quote:

don't want to be paying for bums who just live off the system

Especially because we are just letting all these illegal immigrants into the country and doing nothing about it. What do they do once they are here? Apply for welfare, and sit on there ass doing nothing, taking money from the legal citizens working their asses off.

Exactly! That's another thing that I can't stand! Giving rights to people who broke the law by coming in here illegally! Get out! If want to come to our country, awesome! Do it the legal way or don't do it at all.

To all of you illegals: By coming here illegally, you obviously don't have any respect for the laws that we put in place for good reason. So get the f*** out.

As much as it irks me at times that under the right circumstances undocumented aliens can coverage for emergency medical. The health care system would probably be a lot worse if they weren't paid for these procedures.

What do you mean?

If the ER had to eat a lot more of these charges than they did a couple could happen as a result. Only the treatment of those who have validated insurance coverage. Problematic to prove when someone was injured and didn't have their insurance card on them let alone regular ID. Biometrics could be used, but that leads to a much bigger problem of the government becoming Big Brother. Yet depending how traumatic ones injuries are biometrics might not be able to determine identity. If hospitals were to disregard the Hippocratic oath in order to validate coverage for ER patients the death toll would likely rise.

Yeah I see what you are saying. Hospitals treat everyone regardless of health care and ability to pay. I do like that. But there has to be some way after the fact to figure out who has health coverage and who doesn't and some method of payment must be established.

There's two groups of the uninsured that are in a pretty bad situation. Those who just graduated college and are looking for a job, yet due to them not being full-time students they're no longer eligible for coverage under their parents plan. The other group being those who are disabled yet their Social Security is too much for Medicaid. Especially the ones that got hurt on the job and would rather be healthy working. Two years is a long time to wait for Medicare to kick in for a legitimately disabled person.

I think the only way out of health care dilemma is a form of socialized medicine. Before you crucify me please read on. Reasons to support it/why it makes sense:

1. The obvious- tax payers shouldn't have to go bankrupt (in the best case, die or commit suicide in the worst) because they are sick and have no or inadequate insurance.

2. Placing the burden on businesses (like we are doing now) is harming our competitiveness on an international level.

3. Our system is failing in many ways- in every survey that compares health systems in 1st world countries, we are consistently ranked near the bottom.

4. There can be a happy compromise. I propose a 2 tiered system: the first level can be much like the current one, for those that can afford private insurance, it will probably be a bit better quality (you get what you pay for). The 2nd level would be the federally funded "free" or "low cost" level. To encourage doctors to work in this level you give them tax breaks, longer vacation periods, low interest loans, student debt forgiveness or other perks. You can also have a program under which doctors from the 1st level have to spend a set amount of time working for the 2nd system annually.
The idea is based on market economics- those that want to pay (or can afford) will receive the better product, those that can't will still be covered.

Now this is just a quick glance at the issues involved, so I'm sure there are many problems with the plan, but I think it is worth thinking about.

edit: the obvious criticism would be "what about those that don't pay taxes?" That must also be taken into account and would involve immigration control, welfare reform, etc...

Edit: Oleg, the 2-tier system you're talking about already exists. Hong Kong has that system, if you can afford it (or have insurance), you can go to the private hospitals while everyone else can go to the government run one. And it's not a "bit" better quality, it's night and day, read what I wrote about Universal Healthcare below, that is how the government run ones are.

If you're talking about Universal Healthcare, the answer is NO. Have you ever been to a hospital in a country with Universal Healthcare? First of all, the waiting room is like the DMV, long lines, long waits, people are there dying while they are waiting in a line that goes out the door. Then once you get in, there are no patient rooms, it's an auditorium with one nursing station in the middle and about 50-100 beds surrounding it. No curtains, no privacy, you're lying there and the guy next to you is moaning and dying, they are delivering a child in the bed on the other side, the bed by your head has a guy that is leaking body fluids all over the floor, the bed by your feet has a guy that has been dead for about an hour and the nurses have not noticed.

Yah, not something I want to see in the US. They rank healthcare in the world by availability, not quality. If they ranked by quality of healthcare we would be number 1, or maybe 2, no doubt. Also, in those countries, they don't even attempt to save premature babies. If your baby is born under a certain weight, they just let it die. There are no such things as neonatal intensive care units like there is in the USA. Here, when a baby is born underweight, we put them in the NICU and most of the time they make it out just fine. In those other countries, all of them would have died because the nurses and doctors would have classified them as stillborn and not even attempt to keep them alive. That's what happens when you leave it up to the government to provide the healthcare.

If you want to bring down healthcare costs, make it harder for people to sue healthcare professionals. It has been proven time and time again that the reason for the high costs is because of the high costs of malpractice insurance due to all of the frivolous lawsuits we have in the USA. Get rid of that aspect and I guarantee you we will have affordable healthcare and no drop in quality.

Demon, so you mean to tell me that surveys that place EU countries like France that have the best cancer surviving rates in the world, and are consistently placed ahead of the US system according to QUALITY are lying?

Even in the USSR the medical system didn't have the conditions that you describe- and I would know because I remember them.

Tort reform alone will not solve anything. I dont think that socialized medicine in the US is a question of "if" but rather of "when." When companies like GM are referred to as "health care providers with an interest in the auto field" you know that there is a MAJOR problem here. In a way we do have a socialized system, except instead of the burden being placed on the government, we place it on American business. People shouldn't be dying or going bankrupt because they don't have insurance.

Actually, those lists are rating them based on availability, not quality. The only EU country that I would believe to have better health care would be something like Switzerland or something, lol. What I have described is based on the personal experiences some of my friends have shared with me who have been to hospitals in those countries. The nastiest story was that my friend was in the hospital in Britain, which is a very rich country and one that you would think would have really top notch everything, and two beds from where he was, some guy needed some fluid drained from his kidney, and they were doing it right there, in front of everyone, and some liquid sprayed out, all over the guy in the bed next to him, and it stunk, basically it was urine and other liquids. I'm sorry, but I don't need to have to tell stories like that, no matter how funny, about my visits to hospitals in the USA...

So if universal healthcare is so great, europe can keep it, for me, I will stick to my hospitals here that look like hotels and offer individual rooms for every patient, thanks.

Memorial Hospital Miramar

If you wish to support universal health care, pay for it out of your pocket and stop expecting everyone to pay for it. I am tired of having my pockets picked to pay for services I don't need or do not qualify for due to making to much. Everytime someone says let the government pay for it, they forget that it isn't the government paying for it, it is actually taxpayers who pay. Oleg, if you want socialized health care, go right ahead and fund it yourself, but do not expect me to pay for it.

Let's not make it personal. This is a good debate. Lets keep it that way.

Exactly, I don't expect to be unemployed, if you can't get a regular job, it's not hopeless, join the freakin military, they accept almost anybody, you get free living, free food, free healthcare, actually, correction, it's not free, they actually PAY you to live and eat there, perfect arrangement.

Anyway, I'm covered when it comes to my healthcare, and it's free for me already, I don't need to have to pay for everyone else, screw that. If they want to have healthcare everyone has options and choices, if they choose to be lazy and not work, then it's their choice not to have healthcare. Oh well, not my problem.

You can't be more true.

There are times when you, me or the next man not being willing to foot the medical expenses of others will receive negative consequences as a result. For example being a store, train, post office, etc. with an uninsured individual with TB. Who knows those with no insurance that were treated a little for TB might have helped bring about the increase of drug resistant strains by not exposing it to enough antibiotics they couldn't get.

I knew I was going to get slammed for this, so here I go (sorry for the extremely long post, but I tried to address everyone’s points). I’ve broken it down into three sections to make it easier:
I. Surveys/reports that show that our system is underperforming relative to other advanced countries

II. Addressing Demon’s and WhiteKnight’s points

III. My points, questions for you guys and conclusion

I.
First sources for my allegation that the US ranks in the lower level of international surveys including ones that focus on quality: (here are 3 articles that jumped out at me, but I can find more for the unconvinced)

1. 2007 Commonwealth Fund Survey
-Survey done in 2007 by: the Commonwealth Fund a healthy policy think tank from the USA
-Survey parameters: Compares healthcare in 6 developed countries, in five areas, quality, access, equity, outcomes and efficiency (ranking included, there was 1 tie): 1.Britain, 2.Germany, 3.Australia, 3.New Zealand, 4.Canada, 5.USA
- Source: Top of the class; League tables and the NHS. The Economist. May
26, 2007

2. 2000 World Health Organization World Health System Survey
-Survey parameters- rates each country’s health system on: responsiveness, fairness of financial contribution, overall level of health, distribution of health in the populations. The rankings were based on 1997 numbers.
-Survey results: The US, which spends the most money as a percentage of GDP on healthcare was ranked 37 out 191 countries.
-Link to the full survey: http://www.who.int/whr/2000/en/whr00_en.pdf
-Link to a synopsis: http://www.photius.com/rankings/who_world_health_ranks.html

3. The NY Times did an editorial regarding the US health system this past summer. The article compared the US system to international systems in various categories (the article listed no sources): August 12, 2007. World’s Best Medical Care? Section WK. Pg. 9
-Insurance coverage- no need to go into this, because that is the issue that we’re discussing, the main number is that 45 million are uninsured in the US
-Access- while people in national coverage systems face longer waits for specialist or elective surgeries (Americans get prompter attention, although Germany still beats us there). However Americans have less access to care on weeknights and weekends and usually have to wait 6 or more days for an appointment with their own doctors
-Fairness- we’re dead last among 1st world nations because of the difference in care between rich and poor
-Healthy lives- we suck (last among 23 nations). But that’s not necessarily the health system’s fault.
-Quality- The previously mentioned Commonwealth Fund survey ranked the us first in providing “right care” as defined by standard clinical guidelines and gave us praise for preventive care (pap smears, mammograms, blood tests, etc). But bad marks for care of chronically sick patients, protecting patient safety, meeting needs and preferences, and the fact that our doctors and hospitals kill patients through surgical and medical mistakes more often than any other industrialized country\
-Life and death- in comparison with 5 countries (probably the same ones as in the Commonwealth survey) the US was best in breast cancer survival, 2nd for cervical cancer and childhood leukemia, worst for kidney transplants, and almost worst for liver transplants and colorectal cancer. It goes on to mention low scores in an 8 nation comparison for things like asthma, diabetes and circulatory disease, but I think these are often lifestyle diseases so our health system can’t be blamed for that.
-Patient satisfaction- Polls in EU and North America from 7 years ago found that 40% of Americans were satisfied with the nation’s health care system (14th out of 17 countries surveyed). In the Commonwealth survey- 1/3 of all Americans called for a rebuilding of the entire system compared with 13% of Britons and 14% of Canadians. However, recent Gallup Polls have found that 75% of US respondents rated their care as “excellent or good”

II.
Now to some of the individual points that you guys have made:

Demon:
-Your friend’s personal experience in Britain- individual stories don’t make or break the entire system, my dad was recently in London for a vacation, he got very sick with food poisoning, he went to the ER, he didn’t have to wait, got treated for FREE (even though he isn’t British) and had no complaints about the service or facilities. On the other hand, I had 2 relatives die because of mistakes made in US hospitals. But like I said, individual cases don’t make or break the system
-Your solution for everyone to join the military- c’mon, you know that is a silly suggestion.
-WhiteKnight (and to some extent Demon)- It’s not that I expect you to pay for everyone else, it is the fact that our system clearly is not working very well yet at the same time we’re spending more than anyone. Does it make sense to do this? That is the question you have to ask. Also, you have insurance now, but what if you lose your job, or what about when you retire? What will you do then? What happens if the company that promised you healthcare through your retirement won’t be able to afford it anymore? A universal system benefits all.

Or how do you address the issue of the people that are employed but do not get insurance through their work. Are these people lazy? Do they not need healthcare? Should families have to decide between healthcare and other necessities?

What about students? Many students over 21 are no longer covered by parents’ insurance but can’t afford their own. Compared to other countries American students are hit twice, they’re forced to pay for education and for healthcare. So lets say you’re a typical student- I’ll use myself as an example, when I graduate in 3 years, I will have a student debt of $100,000 (luckily my parents paid for most of my undergrad, so I’m only paying for the grad work). If something was to happen to me during the next 3 years, and I need serious medical treatment it is not unforeseeable that my debt upon graduation would be $150,000+. That is insane. Now mind you, I’m not calling for free education, I think that system works well and should not be tampered with.

III.
Now please address my main questions, (one of which both Demon and WhiteKnight have conveniently ignored ) :

The issue of business competitiveness of American companies on an international stage. Why should the government force businesses to accept responsibility for providing healthcare? Don’t European businesses, who are unburdened by huge employee pension/healthcare liabilities have an advantage over our companies? They can devote more money to R&D, training, etc. Which in the long run will boost productivity and economic growth. As our healthcare liabilities grow due to an aging population, our companies will become less and less competitive and effect overall economic performance. You can already see these things happening in the US auto industry and some of the older manufacturers.

How is a universal system really different from the current system? In a universal system higher taxes pay for your health care. In our system you either buy insurance yourself or your company pays for part of it. Then you have different types of insurance- some only cover part of a procedure, some don’t cover prescriptions, others make you pay for office visits. So either way money is coming out of your pocket. The difference is, under a universal system, when you’re old or if you’re laid off from work, you may not get stuck in a potentially disastrous situation of being sick and having no insurance.

My final points:
-I’m not calling for a complete public system, you can have both.
-If our system was truly better in terms of service and quality, then an argument can be made that no changes are needed. But time and time again it is shown that it isn’t better. The fact that it comes at such a high economic cost adds insult to injury and shows that serious changes must be considered.

I have faith in the USA because we typically come up with systems/laws/procedures that work out in the long run. What we need is a rational discussion on the pros and cons of any potential changes- not hysterical screaming and fear mongering about socialism, laziness, taxes and the like.

Ah, the WHO, I was actually speaking specifically about that one. So no, you didn't bring anything up that I don't already know about, and no, it does not really rate based on quality, it rates mainly on availability. They might have factored quality in there somewhere, but the parameters that had the most weight are those involving availability. Meaning the more socialized it is, automatically the higher up on the list it will be. Notice, you quoted them yourself: "responsiveness, fairness of financial contribution, overall level of health, distribution of health in the populations."

Responsiveness = availability
"fairness" of financial contribution = availability
overall level of health = population averages (still not a rating on quality of healthcare BTW)
distribution of health in the populations = once again, availability.

When they say overall level of health, they are mainly looking at average life expectancies, which is not a really good way to determine quality of healthcare since our high murder rates factor into our average life expectancy and no level of healthcare quality can fix that. I can't find anything on the internet yet, but I heard that this year's or last year's figures show that we have something like 70,000 people in the USA that is age 100 or more. If that is true, and I'm not sure that it is, that must mean that our healthcare cannot be that bad, unless these people are superheroes or biblical characters and we just don't know it yet... lol

BTW Oleg, just because people come up with these "lists" that show the USA is so behind in everything doesn't mean that we actually are. Every list maker, every "ranking" system is composed by someone, and you can dramatically change the results if you change around the parameters, even a little. I've done research into these things and literally, if you change one parameter, you can almost invert any graph and any ranking order for almost any category. The fact is, if we are so behind in everything, people would not be killing themselves trying to get into our country. Consider that. My family all came from a country that has the dual system you speak of, yet, they all came here and we all like USA's healthcare much better. Go figure...

To be honest with you, I'm ashamed the USA is on the top 50 of the WHO list at all, I'd rather us be last because that ranking system is one of the dumbest ranking systems I've ever seen... Being anywhere in the top of that list is almost an insult...

OK, the WHO survey doesn't specify quality, but what about the Commonwealth Survey or the NY Times article?

Also you're still not addressing my main 2 questions regarding burden on business and what the difference would be between the current system and some form of a universal system.

All of your questions have been addressed multiple times already, maybe not directly, but it all boils down to one thing. I don't want to leave our healthcare up to the government to run. Like I said, Hong Kong has both government run free healthcare and privately run healthcare that you had to pay for. The government run one is almost exactly like I described earlier, with long DMV like lines in the waiting rooms and you generally get ignored by nurses for hours on end even when you finally get admitted.

Also, you're acting like all these people don't have a choice, that college students have no way in hell of getting coverage. Which is complete garbage, it is THEIR CHOICE that while they are pursuing their career they do not work in some other job that provides healthcare. There are plenty of jobs that do not require a degree of any kind to do. Retail, security, etc. are all jobs that these college students can EASILY get while they are out of college and looking to get into their career and all of these jobs provide healthcare. They are "in between" healthcare out of their own choice.

And a universal healthcare system will not be free, it'll only be free for those people who are too lazy to work and pay taxes, as usual, and I'm sick of money coming out of my paycheck for those people. I don't want to fund welfare, universal healthcare, nothing, it is their problem, not mine. Like I said before, there are plenty of jobs anyone with any level of education can get, it is their choice they don't try to work. Because as of right now, my healthcare is already covered, if there was a universal healthcare system, I would be paying much more in taxes, and the healthcare I end up getting will be much worse.

Sounds like a lose-lose for me... Pay more for worse coverage... Hm, now why would I be against this, let me think...

Edit: About the other surveys, looking at the commonwealth perameters "quality, access, equity, outcomes, and efficiency" again, 3 out of 5 are different ways of saying availability, quality is one out of 5, and outcomes, again, is a look at average trends in population, just like the WHO survey. Not much difference there.

And I'm not even going to bother looking at what the NY Times wrote, I never listen to any garbage they spew anyhow, not going to start now...

The ONLY perameter I care about, is quality. If they had a survey that ONLY looked at quality, I'll look at that one. Reason being, I have no problem with the availability of healthcare for me or any of my friends or family right now because we're all employed and all covered, so all that really affects us is the quality. You might think I sound selfish, but the fact is, none of us got to where we are from unequal help by others. In fact, being Asian and being immigrants (I'm a citizen now, but not before), it was harder for my family and I to get to where we are, so I firmly believe that if we can do it, anyone can, and those who don't are where they are by choice, so hey, why should I work to change their choice?