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Government funded healthcare: Good or bad?
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Why? Given that Canadian health care is pretty equivalent to ours in terms of wait times and level of service for your average Joe, why is it that we're physically incapable of matching that level of coverage while paying twice as much as them? Is Canada really that much smarter than us?
Look, it's pretty much inarguable that having every last person under the same insurance plan would save a shit-ton more money in bureaucracy as compared to having hundreds of little insurance providers. Plus, the US government is not a business, so you can eliminate the portion of health care costs currently going towards insurance providers' profit. This means that, all things being kept equal, the amount of money going to health coverage from actual people will be less than it is now. Add in the 40 million uninsured, and we're probably back to the same total cost. The difference is that the money is now coming from taxes instead of insurance premiums.
Oh, keep in mind that we'd pretty much be able to axe Medicare and Medicaid, as well as similar state-run programs, as redundant.
Further, we could still have private carriers if we wanted to, so there'd still be market choice. And they'd probably be much cheaper, as the insurance providers would be forced to streamline and specialize to maintain their appeal.
At the end of the day, look at Canada. That's our worst-case scenario. And Canada is not any worse than we are.
Yes, I think 0 is pretty small price to pay.
We should, but we won't. Like, not ever. And so we're left drudging through Next Best Ideas. Like UHC.
We should also pay poor parents to take their kids to check-ups, so they won't have the bitterness of losing needed work hours (and thereby income) to hear doctors tell them that the kids are lacking in nutrients found in foods that they can't afford.
It is for profit. The insurance companies don't want to pay out. The less they help you, the more money they get to take home themselves. That means you are less likely to get the care you need.
Additionally, it means that half of the money you are paying for health care doesn't go to health care. Half the money you pay for health care goes to the insurance companies. So, you are supporting two industries rather than one.
Leave no patient behind!!
The median time to see a specialist in Canada is 5 weeks. I can go see one tomorrow if I want under my health care plan. Please don't compare wait times between corporate and nationalized care, they aren't even close, particularly for specialists, which countries like Canada have fewer of, since they have budget caps.
Not to get the same quality of care. Government care doesn't have profits but lack of profit incentive hurts efficiency and innovation. Consolidating bureaucracy is fine but since it becomes a monopoly market incentives to streamline go away and it almost always creeps. All things will not be kept equal under government controlled care. Canadian care is strictly worse in terms of quality than care in the US for those can afford it, which right now is a large portion of the middle class, although it's admittedly shrinking.
But again I'm paying more in taxes which cripples my ability to take advantage of that. I can't afford private school either.
There are pros and cons vs government and corporate care but I prefer neither.
Even if we concede that, which I still don't believe for the same quality of care, I'm still paying with my freedom when they decide to ration the care because of the lower cost, or strip away unhealthy lifestyles in the name of making the world a better (and less expensive) place.
I'd prefer less regulations on pharmaceuticals, tax credits and/or breaks for individuals to negotiate directly with insurers, and medical savings accounts instead of government controlled health care.
There will be no problem unsolvable by an IV.
Would you care to be more specific? Are the wait times not greater to see specialists? Everything I have read on the subject admits this.
Taxes? They are higher in Canada when you factor in marriage and kids, US taxpayers pay less. If you figure in provincial rates even more so.
Where am I wrong? Please prove it.
Here I'll reinforce my point with data instead of just saying "You're wrong, stop talking about it" like you did.
http://www.statcan.ca/english/freepub/82-575-XIE/82-575-XIE2006002.htm
I was off by one week. So I guess we only have to wait a month to go see a specialist in Canada as opposed to 5 weeks. As opposed to the US, where I call a doctor and get a visit tomorrow with a PPO.
Here are the provincial rates in Canada:
http://www.cra-arc.gc.ca/tax/individuals/faq/taxrates-e.html#provincial
Canadians pay this rate on top of the National rate. Many US states demand 0%. The highest around 10%.
When you factor in children and marriage the US taxpayer pays substantially less than the canadian taxpayer salaries being equal.
You can, but not everyone who's insured can. It varies dramatically based on geographic location, just like it does in Canada. We have no centralized data collection mechanism in the US, so direct comparisons are difficult, but you see the same range of "I saw a doctor in five minutes!/I saw a doctor in five months!" anecdotes in both countries.
Please to be providing the evidence for this, thanks so much.
Also, by how much does the percentage of people who can actually afford health have to shrink before you decide that maybe we should de-status the quo?
Specialized care would be considerably cheaper if it was meant as auxillary care instead of general care.
What's the third option? Magical pixie care?
Even if we concede that, which I still don't believe for the same quality of care, I'm still paying with my freedom when they decide to ration the care because of the lower cost, or strip away unhealthy lifestyles in the name of making the world a better (and less expensive) place.
I'd prefer less regulations on pharmaceuticals, tax credits and/or breaks for individuals to negotiate directly with insurers, and medical savings accounts instead of government controlled health care.[/QUOTE]
As for taxes, that is a far more complicated issue than simply looking at two numbers. There are different taxes - sales tax, income tax, investment tax, estate tax - and different brackets and exemptions to take into account. We can construct scenarios where it's higher in Canada, and scenarios where it's higher in the US. But it is false to say that it's always higher in Canada, in all cases.
:roll:
/sarcasm
There's always a stumbling period when any organization takes over another's responsibilities. If the government did take over healthcare, how many years would it take for them to get into the swing of things?
In 2005, the median waiting time was about 4 weeks for specialist visits, 4 weeks for non-emergency surgery, and 3 weeks for diagnostic tests.
Canada's starting to sound kind of reasonable.
Since we're both being anecdotal at this point I think you should get a PPO instead of an HMO. I never go to general practice unless I actually just want a checkup.
1) Where do you live.
2) What is the price of a PPO, as compared to an HMO?
A Highly populated city. About 400 dollars a year.
Yeah I ditched Kaiser when I left that job. I currently have Blue Cross/ Blue Shield, which is expensive, but I still run into similar problems. The last time I made a doctor's appointment, they told me that the soonest they could fit me in was in SIX MONTHS. By the time that rolled around, my doctor had left the practice.
I am extremely unhappy with US health care as I have experienced it, and I'm one of the "lucky ones" with employer-sponsored health insurance in reputable insurance companies, living in a major metropolitan area.
I'm baffled you've had it that bad. The last time I needed to see a specialist I called 3 doctors in my ppo directory provided by my insurance and found one who could fit me in less than 24 hours. I was able to walk to his office from work. I took an extended lunch.
As I said before. I hate our current system because I recognize the deficiencies in it, especially for those without employment and insurance and I hate the fact that if I quit my job my provider changes but I just don't think going single payer or even two tier is the best solution.
Addendum:
Those damn government roads!!!
Hell, name a way that government health insurance would cost more than equivalent private health insurance.
The wait-time argument is a very bad one. If wait-times are really such a problem in Canada, France, and wherever else, and it's really hurting the health of their citizens then why is the life expectancy in those countries longer than in the US? Are our somewhat higher rates of dangerous habits really canceling out years of life expectancy, or (as I would argue is more likely) is our healthcare system contributing to the problem?
Moreover, taking the median wait time in the United States is deceptive because there is a whole class of people who, since they are uninsured, effectively have lifelong wait times to see specialists.
The purported advantages of a private healthcare system - namely efficiency and better care - are simply not realized. The evidence strongly suggests that the French and Canadian systems are doing a significantly better job of keeping their citizens alive and healthy. US citizens are, on average, less healthy than those in France or Canada, and yet are paying around twice as much per capita for what is, apparently, an inferior system.
Actually, there's a legitimate argument to be made that the nature of profit-driven drug research has slowed work on cures for major diseases. Time you spend working on that new erectile dysfunction medication can't be spent on curing cancer or diabetes.
While there are cases of drug companies putting important stuff off to the side, Viagra isn't. It was invented for something else (helping blood flow), and someone in the lab was a pervert.
I guess a better argument would be that money you spend advertising that new erectile dysfunction medication isn't spent on researching cures for cancer or diabetes.
No, a better example would be a cholesterol drug that doesn't make you healthier, but instead lowers your reading, thereby making you willing to relax, and so makes you less healthy.
Oh no! Taxes are taking away my livelyhood! I worked for that money, goddammit!
Think about it for a second. You work at a job so that you have the means to support yourself and your family in a society that you can rely on to protect you and provide services for your benefit and use. You are providing a service to the community in exchange for the privilege of living there. Money is only a part of it. Wage or Salary is a fictional limit imposed by your employer that dictates how much they percieve your service in their name to be worth. If the government says "I will recieve a portion of the percieved value of this service for health care (among other things), so that the community may thrive and be protected against all that ails them" than you get a community that supports your basic needs, as well as some needs you may perceive to be a luxury depending on your location.
If you want an odd but perhaps effective analogy, a society without taxes is like going to war with an army of mercenaries. Sure, they can fight, and on thier own they make excellent assasins. Set them loose on a highly efficient squadron of soldiers however and you will soon find that mercenaries don't exactly work well as a group. Many die, many run away,and some, but only a very few, fight and live to be a old, fat and wealthy.
While I suppose it sound cool in retrospect (I should have made the soldiers into ninjas.. damb
That sounds like a joke about how many communities have gotten rid of much of the filtration of what was once fresh, nearly free water pumped straight to your home so you could save money to buy bottled water. So they got rid of a service so they could have the privilege to get their own water at a higher price.
That's not a good example at all. High cholesterol is a well-known predictor for heart disease. Drugs that lower cholesterol are worthwhile. The fact that people abuse them is a separate issue, and really doesn't have much to do with the for-profit nature of pharmaceutical research, except incidentally. Abuse of medication is a social issue, and would likely occur whether or not we were to have a for-profit system for pharmaceutical research.
I think advertising is a better example of wastage. If drug-company profits are a necessity because they fund essential drug research, how is it that drug companies can spend so much of this very same money on advertising? The ads we see on TV are basically pure wastage in terms of improving the average health of Americans. I think critiques of profit-driven drug research should start with that.
The problem is that this actually saves money for the very wealthy. They don't have to pay for clean water for everybody - just for themselves. This is the sort of thing that starts happening when you have an increasing gap between rich and poor plus a political system that heavily, heavily favors moneyed interests.
The best PPO covers only about 80% of costs at best and for specialist procedures only about 50% of costs. Fuck that.
That is total bullshit right there. Unless you are talking a massive ($5000+) deductable type of coverage there is no way you could get a decent PPO plan for 400 a year.
Especially if you want to cover a family. I was offered, through work and at a savings from the market rate, a HMO vs. PPO choice and either way it was more than $400 a month. The PPO coverage sucked and was only about 25% less in premiums anyway.
No, I'm talking about some drugs that we recently learned lowered cholesterol, but had no effect of heart disease. There are also indications that the maker knew, but continued to advertise anyway.
Ah. Yeah, you're right, that is a good example.
And if I want to see a doctor, and I get a walk-in in the same day. Now do you have a comparison that actually involves national statistics on non-urgent care throughout the US population (including the uninsured), rather than comparing our national statistics to your personal anecdotal experience?
Care to factor in Federal income tax, sales tax, estate tax, investment tax, tax breaks, tax refunds, tax law loopholes, non-taxable income, tax deductions, and the hundreds of other factors that enter into the tax rate? No? You only want to fish out two numbers at random and pretend that's all there is to it? Alright then.
Do you understand what the word triage means?
Well, first of all, the national government doesn't actually pay for Medicare. In fact, health and education are not the responsibilities of the national government - Constitution Acts 1867-1982 state that the provinces are responsible for those things. Which is one of the primary reasons why the provinces themselves levy a comparatively high income tax. The bulk of the services delivered to Canadians are delivered through the province, in one form or another, so it really states that a lot of the taxation would also be levied through them.
Second, any expenditure by Ottawa for "health-care" is either a) equalization, or, b) transfer payments. The first is determined by a formula that takes into account a number of different variables, but the short of it is B.C., Ontario, and Alberta don't receive equalization, while Saskatchewan and Newfoundland may very soon stop receiving it. All other provinces receive some form of equalization, which Quebec being (I believe) the highest or one of the highest receipients. Transfer payments, both in amount and frequency, are determined by agreement between the provinces and the federal government - and sometimes just by the federal government alone. Which is one of the reasons why statistics which talk about what the government pays for healthcare are most often terribly inaccurate or just plain wrong.
Third, the Chretien government of the '90's cut transfer payments to the provinces significantly, in a bid to get balanced budgets and start paying down the debt. While Paul Martin was Minister for Finance, transfer payments which were specifically ear-marked for healthcare costs were slashed, so that at the end of the decade the feds only supplied approximently 25-30% of each province's costs for medicare, while it had been 50-50 since Diefenbaker era. This, as one might imagine, led to increased pressure on the provinces to make up the lost amount. Some provinces were able to do this, either without issue (Alberta), raising taxes (Ontario, the Atlantic Provinces), or cutting services (BC under Gordon Campbell).
Even for provinces that were able to make up the funding shortfall, there was still an impact on services across the board, which has been seriously exacerbated by the rapidly aging population, and a number of health crisis, the most recent of which is the impending epidemic of diabetes and heart disease as a result of child and teenage obesity.
Quoting the Census without context will only make you look even more out of touch.
Changing the collective minds of millions of educated and powerful citizens is way, way beyond even the most inspirational leader at this point. It would take something very dramatic and something very local to start any kind of change. If, say, the cure for Cancer was discovered tomorrow in the UK or god forbid, China, reactionary minds would close instantly to any possibility of this discovery being likened to a difference in societal values, instead being attributed to luck and skill, rather than money. I would love to see what would happen with said drug. If it became freely available in other countries but extremely expensive and limited in the states. If people continued to die there and the rest of the world was free of the disease. It would be sad, but plausible.
In any case, I am ranting, so I'll be quiet for a bit.
What we need to do is structure the system so that it looks like the average insurance plan, maybe even conforming it to traditional insurance billing schedules.
I had no idea things like pacemaker implants, ACL reconstructions, and biopsies were for kicks. Think you're over-simplifying a wee bit? Furthermore, do you have any actual info on emergent care? What sort of wait times exist there?
One thing I'm certain we do need is a unified, national medical database. You ever want some painkillers, head into a hospital and say you've got sickle cell anemia. Even if the last 5 places you hit tested you, that info isn't easily available and they'll have to test you again.