Universal Health Care

[AlexM]

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Universal Health Care...Three little words that keep popping up. Sounds great... right? After all its free...right? Hey sign me up!
But the real story is that it is a bad idea. Bottom line Universal Health Care= higher taxes. But don`t take my word for it. Ask those who live with it, like the nation of Norway.
The goverment ( Norway ) is giving you free health care, or at least that is what they say. But that means you are paying for it with your tax dollars. Norwegians are some of the most heavily taxed people in the world. That makes Norway one of the most expensive countries in the world to live in.
In Norway a glass of cheap wine costs ( in U.S. dollars) 16 dollars, gas costs 9 dollars a gallon, and the tax on a new car doubles the price of that car.
Remember free health care is a bitter pill to swallow. Would you rather spend 20 dollars co-pay on a doctors visit or an extra 20 grand or more on a new car?
Its your choice.

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Nobody thinks its free. Guess what? Our Army, Navy, AF, Park Service, Schools, Fire Depts, FBI, etc., aren't free either. So until you start railing against "universal national defense" with equal passion, then your argument is selectively applied (i.e., hypocritical).

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This is like saying anyone who opposes Stalin or Hitler and doesn't oppose Lincoln or FDR with equal passion is hypocritical. Personally, I oppose all 4, but Hitler was definitely worse than FDR.

[Copernicus]

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Copernicus,

can you reconcile "The countries that provide socialized health care are evidence that it isn't true, since they are either extremely expensive, lower quality or both. " with observations in the thread that both the US health care system costs more and performs pooer than many socialized countries?

ie, stuff along the lines of "According to a 2000 study of the World Health Organization, publicly funded systems of industrial nations spend less on health care, both as a percentage of their GDP and per capita, and enjoy superior population-based health care outcomes"

Which is backed up through data. Im curious if you are able to cite your comment.

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Outcomes studies, while useful for examining various approaches to different diseases, are not so succesful at comparing "quality" of health care in different societies. Why? Because outcome studies are broad statistics that bury important factors such as the health of the patient before seeking medical care, special risk factors that patients might be subject to etc. They also, out of necessity, dont reflect those who never get the treatment they need.

A good example is "infant mortality", the ultimate "outcome" study. Infant mortality is higher in the US than many industrialized nations. Why? Because the profile of the population giving birth in the US has much higher incidence of risk factors...younger women, older women, and welfare mothers.

There are two major indicators that belie the statistics quoted, one objective, one subjctive. First, there is life expectancy from 5 years old. Even without excluding"unnatural deaths" (eg accident and murder), the US is one of the leaders.

The second is to look at what health care systems attract patients from outside their own systems. Take a look at the license plates around Cleveland hospitals and clinics. A huge number of them are Canadian, because the waiting time, even for "emergency care" in Canada is unconscionable. My son billeted with a Canadian family where the father was out of work and on disability for 2 years waiting for knee surgery. If he could have afforded to come to the US he would have, and his situation was not atypical. The cost of his disability benefits is not reflected in health care costs, and his outcome statistic doesnt reflect the 2 years of pain and immobility he suffered through waiting for "free health care". Where do the world's wealthy go for their critical care? Hint: they dont go to Norway or Cuba.

You are right about one thing re Canada...a good portion of their health care cost is actually subsidized by the US. Their governmental caps on prescription drugs result in higher prices here. Pharmaceutical companies are going to spend their R&D dollars as long as SOMEBODY pays for it through succesful drugs. That inflates a portion of the US cost statistics.

Health care is also a global market, though not to the extent of other goods and services. Watch where the mobile buyers go..more often that not its the US.


Cliff notes: be careful with broad based statistics that obfuscate differentiating factors in the underlying population.

[Copernicus]

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Some economists think that it's because employer-provided medical care is subsidized, meaning that there's a disconnect between who pays and the treatment received. Perhaps if patients could purchase out of mental "disposal income", rather than indulge in health care through a debit from their payroll check, they would make better choices about efficient treatment.


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This is downright silly if you try to use it as a justification for (incorrect) conclusions that health care is worse in the US than in the socialized countries.

The biggest disconnect between the buyer and the payment is in the socialzed countries. The majority of health care users in those countries dont have a clue what percentage of their tax dollars is going toward their health care. The majority of American workers have a VERY GOOD idea of the cost of health insurance because they have a menu of options to elect and see the varying costs.

[CallMeIshmael]

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They also, out of necessity, dont reflect those who never get the treatment they need.

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when patients dont get treatment they *need*, that would certainly be reflected in higher mortality rates.

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Infant mortality is higher in the US than many industrialized nations. Why? Because the profile of the population giving birth in the US has much higher incidence of risk factors...younger women, older women, and welfare mothers.

There are two major indicators that belie the statistics quoted, one objective, one subjctive. First, there is life expectancy from 5 years old. Even without excluding"unnatural deaths" (eg accident and murder), the US is one of the leaders.

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can you cite these two? I dont necessarily believe either is false, Id just like to do the reading.


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the waiting time, even for "emergency care" in Canada is unconscionable. My son billeted with a Canadian family where the father was out of work and on disability for 2 years waiting for knee surgery. If he could have afforded to come to the US he would have, and his situation was not atypical.

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As someone who lives in Canada, neither I, nor my immediate family, nor any of my extended family, nor any of my friends, have ever had to wait for non-trivial medicine. Im defintely not saying wait times arent a problem. But if we are using anecdotal evidence to back claims for what is "not atypical", im going to have to side with myself.

Beyond that, you said it yourself: he was unable able to afford the medical care he needed in the US. So, if he was unable to get the surgery, I dont understand how waiting two years was not preferable to what have happened to him under non-socialized medicine.


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be careful with broad based statistics that obfuscate differentiating factors in the underlying population.

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I think you are making a very similar mistake in your post. Specifically, commenting that people come to the US (ie. the Canadians in Cleveland) for health care. Keep in mind that it is likely that any Canadian who travels to the US for medical care is going to be paying a good deal of money. And, people who pay a good deal of money for something tend to have a good deal of money. I dont think anyone would argue against a claim that the wealthiest 10% of the population (for example) receives the best possible health care in the US. But, I dont necessarily think that is the issue at hand. Nor do I believe its great a representing the "underlying population"


And, again, I say all of the above despite my view that the US going to UHC would be bad (especially for me!)

[Borodog]

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Until you can understand that these sorts of comparisons between things that are not otherwise equal are worse than meaningless, they are outright intentionally deceptive

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However, isn't it useful to try to develop aggregate comparisons that are meaningful? In other words, if you can account for differences in the population to come up with apples-to-apples health care aggregate expenditure costs wouldn't that be useful information? Particularly when one is trying to debunk "ends justifies the means" arguments. If you can show that the "ends" aren't even better, then you don't even have to argue that the means are evil.

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I've already said in the thread that correctly done studies can be useful for illustrating economic theory. But they are very hard to do, take an immense quantity of data, have to be extremely carefully analysed, and even then cannot actually trump theory.

[Copernicus]

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They also, out of necessity, dont reflect those who never get the treatment they need.

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when patients dont get treatment they *need*, that would certainly be reflected in higher mortality rates. <font color="red"> not all medical problems (in fact the majority of them) are not fatal, but affect the quality of life. there is no such "certainty" of reflection in mortality rates </font>

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Infant mortality is higher in the US than many industrialized nations. Why? Because the profile of the population giving birth in the US has much higher incidence of risk factors...younger women, older women, and welfare mothers.

There are two major indicators that belie the statistics quoted, one objective, one subjctive. First, there is life expectancy from 5 years old. Even without excluding"unnatural deaths" (eg accident and murder), the US is one of the leaders.

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can you cite these two? I dont necessarily believe either is false, Id just like to do the reading. <font color="red">One source would be the International Actuarial Association's mortalty and morbidity studies. Not sure if they are available online. The others I have used are from international benefits consulting firms Ive worked for and others may be fruitful. Try "International health" and "wyatt", "towers perrin", and "hewitt". You may find them in one of those. </font>


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the waiting time, even for "emergency care" in Canada is unconscionable. My son billeted with a Canadian family where the father was out of work and on disability for 2 years waiting for knee surgery. If he could have afforded to come to the US he would have, and his situation was not atypical.

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As someone who lives in Canada, neither I, nor my immediate family, nor any of my extended family, nor any of my friends, have ever had to wait for non-trivial medicine. Im defintely not saying wait times arent a problem. But if we are using anecdotal evidence to back claims for what is "not atypical", im going to have to side with myself. <font color="red">i'm sure you know more Canadians than I do, but between Junior Hockey and my business partner, who is a Canadian ex-pat, there isnt a single acquaintence of mine who thinks Canadian medicine is superior to the US. </font>

Beyond that, you said it yourself: he was unable able to afford the medical care he needed in the US. So, if he was unable to get the surgery, I dont understand how waiting two years was not preferable to what have happened to him under non-socialized medicine. <font color="red">wow. Youve missed a lot here. First, what he couldnt afford was the travel to the US for him and his wife, the stay during his surgery, and basically relocating for the necessary rehab. followup. Second, under "non-socialized medicine" in the US he would have had access to affordable medical insurance, and if he didnt opt for it thats his fault not the systems. The rhetoric about "40 million uninsured" in the US is absolute hogwash. search for natedogg's health care posts. he destroyed that one.</font>


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be careful with broad based statistics that obfuscate differentiating factors in the underlying population.

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I think you are making a very similar mistake in your post. Specifically, commenting that people come to the US (ie. the Canadians in Cleveland) for health care. Keep in mind that it is likely that any Canadian who travels to the US for medical care is going to be paying a good deal of money. And, people who pay a good deal of money for something tend to have a good deal of money. I dont think anyone would argue against a claim that the wealthiest 10% of the population (for example) receives the best possible health care in the US. But, I dont necessarily think that is the issue at hand. Nor do I believe its great a representing the "underlying population" <font color="red"> actually, it is very representative of the underlying population. Can you spend more and get better care? Obviously "surgeons to the wealthy" got there by providing something of perceived value for their money. Whether or not that was a better outcome or just a nicer room is open to debate. What isnt open to debate is that the standards of care in the US are relatively uniform. Educational and experience requirements are diligently adhered to by US hospitals, whether they cater to the elite, or are an inner city clinic. The less competent very quickly find themselves unable to get malpractice insurance, even if they manage to keep their licenses.</font>


And, again, I say all of the above despite my view that the US going to UHC would be bad (especially for me!)

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[pokerbobo]

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Except that defense is more efficient when supplied on a "universal national" basis. Nobody has demonstrated that it is true for health care. The countries that provide socialized health care are evidence that it isn't true, since they are either extremely expensive, lower quality or both.

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It has been shown that the perceived supremacy and lower cost of our health care system compared to the world is a myth. Google it yourself (or see below). Americans pay more per capita on health care compared to any other western nation. Yes, we pay a lot more -- to say that the rest of the world is more expensive is a lie ! Stop repeating how efficient our system is when the data suggests it isn't. When you pay more than twice as much per capita as the rest of the world, and still have 43 million w/o coverage compared to 100% coverage elsewhere, you are by any definition of the word, more INEFFICIENT than the rest of the world. It is that simple. You are regurgitating talking points which have no basis in facts -- please show some supporting data to say the rest of the world is more expensive, more inefficient, and worse service, if you can.



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You are quoting a lie yourself.... this number is arrived at by counting every person who spends one day without health insurance...i.e. changing jobs, being unemployed for a week or two....(also add spouses and dependents). There are also many people who choose not to be insured... one of the more famous that I know of is Rush Limbaugh. There are also companies out there which offer X amount of dollars for insurance...employees can choose a plan and use that money, or opt out and take it as income.

Bottom Line... right now in America, there are nowhere near 40 plus million uninsured. And faced with an emergency, there is 100% coverage in the US.

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Fine. 43 million without coverage at one time or another during the year. (You know you could still get hurt or sick while you're between jobs, even for a week or two, right?)


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And you know if you do, you can pay the doctor cash, right?

[CallMeIshmael]

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not all medical problems (in fact the majority of them) are not fatal, but affect the quality of life. there is no such "certainty" of reflection in mortality rates

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well, then there is considerable debate as to whether or not they are needs. Beyond that, I would imagine that if the methodology of these studies overlooks people who were unable to get a surgery, they likely also overlook people whose insurance policy didnt cover a surgery. How these two groups compare, I cannot say.


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wow. Youve missed a lot here

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only if I were to assume that

1) he would have insurance if he lived in the US
2) his insurance would cover part/all of the surgery
3) he could afford to pay whatever costs insurance didnt cover

I only "missed something" if I dont make all 3 of those assumptions.

Whether or not that set of assumptions is good or bade to make isnt something about which Im certain.


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actually, it is very representative of the underlying population. Can you spend more and get better care? Obviously "surgeons to the wealthy" got there by providing something of perceived value for their money. Whether or not that was a better outcome or just a nicer room is open to debate. What isnt open to debate is that the standards of care in the US are relatively uniform. Educational and experience requirements are diligently adhered to by US hospitals, whether they cater to the elite, or are an inner city clinic. The less competent very quickly find themselves unable to get malpractice insurance, even if they manage to keep their licenses.

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Well, its certainly not representative of the population that doesnt have insurance, or for whom certain treatments are not covered by insurance.

Beyond that, other people in the thread seemed to believe that the high cost of US heath care could be party explained by large amounts payed for great care, by the top of the population.

Evidently you disagree.


Why then, is the US so far above others in cost, while still lagging behind. Or, do you believe the US does, in fact, provide the best health care in the world, and any study that claims otherwise is false?

[adios]

Difficult issue to resolve IMO. Giving the government power to make decisions on people's health including who lives and who dies is ceding a lot of power to government. On the other hand, it's bad when people get screwed on their pensions and such that also include health care. Emergency rooms are a joke from what I've experienced though so that should give us a little bit of insight as to what government controlled health care would be like.

[Copernicus]

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Except that defense is more efficient when supplied on a "universal national" basis. Nobody has demonstrated that it is true for health care. The countries that provide socialized health care are evidence that it isn't true, since they are either extremely expensive, lower quality or both.

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It has been shown that the perceived supremacy and lower cost of our health care system compared to the world is a myth. Google it yourself (or see below). Americans pay more per capita on health care compared to any other western nation. Yes, we pay a lot more -- to say that the rest of the world is more expensive is a lie ! Stop repeating how efficient our system is when the data suggests it isn't. When you pay more than twice as much per capita as the rest of the world, and still have 43 million w/o coverage compared to 100% coverage elsewhere, you are by any definition of the word, more INEFFICIENT than the rest of the world. It is that simple. You are regurgitating talking points which have no basis in facts -- please show some supporting data to say the rest of the world is more expensive, more inefficient, and worse service, if you can.



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You are quoting a lie yourself.... this number is arrived at by counting every person who spends one day without health insurance...i.e. changing jobs, being unemployed for a week or two....(also add spouses and dependents). There are also many people who choose not to be insured... one of the more famous that I know of is Rush Limbaugh. There are also companies out there which offer X amount of dollars for insurance...employees can choose a plan and use that money, or opt out and take it as income.

Bottom Line... right now in America, there are nowhere near 40 plus million uninsured. And faced with an emergency, there is 100% coverage in the US.

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Fine. 43 million without coverage at one time or another during the year. (You know you could still get hurt or sick while you're between jobs, even for a week or two, right?)


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And you know if you do, you can pay the doctor cash, right?

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and you do know that there are alternatives to fill the gap between jobs, even if it means a personal policy?