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Post by Supertramp78 on Nov 9, 2009 16:12:42 GMT -5
'The point is that if they gave you the $10 G's in salary (which they won't do), would you be better off taking that chance.'
Not me. Thing is if you take the chance and lose, you are bankrupt. If you don't take the chance and lose, your extra costs are spread out among thousands of other people. Nobody goes bankrupt.
Also, I have a good idea what my medical costs are. I have close to $30,000 in prescription costs a year. I would sign up under that plan if they gave me my $10k and the $10k of about two or three other people.
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Post by millring on Nov 9, 2009 16:14:38 GMT -5
Blue Cross standard family coverage under the federal plans is now up to just under $15K per year total cost. Interesting. You've got to wonder at what point insurance stops being the predominant method of financing medical care. For round numbers, let's say you cover $1000 of that annually as your salary contribution. Let's say that you agree to drop insurance if you can split the $14K take with your employer. And then you drop your annual insurance premium to $500 and just cover anything that goes beyond the extra $7000 in your check. I wonder how many people would actually make out financially, or could adjust to make out financially. I'm pretty sure I could. bingo. |
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Post by sekhmet on Nov 9, 2009 16:22:06 GMT -5
I find it appalling that medical insurance is so expensive in the States. It's hard to imagine from my perspective. As for privately owned clinics - there are some in Canada but it is a hotly debated issue. Some fear that allowing any private clinics will eventually bring the rest of the system down. It is a matter of elitism. Cdns are very proud that we all get the same deal, rich or poor, when it comes to medical care. Prime Minister and his family had to get in line for flu shots. I don't think any of them got them yet, as they aren't in the priority list. Canadians who are rich enough can go anywhere in the world for medical care. They don't need to go to the States necessarily. I really can't see the US doing away with a private option though, can you Bamfiles? Just seems a little too commie.  |
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Post by millring on Nov 9, 2009 16:31:23 GMT -5
The one thing I keep circling back to is that the real problem for Americans is that too much can be done medically. We have the best healthcare in the world. But it's expensive. Both sides say that few can afford our health care -- certainly nobody realistically can afford it on a cash-for-services basis. Historically, because of insurance, I'm guessing that there are a large number of people who have already accessed more health care than they could afford on their own.
And it seems to me that there are several sticking points to the discussion -- sticking points that either are avoided because they're unpleasant, or because we kinda know it, but want what we want anyway.
1. Realistically, we really cannot afford it. Certainly not the House plan that just passed. We are by any measure broke. We can't even point to the kind of debt we've amassed as a reasonable amount as a percentage of GDP -- or any other such rationalization we've grown to accept with a Schlimm ::nod:: . We can argue that we should have prioritized differently. We shouldn't have gone to war. We shouldn't have done lots of things we've wasted money on. But we done did. The real stuff is gone. Way gone. Long gone. We are spending ether.
2. We are selling a VERY expensive commodity -- health care -- to people with the promise of it being free. Yes, there is much talk about raising taxes -- but again, it's raising them on the only ones who are currently paying them, and NOBODY thinks that this plan is really going to raise THEIR OWN taxes. If they want the plan, they're not even asking. I've asked here no fewer that five times, "Does anyone know what they will pay under the new system and how that will compare to what they now pay for insurance?" No answer. There can't be. We are demanding the product and we DON'T WANT TO KNOW ahead of time what it will cost us. The Democrats are the ones who mostly want this reform and they are just not curious -- they are trusting that their people in office have the best of intentions -- and in those best intentions, they will not cost the average Joe more than he's currently paying.
We're selling the best health care in the world as free to people who cannot afford it (because even collectively we cannot afford it) -- the whole package. The underlying assumption is that whatever the rich guy now gets, the poor guy will soon get. Well, fair that may be, but the only realistic way to pull that off is to make sure that the rich guy gets less -- not that the poor guy gets more -- because the spending limit for ALL has been reached. Years ago. Fine. Fair. But it doesn't cover the best means of innovation and improvement. We have the best health care in the world -- and the world has benefitted greatly from our innovations. But that innovation came as a result of people being able to profit from those innovations. Remove that profit motive, go ahead. It makes us feel more honorable....even though we all work for a living and "profit" in the concrete -- in our own hands, profit never seems as evil as it does in someone else's hands.
But you guys want to pay for my health care. That's very generous of you.
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Post by sekhmet on Nov 9, 2009 16:51:54 GMT -5
Just curious, John, why do you think that the US has the best health care in the world?
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Post by bamfiles on Nov 9, 2009 16:51:59 GMT -5
There's always a private option for the folks who can afford it which, unfortunately, includes congress, doctors, lawyers and Indian Chiefs (if their reservations have oil or casinos) and other members of organized crime. I don't know about your Prime minister, but I'll bet that if the Queen wanted a Flu shot she wouldn't have to wait in line and only would do so if it were politically advantageous to do so. I doubt that the leaders of the Communist Party in Moscow used the public system. Even Marx knew that there had to be a ruling class, which, he being an academic, thought should be drawn from the academic class, and that they would of necessity have a higher standard of living than the common people. The problem with communism is that it provides no incentive for personal advancement, so it stagnates. It relies on a large lower class working for their peers benefit while a small upper class lives high off the hog while pretending to be sympathetic to the needs of the lower class.
The U.S. is a strange and possibly unique country in that we have, or had until recently, a comparatively large and growing upper class, an inordinately large middle class and a relatively small and shrinking lower class. IMHO, too many people got to go to business schools where they were taught to make money with money rather than products and got their MBA's majoring basically in gambling. They didn't learn the capitalist system, they learned how to game the capitalist system and then went out to run banks and corporations. Over the past 30 years or so I've seen more bone-headed business deals and scams than I can count but few of them actually went to jail. Some of the perps are now running the government departments that are supposed to be fixing the problems they caused. In business, I saw lots of occasions where someone would cause a problem and then get a promotion either before the problem was discovered or as a reward for their efforts in addressing the problem. Our whole business environment went down the tubes because of these people. I had long discussions with financial people who actually believed that we'd make more money if we could just get rid of these problem customers. Personnel became "Human Resources" sort of like lumps of coal and "Customers" who purchase product became "Clients" who pre-pay for services that with luck you'll never have to deliver. We've taken those theories to their logical ends now, I think. I favor old-fashioned make something people can use and sell it at a profit capitalism. I don't know if that can still be done here. China, India and the rest of the third world can do it given the chance.
The next 5 or 10 years will be interesting. Much past that I may not care.
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Post by Russell Letson on Nov 9, 2009 17:09:11 GMT -5
John, where is the money coming from right now? I mean, not gummint money (which you maintain is gone because the gummint's broke), but the rivers of cash that flow out to the all the providers. It's coming from somewhere, and I take "reform" to refer to a process that somehow analyzes and redirects that flood in a way that doesn't, say, leave a non-trivial segment of the population with no access to non-emergency care while simultaneously enriching (sometimes vastly enriching) some other segments (notably the corporate bodies that include some providers and insurers). The House bill is almost certainly full of flaws and scams and dumb ideas, but the opposition's position that everything is just peachy, or that government intervention amounts to a "takeover", or that the holy frickin marketplace will kiss it and make it well--that's mostly the sound of hands being protectively slapped over wallets. Fat wallets. In a sane and humane polity we all, collectively, pay for everybody's care, even the starving artists' and useless, underemployed scribblers'.
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Post by Russell Letson on Nov 9, 2009 17:21:12 GMT -5
Bruce, you may have noticed that Moscow is now run by ex-communists who have embraced capitalism with a fervor not seen in North America since the day of the robber barons.
Marx was certainly an intellectual, but he was also what academics call an "independent scholar," which is to say that he did not have a university appointment--his paying gigs, such as they were, were in journalism. (There's no money in scholarly books--I'm in a position to know.) And if I'd known that "dictatorship of the proletariat" mean that academics got to run things, I'd have been even more annoyed at losing my teaching job.
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Post by Doug on Nov 9, 2009 17:25:50 GMT -5
There ain't enough money in the world for everybody in the US to have the "best care". And every day the "best care" gets more expensive.
If you think that the best solution to that problem is have government control health care then the best way to do that would be to nationalize the entire industry. 2000 pages of pork has to just complicate the situation more and complication cost a lot of money.
Not saying I favor nationalization but if you thing that government is the answer that's the only sane solution.
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Post by Supertramp78 on Nov 9, 2009 17:30:56 GMT -5
Just a couple of things to follow up on John's recent post.
1. I have no idea who has the best medical care in the world. I don't think anyone does.
2. In 2007, the U.S. spent $2.26 trillion on health care, or $7,439 per person. Every year it goes up. Now if you take a look at that number and do a little math you figure out that we already have socialised medicine because even with insurance costs at $10-$15K per family, you aren't covering $7,500 a person. I'm guessing a large percentage of healthcare costs are medicare and medicaid.
Of that big bucket of money, about $300 billion of it is Medicaid. Medicaid payments currently assist nearly 60 percent of all nursing home residents and about 37 percent of all childbirths in the United States. The Federal Government pays on average 57 percent of Medicaid expenses.
Medicare spending reached $440 billion for fiscal year 2007. Historically it has doubled in price every four years.
3. The Congressional Budget Office has found that "about half of all growth in health care spending in the past several decades was associated with changes in medical care made possible by advances in technology." MRI's are a lot more expensive than X-rays. There isn't much of anything I can think of to drive this cost down.
Now let's go back to that first point....
In 2007, the U.S. spent $2.26 trillion on health care, or $7,439 per person.
Look at that for a moment. If we went to a single payer system and just taxed everyone to use it, we would be taxing people at a rate of $7,439 per person. A family of four would be spending $2,480 a month in healthcare taxes in order for the system to break even. If your personal insurance cost $620 a month, would you buy it? In order to be fair and not progressive, you have to. Otherwise you are charging rich people $15-$30K a year so poor people can pay $300 or $100 a month (but there is a limit to how many poor people can be supported by each rich guy and there are a LOT more poor people than rich guys).
So it doesn't matter who pays for what. At $620 a month for every man, woman, and child in the country, we pay too much.
the questions are then
1) are we being charged to much? Probably. stop advertising drugs and you wouldn't have to pay for their marketing budget.
2) Is tort reform a biggie? Not at all. It looks good because it makes lawyers into bad guys and lawyers have a very bad PR department so they are easy targets. But that is really small beans, sort of like CEO pay (which is funny since the people that tell you how small a real problem CEO pay is will tell you how big a problem tort reform is).
3) We consume to much healthcare. Yeah, we do. rationing or not, we pig out on medical crap. Part of it is because the guys who tell you to go get it are paid whenever you do, part of it we demand tests because we don't trust doctors (someone here thinks that with the Internet and an above average intelligence they should be able to prescribe drugs to themselves. That's how delusional some folks are about the relative smarts of Docs.) As the NPR story pointed out, you add more Docs to an area and the amount of medical procedures done per capita goes up to support the extra Docs. Not sure there is a solultion to this putside of the AMA doing some serious cleaning up of their own.
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Post by omaha on Nov 9, 2009 17:32:10 GMT -5
I think we need to bookmark this thread for the next time Sarah Palin says something silly about a social issue and all the liberals decry the government's attempts at "legislating morality".
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Post by bamfiles on Nov 9, 2009 18:05:18 GMT -5
I'll admit that my Marxist reading was done back in the early 60s but I remember him losing me with the academics being the best source for the government bureaucracy because of their understanding of the needs of the proletariat and the lack of knowledge within the proletariat. It all sounded like a perfect world except that I couldn't buy the lack of incentive. It looked like a plan to stabilize the status quo and perhaps improve the life of the poor but I didn't accept that everyone would be happy working for someone else's welfare with no hope of life getting better. I was of course raised with the old Puritan work ethic of old New England.
I'm not entirely sure the leaders in Moscow now are all embracing capitalism. I think some of them still want their old jobs back. Putin comes to mind. With the U.S. now seen as a weak exhausted power, I expect them to do some more Georgia on my mind things soon.
As to Russell's "Where does the money come from", didn't you watch Monty Python? They explained it perfectly.
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Post by millring on Nov 9, 2009 18:29:39 GMT -5
Just curious, John, why do you think that the US has the best health care in the world? Top 50 hospitals in the world:
1 University of Texas Medical Branch at Galveston
2 University of Michigan Health System
3 University of Kansas Medical Center
4 NYU Langone Medical Center New York, NY
5 University of Virginia Health System
6 Vanderbilt Medical Center 7 Chang Gung Memorial Hospital * 8 Johns Hopkins Medicine 9 Taipei Veterans General Hospital * 10 University of Rochester Medical Center
11 Texas Tech Health Sciences Center
12 Naval Health Clinic
13 University of Texas Southwestern Medical Center at Dallas 14 University Clinic Heidelberg Universittsklinikum Heidelberg 15 Columbia University Medical Center New York, NY 16 Institute of Medical Science University of Tokyo *
17 University of Nebraska Medical Center
18 University of Miami Hospital & Clinic
19 University of Kentucky Academic Medical Center 20 Health Care University of Connecticut Health Center John Dempsey Hospital
21 Wake Forest University Baptist Medical Center
22 M. D. Anderson Cancer Center 23 Buddhist Tzu Chi General Hospital 24 Medizinischen Hochschule Hannover 25 Cleveland Clinic Cleveland, Ohio
26 University of Arkansas Medical Center 27 Centre Hopistalier Universitaire de Rouen 28 University of Maryland Medical Center
29 University of Mississippi Medical Center
30 University California Davis Health System 31 Universitätsklinikum Gießen und Marburg * 32 University of New Mexico Health Sciences Center
33 Children's Hospital Boston 34 Centre Hospitalier Universitaire de Lyon Hopitaux de Lyon 35 Massachusetts General Hospital
36 George Washington University Medical Center
37 Loma Linda University Adventist Health Sciences Center 38 Faculty of Medicine Siriraj Hospital 39 The Institute of Cancer Research Royal Cancer Hospital 40 Hospital Authority 41 Centre Hospitalier Universitaire Vaudois Lausanne 42 Assistance Publique Hôpitaux de Paris 43 Universitätsklinikum Medizinische Fakultat der Martin Luther Universitat Halle Wittenberg 44 Asan Medical Center Seoul 45 Landstinget I Östergötland 46 China Medical University Hospital 47 University of Iowa Hospitals and Clinics 48 Universitätsklinikum und Medizinische Fakultät Tübingen * 49 University of Cincinnati Hospital 50 Brigham and Women's Hospital Nobel Prizes, Medicine (by country)  TOP FIFTY UNIVERSITIES--MEDICINE 1Harvard University
2University of California–San Francisco (UCSF)
3University of Washington
4Johns Hopkins University
5Columbia University
6University of California–Los Angeles (UCLA)
7University of Texas Southwestern Medical Center at Dallas
8University of Michigan–Ann Arbor9Karolinska Institute 10University of Pittsburgh11Stanford University 12University of Oxford 13Mayo Clinic College of Medicine13University College London 15University of Minnesota–Twin Cities16University of Cambridge
17University of North Carolina–Chapel Hill
18Yale University
19Vanderbilt University
20University of Wisconsin–Madison
21University of Texas MD Anderson Cancer Center
22University of Pennsylvania
23Duke University
24Tufts University
25University of California–San Diego (UCSD)26Imperial College London 27University of Toronto 28Emory University29University of Nottingham 30Cornell University
31University of Texas Health Science Center–Houston
32University of California–Berkeley
33Massachusetts Institute of Technology (MIT)33University of Zurich 35Boston University36Leiden University 37University of Munich 38Kyoto University 39Northwestern University
40McGill University
41Brown University
42University of Florida43King’s College London 44University of Chicago45University of Basel 46University of Milan 47University of Colorado Health Sciences Center48University of Tokyo 48University of Amsterdam 50University of Rochester |
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Post by Russell Letson on Nov 9, 2009 18:36:25 GMT -5
I think we need to bookmark this thread for the next time Sarah Palin says something silly about a social issue and all the liberals decry the government's attempts at "legislating morality." I'd admire to read your expansion of this idea, particularly if it involves an explanation of the role of government in maintaining the general welfare and the distinction, if any, between public and private realms |
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Post by omaha on Nov 9, 2009 18:40:13 GMT -5
And to piggyback on John's post, this is exactly what I was getting at here. I am concerned that in their zeal to construct an argument for reform, the would-be reformers have lost perspective and respect for the unparalleled human achievement that is the US medical system. |
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Post by omaha on Nov 9, 2009 18:43:48 GMT -5
I think we need to bookmark this thread for the next time Sarah Palin says something silly about a social issue and all the liberals decry the government's attempts at "legislating morality." I'd admire to read your expansion of this idea, particularly if it involves an explanation of the role of government in maintaining the general welfare and the distinction, if any, between public and private realms I'll leave a full expansion to another time where I have more energy, but for now I'll simply observe that the advocacy for absolute and enforced equality of distribution of health care in society that we have seen on this thread is every bit as much a call for "legislating morality" as is, for example, the call by the Palin's of the world for legal enshrinement of traditional marriage. |
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Post by Russell Letson on Nov 9, 2009 19:03:21 GMT -5
Never mind--I can see that the proposition you're imagining bears no resemblance to the actual debate.
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Post by omaha on Nov 9, 2009 19:10:40 GMT -5
Forgive the flagrant violation of forum protocol. I realize that thread drift on page four is highly irregular. I'll endeavor to wait until page five in the future.
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Post by Doug on Nov 9, 2009 19:26:34 GMT -5
Omaha
Russell Letson
Sure it does. How can legislating that people should pay for the needs of another not be "legislating morality"
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Post by Doug on Nov 9, 2009 19:36:50 GMT -5
On second thought it's not "legislating morality" it's "legislating immorality" it is immoral to take by force from one person to give to another.
Or at least it is by all the modern religions and ethical constructs that I can think of. I guess if your religion is Norse and plunder of others is moral in your religion it's ok.
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