25
   

Free, Public Healthcare

 
 
H2O MAN
 
  -2  
Reply Mon 29 Jun, 2009 10:06 am


Now we know just how ignorant Obama thinks the American people are.


Answer: Dumb as rocks.
0 Replies
 
H2O MAN
 
  -1  
Reply Mon 29 Jun, 2009 10:07 am



US GOING BACKWARDS ON HEALTH CARE
0 Replies
 
Walter Hinteler
 
  2  
Reply Thu 2 Jul, 2009 03:14 pm
From a comment in the Guardian:

Quote:
[...]
If you take nothing else away from reading this, please take this one amazing fact. Health spending accounts for 16% of America's GDP (the figure for the UK is 8.4%) and is projected by some to rise to 20% by 2017. Put another way, this means that health spending currently accounts for a sixth of the entire US economy and within a decade will account for a fifth. Since the US already spends around $2 trillion of its total annual wealth on healthcare this means that US health spending exceeds the entire annual GDP of nations such as Brazil or Italy. If the US healthcare system was itself a country, it would be a member of the G20 and probably even the G8.

In British politics, spending more money on health is paraded as a national virtue. In America high health spending only exposes a national vice. Spending more on health does not mean that Americans suffer from more diseases than other people. Apart from obesity and some others they don't. Nor does America's vastly higher level of spending " nearly twice the OECD average per head and rising " mean its people are significantly healthier. On the contrary, a 2007 study by McKinsey found the US incidence of 130 common diseases was broadly similar to the incidence in Britain, France, Germany, Japan and other nations.

The big difference between Americans and Europeans is not quality of health or quality of treatment but the difference in healthcare costs. In the US, hospital care, outpatient care and medicines all cost far more than they cost elsewhere. America also has a very high number of specialists, who rely more than primary care doctors (of whom there is a national shortage) on expensive technology and high fees. Since health insurers typically pay such specialists most of what they charge, there is little incentive for the system to reduce costs. But since private health insurers are also commercial businesses, premiums are also rising to generate profits. The US private health insurance industry gets $500bn every year from premiums " about three times what the British taxpayer gives to the NHS.

As a result, very large numbers of Americans simply cannot afford the health insurance premiums (typically of up to $1,000 per head per month) which in theory give them access to such treatments. Because many of the over-65s and the very poor are covered respectively by the government's Medicare and Medicaid programmes, most of these uninsured Americans come from the working poor and the middle-class. More than 50 million working age Americans " nearly a third of the total " have no insurance. Large numbers of those who are enrolled are themselves underinsured, especially for expensive treatments or operations, because they stick with lower cost schemes administered through their employers.

Clearly this is an unsustainable system. The temptation from this side of the pond and the progressive side of the argument is simply to say the solution is a no-brainer: what the US needs is a national health service like ours, and with Obama still enjoying soaraway ratings and the Democrats with a blocking majority in the Senate, now is the time to do it. Plenty of Obama's most committed supporters agree.

But it is not going to happen. First of all, it's not going to happen because, especially in the midst of recession, public opinion is uneasy. Voters want reform but, see a Pew Center poll this week, only 41% now actually want the system rebuilt from scratch; the majority want changes within the existing framework. Second, it's not going to happen because Obama's goal is bipartisan reform; the Washington Post reported last month that the president is telling visitors he would rather have 70 Senate votes for 85% of his healthcare goals, than 51 for 100% of it; this recognition that Democratic as well as Republican votes are still up for grabs is why the administration has allowed the congress to shape the legislation. Third, it's not going to happen because there are some very big vested interests involved in this fight, including doctors, hospitals, drug companies, insurers, employers and unions, so some compromises are inevitable; the failure to recognise this was what sank Bill Clinton's plan.

[...]


0 Replies
 
McGentrix
 
  1  
Reply Fri 31 Jul, 2009 12:41 pm
How about expanding medicaid and medicare to include those without insurance? It's a program already setup, would require some expansion, but may not cost a trillion dollars to do so.

Anyone bring that up elsewhere yet?
Cycloptichorn
 
  2  
Reply Fri 31 Jul, 2009 01:22 pm
@McGentrix,
McGentrix wrote:

How about expanding medicaid and medicare to include those without insurance? It's a program already setup, would require some expansion, but may not cost a trillion dollars to do so.

Anyone bring that up elsewhere yet?


This is basically exactly what the Public Option would be.

Cycloptichorn
0 Replies
 
Advocate
 
  2  
Reply Fri 31 Jul, 2009 01:45 pm
Medicare should, with adjustment, be extended to all.


44 Years Of Medicare Success

On July 30, 1965, President Lyndon Johnson signed into law the Social Security Act, part of which included Medicare, a measure to provide low-cost health insurance for elderly Americans. At the time, Johnson called the bill "the most revolutionary and most beneficial measure for older Americans since we passed Social Security itself back in 1935." "They will no longer have to suffer from misery and neglect and depend upon their relatives because they themselves cannot afford the cost of modern treatment," Johnson said. He inaugurated the "Great Society" program at the White House signing ceremony by enrolling former President Harry Truman as the first beneficiary and presenting him with the first Medicare card. "I predict that 30 years from today, this bill will be a welcome and permanent part of our nation's heritage that no representative would ever dare repeal," Johnson said. "Why? Because it represents the moral principle that we just must not neglect in their age those who have given a lifetime of service to their country." Johnson was right. Forty-four years later, Medicare has dramatically improved access to quality health care for the nation's seniors, allowed them to live longer and healthier lives, and has become one of the country's most popular government programs.

MEDICARE'S SUCCESS: Since the advent of Medicare, "the health of the elderly population has improved, as measured by both longevity and functional status," said one study published in the journal Health Affairs. In fact, according to the study, "life expectancy at age 65 increased from 14.3 years in 1960 to 17.8 years in 1998 and the chronically disabled elderly population declined from 24.9 percent in 1982 to 21.3 percent in 1994." Leaders of the Commonwealth Fund wrote in May that, "compared to people with private insurance, Medicare enrollees have greater access to care [and] fewer problems with medical bills." The report added that this finding is significant when considering that those Americans on Medicare represent a demographic that is more likely to be in poor health and to have lower incomes. Prior to Medicare, "about one-half of America's seniors did not have hospital insurance," more than 25 percent "were estimated to go without medical care due to cost concerns," and one in three were living in poverty. Today, nearly all seniors have access to affordable health care and only about 14 percent of seniors are below the poverty line.

CUSTOMER SATISFACTION: A recent Commonwealth Fund survey found that "elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage." Medicare is so popular that most Americans support expanding its coverage to Americans aged 55 to 64. According to a recent Kaiser Family Foundation poll, "over half of Americans (53 percent) 'strongly' support such a proposal and an additional 26 percent say they support it somewhat, totaling 79 percent backing." Similarly, a Health and Human Services Department-commissioned study released in June found that "56 percent of enrollees in traditional fee-for-service Medicare give Medicare a rating of 9 or 10 on a 0-10 scale," while "only 40 percent of Americans enrolled in private health insurance gave their plans a 9 or 10 rating." "The higher scores for Medicare are based on perceptions of better access to care," the National Journal noted, commenting on the surveys, adding that "[m]ore than two thirds (70 percent) of traditional Medicare enrollees say they 'always' get access to needed care (appointments with specialists or other necessary tests and treatment), compared with 63 percent in Medicare managed care plans and only 51 percent of those with private insurance."

FEARMONGERING NEVER CHANGES: Conservatives "bitterly opposed" efforts to provide elderly Americans with access to health care. Ronald Reagan argued in 1961 that if Medicare wasn't stopped, "one of these days you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free." George H. W. Bush called the plan "socialized medicine," and Barry Goldwater asked, "[h]aving given our pensioners their medical care in kind...why not a ration of cigarettes for those who smoke and of beer for those who drink?" Today's rhetoric from opponents of health care reform -- particularly the public option -- is eerily similar to the fearmongering of Medicare. While Republican scare-tactics today contain a regular diet of "socialism" charges, many conservatives and Republicans have even claimed that Americans will die if Congress passes a bill with a public option. "One in five people have to die because they went to socialized medicine!" Rep. Louie Gohmert (R-TX) complained. "Last week Democrats released a health care bill which essentially said to America's seniors: drop dead," said Rep. Ginny Brown-Waite (R-FL). While some conservatives are frightening the American public, right-wing "astroturf" groups are mobilizing anti-reform movements, and other conservatives are simply trying to block reform for political purposes. "If we're able to stop Obama on this it will be his Waterloo. It will break him," Sen. Jim DeMint (R-SC) claimed. On MSNBC last night, Sen. Sherrod Brown (D-OH) recognized these similarities in scare-tactics and urged Congress to move forward with real reform that contains a robust public option. "I go back to 40 years ago when the Medicare bill passed. People like Bob Dole, Strom Thurmond, Donald Rumsfeld, Gerald Ford, as members of Congress, they all opposed it. The fact is, in those days, the Democrats moved forward. They didn't worry about we have to have X number of Republicans. Their mission was we're going to get a good Medicare bill," Brown said.

-- americanprogressaction.org
0 Replies
 
McGentrix
 
  2  
Reply Wed 30 Sep, 2009 12:19 pm
I'd like to bump this up as I think this is still a better alternative then what is being discussed in Congress. Government provided health care would be so much better then government provided health care insurance. Just changing insurance programs does nothing to address the actual ailments of the system. All it does is create more paperwork and boondongles.

I'd much rather see the whole discussion in Congress scrapped because it will simply not work. Making people buy insurance or put them in jail? Shocked

That's an answer to no ones problems. Making people buy insurance does not alleviate expensive co-pays, does not encourage anyone to actually visit a doctor for fear of hidden costs, and it most certainly does nothing to reduce the costs of American health care.

Take the money, pay doctors to treat patients, pay to train new doctors and nurses, make a competitive health care program that people want to use.
roger
 
  1  
Reply Wed 30 Sep, 2009 12:26 pm
@McGentrix,
McGentrix wrote:


That's an answer to no ones problems. Making people buy insurance does not alleviate expensive co-pays, does not encourage anyone to actually visit a doctor for fear of hidden costs, and it most certainly does nothing to reduce the costs of American health care.


Good point on that "fear of hidden costs". I would like to see anyone find out the total costs of a hospital stay for a known condition.
0 Replies
 
maporsche
 
  1  
Reply Wed 30 Sep, 2009 03:45 pm
@McGentrix,
Agreed, but I'm surprised to hear you say this.
0 Replies
 
Cycloptichorn
 
  1  
Reply Wed 30 Sep, 2009 04:08 pm
@McGentrix,
Of course, dismantling 15+% of our economy in one go, and putting under the auspices of the Federal government, would cause one half of the American body politic to accuse the other of all sorts of terrible things. It wouldn't be possible, not for practical reasons but political ones.

Forcing people to buy in under a mandate doesn't work, unless there's a public plan they can buy into instead...

Cycloptichorn
McGentrix
 
  1  
Reply Wed 30 Sep, 2009 04:56 pm
@Cycloptichorn,
Cycloptichorn wrote:

Of course, dismantling 15+% of our economy in one go, and putting under the auspices of the Federal government, would cause one half of the American body politic to accuse the other of all sorts of terrible things. It wouldn't be possible, not for practical reasons but political ones.

Forcing people to buy in under a mandate doesn't work, unless there's a public plan they can buy into instead...

Cycloptichorn


How do you construe anything that I have said into this? It's no wonder I skip so many of your posts.

I would never suggest dismantling anything of the sort. I am saying that the government should be providing an alternative to private health care. Not providing health care insurance to keep going to the same hospitals, paying the same fees.

Unlike the current crop of people we have in the halls of Congress, I see absolutely NO reason to bull rush something like this through the fast track. It's too important and all they are going to do is screw it up.
Green Witch
 
  1  
Reply Wed 30 Sep, 2009 07:04 pm
@McGentrix,
Quote:
I see absolutely NO reason to bull rush something like this through the fast track. It's too important and all they are going to do is screw it up.


Hey, McG, we agree on this. At first I thought they better hurry before I get a serious illness, but now I think they really, really need to look at the long term picture and do it right. I want a pubic feedback campaign, not just the voices of the radicals at either end yelling at each other. At the moment the insurance lobbyists have their foot firmly in the door, but I think they could be dislodged because even the least involved people are getting wise to their swooping in like vultures on a carcass behavior. People need to be asked if they are willing to pay more taxes to guarantee that they will not go bankrupt because of medical bills or if a loved one gets sick they will be assured of having access to good care without having to fight with their insurance providers. I think those are reasons people would be willing to put up some money for the security of a public plan. No one wants to remain at the mercy and whims of insurance companies or trapped in jobs they hate because they need the benefits. Corporations (of all types) have made people fearful of our government and in the process we have given up our power to demand what is best for ourselves.
I would rather wait for the right solutions than have some half-assed plan, approved by the insurance companies, crammed down my uninsured throat.
roger
 
  1  
Reply Wed 30 Sep, 2009 07:24 pm
@Green Witch,
Me too. Something definately needs to change, but change is expensive. Fine, but lets get it right the first time, because whatever the change is, we're likely to be stuck with it for a long time.

I don't have the one and only right answer, either.
0 Replies
 
old europe
 
  1  
Reply Wed 30 Sep, 2009 07:52 pm
@Cycloptichorn,
Cycloptichorn wrote:
Forcing people to buy in under a mandate doesn't work, unless there's a public plan they can buy into instead...


Or unless you regulate the amount of money health insurance companies can charge in premiums, and then subsidize those who still can't afford to pay for their health insurance. At least that's how it's done where I come from.

Not that that's the best system in the world, but I disagree with the idea that introducing a public option is kind of a magic bullet, and that keeping a private health insurance industry in place while establishing a universal health care system is impossible without it.

I've said quite a while ago, on the long running universal health insurance thread, that the Swiss or German model is probably the easiest to implement in the United States, and contrary to Obama's position during the campaign - where he avoided advocating any kind of mandate - it looks increasingly like this is what you might end up with, for the reasons you just mentioned.
FreeDuck
 
  1  
Reply Wed 30 Sep, 2009 08:09 pm
@old europe,
old europe wrote:

Cycloptichorn wrote:
Forcing people to buy in under a mandate doesn't work, unless there's a public plan they can buy into instead...


Or unless you regulate the amount of money health insurance companies can charge in premiums, and then subsidize those who still can't afford to pay for their health insurance. At least that's how it's done where I come from.

But really, once you're done bending private companies to the government's will, won't it have been easier to just establish a public insurance option?
roger
 
  1  
Reply Wed 30 Sep, 2009 08:43 pm
@FreeDuck,
Well, yes.
0 Replies
 
old europe
 
  1  
Reply Wed 30 Sep, 2009 09:49 pm
@FreeDuck,
Given the resistance of health insurance companies to any kind of regulation, it certainly looks like the easy way out.

I just doubt it's an either/or thing.
0 Replies
 
McGentrix
 
  1  
Reply Thu 5 Nov, 2009 03:02 pm
So, driving home last night and this put America's infant mortality rate in perspective as to why we are so high on the list.

Quote:
MICHELE NORRIS, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.

ROBERT SIEGEL, host:

And I'm Robert Siegel.

One of the most common indicators of a country's health is its infant mortality rate. The U.S. lags far behind other industrialized countries on this measure. And a new study puts the U.S. at 30th, behind Poland and just ahead of Slovakia.

As NPR's Brenda Wilson explains, that's because of a high rate of premature births.

BRENDA WILSON: The percentage of infants born preterm in the United States has risen 36 percent since 1984. Infants born at 37 weeks or before have a greater risk of death or disability than infants born full term. Marian MacDorman of the National Center for the Health Statistics examined how the United States stacks up against other industrialized countries.

Ms. MARIAN MACDORMAN (National Center for Health Statistics): In the United States, one of eight births is preterm, compared to one out of 18 in Ireland and Finland and one out of 16 in Sweden and France. So, that's a very large difference.

WILSON: And the higher preterm rate has led to a higher infant mortality rate. In 1960, the U.S. ranked 12th in the world in the rate of infant mortality, and now is down to 30th. The survival rate for infants born prematurely in the United States is actually better than many countries. We do a better job than all but Sweden, Denmark and Austria, in keeping really premature infants alive.

Ms. MACDORMAN: Once they're born too early, we do pretty a good job of saving them. What we're not doing a good job with is preventing them from being born too early in the first place.

WILSON: Even though doctors do a good job of saving them, there are so many preterm births, the infant mortality rate remains high. Dr. Courtney Lynch, a professor at Ohio State University, says too much can be made of international rankings like this. For one thing, she says, dating a pregnancy varies.

Dr. COURTNEY LYNCH (Ohio State University): What's unclear is how gestational age is determined in each of the countries in Europe and there are definitely variable practices as there are in this country as to how often a ultrasound is used to date pregnancies.

WILSON: It can be affected by a women's recall of her last menstrual period or her first visit to the doctor. In comparing preterm rates in the U.S. to European countries, Lynch thinks it's important to consider the population mix here. The preterm rate for African-Americans, for example, has led to an infant mortality rate that has more than doubled the rate for white Americans. And there's a gap even when adjustments are made for income, education, obesity, smoking and disease.

Dr. LYNCH: A black woman who is a physician and is well-educated actually has a higher risk of preterm delivery than the least well-educated white woman.

WILSON: Race alone, Lynch say, remains the distinguishing factor.

Dr. LYNCH: It makes some folks uncomfortable and, you know, it's sort of tough to drill down. Those of us who have been working in this field have really been trying to figure out what it is. But we think that it is something related to the physiologic effects of experiencing lifelong racism.

WILSON: When you look at other groups, for example, Hispanics, the infant mortality rate is higher than for whites, but not as high as blacks. Asian-Americans have an infant mortality rate lower than many European countries. Other things that lead to a high preterm rate in the U.S., Lynch says, are an increase in fertility treatments, which cause multiple births and a high rate of Cesarean sections.

There's also a phenomenon more common in this country of women asking to have labor induced, so they can end a pregnancy early. The consequence, however, is a greater risk of losing the child.

Brenda Wilson, NPR News.
0 Replies
 
Advocate
 
  1  
Reply Thu 5 Nov, 2009 05:11 pm
I think that AARP has just come out for a public option. Of course, they should not have backed off this in 1993 while the Clintons were pushing their plan.
0 Replies
 
sstainba
 
  1  
Reply Fri 6 Nov, 2009 02:46 pm
I would have to disagree with this idea. Having previously used military medical services I can say they are not "top-notch". Also, one of the ways the government is able to keep costs down with respect to that medical service is that as a provision of seeking medical care through the VA or a military hospital, you wave all rights to file suit for poor outcomes. Military physicians are immune to med mal suits.

Part of the big problem in this country is that we don't treat "health insurance" like we do *any* *other* *insurance*. My home owners' and car insurance are only used when some big accident happens. Progressive Auto won't buy me gas or pay for new tires. They don't cover oil changes either. We expect health insurance companies to foot the bill for even the simplest of health maintenance costs. This really starts to add up when you consider the large number of people who suffer from chronic illness or simply seek medical care as a way of procuring drugs.

There is no simple answer to this problem. The issues in health care that make it so expensive are great in number and complexity. Many of the things that would offer the best outcome to the largest portion of the population will never be put into place because we are unable to tell people "NO".
 

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