odds of universal health care by 2020
Started by dbcooper23
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
Advertisement - Members don't see this ad
Agree.
Plus, parts of the new healthcare bill won't even be implemented until 2019. There is no chance in hell of universal healthcare in the US any time soon. The generation before us will have to die off first (for starters).
Sad, but true.
No way. I don't think America is ready for that yet.
Partly cloudy with a 40% chance of rain.
Plus, who would want universal healthcare anyway? It's just leads to untenable and unsustainable cost increases and, ultimately, reductions in quality of care.
Plus, who would want universal healthcare anyway? It's just leads to untenable and unsustainable cost increases and, ultimately, reductions in quality of care.
We can't even take care of the people that we have now on Medicaid. I had a patient last week who was readmitted to the hospital for pneumonia because HPM wouldn't cover the cost of her antibiotics. The fact that this patient is a marijuana smoker is irrevelant. 😀
But seriously, now we (the people) have to pay for her to be hospitalized again (3-5,000 dollar hospital stay which may or may not be combined with her last stay) instead of paying 5-20 dollars for her to get an antibiotic for the next couple of weeks. Budget cuts due to inadequate funding leads to more spending.
But seriously, now we (the people) have to pay for her to be hospitalized again (3-5,000 dollar hospital stay which may or may not be combined with her last stay) instead of paying 5-20 dollars for her to get an antibiotic for the next couple of weeks. Budget cuts due to inadequate funding leads to more spending.
Advertisement - Members don't see this ad
👍
The problem with that is that it is an economics issue. How is the government supposed to take over all healthcare spending in the country when we're something in the ballpark of 9 trillion dollars in debt? You can't just spend money because you think the outcome is deserving of the money spent-you actually have to have the money for it. And if the government could cover all healthcare spending in the country, that money could probably go ten times further paying for poor people to have healthy food and decent homes.
Wrong. If we treat it as more of a rights issue than an economics issue, America will implode. That way nobody gets care. Good idea, right? Wrong.
Proof?
http://en.wikipedia.org/wiki/Negative_and_positive_rights
Healthcare would be a positive right. Avoid conflating "healthcare rights" with negative rights like freedom from slavery and oppression (which is what I presume you are referring to when you say "human rights issue").
You're only considering circumstances under our current health care system. Take a page from some of the European or Japanese systems. Yes, they're expensive, but not nearly as expensive as our own system. They do this NOT by sacrificing the level of care, but rather by functioning as a quasi-single-payer system with hundreds of competing private non-profit insurance companies. This, coupled with universal access to primary and preventative care dramatically reduces the need for more costly procedures and operations that our own Medicare and Medicaid are already shoveling billions of dollars into annually (whether you believe we have socialized medicine or not). Short-term, a complete health care overhaul would be ridiculously expensive and would no doubt increase our debt; I can't argue with you there. Long-term, it will actually cut costs to a more sustainable level than our current institutions (but don't kid yourself, healthcare is still going to be an expensive investment).
Yes, I mean to consider it as a positive right.
(Thanks for adding that link. I had to catch up a little with what you were talking about.)
I definitely agree with the fact that we need more primary care. Our system just leaks money around end of life care and the use of emergency departments as primary care. However, I take issue with the idea of modeling our system after European systems for several reasons:
1) We don't have a homogeneous society in any manner similar to European countries, so I'm not convinced we're comparing apples to apples. We could be, or we could be comparing apples to hamburgers.
2) One thing nobody seems to be willing to admit is that our healthcare system seems to be working great for the middle/upper class. While I think it is abhorrent that it doesn't work for the lower class, it seems that what is in order is a fix, not an overhaul. If my car's brakes don't work, I fix the brakes instead of buying a new car. I realize that is a huge oversimplification, but I'm gonna go with it.
3) Having elements of socialism in a capitalistic society is great... to a point. Giving the government the power to interfere with the way a company runs its business (what would have to happen for all insurance companies to be non-profit) is a really hard thing to justify. Especially because then the government is interfering to differing extents in different businesses.
4) Where is the justification for pumping more government spending into healthcare when it is desperately needed elsewhere? We have tons of people in this country who are getting sick because they don't have healthy food or good housing or education on how to stay healthy. It seems to me that those would be more cost effective areas to focus on than rolling out universal healthcare to everyone when pretty much everyone is covered right now in some way or another.
5) There is some (admittedly still anecdotal) evidence coming out that some of the European systems don't work as well as everyone seems to think. For instance, I read an article a few weeks ago that suggested that France is beginning to have problems funding their healthcare system. In Canada, you generally have to wait a long time to see a doctor. I'm not saying that our system is great or anything, but I also don't see much evidence that these other systems are perfect. Maybe better, but then the question that is most important is, would that system work for us?
Anyway, I don't think that I'm absolutely right and I don't think that you're absolutely wrong. I'm just skeptical that universal healthcare is what we need the most, and I'm not convinced that it would work as well for us as it does for other countries.
Take a look around...do you really think the government can step in and take care of everyone adequately? They can't even afford to take care of the Medicaid/Medicare patients properly.
America doesn't crap money, in case you haven't noticed.
I like.
You make some excellent points. I don't have a perfect answer. I can't be sure there is one. But I too would like to see more investment in healthy lifestyles.
.
Last edited:
How are you judging this? Medicare beneficiaries are more satisfied with their coverage than people with employer-based coverage.
http://www.commonwealthfund.org/Con...erature/2009/May/Meeting-Enrollees-Needs.aspx
I have often heard this refrain, but never quite understood what it means in the context of this discussion. Every patient is unique, even in Sweden.
Answer to OP: no way, and I would be willing to bet my life on it.
If the discussion is about health care costs, then I would argue that it doesn't matter if it is a single-payer system or whatever. What makes the difference in cost is on what basis the payment is made: right now, most of the country pays strictly for service. Instead, we should be paying for quality of care as measured by specific outcomes measures. That way, medical organizations (clinics, hospitals, etc.) will be held accountable for their wasteful spending (non-evidence based services, duplication in services, avoidable errors, etc); in other words, they will not be reimbursed for not doing a good job of taking care of patients.
It will be long before the above happens, but the conversations about it are starting through the Accountable Care Organization models.
If the discussion is about health care costs, then I would argue that it doesn't matter if it is a single-payer system or whatever. What makes the difference in cost is on what basis the payment is made: right now, most of the country pays strictly for service. Instead, we should be paying for quality of care as measured by specific outcomes measures. That way, medical organizations (clinics, hospitals, etc.) will be held accountable for their wasteful spending (non-evidence based services, duplication in services, avoidable errors, etc); in other words, they will not be reimbursed for not doing a good job of taking care of patients.
It will be long before the above happens, but the conversations about it are starting through the Accountable Care Organization models.
Perhaps we should turn this around. Say a private for-profit insurance company decides to drop coverage for someone who was recently diagnosed with breast cancer. Cancer progresses, and patient eventually ends up in County General Hospital, receiving thousands of dollars in chemotherapy and inpatient care.
Thousands of dollars, mind you, that will ultimately derive from the public (aka government) funding of charity care.
Furthermore, the patient lost her job due to illness, and is therefore no longer working or contributing to the tax base for her community. She has become an involuntary social parasite.
If I subscribe to this notion governmental "interference" with business practices is somehow illegitimate, we end up in a rather absurd situation. The corporation acts in its own rational self interest, the citizen is screwed, and the bill is passed onto the public. Should a private company have such unilateral authority?
Welcome to medical practice in the United States.
All I really mean by that is that if you want to make a convincing argument that the United States should adopt a certain healthcare system because it works in another part of the world, you also have to make an argument for how the problems of that country are somehow similar to our own. An analogy might be something along these lines: patient A has a fever and patient B has a fever. We know that we must intervene, and when patient C had a fever before, antibiotics worked. Do we thus conclude that antibiotics will solve the problems of both patient A and patient B? We do not, because while patient A had a bacterial infection, patient B had a viral infection. It is a similar situation with the healthcare debate. If socialized medicine is the solution, you must prove to me that we have the right problem for that particular solution. The reason I am not convinced such is the case is our system seems to work well for everyone but the lower class. If that is really true, then why should we totally overhaul the system when all it may need is smaller fix to that part of it?
The situation that you are describing is stupid, I'll grant you that. The rational conclusion that a capitalist would want to make on such a situation is that it is in the company's best interest not to drop the patient, because that will lead to lower numbers of customers in the future. Of course, that is not always the case in real life, so the government interferes to a certain extent to try to bring the practical situation in line with what market theory predicts should happen. I can't say that having no government involvement would be a good thing, but I also am uncomfortable with the government taking over completely. Another thing that you have to understand is corporations began to identify themselves as 'citizens' under the 14th amendment (I think it was 14, anyway) shortly after the civil war. If you begin to tell companies in one area of business (health insurance, for instance) that they cannot make a profit because it isn't beneficial for the people they serve, you open that argument up for many, many other companies (and private individuals as well). That may or may not lead to better healthcare, but I submit to you that capitalism works fairly well for our society and I for one want to keep that system. I like my personal freedom.
Advertisement - Members don't see this ad
That's all fine and good, but it does not really explain how more "homogenous" societies face problems different from our own. If you break down the health systems of the industrialized world into their component parts, they all have the same fundamental requirements.
You may be interested to read a bit about the inception of Canada's health system back in the 1960's, and the rancor surrounding it. In my opinion, if America did adopt a universal system (by whatever means), after a few years resistance to the idea would melt like snow on an Elk's ass.
Astarael said:
Universal health care does not equal socialized medicine. One could propose socialized delivery of care, such as the NHS in Britain. One could propose socialized insurance with private delivery of care, such as in Canada or Japan. One could propose a two tiered system, such as in Australia. One could propose an insurance mandate, such as in Switzerland.
Interestingly, there is a perfect example of socialized medicine right here in the United States: the VA.
As for your other assertion that our system is fine for the middle and upper classes, two things: 1.) the only thing our system unequivocally leads the world in is spending, and 2.) the middle class is getting smaller every day. In fact, medical costs are a great reason for downward mobility.
Astarael said:
Well, you can breathe easy. The so-called "government takeover" has been greatly exaggerated.
I never said anything about the dissatisfaction of beneficiaries. There are more and more physicians turning down Medicare/Medicaid because the government cannot reimburse them to a point where it is worth their time to provide the care. I work at a federally qualified family health center from 8-5 every day of the work week. The only people we care for are Medicaid/Medicare patients and illegal aliens. Believe me I have a very clear understanding of what is going on. A large percentage of physicians I work with are dissatisfied with all of this, and I can only assume (rather safely, IMO) that this affects quality of care (<-- just a side note).
Last edited:
The VA is an absolutely horrible example for universal/single payer coverage.
The VA is a socialized delivery system, not single payer. And yes, prior to the late 1990's the VA system was a dark, dreadful place.
But, times have changed. The VA has outranked the private sector in patient satisfaction. It has outperformed private providers in various quality measures. It has an integrated system of electronic health records that the private health systems cannot yet match. And it has adapted to care for more veterans with worse problems without the exploding costs of the private health care sector.
That's not to say all is rosy in the VA system. The old adage about VA nurses and bullets still rings true.
I like how this thread evolved from trolling each other with pics to an actual discussion. Bravo, SDN, bravo.
And a fine trolling session it was my friend. Here's to many more in our days under the glorious sun!
Probably 30%.
I hope we get there faster but it's doubtful. I think by 2030, there's a good chance of universal healthcare, otherwise we'll be bankrupt as medical care (which is already a humongous part of our economy) keeps growing unchecked.
I hope we get there faster but it's doubtful. I think by 2030, there's a good chance of universal healthcare, otherwise we'll be bankrupt as medical care (which is already a humongous part of our economy) keeps growing unchecked.
Depends on the rate of health care cost increase and the ability of the US Gov't to borrow money at sweetheart rates.
If medicare costs continue on their current trajectory of exponential growth, and if US begins to have trouble borrowing money at the current rates, then the government could very well become insolvent within 20-25 years, which would force a change, which would possibly be towards a socialized system.
Whether we end up in single payer or not, there will eventually be more strict rationing of care.
If medicare costs continue on their current trajectory of exponential growth, and if US begins to have trouble borrowing money at the current rates, then the government could very well become insolvent within 20-25 years, which would force a change, which would possibly be towards a socialized system.
Whether we end up in single payer or not, there will eventually be more strict rationing of care.
Amen, brother!
I'm not sure how the reduced ability of the government to acquire debt results in increasing the financial burden of the government via a socialized system?
0%
This won't happen before major campaign finance reform takes place. Without it there will never be any political will to do anything but fill campaign coffers and secure well-paying lobbying jobs for after office. The health-insurance companies donate millions to both parties to keep this debate from its obvious conclusion.
About the rightness or wrongness of universal health care: Ask yourself if you'd rather be a random sick citizen in this country or in one with a socialized health system. Not necessarily someone of your current socioeconomic status, which I guess is pretty middle-class to upper middle-class for most of us. A random citizen.
This won't happen before major campaign finance reform takes place. Without it there will never be any political will to do anything but fill campaign coffers and secure well-paying lobbying jobs for after office. The health-insurance companies donate millions to both parties to keep this debate from its obvious conclusion.
About the rightness or wrongness of universal health care: Ask yourself if you'd rather be a random sick citizen in this country or in one with a socialized health system. Not necessarily someone of your current socioeconomic status, which I guess is pretty middle-class to upper middle-class for most of us. A random citizen.
If we're talking "generally" then I definitely disagree with this. Canada's system has it's flaws, but you don't need to wait that long to see a doctor. there ARE family doctors accepting patients (but you might have to go to the other end of the city) and there is always a walk-in clinic that you can go to as often as you need, and see the same doctor there every time. there's always emergency and urgent care to go to too. you hear lots of complaints about waiting a long time for minor surgeries and specialists... but I guess it's how you look at it. I don't mind waiting, knowing that someone who needs it more than I do will go first, rather than thinking it's my right to get care because I have more money and can afford it (while someone less fortunate gets no help).
anyone read this book?
The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care
It's not a bad read.
The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care
It's not a bad read.
Advertisement - Members don't see this ad
I don't think I've ever read a post of yours I did not like or was not informed. Thanks for contributing.
