Very funny.
We be not working, cause of....um...GM and shi*t...and, um, can't find no job...and, um,...akchewly I be need'n disability payment on acount of my back....So..YOU GOT TO PAY FOR ME!
Posted on 11/22/2008 1:46:23 AM PST by Halfmanhalfamazing
In The Undercover Economist, Tim Harford highly praised the health care policies of Singapore. But it wasn't until I read the section on health care in Ghesquiere's Singapore's Success that I realized how amazing the official numbers are. If the following is true, all the comparisons showing that the U.S. greatly outspends Europe without getting better health are beside the point, because Singapore makes Europe look like the U.S.:
The Singapore government spent only 1.3 percent of GDP on healthcare in 2002, whereas the combined public and private expenditure on healthcare amounted to a low 4.3 percent of GDP. By contrast, the United States spent 14.6 percent of its GDP on healthcare that year, up from 7 percent in 1970... Yet, indicators such as infant mortality rates or years of average healthy life expectancy are slightly more favorable in Singapore than in the United States... It is true that such indicators are also related to the overall living environment and not only to healthcare spending. Nonetheless, international experts rank Singapore's healthcare system among the most successful in the world in terms of cost-effectiveness and community health results.
How does Singapore do it? Singapore is no libertarian health care paradise, but it does self-consciously try to maintain good incentives by narrowly tailoring its departures from laissez-faire:
>The price mechanism and keen attention to incentives facing individuals are relied upon to discourage excessive consumption and to keep waste and costs in check by requiring co-payment by users.
[...]
The state recovers 20-100 percent of its public healthcare outlay through user fees. A patient in a government hospital who chooses the open ward is subsidized by the government at 80 percent. Better-off patients choose more comfortable wards with lower or no government subsidy, in a self-administered means test.
I've heard a lot of smart people warn that co-payments are penny-wise but pound-foolish, because people cut back on high-benefit preventive care. Unless someone is willing to dispute Singapore's budgetary and health data, it looks like we've got strong counter-evidence to this view: Either Singaporeans don't skimp on preventive care when you raise the price, or preventive care isn't all it's cracked up to be.
More details on how Singapore's system works:
* There are mandatory health savings accounts: "Individuals pre-save for medical expenses through mandatory deductions from their paychecks and employer contributions... Only approved categories of medical treatment can be paid for by deducting one's Medisave account, for oneself, grandparents, parents, spouse or children: consultations with private practitioners for minor ailments must be paid from out-of-pocket cash..."
* "The private healthcare system competes with the public healthcare, which helps contain prices in both directions. Private medical insurance is also available."
* Private healthcare providers are required to publish price lists to encourage comparison shopping.
* The government pays for "basic healthcare services... subject to tight expenditure control." Bottom line: The government pays 80% of "basic public healthcare services."
* Government plays a big role with contagious disease, and adds some paternalism on top: "Preventing diseases such as HIV/AIDS, malaria, and tobacco-related illnesses by ensuring good health conditions takes a high priority."
* The government provides optional low-cost catatrophic health insurance, plus a safety net "subject to stringent means-testing."
” Urine samples were screened for amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, and opiates. Nearly 27% of the urine samples tested positive for one or more of these substances.”
Marktwain replies:
A statement designed for propaganda purposes. Lumping in marijuana (cannabinoids) with the hard drugs renders the number meaningless.
*****
Polybius posted:
“We see a lot of gunshot injuries, including those from high velocity automatic weapons. So we do see situations very close to the military situation, patients coming with seven, ten bullets all over the body.”
Marktwain replies:
Another propaganda statement. “High velocity automatic weapons” is simply a propaganda phrase used to frighten the ignorant. America's murder rate is down.
Yes, we have a dysfunctional culture in many inner cities. They will respond to incentives. Giving them free health care without any incentives is sending the wrong message.
DING DING DING! We have a winna!!!
Exactly why it would never work here.
One item left out of the original article:
* In order to keep costs down, people who go to the Dr for treatment and are found not to be sick are caned without mercy.
As a Federal Government employee (Flame suit on), we are heavily encouraged to use the Health Savings Accounts. I haven’t up to this time, because it’s a use-it-or-lose-it type program. If you don’t spend it, it is taken away at the end of the year. It’s hard to predict what your needs will be from year to year, therefore hard to determine what amounts to contribute.
What you are describing sounds like a Flexible Savings Account (FSA). A Health Savings Account (HSA) is more like a 401k, any money lodged to the account remains yours. It can roll forward from year to year, building the balance. HSAs must be tied to a high deductible insurance policy.
Besides being far wealthier than Indonesia they have a tradition of having "servants", and will do just about anything to make sure they have a good supply.
Both nations recurringly "send 'em back". The consequence is they never have to take care of an aging illegal alien population.
Life can be tough in the Orient!
Singapore actually has a very diverse population.
Then there are the folks from India, SE Asia, United Kingdom, .....
It may well be more mixed than the USA, but not by much.
America and Singapore were once part of the British Empire you know. No "racial purity" there Fur Shur!
Inner-city slum "values" and behavior, like drug use, illegitimacy, shacking up, ghetto dress styles and music, etc. are increasingly becoming mainstream. You can find these wonderful things in rural areas and affluent suburbs today.
See post 2. HSAs seem to be working here in the US wherever tried.
So the Singapore reference might be better than some want to consider.
No matter where humans come from, where they’re at, or what their goals, most of us aren’t really all that different. I learned that when I saw Iraqis with smiles and purple fingers.
Big government doesn’t work. But this does seem to.
These comparisons are always specious, because none of these places are absorbing hundreds of thousands of illegal immigrants every year.
” Singapore has no parasite class, here in the USA we have two: the uneducated illegal immigrants, and the ghetto underclass. “
You forgot the largest, most harmful, parasite class here in the ol’ USA — that one comprised of politicians, ‘journalists’ and the punditry, academics, union leaders, and ‘activitists’ and ‘community organizers’ of all stripes....
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The modern socialist state is far more diverse than you think - within its political ecosystem are found parasites, to be sure, but those you enumerate seem to be occupying more of the predator and scavenger niches.
It’s more holistic this way. ;^)
It's also worth noting that Singapore can't possibly serve as a valid point of comparison on a national level simply because it's barely a "country" as we would understand it.
Singapore is a city-state, which means it doesn't have to cope with one of the factors in most countries that affect vital statistics: rural health care, and all of the difficulties that come with it (mainly lack of timely access for emergency care).
For a valid comparison, Singapore would have to be compared to a typical urban area in the U.S. When you eliminate any consideration for crimes related to personal and social dysfunction (crime, drug abuse, etc.), I would venture to guess that Singapore would be no different than most U.S. cities when it comes to the standard of health care.
One of the defining characteristics of an HSA is the person's ability to build up a pile of cash over a long period of time to pay for future (undetermined) medical expenses.
An FSA is ideal for short-term, recurring medical expenses (if you're already being treated for a chronic condition, for example, that requires expensive prescription drugs).
Very funny.
We be not working, cause of....um...GM and shi*t...and, um, can't find no job...and, um,...akchewly I be need'n disability payment on acount of my back....So..YOU GOT TO PAY FOR ME!
People like to dream dreamy dreams and then you go bringing up all that reality stuff.
Killjoy.
These people from Mexico are getting a bum rap. For the most part they are young and are beneficially employed. IMO, (ouch) the parasites are those who game the system, because they have coverage. This includes a medical system that run up the prices, because the system pays for just about anything.
Way back, when companies started medical benefits they thought it would be 'nice' to add drug coverage. After all, ~$50 a year coverage per employee wasn't all that much, in that it would attract and keep good workers.
The drug companies not being stupid, figured if a customer was willing to pay initially ~$1.00 per pill and the company ~$1.00, then why not charge $2.00?
Upshot is that the market is is determined by what the customer is willing to pay, and the 'customer' now includes the government. This flaw has snowballed through out the system and is a bigger problem than immigrants and the 'ghetto' unemployed.
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