private insurance and expands coverage to all Americans. The Democrats proposed several in 2004. Why can't you?
2) You have to show how socialized medicine per se leads to shortages. Does the government simply elect to not offer the services? Are people unwilling to pay for additional services through taxes?
3) I will repeat my challenge to fiscal conservatives on SDN. Come up with a plan that protects private insurance and expands coverage to all Americans. The Democrats proposed several in 2004. Why can't you?
i always thought it was funny that people who choose to allocate brain space to memorize this statistic never bother remembering what percentage of this number is uninsured by choice. but if you included that, the emotional impact of the original figure would be less, i suppose.trinitrotoluene said:
our system is better than people give it credit for, but other systems work, too. why is it always "socialized medicine is better than our system," or vice versa?
i know. hell, i'm uninsured right now, too. its not cool, and i'd hate to be like this for an extended period of time. unfortunately, most people's remedy to this is simply to "socialize medicine" and go to a single-payer (which would be the fed govt) system, which doesn't sit well with me. have you seen the way our government handles sticky situations?trinitrotoluene said:
we need to get creative in america, not just say, "hey, look at how that country is doing it. let's do that."
- Thread Starter
- #7
We already have a social safety net system in the USA.trinitrotoluene said:
It is called Medicaid!
And nobody waits like in the U.K and Canada.
I don't support socialized medicine per se. However, I do support expanding Medicare and Medicaid so that people who can't afford insurance can get it.superdevil said:unfortunately, most people's remedy to this is simply to "socialize medicine" and go to a single-payer (which would be the fed govt) system, which doesn't sit well with me. have you seen the way our government handles sticky situations?
I dislike binary dualism.
i'm all for expanding medicare and medicaid, but socialized medicine is the knee-jerk reaction of many people to our current problems. as i said, we need to get creative to improve the care of those who cannot afford it.trinitrotoluene said:
Are you kidding? Medicaid=social safety net system.Fullosseousflap said:
You have a lot to learn.
http://www.ncpa.org/w/w44.html
BTW, I do not believe that healthcare is no a "right," nor do I believe that you and your family should be insured just because you work. Should college students get automatic insurance if they are working some minimum wage job? How about high school students? By increaseing the costs of employment, wounld mandatory healthcare for workers increase the cost of products while decreasing jobs since each worker now costs more?
I also agree with their plan. Since busniesses pay for insurance with money before they pay taxes, extend that option to the individual.
BTW, I do not believe that healthcare is no a "right," nor do I believe that you and your family should be insured just because you work. Should college students get automatic insurance if they are working some minimum wage job? How about high school students? By increaseing the costs of employment, wounld mandatory healthcare for workers increase the cost of products while decreasing jobs since each worker now costs more?
superdevil said:
So why dont u tell me how we can fix the healthcare problem? Be creative! I know socialized healthcare isn't perfect but at least everybody despite their socioeconomic background have healthcare. I think that they have the right idea. I work in a medical clinic and I see what happens when people dont have healthcare- no preventative treatment. If we can spend so much money making weapons we can certainly provide everyone with equal or atleast some sort of healthcare.
Health care didn't free the Jews during WW2 nor the Kuwaities during Gulf Storm. Our militarty technology and might freed them while saveing several of our soldier's lives.
utterlyconfused said:
oh, you've got me! seriously, if i held the silver bullet for our nation's problems i wouldn't be on SDN. and if you had the silver bullet, you wouldn't be posting here, either. don't be so stand-offish. our entire national economy is structured differently than, say, canada (everybody's example of perfect medical care). just throwing the mess in the govt's hands probably wouldn't have the rosy results many think it would have.and let this be a warning to everyone else: if you haven't solved our healthcare crisis and aren't willing to defend your solution, don't even post!
I think this is falsely presuming the goal of fiscal conservatives is to see every American insured
Well y dont u try? I dont necessarily think that we should have socialized healthcare but I think that things do need to change. I think that we need to expand work provided healthcare; I also think that the government should provide healthcare to those who really cant afford it.superdevil said:
and let this be a warning to everyone else: if you haven't solved our healthcare crisis and aren't willing to defend your solution, don't even post!
And what about u "No we shouldnt have socialized healthcare, we should be creative but I dont know how, just dont involve the government"
i agree. my previous posts are evidence.utterlyconfused said:
that's a pretty good start.
i already posted that i would increase medicare and medicaid.
what about my position is so utterlyconfusing (sorry, couldn't resist the pun!)? we actually agree on a lot of things. i just don't spend my time conjuring up comprehensive nationwide health stragegies. maybe i will, someday--you know, when i'm actually a doctor qualified to discuss such matters and not just an internet forum poster. what's the big deal, anyway?
Siggy said:
The right to life assumes a right to that which sustains life.
Also, if I am going to give 40+ hours / week to my employer toiling for his/her profit, I should be provided the tools needed to arrive to healthy and productive.
Thanks for the edit on my typo. My post now contains the negitive.
Is $9.50 expensive to see a movie? How about gas prices? By increases the cost per hour of labor by adding perks (such as healthcare), you will also force companies to either raise their prices (which will force a lot of people to cease being happy) or fire workers/cut time. If you have your time cut to, say 30 hours, then you still aren't getting health care as well as making less money.
Is $9.50 expensive to see a movie? How about gas prices? By increases the cost per hour of labor by adding perks (such as healthcare), you will also force companies to either raise their prices (which will force a lot of people to cease being happy) or fire workers/cut time. If you have your time cut to, say 30 hours, then you still aren't getting health care as well as making less money.
superdevil said:i know. hell, i'm uninsured right now, too. its not cool, and i'd hate to be like this for an extended period of time. unfortunately, most people's remedy to this is simply to "socialize medicine" and go to a single-payer (which would be the fed govt) system, which doesn't sit well with me. have you seen the way our government handles sticky situations?
we need to get creative in america, not just say, "hey, look at how that country is doing it. let's do that."
A couple of points:
(1) You do choose to be uninsured. Since I don't get insurance through work, I pay $70 a month to Blue Cross to take care of my health worries.
(2) The U.S. already does offer universal health care in the form of military benefits. If you take a peek at a VA hospital, you'll see socialized health care at its finest. Imagine what would happen if the U.S. turned all of the country's hospitals into one large VA system. That way, you'll never get seen whenever you need a procedure performed.
I dont agree with socialized medicine in the US either. It wouldnt work, I dont care how many people are uninsured here. Our current system fits the type of society we live in. I have no answers for how to fix our system, and if experts around the nation dont have the answers, us fellow SDNers wouldnt have any answers either!
1) If all employers offered affordable health insurace, they would all be at the same disadvantage.
2) 70 / month is about 9% of a minimum wage budget that is 40% below minimum wage.
3) I'm not advocating for socilaized medicine. I want to extend Medicaid.
2) 70 / month is about 9% of a minimum wage budget that is 40% below minimum wage.
3) I'm not advocating for socilaized medicine. I want to extend Medicaid.
Actually, no, you're heading in the exact opposite direction with that one. The fact that employees in Canada have health care provided by someone other than the employer gives us a competitive advantage for business. Ontario's economy has outperformed virtually every jurisdiction in the industrialized world over the past several years. Alberta has no debt. Why do you think Ontario is the leading automotive producer in North America, GM is now investing another $2.5 billion in plants and educational initiatives here, and Toyota is considering adding yet another plant? Autoworkers have strong unions and high wages, and these companies, which don't have to pay a penny directly towards employee health plans in Canada, save many miillions of dollars compared to operating in the US.Siggy said:
And by the way, the NHS isn't not all public, there is a second private tier. Many of the problems now coming to light developed as a direct result of the establishment of this second tier. "Socialized medicine" isn't responsible for waitlists here; France has a national system and no waits.
I agree that the Canadian model won't work in the US. Not because it costs more (it doesn't), it's more inefficient (it's not) or delivers poorer care (it doesn't). I won't respond to posts suggesting otherwise as there will simply be no evidence beyond NY Post articles to back it up. There are simply different cultures in the two countries, none better than the other, and dramatically more private sector clout in the US. Some type of mixed model has to be developed. Maybe Germany's or the Netherlands's system is the most appropriate starting point for comparison among other OECD nations. In both of those countries, people can opt out of the national system.
Well, of course its better for busniess. What is the Canidian tax rate set at? The American? Sure, busniesses don't pay for it. The citizens pay for it by taxes. Could this be a reason that American busniesses go to Canada for production (cheaper production in Canada, but they stay American for the lower tax rates)?
I don't know what you mean by "stay in America." The Big 3 auto companies are American and even if they wanted to, it would be impractical to relocate the company itself to Canada. We actually have decent corporate tax rates* and the governments (Fed. and provincial) support the auto industry here.Siggy said:
*Ontario doctors will soon vote on a bargaining agreement that will allow them to incorporate and pay corporate rates. The billing cap will also be lifted if the deal is accepted.
Man and I almost wanted to post something to make hyper-conservatives look ridiculous..Siggy said:
The number of insured Americans (in the U.S.) is (hold your breath) 100%. The number of insured illegal immigrants is (hold your breath again) 100%.
100% of all humans with feet on American soil are insured - and by Federal law, there are no exceptions - period.
These are the facts, and they cannot be disputed.
As one of the evil rich of the near future, you will be footing virtually all of the bill for those that don't have commercial insurance. In other words, you will pay for the cost of government insurance. On behalf of all those that will not matriculate to medical school - thanks for your (involuntary) contributions. Without them, well, everyone else would have to pay more!
100% of all humans with feet on American soil are insured - and by Federal law, there are no exceptions - period.
These are the facts, and they cannot be disputed.
As one of the evil rich of the near future, you will be footing virtually all of the bill for those that don't have commercial insurance. In other words, you will pay for the cost of government insurance. On behalf of all those that will not matriculate to medical school - thanks for your (involuntary) contributions. Without them, well, everyone else would have to pay more!
The fact is that no one goes without medical care. No one. Maybe you have to make a difficult choice about writing a big check, or maybe you have health insurance through your employer, or maybe you're on Medicaid or Medicare. Either way, you will get medical care. No one in this country is prevented or precluded from getting medical care. It may not always be the best available, and it may not be in the ritziest of settings. But everyone gets basic medical care if they want it, period. Most of the reasons why people don't get treated have nothing to do with physicians, hospitals, insurance companies, or governments; most of those reasons are laid at the feet of patients.
And now, the test. There are three parts. If you're one of socialized medicine's true believers, post your answers on this thread for everyone else to see..
Let's begin!
The concept of entitlement is woven throughout our legal system. By this I mean someone or some group of people is entitled to some benefit regardless of the cost to anyone else.
(a) Short answer - 30 points (5 points each)
(b) Essay: 40 points
(c) Essay: 30 points
------------------------------------------------------------
Good luck!
And now, the test. There are three parts. If you're one of socialized medicine's true believers, post your answers on this thread for everyone else to see..
Let's begin!
The concept of entitlement is woven throughout our legal system. By this I mean someone or some group of people is entitled to some benefit regardless of the cost to anyone else.
(a) Short answer - 30 points (5 points each)
Everyone has the same basic requirements to get along in this world: food, housing, clothing, education, transportation, and medical care.
(1) Are all Americans entitled to the absolute best food money can buy, even if they can't afford to pay?
i.e. "It isn't fair that I get chicken soup when those people over there get steak and potatoes!"
(2) Are all Americans entitled to the absolute best clothing money can buy, even if they can't afford to pay?i.e. "It isn't fair that I have to wear K-Mart rack rags when those people over there have leather jackets!"
(3) Are all Americans entitled to the absolute best housing money can buy, even if they can't afford to pay?i.e. "It isn't fair that I have an apartment when those people over there have houses!"
(4) Are all Americans entitled to the absolute best education money can buy, even if they can't afford to pay?i.e. "It isn't fair that I only have high school diploma when those people over there have college degrees!"
(5) Are all Americans entitled to the absolute best transportation money can buy, even if they can't afford to pay?i.e. "It isn't fair that I have to ride the bus to work when those people over there have cars!"
(6) Are all Americans entitled to the absolute best medical care money can buy, even if they can't afford to pay?i.e. "It isn't fair that I can't get a hip replacement when those people over there can!"
(b) Essay: 40 points
How much power should Americans cede to some government bureaucracy to make these decisions for us?
In other words - how much freedom should we give up for appearances' sake? And don't say that socialism/bureaucratic control of anything works well for everybody - because there's absolutely zero proof of that. It would make us feel good to say that it does, but - it doesn't. Do you honestly believe that the rich and powerful (that's going to be you soon) will be denied anything - here or anywhere else in the world? Has this ever happened in human history?
(c) Essay: 30 points
We know that no one is entitled to legal representation in civil matters (as opposed to criminal matters). Are all Americans (criminal defendents) entitled to the absolute best legal defense money can buy, even if they can't afford to pay?
When answering this question, consider yourself to be hands down the absolute best defense attorney practicing in your medium to large American city. If your fellow citizens decide to give the government the power to force you to defend the many indigent criminal defendents in your community, how many months will it be before you decide to stop practicing law?
------------------------------------------------------------
Good luck!
It's Mothra again! You know, I wonder why if 100% of us are insured, I got asked if I have insurance when I scheduled a doctor's appointment last week? Actually it was the first question they asked me.Mothra said:
And don't bother to take his test (I see you've expanded it, Mothra, to include some essay questions now), it won't matter what you say.
That's a nonsensical rationale. Shelter sustains life-- do we all have a right to free housing? Water sustains life-- when's the last time you got free running water in your home? Food sustains life-- have you tried not paying your grocery or restaurant bill lately? You're glossing over a lot of pertinent (and non-trivial) distinctions.trinitrotoluene said:
From my post in another thread:
Health care is not a "right", for the simple fact that you CANNOT have a natural right that is contingent on the toil of another man. For instance, you have the right to free speech, but you do NOT have the right to have a newspaper commissioned for you to exercise that free speech, with workers manning the presses for "free". You have the right to assembly, but you do NOT have the right to force the owner of Madison Square Garden to allow your group in on a winter's night, providing "free" shelter and shouldering the heating and electricity costs himself. You have the right to the pursuit of happiness, but if your happiness comes through having people build homes or boats for you, you had better be prepared to ante up. Why is nourishment-- by anyone's account a more basic need than healthcare-- not sought by waltzing into some upscale dining establishment and compelling their master chefs to prepare meals for the indigent, as opposed to sending them to a soup kitchen or some such? If you'd argue that only some bare minimum threshold must be met with regards to food, speech etc., then why do you not understand that there are, in fact, such things as free clinics, where that same bare minimum will be met. It obviously won't be the same quality of care, but, then again, Manwich Meal isn't exactly foie gras either, no (as in the previous example)? Why, then, are those things somehow different qualitatively? And why should we countenance such a notion? Particularly in light of the total injustices which would transpire under socialized medicine...
Water, sustenance and shelter are all more basic needs than healthcare, yet we don't hear any carping over people having to pay water bills, or having to pay for their own homes/apartments (good luck getting that house constructed for "free"). The entitlement culture that has developed in this nation (and around the world in regards to medical care) is truly appalling and rationally indefensible.
Think about every enumerated right as expressed in the Constitution-- not a single one's expression or realization hinges on the work of another man's hands, and for good reason. We have a name for such relationships as you seemingly espouse: indentured servitude.
As for my personal "solution" to the health care problem in the US, here's a brief outline; for elaboration and my responses to critiques of such a plan, see this thread, beginning with post #17. But here's the gist of it:
People should still have health insurance, but it will be more akin to catastrophic coverage (which has largely been discontinued for single payers, iirc, due to its lack of profit margin for the insurance co's). I would propose a model whereby people would have to pay for their health services up until a pre-set deductible, which would be based upon their income bracket. After that amount, insurance would take over and (hopefully) cover the rest, or at least a reasonable amount (unlike what occurs presently).
So, for example, take the following income brackets and what I feel a reasonable deductible would be for people in said brackets to pay to their physicians:
$15-20K Income = $150-250 deductible
$55-60K Income = $1000-1800 deductible (it's not proportional to the previous case due to sustenance costs which more greatly affect those in lower income brackets)
$85K Income = $2200-3500 deductible
$120K Income = $6500 deductible
I feel that this would be a fair system for several reasons: first, it would allow primary care physicians to finally have fee-for-service again, benefitting their bottom lines and allowing them to give the sort of care that all patients desire, rather than having to rush through patients assembly-line style in order to keep their practices solvent; secondly, those who are earning $60K per annum can certainly afford to pay $1800 for their medical costs (realistically, the only time costs would ever get to that point would be the rare procedure or expensive diagnostic test, which would be needed perhaps once or twice per year if that). I say that they can afford it because these largely comfortable middle-class people don't hesitate in the slightest to shell out $400 for a battery of tests for their dog at the vet, or $800 for a new TV set, or $150 on a dinner, or $350 for their plumber, or $1000 when the coils blow on their car. Yet these same people, by and large, want to be able to go to their primary care physician and hand over the insurance card and a $10-15 co-pay. That is injustice right there, I'm sorry; it cannot be philosophically defended. A person's health is presumably more important than entertainment, or cuisine, or even their pet's health, yet they have no qualms in denying a physician, who is among the most skilled and dedicated of professionals, his due compensation. The sense of entitlement in this country is shocking, and that definitely contributes to this sentiment among the populace; also, however, I do not believe that the majority of people understand how primary care (and ER and other) docs are being squeezed at the moment-- if they did, I do believe that many of them would be more amenable to such plans, or at least with throwing some extra cash or a check their doctor's way after a visit.
It would also benefit insurance companies, as their payouts would decrease, if only due to the fact that they would no longer have to reimburse primary care physicians except in the most exceptional of cases where the cost of care ran over the pre-set deductible. Since the incidence of more expensive procedures such as surgery should remain relatively constant, insurance companies will be able to generate larger profit margins if they keep their premiums steady. However, what would most likely have to ensue is 1) sufficient education of the consumer/employee as to the reasons for the new cost structure, and 2) at least a slight reduction in premiums to account for the company's decreased financial liability for all sorts of primary care. I do honestly believe that most people would be accepting of such a system so long as they are comforted by the knowledge that their medical costs will never go beyond their reasonable means. For instances of extended hospitalization etc. (where costs would go quite far beyond the deductible, not merely a couple of thousand dollars), perhaps a system could be worked out where for every $X in costs incurred, the patient has to pay a certain amount. So, say, for every $10K in costs incurred above the deductible (but only once cost has gone above $10K beyond the deductible), the patient may have to chip in another $1000 or so (this would, ideally, also be tied to income bracket in my opinion, so the less fortunate pay less and the more well-off pay more).
Also, those who legitimately cannot afford to pay even for primary care service-- either because their income falls below the $15K level or they are currently unemployed-- should not be denied care despite their inability to pay. I feel that if all of the above policies (conceived in haste, but that's the general idea) were implemented, most, if not all, physicians would not have any problem with treating the occasional non-paying patient. Hell, in many cases, they do so now, and actually LOSE money on the transaction with the insurance company. The problem with the current system is that, since everybody is covered by these ludicrous plans, the physicians cannot recoup the costs anywhere else; in the proposed plan, they'd be able to recoup these costs from the people who can actually afford to pay.
I believe education is the key to this plan, and I've begun it in my own way by speaking to my family about the realities of the current system. My family's combined income is around $60-65K before taxes, and my mother is one of the aforementioned folks who will glady (well, not gladly, but she's done it) drop $600-1000 on my dog at the vet when he's sick, but still hands over a $10 co-pay at the doctor's office. Now, it's not because she's greedy, or feels entitled-- it's because she just doesn't know any better; I'd wager most people don't. I've already told my mother and father that it wouldn't kill them to throw another $20-30 (in addition to the $10 co-pay and the pittance the insurance co. reimburses the doctor) to the doctor when they have to see him once every 2-3 months. We're not going to starve. But medical professionals who've worked so hard for so long and are dedicated, caring (for the most part), and knowledgeable (and saddled with debt in many cases) deserve their due. I'm sorry.
Just my two cents.
This is not to say that such a plan is perfect-- no plan is. One legitimate criticism of it would be that people would say "why should I pay twice for my medical care-- once to my insurance co. and once to the physician?" My short answer to that would be: People did that for decades. Catastrophic coverage was the dominant paradigm for health insurance up until the early-mid 90's. What, precisely, about human nature, the concept of service provider/consumer/payment for services rendered, or the expertise of doctors has changed in that time which now entitles you to essentially "free" care on the backs of physicians who are making less and less after having dedicated, in many cases, nearly a decade in post-graduate schooling to their profession? Answer: Nothing has changed except people's biases and expectations, which is why they have to be re-educated on such matters. When the catastrophic coverage model was dominant, self-reported customer satisfaction with the medical system was actually at an all-time high, especially as compared with today. But my above system is by no means perfect; then again, is our current system perfect? Hardly. Can anyone propose a flawless system? Doubtful, but I'd be quite open to hearing it if you can. What I've outlined above is simply the fairest system I can conceive of for all involved parties; I feel it strikes an appropriate balance where there currently is none. Obviously all notions of "fairness" are inherently subjective, and so I clearly leave myself open to charges of bias and/or skewed notions of propriety. But I would argue we all do to one extent or another.
So that's my idea, for what it's worth (which may not be much).
People should still have health insurance, but it will be more akin to catastrophic coverage (which has largely been discontinued for single payers, iirc, due to its lack of profit margin for the insurance co's). I would propose a model whereby people would have to pay for their health services up until a pre-set deductible, which would be based upon their income bracket. After that amount, insurance would take over and (hopefully) cover the rest, or at least a reasonable amount (unlike what occurs presently).
So, for example, take the following income brackets and what I feel a reasonable deductible would be for people in said brackets to pay to their physicians:
$15-20K Income = $150-250 deductible
$55-60K Income = $1000-1800 deductible (it's not proportional to the previous case due to sustenance costs which more greatly affect those in lower income brackets)
$85K Income = $2200-3500 deductible
$120K Income = $6500 deductible
I feel that this would be a fair system for several reasons: first, it would allow primary care physicians to finally have fee-for-service again, benefitting their bottom lines and allowing them to give the sort of care that all patients desire, rather than having to rush through patients assembly-line style in order to keep their practices solvent; secondly, those who are earning $60K per annum can certainly afford to pay $1800 for their medical costs (realistically, the only time costs would ever get to that point would be the rare procedure or expensive diagnostic test, which would be needed perhaps once or twice per year if that). I say that they can afford it because these largely comfortable middle-class people don't hesitate in the slightest to shell out $400 for a battery of tests for their dog at the vet, or $800 for a new TV set, or $150 on a dinner, or $350 for their plumber, or $1000 when the coils blow on their car. Yet these same people, by and large, want to be able to go to their primary care physician and hand over the insurance card and a $10-15 co-pay. That is injustice right there, I'm sorry; it cannot be philosophically defended. A person's health is presumably more important than entertainment, or cuisine, or even their pet's health, yet they have no qualms in denying a physician, who is among the most skilled and dedicated of professionals, his due compensation. The sense of entitlement in this country is shocking, and that definitely contributes to this sentiment among the populace; also, however, I do not believe that the majority of people understand how primary care (and ER and other) docs are being squeezed at the moment-- if they did, I do believe that many of them would be more amenable to such plans, or at least with throwing some extra cash or a check their doctor's way after a visit.
It would also benefit insurance companies, as their payouts would decrease, if only due to the fact that they would no longer have to reimburse primary care physicians except in the most exceptional of cases where the cost of care ran over the pre-set deductible. Since the incidence of more expensive procedures such as surgery should remain relatively constant, insurance companies will be able to generate larger profit margins if they keep their premiums steady. However, what would most likely have to ensue is 1) sufficient education of the consumer/employee as to the reasons for the new cost structure, and 2) at least a slight reduction in premiums to account for the company's decreased financial liability for all sorts of primary care. I do honestly believe that most people would be accepting of such a system so long as they are comforted by the knowledge that their medical costs will never go beyond their reasonable means. For instances of extended hospitalization etc. (where costs would go quite far beyond the deductible, not merely a couple of thousand dollars), perhaps a system could be worked out where for every $X in costs incurred, the patient has to pay a certain amount. So, say, for every $10K in costs incurred above the deductible (but only once cost has gone above $10K beyond the deductible), the patient may have to chip in another $1000 or so (this would, ideally, also be tied to income bracket in my opinion, so the less fortunate pay less and the more well-off pay more).
Also, those who legitimately cannot afford to pay even for primary care service-- either because their income falls below the $15K level or they are currently unemployed-- should not be denied care despite their inability to pay. I feel that if all of the above policies (conceived in haste, but that's the general idea) were implemented, most, if not all, physicians would not have any problem with treating the occasional non-paying patient. Hell, in many cases, they do so now, and actually LOSE money on the transaction with the insurance company. The problem with the current system is that, since everybody is covered by these ludicrous plans, the physicians cannot recoup the costs anywhere else; in the proposed plan, they'd be able to recoup these costs from the people who can actually afford to pay.
I believe education is the key to this plan, and I've begun it in my own way by speaking to my family about the realities of the current system. My family's combined income is around $60-65K before taxes, and my mother is one of the aforementioned folks who will glady (well, not gladly, but she's done it) drop $600-1000 on my dog at the vet when he's sick, but still hands over a $10 co-pay at the doctor's office. Now, it's not because she's greedy, or feels entitled-- it's because she just doesn't know any better; I'd wager most people don't. I've already told my mother and father that it wouldn't kill them to throw another $20-30 (in addition to the $10 co-pay and the pittance the insurance co. reimburses the doctor) to the doctor when they have to see him once every 2-3 months. We're not going to starve. But medical professionals who've worked so hard for so long and are dedicated, caring (for the most part), and knowledgeable (and saddled with debt in many cases) deserve their due. I'm sorry.
Just my two cents.
This is not to say that such a plan is perfect-- no plan is. One legitimate criticism of it would be that people would say "why should I pay twice for my medical care-- once to my insurance co. and once to the physician?" My short answer to that would be: People did that for decades. Catastrophic coverage was the dominant paradigm for health insurance up until the early-mid 90's. What, precisely, about human nature, the concept of service provider/consumer/payment for services rendered, or the expertise of doctors has changed in that time which now entitles you to essentially "free" care on the backs of physicians who are making less and less after having dedicated, in many cases, nearly a decade in post-graduate schooling to their profession? Answer: Nothing has changed except people's biases and expectations, which is why they have to be re-educated on such matters. When the catastrophic coverage model was dominant, self-reported customer satisfaction with the medical system was actually at an all-time high, especially as compared with today. But my above system is by no means perfect; then again, is our current system perfect? Hardly. Can anyone propose a flawless system? Doubtful, but I'd be quite open to hearing it if you can. What I've outlined above is simply the fairest system I can conceive of for all involved parties; I feel it strikes an appropriate balance where there currently is none. Obviously all notions of "fairness" are inherently subjective, and so I clearly leave myself open to charges of bias and/or skewed notions of propriety. But I would argue we all do to one extent or another.
So that's my idea, for what it's worth (which may not be much).
Do you think maybe they wanted to know what type of insurance you have? Or whether you're rich - and pay cash for everything?tacrum43 said:
In the end, I suppose you must have answered "yes"...
I rest my case.tacrum43 said:
Again if 100% have insurance, they wouldn't have asked. But yes, I do have insurance. It's a PPO with a $20 copay from Blue Cross of California since you're so interested.Mothra said:
On a related note, it makes sense even for rich people to have insurance, because even if they have a very high deductible, they still get cheaper rates for tests, procedures, etc.
I wouldn't exactly call my previous posts "emotional rants". If you wanna talk about emotional rants, see Mothra's posts with lots of bold, capital letters, exclamation points and name calling.
I didn't feel like wasting my time taking a biased test. When you provide supplementary answers that basically tell you what is the right answer and challenge you to defy it, that kind of takes the objectivity out of a test.
CJM:
First, sorry about the grammatical and spelling errors. It's late and I cannot sleep.
You are laboring under a false assumption.
I am going to say this for the 19th time: I DO NOT SUPPORT SOCIALIZED MEDICINE!!! As a matter of fact, I do not support socialized anything in the purest sence. I do support expanding government support services (food, shelter, and medical assistance) to the helpless and the working poor. To quote myself from the fifth of March: "I don't support socialized medicine per se. However, I do support expanding Medicare and Medicaid so that people who can't afford insurance can get it."
Now that I've informed you on the part of this thread you have not read, I will explain the implications. First, I need to explain a basic liberal concept: the living wage. The living wage is the lowest amount of income a person needs to secure clean water, editable food, basic shelter, reasonable health coverage, and the other basics of life. The living wage varies by locality, but the average is about $8.50 per hour for 40 hours per week of work.
Now, if a person is at or above the living wage, government intervention is most likely not needed. It would be ideal if every person could find such a job. Indeed, if you do not have such a job and can find such a job, I think you have an obligation to take it. So when I say that, "The right to life includes the right to what sustains life," there is an unspoken obligation to do what you can to secure that sustanence for yourself before turning to government for a hand out. After all, if you take something out of the community chest, you should put something back in if you can.
Here is the key: "That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed." Our government has decided that well-regulated free markets will deliver sustanence to its citizens. Now, we could switch over to socialism, but the invisable hand just does a really good job doing what so many government bureaus cannot.
The problem arises when the invisable hand turns into the community molester. There are limits on the right to free speech; I cannot yell "FIRE!" in a crowded theater or do a nude photoshoot in a public park (unless I live in 1968 Berkley). I can own a gun, but I cannot kill someone without just cause. I can own my own home and keep it private, but the government can search it if a break the law and seize it if I don't pay my taxes. Rights end when they unjustly abuse the public good and shock the public conscieous. Well, if some people work and work and work and work to death in a minimum wage job without any hope of upward mobility while HMO executives make $8 million per year, doesn't that shock the public consciencious? Doesn't that abuse the public good? How is that different killing someone without just cause?
Now, you might be thinking that the minimum wage / wealthy executive divide is OK b/c it is the result of an organic process. That's just the way life and capitalism go. WRONG!!! I could argue murder is an organic process. A wife cheats on her husband because she was attracted to a co-worker. After the husband finds out about the affair, he kills his wife out of jealously. It's an organic process--that of human emotions, but the state sends the husband to jail anyway. Remember, life is a right that the government must defend. Now, if capitalistic mores and policies are allowing multi-millionaires to live it up while poor people starve, freeze to death, and roam the streets with untreated mental illnesses, the state needs to step in to protect the right to life.
Now, you might be thinking that people need to go to school and learn a trade. Well, now you hit right number three: the pursuit of happiness. Education can provide the type of upward mobility that Jefferson envisioned. However, people need to be able to afford that education, people need to be ready to take on the challenge of higher education, and people need to have jobs to fill after they get that education. Unfortunately, many people lack at least one of those three. If the market cannot correct this, government will have to.
One final thought:
First, sorry about the grammatical and spelling errors. It's late and I cannot sleep.
You are laboring under a false assumption.
I am going to say this for the 19th time: I DO NOT SUPPORT SOCIALIZED MEDICINE!!! As a matter of fact, I do not support socialized anything in the purest sence. I do support expanding government support services (food, shelter, and medical assistance) to the helpless and the working poor. To quote myself from the fifth of March: "I don't support socialized medicine per se. However, I do support expanding Medicare and Medicaid so that people who can't afford insurance can get it."
Now that I've informed you on the part of this thread you have not read, I will explain the implications. First, I need to explain a basic liberal concept: the living wage. The living wage is the lowest amount of income a person needs to secure clean water, editable food, basic shelter, reasonable health coverage, and the other basics of life. The living wage varies by locality, but the average is about $8.50 per hour for 40 hours per week of work.
Now, if a person is at or above the living wage, government intervention is most likely not needed. It would be ideal if every person could find such a job. Indeed, if you do not have such a job and can find such a job, I think you have an obligation to take it. So when I say that, "The right to life includes the right to what sustains life," there is an unspoken obligation to do what you can to secure that sustanence for yourself before turning to government for a hand out. After all, if you take something out of the community chest, you should put something back in if you can.
Here is the key: "That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed." Our government has decided that well-regulated free markets will deliver sustanence to its citizens. Now, we could switch over to socialism, but the invisable hand just does a really good job doing what so many government bureaus cannot.
The problem arises when the invisable hand turns into the community molester. There are limits on the right to free speech; I cannot yell "FIRE!" in a crowded theater or do a nude photoshoot in a public park (unless I live in 1968 Berkley). I can own a gun, but I cannot kill someone without just cause. I can own my own home and keep it private, but the government can search it if a break the law and seize it if I don't pay my taxes. Rights end when they unjustly abuse the public good and shock the public conscieous. Well, if some people work and work and work and work to death in a minimum wage job without any hope of upward mobility while HMO executives make $8 million per year, doesn't that shock the public consciencious? Doesn't that abuse the public good? How is that different killing someone without just cause?
Now, you might be thinking that the minimum wage / wealthy executive divide is OK b/c it is the result of an organic process. That's just the way life and capitalism go. WRONG!!! I could argue murder is an organic process. A wife cheats on her husband because she was attracted to a co-worker. After the husband finds out about the affair, he kills his wife out of jealously. It's an organic process--that of human emotions, but the state sends the husband to jail anyway. Remember, life is a right that the government must defend. Now, if capitalistic mores and policies are allowing multi-millionaires to live it up while poor people starve, freeze to death, and roam the streets with untreated mental illnesses, the state needs to step in to protect the right to life.
Now, you might be thinking that people need to go to school and learn a trade. Well, now you hit right number three: the pursuit of happiness. Education can provide the type of upward mobility that Jefferson envisioned. However, people need to be able to afford that education, people need to be ready to take on the challenge of higher education, and people need to have jobs to fill after they get that education. Unfortunately, many people lack at least one of those three. If the market cannot correct this, government will have to.
One final thought:
It's oxymoronic that you mention "servitude." If I remember it correctly, many, many, many men toiled and died giving freedom to African Americans. Their rights are contigent on another's toil. Indeed, I would conclude that all rights are contengent on other's actions. If all the farmers quit growing food and the food supply dried up, would you still be able to eat? Maybe not. If all the doctors went on strike and you appendix exploded, would you live for very long? I doubt it.CJM said:
Mothra said:
Its amazing to see those that have never lived with poverty, missed a meal, or did not receive medical treatment for lack of money attempting to decide the fate of healthcare. Obviously, this is probably the major problem with the current state of healthcare. You have well greedy corporations (ie. insurance, HMOs, etc) trying to maximize profits, while you have greedy politicians making the decisions over $3000/plate fundraising dinners. All the while millions of poor people with no voice are getting screwed. This situation and the lack of a prospect at true reform is rather saddening.
Much lower than they are now, as insurance companies would have to lower their rates due to decreased liability for all sorts of primary care. As for a specific number, it would merely be conjecture on my part. They'd certainly be (significantly) lower than they are currently, though, due to the new dynamic which would be in place. I discussed a lot of my rationale behind these ideas in the thread I linked to above if you're interested.trinitrotoluene said:
For what it's worth, I didn't mean to imply that you were pro-socialized medicine. I simply took your quote about "rights" (which disagree with) and then pasted a quote of mine from a previous thread, which had the words "socialized medicine" towards the tail end of it-- it's my fault for not reading the quote I was posting more closely and tailoring it to suit the current conversation. I'd like to speak to your points individually, but I don't have the time at the moment. Suffice it to say that although I disagree with certain things, I also agree with many things (e.g., I firmly believe in a livable wage-- I believe that anyone who is willing to work an honest job for 40 hours/week should be entitled to, say, $30-32K/year for a place like NY; this amount would be scaled relative to the cost of living in various locales. If minimum wage had merely kept up with inflation from 1965-- never mind cost of living-- it would have stood at about $11.50/hour now).
Scarletbegonias said:
I'm not sure what your point is here.. are you saying that it is naive to consider Medicaid a safety net system?
I'll throw in my two cents:
I think our current system works, it just needs alittle tweaking. Sure there are people who are uninsured, but we have Medicaid and other programs for those up to around 200% of the poverty line (ie: FHP/CHP in NY), people who really have no choice about health care.
After that you are getting to lower middle class/ middle class, a class of people who have to make the difficult decision of moving up to a better apartment/house (or whatever) or getting health insurance if they aren't covered by their employer. I'm guessing most of these are voluntarily uninsured.
To fix our current system (a hybrid of a free market system and a socialized system):
1) allow Medicaid/Medicare to utilize their purchasing power and negotiate rates for prescription medicine (reducing the financial strain on subsidies)
2) create incentives for high deductible (giving consumers a more realistic idea on the cost of healthcare without increasing their out of pocket costs substantially)
3) Close loop holes that allow wealthy people to take advantage of Medicare
Thoughts?
I think our current system works, it just needs alittle tweaking. Sure there are people who are uninsured, but we have Medicaid and other programs for those up to around 200% of the poverty line (ie: FHP/CHP in NY), people who really have no choice about health care.
After that you are getting to lower middle class/ middle class, a class of people who have to make the difficult decision of moving up to a better apartment/house (or whatever) or getting health insurance if they aren't covered by their employer. I'm guessing most of these are voluntarily uninsured.
To fix our current system (a hybrid of a free market system and a socialized system):
1) allow Medicaid/Medicare to utilize their purchasing power and negotiate rates for prescription medicine (reducing the financial strain on subsidies)
2) create incentives for high deductible (giving consumers a more realistic idea on the cost of healthcare without increasing their out of pocket costs substantially)
3) Close loop holes that allow wealthy people to take advantage of Medicare
Thoughts?
There was an article in slate a day or two ago (www.slate.com) by Timothy Noah that argued that we already have socialized medicine: the VA system, and that it is more efficient and better than our non-socialized private hospitals by just about every metric possible. He cites heavily from NEJM article. Seems to be a bit less arbitrary than the discussion here thus far.
Well... it might seem so, until you realize that the people that have to foot the bill should have a vote, too. But everyone of age can vote, so, I guess we all have a say if we want.jdovez said:
You couldn't possibly be talking about me... I missed plenty of meals as a child. When I had breakfast, it was virtuall always plain oatmeal. Cereal was a treat! In elementary school, I had one pair of leather shoes per year, maybe two. I still remember the day we got air conditioning. I saw a physician maybe once every three years. I survived. My mother (single parent) asked for no handouts, and raised two kids and cared for her aged father on a very small income. (She could do it only because we lived in in my grandfather's house.)
Greedy corporations? Greedy politicians? That's to be expected. I mean - ultimately, all corporations are owned by somebody (maybe all politicans are owned by somebody? LOL). And all those somebodies out there want a return on their investment. It shouldn't come as a surprise...
Heck, if corporations weren't greedy, then the rest of us would sell our stock, and invest somewhere else, and the un-greedy ones would go out of business.
Maybe "competitive" is a better description. If greed isn't good, then maybe we could all agree that competition is good.
One key difference between the VA system and Medicare is the ability for VA to negotiate drug prices...PhotoMD said:
CJM-premed, please don't use terms you're not familiar with (indentured servitude). Comparing anyone who simply through his taxes supports another's health care to an indentured servant is ridiculous and offensive to anyone who has actually been affected by that. My ancestors left India for Trinidad unden the British indentured labourer system to work under conditions that closely resembled slavery. My taxes may help another Canadian get health care, but I would never say that I'm in a situation that even closely approximates what my great-grandparents went through.
If I said you can have a 2005 Mercedes CL65 AMG for $4 but you had to take it in 3 months, what would you do? Now what if I said you could have a liver transplant or have a course of chemotherapy for $4 but you have to start it within 3 months as well? Nobody would take the chemo or transplant unless it was needed just because they had access to it. Essential health care is driven by need, not desire.
Health care is not a commodity like cars, mansions, Prada puses, Nike shox or filet mignon. (Most if not all people have access to food and water through community programs which, I know, aren't the best but it's still access). You don't need a car to get around, a bike will do though it may take longer. You don't need a mansion, a bachelor pad or even homeless shelter will work. You don't need nike shox, or Prada, because payless shoes and a vinyl wallet will still work. You don't need steak and potatoes because chicken soup is still food. There are substitutions for these things that still allow survival and a reasonable quality of life.
If I need bypass surgery, a bandaid won't work. If I need insulin, I can't inject water into my arm and hope it works. If I have a kid, a visit to my neighbour won't substitute for a well-baby visit. If I need a hip replacement, Deep Cold or A535 ointment won't get the job done.
People do not have the right to the "best" possible health care at Harvard or Hopkins, but all people should have access to at least "medically necessary" services and it should be the right of any jurisdiction to define what that means. There are different ways of making sure this access is there.
If I said you can have a 2005 Mercedes CL65 AMG for $4 but you had to take it in 3 months, what would you do? Now what if I said you could have a liver transplant or have a course of chemotherapy for $4 but you have to start it within 3 months as well? Nobody would take the chemo or transplant unless it was needed just because they had access to it. Essential health care is driven by need, not desire.
Health care is not a commodity like cars, mansions, Prada puses, Nike shox or filet mignon. (Most if not all people have access to food and water through community programs which, I know, aren't the best but it's still access). You don't need a car to get around, a bike will do though it may take longer. You don't need a mansion, a bachelor pad or even homeless shelter will work. You don't need nike shox, or Prada, because payless shoes and a vinyl wallet will still work. You don't need steak and potatoes because chicken soup is still food. There are substitutions for these things that still allow survival and a reasonable quality of life.
If I need bypass surgery, a bandaid won't work. If I need insulin, I can't inject water into my arm and hope it works. If I have a kid, a visit to my neighbour won't substitute for a well-baby visit. If I need a hip replacement, Deep Cold or A535 ointment won't get the job done.
People do not have the right to the "best" possible health care at Harvard or Hopkins, but all people should have access to at least "medically necessary" services and it should be the right of any jurisdiction to define what that means. There are different ways of making sure this access is there.