IT'S TIME FOR UNIVERSAL HEALTH CARE

@Advocate,

Jesus had a very clear understanding that it was ok to die.

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@georgeob1,

"Happily, we have a secular government. "

http://www.youtube.com/watch?v=9H-btXPfhGs

Rolling Eyes

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@Cycloptichorn,

Cyclo, I'm very skeptical about those numbers being produced by the CBO; how often have they ever gotten their numbers right?

The biggest problem about what savings they can anticipate for ten years in the future is an impossible task, because nobody knows how any economy will perform that far ahead. I would prefer to see numbers that details out how much it's going to cost consumers and taxpayers vs anticipated savings from which areas of fraud and waste for the very short term. We can then play games with those numbers, and try to figure out what the real long term effect of this plan will be. I betcha no two economists will arrive at the same conclusion.

We need to have congress show us how they're going to pay for this plan from revenues; not from all the gamesmanship they seem to play with most of their budgets.

Our current debt trend is not sustainable.

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@georgeob1,

george, I don't go quite that dramatic on universal health care, because many developed countries already have it, and they're not on the brink of changing into communism/socialism, and none seems to have suffered in their economic output. Germany is a good case in point; they've had universal health care before the 19th century, but their productive capacity has been relatively strong relative to the world economies. I believe it has to do more with their educational system, culture, and environment. Japan is another good example, but they made the mistake of not controlling inflation that caused their economy to suffer the past couple of decades - even while they expanded economic output.

Here's an excerpt on Japan's universal health care.

Quote:

Everyone in Japan is required to get a health insurance policy, either at work or through a community-based insurer. The government picks up the tab for those who are too poor.

It's a model of social insurance that is used in many wealthy countries. But it's definitely not "socialized medicine." Eighty percent of Japan's hospitals are privately owned " more than in the United States " and almost every doctor's office is a private business.

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@cicerone imposter,

I would agree with you if (1) Americans were Germans or Japanese or even had such a homogenious culture; or (2) if anyone in our political structure proposed such a rational and limited plan.

However neither is the case here.

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@georgeob1,

Your comment raised the question, how homogeneous are those countries? I found this on Wiki that's quite interesting on Japan.

Quote:

Regions with significant populations
Japan 127 million
Significant Nikkei populations in:
Brazil 1,400,000 [17]
United States 1,200,000 [18]
Philippines 120,000 [19]
China (PRC) 115,000 [20]
Canada 85,000 [21]
Peru 81,000 [22]
United Kingdom 51,000 [23]
Germany 30,125 [24]
Argentina 30,000 [25]
France 28,000 [26]
Australia 27,000 [27]
Singapore 23,000 [28]
Mexico 20,000 [29]
Taiwan (ROC) 16,000 [30]
South Korea 15,000 [31]

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@georgeob1,

georgeob1 wrote:

This is just a fiction for the basic notion of "let someone else pay for my needs and desires".

More like, "I'm already paying for everyone else's needs and desires, let us all have the same benefits."

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@FreeDuck,

FreeDuck, There's more; we're already paying for everybody, but at highly inflated cost. We must reform the system to a) make it more affordable, b) cover all Americans, and c) reduce the cost for both private and public plans.

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@cicerone imposter,

That sounds very odd because the current Senate Plan calls for rather large additional taxes on those who currently have health care insurance, and involves a substantial reduction in Medicare benefits. It seems clear that we will end up paying a lot more in direct charges and taxes (plus the additional negative effects of these taxes and the added deficits on economic activity), and will very likely end up getting less service for our dollars.

In addition there is no basis to believe that the new government programs will be any less politicized than those that preceeded it or that the government will suddenly become any more effective in limiting fraud and waste than it has always been.

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@georgeob1,

I'm still not sure what any of the plans being developed by congress will end up costing; they've given some numbers, but as I've mentioned before, ten year plans are meaningless. How much revenue will any of the plans bring in from all forms including rates *by income and/or different levels of coverage, how much the subsidies are going to cost when fully implemented, and how much in savings we can anticipate by increasing efficiency (many CEOs of hospitals claim that the goal to save $2.7 million per hospital, an average, is doable), and reduce fraud by instituting tough penalties. Additionally, we all know that Americans pay more for American produced drugs than people in other countries; that needs to stop. Why are we subsidizing foreign patients with our drugs?

I still want to see increased competition in how insurance plans are offered to the general public. I'm still not sure whether national insurance plans will increase efficiency; I haven't seen enough information or studies on this subject.

Thinking in global terms concerning how much the US spends on health care while some 60 million have no insurance or inadequate insurance, I'm sure there are ways to reform the whole system without adding too much cost; all developed countries already do it.

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@georgeob1,

George, I think you are exactly right. Those unpaid for hospital stays could represent some savings, if everyone had insurance. That would be especially true of emergency room charges written off, and often times just because private doctors require payments. I don't know if anyone has quantified the expected savings, but I remain doubtful that it will make up the difference.

At a minimum, I hope there will be fewer hospitals closing their emergency room facilities because of the costs. This is something of a concern as my town has exactly one hospital.

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@cicerone imposter,

We cross posted - again.

I do wonder what is meant by "inadequate insurance" means, and whether any sort of government mandated insurance will be above that standard. I'm also wondering who, if anyone, will be willing and/or required to accept that insurance. I continue to be very aware that Medicare is not universally welcomed, and Medicare standards seem to have become a standard for some proponents of a reworked health payment system.

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@roger,

This is what I found that explains "inadequate insurance." It essentially means that people who may have insurance are not covered adequately for their health needs. They may have life-time limits, high deductibles and/or co-pays.

Quote:

by Cathy Schoen, Michelle M. Doty, Sara R. Collins, and
Alyssa L. Holmgren
ABSTRACT: Health insurance is in the midst of a design shift toward greater financial risk for patients. Where medical cost exposure is high relative to income, the shift will increase the numbers of underinsured people. This study estimates that nearly sixteen million people ages 19"64 were underinsured in 2003. Underinsured adults were more likely to forgo
needed care than those with more adequate coverage and had rates of financial stress similar to those of the uninsured. Including adults uninsured during the year, 35 percent (sixty-one million) were under- or uninsured. These findings highlight the need for policy attention to insurance design that considers the adequacy of coverage.

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@cicerone imposter,

Not really an explanation, though. Surely, those with high co-pays will have fewer unnecessary doctor's appointments than those with no deductable and no copay. This is not entirely undesirable. I hate the expresion "skin-in-the-game", but it is a factor. I don't see any plan coming along without either co-pays or deductables of some sort.

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@roger,

I personally believe it's a big mistake not having some kind of co-pay, because it will reduce unnecessary visits/abuse to the doctor/hospital. Co-pays also help at the revenue side of the plan that needs to be considered.

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@cicerone imposter,

but there are also studies that claim "co-pays" increase total health-care cost since some patients will wait to see a doctor/hospital early on .
delayed diagnosis can be costly to both patient and the health-care system .
certainly not easy to strike the right balance .

( an ounce of prevention - or early intervention - is worth a pound of cure )

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@hamburgboy,

Quote:

but there are also studies that claim "co-pays" increase total health-care cost since some patients will wait to see a doctor/hospital early on

can you document? I have known too many parents who have the urge to run to the doctor's office for every sniffle, too many adults who want every test under the sun for peace of mind, to believe that. Health care must be rationed, and co-pays are part of the rationing process. One must want something enough to pay something for it.

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@hamburgboy,

I have never seen any studies on this, but speak from personal experience working with nonprofit organizations. That may be comparing apples and oranges, and I see your point about prevention.

When we were kids, we didn't go see a doctor for every little cold or cuts, and survived pretty well. Our mother did call a doctor for me once when I was a youngster, and complained about having difficulty breathing.

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@roger,

roger wrote:

At a minimum, I hope there will be fewer hospitals closing their emergency room facilities because of the costs. This is something of a concern as my town has exactly one hospital.

I expect we will see more closings of hospitals, clinical testing facilities and treatment centers. In the upside down world of government price controls, cost are limited by reducing the number of claimants (i.e. service providers). In the real world of free economic activity, costs are reduced by surplus capacity and competition among providers.

How quickly we have forgotten the dismal results achieved by the centrally planned economies of Eastern Europe.
Indeed the advent of Medicare and Medicaid (in particular) has motivated state and local governments (with the active support of the Feds) to limit the construction of new facilities - even in the presence of investors and providers who wanted to build them - and to force the closure or reduction of existing "surplus" facilities. This can also be (from the perspective of government) a politically tolerable (for the pols themselves) way to impose rationing. The first casualty in all of this is the quality of care and the freedom of providers and consumers.

All this has already happened in the UK and Canada. However don't expect those who have already drunk the poisioned Kool Aid to speak out and warn us - it's lonely down there for the cattle who have already lost their freedom.

We are going to throw our freedom away and for a very cheap price.

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@georgeob1,

Not true in every community, although there are both old and new hospitals where we live. The new Kaiser hospital is only one block from where we live; it's prime location not only for the hospital, but for high tech jobs. We're pretty lucky to be living here, because our home prices have not seen the depreciation in prices in our ZIP code compared to others in our city and neighboring communities.

I believe San Jose has closed a couple of hospitals, and their community hospital (Valley Med) has been running deficits for quite a few years.

Quote:

Friday, September 11, 2009
Editorial
First, do no harm at Valley Medical
Silicon Valley / San Jose Business Journal

* $20M audit garners $100M in savings at Santa Clara Valley Medical Center [09/04/2009]

Santa Clara County officials are sounding the alarm about one part of the health care reform package being discussed in Washington.

County officials are worried that they could lose as much as $100 million in federal funding annually. This money is given to Santa Clara Valley Medical Center because it cares for more uninsured than any other hospital in the region.

Those advocating for reform say their proposals will wipe the hospital slate clean of uninsured costs. So these reformers propose to also do away with special funding for hospitals such as Valley Med.

This reasoning is flawed, according to county officials, and comes at a time when the local system is already dealing with massive shortfalls in state funding and pressure from county deficits.

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IT'S TIME FOR UNIVERSAL HEALTH CARE

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