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Universal Healthcare

Started by DannMann99
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DannMann99

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So I was recently asked by someone if I could find a scholarly article on the downsides of universal healthcare.

I tried, but i'm also lazy and an M1

I have heard many positive arguements but I wanted to see some counterarguements which actually cite references and sources.

Anyone able to help me out with this one?
 
Not that this really helps much but my wife is a critical care nurse and recently toured Sydney, Australia’s hospitals for a month and what she has told me is that anyone could get better care in the emergency room in the US then what was available at the public health centers.

The good health care facilities were next to the public ones but staffed with experienced doctors and took patients that could pay for top notch care and had additional insurance than what the govt. could offer. She said that the public facility was truly dirty and foul compared to any facility she had seen here in Oregon including the jail facilities. The total cost to the citizens was 1% of their income according to the staff she toured with... which I will admit is a great price.

So... I guess the argument would be... Could the govt. actually put the taxes to good use better than the private sector and make health care facilities that would give actual quality care and competitive pay to keep more than just the rookies on staff?
 
kevinmd.com

edit: I'm a museum quality liberal and thus I disagree with everything he says. But, he's a doc, he's very anti-UHC, and he publishes links to blogs citing reasons why UHC would bring about the end of civilization.
 
I've posted this before and I'll post it again. Here's the opinion of the Supreme Court of Canada which held that Quebec's prohibition of private health insurance violated the Canadian Constitution.

http://www.canlii.org/en/ca/scc/doc/2005/2005scc35/2005scc35.html

The upshot of the opinion is that Quebec's system stunk. One year waits for orthopedic surgery etc. Please note paragraphs 40-50 in the opinion

My daughter did a study abroad program in Australia. She and her fellow international students were obligated to buy Aussie national health insurance. One of her friends over there got walking pneumonia and no one would see her. She had to self-medicate.😡
 
Similarly, my best friend lived in France for a year. She had some bumps down there. The doctor had her get undressed in front of other people because there weren't enough rooms, where she refused. He then saw her, said there was nothing wrong with her, but told her to take penicillin. She told him she was allergic, but he told her that was the only kind of medication he could prescribe her (WTF?) She came home and has HPV. I appreciate the idea of Universal Healthcare, but I don't think it's feasible in our kind of society.
 
try taking sides clashing views on controversial issues in health and society the edition i have is second and has both sides of argument of health care crisis in us. its outdated though published in 1996 maybe someone has newer ed or its prob in medical library at your school.
 
I am currently taking a graduate course entitled U.S. health care systems. Thus far, we have done a comparitive analysis of this issue, along with many others. In short, when looking at international models of health care, we see that it is a dynamic and complicated issue at best, in which one extreme (national HC) or the other (privatized HC) can and do often reach the same outcomes, par and subpar. Personally I do not believe a complete restructuring of the current US HC system would "solve" all if any of the issues we face. IMO, what we should do is strive to connect legislation with the practical realities of the field. As a nation we spend approx. 97% of the healthcare expenditure on direct services, while 70% of disease origins can be found in behavioral/preventive domains.

sorry for the rant....have a nice day....T
 
Obnoxious Dad said:
I've posted this before and I'll post it again. Here's the opinion of the Supreme Court of Canada which held that Quebec's prohibition of private health insurance violated the Canadian Constitution.

http://www.canlii.org/en/ca/scc/doc/2005/2005scc35/2005scc35.html

The upshot of the opinion is that Quebec's system stunk. One year waits for orthopedic surgery etc. Please note paragraphs 40-50 in the opinion

My daughter did a study abroad program in Australia. She and her fellow international students were obligated to buy Aussie national health insurance. One of her friends over there got walking pneumonia and no one would see her. She had to self-medicate.😡
Click to expand...
And how do you self-medicate doxycycline, exactly? lol
 
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Bacchus said:
And how do you self-medicate doxycycline, exactly? lol
Click to expand...

I would personally have used azithromycin (Z-pak) but doxy works (just more side effects)


As for universal healthcare - there are too many variations to it to argue the pros and cons. The question should be more single-payer source versus multiple-payer source, funding, any spending restrictions, and economic liability of the consumers. Any proposals will have to take into account long term effects on the population as well as human psychology/behavior, as well as economic reality.

For example - if we were to go to a purely government single payer system, what are the cons? As we can see with California Medicaid, the VA system (funded by Congress) - when the government needs money, healthcare is on the chopping block. With single payer, you have no leverage, no other source of income. You will take what the government pays you. You see some of this right now with medicaid/medicare providers, especially those whose patients population are mostly medicaid/medicare - they are affected by state government budget as well as the medicare budget (with the annual threaten cuts). Tackle on this $700 billion-$1 trillion bailout, Congress may just cut reimbursement to help balanced the budget. Remember it was only recently that Congress got rid of the economic hardship deferrment for medical residents to help with the budget.

Also associated with government payment system are insane rules. Right now you cannot balance-bill. If the actual physical cost of a patient visit is $100 (rent, utilities, office staff, insurnace, etc, excluding your income) BUT medicare only pays $70 - you cannot bill the patient for the difference. You will have to see that patient for $70 and take a $30 loss on your books.


Another issue with universal healthcare is the LACK of primary care physicians. Right now with so few US graduates entering primary care from medical school (and fewer internal medicine residents going into primary care after residency) - who will take care of the expected influx of elderly patients? Look right now at what is going on in Massachusetts when they mandated health coverage (a multi-payer form of univeral healthcare). Multiple physician offices are closed to new patients (due to influx overwhelming their office) making it difficult to find physicians willing to take new patients without compromising their current patients. There is an acute need for more primary care physicians in MA ... but current environment in MA does not lead to a favorable practice environment (ie., you don't see doctors banging on the door to practice in MA)
 
Limvostov said:
So... I guess the argument would be... Could the govt. actually put the taxes to good use better than the private sector and make health care facilities that would give actual quality care and competitive pay to keep more than just the rookies on staff?
Click to expand...
Scary prospect. I've yet to see any government institution that is impressive except our military and USPS (and the USPS still sucks compared to UPS/Fedex). I just have very little faith in our "elected representatives" ability to do anything and feel like I'm stuck between a rock and a hard place given that the American people have become so complacent and passive in their comfortable lives. 🙁
 
I lived in three countries where we have universal health care. I don't know what's going on in the U.S. But I and my friends did not have any problems with universal health care. 🙂
 
tennisball80 said:
I lived in three countries where we have universal health care. I don't know what's going on in the U.S. But I and my friends did not have any problems with universal health care. 🙂
Click to expand...

How old/healthy are you and in which countries did you live? I'd be willing to bet that the answers to these would affect a given population's perception of UHC, in general.
 
khen7513 said:
Similarly, my best friend lived in France for a year. She had some bumps down there. The doctor had her get undressed in front of other people because there weren't enough rooms, where she refused. He then saw her, said there was nothing wrong with her, but told her to take penicillin. She told him she was allergic, but he told her that was the only kind of medication he could prescribe her (WTF?) She came home and has HPV. I appreciate the idea of Universal Healthcare, but I don't think it's feasible in our kind of society.
Click to expand...

The problem with this kind of anecdote is that it's far more a reflection of the doctor than the healthcare system at large. There is jack you can do for HPV, really, so aside from the confusing bit about penicillin, I'm not sure what your friend was hoping for. I've had both fabulous care here in the US and crappy care, all while having top of the line insurance. It would be easy for me to say that doctor X was horrrible, hence the US system sucks, or doctor Y was great and wow, don't we love healthcare here!

OP, a lot of the universal healthcare stuff out there is in book form, have you glanced at your library shelves or catalogue? I have read some fantastic pro-universal healthcare stuff, but I have yet to find any truly solid counter arguments. Most of them are more or less anti-government, and use anecdotal evidence. I would be curious to read an argument that didn't rely on those.

And group_theory, I think you're right on the money about single-payer versus multiple-payer and other variables. I have the feeling too many people see the term "universal care" and automatically think "socializied" and have some sort of trained reaction to go "gah! no more government!" Given that people seem to be ok with "socialized" education, police & fire depts, etc, I don't get what the big deal is. But that's just my view...as largely influenced by Arnold Relman (A Second Opinion...go read it, people).
 
group_theory said:
For example - if we were to go to a purely government single payer system, what are the cons? As we can see with California Medicaid, the VA system (funded by Congress) - when the government needs money, healthcare is on the chopping block. With single payer, you have no leverage, no other source of income. You will take what the government pays you. You see some of this right now with medicaid/medicare providers, especially those whose patients population are mostly medicaid/medicare - they are affected by state government budget as well as the medicare budget (with the annual threaten cuts). Tackle on this $700 billion-$1 trillion bailout, Congress may just cut reimbursement to help balanced the budget. Remember it was only recently that Congress got rid of the economic hardship deferrment for medical residents to help with the budget.

Also associated with government payment system are insane rules. Right now you cannot balance-bill. If the actual physical cost of a patient visit is $100 (rent, utilities, office staff, insurance, etc, excluding your income) BUT medicare only pays $70 - you cannot bill the patient for the difference. You will have to see that patient for $70 and take a $30 loss on your books.
Click to expand...



So with UHC there is no guarantee that physicians will get paid? That's nice...I guess I don't want to have "DMV" style medicine when I am older and know that for my visit my physician will not be paid and therefore will take less time to do the job in order to increase the amount of patients seen in a day to offset some of the lack of pay.

The idea of UHC just sounds like a bad idea. I can't say that I like the health insurance companies making billions off the misfortunes of others any better, but at least I know exactly what will be coverd by their policy and how much I will be liable for.

As for their not being enough PCP's out there... well maybe someone should redo the payscale a little to make it so that certain specialties don't get tripple or more pay. No one goes to med school thinking that they will make $95k in peds. especially when work more hours and paid the same amount for school as the dermatologist next door. I can only imagine that paying off school loans for a PCP is a real long process, especially if their spouse doesn't work to help.
 
with the current debt and economic situation. the mere Idea of either person being able to introduce any type of universal healthcare is borderline laughable. Mark my words. Even if Obama is elected universal healthcare will NOT happen. Just my 2 cents.
 
tncekm said:
Scary prospect. I've yet to see any government institution that is impressive except our military and USPS (and the USPS still sucks compared to UPS/Fedex). I just have very little faith in our "elected representatives" ability to do anything and feel like I'm stuck between a rock and a hard place given that the American people have become so complacent and passive in their comfortable lives. 🙁
Click to expand...

The USPS lost $1 Billion dollars last quarter, has a mandate to reduce staff by 40,000 in the next year, and the Postmaster General has called the situation "dire." The business model of the USPS is outdated and they've shown an inability to adapt. If the government ran healthcare, could it adapt in a timely fashion to change?
 
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DannMann99 said:
So I was recently asked by someone if I could find a scholarly article on the downsides of universal healthcare.

I tried, but i'm also lazy and an M1

I have heard many positive arguements but I wanted to see some counterarguements which actually cite references and sources.

Anyone able to help me out with this one?
Click to expand...

Two words: John Stossel.

[YOUTUBE]http://www.youtube.com/watch?v=aEXFUbSbg1I[/YOUTUBE]
 
I know that alot of the argument against UHC is that it will cause a degradation in health care in the USA. But I sort of view that as at least everyone will have some health care. I mean if we averaged healthcare quality in this country with the 40 million who are uninsured and don't have access, I bet we'd come pretty to close to an average of quality of healthcare under UHC.

260 million with 80/100 average care + 40 million with 0/100 care, versus 300 million with 70/100 care under UHC.
 
Here is a downside to Universal Healthcare.

Our country is primarily a competition-based system. Companies come up with new technologies because they know that if their product makes it to market, they will be paid a lot of money. Hospitals buy expensive technology because they know that people who car afford it (through individual payment or insurance) will use it and make them money (remember, everything is a business). If we switched to a universal health plan, there is no incentive for competition because they (makers of new technology) will not be paid as much money as before. This is why in the United States, the 'technology' is better in health care than in other countries.

I am actually for universal health care, as it should be a necessity and not a privilege. However, to have UHC, there MUST be an incentive for competition. The country must do something to continue the growth of technology.
 
koojo said:
Here is a downside to Universal Healthcare.

Our country is primarily a competition-based system. Companies come up with new technologies because they know that if their product makes it to market, they will be paid a lot of money. Hospitals buy expensive technology because they know that people who car afford it (through individual payment or insurance) will use it and make them money (remember, everything is a business). If we switched to a universal health plan, there is no incentive for competition because they (makers of new technology) will not be paid as much money as before
Click to expand...

I would have to agree. It would also seem to me that if competition were taken away salaries in the healthcare professions would decrease (where else is the money going to come from? im not sure the gov't can be depended upon to compensate on par with current earnings), doctors would have a harder time paying off loans of schools who's tuitions are steadily rising, making it difficult to live and be a physician..doesn't sound all that great to me. A surgeon I talked to thought that this very dilemma would end up lowering the quality of physicians in the next decade because of how undesirable it would make the career to many qualified applicants (amt. of work vs. compensation)

But i could be totally wrong, its hard to predict what exactly would happen 😕
 
Tachymeter said:
...But I sort of view that as at least everyone will have some health care. I mean if we averaged healthcare quality in this country with the 40 million who are uninsured and don't have access, I bet we'd come pretty to close to an average of quality of healthcare under UHC....
Click to expand...

One big problem is that if everyone is entitled to the same healthcare....eventually you have to start rationing it. The most expensive things are going to be cut out. Right now, if you are 75 but have blocked coronary arteries, you'll get lots of expensive treatment that may well keep you alive into your 90's. It won't happen under UHC. Right now, if your baby is born at 24 weeks, millions will be spent on keeping him/her alive. Don't count on it under UHC. Does your teenager need an expensive experimental drug in order to live? Under UHC you just can't spend that much on one person. The expensive treatments and extraordinary life-saving measures will become a thing of the past.
 
http://www.medpagetoday.com/PublicHealthPolicy/Medicaid/tb/11106

Some select quotes

"WASHINGTON, Sept. 29 -- Medicaid payments to physicians may be trimmed next year as states seek to offset the cost of growing enrollment in the programs, according to the authors of a Kaiser Family Foundation Survey. "


and


Physician reimbursement is a likely area for cost savings, said Vernon K. Smith, Ph.D., a principal at Health Management Associates and author of the report called "Headed for a Crunch: An Update on Medicaid Spending, Coverage and Policy Heading into an Economic Downturn."
"No states like to cut provider payments," Dr. Smith said. "But it is perhaps one of the first places states would turn to because it is a real savings."
He said other cost-cutting measures, such as raising requirements to drive down enrollment, might take longer to generate savings
 
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