US has best healthcare if you're not poor?

[DermViser]

The thing some have a problem with is that if the private insurance is the only one available, it becomes unaffordable for many. That's why a lot of people, including me, believe that some form of government regulation should be in place. Obviously, not living in the US I don't know all the details, but expanding government programmes (medicare/medicaid) to provide insurance to those who can't afford it (not those who elect not to buy it) would not be that bad of a solution. Plenty of countries do that and it seems to be working. Obviously, the issue is whether the government can be trusted to do it well, without wasting too much money on it.

Yeah, except the programs of Medicare and Medicaid are on the verge of going broke, that's all. Exhibit A: Greece and it's entitlement programs.

---

Members don't see this ad.

 

[PL198]

[QUOTE="Nephronlearner, post: 15362956, member: 571413"]The thing some have a problem with is that if the private insurance is the only one available, it becomes unaffordable for many. That's why a lot of people, including me, believe that some form of government regulation should be in place. Obviously, not living in the US I don't know all the details, but expanding government programmes (medicare/medicaid) to provide insurance to those who can't afford it (not those who elect not to buy it) would not be that bad of a solution. Plenty of countries do that and it seems to be working. Obviously, the issue is whether the government can be trusted to do it well, without wasting too much money on it.[/QUOTE]

Well I want a Porsche 911 turbo, but damn those things are expensive! If only the government could force Porsche to give me one and then another after I wreck the first one being an idiot.

 

[Nephronlearner]

Oh so you mean if those services were private, they'd actually be able to be used by the people that pay for them, unlike now where huge majorities of their time is spent on people that don't even pay any taxes? What a tragedy that would be! Every little thing affects the well being of a population. That's the problem. You can be abstract and say the economic access to certain products has socially repercussions on a population. What is the number 1 "justification" for obesity among poor people? Lack of access to local markets. Oh, so now grocery stores are another industry that can't make a profit, right? Here's a hint: Businesses develop where the economic conditions are present for them to succeed.

Lack of good grocery stores may affect people indirectly but lack of access to health care affects people directly.

I still don't see why it is okay to pay the police through taxes but it is not okay to pay for healthcare through taxes, even if not entirely, just for some basic coverage (and then having private companies provide additional full coverage).

 

[Nephronlearner]

Well I want a Porsche 911 turbo, but damn those things are expensive! If only the government could force Porsche to give me one and then another after I wreck the first one being an idiot.

You can't possibly believe that cancer treatment and Porche turbo are comparable, especially in regards to what I wrote earlier...

 

[Nephronlearner]

Yeah, except the programs of Medicare and Medicaid are on the verge of going broke, that's all. Exhibit A: Greece and it's entitlement programs.

What does Greece have to do with anything? Yes, Greece is broke, so are a few other countries in Europe but they weren't the topic of the discussion. People were comparing American system to that of the richest European countries, not the poorest. I never said American system was significantly worse, I merely pointed to differences that appeal to some, while don't appeal to others.

I can't comment on the state of Medicare and Medicaid and on whether the US government could do what some governments in the EU did, but some countries have succeeded in providing basic healthcare through taxes and then letting people purchase private insurance for additional coverage.

It is not all black/white - ie the NHS and the US system are not the only 2 options - actually there is a very good middle ground that should be considered in the debate

 

[DermViser]

What does Greece have to do with anything? Yes, Greece is broke, so are a few other countries in Europe but they weren't the topic of the discussion. People were comparing American system to that of the richest European countries, not the poorest. I never said American system was significantly worse, I merely pointed to differences that appeal to some, while don't appeal to others.

I can't comment on the state of Medicare and Medicaid and on whether the US government could do what some governments in the EU did, but some countries have succeeded in providing basic healthcare through taxes and then letting people purchase private insurance for additional coverage.

It is not all black/white - ie the NHS and the US system are not the only 2 options - actually there is a very good middle ground that should be considered in the debate

You said: "Obviously, not living in the US I don't know all the details, but expanding government programmes (medicare/medicaid) to provide insurance to those who can't afford it (not those who elect not to buy it) would not be that bad of a solution."

The point is what is defined as "not being able to afford it" (with respect to income) keeps increasing, and increasing to where more and more people qualify for Medicaid. Which then is paid by the REST OF US. Taxes are high enough in this country as it is. It comes to a point where eventually Americans say, "Leave me alone!"

 

[Nephronlearner]

You said: "Obviously, not living in the US I don't know all the details, but expanding government programmes (medicare/medicaid) to provide insurance to those who can't afford it (not those who elect not to buy it) would not be that bad of a solution."

The point is what is defined as "not being able to afford it" (with respect to income) keeps increasing, and increasing to where more and more people qualify for Medicaid. Which then is paid by the REST OF US. Taxes are high enough in this country as it is. It comes to a point where eventually Americans say, "Leave me alone!"

That is reasonable, sorry if I expressed myself badly.

However, the reason why more and more people can't afford it is pretty clearly related to increasing cost, which is in part also driven by corporations generating lots of money off someone's illness.
Taxes in most European countries are not that significantly higher than in America (usually ~35-40% income tax) but include decent health coverage. Just like police and fire department are financed by 'the rest of the population', even those who don't need their services at that particular time, it doesn't necessarily have to be wrong for healthcare to be financed that way too.

Again, I am not claiming one system is better than the other, and the reason there will never be an agreement is that both sides make a valid point, what differs is one's own viewpoint. I still strongly believe that every system could learn something from the others since no country (or no community or no person) is doing everything perfectly.

 

[DermViser]

That is reasonable, sorry if I expressed myself badly.

However, the reason why more and more people can't afford it is pretty clearly related to increasing cost, which is in part also driven by corporations generating lots of money off someone's illness.
Taxes in most European countries are not that significantly higher than in America (usually ~35-40% income tax) but include decent health coverage. Just like police and fire department are financed by 'the rest of the population', even those who don't need their services at that particular time, it doesn't necessarily have to be wrong for healthcare to be financed that way too.

Again, I am not claiming one system is better than the other, and the reason there will never be an agreement is that both sides make a valid point, what differs is one's own viewpoint. I still strongly believe that every system could learn something from the others since no country (or no community or no person) is doing everything perfectly.

Fire and police depts. are subsidized on a local level not the federal level (and yes there is a difference). One easy way to decrease your overall healthcare costs: eat healthy and get plenty of exercise.

 

[Nephronlearner]

Fire and police depts. are subsidized on a local level not the federal level (and yes there is a difference). One easy way to decrease your overall healthcare costs: eat healthy and get plenty of exercise.

I don't see the difference between someone having cancer and house burning in regards to the service he/she should get. Healthcare could probably be dealt with on local level as well.

That would certainly help but I am yet to encounter a patient who actually expects advice rather than pills.

Whether some of the money generated by insurance company managers should instead be used to provide access to care to more people... I say it would be better, you say it wouldn't... maybe one day we will all find out

 

[DermViser]

I don't see the difference between someone having cancer and house burning in regards to the service he/she should get. Healthcare could probably be dealt with on local level as well.

That would certainly help but I am yet to encounter a patient who actually expects advice rather than pills.

Whether some of the money generated by insurance company managers should instead be used to provide access to care to more people... I say it would be better, you say it wouldn't... maybe one day we will all find out

I was referring to covering a pre-existing condition that existed before the insurance policy that took effect. If you had a burning house, no insurance company would ensure that house.

All health insurance companies have to make profit in order to pay their workers and employees. At most then make 3% profit, and that's at MOST.

 

[Nephronlearner]

I was referring to covering a pre-existing condition that existed before the insurance policy that took effect. If you had a burning house, no insurance company would ensure that house.

All health insurance companies have to make profit in order to pay their workers and employees. At most then make 3% profit, and that's at MOST.

I am not saying insurance companies should be covering everyone and everything for little money as it is obvious that they would go bankrupt. But some countries have managed to successfully balanced the 'government involvement' and private enterprise in healthcare.
As for the house burning - but you don't have to worry about it because it was paid through taxes. So some form of healthcare tax that would provide some form of health coverage to everyone wouldn't necessarily destroy neither an average American, nor the insurance companies (especially if other taxes were somewhat reduced).

The topic, however, is about which system is better for the patient so the whole discussion has gone somewhat off topic.
American system is, imo, better for doctors. Shorter, more organised training, higher salary, easier to make a good career, on average more research opportunities etc.
As for the patient - (back to my first post) - it depends on the situation, one isn't always better than the other. American system provides more 'luxury' to an average upper-middle class family.

 

[DermViser]

American system provides more 'luxury' to an average upper-middle class family.

As is any commodity in the United States, not just healthcare.

Yes, I happen to like the system as it is now, esp. based on the ridiculous amount of tuition we all pay for our medical school education (along with the 4 years of college before that and the huge amount of ECs, and taking the MCAT). Also with all due respect, our patients benefit BECAUSE of those research opportunities.

 

[Nephronlearner]

As is any commodity in the United States, not just healthcare.

Yes, I happen to like the system as it is now, esp. based on the ridiculous amount of tuition we all pay for our medical school education (along with the 4 years of college before that and the huge amount of ECs, and taking the MCAT). Also with all due respect, our patients benefit BECAUSE of those research opportunities.

I never said you should't like it and I never said it was a horrible system. I am saying I think it could be better.

The number of people who benefit from a proportionally larger number of clinical trials and drugs approved within the last 2 or so years is much, much smaller than the number of people who would benefit from actually having any coverage.
Furthermore most of the people never even need clinical trials or latest generation biological drugs discovered in the last 2 months.

The huge debt is another matter that obviously justifies significantly larger salaries but I don't think physician salaries are the main reason lots of people can't afford health care.

The issue is far too complex to be that simplified and despite not agreeing that American system (or any of the European ones for that matter) is perfect, you did make some valid points unique to the US but I still believe more could be done to improve access to care - one area where the US is behind most other places.

PS I probably won't write again until tomorrow, it is way too late now! Hope I didn't offend anyone by advising everyone to keep an open mind. It is just my 'European' view of the American health care

 

[PL198]

You can't possibly believe that cancer treatment and Porche turbo are comparable, especially in regards to what I wrote earlier...

On the contrary, I believe they are very comparable. There's no magic brownie points set for policy about someone's life. If we go down that road, it's just exploited until everything is considered necessary and thus we are at the Porsche I will own. So either way, same result.

 

[Nephronlearner]

On the contrary, I believe they are very comparable. There's no magic brownie points set for policy about someone's life. If we go down that road, it's just exploited until everything is considered necessary and thus we are at the Porsche I will own. So either way, same result.

How many people have died due to 'lack of Porsche'?

There is a huge difference between something necessary for ones's survival and... a super expensive car. I am just not sure whether you are intentionally or unintentionally missing (or ignoring) the point I tried to make but... whatever.
Comparing cancer treatment to taking someone out of a burning building is comparable - not getting either would kill the person, while not having a Porsche... lol

 

[Psai]

There's a difference between killing someone and letting someone die.

 

[Nephronlearner]

There's a difference between killing someone and letting someone die.

Both not providing medical care and not taking someone out of a burning building is 'letting someone die'. Neither of that is the same as stabbing someone. It isn't the same as not buying them a car, either.

 

[deleted480308]

American system provides more 'luxury' to an average upper-middle class family.

the american system does not provide that luxury to the uppermiddle class family. The uppermiddle class family provides that luxury to the uppermiddle class family.

the system does not work overtime for me to pay my kids soccer fees and the system does not do my homework at 3am to get me into med school

 

[Psai]

How do you place a value on a human life? Do you think that it's worth paying $60,000 for a knee replacement for some obese 70 year old who is suffering from multiple co-morbidities that are generally self-inflicted? Or $1600 per month per injection for ranibizumab?

 

[deleted480308]

How do you place a value on a human life? Do you think that it's worth paying $60,000 for a knee replacement for some obese 70 year old who is suffering from multiple co-morbidities that are generally self-inflicted? Or $1600 per month per injection for ranibizumab?

I think that decision is up to her and her family/friends. I don't think I have the right to force other people to pay for my grandmother

 

[Nephronlearner]

the american system does not provide that luxury to the uppermiddle class family. The uppermiddle class family provides that luxury to the uppermiddle class family.

the system does not work overtime for me to pay my kids soccer fees and the system does not do my homework at 3am to get me into med school

This message is pointless :S which probably proves that the sole purpose of such threads is to argue for the sake of arguing...

Neither me, nor anyone above the age of 5 probably believes that either Obama or Queen Elizabeth or Francois Hollande pay for anyone's healthcare out of their pockets - but it obviously isn't the point - of course every family pays for health insurance, either through taxes or buy private insurance, depending on the country...

So yes, average American and average European families finance their own health care - perfectly clear. My point was - all European families get good health care with relatively little luxury (longer waiting times for non-urgent procedures, less privacy in hospitals etc). In America, not everyone can afford it, but those who do, simply get better 'customer service'. The treatment will in 99.9% of cases be identical. Something like flying 'economy' vs flying 'business class' - both will get you to the destination but you will prefer your experience in business class and you will pay a lot more for it. (obviously this goes only to service, I am not suggesting that taxpayers should cover anyone's economy flight to Australia, before anyone takes that out of context)

How do you place a value on a human life? Do you think that it's worth paying $60,000 for a knee replacement for some obese 70 year old who is suffering from multiple co-morbidities that are generally self-inflicted? Or $1600 per month per injection for ranibizumab?

This is absolutely a valid point and something I have addressed several times already.
I assume neither most insurance companies, nor most government run systems would readily pay for such surgeries, even though, I do know plenty of 80 year olds with 25,000 co-morbidities who have had hip surgeries here. They aren't denied care based on their age - if it is necessary.

It is impossible to place value on human life, but I strongly support the idea of providing basic care (through taxes), at least for life-threatening conditions, not necessarily for the example you gave above, but more like for a 45 year old with breast cancer, or AA aneurysm.

Whatever you do, you will never get a perfect system, but the reality is - despite all the troubles, the majority of people still get good care (both in the EU and US).

 

[Nephronlearner]

I think that decision is up to her and her family/friends. I don't think I have the right to force other people to pay for my grandmother

But aren't people already forced to pay for others... public schools? Universities? I am pretty sure those are paid through taxes - so why is it fine for you to pay taxes so that someone could get 'in-state tuition' while it is completely unacceptable to pay taxes so that someone could get life-saving surgeries?

 

[Psai]

Education is an investment in the future and is generally worth it, especially if you're making doctors, engineers, electricians, etc. If you're doing a surgery to prolong a life simply to prolong life without a thought to the quality or utility of that life, that's not much of an investment.

 

[deleted480308]

Neither me, nor anyone above the age of 5 probably believes that either Obama or Queen Elizabeth or Francois Hollande pay for anyone's healthcare out of their pockets - but it obviously isn't the point - of course every family pays for health insurance, either through taxes or buy private insurance, depending on the country...

No, due to the "progressive" taxation in our nation approx. 1/2 of the nation pays no federal income tax. The people in that lower half of income are also the ones most likely to be uninsured in America, and now if they have insurance it's subsidized by the larger earners. It is a fallacy that everyone pays for what they get out of government in the states.

But aren't people already forced to pay for others... public schools? Universities? I am pretty sure those are paid through taxes - so why is it fine for you to pay taxes so that someone could get 'in-state tuition' while it is completely unacceptable to pay taxes so that someone could get life-saving surgeries?

I find your response akin to saying, "but you have to pick cotton for free for the slave owners, what does it matter if you have to shuck corn for free too?"

It's a rabbit trail...but since you make incorrect assumptions about my belief, I'll respond
I don't support the federal dept of education even existing as it's a violation of the enumerated powers clause. States have decidedly more freedom to enact policies as they are not subject to the enumerated powers clause even if I don't personally agree with public schools existing. I think education should be decidedly more free market and would be cheaper if the government got out of the student loan business.

I would also say that my opinions are partially a response to the coldly logical thought process (like @Psai articulates) which will eventually permeate a society paid health program. If a self paid 90yr old woman wants to have 17 surgeries to offer a 5% increase in mobility....good for her, it's her decision. If society pays, then she becomes nothing more than an expenditure and society begins to evaluate the return on investment in offering her surgery. It's sad and it happens (cue video of Obama on campaign trail answering question about 90yr old gramma and answering with (parahprase) "at a certain point, we consider whether it's better to give her the pacemaker of just give her some meds to make her comfortable till she passes". It's up to her/her family/charity to decide if the surgery is worth it.....not the rest of society.

 

[notbobtrustme]

sb247, your version of society is cruel and inhumane and I am glad that your ideology does not hold any water with the vast majority of Americans.

 

[deleted480308]

sb247, your version of society is cruel and inhumane and I am glad that your ideology does not hold any water with the vast majority of Americans.

so it's charitable and kind to seize over 1/3 of someone's income to force them to pay other people's bills?

 

[Nephronlearner]

No, due to the "progressive" taxation in our nation approx. 1/2 of the nation pays no federal income tax. The people in that lower half of income are also the ones most likely to be uninsured in America, and now if they have insurance it's subsidized by the larger earners. It is a fallacy that everyone pays for what they get out of government in the states.




I find your response akin to saying, "but you have to pick cotton for free for the slave owners, what does it matter if you have to shuck corn for free too?"

It's a rabbit trail...but since you make incorrect assumptions about my belief, I'll respond
I don't support the federal dept of education even existing as it's a violation of the enumerated powers clause. States have decidedly more freedom to enact policies as they are not subject to the enumerated powers clause even if I don't personally agree with public schools existing. I think education should be decidedly more free market and would be cheaper if the government got out of the student loan business.

I would also say that my opinions are partially a response to the coldly logical thought process (like @Psai articulates) which will eventually permeate a society paid health program. If a self paid 90yr old woman wants to have 17 surgeries to offer a 5% increase in mobility....good for her, it's her decision. If society pays, then she becomes nothing more than an expenditure and society begins to evaluate the return on investment in offering her surgery. It's sad and it happens (cue video of Obama on campaign trail answering question about 90yr old gramma and answering with (parahprase) "at a certain point, we consider whether it's better to give her the pacemaker of just give her some meds to make her comfortable till she passes". It's up to her/her family/charity to decide if the surgery is worth it.....not the rest of society.

Okay, fair enough if your view is that government shouldn't interfere at all. However, don't you fear what an anarchy it could become?

Imagine the following scenario: no more public universities. They all get to charge any tuition they want (no government control). American medical schools can enroll ~20,000 students. And they all decide to charge 300,000 a year in tuition! There are enough rich families both in America and abroad who would love to see their children go to medical school - and who will gladly pay that amount (again - no control - they get to admit whoever they want). System becomes entirely money based instead of merit based and nobody except for a select few of the richest get to go to medical school any more.

Another potential scenario: hospital performs twenty 5,000 dollar procedures in one day. Suddenly, they decide to increase the cost to 100,000. Of the 20 people who could afford the 5,000 dollar procedure, maybe 1 can afford to pay 100,000. The hospital would actually benefit - less work to do, same profit. And only a few Americans would get any access to medical care whatsoever.

Yes, I am aware that those are extreme cases but if there is no oversight and/or competition coming from the government, private companies could ruin things pretty quickly.

 

[Psai]

Okay, fair enough if your view is that government shouldn't interfere at all. However, don't you fear what an anarchy it could become?

Imagine the following scenario: no more public universities. They all get to charge any tuition they want (no government control). American medical schools can enroll ~20,000 students. And they all decide to charge 300,000 a year in tuition! There are enough rich families both in America and abroad who would love to see their children go to medical school - and who will gladly pay that amount (again - no control - they get to admit whoever they want). System becomes entirely money based instead of merit based and nobody except for a select few of the richest get to go to medical school any more.

Another potential scenario: hospital performs twenty 5,000 dollar procedures in one day. Suddenly, they decide to increase the cost to 100,000. Of the 20 people who could afford the 5,000 dollar procedure, maybe 1 can afford to pay 100,000. The hospital would actually benefit - less work to do, same profit. And only a few Americans would get any access to medical care whatsoever.

Yes, I am aware that those are extreme cases but if there is no oversight and/or competition coming from the government, private companies could ruin things pretty quickly.

This is actually pretty much what's happening already

 

[deleted480308]

Okay, fair enough if your view is that government shouldn't interfere at all. However, don't you fear what an anarchy it could become?

Imagine the following scenario: no more public universities. They all get to charge any tuition they want (no government control). American medical schools can enroll ~20,000 students. And they all decide to charge 300,000 a year in tuition! There are enough rich families both in America and abroad who would love to see their children go to medical school - and who will gladly pay that amount (again - no control - they get to admit whoever they want). System becomes entirely money based instead of merit based and nobody except for a select few of the richest get to go to medical school any more.

Another potential scenario: hospital performs twenty 5,000 dollar procedures in one day. Suddenly, they decide to increase the cost to 100,000. Of the 20 people who could afford the 5,000 dollar procedure, maybe 1 can afford to pay 100,000. The hospital would actually benefit - less work to do, same profit. And only a few Americans would get any access to medical care whatsoever.

Yes, I am aware that those are extreme cases but if there is no oversight and/or competition coming from the government, private companies could ruin things pretty quickly.

Basic economics, the same reason a cheeseburger doesn't cost $40mil. Schools (private) already can charge $1mil and so can all private surgeons.....they don't

 

[Nephronlearner]

Basic economics, the same reason a cheeseburger doesn't cost $40mil. Schools (private) already can charge $1mil and so can all private surgeons.....they don't

Anyone would give up a cheesburger for that money, plenty would still choose to pay 300,000 a year for tuition, though. And they still don't charge it because there want to be competitive (and state schools charge significantly less as far as I know).
Also, you can make cheesburger in your own kitchen for a few dollars, while you can't set up a medical school or a hospital for yourself.

That's why IMO oversight and/or competition coming from a non-profit organisation is not a bad thing to keep things in order.

This is actually pretty much what's happening already

Yeah, possibly but less oversight is probably not the solution. I remember reading somewhere that Florida medical schools are not allowed to admit anyone who isn't a resident of the US, which certainly benefits Americans. And I am sure Florida residents are happy about it as they wouldn't want all of their med school places going to rich relatives of 3rd world emperors who could pay a million a year.

 

[deleted480308]

There is only one for profit medical school in the country and no limit on allowable tuition by all the private schools. Tuition is not $1mil. You are making my point for me.

 

[alpinism]

How do you place a value on a human life? Do you think that it's worth paying $60,000 for a knee replacement for some obese 70 year old who is suffering from multiple co-morbidities that are generally self-inflicted? Or $1600 per month per injection for ranibizumab?

Don't forget about the >$2,000 per day ICU stay afterwards when the patient slowly dies over the next month from complications.

 

[PL198]

lol I don't think you understand how economics works. If medical school magically costed 300k a year, with no inflation so that 300k would be the same value as it is today, then basically no one would go to medical school. Medical students are terrible with money, but not that terrible. If something is so economically unfavorable even people with the common sense of a brick will figure it out. You realize the factors controlling the private market are 100x more powerful than those controlling the public? See when the private sector screws up badly, they lose their ****. When the public sector screws up, the government just siphons more money from some place where we don't even have money to the place screwing up.

but seriously, i think you need to learn a bit more about how a private market works. It's not just people arbitrarily going " hm I think my first aid book should cost $42.24."

 

[Mad Jack]

Saying that the health care system alone is responsible for life expectancy in the US is a really poor argument to make. Anyone with a decent understanding of science knows that how long you live is greatly impacted by genetic, environmental, social, and cultural factors.

http://kff.org/other/state-indicator/life-expectancy-by-re/

There are massive differences in life expectancy even within the United States. They exist across racial lines and income groups. Economic inequality leads to many choices and unavoidable outcomes that lower life expectancy- lower quality food, lower education (which correlates with reduced compliance with medical care), less access to medical care (this whole thread is about quality of care *for those that can access it*), careers that result in poorer health (welding, painting, construction, etc) due to occupational exposures and hazards, the choice to engage in violent crime due to a lack of any other opportunities, and much more. And we certainly can't ignore the fact that African Americans, who disproportionately suffer from a generic predisposition toward hypertension and diabetes, also are more likely to live in poverty, which leads to poor lifestyle choices that can result in their disease manifesting far sooner than if they had lived a more healthy lifestyle.

And don't even get me started on how most other countries have a cutoff for fetus viability while here we'll try to save any and every baby we can. We lose a 22+4 weeker and it counts as a dead baby in our mortality reporting. France losses a 28 weeker and it isn't considered a viable fetus and this isn't counted. All of those people dying at damn near zero that we count but other countries don't drag our overall life expectancy down.

http://healthreformquestions.com/american-health-care-facts.php

And then there's violent and accidental deaths, something we excel at that many other countries do not. I don't want to write a book on this topic so I'll stop right there.

http://www.rawstory.com/rs/2013/09/...untries-fbi-data/?onswipe_redirect=no&oswrr=1

 

[WhippleWhileWeWork]

sb247, your version of society is cruel and inhumane and I am glad that your ideology does not hold any water with the vast majority of Americans.

so it's charitable and kind to seize over 1/3 of someone's income to force them to pay other people's bills?

@sb247, do you propose an alternative to taxation to raise funds for the needy?

 

[Mad Jack]

lol I don't think you understand how economics works. If medical school magically costed 300k a year, with no inflation so that 300k would be the same value as it is today, then basically no one would go to medical school. Medical students are terrible with money, but not that terrible. If something is so economically unfavorable even people with the common sense of a brick will figure it out. You realize the factors controlling the private market are 100x more powerful than those controlling the public? See when the private sector screws up badly, they lose their ****. When the public sector screws up, the government just siphons more money from some place where we don't even have money to the place screwing up.

but seriously, i think you need to learn a bit more about how a private market works. It's not just people arbitrarily going " hm I think my first aid book should cost $42.24."

Look at vets. They pay roughly 300k to go to vet school for a job that has an average first year earnings of 45k, so more than 6 times debt:income ratio. Physicians with 1.2 million in debt but incomes of 200k would actually have a better debt:income ratio than vets, and specialists would fare far better. Some people would still go to medical school, but I do predict applicant quality would suffer dramatically. We'd probably be looking at pod school applicant stats on average.

 

[Nephronlearner]

There is only one for profit medical school in the country and no limit on allowable tuition by all the private schools. Tuition is not $1mil. You are making my point for me.

lol I don't think you understand how economics works. If medical school magically costed 300k a year, with no inflation so that 300k would be the same value as it is today, then basically no one would go to medical school. Medical students are terrible with money, but not that terrible. If something is so economically unfavorable even people with the common sense of a brick will figure it out. You realize the factors controlling the private market are 100x more powerful than those controlling the public? See when the private sector screws up badly, they lose their ****. When the public sector screws up, the government just siphons more money from some place where we don't even have money to the place screwing up.

but seriously, i think you need to learn a bit more about how a private market works. It's not just people arbitrarily going " hm I think my first aid book should cost $42.24."

I just love it how desperately some people try to prove that others are clueless. I also can't believe it's so wrong to say that I see what you call 'socialised medicine' in action on daily basis and it's not as terrible as some people here are trying to present it. Moreover, most of the rhetoric seen on this thread is identical to stuff you can see on Fox News - silly scare stories (such as government saying 'mr Fred will not get treatment' - this is just laughable, sorry). For that matter, Fox News managed to mess up European countries on a map so I don't think they should be trusted as a source of information about foreign health care systems. And this thread really looks like a Fox News article.

If anyone here really believes that ANY system (be it health care, education or whatever) is absolutely perfect, that's fine, but keep in mind that stuff you see in the news (with some additional blind patriotism) does not necessarily illustrate the world accurately. This is not a personal attack, as I don't know anyone here - it's just my view of the ridiculousness of this discussion (despite taking part in it myself).
Pretty sure that someone will get deeply offended by the term 'blind patriotism' - I am just not sure which other term to use for people who get so upset when someone points to one or 2 negative things about the system they live in. Especially since it's coming from someone who lives and studies in a 'socialised system', and who can testify first hand that plenty of things mentioned in the 2 recent threads are just wrong)

I never claimed I knew everything about economics -> I don't because I am a medical student, not an economist. And unless everyone else on this thread has finished a degree in economics, what you write here is also just an opinion of a lay person.

I am also not saying that the US system is terrible - it isn't. But I AM saying that European systems aren't terrible either, contrary to what some people here believe. And we do not die of plague or lack of available care or whatever else someone here might believe.

But somehow everything I say on this topic gets twisted into 'which system is better' debate, something I never intended to take part in in the first place - because there is no definitive answer - which is why the debate keeps going on.

And this discussion is going way too far. I never said any system was necessarily better, in fact I pointed out several good things about the American system but people here just don't care and keep arguing for the sake of arguing. I have made my point clear, feel free to insult me, feel free to think I am stupid and ignorant but please stop the ridiculous discussion as nobody is going to change anyone's opinion.
But for whatever reason, I am quite certain that someone will come up with another attack... again...

 

[Kahreek]

Yeah, except the programs of Medicare and Medicaid are on the verge of going broke, that's all. Exhibit A: Greece and it's entitlement programs.

what about Canada, UK, france and countless other countries

 

[PL198]

what about Canada, UK, france and countless other countries

All of those nations have quite the large amount of debt, with astronomical taxes....

 

[notbobtrustme]

so it's charitable and kind to seize over 1/3 of someone's income to force them to pay other people's bills?

yes, yes it is. You have no problem using other people's money to pay for your medical school tuition. When the system benefits you, you take full advantage of it. Don't give me that crap "I'm in the system so I have to take part in the system". If you truly believed that taxation = theft, you should be eschewing everything relating to taxation.

Taxation is not theft. It is the price of living in a civilized nation that has needs and obligations to meet to it's citizenship.

 

[notbobtrustme]

All of those nations have quite the large amount of debt, with astronomical taxes....

Taxes arent noticibly higher and frankly they have higher after-tax income because they aren't paying for insurance + deductibles + college tuition etc etc etc.

 

[Nephronlearner]

All of those nations have quite the large amount of debt, with astronomical taxes....

Now another discussion...

What astronomical taxes? lol Where does this come from? I have no idea where you people find that stuff :S

1) Debt % GDP: http://www.economicshelp.org/blog/774/economics/list-of-national-debt-by-country/
- US has larger debt than plenty of European countries

2) Taxes... let's take a person from NY state who earns $100,000 annual salary. According to pay check city that translates to $5,507.65 per month after tax ( http://www.paycheckcity.com/ )

Now let's take someone from the UK:
$100,000 = 58,772.19 GBP annual salary: http://www.thesalarycalculator.co.uk/
- monthly income after tax: 3,435.76 GBP = $5,845.89 (and that includes the cost of health insurance)

That means that a person earning $100,000 pre-tax in both countries, would get ~$340 more after tax in UK! (which is probably enough to buy extra private insurance)

Now if you have any other actual EVIDENCE to the contrary, I'd be glad to take a look and change my stance (if you can prove me wrong)...

 

[PL198]

You're not comparing apples to apples. relative to your nation, it's power and what your tax dollars give you, you're paying way more than what an American pays. You cannot compare the value gained from American tax vs European tax. I pay to support the world police force, which I don't even agree with, but still is very real. You pay to support the world beggar force. It's funny how people always forget that.

 

[WhippleWhileWeWork]

Now another discussion...

What astronomical taxes? lol Where does this come from? I have no idea where you people find that stuff :S

1) Debt % GDP: http://www.economicshelp.org/blog/774/economics/list-of-national-debt-by-country/
- US has larger debt than plenty of European countries

2) Taxes... let's take a person from NY state who earns $100,000 annual salary. According to pay check city that translates to $5,507.65 per month after tax ( http://www.paycheckcity.com/ )

Now let's take someone from the UK:
$100,000 = 58,772.19 GBP annual salary: http://www.thesalarycalculator.co.uk/
- monthly income after tax: 3,435.76 GBP = $5,845.89 (and that includes the cost of health insurance)

That means that a person earning $100,000 pre-tax in both countries, would get ~$340 more after tax in UK! (which is probably enough to buy extra private insurance)

Now if you have any other actual EVIDENCE to the contrary, I'd be glad to take a look and change my stance (if you can prove me wrong)...

Is this just comparing income taxes? If so, this is a meaningless analysis.

 

[Nephronlearner]

You're not comparing apples to apples. relative to your nation, it's power and what your tax dollars give you, you're paying way more than what an American pays. You cannot compare the value gained from American tax vs European tax. I pay to support the world police force, which I don't even agree with, but still is very real. You pay to support the world beggar force. It's funny how people always forget that.

Um... I am not sure I am following
First of all, I am not from the UK, I used the UK example simply because it was relatively easy to find a salary calculator. But, I do know that people there for their taxes get a bunch of benefits Americans don't, get more holidays, much more sick leave, health insurance and so on.

I am not exactly sure how much YOU gain from supporting the 'world police' and I am pretty sure plenty of people would rather pay for health insurance than for wars.

But this whole post is so ridiculous that I don't even know why I am wasting time responding...

Is this just comparing income taxes? If so, this is a meaningless analysis.

I wasn't saying that total taxes aren't higher in Europe - just showing it as evidence that the difference isn't 'astronomical'

 

[Mad Jack]

As for the house burning - but you don't have to worry about it because it was paid through taxes. So some form of healthcare tax that would provide some form of health coverage to everyone wouldn't necessarily destroy neither an average American, nor the insurance companies (especially if other taxes were somewhat reduced).

The topic, however, is about which system is better for the patient so the whole discussion has gone somewhat off topic.
American system is, imo, better for doctors. Shorter, more organised training, higher salary, easier to make a good career, on average more research opportunities etc.
As for the patient - (back to my first post) - it depends on the situation, one isn't always better than the other. American system provides more 'luxury' to an average upper-middle class family.[/QUOTE]
The topic of the thread isn't which system is better for the patient, but how high the quality of the system is for those that have access to it.

If you look at outcomes, the US does not perform all that poorly. We've got the best 5-year cancer survival rates in the world for most types of cancer, the fourth best stroke survival rates in the world, and comparable outcomes to other industrialized countries when looking at overall health outcomes. This is despite the large number of Americans lacking adequate care. If our outcomes are that good despite having many millions of uninsured, it only stands to reason that if they were insured, our outcomes would likely be superior to most other countries in even more metrics.

We've got great health care, if you can afford it. There's a reason people fly here from all around the world for procedures and cancer treatment- because it's the best care out there and it's available when you want it, if you can pay.

http://www.webmd.com/heart-disease/news/20040920/us-tops-canada-in-post-heart-attack-care I can't find a solid multinational study on post-MI care.

Solid stroke results, far superior to many countries with socialized medicine.

http://content.healthaffairs.org/content/23/3/89.long We've got comparable outcomes to other developed nations despite much poorer access to care
http://healthreformquestions.com/american-health-care-facts.php Site that goes over a bunch of the data on the topic.

 

[Mad Jack]

Um... I am not sure I am following
First of all, I am not from the UK, I used the UK example simply because it was relatively easy to find a salary calculator. But, I do know that people there for their taxes get a bunch of benefits Americans don't, get more holidays, much more sick leave, health insurance and so on.

I am not exactly sure how much YOU gain from supporting the 'world police' and I am pretty sure plenty of people would rather pay for health insurance than for wars.

But this whole post is so ridiculous that I don't even know why I am wasting time responding...



I wasn't saying that total taxes aren't higher in Europe - just showing it as evidence that the difference isn't 'astronomical'

The difference doesn't need to be astronomical. Even if you lose an extra 10% of your disposable income to taxes, that's going to kill when you factor in how much it could have compounded until retirement. For a physician, 10% can be 20k a year plus of lost income that could've gone toward retirement, a HUGE amount when compound interest and yearly contributions are considered.

 

[PL198]

Um... I am not sure I am following
First of all, I am not from the UK, I used the UK example simply because it was relatively easy to find a salary calculator. But, I do know that people there for their taxes get a bunch of benefits Americans don't, get more holidays, much more sick leave, health insurance and so on.

I am not exactly sure how much YOU gain from supporting the 'world police' and I am pretty sure plenty of people would rather pay for health insurance than for wars.

But this whole post is so ridiculous that I don't even know why I am wasting time responding...



I wasn't saying that total taxes aren't higher in Europe - just showing it as evidence that the difference isn't 'astronomical'

You can say this because the rest of the world has continually bailed you out over time. The US isn't alone in this- Russia has played a large part over history as well. I just find it funny Europe in general is so critical of the nations that essentially are the only reason it still exists and isn't just one nation.

 

[Reckoner]

And don't even get me started on how most other countries have a cutoff for fetus viability while here we'll try to save any and every baby we can. We lose a 22+4 weeker and it counts as a dead baby in our mortality reporting. France losses a 28 weeker and it isn't considered a viable fetus and this isn't counted. All of those people dying at damn near zero that we count but other countries don't drag our overall life expectancy down.

Please, don't get started. It's already been addressed by the CDC. Even when you exclude births before 22 weeks, we still do worse than many of our European peers (almost double the mortality rates of Norway and Sweden, for example). And when you break it down by gestational period, we actually do better than most of our peers in births before 27 weeks. Where we struggle most (comparatively) is in births after 37 weeks. See Table 2 from the report.

This line is particularly egregious:

most other countries have a cutoff for fetus viability while here we'll try to save any and every baby we can.

Bull****. Of the 19 countries in that report, 14 report births the same we do (i.e. all live births). France's cutoff is 22 weeks and 500 grams, by the way.

It's frustrating to see this excuse get trotted out over and over, when the evidence doesn't support it.

 

[Brain Bucket]

Now another discussion...

What astronomical taxes? lol Where does this come from? I have no idea where you people find that stuff :S

1) Debt % GDP: http://www.economicshelp.org/blog/774/economics/list-of-national-debt-by-country/
- US has larger debt than plenty of European countries

2) Taxes... let's take a person from NY state who earns $100,000 annual salary. According to pay check city that translates to $5,507.65 per month after tax ( http://www.paycheckcity.com/ )

Now let's take someone from the UK:
$100,000 = 58,772.19 GBP annual salary: http://www.thesalarycalculator.co.uk/
- monthly income after tax: 3,435.76 GBP = $5,845.89 (and that includes the cost of health insurance)

That means that a person earning $100,000 pre-tax in both countries, would get ~$340 more after tax in UK! (which is probably enough to buy extra private insurance)

Now if you have any other actual EVIDENCE to the contrary, I'd be glad to take a look and change my stance (if you can prove me wrong)...

Assuming those numbers are correct, the 5.5k in teh states buys more than 5.8k does in europe and you know it , but that is a different story.