Just another point: the U.S. spends the 3rd most on healthcare yet only gets the 37th best outcome of that spending. So clearly something has to change.
The current system is just way too costly.
The current system is just way too costly.
Psychology and the US Healthcare Debate
- Thread starter thewesternsky
- Start date
How do you do quotes?
Anyway, @ Jocknerd: quite true that we all value different domains of public spending, and a number of domains have been nominated for relegation to the "not-really necessary" category. Maybe when I become Queen of the Universe, one of the changes I'll institute is that so long as we are paying taxes in support of the common welfare, people will be able to assign their tax dollars. It doesn't bother me, for example, to pay my school taxes, because I value education. Likewise, paying the sewer bill beats having an outhouse in the back yard. And in the neighbors
And supposedly environmental regulations insures that the city's sewage doesn't go directly into the river. Wouldn't it be interesting to discover just where our collective priorities are - and how or whether those priorities shift when we actually experience the consequences of reducing or eliminating public services.
Of course, if, come tax-time, we not only had to pay them, we had to endure the kind of intense campaigning we currently put up with every 4 years. ...*Sigh* The thought is exhausting.
Anyway, @ Jocknerd: quite true that we all value different domains of public spending, and a number of domains have been nominated for relegation to the "not-really necessary" category. Maybe when I become Queen of the Universe, one of the changes I'll institute is that so long as we are paying taxes in support of the common welfare, people will be able to assign their tax dollars. It doesn't bother me, for example, to pay my school taxes, because I value education. Likewise, paying the sewer bill beats having an outhouse in the back yard. And in the neighbors
And supposedly environmental regulations insures that the city's sewage doesn't go directly into the river. Wouldn't it be interesting to discover just where our collective priorities are - and how or whether those priorities shift when we actually experience the consequences of reducing or eliminating public services. Of course, if, come tax-time, we not only had to pay them, we had to endure the kind of intense campaigning we currently put up with every 4 years. ...*Sigh* The thought is exhausting.
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And, ironically, your taxes pay for a not-insignificant amount of that every-4-years campaigning.
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the life span argument doesn't really work. We have many factors that decrease our life span that have very little to do with health care. Americans have horrible diets compared to almost every other nation, which contributes to many of the diseases that cause us to need health care.
The USA is also one of if not, the most diverse country in the world. You are a psychologist, therefore you should understand individual differences....African Americans have shorter lifespans than whites, whites have shorter life spans than Hispanics, Hispanics have shorter life spans than Asians (on average) so in order to actually compare life span to that of Columbia you would need to parce out all the whites, african americans, and asians and compare our hispanic population to columbia's hispanic population, as Columbia consists of mainly hispanics. You are looking at range restrictions due to individual differences that the US does not have.
In review I hate that argument on health care, there are way to many other circumstances that affect life span and health care is only a very small piece of the puzzle.
This is a flawed argument, and, to throw your words back at you, as a psychologist, it should be obvious to you why. Do you really think that those differences are entirely based in some biological/inherent racial quality? (That's ignoring the fact that race is a social construct anyway, which I'm sure could be a whole other debate, so let's not derail.) Black Americans die younger on average most likely because, as has been well documented through research, they receive much worse health care as a group, particularly in regards to preventative health and early treatments for conditions, and have more limited access to resources. Yes, there is also the very real issue of different rates of violence between these groups, but differing access to resources may still play a role in that vicious cycle. So basically, the very reason that some of those differences exist are because we don't have universal access to health care in the first place. It's not at all a reason to think that we're doing pretty well given the population we're working with or that there are some inherent limitations preventing us from doing better if we tried.
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Interesting discussion on life span. Why do African Americans or Latinos have shorter life spans than Caucasians in the US? Is it because people of such backgrounds live shorter lives? If so, I would be interested in learning how Hispanics in Cuba or Columbia have longer life spans than Hispanics in America.
Perhaps, rather, it is the high inequity inherent in the United States that contributes to these disparities? Many epidemiological studies have investigated the many factors that preclude full use of the health care system by people of color as compared to Caucasians.
Just look at our field - African American, Latinos, and other minority groups do not receive needed treatment in any way commensurate with Caucasians (who are also, admittedly, under-served).
You are right in that there are many factors that contribute to our poor health system - genetics, however, are not one of those factors. Rather, it is our systems inherent inequality (perpetuated by beliefs like yours, to be honest -) that, I believe, is a major contributor to our lower life spans and poorer health outcomes (in spite of spending 150% of what most industrialized nations spend on their healthcare and significantly more than many industrializing nations spend providing healthcare). So, to conclude, it is your argument that really does not work.
Perhaps, rather, it is the high inequity inherent in the United States that contributes to these disparities? Many epidemiological studies have investigated the many factors that preclude full use of the health care system by people of color as compared to Caucasians.
Just look at our field - African American, Latinos, and other minority groups do not receive needed treatment in any way commensurate with Caucasians (who are also, admittedly, under-served).
You are right in that there are many factors that contribute to our poor health system - genetics, however, are not one of those factors. Rather, it is our systems inherent inequality (perpetuated by beliefs like yours, to be honest -) that, I believe, is a major contributor to our lower life spans and poorer health outcomes (in spite of spending 150% of what most industrialized nations spend on their healthcare and significantly more than many industrializing nations spend providing healthcare). So, to conclude, it is your argument that really does not work.
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Glad to see there are some on this website that are able to think critically. Well said!
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You make some good points, but I should clarify my terminology, I meant individuals of african decent regardless of where they live in the world. I think you misunderstood me, Hispanics in the US have a longer lifespan than Caucasians do. If you look at worldwide statistics; individuals of African decent have the shortest lifespans, followed by Caucasians, followed by Hispanics, followed by Asians (regardless of country, almost always within each country too)
Here is a little clip from an article "In the United States, Hispanics, despite their socio-economic hurdles, on average live longer than blacks by seven years, and whites by five years, says Dr. David Hayes-Bautista, a professor of medicine at UCLA."
http://www.hispanicbusiness.com/edi...anic_paradox_us_hispanics_live.htm?FORM=ZZNR7
I don't really understand how you can say genetics doesn't contribute to lifespan. If you believe that then how would you explain the lifespan differences in males and females and the above data?
I believe it has less to do with an individual's "color" and more to do with the evolution of each subgroup.
So to clarify, I was simply saying in order to accurately compare "our" lifespan to that of Columbia and Cuba (countries made up of individuals of Hispanic origin) you would need to parce out the lifespan of individuals of African decent, Caucasians, and Asians within the US.
The diversity in this country causes a wider range of lifespans that is not present in many other countries. It would be like taking an incoming undergraduate class from Harvard and asking them to take the GRE and then comparing the scores the students receive to those of a state school like FSU. You have a range restriction on ability at Harvard, just as you have a range restriction on lifespan by selecting a country made up almost entirely of individuals of Hispanic origin.
However my main argument is still the fact that our lifestyles and diets are the main contributors to the diseases that our healthcare is supposed to prevent. It doesn't matter how efficient our healthcare system is if we continue the behaviors that cause the diseases all you can do is slow it down.
If I eat 20k calories a day I could have the best healthcare money will buy and I would have a very short lifespan.
P.S. I'm not trying to step on toes, I guess my statement came off as harsh, I just here the money spent on healthcare and lifespan comparison all the time and I think there are way to many other factors that contribute to diseases and death. I do think we need healthcare reform, but I do not think a single payer system is the best option.
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Your immediate assumptions is that this is attributable to genetics? Is this a joke?
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I never stated it was completely attributed to genetics, but to insist genetics has nothing to do with lifespan is just as big of a joke.
As I have stated in both responses I believe it is a combination (nature vs. nurture). I look at it as a regression equation and to assume that genetics plays no part in the lifespan of individuals is uneducated at best. I believe it is a combination of multiple factors, that is why I stated directly below that argument that I still believe the main reason we are so far behind is because of our horrible eating habits/lifestyles (lack of exercise, driving everywhere, etc.).
Because I bring in an argument that says nature might have SOME part in lifespans I get my head chopped off?
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Really? As a thought experiment, I'm reasonably confident that once SES, education, and health care (maybe a few other things) are factored in, race would explain prettymuch 0% of the variance in life expectancy.
I mean, seriously. You're talking about the worldwide life expectancy for people of African descent being lower? You are aware that the worldwide population of people of African descent includes.... Africa?
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You are focusing on one aspect and you may be right there, but what about within group? How would that be explained? Are individuals of african descent somehow not given the same healthcare in universal healthcare countries like Canada, and Britain. (The same lifespan statistics come up regardless of country) (Af<C<H<As)
Also how would you explain the worldwide difference in life expectancy using Hispanics? Caucasians are somehow given worse healthcare, SES, and education than Hispanics?
Here is a small excerpt from an article that uses citations from a brief put out by the National Center for Policy Analysis.
"In 1999, the life expectancy for a white, non-Hispanic man was 74.7 years, compared to 68.4 years for a Black man, 72.9 years for an American Indian man, 80.9 years for an Asian man and 77.2 for a Hispanic man. 85
That same year, the life expectancy for a white, non-Hispanic woman was 80.1 years, compared to 75.1 years for a Black woman, 82 years for an American Indian woman,
86.5 years for an Asian woman and 83.7 for a Hispanic woman.86
The life expectancy rate for the United States as a whole, 74.1, is therefore a composite of the widely differing rates for these different racial and ethnic groups. Not surprisingly, white
Americans have life expectancy rates (74.7 years for men and 80.1 for women) that are similar to the rates for Western Europe (75 years for men and 81 years for women).87 The differences that exist between the expected life spans of groups in the United States cannot be explained by differences in access to health care. Take the case of Japanese-Americans. At 78.6 years, Japan has the longest life expectancy of any industrialized country – about three years longer than that found in the United States. If the health care system were the cause of shorter life spans in the United States, one would not expect a Japanese-American to live as long as their counterparts living in Japan. But they do.88 As a percentage of the total population, the United States has historically had a larger immigrant population and a larger refugee population than any other developed country.89 With a few exceptions, such as the Japanese, immigrant groups tend to have poorer health and shorter life spans than the native U.S. population, and therefore have caused the composite national rate to decrease."
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I'll try and keep my politics out of this the best I can.
1. Cost (outrageously expensive in its current form). Whether it comes from the tax payers, cutbacks, or some magical castle in the sky....it is a very large (under-estimated) cost that does not have an answer for substainability that doesn't include raising taxes and/or taking from existing allocations.
Let me add a few more:
2. Degredation/Erosion of our individual rights in favor of "the greater good".....according to the gov't.
3. Unrealized consequences like the economic impact against the healthcare companies, local businesses (anyone ever see who gets the majority of gov't contracts....not local businesses), and international companies. The gov't doesn't play fair, and they still find a way to cost more than corp competition. USPS v. UPS & FedEx. It is a lose/lose proposition.
4. The bearucratic mess that happens when thousands of pages of yet unwritten regulations are unleashed on the public. Every 1000+ page document makes me marvel that our founding fathers drafted the Constitution.
I could go on and on, but suffice to say the current plan could set us back for decades.
I guess I'll have to work more hours to subsidize other people's benefits. Ouch.
This is the Elephant in the Room. Without tort reform, this is a pointless discussion, because malpractice insurance is canabalizing many health professionals, and the vultching will continue to get worse, and at the expense of people in need of medical services that have been priced out because of external factors.
Good ol' HMOs. They took a utopian/pie in the sky idea and twisted into the mess that it is today.
Finally....someone else that realizes that the Environment has taken enough of our money, and that it should learn to fend for itself and needs to stop relying on our money to survive!!
This is an issue that I'll just leave off the table, or suggest people discuss it in the Socio-Political Forum.
Okay...off to do some more assessments, I'll come back tonight with some ideas for an actual solution, in addition to some MH specific concerns we all should have with any suggestion of gov't influenced healthcare.
There are technically only TWO races in the world: people who acknowledge their African heritage and people who do not.
WE ARE ALL OF AFRICAN DESCEDANT. That is where we all started evolutionarily. I/O Psych, brush up on your history and anthropology.
Which brings me to the next point: race is a social construct (as said by someone before). It technically does not exist genetically. Different races appear to exist, because, since racism has exist for thousands of years, people tend to only reproduce with people within their race. If everyone started marrying outside of their race, in a few decades that would be no such things as white people versus black people versus any kind of other people. In addition, African-Americans are probably genetically more related to Caucasian Americans than they are to other blacks in other countries. Same goes for black in Europe. They are probably more related to other groups in Europe than to African-Americans.
It is hard to group people into racial categories globally and perform an effective study. How do you even define "black" globally? By skin color? Some people from the Phillipines are pretty dark, so do they count as well? Are people from Spain and Portugal black as well, since they were invaded and populated by people from North Africa. In that case, most Columbians and Cubans are BLACK not Hispanic, since they are in turn invaded by and populated by Spain and Portugal. See how messy this gets.
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We are also all members of the hominini tribe, the same species as apes and chimpanzees...do we not differ a little genetically from them? You could effectively say we are all members of the same single cells, however it appears through millions of years we have grown further apart from apes, could individuals not change even a little after selectively reproducing for hundreds of thousands of years?
Who said black? You are throwing in color terms, I am referring to countries of origin.
Where am I being racist? I am simply stating there are genetic differences between subtypes and these genetic differences appear to have SOME impact on life expectancy. I am in no way being intolerant or inferring that any subgroup is better than any other. However, there does appear to be genetic differences that have evolved over thousands of years, most likely adaptations made to survive in the vastly different environments they lived in (ie skin color, height, metabolism,etc.). All these differences are fairly evident, yet you somehow think that life expectancy was the one thing not affected?
Also go try telling a Cuban or a Dominican they are black; ( I am very close with many Dominicans and Cubans and they would be extremely upset if you referred to them as black)
You are mistaking skin color with descent....I am referring to the country of origin of the ancestors of individuals it has nothing to do with skin color.
Why does a debate about individual differences have to be coined racist if it somehow involves individuals of vastly different environmental origins?
I think everyone (on both sides of the race discussion) is drastically oversimplifying.
Race is certainly a social construct. Skin color is not magically different from other surface-level biological traits. Hair color also comes in many shades. Two people with brown hair can have similar genes, or they can have very different genes.
That said, there are real genetic differences across these groups. Race is at best a mediocre proxy variable for genetic differences that arose as a result of geography. However, its completely unscientific to ignore or discount the differences in gene distributions across these geographic regions.
To illustrate my point...I don't think anyone here would argue religious affiliation is biological (though if you want to try, go for it ). However, does anyone think if we compared the incidence of Tay-Sachs across Jewish and non-Jewish individuals, completely blind to background, origin etc. we wouldn't see a difference?
Of course, survival is a much more distal construct from genes relative to incidence of a single disease. However, I'm not comfortable saying the genetic disorders that affect survival across groups are in perfect balance. I'm equally uncomfortable saying that "health care access" or "diet" is the final answer. Its just not that simple. There's a whole lot of variables at work here, and we don't know WHAT half of them are, let alone how they interact with eachother. This is not going to boil down to any one, or any 10, or even any 100 variables.
Race is certainly a social construct. Skin color is not magically different from other surface-level biological traits. Hair color also comes in many shades. Two people with brown hair can have similar genes, or they can have very different genes.
That said, there are real genetic differences across these groups. Race is at best a mediocre proxy variable for genetic differences that arose as a result of geography. However, its completely unscientific to ignore or discount the differences in gene distributions across these geographic regions.
To illustrate my point...I don't think anyone here would argue religious affiliation is biological (though if you want to try, go for it
). However, does anyone think if we compared the incidence of Tay-Sachs across Jewish and non-Jewish individuals, completely blind to background, origin etc. we wouldn't see a difference? Of course, survival is a much more distal construct from genes relative to incidence of a single disease. However, I'm not comfortable saying the genetic disorders that affect survival across groups are in perfect balance. I'm equally uncomfortable saying that "health care access" or "diet" is the final answer. Its just not that simple. There's a whole lot of variables at work here, and we don't know WHAT half of them are, let alone how they interact with eachother. This is not going to boil down to any one, or any 10, or even any 100 variables.
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I think everyone (on both sides of the race discussion) is drastically oversimplifying.
Race is certainly a social construct. Skin color is not magically different from other surface-level biological traits. Hair color also comes in many shades. Two people with brown hair can have similar genes, or they can have very different genes.
That said, there are real genetic differences across these groups. Race is at best a mediocre proxy variable for genetic differences that arose as a result of geography. However, its completely unscientific to ignore or discount the differences in gene distributions across these geographic regions.
To illustrate my point...I don't think anyone here would argue religious affiliation is biological (though if you want to try, go for it
Of course, survival is a much more distal construct from genes relative to incidence of a single disease. However, I'm not comfortable saying the genetic disorders that affect survival across groups are in perfect balance. I'm equally uncomfortable saying that "health care access" or "diet" is the final answer. Its just not that simple. There's a whole lot of variables at work here, and we don't know WHAT half of them are, let alone how they interact with eachother. This is not going to boil down to any one, or any 10, or even any 100 variables.
I would completely agree with that...The way the whole thing got started was because people were using life expectancy averages across countries to highlight how effective healthcare systems were and I simply stated there are way too many factors at work that influence life expectancy to conclude life expectancy is an outcome of effective healthcare. Genetics and diet appear to be pretty significant predictors, but significant in a field of hundreds to thousands of predictors could mean they explain 10-20% of the variance.
Well, I also think you went too far in discounting the potentially enormous role that healthcare might play in that. I don't doubt that it does account for some portion of the variance, and probably a rather sizable one. Within this country it certainly does. Not that I want to try and define "healthcare" as a construct...
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Even ignoring the rest of the world, our healthcare is pretty obviously an unsustainable train wreck of a system. Continuing down the current road is just not an option so the only remaining question is what the best thing to do about it is.
.Even ignoring the rest of the world, our healthcare is pretty obviously an unsustainable train wreck of a system. Continuing down the current road is just not an option so the only remaining question is what the best thing to do about it is.
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Well, I also think you went too far in discounting the potentially enormous role that healthcare might play in that. I don't doubt that it does account for some portion of the variance, and probably a rather sizable one. Not that I want to try and define "healthcare" as a construct...
Even ignoring the rest of the world, our healthcare is pretty obviously an unsustainable train wreck of a system. Continuing down the current road is just not an option so the only remaining question is what the best thing to do about it is.
I do believe healthcare plays a role in life expectancy, but as I mentioned above I don't think individuals should be using it as the sole predictor as others were (I should have been more clear).
I would also agree with you that our healthcare system needs change and I believe tort reform and state deregulation would be the most effective place to start. With the amount of debt we are projecting as is and the current state of social security, medicare, and medicaid I think adding another trillion in expenses is delusional.
It's called scientific racism or racialism. Way back in the day, scientists tried to argue that people from different areas of the world were different subspecies. They used terms like Caucasoid, Negroid, Mongoloid, etc to descibe people. That just is not true. Today, many scientists discourage people fom using race to explain health differences. There are just too many other facts to consider.
Here is some reading about the subject: "Abandoning 'Race' as a Variable in Public Health Research: An Idea Whose Time has Come," American Journal of Public Health 88 (1998): 1297-1298"
People who look alike or came from the same country do not necessary share identical genes and suprisingly race is not a constant for some individuals. They is even some research that suggest that people, especially multicultural children, "change" their race depending on the situation. (For instance, I do know some Domicians and Cubans who has identified themselves as black around me, but maybe around you they would not identify as such). And I am not talking about lying; they geniunely believe they as such and such race and eventually grow up identifying with one.
A person's race reveals more about their history than their genes. Thus, the research you mention would not hold up much globally.
By the way, apes and chimpanzees are different species, because their DNA is slightly different from ours (literally like 99.9%). All human are the same species, though
Ok, I am done, since this is off topic. I support a public health option by the way, but the change needs to be backed by research.
Given the concern that you folks have regarding the intersection of psychology, healthcare and especially the financial aspects of that intersection in the USA, .... I'm a little surprised that no-one in this thread has mentioned -I'll try and keep my politics out of this the best I can. ...
4. The bearucratic mess that happens when thousands of pages of yet unwritten regulations are unleashed on the public. Every 1000+ page document makes me marvel that our founding fathers drafted the Constitution.
... specific concerns we all should have with any suggestion of gov't influenced healthcare.
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 which was signed into law in the USA on October 3, 2008 and comes into force on 1 January 2010. It profoundly affects how treatment for mental ailments (real and imagined) are paid for as to the estimated 113 million US employees affected by that Act. (For comparison the are about 150 million total workers in the USA)
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I have a few comments:
Firstly, many people, especially those in the helping professions, appear to be worried about managed health care. Managed health care (in case you aren't that familiar) is a system that industrializes health care, in other words, large organizations in the private sector control the delivery of services. I know most within the mental health field or who receive services are worried that managed healthcare will begin to control the amount of sessions a client can have, the fees, and types of treatment that can be used, etc. For example, managaed health care will require psychologists to justify the use of their therapies on the basis of whether they are empirically based. If research reveals that CBT (cognitive behavior therapy) is more successful than another therapy for say some phobia, then therapy using the latter might be denied by the insurance company.
Managed health-care is something many U.S. citizens are against. However, I tend to think reform is not that big of a deal, but it is to a select few because most U.S. citizens tend to support an individualistic society (that is, capitalism), while countries such as Canada and Japan tend to support a collectivist society (that is, socialism) and these countries have done just fine. In fact, many U.S. citizens are going to Canada for their health-care!!
Secondly, health-care costs according to Sue, Sue, & Sue (2006) in the United States have ExPLODED from $27.1 billion in 1960 to $1.1 trillion in 1998, to $2 trillion in 2007, and I bet it's even more expensive today! The U.S public spends increasing amounts each year for mental health care services. Taking this into consideration, our current health care reform plan sounds like a pretty good idea to me, although I'm not all too sure what it will do to the mental health field.
Thirdly, what is the big deal about socialism? It is something that is going to create equality in the health-care field. It really isn't that bad. When you think of it in terms of what is ultimately moral and what isn't, then a collectivistic society looks more attractive. If a socialist health-care reform policy (which I don't believe it truly is) will help cover most underpriviliged as well as privilaged U.S. citizens and allow them some mental health services, then I say we support it.
Some insurance companies, with the current health care policy we have now, will terminate mental health services because either they refuse to pay or cannot come to a consensus with the therapist. Clients then are left to figure out what to do, or the therapist will provide services for free, or help that client find other services. If that's the case with our current health-care policy and we are now being offered something that will change insurance policies that terminate services and prejudge you on the basis of a pre-existing health condition (for the next 3+ years), then I say we support it.
Fourth, some are worried exclusively about taxes that will be spent on the new health-care plan. But I tend to think they are missing something. Perhaps the taxes (if the reform is passed) that will be spent on such as policy is still being spent with our current health-care plan, just on some other area of life. For example, citizens may not see "extra" tax money being put toward our current health-care plans, but it is probably being put toward something else such as road reconstruction or new establishments. Essentially, I am saying that perhaps taxes that some are concerned about with the new health-care plan is being spent already but just not on healthcare. That is why citizens think they will be spending more for the new plan.
What do you think is the worst that could happen with our new policy? Any thoughts?
Firstly, many people, especially those in the helping professions, appear to be worried about managed health care. Managed health care (in case you aren't that familiar) is a system that industrializes health care, in other words, large organizations in the private sector control the delivery of services. I know most within the mental health field or who receive services are worried that managed healthcare will begin to control the amount of sessions a client can have, the fees, and types of treatment that can be used, etc. For example, managaed health care will require psychologists to justify the use of their therapies on the basis of whether they are empirically based. If research reveals that CBT (cognitive behavior therapy) is more successful than another therapy for say some phobia, then therapy using the latter might be denied by the insurance company.
Managed health-care is something many U.S. citizens are against. However, I tend to think reform is not that big of a deal, but it is to a select few because most U.S. citizens tend to support an individualistic society (that is, capitalism), while countries such as Canada and Japan tend to support a collectivist society (that is, socialism) and these countries have done just fine. In fact, many U.S. citizens are going to Canada for their health-care!!
Secondly, health-care costs according to Sue, Sue, & Sue (2006) in the United States have ExPLODED from $27.1 billion in 1960 to $1.1 trillion in 1998, to $2 trillion in 2007, and I bet it's even more expensive today! The U.S public spends increasing amounts each year for mental health care services. Taking this into consideration, our current health care reform plan sounds like a pretty good idea to me, although I'm not all too sure what it will do to the mental health field.
Thirdly, what is the big deal about socialism? It is something that is going to create equality in the health-care field. It really isn't that bad. When you think of it in terms of what is ultimately moral and what isn't, then a collectivistic society looks more attractive. If a socialist health-care reform policy (which I don't believe it truly is) will help cover most underpriviliged as well as privilaged U.S. citizens and allow them some mental health services, then I say we support it.
Some insurance companies, with the current health care policy we have now, will terminate mental health services because either they refuse to pay or cannot come to a consensus with the therapist. Clients then are left to figure out what to do, or the therapist will provide services for free, or help that client find other services. If that's the case with our current health-care policy and we are now being offered something that will change insurance policies that terminate services and prejudge you on the basis of a pre-existing health condition (for the next 3+ years), then I say we support it.
Fourth, some are worried exclusively about taxes that will be spent on the new health-care plan. But I tend to think they are missing something. Perhaps the taxes (if the reform is passed) that will be spent on such as policy is still being spent with our current health-care plan, just on some other area of life. For example, citizens may not see "extra" tax money being put toward our current health-care plans, but it is probably being put toward something else such as road reconstruction or new establishments. Essentially, I am saying that perhaps taxes that some are concerned about with the new health-care plan is being spent already but just not on healthcare. That is why citizens think they will be spending more for the new plan.
What do you think is the worst that could happen with our new policy? Any thoughts?
http://www.apa.org/monitor/2009/04/health-care.html this website explains the goal of psychology in health care. I don't know if we'll get there, but these ideas are pretty sound.
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Oh to be selfish. Those opposed to taxes -
I suggest that to be ethically coherent, you repay any tuition waivers, assistantship/fellowship salaries, and other benefits you receive as a doctoral student. Those benefits are all possible through taxes paid by people. Oh yeah, while your at it - for those attending or who attended public universities - please re-pay 20% - 30% of all tuition costs you have accumulated (whether you paid them or not) through your years of schooling - public universities are subsidized through tax dollars.
Why stop there - please repay all public schooling costs you had prior to enrolling in college. For those of you privileged enough to attend private elementary and secondary schools, you still owe some monies since private schools are publicly subsidized in a variety of ways (i.e. psych special ed services, buses are often publicly funded, etc.). Obviously, I can go into a variety of other public spheres that we have all participated in one way or another (i.e. paved roads), but I will end my discussion on public infrastructure at this point -
Part of being in a public society involves paying TAXES. It is what distinguishes a civilized society. Unfortunately, we can not pick and choose which programs to support - if we did, for example, public schools would be obsolete since a good number of the large percentage of the population who does not utilize them (i.e. seniors) would elect not to put any tax dollars toward schools, thus either exponentially raising the cost of schooling for those who "elect" to pay for them or eroding the funding and quality drastically.
I find it amazing (and a bit scary) that so many people completing doctorates are so ignorant about how society works. Quality institutions take money - Europe does have higher taxes, but they also have far better public infrastructure (and better overall quality of living) for its inhabitants.
To those concerned with the costs of things such as public healthcare, I pay little attention - the cost of national healthcare for 10 years, for example, would have been paid for had our government not invaded Iraq (and that does not include the long term cost savings that would accrue through reform of healthcare).
Similarly, those who oppose public infrastructure should also pay heed to military expenses. Actual dollars spent on the military (which does not include the billions that are hidden annually through different programs or undeclared expenditures) is greater than that spent by EVERY country in the world. Yes - the United States, which makes up less than 5% of the worlds population, spends more than all other countries combined on our military. If we cut our declared military spending by 50%, we would make up the 1 trillion cost of national healthcare that has been bantered about in about 3-4 years (and we would still spend more on our military than ANY other country in the world). So please, educate yourselves on reality -
I suggest that to be ethically coherent, you repay any tuition waivers, assistantship/fellowship salaries, and other benefits you receive as a doctoral student. Those benefits are all possible through taxes paid by people. Oh yeah, while your at it - for those attending or who attended public universities - please re-pay 20% - 30% of all tuition costs you have accumulated (whether you paid them or not) through your years of schooling - public universities are subsidized through tax dollars.
Why stop there - please repay all public schooling costs you had prior to enrolling in college. For those of you privileged enough to attend private elementary and secondary schools, you still owe some monies since private schools are publicly subsidized in a variety of ways (i.e. psych special ed services, buses are often publicly funded, etc.). Obviously, I can go into a variety of other public spheres that we have all participated in one way or another (i.e. paved roads), but I will end my discussion on public infrastructure at this point -
Part of being in a public society involves paying TAXES. It is what distinguishes a civilized society. Unfortunately, we can not pick and choose which programs to support - if we did, for example, public schools would be obsolete since a good number of the large percentage of the population who does not utilize them (i.e. seniors) would elect not to put any tax dollars toward schools, thus either exponentially raising the cost of schooling for those who "elect" to pay for them or eroding the funding and quality drastically.
I find it amazing (and a bit scary) that so many people completing doctorates are so ignorant about how society works. Quality institutions take money - Europe does have higher taxes, but they also have far better public infrastructure (and better overall quality of living) for its inhabitants.
To those concerned with the costs of things such as public healthcare, I pay little attention - the cost of national healthcare for 10 years, for example, would have been paid for had our government not invaded Iraq (and that does not include the long term cost savings that would accrue through reform of healthcare).
Similarly, those who oppose public infrastructure should also pay heed to military expenses. Actual dollars spent on the military (which does not include the billions that are hidden annually through different programs or undeclared expenditures) is greater than that spent by EVERY country in the world. Yes - the United States, which makes up less than 5% of the worlds population, spends more than all other countries combined on our military. If we cut our declared military spending by 50%, we would make up the 1 trillion cost of national healthcare that has been bantered about in about 3-4 years (and we would still spend more on our military than ANY other country in the world). So please, educate yourselves on reality -
I'll try and keep my politics out of this the best I can.
1. Cost (outrageously expensive in its current form). Whether it comes from the tax payers, cutbacks, or some magical castle in the sky....it is a very large (under-estimated) cost that does not have an answer for substainability that doesn't include raising taxes and/or taking from existing allocations.
Let me add a few more:
2. Degredation/Erosion of our individual rights in favor of "the greater good".....according to the gov't.
3. Unrealized consequences like the economic impact against the healthcare companies, local businesses (anyone ever see who gets the majority of gov't contracts....not local businesses), and international companies. The gov't doesn't play fair, and they still find a way to cost more than corp competition. USPS v. UPS & FedEx. It is a lose/lose proposition.
4. The bearucratic mess that happens when thousands of pages of yet unwritten regulations are unleashed on the public. Every 1000+ page document makes me marvel that our founding fathers drafted the Constitution.
I could go on and on, but suffice to say the current plan could set us back for decades.
I guess I'll have to work more hours to subsidize other people's benefits. Ouch.
This is the Elephant in the Room. Without tort reform, this is a pointless discussion, because malpractice insurance is canabalizing many health professionals, and the vultching will continue to get worse, and at the expense of people in need of medical services that have been priced out because of external factors.
Good ol' HMOs. They took a utopian/pie in the sky idea and twisted into the mess that it is today.
Finally....someone else that realizes that the Environment has taken enough of our money, and that it should learn to fend for itself and needs to stop relying on our money to survive!!
This is an issue that I'll just leave off the table, or suggest people discuss it in the Socio-Political Forum.
Okay...off to do some more assessments, I'll come back tonight with some ideas for an actual solution, in addition to some MH specific concerns we all should have with any suggestion of gov't influenced healthcare.
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I don't understand this argument. It's not like the government is going to force everyone to take the public option (not like it looks like there is going to be a public option anyway,
). Like with many things, people could choose the public plan, or remain on private health insurance. Or do you mean individuals should have the right not to be insured? Auto insurance is mandatory and nobody seems to raise an outcry over that. Why is it mandatory? Because its not fair if a driver causes an accident and is unable to pay to repair the damage to the other person's vehicle. Similarly, it's unfair for the public to have to pay the emergency room costs of the uninsured when it would be much cheaper to offer preventative options. As long as there is a health care option that is economically viable for people, then I have no problem with mandating health insurance for all tax payers (which is how they enforce the mandate).
There will likely be some economic fall out from the insurance companies having to cut costs. At the same time, the economy will be stimulated when people are asked to pay less for health insurance.
What local businesses would be negatively affected here?
Yeah, a mess...but so is all the paperwork and runaround that needs to be done when dealing with insurance now. I call that one even. Unless we go to a single payer system, that aspect is never going to get easier because we will all have to deal with a bunch of different organizations that all implement their plans differently.
You'd already be working those extra hours in order to afford private insurance premiums.
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Just make sure you cite me on that one
Ethically coherent" ... If it's all right with you, I just might adopt that phrase
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Our health care system is ranked 37th in the world (to quote Stephen Colbert - "suck it Slovenia"). How can anyone say that what we're getting is "the best?"
On the flip side, I spent a year working in the VA system so I witnessed a prime example of government run health care. Would I want to trade in my private insurance for dealing with that bureaucracy? Not especially. But, I would be much happier to know that I had that option should I lose my insurance so I could continue treating a chronic condition without having to file for bankruptcy or take my chances and stopping treatment. COBRA is a laughable option when you have to pay $500 a month for insurance when you're unemployed.
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KD....check your PM, as I don't want to take this further off track, but I do want to reply to your questions.
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COBRA is a laughable option when you have to pay $500 a month for insurance when you're unemployed.
More like 1000/mo for family coverage. I'm speaking from personal experience here. It's brutally unrealistic!
