America's Health Care System Compared to Other Nations

[top gun]

Oh, I forgot one: Health care will be rationed if we have a universal coverage plan, as opposed to the unlimited health care we get now.

Maybe we could number them, so, instead of repeating the same arguments (all of them fully shot full of holes by now), we could simply post the numbers.

Yeah you notice only being able to go to an emergency room for all your healthcare is great excellent service to them right now... but if anyone had to even wait a second for anything after Health Insurance Reform when everyone is covered... oooooooo scary!

 

[Dr.Who]

You are so much more reasoned than some others.

Yes, most of our poor are better off than the poor of the third world countries.

What you say it true but the stats I posted actually made the point that our poor are better off than all the poor of the world.

We have a lot more of them than the European nations do, but they aren't so bad off overall.

Do we really have more poor than the European nations do?

As for access to medical care, yes, the very poor do have access through government sponsored "public options."

The definition that our country uses for poor is so broad that those who have access to government sponsored plans extend well into what any reasonable person would not call poor. Many of the working poor have access to free care. In the Census report that I posted none of the poor in any categories reported that they did not have access to health care.

It is the working families who aren't fortunate enough to be working for an employer who provides insurance who have to make the choice between health and continued financial well being.

For those who need health insurance there is not luck about it. A job paying 6 dollars per hour in the mail room for a large company that provides health care is better than a job paying 9 dollars per hour at Mcdonald's with no health insurance. It is choices in life that determine which job one has.

For the working families you mention there are also choices to buy all the TV's, phones, cell phoes, jewelry, a house, two cars, etc. that the US census reports that most poor people have and all working poor have. The cost of catastrophic insurance is quite reasonable and the cost of regular exams is also quite reasonable. The working poor can afford both if they budget well.

It is the family whose breadwinner has been laid off who risks losing savings, retirement, equity in order to obtain medical care. If they're 30 or so, they can make it back, but the older set doesn't have time to re establish a retirement fund.

You are right. This person risks losing his assets. What he does not risk is not having access to health care. You are not suggesting that we re-make the entire health care system of the US and make it more socialistic and coerce 100% of the population to pay more in either taxes or higher cost of living so that the working poor have less risk to their assets? After all many richer people also face risk to their assets. If we look at many successful people they have been alternately rich and poor several times having won it all and lost it all. What they do better than the working poor is make choices that allow them to gain it in the first place and gain it back when they lose it. Suppose we focus on that problem instead of giving health care handouts to those who do not lack health care because they lack financial security. The way to address financial insecurity is to address it head on not by addressing health care.

What we need is neither the current system, nor what Congress is debating currently.

Agreed. The current system has too much government intervention causing it to be inefficient.

What we do need is a catastrophic care package that covers everyone,

Everyone can afford catastrophic coverage or other coverage or is on a public plan and does not need it. I have had that kind of insurance and I had it back when I was paying for my own tuition at a community college and worked part time as a delivering person earning slightly above minimum wage. That kind of coverage does not cost much. And the purpose of that kind of insurance is not to provide health care (because everyone can get health care by applying for public aid as soon as they exhaust their assets) but to protect what little assets a person has.

but requires everyone to pay for ordinary and affordable care.

Requiring people to buy a product is a restriction of a basic civil right. It is a draconian solution to a problem that has been blown out of proportion. I sometimes think that is the true purpose of liberal health care reform.

What we need is a national insurance policy that relies on the marketplace to ensure that people make an effort to keep costs under control, but will pay when those costs become unmanageable. If, for example, everyone paid for their own care up to, say for example, 10% of their income, that would control costs by encouraging shopping around and wise decisions, yet no one would have to choose between physical and financial well being.

Lets eliminate the restriction congress has placed on insurance companies ( the ones that do not protect people against fraud) so that they can compete across state lines. Right now there are over 3000 insurance companies in this country. That is ample competition to bring down prices but in any particular area each person only has access to a few companies. And even with that barrier to competition the insurance industry only makes about 4% profit. The most costs of insurance could be brought down would be about 4%. The cost of drugs and devices could come down more but not by changing insurance. The present plan will increase the costs of drugs and devices. In fact as a pre-emptive response to the gov. plan drug companies already raised prices about 9% last year ( a taste of things to come).

Lets do all we can to lower health care and insurance costs so that it becomes more affordable.

Then and only then lets ask: What do we do when people can't afford insurance but still have access to health care?

Such a system would lift the burden of providing insurance from the shoulders of employers, which would improve the bottom line and raise salaries as well.

Yes we do need to lift that burden. It is precisely that burden that has caused a disconnect between the buyer of a plan (employer) and the user of a plan (employee) and the provider of a service. We need to user of the plan to be the decision maker who interacts with the provider of the service. Anything else is not market forces lowering prices.

It is the gov who caused employers to have that burden to begin with. With a stroke of pen we could make the cost of personal insurance tax deductible and that would not lower the cost of insurance and restore the buyer of the plan as the decision maker.

It would make it far easier to ditch the corporate world and establish a small business. It would help keep that 2.5 trillion dollar health care bill from becoming 3 trillion, then 4, until even the middle class would be priced our of the market.

All true. So why did congress make employer coverage tax free while the coverage an individual buys is taxes?

Isn't it too bad that partisan politics is taking the place of rational debate about how to rein in the cost of health care and make it more affordable for everyone?[/QUOTE]

Yes it is. If gov were responsible for less of what they should not be responsible for in the first place the partisan debate would not exist.

 

[Dr.Who]

Yeah you notice only being able to go to an emergency room for all your healthcare is great excellent service to them right now... but if anyone had to even wait a second for anything after Health Insurance Reform when everyone is covered... oooooooo scary!

If we debate with the right facts we might just get somewhere.

All the poor can go to an emergency room anytime. That is true. What is not true is that they can ONLY go to an emergency room.

I have know truly poor people (people who were both physically and mentally disabled and earned about 8$ per day.) Public aid does not in any way demand that poor people only go to the emergency room. The medicaid card allows them to go to any doctor who accepts medicaid and to make an appointment just like anyone else. Not all doctors accept medicaid but a large number of them do. There is no lack of doctors to see.

And what about the low income worker who is not poor? He can afford a doctors visit which does not cost that much.

 

[Mr. Shaman]

It seems to me we would be better off with fewer people having to depend on welfare.

....Or, the E.R.​

"We all pay when uninsured residents must use expensive emergency roomshttp://www.democrats.com/node/20919. In most cases, had they been given regular preventative care, they would have required much less total health care and thus cost us much less."

 

[PLC1]

You are so much more reasoned than some others.




What you say it true but the stats I posted actually made the point that our poor are better off than all the poor of the world.


Do we really have more poor than the European nations do?



The definition that our country uses for poor is so broad that those who have access to government sponsored plans extend well into what any reasonable person would not call poor. Many of the working poor have access to free care. In the Census report that I posted none of the poor in any categories reported that they did not have access to health care.

and yet, this is what Medicaid says:

Medicaid does not provide medical assistance for all people with limited incomes and resources. Even under the broadest provisions of the Federal statute (except for emergency services for certain persons), the Medicaid program does not provide health care services for everyone. You must qualify for Medicaid. Low-income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds. As noted earlier, categorically needy persons who are eligible for Medicaid may or may not also receive cash assistance from the Temporary Assistance for Needy Families (TANF) program or from the Supplemental Security Income (SSI) program. Medically needy persons who would be categorically eligible except for income or assets may become eligible for Medicaid solely because of excessive medical expenses.

But, the real issue is not so much access as it is affordability. Our system is simply too expensive. I think we agree on that.

For those who need health insurance there is not luck about it. A job paying 6 dollars per hour in the mail room for a large company that provides health care is better than a job paying 9 dollars per hour at Mcdonald's with no health insurance. It is choices in life that determine which job one has.

In today's economy, any job is welcome. No one is able to pick and choose between a lower paying job that has insurance, and a higher paying one that doesn't. In a 10% jobless economy, which is really more like 15% or more, you take what you can get.

For the working families you mention there are also choices to buy all the TV's, phones, cell phoes, jewelry, a house, two cars, etc. that the US census reports that most poor people have and all working poor have. The cost of catastrophic insurance is quite reasonable and the cost of regular exams is also quite reasonable. The working poor can afford both if they budget well.

All of those things are quite reasonable for young healthy people.

You are right. This person risks losing his assets. What he does not risk is not having access to health care. You are not suggesting that we re-make the entire health care system of the US and make it more socialistic and coerce 100% of the population to pay more in either taxes or higher cost of living so that the working poor have less risk to their assets?

Not at all. What I'm suggesting is that the cost be reined in, and health care be affordable to everyone. the way we're going now, even the middle class will soon be priced out of the market and be forced to choose between continued middle class status and needed health care.

After all many richer people also face risk to their assets. If we look at many successful people they have been alternately rich and poor several times having won it all and lost it all. What they do better than the working poor is make choices that allow them to gain it in the first place and gain it back when they lose it. Suppose we focus on that problem instead of giving health care handouts to those who do not lack health care because they lack financial security. The way to address financial insecurity is to address it head on not by addressing health care.

that's a lot easier to say when you're 30 and in good health. When you're 60 and not in good health, it's a lot harder to do. Even if you are in good health, a 60 year old is going to have a difficult time finding employment in most cases.

Agreed. The current system has too much government intervention causing it to be inefficient.


Everyone can afford catastrophic coverage or other coverage or is on a public plan and does not need it. I have had that kind of insurance and I had it back when I was paying for my own tuition at a community college and worked part time as a delivering person earning slightly above minimum wage. That kind of coverage does not cost much. And the purpose of that kind of insurance is not to provide health care (because everyone can get health care by applying for public aid as soon as they exhaust their assets) but to protect what little assets a person has.

No, not everyone can afford catastrophic coverage, nor can everyone even get it. That's why we need such insurance that will cover everyone. That way, no one has to choose between having that operation and paying the mortgage. The proposal to end the "pre existing conditions" clause in most policies would make such a policy available, but is likely to raise the cost.

Requiring people to buy a product is a restriction of a basic civil right. It is a draconian solution to a problem that has been blown out of proportion. I sometimes think that is the true purpose of liberal health care reform.

Look again: I'm not suggesting that everyone have to purchase a policy, but that they have to pay out of pocket for ordinary care. If they don't want care, then they don't have to buy it.

Lets eliminate the restriction congress has placed on insurance companies ( the ones that do not protect people against fraud) so that they can compete across state lines. Right now there are over 3000 insurance companies in this country. That is ample competition to bring down prices but in any particular area each person only has access to a few companies. And even with that barrier to competition the insurance industry only makes about 4% profit. The most costs of insurance could be brought down would be about 4%.

Absolutely, let's have competition across state lines. Why would anyone oppose that?

The cost of drugs and devices could come down more but not by changing insurance. The present plan will increase the costs of drugs and devices. In fact as a pre-emptive response to the gov. plan drug companies already raised prices about 9% last year ( a taste of things to come).

by all means, let's negotiate the cost of drugs and devices. Currently, the pharmaceuticals charge whatever they feel like charging.

Lets do all we can to lower health care and insurance costs so that it becomes more affordable.

Absolutely.

Then and only then lets ask: What do we do when people can't afford insurance but still have access to health care?

With a universal catastrophic insurance, no one would be without insurance. They could purchase an individual policy, or not. No one would have to have a policy. That alone would bring the costs down.

Yes we do need to lift that burden. It is precisely that burden that has caused a disconnect between the buyer of a plan (employer) and the user of a plan (employee) and the provider of a service. We need to user of the plan to be the decision maker who interacts with the provider of the service. Anything else is not market forces lowering prices.

You have that right.

It is the gov who caused employers to have that burden to begin with. With a stroke of pen we could make the cost of personal insurance tax deductible and that would not lower the cost of insurance and restore the buyer of the plan as the decision maker.

That, too.

All true. So why did congress make employer coverage tax free while the coverage an individual buys is taxes?

Good question. Either all insurance, or no insurance should be tax free.

Isn't it too bad that partisan politics is taking the place of rational debate about how to rein in the cost of health care and make it more affordable for everyone?

yes, it is.

 

[chestnut]

Another poll, this time NBC, showing America doesn't want our system reformed.

Obama isn't getting the news is he?

NBC poll: Public sours on health reform
Posted: Wednesday, December 16, 2009 1:00 PM by Mark Murray
Filed Under: Polls
From NBC's Mark Murray
As the Senate sprints to pass a health-care bill by Christmas, the latest NBC News/Wall Street Journal poll finds that those believing President Obama's health-reform plan is a good idea has sunk to its lowest level.

Just 32 percent say it's a good idea, versus 47 percent who say it's a bad idea.

In addition, for the first time in the survey, a plurality prefers the status quo to reform. By a 44-41 percent margin, respondents say it would be better to keep the current system than to pass Obama's health plan.

By comparison, in September's and October's NBC/Journal polls, the American public preferred changing the system to the status quo, 45 to 39 percent.

The poll was conducted Dec. 11-14, and has a margin of error of plus-minus 3.1 percentage points.

The full survey will be released tonight at 6:30 pm ET on NBC Nightly News and MSNBC.com.

 

[Dr.Who]

and yet, this is what Medicaid says:

"Medicaid does not provide medical assistance for all people with limited incomes and resources. Even under the broadest provisions of the Federal statute (except for emergency services for certain persons), the Medicaid program does not provide health care services for everyone. You must qualify for Medicaid. Low-income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds. As noted earlier, categorically needy persons who are eligible for Medicaid may or may not also receive cash assistance from the Temporary Assistance for Needy Families (TANF) program or from the Supplemental Security Income (SSI) program. Medically needy persons who would be categorically eligible except for income or assets may become eligible for Medicaid solely because of excessive medical expenses."

As a person who used to administer medicaid benefits let m explain what that means.

Income is not the only test for eligibility. If a person has limited income but also has $100 grand in the bank he will not be eligible. do you not agree that a person with a bundle in the bank should not be eligible for welfare?

I stand by my previous statement that not only the very poor qualify for medicaid but also many people that you and I would not with a sane mind say are poor. People with jobs but who are eligible are eligible based on these guidlines:

"You are eligible for Medicaid if your income is below the community standard income level [Federal poverty level]. If your income is over the community standard, you will have an income spend down before Medicaid will be available to cover medical bills. The spend down process is discussed in greater detail later."
http://www.illinoislegalaid.org/index.cfm?fuseaction=home.dsp_content&contentID=1380

And what is the fed poverty level? For a single person they can earn almost 11 grand and still be called poor. For a family of four they can earn about 22 grand and still be called poor.
http://www.illinoislegalaid.org/index.cfm?fuseaction=directory.showPovertyLevels

With incomes like that and careful budgeting a person can afford doctors exams or catastrophic insurance. Though I am not immune to the difficulties of that budget. I think there are numerous sources of support without increasing the federal payout. For starters I doubt there is a city in this country in which a church would not offer cash or other help to any person with incomes like those above who could not afford a doctors visit. I would add that I have searched for a charity that helps people in that situation. I found charities that help cats and charities that help the arts and even charities that help three legged cats, but none that are set up for people who don't have catastrophic health insurance. I suggest that the reason why is that there are NO people who have that problem that are not helped by the social services department at the hospital.

 

[Dr.Who]

[




All of those things are quite reasonable for young healthy people.

How is it that the young healthy person managed to become old and sick without any retirement plan which would account for the fact that when they got old they were going to have health issues?

The answer is that for the first 50 or 80 years of their life they made poor choices and did not save. (statically though the old people own most of the money in this country compared to young for the very reason that most of them have saved and own their houses outright)

So by all means lets help them through state welfare programs and require that they do not have a bundle in the bank or that they do not earn a lot of money. Lets first help them through non state programs too.

 

[Dr.Who]

Not at all. What I'm suggesting is that the cost be reined in, and health care be affordable to everyone. the way we're going now, even the middle class will soon be priced out of the market and be forced to choose between continued middle class status and needed health care.

"The way we are going now"

What makes you think that the cost of healthcare is rising to fast compared to other industries (like college) or too fast compared to inflation? What makes you think it is even a trend or that if it is a trend it would continue? Don't market forces most reign in costs that are rising too fast?

We need most to restore market forces. Congress has removed many market forces that already would have resulted in lower costs and the new bills are due to remove even more market forces. I can't help thinking that that is the plan.

 

[Dr.Who]

I didn't respond to most of the rest because I either agreed or it was just not IMO too important. If I missed something you care to dig deeper into let me know.

 

[Mr. Shaman]

Another poll, this time NBC, showing America doesn't want our system reformed.

Obama isn't getting the news is he?

Yeah....that's who's problem it is.

​

"Yet before Republicans cheer that they may defeat this effort, they should beware what they wish for. A vast majority of Americans still believes that we need fundamental health-care reform. If the legislation fails, Democrats can blame Republicans by saying reform was in sight and the GOP blocked it without offering a real alternative to decrease costs and increase access."

 

[chestnut]

Yeah....that's who's problem it is.

BUZZZZZ!!! Wrong again Shame Man!!

Dems have majority in House and Senate. No blame on the republicans. They were not even allowed to participate in the "back room dealings"

This whole miess is strictly a democratic problem. END OF STORY!!

 

[PLC1]

"The way we are going now"

What makes you think that the cost of healthcare is rising to fast compared to other industries (like college) or too fast compared to inflation? What makes you think it is even a trend or that if it is a trend it would continue? Don't market forces most reign in costs that are rising too fast?

We need most to restore market forces. Congress has removed many market forces that already would have resulted in lower costs and the new bills are due to remove even more market forces. I can't help thinking that that is the plan.

Are you serious? The cost of health care has been going up by double digits for years now. The cost of health insurance has followed suit, of course.

Sure, let's restore market forces, but while we're doing it, let's not pretend that there isn't more that has to be done. If market forces are so great, why is it that we pay a greater share of our GDP for health care than other countries? Are their "socialized medicine" plans using market forces?

 

[PLC1]

How is it that the young healthy person managed to become old and sick without any retirement plan which would account for the fact that when they got old they were going to have health issues?

The answer is that for the first 50 or 80 years of their life they made poor choices and did not save. (statically though the old people own most of the money in this country compared to young for the very reason that most of them have saved and own their houses outright)

So by all means lets help them through state welfare programs and require that they do not have a bundle in the bank or that they do not earn a lot of money. Lets first help them through non state programs too.

And after they are out of the hospital, then what? With no savings left, are they to live on the joke that Social Security has become? Are they to enter the job market at the age of 75? Who is going to hire them?

Oldsters and people who have health issues can't buy their own health insurance. If they bought in while young, there is no guarantee that they can keep it later. There is pretty much a guarantee that they will lose private individual insurance should they become a risk that the insurance company doesn't want to take.

National catastrophic health insurance that covers everyone is the way to go. It will bring down costs, get those market forces working, and get the burden of health care off of the backs of employers.

Of course, the federal bureaucracy won't do anything so simple and logical, probably, so costs will continue to soar for a time at least.

 

[Dr.Who]

Are you serious? The cost of health care has been going up by double digits for years now. The cost of health insurance has followed suit, of course.

Sure, let's restore market forces, but while we're doing it, let's not pretend that there isn't more that has to be done. If market forces are so great, why is it that we pay a greater share of our GDP for health care than other countries? Are their "socialized medicine" plans using market forces?

You didn't answer the question. What makes you think it is going up too much?

In a couple of years the amount of money spent on green technology will have doubled or tripled. Will it have gone up too much? Or will that just mean that people wanted to spend more money on green products and they completely got their money's worth? Will that just mean that the green industry is a better place for people to spend their money than coal?

Growth in health care spending is expected to be about 6.7% annually. Why do you think that is high? We have heard that it is higher than inflation but inflation is of course at a very low rate because we are in a recession. Often inflation is higher than that which would mean that the growth in health care is lower than the typical growth in inflation. Then we could compare it to other industries. How many industries do you think are growing faster than health care? And how many of them are offering new innovations and better service all the time.

Then of course who is to say that the growth in health care will remain unchecked? It certainly will be checked if we stifle innovation and reduce care neither of which we want to do. But it could be checked appropriately if we restore market forces.

So again I ask why do you think it is growing too fast?