Can someone explain the health care 'crisis' to me?

[tolbiny]

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Do you think it's the average mexicans fault that they are dirt poor? I'm talking about the mexicans who live in the country of mexico.



As a generilization, no its not their fault. Is it my fault?

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I'm suggesting that sometimes, as in the case of mexico and its elite ruling class and the rest being very poor, it's a systemic thing.

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Yes. And Tolbiny, among others, is constantly attacking that very system.

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I don't now about constantly attacking, frequently bitching about sounds more accurate.

[NapoleonDolemite]

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do you make minimum wage? if you did, you wouldn't have access to affordable health care, and, when you only make 7 or 8 bucks an hour, you can't afford to go to the doc...jeez, think beyond your own nose...

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Sounds like a great incentive to do a good job so you aren't stuck making minimum wage very long.

The minimum wage is a myth, its a fake number to make it look like politicians care about the lower financial rung people.

Where I live, even McDonalds starts you out higher than the min wage if you have any basic skills. The only people who would ever work for it are first job kids.

The minimum wage was not designed to raise a family of four on. To think large numbers of Americans do this, is to believe the soup line America portrait John Edwards likes to paint. It just aint so, and we dont have millions of people dying outside the hospital because they are being refused treatment for lack of insurance.

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You're right about refusal of treatment for lack of insurance. The problem isn't that people with no health insurance will be left on the street to die- the problem is that as someone who pays for health insurance, YOU foot the bill for those who can't pay for their own healthcare.

Hospitals overcharge the insurance companies to make up for the cost of providing the uninsured with care, the insurance companies overcharge their customers, and the costs continue to balloon even though no value is being added. Insurance companies push their profits higher by looking for ways to leave their customers with the bill. This whole situation is unworkable, and is very very bad for the consumer.

Even though I'm pretty much a libertarian, being that we don't actually have a free market system in this country at all, some sort of basic low cost health coverage should be available to everyone. If a self-employed person like myself could buy the same health insurance that all our government employees had, for example, I'd be satisfied.

[tolbiny]

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I'm suggesting that sometimes, as in the case of mexico and its elite ruling class and the rest being very poor, it's a systemic thing.


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I won't disagree that certain classes have been created by exploitation, that doesn't mean all classes are, and that doesn't make any system that pretends to alleviate that exploitation correct or reasonable.

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As far as you paying, well, that's like a less poor mexican peasant complaining that he has to pay for a dirt poor mexican peasant; while it's probably a very valid point in and of itself, it leaves out the main point of the elite ruling class and the systemic exploitation.

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Wealth redistribution doesn't end exploitation, it just switches it. I was originally going to say reverses it, but thats not accurate, because usually those who end up paying are not the ones who were exploiting in the first place. That burden is usually on to two groups,
1. People who currently produce a lot
2. Future generations.
The problem of systemic exploitation is not ended, it is renewed with new victims and new benefactors, and generally speaking it grows in size and scope.

[sandycove]

Nature of the crisis:

Cost of health care per capita is unreasonably high.

Patients, in the main, are not the real consumers -- their employers, and the insurance firms that serve them, are.

Public health, preventative medicine and community-based general practice are in decline as boutique specialists and high-end diagnostic and surgical procedures increase.

Pharmaceutical research is wholly profit-driven.

The health-care professional culture is increasingly entrepreneurial, rather than motivated by public service.

Solutions:

A two-tier, public/private system (with emphasis on the public part). Universal health care does not have to mean nothing but comprehensive "socialized" medicine.

A general acceptance at every level of government that basic health care is a fundamental right of all persons in the United States, including guests, and particularly the very young and the very old. More emphasis on public health information and cultural pressure to accept increased personal responsibility for one's health.

A re-dedication to health care screening for elementary school children, less emphasis on "parents' rights" on this issue, more emphasis on fundamental dental care and nutrition.

A move away from mandatory (emphasis here) direct, employer-based health-care benefits.

Stricter regulation of health-care insurance providers.

A shift back to community-based, first-echelon, first-stop medicine. All medical professionals must spent some early career time here. All medical education should be funded, in part, by the government, establishing a natural public/private partnership.

Government support for "orphan" drug research and a change in the basic model of the pharmaceutical sector to bring it more in line with public health demands.

If the society should ever opt for a two-year period of national service for all young men and women (as I have long believed it should), the entry phase should focus profoundly on individual health issues -- identify deficiencies early and fix 'em pronto. This is another opportunity for fresh medical/dental graduates.

[tolbiny]

How does this?

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A two-tier, public/private system (with emphasis on the public part). Universal health care does not have to mean nothing but comprehensive "socialized" medicine.


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solve this?

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Patients, in the main, are not the real consumers -- their employers, and the insurance firms that serve them, are.

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And BTW the US HAS in existence, right now a two tiered system. > 11% of the GNP is currently spent by the government on programs ranging from Social security to medicare. Those high prices you complained about in point #1 are a direct result of the government spending money in competition with its citizens. Since the government has no incentive to really try to keep costs down producers of health care find ways to provide the services that they can charge the most markup to the government.

[sandycove]

A. The two issues are not directly related, in a cause and effect manner.

B. I don't accept your premise.

Nor do I claim any professional expertise. Those are just some observations after some years on the health-care beat and as an employer and as an observer of the pharmaceutical and insurance sectors, and as an ex-pat in a country that offers (an inferior quality of) universal public health care, and a consumer of private health insurance for a family of four that costs the equivalent of some $6,000 a year, who will be grateful for Medicare eligibility soon.

At its most fundamental, I believe the nation, as a whole, has a responsibility to look after the health of its people, regardless of circumstance. I do not believe that access to the system is something a person in the U.S. should have to earn. You could even argue that the health of the nation is an investment in its human capital. It's a proper place for government, although I sympathize with your lack of trust that government will do the job well.

[ShakeZula06]

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A general acceptance at every level of government that basic health care is a fundamental right

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Where's this right come from? [img]/images/graemlins/confused.gif[/img]

[tolbiny]

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B. I don't accept your premise.

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You don't accept supply and demand?

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At its most fundamental, I believe the nation, as a whole, has a responsibility to look after the health of its people, regardless of circumstance

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So a hypothetical junkie who has multiple organ failure thanks to his poor choices needs a liver transplant which would cost $500,000 give him an extra 6 months to live before his kidneys fail (another 6 months at 500,000) should receive treatment. Even if you increased the cost to 5,000,000, or 15,000,000 and decreased his life expectancy to 6 weeks, or 6 days?

[Acein8ter]

See the movie Sicko by M. Moore, it should be coming out soon.

[Nonfiction]

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See the movie Sicko by M. Moore, it should be coming out soon.

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Yes lets all see Mr. Moore's genius plans to turn America socialist, sounds like a fair and balanced documentary exploring ideas from all angles.