Health Care Non-American Style

Walter Hinteler wrote:

CalamityJane wrote:
Patient care is definitely better here in the United States.

That's the most important thing.

If so, I wouldn't like to change the system neither.
(The time a doctor takes care personally with her/his patient here has a lot to do with the fact how much she/he gets paid for it.
Unfortunately.
That works better in smaller communities.
Fortunately.)

Exactly! It's how physicians are compensated here, that makes the
difference. But it has nothing to do with universal health care per se -
still, every American should be able to get insurance either through
employment or through government sources. That's important!

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I suppose it was inevitable that this discussion would come around to an argument about whether the US goes with universal health care or not. I was hoping to just be able to talk about what kind of system we could have that would not sacrifice quality or timely access to health care.

I still wish that those who want to discuss the merits of the present system v.s. universal would get there own thread.

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Swimpy wrote:

I was hoping to just be able to talk about what kind of system we could have that would not sacrifice quality or timely access to health care.

It's not that easy, Swimpy. In order to have a system that is suitable
to all, you really have to look at other systems in how they operate -
what they're lacking, resp. where they are superior.

My idea of a universal health care system in the US would be:
a) basic insurance for all
b) employment based insurance 50/50 employer/state
c) private group plans for PPO or premium health care insurance

Basic healthcare should be paid from a fund generated by all tax payers,
meaning as long as you work, a certain percentage of your taxes will
be allocated to the universal health care fund. Any tax payer can apply
for these funds for universal health care should there be no other means
(employer) to receive coverage.

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CalamityJane wrote:

It's not that easy, Swimpy. In order to have a system that is suitable
to all, you really have to look at other systems in how they operate -
what they're lacking, resp. where they are superior.

My idea of a universal health care system in the US would be:
a) basic insurance for all
b) employment based insurance 50/50 employer/state
c) private group plans for PPO or premium health care insurance

Basic healthcare should be paid from a fund generated by all tax payers,
meaning as long as you work, a certain percentage of your taxes will
be allocated to the universal health care fund. Any tax payer can apply
for these funds for universal health care should there be no other means
(employer) to receive coverage.

I agree with your goal, CJane. I think we also don't need to reinvent the wheel. We have programs that are working now. They need to be funded better, especially Medicare, but I think that with some minor adjustments these programs would cover every American. I think the real stickler is finding a way for a employer with only a few employees (or even the self-employed) to offer employees health care insurance without breaking the bank.

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baldimo wrote about the canadian health care system :

Quote:

Need an organ transplant better luck next time.

i don't know what canada you are referring to .
all kinds of organ transplants are done quite routinely in the canada i live in .
(don't want to get the thread off the track - so i'll stop).
hbg

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Swimpy wrote:

I think the real stickler is finding a way for a employer with only a few employees (or even the self-employed) to offer employees health care insurance without breaking the bank.

Yes, but for that we need a insurance reform. Don't get me
started on that, I would regulate and restrict the providers quite a bit.
We're a small outfit with 10 employees and pay over $ 6000/month
in premiums.

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I know, CJ. I've lived without health insurance because I couldn't afford the premiums and I had a job. I'm thankfull that I have an employer now that offers health insurance coverage. I agree that the insurance industry is in need of reform.

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swimpy :
if there were only ONE advantage to the canadian health care system , it is that you don't have to be concerned whether or not your employer can afford to offer you health insurance . if you are a "resident" of canada , you have health-insurance .
as an aside : this is one of the reasons why ford , GM and chrysler have major automotive factories in canada : their health insurance costs are much lower in canada - which helps lower their total production costs !
hbg

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CalamityJane wrote:

Swimpy wrote:
I was hoping to just be able to talk about what kind of system we could have that would not sacrifice quality or timely access to health care.

It's not that easy, Swimpy. In order to have a system that is suitable
to all, you really have to look at other systems in how they operate -
what they're lacking, resp. where they are superior.

My idea of a universal health care system in the US would be:
a) basic insurance for all
b) employment based insurance 50/50 employer/state
c) private group plans for PPO or premium health care insurance

Basic healthcare should be paid from a fund generated by all tax payers,
meaning as long as you work, a certain percentage of your taxes will
be allocated to the universal health care fund. Any tax payer can apply
for these funds for universal health care should there be no other means
(employer) to receive coverage.

I think you also have to look beyond how other systems operate and go as far as looking at how the rest of the social support systems operate as well as the social norms in their countries.

IMO, if there is going to be a true universal health care system then the entire idea of tagging employers goes out thw window. I don't understand the concept where people think that employers should somehow be responsible for this.

Health insurance through the employer was done as either a benefit to attract/retain employees or through labor agreements. There is no inherent responsibility for an employer to provide it though. If it is decided that there is some social reaponsibility to provide health care for all that is what government is there for.

As a result I'd cut your list of 3 to a list of 2.

a) basic insurance for all
b) private group plans for PPO or premium health care insurance

If the employer chooses to (or agrees to) cover a cost of their employees share of the "b" section so be it. But there shouldn't be any mandate for then to do so.

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I do not want my employer to be responsible for providing my health care. Period. My health care should not be dependent on my job.

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You're right, fishin'

I wouldn't mandate for employers to provide health insurance, however,
if they'd choose to, a 50/50 employer/state payment would be fair.

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maporsche wrote:

I do not want my employer to be responsible for providing my health care. Period. My health care should not be dependent on my job.

Are you in the US?

If not your employer, who should - yourself or the state?

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My husband and I own a business. We employ 6 people. My husband and I can't afford health insurance and we make too much money to afford the NY state assisted program for people without insurance. Basic insurance would cost us $8,000 dollars per year, we only make $35,000 before taxes. We know many people who are self-employed and cannot afford insurance. It's a major reason people stay in jobs they hate instead of starting there own business. Lack of affordable insurance is killing entrepreneurship in the US.

People with insurance pay for people without it directly and indirectly. Hospitals over bill and over service those with insurance to pay for people that do not have insurance. I know if I get sick a hospital is required to give me service, they might offer me a payment plan, but they will certainly charge the next person who has insurance $8 for an aspirin to pay for what I can't.

45 million American CITIZENS do not have insurance (10 million of those own a small business), the amount of illegals that walk into hospitals are barely counted. Most hospitals treat them and release them knowing they will not collect and will have to make up the loss on the next person who has insurance.

Americans pay more per person for health insurance than nations with a national program. I would like to see the US learn from the mistakes other nations have made and fix our broken system. We all have to pay to spread out the cost. I can afford to pay something, just not $8000 per year. People who smoke or are classified as obese should pay more than those that don't.

Washington doesn't give a poop about little business people like me. However, companies like GM, Ford, and Walmart are sending their lobbiests to congress to make the point that Amercia can't be competitive in the world market until they are released from the health care burden.

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Green Witch wrote:

People who smoke or are classified as obese should pay more than those that don't.

The second anyone talks about doing this sort of thing (officially) any hope of universal care is dead.

If you are going to charge more for smokers or the obese then you have no basis for not having those who consume alcohol, drive cars, are born with some congentital disease, women, etc.. pay more.

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fishin wrote:

Green Witch wrote:
People who smoke or are classified as obese should pay more than those that don't.

The second anyone talks about doing this sort of thing (officially) any hope of universal care is dead.

If you are going to charge more for smokers or the obese then you have no basis for not having those who consume alcohol, drive cars, are born with some congentital disease, women, etc.. pay more.

I agree, fishin'. We don't need any more reasons to discriminate.

I also see what you are saying about putting the onus on the employers. However, I think it's worked fairly well to this point. Large employers have the buying power to keep health care costs in check. The federal government has that power, too.

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fishin wrote:

Green Witch wrote:
People who smoke or are classified as obese should pay more than those that don't.

The second anyone talks about doing this sort of thing (officially) any hope of universal care is dead.

If you are going to charge more for smokers or the obese then you have no basis for not having those who consume alcohol, drive cars, are born with some congentital disease, women, etc.. pay more.

Why shouldn't we charge people who live risky lives more for their insurance. We would be talking about people who don't things outside of everyday normal things. Driving a car is done by the majority of americans and not considered risky. Those they race cars for a living would pay more because not a majority of people race cars. Unless of course you are always late for work. Laughing

Why should I pay the same for insurance as someone who goes sky diving on a regular basis? I'm in the military and my standard life or health insurance does not cover those things related to the military. My life insurance was put on hold while I was deployed because they don't death related to military actitives. Is that fair? Of course it is because I'm in a risky business in the military.

I think those things that aren't seen as everyday occurances for the average American should be listed as higher rates for health insurance.

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You're the original misanthrope, aren't you, Baldino.
Who is to determine what's risky and what's not?

Some indulge in an artery clogging meal day after day, eating junk food to no end, and ultimately get a heart attack, yet having no risky hobbies
makes them eligible for a lower rate, while the race car driver is in top shape and healthy, but has to pay a higher premium.

When is someone considered obese and what guidelines are there to follow? What about the anorexics? They have just as many health problems as
the obese, and how about your friend, cjsa, who accidently shot himself
in the foot while on a hunting trip? Should we really pay for his stupidity?

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Baldimo wrote:

Why shouldn't we charge people who live risky lives more for their insurance. We would be talking about people who don't things outside of everyday normal things. Driving a car is done by the majority of americans and not considered risky. Those they race cars for a living would pay more because not a majority of people race cars. Unless of course you are always late for work.

Why should I pay the same for insurance as someone who goes sky diving on a regular basis? I'm in the military and my standard life or health insurance does not cover those things related to the military. My life insurance was put on hold while I was deployed because they don't death related to military actitives. Is that fair? Of course it is because I'm in a risky business in the military.

I think those things that aren't seen as everyday occurances for the average American should be listed as higher rates for health insurance.

Your civilian policies cover anything other than combat related injuries. They don't have any choice in the matter because that's how Federal law is currently spelled out so you are making things up here. Tricare always defaults to being the secondary insurance.

And while you are deployed in a combat zone you are covered under Tricare and SGLI at significantly lower rates (in fact Tricare is free for you) than what any smililar civilian health or life insurance policy would cost.

Are you saying that people that engage in high risk activities should pay less? Sorry but your examples aren't working well for you here...

Not that it matters much. If there was a basic universal heath insurance program it wouldn't matter whether you were deployed or not. You'd still be covered.

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imo an extensive (and fair - that is , agreed to by all) risk rating system for health insurance would be an administrative nightmare .
any posssible premium savings would likely exceed the cost of administration .
most of us engage in activities that someone else might classify as being at least somewhat dangerous .
a "universal" health system has be be exactly that : "UNIVERSAL" or you'll never get it off the ground (already stated by cj much better !) .
the idea of the universal health care system is that you keep the cost low enough to be affordable for the nation as a whole , that is , financed by tax revenues .

while i'm not really familiar with the american system , i've heard numerous AMERICAN health economists state that the per person administration costs of the american system are twice the cost of the canadian (and they were only speaking of the administration costs , NOT the medical costs) .

while i would like to see improvements to the canadian/ontario system , i would not like to give it up for a FULLY PRIVATE system .

btw canadian physicians are really "businesspeople" delivering health care services - they are not employed by the government .
similarly , hospitals are not operated by the government but local hospital boards . their operating costs , of course , are provided by the government health insurance for services performed .
they may also collect some additional revenue from private insurance companies or individuals for such services as private rooms and private nursing care .
hbg

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As we've seen in the US, a private only system leaves many people out. We've had the advantage of seeing how various systems work and don't in other countries, I'd like to see if we can't come up with something that builds on those successes and is, I would hope, an improvement.

I found this editorial by Robert Samuelson interesting:
http://www.washingtonpost.com/wp-dyn/content/article/2007/01/30/AR2007013001666.html

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