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Yes indeed. It's do-able if we had the will and our political leadership had the guts
Health Care Reform
Started by LuciusVorenus
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Granted that single payer is not magic bullet that solves the problem.
Obamacare is one approach that unfortunately was patched together to
appeal to various constituencies for the sake of passage. The run-away
cost of health care is predicated on a health care consumer market that
demands more and better, but an unwillingness to pay for it through
taxation or other funding sources. Single payer is the system we use
for Medicare so its been tested since 1965 for better or worse. Obviously,
there is waste in the Medicare system and maybe that's the major
problem which needs to be confronted. We now cover 40 million citizens (age 65 and over) under a single payer system. The VA system could also arguably be considered a single payer operation There is still three hundred million out there that should have access. The NHS in England
is the equivalent of the VA with government owned hospitals etc., which
may not be the best approach for a nation-wide health care system. But,
the Brits also have access to private health insurance so many employers
offer a private plan besides all Brits having access to the comprehensive
government system. You have suspenders and a belt to hold up your pants.
Maybe we should just hire this guy to solve the rising cost of health care...
http://www.youtube.com/watch?v=6csPWzurwHo
http://www.youtube.com/watch?v=6csPWzurwHo
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Several insurance companies have already stopped covering kids altogether:
Link
It's become quite clear that the profit motive is not fit for health insurance.
Like with everything, I think progressive ideas will win out eventually. In my lifetime, this country will have single-payer health insurance and our insane defense budget will be a fraction of what it is. I don't think the right-wing will be able to "fool all of the people all of the time". The changes won't happen during this weak-sauce, kid-gloves administration, though.
Also, to LuciusVorenus, may I say, "13! 13! 13!"
Link
It's become quite clear that the profit motive is not fit for health insurance.
Like with everything, I think progressive ideas will win out eventually. In my lifetime, this country will have single-payer health insurance and our insane defense budget will be a fraction of what it is. I don't think the right-wing will be able to "fool all of the people all of the time". The changes won't happen during this weak-sauce, kid-gloves administration, though.
Also, to LuciusVorenus, may I say, "13! 13! 13!"
Unfortunately, the "no-nothings" have again become a dominant political force
rallying folks who continue to want more but pay less.
So what else isn't profit meant for. Should cars be made not for profit, by the government? You wind up with the Trebant. Profit is good, healthcare is a privilege not a right.
Profit is good, but not in all things. Our military isn't run on profit. Healthcare is not a right, but it should be. The medical school you are going to is not for profit (unless you're going to Rocky Vista or in the Caribbean), neither is your university, or most of the hospitals you'll be working for.
To say profit is always good is as blind and stupid as the communists who say profit is never good.
To say profit is always good is as blind and stupid as the communists who say profit is never good.
Universities may nominally not be for profit, but looking at administrators' salaries they might as well be. SGU, Ross and AUC are for profit and are of decent quality; most private practices are. Healthcare would be better without insurance, which really isn't insurance, it's a form of collective bargaining. True insurance would protect you from catastrophic emergencies.
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Don't tell the ADCOM you're not compassionate or you'll be outside looking in.
No bucks no treatment. If Healtcare is a privilege then only the privileged
should receive healthcare
I don't think you understand the concept of non-profit. Non profit does not imply you cannot pay people competitive salaries.
Can you give a real life example of where this model works in healthcare?
All ready in. Suggesting that medicine should be in the private sector and should be given to those who pay is shocking. I would be willing to do pro bono in some cases, however I won't treat every single non-payer.
you don't have to except if you work in public hospitals. It may be shocking but
the poor and destitute also get sick and deserve treatment. That's why health
care is a right and not a privilege. FutureDoc the C word is compassion. If
that's not in the cards then Wall Street is waiting.
I hate to break the news, but to survive one needs to make a profit. I said I would give some pro bono to those that are deserving, not all indigent people deserve pro bono care. The profit motive is fine. If a surgeon provides excellent care because it makes him rich versus his compassion, does it make a difference? The answer is no. I'm not here to impeach your motives, how about we lay off the ad hominem attacks.
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you said not all indigent people need pro bono care...pray tell if you don't have
money to pay the for-profit surgeon how do you get care? You're indigent because
you don't have money. That's some of the issues Obamacare is trying to address.
Again heath care is a right and not a privilege.
I said deserving of, don't mischaracterize my statements. Please demonstrate how healthcare is a right, since for a positive right you must prove the argument. If you don't have money you don't get care, if I can't pay the attorney they don't represent me, medicine should be no different in that respect. Getting care with no intention of paying is theft of services.
Future Doc don't tell ADCOM no on the C word (i.e.) compassion even if you have
40 on the MCAT and a 4.0 GPA. Everybody who is sick or injured is deserving or
do you plan to pre-screen folks for treatment. How do you pay if your are
homeless and flat broke??? Re-think your future career
Actually, an attorney for defense is a right, if you can't afford one yourself. Healthcare is a right so much as having police protection is a 'right', even if I can't personally afford to pay. It's a service that we as a society should decide should be available to everyone and pay for it collectively.
Let me ask you: 1) Should police protection be privatized and available to only those who can afford it? and 2) If so why? And if not, how is that different from medical care?
Here's why a lot of people have a problem with healthcare being a right. First, let me re-frame this discussion as not what is a right or a privilege, but what people in a society have agreed upon as a service that society will provide. Read some Rousseau for background on social contract theory if necessary (I'm not trying to say you haven't, just that it's really interesting if you haven't).
Police services are something that most people agree upon, because there are people in our society who are criminals. I pay the police through tax to protect me, and everyone else, from other people and the stupid things they perpetrate upon others. That doesn't make police service a right, but something that I (theoretically) have agreed to pay for by living in this society. Now take healthcare. Whether or not you consider it a right, in order to have socialized health care of some kind, we would have to all (theoretically, again) agree that we will pay for it. But a lot of what health care pays for is not what one person does to another in an uncontrolled way, but the stupid things a person does to themselves. I don't want to pay to take care of the aftermath of the poor decisions another person made. For instance, take a person who has lung cancer due to smoking. Smoking was a stupid decision, and it resulted in an expensive health problem. That wasn't my problem, because I never decided to smoke, and never decided that the other person should smoke either. Yet socialized health care says that I still have to pay for it. Now tell me, how does that make sense? If you destroy your tv in a fit of rage, should I pay for that as well?
That's a really insulting assumption to make based on what I said. I did not say that I thought they should not be treated. I support the payment of treatment for those conditions by insurance companies. I do not support the payment for treatment of those conditions by myself, which is what a single payer system amounts to.
How about if they don't have insurance or can't get insurance....what then? Medicare
is a single-payer health insurance plan covering 40 million old folks. The single-payer
system is health insurance that covers the remaining 300 million citizens including you.
It's insurance plain and simple and you said insurance is good.
is a single-payer health insurance plan covering 40 million old folks. The single-payer
system is health insurance that covers the remaining 300 million citizens including you.
It's insurance plain and simple and you said insurance is good.
I'm not saying that there aren't problems with insurance. I find it appalling that you can be dropped from insurance for a medical problem, or that insurance doesn't pay for some things that doctors deem necessary. But the fact of the matter is that insurance is something that you pay into in case you need it later, while single payer is the government taking over all health-related costs. Those are not the same thing, because I have no choice in the matter if the government takes it over.
What I really don't get is how I'm not getting across to you that the problem most people have with single payer is that it forces us to pay for other people's health problems. Maybe I don't want to do that. This is especially so since I want to go into medicine. I find it perverse that under a single payer system I would be paying part of my own salary. There are other ways to accomplish covering everyone with insurance to some extent or another that don't violate my rights the same way single payer does.
In addition, there are huge issues with having a monopoly in anything, let alone health care. If the government controls prices on everything, I guarantee you that they will eventually start to try to cut costs by lowering reimbursement despite the fact that doing so might not be the best thing for the people involved. If you don't believe me, look at public education. Despite numerous studies that show that education correlates with pretty much every measure for how we are doing as a society, the government continually cuts education spending. What makes you think that it would be any different for health care?
Monopolies also do not encourage private spending on innovation. It isn't a coincidence that we have the best medical technological advances in the world - no other health care system incentivizes them the way ours does. That is ok for them, since they get the benefit of our progress without having to pay for it. But if we're not the ones making the progress, then no-one will be doing so. All of your expensive treatments for cancer and heart disease and every other health issue will cease to exist, and you're right: we'll end up paying less. You'll also still end up with people dying that didn't need to.
Yes, it sucks that there are people out there that don't have insurance, and yes we should find a way to get them health care of some sort. But you can't just close your eyes to the fact that we live in a capitalist society that doesn't tolerate socialized functions well. Both our economy and our government are not set up for it, and to think that you can just ignore that because health care policy is magically exempt is dangerous.
Europe has single payer....Australia has a single payer...Taiwan has single payer etc.
that are paid for in most cases by a Value Added Tax. You can also buy private insurance and your employer can offer same as part of the benefit package. Nobody falls between the cracks like folks in the U.S. The small government, no tax -tea baggers who are 65+ would go beserk if you took away their Medicare. Public schools
are socialistic institutions. You pay for people who have kids although you don't have
any etc. Our government is set up for it because we've been covering 40 million
old folks under the socialist type Medicare system since 1965. Sub-sahara Africa
has the type of system you envision. No pay no care because no insurance. Capitalist
loving Switzerland has a national health insurance scheme that covers all its citizens.
First, it's really disingenious to compare a TV with getting cancer. Secondly, you pay for people's police protection even if they live in an usafe area. You pay their attorney's fees even if they've confessed and are guilty. They've committed the crime, and yet you give them an attorney. We do it because we realize that while no one wants to pay for an attorney to defend a murderer, the overall good to society that we get from providing such services is greater than the expenses we may waste providing a service to someone who is at fault.
And I would ask how many of the teabaggers want to get rid of Medicare - the demographics of the 'tea party' tend to be older folks and try telling even them that we won't fund medicare via taxes. The new plan that Republicans offered last week explicitely put medicare cuts off the table, same with social security cuts, and military cuts. Yay, there goes 70% of the budget. If people who have it are happy with it, and even a majority of the so called fiscal conservatives are deadset against gettign rid of medicare because they think it does more good than harm for our seniors than our society, surely that is the mark of a good program? If it's such a dystopia to have medicare and other government services, surely people wouldn't defend it so ardently?
Of course, I think many people are like this guy:
http://www.youtube.com/watch?v=yTwpBLzxe4U
"I've been on food stamps and welfare, did anybody help me out? No."
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Did you even read what I wrote? The problem that I have with single payer is that it violates my rights, not that I don't want people to have health care.
You say that public schools are socialistic institutions. I agree. My point is that the government is decreasing education spending because it can, and that such is likely to happen under socialized health care. So what exactly are you arguing with there?
You're right, comparing a tv and cancer are not the same thing. However, I think you understood my point, which I couldn't think of a better metaphor for. You're also correct that I pay for police services for people that live in bad areas, but that is still a protection against a one person to the other type situation. Your example of the attorney for a person who has confessed to murder is a good one, except for the fact that the public defender is rarely the highest caliber lawyer available. If we go to a single payer health system, everyone will get the same access to health care, and that access won't be very good because both the government and its constituents won't want to pay for it.
I'm not against having everyone in the country insured. I think it's a great idea. What I'm against is having all of the money, and thus all of the control, in one place. I don't see how the system of private insurance for everyone supplemented by government funding where appropriate that we're moving towards right now is inherently worse than a single payer system, which is what I'm arguing against.
Again, the government pays for 46% of healthcare costs in this country already, and people who have medicare are deadset against defunding it. So obviously this is not the case.
Because every country with single payor has 100% coverage and every first world country spends half or less per person on their healthcare with comparable outcomes.
The only way you'll bend the cost curve downwards is by single payor.
Today's insurance companies are merely conduits for payment of medical bills. They
apparently take 30% off the top for their administrative costs. Single-payer schemes
as well as Medicare perform the same functions. A single-payer system will not focus on denying claims etc. The private carriers are in business to make a profit. They collect premiums and work like hell to deny claims because this translates
to higher numbers on their bottom line. Docs will still do what they've been doing,
but now the claim forms and payments will be sent to one entity for payment.
Obviously, you can say I don't want to accept patients under this plan and only
deliver services to folks who pay on delivery. Remember this is how folks in
cosmetic plastic business run their shop. You can do the same as an internist etc.
The single-payer doesn't leave people out in the cold. Obamacare is trying to bridge
the gap but teabagger types and other true-believers want to kill the plan. I'm
watching with glee to see if the same faction attacks Medicare. It's interesting to
note that 70% of the Federal budget is spent on medicare, social security and defense and let's seem them reign in spending without dismantling those program.
I'm afraid the no-nothing party has again come on the scene
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I'm really confused. You're saying that by taking over the other 54% of costs, we're going to reduce expenditures? Unless you think that 54% of all health care costs in the country are unnecessary, I would have to disagree with you on that one.
The only thing that I can assume you mean is that the government, throught the act of taking over, will make everything more efficient. If that's the case, I'd have to say I don't believe it, and reference the large bureaucratic nightmare that is every government program funded through the OMB or legislative decree.
Why would a single payer system not work to deny claims? The government is motivated by money issues in much the same way that companies are, except for the fact that instead of answering to investors, it answers to constituents. The idea that you could deny patients under a government funded system is pretty ridiculous as well. All you have to do is look at the government's current propensity for using Medicare funding as a lever to get hospitals to accept EMTALA, and you can see how I would be unconvinced that they wouldn't do the same under a single payer system. My opinion is that you would get something along the lines of, "If you see one of our patients, you must see them all," (which is exactly what EMTALA currently is) except everyone will be under the same system.
Also, I wish you would stop using the term 'tea-bagger.' Its a pretty insulting attack on people who have legitimate opinions about the way that the country should be run, and it completely denigrates the original people involved in the Boston Tea Party, to whom you owe a great deal of respect for us to be even able to have this conversation.
40 million Americans do because they're covered by Medicare
Oh come now. The current tea-bagges.. oops tea advocates want less government
and reduced taxes, but ask the old guys if they would take a hit on social security
and medicare and gun totters if they would dismantle the war machine for a local militia. That's 70% of the budget. I'm sure they're good folks, but Main Street
Disneyland is part of an amusement park. This group and the folks in 18th century Boston don't share the same smarts. Now it's show biz with a $100,000 per speech
Barbie leading the parade.
You pay for thay 54%. Either through your employer or directly to insurance companies. That money, if paid via taxes to the government, would go a lot further.
Let's see, if only we had a government insurance plan to compare like.....medicare? With less overhead and beurocractic costs than insurance companies?
Or...maybe government healthcare in every other first world country?
Astarael, you have no idea what the hell you are talking about.
Aside from the stupidity of your arguments against willingness to increase health and welfare spending (which the majority of the public tends to support, despite corporate propaganda), especially the vile and laughable argument that the poor gaming the system will draining government resources, your argument in favor of innovation is likewise vacuous.
Capitalists on their own will not invest the necessary resources into research to produce new technologies (note the difference between adapting technologies for market usage and profiting versus development). The vast majority of significant technological advances in our last 50 (easily more) years of development have been driven by government (i.e. public) investment in technologies that often take years to become commericially viable. Intellectual property laws then allow business to profit from these advances. The risks of innovation are subsidized by the public while the profit is privatized (e.g. internet, computers, airplanes, etc, etc).
Aside from the stupidity of your arguments against willingness to increase health and welfare spending (which the majority of the public tends to support, despite corporate propaganda), especially the vile and laughable argument that the poor gaming the system will draining government resources, your argument in favor of innovation is likewise vacuous.
Capitalists on their own will not invest the necessary resources into research to produce new technologies (note the difference between adapting technologies for market usage and profiting versus development). The vast majority of significant technological advances in our last 50 (easily more) years of development have been driven by government (i.e. public) investment in technologies that often take years to become commericially viable. Intellectual property laws then allow business to profit from these advances. The risks of innovation are subsidized by the public while the profit is privatized (e.g. internet, computers, airplanes, etc, etc).
Is innovation driven by goverment (public) subsidy?
In summary:
Major past examples:
Government funding continues to drive innovation. Another good example is Reagan's Star Wars program.
More recently, massive tech subsidies through DARPA, billions in biomedical research by the NIH, etc. Not only is massive public funding directly channeled to private companies, often in an enviroment of limited competition, but technologies produced by publical funding at universities are often transferred to the private sector.
In summary:
Major past examples:
Government funding continues to drive innovation. Another good example is Reagan's Star Wars program.
More recently, massive tech subsidies through DARPA, billions in biomedical research by the NIH, etc. Not only is massive public funding directly channeled to private companies, often in an enviroment of limited competition, but technologies produced by publical funding at universities are often transferred to the private sector.
What a lot of healthcare pays for is old people who are old. If you have a better idea how to pay for the care of the elderly, please speak up.
Astral: As a pre-med - taxpayers who don't know you will help subsidize
your medical education, school loans, residency and essentially the whole
enchilada so you can selectively choose whom you want to treat. The
question being WHY SHOULD WE? Dig deep into your bottomless pockets
and pay your own way and get off the dole. Even in private med schools
you're being subsidized because they're non-profits so they don't pay
taxes, Federal research monies generates an income stream for the
school etc. Lots of muddled thinking with a dollop of half-baked Ayn Rand.
your medical education, school loans, residency and essentially the whole
enchilada so you can selectively choose whom you want to treat. The
question being WHY SHOULD WE? Dig deep into your bottomless pockets
and pay your own way and get off the dole. Even in private med schools
you're being subsidized because they're non-profits so they don't pay
taxes, Federal research monies generates an income stream for the
school etc. Lots of muddled thinking with a dollop of half-baked Ayn Rand.
O
OncoticPressure
Yes, taxpayers like all the welfare queens and coke dealers are contributing their heard earned money towards medical education.
Care to inform us exactly what percentage of the population pays 95% of the taxes and what percent pays nothing?
Obama is giving you a round of applause...
Can you give examples of these welfare queens? I grew up in the ghetto and I don't recall any of my neighbors living large off the public dole. It seems like that's another one of the Reagan era fantasies designed for people whose experience with poor people is limited to the one night a year they happen to stumble upon someone begging for change at a stop light.
O
OncoticPressure
If you are on welfare you should NOT have a car, should NOT have a cell phone, should NOT be wearing brand new shoes, should NOT be wearing ANY jewelry or "grills", should NOT be wearing anything other than Goodwill clothing, and should not be eating ANYTHING other than bread and water.
You never even answered my previous question I posed.
This one? Yea, of course they do. They need to pay more. In absolute terms, it's a lot of course but as a percentage of their income, they are not paying nearly enough.
O
OncoticPressure
O
OncoticPressure
You still didn't aswer the question.
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why is the answer relevant? i assume you're being rhetorical, and none of your opponents are going to be impressed by any answer provided - i suspect they base their value judgments on different criteria.
Get out, you ignorant, classist scum.
Yes, taxpayers like all the welfare queens and coke dealers are contributing their heard earned money towards medical education.
Care to inform us exactly what percentage of the population pays 95% of the taxes and what percent pays nothing?
Obama is giving you a round of applause...
Sadly a lot of the posters look at medicine as the equivalent of being a
car salesman. If you have money for wheels fine, if you don't walk. The
nobility of the profession revolves around the fact that you treat the sick
and the injury regardless of their ability to pay. It appears that the practice of medicine is merely viewed as another commercial activity and you get to wear a white coat rather than a silk suit. I seriously doubt that the aspiring pre-med even under Obamacare or Single Payer will be unable to pay for the Rolex that peaks out beneath the sleeve of their white coat.
There is essentially three options: the current insurance system that's
dependent on paying $1200 per month for family coverage although you
may only net $1500, if you're employed in a $15 per hour job and are
not on welfare or selling crack, Obamacare, or Single Payer that works well for the 40 million covered by Medicare and the other couple hundred million in Europe. The current system doesn't work except if an employer picks up the insurance tab (quickly disappearing) or you have deep pockets like Astarael et. al. who can pay the Internist or Surgeon when he's sick and injured the same way Beverly Hill Matrons pay for tummy tucks with a credit card. Come on boys/girls get real. Times are a changin
O
OncoticPressure
Still didn't answer the question. Use facts and less name calling (Remuneration).
I'm going to try to keep my responses short, so that this doesn't turn into a book. Before I begin, I would like to say that I believe all of you have a right to have a different opinion to mine, and while I respect that right, I disagree with your opinion on the subject. I am merely trying to put forth an argument for a differing viewpoint. By some of your comments, it seems that you think my viewpoint makes me a bad person. If I am correct in that assumption, let me know, because then I have no further desire to engage in discussion with you. I hope, however, that I am incorrect and you respect my right to my opinion. If such is the case, let us continue to argue (I guarantee we'll all benefit from it when interviews come around).
While I agree that significant funding comes from the public sector, what you just cited was a list of privately held businesses. I don't feel that this supports your claim that my argument to innovation is vacuous, because under a single payer system, the government would not be subsidizing the business, it would be the business's only customer. That distinction is very important.
I do not think that all health care should be dropped for the elderly. However, given the amount spent on futile treatment and our current understanding of the benefit (or lack thereof) to both the family and the patient, I think a lot of funding could be dropped from this area and put towards more useful things, such as insuring people who are poor. Not quite sure why we spend billions of dollars extending the lives of elderly people by a couple of months to the detriment of their families and don't provide anything for the lower middle class, but there it is. Hopefully that will change with the new health care bill.
I'm not saying that I've never received the benefit of taxpayer's money, and I'm grateful for what I've received. However, for a person like me, receiving aid is a huge incentive for me to give back to my community. For many of your 2 pack a day smokers, receiving aid is an excuse to keep smoking. I also think you're vastly overestimating the cost/benefit ratio for a person going into medical school. You are correct, as a resident, Medicare pays your salary. On the other hand, you provide health care to the population at a rate of around $15 an hour. I'd say Medicare is getting a good deal out of that equation.
Why should a person who has a lot of money be made to pay a higher percentage of their income? That's not really fair, and while I agree that there would be no feasible way to drop income tax to a flat percentage, I differ from you in one way: I am grateful that they pay so much to make our country continue to work. The lack of gratitude is kind of ridiculous - no one is entitled to the money of a wealthy person, and yet it is given anyway. We should all be saying "thank you," instead of, "you should be paying more."
In what way was that necessary? We were having a pleasant, albeit heated debate. I enjoy that, what I don't enjoy are personal attacks, even when they're not against me.
While I agree that significant funding comes from the public sector, what you just cited was a list of privately held businesses. I don't feel that this supports your claim that my argument to innovation is vacuous, because under a single payer system, the government would not be subsidizing the business, it would be the business's only customer. That distinction is very important.
I do not think that all health care should be dropped for the elderly. However, given the amount spent on futile treatment and our current understanding of the benefit (or lack thereof) to both the family and the patient, I think a lot of funding could be dropped from this area and put towards more useful things, such as insuring people who are poor. Not quite sure why we spend billions of dollars extending the lives of elderly people by a couple of months to the detriment of their families and don't provide anything for the lower middle class, but there it is. Hopefully that will change with the new health care bill.
I'm not saying that I've never received the benefit of taxpayer's money, and I'm grateful for what I've received. However, for a person like me, receiving aid is a huge incentive for me to give back to my community. For many of your 2 pack a day smokers, receiving aid is an excuse to keep smoking. I also think you're vastly overestimating the cost/benefit ratio for a person going into medical school. You are correct, as a resident, Medicare pays your salary. On the other hand, you provide health care to the population at a rate of around $15 an hour. I'd say Medicare is getting a good deal out of that equation.
Why should a person who has a lot of money be made to pay a higher percentage of their income? That's not really fair, and while I agree that there would be no feasible way to drop income tax to a flat percentage, I differ from you in one way: I am grateful that they pay so much to make our country continue to work. The lack of gratitude is kind of ridiculous - no one is entitled to the money of a wealthy person, and yet it is given anyway. We should all be saying "thank you," instead of, "you should be paying more."
In what way was that necessary? We were having a pleasant, albeit heated debate. I enjoy that, what I don't enjoy are personal attacks, even when they're not against me.
