Many use of taxpayer money for Americans; 1) increase funding for our schools, 2) provide health care to all children, 3) help the homeless and the poor, 4) provide total and free health care for our veterans, and 5) stop government waste.
The reason we will have Universal Health Care in America is because companies like Walmart,that don't want to offer it, and companies like General Motors, that are dying because of it, are sending their lobbyists to Washington. With the right bribes, Congress will do their bidding and release corporations from the strangle hold of suppling health care. The only way they might lose is if the insurance companies come up with even more money to counter act any legislation.
Here's another interesting result of "Sicko." Almost all of the newspaper movie critics gave Sicko a star (DON'T MISS IT) rating.
cicerone imposter wrote:Here's another interesting result of "Sicko." Almost all of the newspaper movie critics gave Sicko a star (DON'T MISS IT) rating.
That's because people like movie critics don't practice medicine in the USA...
From reading this thread I would conclude that Germany's universal insurance system works well and enjoys widespread public support. Apparently the system in France enjoys similar public support. In Canada and the UK poor service and long delays have made public health care a major politicaL issue for governments over the last two decades and several of the comments here have reflected that.
All of these countries have, to varying degrees, more fully developed welfare systems than in the U.S.; government operated, sponsored, or regulated universal health care systems; more highly regulated labor markets -- and the higher tax rates that go with these programs. All of these countries also have much lower levels of immigration, and in general, relatively more social and political difficulties in assimilating the immigrants they do accept (Canada is likely an exception). They also have lower economic growth rates. My point here is that to a degree these policies should not be considered in isolation. What is best may vary with the temper of the people and the internal conditions they face. Moreover these systems can have significant side effects that are all too often ignored in these discussions.
On another thread there was ample data indicating that in general physicians in the U.S. earn substantially more than they do in other advanced countries. I strongly suspect the data may be subject to several distortions due to different systems for managing liability insurance, tax rates and other like factors. Still it seems likely that physicians here earn a bit more than in other countries. Is that good or bad for the public??? I believe that is an interesting and largely unexamined question. Recent events in Scotland may suggest that government policies to keep physician salaries down through foreign imports may have unforseen side effects.
Some here have made reference to "greedy insurance companies", apparently in the belief that under a universal care system such as (say) that of Germany, insurance companies will suddenly change their behavior and become less greedy or cost conscious. There is no factual basis on which to base this delusion, which, in addition, defies common sense.
Ultimately any government managed health care system will have to institute some form of rationing to replace the raw economic limits of a free market. If a health care transaction is apparently free to the consumer, then artificial or management processes must be developed to replace the feedback signals for supply & demand that are implicit in a free market. In addition ceilings must be established on total cost. Inevitably these lead to limitations on individual transactions or services. Whether these limitations are done explicitly by insurance companies or implicitly by governments in limiting the supply of hospitals and providers, the result is the same. One can rationally prefer one system over another, but the notion that universal systems are free of such things defies belief.
There is no free lunch.
Good post, georgeob. There's never a "free lunch," but as things stand in the US now like a) highest cost health care system in the world, b) our standard of health care falls below most developed countries, and c) many patients are turned away if they don't have insurance or the private means to pay for care. Emergency rooms in the US only needs to stablize the patient, then turn them out to fend for themselves no matter what ails them. If we can spend 2.7 billion every week in Iraq, we can help those people with "free" health care who needs it.
Quote:Still it seems likely that physicians here earn a bit more than in other countries. Is that good or bad for the public??? I believe that is an interesting and largely unexamined question.
It's examined 24/7 on most medical blogs today. The final conclusion by the physicians who post on these blogs is that high quality medical care in the US is a function of the re-imbursments paid to the practing MD. Those doctors in private practice, who treat a significant number of medicare and medicaid patients often go into deblt, (due to low re-imbursements by the Federal Government) if another source of revenue isn't found.
Many doctors are now refusing to take medicare/medicaid patients and some are even refusing to take any form of insurance and insist on payments strictly in cash, to reduce the overhead.
Another type of medical practice developing in the Boston area and elsewhere is the concierge MD, an individual who takes a retainer fee for about $3000/year to be an individual's physician and this $3000 is in addition to the amount the patient pays in premiums to the insurance company. The conceirge MD, instead having the usual 3000-5000 patients in his practice keeps the number to about 800, so that the number of patients seen each day is low and more time can be spent with each patient.
The concierge MD is also available to the patient 24/7 and is also the referral point for any specialists, should any be needed.
Quote:Ultimately any government managed health care system will have to institute some form of rationing to replace the raw economic limits of a free market
In Texas, about 30% of the residents are un-insured , but can receive free care at several free hospitals in the state. Wait times in these places can often be as long as 2 days.
Quote:In addition ceilings must be established on total cost. I
And as a result, as mentioned above, re-imbusements by the Government are strictly regulated both by dollar amount as well as procedure covered. When the Government is paying your insurance, they have the right ( apparently ) to regulate what procedures and drugs will be covered.
An elderly man had severe chest pain, thought he was having a heart attack and so he called an ambulance to take him to the hospital. At the hospital, the patient was found to not have suffered a heart attack and instead he had a tumor on his heart.
The Governement would not pay for the ambulance, his trips to the hospital for heart tumor evaluations is not covered.
Yeah, everybody feels badly for those "poor" doctors.
Salary of a Doctor
The Physics FactbookÂ
Edited by Glenn Elert -- Written by his students
An educational, Fair Use website
Bibliographic Entry Result
(w/surrounding text) Standardized
Result
Antell, Gerson, & Harris, Walters. Economics: Institutions and Analysis, Third Edition. New York: Amsco School Publications, Inc., 2001:182. "Table 8.2
Median Weekly Earnings, 1999
Physicians $1,266" $65,832
Physicians and Surgeons. Medical Group Management Association, Physician Compensation and Production Report, 2003. Table 1. Total compensation of Physicians by Specialty; 2002
Anesthesiology $306,964
Surgery, general $255,438
Obstetrics/Gynecology $233,061
Internal medicine $155,530
Pediatrics/Adolescent medicine $152,690
Psychiatry $163,144
Family Practice $150,267
$150,267 - $306,964
"AMA: Doctors' income still rising." Managed Care. (June 1998). "The American Medical Association' annual physician income survey shows that, an average, doctors are making close to $200,000 a year." $200,000
Terkell, Studs. Hard Times. New York: Pantheon Books, 1970: 80. "I just came across a bankbook that I had between 1931-1934, and, by God, I was in those days making $2,000 a month." $24,000
Enzmann, Dieter R.Surviving in Health Care. St. Louis, Missouri: Mosby-Year Book., 1997: 98. "Perhaps because of persistent high salaries ($186,000 average physician compensation in 1994) there is little public sympathy for the physician's current plight." $186,000
Chatter wrote:If you are speaking of a system of medi-care like we have here in Sask., Canada, it's not the end-all and be-all you seem to think it will be. We do pay for it in higher taxes and the quality of service is deplorable. Two weeks ago, I NEEDED to see a doctor, but was unable to get any attention whatsoever. Every office I phoned was either booked, on holidays or simply not taking new patients. Thankfully my issue was not life-threatening, but nonetheless I was very frustrated with the lack of medical assistance. It is nice to have medical attention available for all regardless of financial ability but we need to make some reformations to the way our medical system carries itself everyday. Very often essential medical services are not available when we need them and we are placed on long waiting lists. a nighbor of mine recently passed away because the waiting list was too long.
I'm wondering how old you are and just where in Saskatchewan you live and what your neighbor suffered from and why you attribute a "waiting list" to his/her death.
Canadian medical services have declined over the last two decades mainly as a consequence of reduced transfer payments from the federal government to the provices, who deliver med services. That's a trend that began under Mulroney and which was driven by his conservative ideology and the corporate interests related to his government. Which is not to say that the government which followed his did much better, sadly.
As you likely know, there is not chance that Canadians will voluntarily revert to a system such as is in place in the US. That's true as well for England or Germany or any of the other European countries.
As regards finding medical practictioners, we have just moved to Oregon and we are having trouble finding doctors to see us here. Partly it is because their is an apparent shortage of practitioners and partly because it is summer when lots of them are away on vacation.
Glad to see your posts here again Bernie. I hope you & Jane are comfortably settled and enjoying the delights of the Pacific Northwest.
I noted your comment about the declining transfer payments begun by Mulroney and sustained through ten years of Liberal governments. If I am not mistaken this period also started with unsustainably high Canadian national debt (as a % of GDP) and involved sustained reduction of that debt load through economic growth and sending restraint. Canadian national debt is now on the low side of the normal range for developed countries and the economy is doing well.
My point here is that, with a government financed or managed health care system, services are inevitably rationed or bounded by government actions and decisions made based on a host of economic and political factors independent of and sometimes contrary to the welfare of an individual. I don't claim that this alone makes them generally undesirable, but rather note that they are not the panacea, free of side effects and defects, their protagonists here often make them out to be.
Balanced against the "free market place" for medical care, I prefer the imperfections of a universal health care system.
georgeob1 wrote:My point here is that, with a government financed or managed health care system, services are inevitably rationed or bounded by government actions and decisions made based on a host of economic and political factors independent of and sometimes contrary to the welfare of an individual. I don't claim that this alone makes them generally undesirable, but rather note that they are not the panacea, free of side effects and defects, their protagonists here often make them out to be.
Though our health care sstem is neither governmental financed nor governed (well, yes, it is: since 1883 we have a law [resp. laws] that made health insurance nationwide mandatory for [certain] workers/employees), some is regulated by parliament (in laws).
Like the Pharmaceutical Price Ordinance and the Pharmaceutical Expenditure Limitation Act, or the Health Insurance Cost-containment Act and the Health Insurance Contribution Rate Exoneration Act etc ect.
And lawmakers like such - in this legislatural period we so get at least 1228 plus opinions on each subjects (each lawmaker -614 actually- has at a minimum of two different opinions on health topics). :wink:
cicerone imposter wrote:Good post, georgeob. There's never a "free lunch," but as things stand in the US now like a) highest cost health care system in the world, b) our standard of health care falls below most developed countries, and c) many patients are turned away if they don't have insurance or the private means to pay for care. Emergency rooms in the US only needs to stablize the patient, then turn them out to fend for themselves no matter what ails them. If we can spend 2.7 billion every week in Iraq, we can help those people with "free" health care who needs it.
I think you are reciting several frequently repeated propositions that don't stand up well under close scrutiny.
There are lots of statistics that indicate much higher per capita spending on health care in the U.S. than in (say) Canada, Britain, Germany, France and other advanced countries. Though I don't know the details, I can't help but suspect there may be other aspects of popular behavior and other facts of national demographics that may affect this data in ways that are usually not cited. A couple of examples; (1) If waiting lists and other forms of triage are imposed, people will more often just wait out minor problems and thereby impose no cost for them on the system. (2) Female fertility is much higher in the United States than in any of the cited countries. This must impose a significant differential cost on the system. (3) The capitalist remnants in our system do preserve a measure of competition among hospitals, doctors and other providers. That means competing excess capacity - a built in remedy for the problems of government underfinancing noted in other countries. This costs money. There are more, and I would like to see a more detailed and meaningful comparison of costs than is generally available.
Is it really true that the "standard of care" in this country is below that of all the others? The usual demonstration of that proposition involves comparisons of statistics for life expectancy and infant mortality. We do lag but, particularly for life expectancy, not by much, and certainly not enough to ascribe the difference to the availability and efficacy of medical care. Sound statistical corrections to life expectancy data based on our much higher birth rates alone would eliminate the differences in most cases. Next consider our much higher immigration rates with the other countries noted (Canada is an exception, being similar to us). Surely the large influx of usually poor people from around the world has some effect on these statistics. Only rarely doe one see acknowledgment of this.
I don't know why, but it seems that those criteria choosen are accepted by .... whomever.
At least, these data are compaable and used by all statistical offices.
While looking at some of those statistics, I found that in Germany the number of 'statituary sickness funds' (compulsory health insurance companies)reduced from 18,776 in 1885 (with only 229 contibuting members per fund) over 4,625 in 1938 and 1,182 in 1987 to only 263 in 2006.
georgeob1 wrote:Glad to see your posts here again Bernie. I hope you & Jane are comfortably settled and enjoying the delights of the Pacific Northwest.
I noted your comment about the declining transfer payments begun by Mulroney and sustained through ten years of Liberal governments. If I am not mistaken this period also started with unsustainably high Canadian national debt (as a % of GDP) and involved sustained reduction of that debt load through economic growth and sending restraint. Canadian national debt is now on the low side of the normal range for developed countries and the economy is doing well.
My point here is that, with a government financed or managed health care system, services are inevitably rationed or bounded by government actions and decisions made based on a host of economic and political factors independent of and sometimes contrary to the welfare of an individual. I don't claim that this alone makes them generally undesirable, but rather note that they are not the panacea, free of side effects and defects, their protagonists here often make them out to be.
hi george, nice to see you again
In Canada, under Mulroney as with your government under Reagan, the national debt increased rather than decreased.
I think I've mentioned before that my twin brother's wife is (or was until a recent and successful battle with cancer) the head administrator at one of Vancouver Island's large medical regions. This allows me a pretty good perspective into the situation here over the last two decades or so. There's no question that budget restraints have cut away waste that wasn't evident as waste previously. But care has declined, often seriously, and nobody within the system is happy about this decline except those who aren't medical people (read political appointees). And you are right to suggest that such systems are inevitably imperfect.
But the telling argument for broad universal health care (with profit incentives for avoiding care of people removed) is that the consumers under such systems, in Canada and elsewhere, do not allow the dismantling of their systems. In the US, the majority of citizens desire such a system. The forces wishing to continue denying Americans such a system are either corporate or ideological.
In all of the reports I have read on this subject, I was never able to refute these claims - by Wikipedia:
According to a 2000 study of the World Health Organization, publicly funded systems of industrial nations spend less on health care, both as a percentage of their GDP and per capita, and enjoy superior population-based health care outcomes.[5]
cicerone imposter wrote:... I prefer the imperfections of a universal health care system.
Does california have Univeral Health Care? I thought
we were unique in the Commonwealth of Massachusetts for having this type of health coverage.
So tell us, CI, based on your experiences with Universal Health Care, as an enrollee in such a plan,
what did you like about your coverage?
