You are ignoring my main point- the economic costs of our current system that are paid by our corporations. As health costs keep rising, how long do you think this will keep up? Already there are trends with fewer and fewer employers willing to cover the costs of health insurance for their employees. Nationwide (in 2005-06)63% were covered through their work, that's a decline of 4.5% from 2000-01. Business isn't obligated to pick up the ball that the feds have dropped, and I'm willing to wager within a decade (if health costs continue to rise) most will not be providing insurance for their employees.

The situations that you describe to attack universal coverage can be found in our system all the time. Once again, generalizations don't make or break a system. But if you must generalize, then I can do the same about what we have- Have you ever been to the ER? How long have you had to wait? What about the case last year in LA when the woman was bleeding to death in the ER waiting room and no one came to her aid?

As for college students, how are students supposed to work full time and go to school full time? I have not seen a single part-time job that offered benefits, have you? I have worked in the legal, investment and service industries, not exactly low class fields- none of them offered benefits to part timers. Do the people making minimum wage receive benefits? I'm pretty sure your local mom and pop grocery stores can't afford to pay the premiums for their employees.

Furthermore, it doesn't have to be a zero sum game (you have more options than just winning and losing), and it doesn't have to allow people to mooch off the system. A system that takes into account the needs of modern business and the population and focused on providing a high quality service, can succeed with proper oversight.

On the over-21 healthcare issue, C-Span had a very interesting program on relating to the healthcare dilema. In that program, they had several people from the 25-35 age group that they interviewed about various issues regarding healthcare and the overall concensus seemed to be that they would have it but couldn't afford it. But then...later in the program, they asked those same people about how much money they estimated that they spent every month on dining out and social activities. The average was $300-$400 every month! YIKES!!! Do their "social activities" involve any illegal substances? Its simple, its a matter of learning how to live within your means and prioritizing what is most important to you. The United States is rated lowest because of the ACCESSIBILITY TO ALL, the ratings don't take into account the quality of care. They don't take into account the fact that life-saving diagnostic procedures can usually be accomplished within 10 days or sooner in the US. In other countries, Canada for example, that same procedure can often have a waiting list of 10 WEEKS, OR MORE! The US also has the lowest death rate among people who are undergoing treatment for lifethreatening illnesses or conditions. Sure, our pharmaceuticals are more expensive, and this is because the vast majority of pharmaceutical R&D is done right here in the US. Our pharmaceutical companies have to defray the R&D costs and, unfortunately, they have no protection from foreign companies producing the same product. I saw a comment earlier about not wanting a UHCS because we don't want to pay for bums. I agree with that sentiment, but the thing is, we already DO pay for them. There seems to be this myth that in the US, if you don't have health insurance or big money that you'll be thrown back out on the street to die. This is absolutely false. No person is EVER refused medical treatment in the US based on their ability to pay. There are hundreds of thousands every year who receive medical care without insurance or money up-front. They are sent a bill, which many of them don't pay. What does this do to them? Sure, it makes a black mark on their credit report, but in general, the treatment facility is left holding the bill. Now, will that same person be able to go back to that same facility for treatment in the future? Absolutely! Again...nobody is EVER refused medical treatment in the US, contrary to what all of the Socialist scare mongers try to tell everybody. Another thing to consider in these "wonderful" UHCS countries is how much they pay in taxes. Both income taxes and sales taxes on various goods are SIGNIFICANTLY higher in those other countries...for example, a friend of mine in Belgium told me his income tax is right around 65%. Even in countries that aren't that high, they are still SIGNIFICANTLY higher than tax rates in the US. So, why am I jabbering about all of this tax stuff? Its simple...think about your income and how much you net every year after taxes. Then, think about the total additional amount you'd lose every month if your taxes were increased by 18% (using Canada's example). Now that we have established the basis for comparison and given one example...compare the income loss from an 18% increase in your income tax to the monthly premium you'd have to pay for health insurance. The monthly premium wins EVERY TIME. So, you have more money in your pocket, and better care. Why do you have better, faster care? Because a young doctor is a man or woman who spent 8-12 years in school and has a $250,000-$500,000 student loan to pay off. He/she, who will be taking care of you for years to come, DESERVES BETTER than to be a government employee and paid government wages. I wonder...do the UHCS countries have a UFRSPFMS (Universal Full-Ride Scholarship Program For Medical Students)?

And again, you've missed a point that I've brought up already. The problem with our healthcare system is not inherent. The ONLY reason why healthcare is so expensive is because of insane medical malpractice insurance costs to the healthcare professionals. And this is due to all of the frivolous lawsuits that is so popular in the USA. And ironically, the people who work to make it EASIER to sue every doctor left and right are the very people complaining about our healthcare system. They cause the problem, then complain about it, ironic isn't it?

If you think the system is flawed you look for the root of the cause of the problem and try to solve it. Instead, you're suggesting some radical system that really doesn't save us anything, just makes it better for the lazy people who don't actually work.

You keep saying to think about how much of my paycheck goes to the healthcare, blah blah blah. Listen, I will repeat it once again, my healthcare is COVERED, as in I pay $0, because of my employment. So yes, an increase in taxes would DEFINITELY be more than the amount I'm currently paying for healthcare, and then the quality of healthcare would go down at the same time. So how can you even imagine that I will want this??

And anyway, I don't see any of the things I've complained about universal healthcare happening where I go. You've seen the photos of the hospital I go to if I ever need anything. It's a freakin' hotel. There are no lines to wait in, every room has its own television, your complete privacy, the staff is excellent, I mean, I have no complaints. So I don't see how you can claim that I have the same problems here with the healthcare system that I am currently using...

Edit: Also Oleg, about your point of college students. I'm not sure if you forgot about this or don't know about this, or simply left this point out, but you do know that most insurance coverages extend your parents' coverage to you if you can prove that you're a full-time student right? Meaning the family coverage that you had while you were under 18 will be extended if you prove you're a full-time student and still claimed as a dependent of your parents. That's why I skipped straight to the after college and before career point.

iguana, exactly my point what you said about the college students. It's all about choice. I hear these people ***** and whine all day about how they have no money or have any time to study, yet every weekend they are out in drinking parties where they spend hundreds of dollars in drinks. Well, if you would have saved that money and spent that time studying, you would have solved both problems at once now wouldn't you? Dumbasses... It's called priorities, people need to have their priorities straight.

Yup! I had a full-time job in high school and maintained a 3.83GPA, and a full-time job in college while maintaining a 3.95 GPA, so I guess I was just used to it. Oh...but allow me to play "My Heart Bleeds for You" on violin for those who can't keep up, because not everybody had the same "advantages" growing up that I had. Granted, in college I went through a few girlfriends, whereas in high school I had one the entire time, but...sigh...such are the sacrifices of the underprivileged, relationships suffer (just in case any bleeding hearts want to have a go at that...its the truth...I was raised in the proverbial "projects" but had priorities very early-on in my life...so sue me).

Demon, you work for the feds right? Most non-government employers don't cover 100% of your health care.

I am very well aware that college students get coverage through their parents. But this gets cut off after a certain age.

Torts/lawsuits have little to do with the spiraling costs of health care. Here are numbers that are provided by the Congressional Budget Office (so even you guys can't attack them):

-In 2002 malpractice costs amounted to $24 billion, but that number is less than 2% of overall health care spending. This means that a reduction in 25-30% in malpractice costs would lower health care costs by only 0.4-0.5% and the effect on health insurance premiums would be small

Why are both of you ignoring my question about the impact that health care costs are having on our companies?

Also, the Commonwealth survey included quality as one of the parameters, yet the USA still came in last.

BTW, none of you are providing any concrete evidence for your arguments- why is that?

Oleg, as the owner of a small company, I am not at all ignoring your question. Things became most difficult for us the first time Hillary tried to "fix" the problem. Under her, HMOs gained unprecedented power, not to mention the fact that they were ALL forced to shoulder the burden of the indigent on an ever-increasing level. Granted, I cannot give you a web-link that you would accept as a valid argument, but that's the way real-life happens to be, Oleg. No, your "survey" did not include quality factors. How can a person living in the US honestly believe that it did?

OK...so lets consider you to be among the 25-35 age group that cannot afford health insurance premiums, and lets ignore every damn thing I said about how the US does not refuse treatment to anyone based on ability to pay. What group do you fall in, Oleg? Are you insured? If so, or if not, how much does your employer pay and how much do you pay every month? How much do YOU spend every month (average) on dining out and other "social activities"?

That study only shows the amount that is spent on actual malpractice lawsuits. Not the actual affect on malpractice insurance premiums on the healthcare industry. They say that insurance premiums are increasing because they are trying to make up for money lost on less than expected investment yields. That study does NOT show that medical malpractice insurance premiums is not the cause of rising healthcare costs. In fact, it basically assumes it. Nowhere did I say that the actual medical malpractice lawsuits is driving up the healthcare costs, I said the malpractice INSURANCE is doing it. So for whatever reason the insurance companies are increasing their premiums, it IS the cause for our increasing healthcare costs.

And it is because of all of the frivolous lawsuits that force people in the medical field to pay these ridiculous insurance premiums. If we can somehow fix that, such as putting a cap on how much the premiums can be, making it so it's not required for a clinic or hospital to be insured and making it harder for people to sue medical professionals for whatever the heck they please so more hospitals and clinics are more inclined to not buy insurance. These things can cause a decrease in our healthcare costs.

But of course, your idea for the best solution is for me to pay more for worse quality healthcare. Yep, makes total sense, I'm all for that...

Demon:

-What does this sentence mean to you- "...would lower health care costs by only 0.4-0.5% and the effect on health insurance premiums would be small." Does that not say that malpractice costs have a small effect on health insurance costs?

Here is a link to the study so that you can read it http://www.cbo.gov/ftpdoc.cfm?index=4968

Iguana:

-You're right, people will get treated if they have no funds, but the black mark on their credit report is far from insignificant. Credit effects every part of your life- from credit cards and auto loans to student loans and job applications (jobs in finance check your credit, your credit is checked as part of the BAR examination process). Is it fair to have a system where if you're sick and happen to be out of work, your financial future can be ruined for at least 7 years? Should you be forced to make a choice between your health and your future?

-Yes taxes are higher in the European nations we are comparing to the USA. But you have to account for the benefits that you receive- retirement, medical and education. Also, take into account the effect of not worrying about these things has on your life. Less stress, more focus on the family instead of work. This is reflected in much lower divorce rates, lower rates of violence, etc. Of course I'm not saying that those are the only factors effecting quality of life issues but I think focus on the family is a big factor.

-If you want to take into account how much you're saving for your retirement, paying for education and health care, then over the course of your life these would probably closely match how much taxes you would pay in the EU.

-As far as doctor's salaries- you don't have to have a completely nationalized system, you can allow doctors to have private patients that are willing to pay top dollar for their care.

-You are NOT at all addressing my question. You're making a general "blame Clinton" statement and do not link it to my question of why should our companies be the ones burdened by health care costs and how this reduces our competitiveness on an international stage.

-My personal situation- currently I'm covered by my parents' insurance, next year I turn 25 so I will have to figure out how to buy my own while still being in school.

Demon and Iguana:

For the last time, the Commonwealth Survey was based on QUALITY

http://content.healthaffairs.org/cgi/content/full/23/3/89

Here are some of the 21 QUALITY indicators that went into the study: survival rates for various cancers and transplant procedures, avoidable events such as STDs, suicides and asthma and process indicators such as screenings for various cancers and vaccinations.

The study concludes "While the United States often performs relatively well for this set of indicators, it is difficult to conclude that it is getting good value for its medical care dollar from these data. The huge difference in the amount the United States spends on health care compared with the other countries could very well be justified if the extra money provided extra benefits. Population surveys have shown that the extra spending is probably not buying better experiences with the health care system, with the exception of shorter waits for nonurgent surgery. Earlier studies have shown the United States to be in the bottom quartile of population health indicators such as life expectancy and infant mortality. Our results also fail to reveal what the extra spending has bought..."

So they are confirming my assertion that for all the money that we spend (the most in the world) there is no real improvement in quality of care. Not only are we spending more on health care without any discernible benefits we are also not covered in case we lose our health insurance due to loss of work, etc.

-Social spending: yes I agree, if people are spending hundreds of dollars a week on entertainment then they shouldn't be complaining about not being able to afford insurance. But you also have to remember that you're only young once, you can't get these years back once they're gone.

-Abuse of the system: a national system must only cover citizens and legal residents (the tax paying population). The argument between actual enforcement of our immigration laws v. an open door policy is something that needs to be discussed in a different thread- although I doubt we'd disagree too much on that topic.

The ball is back in your court

quote:

Originally posted by Olegious:
Demon:

-What does this sentence mean to you- "...would lower health care costs by only 0.4-0.5% and the effect on health insurance premiums would be small."

That fragment of a sentence means that tort reform alone will not have a large impact on healthcare costs. But I'm not talking about tort reform alone. I'm talking about not needing malpractice insurance at all, and I also make the point that I don't want to have to pay more for worse coverage.

The only way to bring down the costs of healthcare more than you can by eliminating malpractice insurance is by lowering the quality standards. Now, are you willing to trust your own life to a lowered standard just so other people can benefit from your tax dollars? I'm sorry, but I've done my part to get myself where I am. I don't know why I need to pay more for taxes to help those who are lazier than I am since nobody gave me anything free while I worked to get where I am... If they want a crappy healthcare system, they can pay for it themselves. I'm sure there are plenty of doctor wannabes out there that would be willing to provide their treatments for very cheap... Good luck to them.

I agree with you on quality, it shouldn't be sacrificed, it doesn't have to be. Malpractice insurance is necessary because malpractice torts, while they should be limited, they shouldn't be eliminated. Malpractice torts protect you and me against bad doctors and bad hospitals, thereby improving the all important quality. Extreme awards should not occur, just like they shouldn't occur in any of the tort fields. So at least we agree on that.

I'm sticking to my guns regarding our quality relative other 1st world countries- that the difference (if there is one) isn't great enough to justify the extreme costs.

We'll just see what happens.
Good discussion, now go out and see No Country for Old Men!!!! (I put a link to the trailer in the other post)

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/11/21/BUQOTFL6C.DTL

Here is another point that I haven't even considered- the people in their 50s who are not eligible for Medicare but are not part of group insurance plans and have to look for individual coverage. These people are business owners, early retirees or those laid off from their jobs.

Insurance providers have the right either reject providing coverage to these people based on previous medical history and other factors. If they don't allow coverage, then they could give ridiculous quotes- for example- a 62 year old woman was offered a plan that cost $840 a month and included a $5,000 deductible.

So as you can see (based on this whole discussion), this issue effects people of all age groups. Just because you currently have coverage doesn't mean that you'll have it in the future and an attitude of "I'm covered, so screw the rest" is very short cited.

And again, just because something needs fixing, doesn't mean we should hand over the control of it to the government. Unless you like big government...

It's like saying because I got into 2 accidents over the last 5 years, control of my car should be handed over to the DMV and they can remote control me around because my driving record isn't perfect... Oh yah, that's how you fix things...

So you do agree that there is a problem then?

quote:

Originally posted by Olegious:


For the last time, the Commonwealth Survey was based on QUALITY

For the last time, Oleg, no...it was NOT! Not only is its assessment in disagreement with the report I read, but its obvious why it disagrees. Have you looked at the charts provided in that link? They all list 3 countries, Australia, New Zealand, and Canada. Do you see the US on any of those charts? No, the US is not on any of those charts. The US is mentioned several times in the article, but no actual quatitative data is presented. I wonder why. Its probably similar to a discussion I once had with a rival in the reptile world about the type of lighting I have chosen to use. This guy pointed everybody to a link to a spectrographic study that he swore up and down proved that this particular type of lighting is dangerous and has characteristics unlike any type of lighting ever seen before. Well...I read the article he linked, and nowhere in it did it even MENTION a study on that lighting, much less provide any actual data.

As for my "blame Clinton for everything statement", I stated nothing that was not factual information. HMOs DID gain unprecedented power due to the attempts at "improving" the system, along with being forced to shoulder more and more financial burden from "economically disadvantaged" people. Unfortunately, the effect of this is to make operating costs higher for the insurance companies...and guess how they compensate for those added costs. By increasing premiums on their "economically advantaged" customers. Therefore, more and more companies are decreasing benefits to their employees, and some are even dropping those benefits altogether.

BTW, since you brought up your current situation. Who is paying for your college education, Oleg? Just curious.

Iguana:
I was lucky enough to be in a situation where my parents paid for most of my undergrad (about $80K), I'm paying for my graduate work, by the time I get out (2.5 years from now) I should have about $110,000 in education debt (a more detailed explanation of my background is found below). Fun!

Now for your response, you're wrong about the survey- Exhibit 1 http://content.healthaffairs.org/cgi/content/full/23/3/89/T1
gives the numbers for all the countries involved in all the QUALITY categories (the US is the 5th column). Can you point me to the report that you read (I'm assuming it showed that the US has far superior quality vs. other 1st world states)? Also, how are cancer survival rates, screening rates, and disease rates not symptoms of quality?

Your point about Clinton and the HMOs- exactly, so how is this situation fair? The working public is forced to pay for those that don't work, and then when they lose their benefits they must struggle to get coverage. Would it not be better to have a system under which everyone would be covered? I'm not saying that it should be a blanket system that is abused by those too lazy to work. The best way to do this is to make sure that the "care" fee isn't based on income, or taxes targeting individuals but rather taxes that everyone pays- sales tax, etc. Also have true immigration reform- either enforce/defend the border and deport the illegals or have some kind of a guest worker program. To defend against domestic abuse, reform the welfare system- don't allow perpetual payments, link payments to education/job training and encourage people to find work, once again, these are issues for a separate discussion.

Your previous questions lead me to believe that you think I come from a situation of coddling/lap of luxury- you couldn't be more wrong. My family came to this country in 1992, escaping a brewing civil conflict in my home nation (Moldova). We came here with what was in our suitcases- no English, no money. My parents worked like dogs, while I took care of my younger brother (I was 9 he was 5 when we came here). We were on welfare, received foodstamps and Medical. I attended inner city public elementary and middle schools, got made fun of for my accent and my name. However by 1997 we owned a house, by 2003 my dad owned his own business and my mom had a good tech job, and both my brother and I attended private universities. We worked hard to get to where we are today, and I know all about the value of hard work, I've had minimum wage jobs and have worked 70 hour weeks and night shifts. My views on universal health care are based on economics, not feelings of laziness or entitlement.

I think I've answered all your questions, so please, answer my (often repeated) question:

"why should our companies be the ones burdened by health care costs and how this reduces our competitiveness on an international stage"?

quote:

Originally posted by Olegious:
So you do agree that there is a problem then?

There is a problem with everything. But at the same time, everyone has a choice to fix it for themselves. If they don't, then guess what, it's THEIR problem. Yes healthcare is expensive, but guess what, when it comes to your HEALTH and whether you will live or DIE, I think that's one area that is worth paying for. People spend way too much on many other things, then they complain and say it's impossible when it comes to something as important as their health.

I'd rather have higher quality healthcare than free crappy healthcare.

And no, those surveys are not based on quality, I've already addressed this, but obviously you don't want to hear it.

So how exactly is a survey based on 21 areas of quality doesn't rate quality? The only argument that you can make is that it focuses on quality in narrow areas like disease survival and prevention, and you don't agree that this is what quality is. Then what is quality in your opinion?

It boils down to what you'd rather believe. Some survey written and conducted by individuals with individual agendas and/or opinions? Or your own personal experiences? I know people who live and who have been to those countries that are supposedly ahead of the USA in "quality." Many of whom have either lived here in the USA also or have been here as well. I too am from outside the USA so I've experienced hospitals from other countries as well. We ALL agree that based on our EXPERIENCES that the quality of hospitals here in the USA FAR exceed those of other first world countries like the UK and France. So either the people who conducted these surveys fooled around with the parameters to get their results, or they got it some other way. If you work in the field of research and data collecting, you'll realize how changing the parameters, even just a little, can cause the results to do a complete 180. Like if you were to do a survey on crime, changing the definition of what is "rape" can make the results of that study go one way or the complete other way. Or if you separate multiple crimes versus only collecting data on the worst crime of each crime spree, that's another way to skew the results. Or if you mess with the minimum guidelines for what is considered "high," "medium," or "low" levels of something, you can drastically change the way the chart looks as well. These are all tricks people do to falsify statistics. I am just using crime as an example because that's the subject I work with the most. I tend to trust personal experience, I'm weird like that.

But hey, if you'd rather listen to what some other people say than what you see with your own eyes, go ahead, I won't call you a gullible fool, nope, won't say that at all. I won't say that you're being herded like a sheep and the media are the sheep dogs, nope, won't say that either...

Just look at the other "studies" you've referred to so far. You didn't think that their parameters focused on availability, but they clearly are. All of them so far that I quoted back to you have been at the most 1/5 on quality and the rest on availability. The funniest is th