Posted on 06/07/2009 9:45:48 AM PDT by SonOfDarkSkies
Paul Ryan (R-WI) and some others (some of whom I know are conservatiaves) have proposed a patient-centered alternative/solution: I will post a new thread on this....
http://www.house.gov/ryan/PCA/index.htm
No, but a health care system will either be a drain or a benefit to society. Money unspent destroy worker productivity. Money spent poorly is wasted. Uncovered citizens combined with an overly expensive system saps American competitivness. How much more competitive would American companies be compared to their European/Japanese counterparts if they weren't saddled with the health care expense?
I think that may determine how you define “results.” We don’t ration health care like other socialized systems do. The government is not dictating which procedures I can receive—I am in conjunction with my choice of insurance options. You put out a lot of statistics, yet I am not sure they tell the whole story.
Actually it is rationed and the US has defacto universal care. It is just provided through the emergency room. It is hugely wasteful since this is the most expensive form. Moreover, the lawyers always take their share to make it even worse. Health care is by nature scarce and a nation can only spend 100% of GDP on it. It is therefore a good that will be rationed to some extent.
So you define more results to spend less and cover more—we spend more because we are spending a lot more on technology than socialist systems. Technloogy that is available to the 85% as opposed to fewer under rationed systems. My daughter had an MRI done on newest machine in state of IL. It was done within 2 hours of doc determining it needed to be done. It was done by a private company that is competing with local hospitals for Imaging business. You won’t find that occuring in a socialized system.
What you are saying simply is not true. I can get an MRI in Germany right away. There are also more doctors per capita in Germany. Moreover, I can also purchase private insurance to get me extras (like a single bed or only being attended by the chief doctor) if I want. Totally flexible and "unrationed", but with minimum and required coverage for everyone.
I don’t define best by cheapest or most coverage. If I need a procedure done, I am going to go for the best doctor I can find—the most competent. We are going to lose the best and brightest if we have to emulate European health care. I have a friend whose daughter just took MCAT. I think she is nuts to want to go to 6+ years of Med school with the changes that are sadly likely to occur. My daughter a FR in college, is even reconsidering nursing/nurse practitioner career.
You are confusing the university system with the health care system. There is a difference. The US will continue to lead the world in Medical Research as long as the university sytem remains in tact. Universal coverage wont' affect it. This is the key misunderstanding in the "health care debate". Also, if you want choice, you pay more. Same as in Europe.
You mention US life expectancy being lower than any other industrialized nation—Well in fact, we have longer life expectancy than Denmark and Ireland, and if you look at the table, pretty much most industrialized nations have average life expectancy to live to late 70s.— Japan-81, Germany-78, England-78, US-77—this is not a huge difference among countries in my opinion. Life expectancy is determined by many factors besides access to health care—a lot is determined by lifestyle choices as we look at Japan and other Asian-Island nations.
Yes, but the US spends fully 3% more in GDP than the nearest comparison and achieves worse results. Is that not worse bang-for-the-buck? Lifestyle is all well and good, but there appears to be massive waste around.
You note a distinction between research, our university system, and general health care. Don’t you see that the advances in the University system become available to general health care—often immediately, always over time. In the Chicago area there are several University Hospitals that are open to the public as well as doing cutting edge research. There are constantly commercials on the radio for participating in research studies too.
But this hasn't translated into a better or more effective system. It just translates into more needless tests and opens up lawsuits. People in America don't live longer so the statistics prove that fast adoptation it is purely a waste of money.
I agree that Tort reform would help the system, but that won’t happen with Dem controlled government. I don’t blame what is going to happen on GOP cowardice. I believe that Bush even proposed private health care spending accounts for health insurance. That in my opinion should be the tact the GOP takes—give more choice and control to the citizenry...imagine that?!
Ok. Just an issue of opinion and perspective.
You state that “The German, French and Japanese systems are so far superior and cheaper as to make anyone with a clue know how laughable and Goebbel-esque propaganda based lying is going on.” I really am not familiar with those systems as much as the Canadian system (lived in ND and Canadians in Fargo for med procedures was pretty common). Tell me why do you think these systems are superior and cheaper? How do you define superior and cheaper?
I think I defined it above in terms of % of GDP % of citizens covered and life expectancy achieved. If lazy American reporters could speak other languages, you might have a different view of possible health care systems other than what the Canadians and British have done. Alas, you only get this perspective because the explanations are all in English. Germany, what I know best, spends about 9% of GDP, it covers everyone and offers a combination public/private insurance in which you can choose public and get extra services with private, or just choose private and get better service. There is not real limit to the services and there is no waiting and no rationing.
The key to universal health coverage is making it universal. Health care is an asymetric information game between the individual and insurance company. Only people who need expensive treatment will be willing to pay a lot. The only way the overall price can be kept low is if everyone is made to pay the average. The fewer healthy people who buy coverage, the higher the cost for the rest. The American system is clearly broken. There are alternatives that work better. The US can try its own path, but what it is doing right now primarily enriches lawyers and drug companies at the expense of American workers and businesses. That does not make a lot of sense to me.
Sounds like you should move to Germany—I don’t mean that to be sarcastic, but if it is as great as you say, why not? You seem familiar with it. But don’t make MY health care system in the US (which I firmly believe is the best in the world) into yours in Germany. More importantly, even if Germany’s is great, it is not likely that our “solution” will look like Europe’s—I think more likely it will look like Canada’s at best Cuba’s at worse.
Uh No, I don’t read German press on German health care, but Canadian health care news is reported in English. They have huge problems. Period. Canadians flock south of the border to get decent, timely health care here in the US. Fact, and I know this first hand as I lived in North Dakota. In fact, Canada is looking to make changes in their system to make it more like ours. The British freely admit their health care system is poor. So Germany must be an island of health care nirvana.
We may be spending 15 percent of GDP, but that is ME and my company making decisions, not just the government. Yes the government can reduce spending, but they will reduce choice and access—everyone will have access only less access to procedures they need. That is rationing which you say is OK. Oh and if you think there won’t politics, waste and corruption, well you forget that the President learned politics in the City of Chicago, IL—the corruption capital of the USA.
As I said, my daughter had MRI done in 2 hours by the newest MRI machine in the State of IL. Cost? $3,600. A PRIVATE imaging company has started a business to compete with the area hospitals. Tho I did not have to pay all because I had insurance, I was glad to have the opportunity not to have to wait for some government-DMV-style approval system. Are you telling me you get state-of-art MRI “right away” and it is free? Again, I suggest you move to or stay in Germany. Reduced profit incentive will not allow this company to stay in business. Period.
You say there are more doctors per capita in Germany, well Germany is not as large as the US in terms of land mass or population, and you do not specify what type of doctors GP, specialists, what. You mention nothing about their wages, German tax rate, etc. either.
You state that I don’t know the difference between the University system and the health care system. and that the US will continue to lead the world in Medical Research as long as the university sytem remains in tact. Universal coverage wont’ affect it. This is the key misunderstanding in the “health care debate”.
Why do you say it as fact? It is not a fact and I disagree that universal health care will not impact the American Research Hospitals and universities. WHY are they number 1 in the world??? It is not because we have socialized medicine! In fact, I am pretty sure that hospitals and universities will cease to lead the world in research. So we are going to cut costs, yet somehow fund cutting-edge research when there is no profit potential. It does not add up unless government wants to tax my future grandchildren even more.
There is this incentive in a capitalist economy—it is called PROFIT. There will be no incentive. I live in an area that has multiple research hospitals and med schools, as well as pharmaceutical companies. I see things first- hand here in US, not in Germany. These institutions all revolve around staffing with the brightest, funding and profitability. Period. Take away the profit incentive and you will not have the cutting edge research. Do you think the best and brightest students are going to want to go to med school when their salaries are capped by some health care pay czar? Think it won’t happen? Google Bank Pay Czar. Czars of course are not under the control or approval of congress, they serve at the pleasure of the president and this one has appointed 21 so far.
So the dirty little secret is that you say rationing is OK. That is the crux.
I am not disagreeing that we need to need to address aspects of our health care system such as huge malpractice premiums for doctors or going to ER for stomach flu or a cold. However, that doesn’t require a governmental take over of all health care!!!
I personally like the idea that I GET TO CHOSE MY INSURANCE OPTIONS, & I GET TO CHOOSE WHERE I WANT TO GO, WHEN I WANT TO GO, AND TO WHOM I WANT TO GO TO. Lest you think that I am over-using the system, tho I have taken my kids to doctors fairly regularly, I have not gone for several years until last week for a tetnus shot.
You talk how this will save money, and make our companies more competitive....in addition to corruption and political payoffs,
1. How many jobs are leaving the US to go to Europe? I know they go to Ireland because they speak English and are educated and will accept lower wages, but really, are you saying that Europe is more competitive than US—I have not heard that and tho I don’t listen to German press, I would need stats in English to buy that. I think lower wages in general and less corporate tax is what drives jobs off-shore, not just health care costs, companies can and do simply CHOOSE to offer less, tho that will not be the case under obamacare where they will be REQUIRED to offer insurance.
2. Do you know how they are proposing to pay for this???? VAT just like in Germany! I don’t know the tax rates for Germans, but you mention nothing about that or the fact that in addition to the 11+ trillion we are now in debt for future generations, our government is going to
a. implement a VAT—Funny how conservatives in Euirope are winning elections because they know that thesocialist policies of the past 20 years has hurt their competitiveness.
b. tax our health care benefits and tax employers’ contributions—well that makes them more competitive and I can hardly wait to pay even more taxes so everyone can have minimal coverage. What do we win in this scenario?
c. Start taxing my lifestyle choices—the government is going to tax sugar? salt? because they have deemed that I consume to much? Wow got socialism?
You note our spending, as I said, a lot of that is private spending which may not be available—it is not available in Canada—you have to come here to pay more for procedures the government in Canada has decided to ration. In fact people are now actually suing the government in Canada to get access to procedures. Maybe just what one is used to....
By the way, I don’t equate life-expectancy with bang for buck. Tho my family did not approve, my mother chose to smoke. She cut her life expectancy, but I don’t think that she did not live a full or productive life. Just because our life expectancy is SLIGHTLY LOWER than some countries in Europe, that does not mean that our lives are not better and we are not generally just as healthy.
Finally, I think you are ignoring the most basic of points. The purpose of the health care overhaul is NOT to provide access and reduce costs, it is to take over the one remaining profitable segment of the economy and further control the population.
Tho I do appreciate your lengthy response, I am sorry but you have convinced me of nothing other than fact that you seem to support a western European system, which by definition historically has been a type of soft socialism from which they seem to be currently moving away. I think there are issues within our US health care system, but I believe that they can be resolved in other ways that do not involve a full-fledged fascist take-over by the government.
As I often say, I guess we just agree to disagree, and I REALLY DISAGREE.
oops meant to tag thread in my previous post above....
they will control the “level” of care, depending on one’s “value” to society, i.e., the unborn are simply aborted... the elderly are irrelevant and too expensive.... those “productive” young and middle aged healthy people will get care to remain productive. Those born defective will not be allowed to live... i.e., their level of care will be minus 1.
All of this will be worded very simply as just using the available money for healthcare wisely for everyone.
Those of you who now say you like this because you don’t have healthcare.... how about when you go to the clinic’s or the Emergency Room? That will no longer be an option... so might want to think again.
You nailed it!!!
Tell me, as Obama and Rohm (& others) are from Chicago/IL, is it not a very real possibility that in obamacare, people will be able to buy themselves a cut in lines, an unauthorized procedure, etc. and that people with connections will get perks...:?
Look at the whole pay-for-play culture in Chicago/IL. Reminds me of Soviet Union. :(
Ummm. . . I do live in Germany.
Sounds like you should move to Germany
Ummm. . . I do live in Germany.
Glad you live where you like your health care. With all due respect, I live where I like mine & don’t want our social/fascist government driving private insurers out of business, rationing care,discouraging best/brightest to go into the field/conduct cutting edge research, and all this by raising taxes of me and my children to pay for it!
Why is it that people who will not be impacted by changes in health care (i.e., Congress for example as they have their own “special” plan) are interested in changing ours?
You live in Germany and are happy with it obviously, but there are many in Canada that want their health care system to look more like ours.
BTW, Tho your initial premise referred to health care in US not being “best in the world” due to its percentage of GDP, but you never answered my taxation questions, so I checked into it...
I don not know that actual tax rates; however, according to Wikipedia, Germany pretty well blows away the US in the amount that is paid in TAXES both by corporations and individuals (over 30% for corp and over for 50% INDIVIDUALS!!!, so it certainly is not more competitive or free. So tho your percentage of GDP for health care spending is less, it is government directed, and your tax rates are hugely higher. :(
German Health Care System? No thanks.
Not sure where you got your info. The top tax rate in Germany is 43%. The corporate rate is nomially 30%, but just try and find a corproation that actually pays that much.
The German state is a bit larger as a percentage of GDP than the US, but for that the social safety net is quite a bit larger. In my opinon too large and I think the system could take a lot of advice from the American system.
But, the healthcare is superior in Germany not just in terms of bang for the buck, but also in the security that losing one’s job does not cause a loss of coverage.
One more thing I should mention is that Germany does have extra money to pay for social programs because it relies on the US for defense. This is mentioned too infrequently and often forgotten that the world is the way it is (generally a decent place) because the US is the way it is.
By the way, I have lived 22 years in the US.
“One more thing I should mention is that Germany does have extra money to pay for social programs because it relies on the US for defense. This is mentioned too infrequently and often forgotten that the world is the way it is (generally a decent place) because the US is the way it is.”
Interesting observation. Glad that some outside the US recognize that there is and has been good that is done by the US—our new President spends quite a bit of his his time flying around the world apologizing for his perception of our past misdeeds. I fear that The US is not going to be “the way it is” for much longer. It is changing; many of us are very concerned. Words like financial disaster are being used to describe this new health care initiative. Many feel we are going in the opposite direction (central planning) to where we need to to improve our economy.
Not that there are not improvements that can be made to our health care system—there are, but they could be addressed incrementally and with private choice and market-based solutions in a capitalist economy. That is not what is happening here.
I got my information on life expectancy and taxes of various countries from Wikipedia—they have a chart comparing taxes of countries http://en.wikipedia.org/wiki/Tax_rates_around_the_world
Sorry, but with the exception of Belgium, Germany had the highest tax rates as of 2005. Now perhaps your conservative new Chancellor has reduced taxes by 20%, but that is what the chart says. Maybe it is wrong....
If you look at the US-administration of our Medicaid and Medicare systems as well as some of our state-run health care programs, you will find that these programs (which could be considered test pilot programs for a national program) are not effective—increasingly, physicians will not even participate in Medicaid/Medicare without supplemental fees thereby actually reducing access. These programs actually drive up costs because they encourage people to go to the ER for minor problems—because the people don’t pay—government does so cost does not matter....
California, known for its medical and social benefits is literally bankrupt—truly—in 50 days, they will be in default. They covered all kinds of people for all kinds of services, but now the bill is coming due ^ they can’t pay. Many fear that is what will happen in our country’s future.
You really can’t look at the new oboma-lead universal health care initiative in a vacuum tho. Our economy is now 11 Trillion in debt due to the spending of our Democratic congress and new president’s agenda. We have or will have quadrupled both the debt and the deficit. Some say estimates are higher and now oboma is saying he wants his office to make the health care budget projections as opposed to our usual Congressional Budget office. Some are saying that is likely in order to understate the true expenses that will be incurred for us to move to a socialized system. BTW, if you lived in US for 22 years, you know that government pretty much ALWAYS underestimates costs.
In addition to the costs concern, there is the larger social liberty concern. Many here feel that the reason oboma wants to take over our private health care system is not to improve health care—as I said before, more folks will get less—at least that is what will happen here in US. But many feel the goal isn’t to improve health care—it is to expand socialism via the safety net which interestingly you believe should be reduced in Germany to be more like what we have. oboma leans socialist (at best) and wants to transfer decision making from private sector and wealth and choices from those who carry the load, pay taxes, and have choices to the 43% of Americans who pay no income tax and power/decision making to the government.
When you look at ALL that is happening in America regarding the takeover of private industries by our government due to all the “crises” (banking, insurance, auto manufacturing and dealerships) it becomes more clear that there may not be so many “crises” and there is an larger agenda—to move the US towards socialism by creating a large lower class dependent on the government for most goods and services that will pay most of their income to the government via taxes.
This is to be done by eliminating the middle & upper middle class-leaving the large lower class and a type of “ruling class” of wealthy employed in government and government related/subsidized sectors. If you look at statistics, all sectors of our economy have job reductions EXCEPT for government which is increasing hiring. No one here talks about cutting budgets—just increasing debt or taxes.
Sorry, but many of us truly do not believe that the goal is to improve health care.
You are in Germany; enjoy your great health care. I am happy you live where you are pleased. I wish I could be happy, but right now, I am very worried for my children’s future.
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