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Health Care in the U.S.

24

Posts

  • Johnny NopantsJohnny Nopants Registered User
    edited May 2007
    Nova_C wrote: »
    You can't be serious. Socialized medicine is like any other government program. Do you also believe that cancer research should only be supported by those who have cancer?
    No, it should only be supported by people who wish to support it. If you want your tax dollars to go to it, more power to you. Some government programs I agree with and willingly pay for, some I do not, and my tax dollars are taken from me.
    You would only give someone medical treatment if they need it. You don't give someone a chemotherapy course just for kicks.
    I have no problem with that. I just think I should not be forced to pay for it.

  • ShintoShinto __BANNED USERS
    edited May 2007
    Irond Will wrote: »
    Shinto wrote: »
    By the way - God damn Hillary Clinton is incredibly impressive on this issue. I am blown away and will now probably vote for her in the primary.
    She's actually incredibly impressive on pretty much all nuts-and-bolts issues.

    I'm swooning Will.

    Swooning.

    Madam President! Madam President!

  • FeralFeral Who needs a medical license when you've got style? Registered User regular
    edited May 2007
    Shinto wrote: »
    God damn Hillary Clinton is incredibly impressive on this issue.

    Well, you can't beat real-world experience.
    I just hope they don't bring back the old "Hillarycare" cudgel.
    ElJeffe wrote:
    Right. Devices that, say, can find cancer much earlier, or can determine if the kid in your belly is likely to kill you on the way out.

    Or anti-seizure implants or drug-eluting arterial stents or artificial limbs...

    yep, it's a concern.

    The problem is that a lot of people think about R&D when talking about prescription drug coverage. That's the wrong time to be thinking about it because fucking with prescription drug costs isn't going to run us up a creek on pharma R&D. We'll still get good drugs, no matter what.

    As for non-commodity patient devices (like limbs and stents) I wouldn't be broken-hearted if as a general rule a single-payer system didn't cover those. If the difference between being rich or poor in a car crash spells out to getting your leg amputated and an robotic prosthetic versus getting your leg amputated and a free wheelchair, I'm not too concerned about that.

    For the most part, that leaves diagnostics. And I'll be honest. I don't totally grok the economics of diagnostic devices, which are basically infrastructure costs - a hospital buys a single MRI and then charges patients X amount hoping that X dollars per patient times Y patients per year times Z lifespan of MRI = profit. I don't know how different plans would affect the number of dollars going back into diagnostics R&D. Likewise I would imagine that similar economic principles cover surgical technology, like robot-assisted surgery and laparoscopy as such.

    every person who doesn't like an acquired taste always seems to think everyone who likes it is faking it. it should be an official fallacy.
    the "no true scotch, man" fallacy.
  • AngelHedgieAngelHedgie Registered User regular
    edited May 2007
    ElJeffe wrote: »
    Thanatos wrote: »
    ElJeffe wrote: »
    I would also, of course, tackle many of the problems deeply ingrained within the health care system, such as skyrocketing medical malpractice insurance costs, and the ridiculous amount of overeducation that's required for someone to even qualify to look in your ear and say, "You have an infection." Chances are, if you had to go to school for 8 years to tell me what I already knew from spending 10 minutes on WebMD, you spent too much time in school.
    How much have medical malpractice insurance costs gone up, on average? What percentage of a doctor's expenses does it comprise?

    Here's an article about it. Short answer: a lot.
    The thing, however, is that it's not like malpractice insurance is the only type of insurance that's seen this rise in the past few years. Insurance across the board has seen raised rates and a much lower tolerance for "high risk" clients (a.k.a. people who actually USE their policies) - it has become common to see people lose their policies for daring to use them, which in turn has caused them to lose their houses (most mortgages require that the homeowner must have homeowner's insurance). The ultimate culmination has been the bullshit with State Farm after Katrina, where the state insurance commissions had to force State Farm to honor their policies. The reason for this is due to insurers overextended on policies thanks to them investing in the tech bubble, which then popped.

    Also, I don't have much sympathy for the doctors either - they have continually refused to take a hardline stance on malpractice, which would make the actuarial tables that the insurance industry uses now untenable, which would force rates down.

    XBL: Nox Aeternum / PSN: NoxAeternum / NN:NoxAeternum
    Spoiler:
  • Phoenix-DPhoenix-D Registered User regular
    edited May 2007
    Nova_C wrote: »
    You can't be serious. Socialized medicine is like any other government program. Do you also believe that cancer research should only be supported by those who have cancer?
    No, it should only be supported by people who wish to support it. If you want your tax dollars to go to it, more power to you. Some government programs I agree with and willingly pay for, some I do not, and my tax dollars are taken from me.
    You would only give someone medical treatment if they need it. You don't give someone a chemotherapy course just for kicks.
    I have no problem with that. I just think I should not be forced to pay for it.

    This is called "democracy". Sometimes it makes decisions you don't agree with. Deal, or lobby to change it.

    I'd say more on that aspect but I must respect the LARGE MOD TEXT.

    Anyway, to apply this directly to health care: If the only people who pay for health care are those who need it Right Now, it ends up with a LARGE number of people dying because there is NO way any but the most rich can afford critical medical care on an out-of-pocket basis.

    You'll excuse me if I don't find that an acceptable result of a few people feeling they've been freed from "slavery".

    And guess what? You benefit from the medical system even if you don't use it, so what you're really trying to do is put the cost on everyone ELSE. How much money are you saving because you didn't get infected and didn't have to get treated? How much more would you have to pay for basic services if half the people that provided them were dead or too sick to work?

  • CreepyCreepy Tucson, AzRegistered User regular
    edited May 2007
    Edited out for modliness. =)

    Phoenix said it better anyways.

    Live: Broichan

    PSN: Broichan
  • WalrusWalrus Registered User
    edited May 2007
    Nova_C wrote: »
    You can't be serious. Socialized medicine is like any other government program. Do you also believe that cancer research should only be supported by those who have cancer?
    No, it should only be supported by people who wish to support it. If you want your tax dollars to go to it, more power to you. Some government programs I agree with and willingly pay for, some I do not, and my tax dollars are taken from me.
    You would only give someone medical treatment if they need it. You don't give someone a chemotherapy course just for kicks.
    I have no problem with that. I just think I should not be forced to pay for it.

    Ok, but would you be willing to contribute to a healthcare fund of some kind that was solely for your own benefit? The problem with allocating healthcare in financial terms is that healthcare is not a luxury for those who require it, and no-one else has any need for it. It is a rare and specialised 'good' but one whose only criteria of allocation is by need not by means. Everyone might contribute to health insurance or however it works, but not everyone who contributes will need to use the service - in that case, what is the problem in letting someone who does need to use the service, use it at a cost to the other contributors?

  • ThanatosThanatos Registered User regular
    edited May 2007
    Listen, guys, the libertarian's point of view makes a lot more sense if we just assume there are no societal costs to not having healthcare. I mean, really, it's not like there are a million people declaring bankruptcy every year due to health care costs, right? And it's not like that would drive up interest and fees on all sorts of credit any of us might get, not to mention what we have to pay for health care, right?

    It's just a matter of ignoring negative externalities, and everything works out to be a Libertarian Utopia.

  • FeralFeral Who needs a medical license when you've got style? Registered User regular
    edited May 2007
    Walrus wrote: »
    The problem with allocating healthcare in financial terms is that healthcare is not a luxury for those who require it, and no-one else has any need for it. It is a rare and specialised 'good' but one whose only criteria of allocation is by need not by means.

    I disagree with this.
    Everybody needs health care. Some people just don't realize it yet.
    Thanatos wrote:
    Listen, guys, the libertarian's point of view makes a lot more sense if we just assume there are no societal costs to not having healthcare. I mean, really, it's not like there are a million people declaring bankruptcy every year due to health care costs, right? And it's not like that would drive up interest and fees on all sorts of credit any of us might get, not to mention what we have to pay for health care, right?

    Exactly. And just to add fuel to this fire, it's not like uninsured people don't rack up thousands of dollars of bills at emergency rooms when they get hurt (or die). And it's not like the hospitals need to recoup that money from somebody. And it's not like the hospitals wouldn't just close their emergency departments if the government didn't already bail them out.

    And it's not like illness doesn't cost the economy billions of dollars in lost productivity already anyway.

    Double edit: Diversifying risk across a large group of people reduces costs for everybody, and the largest possible diversification of risk can be found by covering the entire United States citizenry. The more people contribute, the more anybody benefits. Shit, it's a community action problem, isn't it? That's like, libertarian kryptonite.

    every person who doesn't like an acquired taste always seems to think everyone who likes it is faking it. it should be an official fallacy.
    the "no true scotch, man" fallacy.
  • ThanatosThanatos Registered User regular
    edited May 2007
    Feral wrote: »
    Thanatos wrote:
    Listen, guys, the libertarian's point of view makes a lot more sense if we just assume there are no societal costs to not having healthcare. I mean, really, it's not like there are a million people declaring bankruptcy every year due to health care costs, right? And it's not like that would drive up interest and fees on all sorts of credit any of us might get, not to mention what we have to pay for health care, right?
    Exactly. And just to add fuel to this fire, it's not like uninsured people don't rack up thousands of dollars of bills at emergency rooms when they get hurt (or die). And it's not like the hospitals need to recoup that money from somebody. And it's not like the hospitals wouldn't just close their emergency departments if the government didn't already bail them out.

    And it's not like illness doesn't cost the economy billions of dollars in lost productivity already anyway.
    And of course, it's not like poor people aren't racking up $10,000 emergency room bills on gangrene that could have been solved by $50 worth of antibiotics, if they could get preventative care.

    I also think it's ironic that the same people who are against abortion have no problem denying women pre-natal care because they can't afford it. Oh, wait, that's not ironic, it's just fucking retarded.

  • ElJeffeElJeffe Super Moderator, Moderator, ClubPA mod
    edited May 2007
    Feral wrote: »
    I disagree with this.
    Everybody needs health care. Some people just don't realize it yet.

    I would amend this to read:

    Everyone, at some point in their life, will almost definitely need health care.

    The way that reads, and the way many people talk about it, not having health care will cause a perfectly healthy person to drop dead in their tracks, because health care is just as fundamental to survival as oxygen.

    Not everyone needs health care at all points in their lives.

    Maddie: "I named my feet. The left one is flip and the right one is flop. Oh, and also I named my flip-flops."

    I make tweet.
  • ElJeffeElJeffe Super Moderator, Moderator, ClubPA mod
    edited May 2007
    Thanatos wrote: »
    I also think it's ironic that the same people who are against abortion have no problem denying women pre-natal care because they can't afford it. Oh, wait, that's not ironic, it's just fucking retarded.

    If you start a fucking abortion debate in here, I will cut you.

    Maddie: "I named my feet. The left one is flip and the right one is flop. Oh, and also I named my flip-flops."

    I make tweet.
  • WalrusWalrus Registered User
    edited May 2007
    Feral wrote: »
    Walrus wrote: »
    The problem with allocating healthcare in financial terms is that healthcare is not a luxury for those who require it, and no-one else has any need for it. It is a rare and specialised 'good' but one whose only criteria of allocation is by need not by means.

    I disagree with this.
    Everybody needs health care. Some people just don't realize it yet.

    I might disagree with you, but even in that case there is a massive disparity between the most and least needy.

  • FeralFeral Who needs a medical license when you've got style? Registered User regular
    edited May 2007
    ElJeffe wrote: »
    Feral wrote: »
    I disagree with this.
    Everybody needs health care. Some people just don't realize it yet.

    I would amend this to read:

    Everyone, at some point in their life, will almost definitely need health care.

    The way that reads, and the way many people talk about it, not having health care will cause a perfectly healthy person to drop dead in their tracks, because health care is just as fundamental to survival as oxygen.

    Not everyone needs health care at all points in their lives.

    The reason I phrase it the way I do is that early detection and prevention can prevent literally thousands of dollars of expenses later on (as Thanatos pointed out above). Everybody should see a doctor at least once every couple of years, preferably with blood work, regardless of age or general health. It's true that most people will walk out with a clean bill of health and a general recommendation to eat better and exercise more; but the small minority who detect abnormal glucose levels or a testicular lump before it becomes diabetes or cancer respectively will save enough money in the long run to pay for 10 or 100 of all the other guys' checkups.
    Walrus wrote: »
    I might disagree with you, but even in that case there is a massive disparity between the most and least needy.

    Sure. I'm totally with you on this.

    every person who doesn't like an acquired taste always seems to think everyone who likes it is faking it. it should be an official fallacy.
    the "no true scotch, man" fallacy.
  • ElJeffeElJeffe Super Moderator, Moderator, ClubPA mod
    edited May 2007
    You know, Feral, about 90% of the issues you just brought up could be addressed by government-funded annual physicals that would be a lot cheaper than full-on health coverage.

    Maddie: "I named my feet. The left one is flip and the right one is flop. Oh, and also I named my flip-flops."

    I make tweet.
  • ShintoShinto __BANNED USERS
    edited May 2007
    Alright, I rewatched the Obama speech because it was only about 20 minutes and took notes. I think this is basically right. There were a couple of points where the interpretation of his phrase would make a difference, so this may not be 100% accurate, but it is the impression I got.

    His goals are to cover everyone and bring down the average family premium by $2,500. He reckons the cost at an increased tax on businesses except for small businesses, and not renewing the Bush tax cut. It should be noted that he would also seem to think that the lowered resulting costs of private healthcare will offset the business tax to some degree in terms of the burden on businesses.

    1. Cover every American - A government healthcare plan similar to the one federal employees now have will be made available to every American. No one, no matter their current health, will be refused. If someone cannot pay the cost of this insurance, a subsidy will be provided allowing them to purchase it. If they are disatisfied with the level of choice under this plan, the subsidy can be applied toward a private plan.

    2. Reduce costs

    A) Government picks up part of the tab for the most expensive illnesses and conditions, alleviating private insurance providers of the burden of their most costly customers.

    B) Require insurance companies to cover preventative care. I gather that he also has other thoughts on prevention that aren't quite ready for prime time that he plans to flesh out later in the campaign.

    C) Create uniform metrics for medical performance and require hospitals and other care providers to publically report them. The goal is for individuals to be able to see a facility's record on preventable errors, hospital aquired infections and nurse/patient ratios etc. and so subject service providers more fully to the discipline of the market.

    D) Reduce administrative efficiency by computerizing medical records and transactions.

    E) Make generic drugs more available and more strongly investigate monopolistic practices in the healthcare industry and increase competition. Monopolies either forced to split or fined a share of their profits which are then applied toward lower patient costs.

    I left out a lot of the argumentation on these points, because to add it in would basically be to recreate a transcript of the speech.

  • LondonBridgeLondonBridge __BANNED USERS
    edited May 2007
    Yar wrote: »

    I call it inevitable.


    Maybe, but how soon? If a Republican wins the White House then we won't see it. I don't think the Dems have enough seats in the Senate to pass it either.

    I'm against Socialized Healthcare but I don't think the pharmaceuticals and the Insurance companies are helping. I cannot visit a doctor's office without seeing at least one or two Pharm reps with their big sample bags there.

  • WalrusWalrus Registered User
    edited May 2007
    Just don't use the NHS as a model.

  • ShintoShinto __BANNED USERS
    edited May 2007
    Yar wrote: »

    I call it inevitable.


    Maybe, but how soon? If a Republican wins the White House then we won't see it. I don't think the Dems have enough seats in the Senate to pass it either.

    I'm against Socialized Healthcare but I don't think the pharmaceuticals and the Insurance companies are helping. I cannot visit a doctor's office without seeing at least one or two Pharm reps with their big sample bags there.

    Depends on the Republican. Mitt Romney helped create Massachusetts' new state healthcare program.

    I notice that even though he isn't doing much in the polls nationally he is actually first place in both Iowa and New Hampshire.

    Plus, you know, the Democrats are going to win the White House.

  • FeralFeral Who needs a medical license when you've got style? Registered User regular
    edited May 2007
    ElJeffe wrote: »
    You know, Feral, about 90% of the issues you just brought up could be addressed by government-funded annual physicals that would be a lot cheaper than full-on health coverage.

    Sure, there are strengths and weaknesses to that approach. I'd be open to discussing it.

    I was just defending my phrasing that "everybody needs health care." If you want to argue that a large majority of people only need the most minimal health care necessary, and that the government could be in the business of providing only this minimal care, I see that as a defensible position and I respect that (even though I don't necessarily agree.) I do see that as a different statement than "some people just don't need health care."

    Edit: It might be hairsplitting, but this is a furball of an issue.
    Shinto wrote:
    D) Reduce administrative efficiency by computerizing medical records and transactions.

    E) Make generic drugs more available and more strongly investigate monopolistic practices in the healthcare industry and increase competition.

    These points make me a very happy panda. Partly because they can be implemented, and would be beneficial, without any significant further overhaul. They would be half-measures, but they'd be better than no-measures.

    every person who doesn't like an acquired taste always seems to think everyone who likes it is faking it. it should be an official fallacy.
    the "no true scotch, man" fallacy.
  • ShintoShinto __BANNED USERS
    edited May 2007
    Yeah.

    The medical records thing - a Rand study says it would save 77 billion dollars a year. This is the reform that Hillary and Newt Gingrich famously colaborated in promoting.

  • ElJeffeElJeffe Super Moderator, Moderator, ClubPA mod
    edited May 2007
    Shinto wrote: »
    D) Reduce administrative efficiency by computerizing medical records and transactions.

    I lol'd.

    Taken from the POV that some sort of heavy government involvement is a given, I don't hate this plan. I'm not sure I like it, though, because there's a lot of hoping involved.

    For one thing, we're talking about a substantial tax increase, which is cool if it really does lower average health care expenditures by $2500/yr. However, I'm skeptical that would be the case.

    I can see C) as creating a lot of extra bureaucracy in hospitals, thus increasing health care costs, without resulting in a meaningful grading of hospitals that is useful to consumers. I'm imagining the problems with standardized testing in schools. "Okay, last month we had a lot of errors with Procedure X. We need to address this. From now on, we need a 25% decrease in the number of times Procedure X is performed."

    E) makes me uneasy. How are we going to make generic drugs more accessible without hamstringing the pharmaceutical companies who do all the legwork to bring drugs to market? Because I'm reading this as "Fuck you, and fuck your patents."

    There are some good ideas lurking about in there, though. Kinda like there were some good ideas lurking in the massive abortion of a Medicare bill we passed a few years back.

    Maddie: "I named my feet. The left one is flip and the right one is flop. Oh, and also I named my flip-flops."

    I make tweet.
  • ShintoShinto __BANNED USERS
    edited May 2007
    ElJeffe wrote: »
    Shinto wrote: »
    D) Reduce administrative efficiency by computerizing medical records and transactions.

    I lol'd.

    Seriously - why does power point never work right when you need it for a presentation!?! :P

  • ElJeffeElJeffe Super Moderator, Moderator, ClubPA mod
    edited May 2007
    Feral wrote: »
    If you want to argue that a large majority of people only need the most minimal health care necessary, and that the government could be in the business of providing only this minimal care, I see that as a defensible position and I respect that (even though I don't necessarily agree.)

    This is more or less my position, and the direction I would like to see the government move in. It won't happen, though, for reasons I previously mentioned.

    Maddie: "I named my feet. The left one is flip and the right one is flop. Oh, and also I named my flip-flops."

    I make tweet.
  • ShintoShinto __BANNED USERS
    edited May 2007
    ElJeffe wrote: »
    E) makes me uneasy. How are we going to make generic drugs more accessible without hamstringing the pharmaceutical companies who do all the legwork to bring drugs to market? Because I'm reading this as "Fuck you, and fuck your patents."

    I couldn't tell you what his favored modus operadi is on this because he didn't dive into the details of it.

    What he did complain about as he was making this point was companies that spend more money on advertizing to patients and marketing to doctors than on research and then turn around a buy out manufacturers of competing generic drugs so that only their expensive newer version will be widely available.

    So I'm not sure exactly how he plans to take it on, but it seems that the marketing and the buying out would be the targets he'd like his plan to reduce.

  • FeralFeral Who needs a medical license when you've got style? Registered User regular
    edited May 2007
    ElJeffe wrote: »
    I can see C) as creating a lot of extra bureaucracy in hospitals, thus increasing health care costs, without resulting in a meaningful grading of hospitals that is useful to consumers. I'm imagining the problems with standardized testing in schools. "Okay, last month we had a lot of errors with Procedure X. We need to address this. From now on, we need a 25% decrease in the number of times Procedure X is performed."

    Yeah.

    I'm not even sure there would be accurate reporting. Medical practitioners are masters of CYA; you'd either have to have somebody external to the system providing direct ground-level observation - and by this I mean a state-appointed lawyer or social worker on location literally examining patient records one by one for inconsistencies; or you'd have to have a cultural sea change in the way medical professionals view errors. But that's a chicken-and-egg problem - medical providers have trepidation about revealing errors because if they do they get fucked in the ass by malpractice suits so they feel like they have to be superhuman; but it's going to be hard to institute significant reform without getting providers to be more open about the errors that they make.

    In terms of malpractice reform, I'd like to see malpractice complains go in front of a governmental review board first. In socialized systems and most HMOs, this is already how it works - you don't have the legal right to a lawsuit until the review board or arbitrator tells you to piss off. This has the side effect of preventing even failed complaints from going to trial and saving money overall.
    ElJeffe wrote: »
    E) makes me uneasy. How are we going to make generic drugs more accessible without hamstringing the pharmaceutical companies who do all the legwork to bring drugs to market? Because I'm reading this as "Fuck you, and fuck your patents."

    Well, one of the major problems right now is that many brand-name drugs are being prescribed when generic drugs would have worked just as well. (Or the generic would have worked a little worse, but not worse enough to justify $200 difference to an insurance company for the brand name.) This is mostly because we have an entire pharma marketing industry devoted to getting physicians to prescribe brand-names but nearly nobody pushing generics in the same way.

    In a single-payer system, I would have no problem with a blanket policy that only generics and certain on-formulary unsubstitutable brand-names are covered (or off-formulary brand names are covered at a significantly higher copay) until a physician can fill out some kind of form justifying the additional expense. If that's going to create an issue due to delay of therapy... well, that's what free samples are for.

    every person who doesn't like an acquired taste always seems to think everyone who likes it is faking it. it should be an official fallacy.
    the "no true scotch, man" fallacy.
  • ShintoShinto __BANNED USERS
    edited May 2007
    The data recording thing - apparently states have been implimenting things like this for the last few years. He mentioned Pennsylvania and Illinois in particular. So there should be some kind of information on the drawbacks/effectiveness of it.

  • FeralFeral Who needs a medical license when you've got style? Registered User regular
    edited May 2007
    Shinto wrote: »
    The data recording thing - apparently states have been implimenting things like this for the last few years. He mentioned Pennsylvania and Illinois in particular. So there should be some kind of information on the drawbacks/effectiveness of it.

    I think I might look that up later.

    every person who doesn't like an acquired taste always seems to think everyone who likes it is faking it. it should be an official fallacy.
    the "no true scotch, man" fallacy.
  • ShintoShinto __BANNED USERS
    edited May 2007
    Feral wrote: »
    Shinto wrote: »
    The data recording thing - apparently states have been implimenting things like this for the last few years. He mentioned Pennsylvania and Illinois in particular. So there should be some kind of information on the drawbacks/effectiveness of it.

    I think I might look that up later.

    I'd suggest "Illinois hospital report card" and "Pennsylvania hospital infection" as keyword searches based on what he was talking about.

  • SavantSavant Registered User regular
    edited May 2007
    Feral wrote: »
    ElJeffe wrote: »
    E) makes me uneasy. How are we going to make generic drugs more accessible without hamstringing the pharmaceutical companies who do all the legwork to bring drugs to market? Because I'm reading this as "Fuck you, and fuck your patents."

    Well, one of the major problems right now is that many brand-name drugs are being prescribed when generic drugs would have worked just as well. (Or the generic would have worked a little worse, but not worse enough to justify $200 difference to an insurance company for the brand name.) This is mostly because we have an entire pharma marketing industry devoted to getting physicians to prescribe brand-names but nearly nobody pushing generics in the same way.

    In a single-payer system, I would have no problem with a blanket policy that only generics and certain on-formulary unsubstitutable brand-names are covered (or off-formulary brand names are covered at a significantly higher copay) until a physician can fill out some kind of form justifying the additional expense. If that's going to create an issue due to delay of therapy... well, that's what free samples are for.

    That negatively affects the feasibility of that plan, unfortunately. That puts up a fair number of bloat marketing positions for the chopping block, so you have a focused group to formulate opposition. I doubt pharma will be thrilled with the idea of their big moneymakers drying up due to that and increased focus on generics either.

    The nature of the pharmaceutical industry currently and their massive program of marketing does suggest that their current market system is at least somewhat degenerate. As was mentioned, a lot of R&D is accomplished by universities and academics so cutting back on the profit motive won't kill the development of new drugs outright. And focusing research on the most profitable drugs/treatments isn't necessarily the best for public health or the prevention of disease.

    A lot of that gets into IP issues, since pharma's based on holding patents to their drugs. Generics are so much cheaper because once the patent is up competitor manufacturers can start producing the drugs without licensing and move the market to supply and demand equilibrium. I'm not sure how much that would affect diagnostic equipment however, since it seems like more of their cost is in the actual production side of the equipment than designs and that those designs would be more difficult to reverse engineer.

  • ShintoShinto __BANNED USERS
    edited May 2007
    ElJeffe wrote: »
    There are some good ideas lurking about in there, though. Kinda like there were some good ideas lurking in the massive abortion of a Medicare bill we passed a few years back.

    Of course you disapprove. You'll be casting an extremely painful vote for Rudy McRomney.

    HAHAHAHAHAHAHAHAHA

  • dvshermandvsherman Registered User
    edited May 2007
    ElJeffe wrote: »
    You know, Feral, about 90% of the issues you just brought up could be addressed by government-funded annual physicals that would be a lot cheaper than full-on health coverage.

    And this would be ideal if we only had to worry about illnesses. And only illnesses that crept up slowly, with very noticable and easily treatable early symptoms. Of course, it totally ignores all other forms of illness, as well as the entire realm of physical injury for which healthcare is good to own. This issue would be very easy to solve if all we had to worry about was major, easily diagnosable illness. An annual checkup isn't going to do shit for the sap that falls off a ladder. Or the person who gets t-boned by some asshole who runs a redlight.

    If the government is going to stick their paws in this issue any further than it has already, then it should focus on providing very basic catastrophic coverage. What's that? That's the $10,000 deductible policy I mentioned on page one.

    Thanatos, the example I used was of someone I've actually had a policy issued on. Middle aged smoker, $10,000 deductible, $10 per month premium. Obviously, other health conditions affect insurability. But there is such a thing as high risk underwriting. And there are already plans at the state level in which individual state governments take on the responsibility of covering otherwise uninsurable risk pools. I know. My father is a diabetic, with severely advanced deterioration due to said diabetes. My father is on such a program. I am unaware of how much, if anything at all, he pays into this program.

    That's the thing that I fail to understand about arguments about this type of stuff. Why must everything be done at the federal level to be considered valid by the public at large? For the most part, anyone running about without insurance who needs it is plainly ignorant of their options. There are plenty of programs for people who can't afford it. And as mentioned, there are options for the supposedly uninsurable.

    I actually have a pet project I work on in the spare time that is helping to raise awareness of local, state and federal programs that are available for the people who need them. I found out fairly quickly upon getting into this industry that most people (especially the have nots) are woefully ignorant of programs both public and private. So I have been working in my area to change that. Maybe it will take off and become my full-time endeavor.

    EDIT: Proof that such programs exist.
    Many States maintain comprehensive websites that provide objective data about the insurance companies doing business in your state. Since HIPAA, all states must provide avenues of guarantee issue health insurance policies. Our links provide you the opportunity to find the information you need.

    There it is. Every state, since the inception of HIPAA, is required to provide guaranteed issue health insurance. That means no matter what's wrong with you, you get the health insurance.

  • ThanatosThanatos Registered User regular
    edited May 2007
    Can we at least agree that outlawing direct-to-patient marketing of prescription pharmaceuticals is a step in the right direction? That's right up there with TV advertisements for lawyers, as far as I'm concerned.

  • FeralFeral Who needs a medical license when you've got style? Registered User regular
    edited May 2007
    dvsherman wrote: »
    That's the thing that I fail to understand about arguments about this type of stuff. Why must everything be done at the federal level to be considered valid by the public at large? For the most part, anyone running about without insurance who needs it is plainly ignorant of their options. There are plenty of programs for people who can't afford it. And as mentioned, there are options for the supposedly uninsurable.

    ...

    There it is. Every state, since the inception of HIPAA, is required to provide guaranteed issue health insurance. That means no matter what's wrong with you, you get the health insurance.

    You know that state programs would not exist without HIPAA (a federal law) and Medicaid (a federal program), right?

    Besides, state-administered Medicaid programs range. Some are kinda okay, some are bureaucratic clusterfucks. California's MediCAL program isn't bad, except for one major flaw. They put a lien on any major assets you own that is repayable upon your death. If you hate the estate tax, you'll really love this - it basically amounts to a 100% estate tax for the poor.

    Also, there are still people who are uninsurable. Middle-income people with chronic conditions. When I was diagnosed with sleep apnea, I lost my employer-paid coverage about the same time (because of a paperwork fuck-up with Blue Cross). I went out looking for individual coverage - Blue Cross, Kaiser, Aetna, and Pacificare all gave me a big fat no. I found catastrophic health insurance from a couple of smaller companies whose name I no longer remember but with a total exemption for my sleep apnea. I eventually just said 'fuck it' and decided to look for another job - saving the $200 per month I would have spent on "coverage" that wouldn't even cover my primary complaint in case I'd find myself unemployed and in need of food. I eventually found a job that would give me health coverage, and after a total wait of 33 months, managed to get the (relatively simple) surgeries that cured my little breathing problem.

    I'm glad to know there was a cure for my problem. My girlfriend has incurable chronic daily migraines among other problems. This makes her relatively unemployable for typical office work because she can't keep a regular schedule. She is working, from home, part-time, but work-from-home jobs don't offer insurance. She can't get individual insurance that will cover her primary health complaints. Right now, the only reason she gets health care at all is because California, being the lovely gay-friendly state that it is, allows me to keep an unmarried domestic partner on my insurance as a dependent. She's almost totally dependent on me for her medical care until her Social Security income assistance goes through, which might be another year or so. Do I sound bitter? Yeah, I am. I turn 29 in two weeks. I should be saving for a house, not paying inflated medical bills.

    This is a country that values independence and entrepreneurship. Every reasonably capable individual should be able to stand on their own two feet without needing to lean on another human being. I don't believe that people have a right to medical care, but I do believe that people have a right to pursue happiness. The government's primary responsibility is to promote an economic and social environment where people have the best chance at finding this happiness. Right now, we have the opportunity to significantly limit the obstacle that medical bills represent to the pursuit of happiness. Yet a strangely large fraction of the population opposes it, because of some vague fear of socialism or communism or some other red-tinted bogeyman. The implication is that national health care is something unAmerican. I call bullshit - national health care is preeminently American.

    By the way, the next person who says "But in Canada you have to wait 18 months for knee surgery!" gets my foot in their ass. I had to wait 33 months for a fucking tonsillectomy due to a bureaucratic fuck-up. Some people never get the surgeries they need. You know what the mean average is of a data set that contains infinity? Infinity, fuckers.

    every person who doesn't like an acquired taste always seems to think everyone who likes it is faking it. it should be an official fallacy.
    the "no true scotch, man" fallacy.
  • MrMisterMrMister Valuing scholarship above all elseRegistered User regular
    edited May 2007
    Feral wrote: »
    You know what the mean average is of a data set that contains infinity? Infinity, fuckers.

    Well, you can't actually average infinity. But the rest of your post is all lime.

  • FeralFeral Who needs a medical license when you've got style? Registered User regular
    edited May 2007
    MrMister wrote: »
    Feral wrote: »
    You know what the mean average is of a data set that contains infinity? Infinity, fuckers.

    Well, you can't actually average infinity. But the rest of your post is all lime.

    I know. :P I took some rhetorical license.
    And why does my good shit get bottom-paged?

    every person who doesn't like an acquired taste always seems to think everyone who likes it is faking it. it should be an official fallacy.
    the "no true scotch, man" fallacy.
  • LondonBridgeLondonBridge __BANNED USERS
    edited May 2007
    So... does anybody have an idea what kind of tax increase we would see if there was universal healthcare in the USA? Be honest.

  • ShintoShinto __BANNED USERS
    edited May 2007
    So... does anybody have an idea what kind of tax increase we would see if there was universal healthcare in the USA? Be honest.

    Obama's plan has a repeal of the Bush tax cuts plus an increased tax on medium/large businesses which would be in part offset by lower private healthcare costs.

    I think in another thread I pointed out that if the government were to simply purchase private healthcare plans for 45 million uninsured people at the cost of roughly $400 per month it would be about 216 billion dollars per year. That's a kind of baseline figure for covering everyone without costs going down.

    Of course, every plan out there includes ways to cut costs also.

    What kind of tax increase would that be? I think something like a 5% increase on the top tax bracket.

    So taxes something like we had in the 90s.

  • nexuscrawlernexuscrawler Registered User regular
    edited May 2007
    what would you opinion be of a susdiized insurance system similar to the ones NY and Nj already have to some degree. You have a sliding scale of cost to the person based on income and whatnot. The government then susidizes the rest of what is essentially a private insurance policy for you. Basically you make insurance that anyone can buy and people who are really desituite can get virtually for free.

  • ShintoShinto __BANNED USERS
    edited May 2007
    what would you opinion be of a susdiized insurance system similar to the ones NY and Nj already have to some degree. You have a sliding scale of cost to the person based on income and whatnot. The government then susidizes the rest of what is essentially a private insurance policy for you. Basically you make insurance that anyone can buy and people who are really desituite can get virtually for free.

    Massachusetts is doing the same.

    Seems to be the prefered mechanism for getting insurance to the uninsured of every plan I've seen so far.

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