Here is an interesting video about government-run health care and preventative medicine.
Too bad I can't embed the YouTube video. Now I have a source tab!
"Universal" Health Care
Posted March 26th, 2007 at 10:29 AM by Adam
in
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Just click on the "source" tab and copy the embed code into the source code for the post.
"Now I have a source tab!"
Now so do all the other Registered Users!
Health care is rationed, everywhere. Do we want money to do the rationing, or some gatekeeper in parliment?
Nice post Adam.
It is possible to ration health care without rationing it in the most near-sighted, asinine, inefficient, expensive way possible.
Those who defend the current system are fighting against a cheaper, more comprehensive alternative. It benefits everyone in the country when the workforce is healthier and more long-lived.
It is possible to ration health care without rationing it in the most near-sighted, asinine, inefficient, expensive way possible.
I agree. I think a free-market would be the best way.
Do you think that in Canada they tell their citizens that they are going to ration health care in the worst way possible? Of course not. One might then wonder why it happens that way. The answer is simple. The government doesn't really care about any individual.
No matter how smart health care is rationed by a government system, the fact will always remain that there will be people who want some procedure or care who will be denied by the government. And when the government is paying, the patients really have no say in the matter at all. Should those people get a letter assuring them that the government is acting in the best interests of the country so they will just have to wait a few months to get their new hip?
what if the gov't mandated the abortion of all babies that showed Down's? Or outlawed sex- change operations, or fertility treatments? Or made masectomy the only treatment option for breast cancer?
Xian, I don't share your faith that the gov't wouldn't screw the rationing up - miserably. I care too much about health care to let the gov't control it.
To borrow from Adam's argument: "Do you think that in the United States they tell their citizens that they are going to ration health care in the worst way possible? Of course not. One might then wonder why it happens that way. The answer is simple. Insurance companies don't really care about any individual.
No matter how smart health care is rationed by a private insurance system, the fact will always remain that there will be people who want some procedure or care who will be denied by the insurance company. And when the insurance company is paying, the patients really have no say in the matter at all. Should those people get a letter assuring them that the insurance company is acting in the best interests of the country so they will just have to forget about ever getting a new hip?"
My point is, I don't see the difference, except that Canada's system is cheaper and covers everyone. Our system is way more expensive and leaves forty million people without squat.
I don't think either system is perfect, but they both clearly have different strengths and weaknesses. How's about this: let's learn from the best practices of Canada and avoid their mistakes in order to craft a uniquely American approach that fixes the obvious inadequacies of our system.
BTW, I really hate the type of so-called "journalism" represented by the film clip, regardless of who does it or which side is trying to make a point. It is entirely counterproductive to take two singular examples that are selected, not necessarily because they are the most representative of the common experience of the majority, but rather because they are the most sensational and evoke the most intensely visceral emotional response, and then imply that this is in any way descriptive of the entire system without any supporting evidence or even background information. The implication of the film is that no one ever receives any primary care because the system is too busy providing the millions of sex change operations that allegedly take place every year in Canada. That's obviously not true.
The fact of the film is that the system failed for one woman, possibly due in large part because of the failings of one minister. It would be a fallacy of monumental proportions to condemn the entire system without a whole lot more information. I hate this crap. I hate it when unions do it, I hate it when social activists do it, and I hate it when capitalist "hapless status quo defenders" do it. It is yellow journalism at its worst, and it serves no one well.
I don't want to paste in Kevin's opening three paragraphs, but they were right on the mark. The main difference between the US private insurer system and Canada's plan lies in who makes the rules. My observations and opinions on this issue are based on two important sources of information: 1) My wife has worked in management in the healthcare industry for twenty years, and she deals on a daily basis with patient's woes over insurance coverage, "usual and customary", public aid patients, and similar issues. 2) The entire paternal side of my family is Canadian, so I have had many discussions over health care solutions. Some of my relatives have stories of frustration concerning their treatment by the Canadian system, but most buy into its concept and understand that no such system can be without its flaws.
"I don't think either system is perfect, but they both clearly have different strengths and weaknesses. How's about this: let's learn from the best practices of Canada and avoid their mistakes in order to craft a uniquely American approach that fixes the obvious inadequacies of our system."
What a concept...but under the current system we immediately face the obvious roadblock: What incentive is there for the insurance industry, whose lobbying power in Washington is second to none?
Do you think health care is too important to be managed by the government, who will almost certainly screw it up; or too vital to be left in the hands of a largely-unregulated private industry?
And I might add: Look at the other nationalized health care systems which are performing better than Canada, which is in turn performing better than ours...
It is easier to switch insurance companies than to switch governments. That is the incentive for insurance companies. I would agree that the power the insurance companies get from the government is harmful and should be eliminated. However, this is a problem with the government, not the market.
And if all else fails, in a free-market, you could at least pay for your own treatment instead of suffering on the government waiting list.
Xian, in your opinion, which country in the world has the best health care?
"It is easier to switch insurance companies than to switch governments."
For many (if not most) people, that is patently untrue. Their insurance company is often dictated by their employer. In other cases, it is sometimes dictated by their choice of physician. A lot of people have no choice whatsoever when it comes to picking an insurance provider.
"And if all else fails, in a free-market, you could at least pay for your own treatment instead of suffering on the government waiting list."
That assumes that you have the money, after already paying your insurance premium that you thought would take care of it. Many people can barely afford their insurance. Where are they supposed to get the money to pay for treatments their insurance company denies?
There is a lot to like about our health care system, but there is certainly also a great deal of room for improvement.
Kevin makes good points as to why actually having a free market health care system might work... if we ever actually tried it. Remember, it was progressive Ted Kennedy that gave you HMOs. How long has Medicaid been around and we still can't get health care to the poor? What makes you think those same people will suddenly be able to get health care for everyone?
There are plenty of fixes that can be had with the current system which almost completely takes the patient (i.e. the consumer) out of the decision-making process.
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j
Part-Time Pundit
"Many people can barely afford their insurance. Where are they supposed to get the money to pay for treatments their insurance company denies?"
Who knows, but it is still an option this poor lady in Canada didn't have.
"Who knows, but it is still an option this poor lady in Canada didn't have."
With all due respect, if you can't do it, for whatever reason, it's not really an option, is it?
I have heard of folks having fundraisers to help pay for stuff. Mortgaging their house. Cashing in their 401k. Borrowing money from family.
"Health care is rationed, everywhere. Do we want money to do the rationing, or some gatekeeper in parliment?"
We currently have money doing the rationing in this country. In fact if you look closely at Great Britian's system it is a real "highbred' of ours and Canada's system. There, you get health care coverage through the government but if you wish to advance your scheduled treatment, especially surgeries, you can pay to move it forward in the que. It is also my understanding that you have physican/hospital/clinic choice in Great Britian.
"Do you think health care is too important to be managed by the government, who will almost certainly screw it up; or too vital to be left in the hands of a largely-unregulated private industry?"
If this is not a chicken-or-egg question, I believe there is middle management area that could be attained. Yes, I have been called an optimist, except on this blog. Regardless, review how commerce is handled in this country, the government manages most (except illegal drugs and aliens) with private industry preforming all the functions.
"I have heard of folks having fundraisers to help pay for stuff. Mortgaging their house. Cashing in their 401k. Borrowing money from family."
Of course. What was I thinking? Just sell the Krueggerands. Or the speedboat. Or the house in Monte Carlo. Problem solved. Next.
I don't mean to demean what you're saying, but you seem to be making the same mistake as Adam. He assumed that everyone had the money. You're assuming everyone can get it, even if they don't have it.
Any of those things would be great if you can do it, but not everyone owns their house, or has a 401K, or has friends or family who have funds to spare. In fact, people who can barely afford their insurance are less likely to have any of this. And what do you do the next time, down the road, if someone else in the family gets sick and you've already pulled several of these rabbits out of your hat?
None of which speaks to my original point: what if you don't have the money? And by that I mean, what if you just really, really don't have it?
"Any of those things would be great if you can do it, but not everyone owns their house, or has a 401K, or has friends or family who have funds to spare. In fact, people who can barely afford their insurance are less likely to have any of this. And what do you do the next time, down the road, if someone else in the family gets sick and you've already pulled several of these rabbits out of your hat?
None of which speaks to my original point: what if you don't have the money? And by that I mean, what if you just really, really don't have it?"
Medicaid?
I never assumed that everyone always has money to buy whatever they want. And I've been criticized as heartless to suggest that in this imperfect world, people will get sick and die - and that taking other people's money (and causing some unknown negative consequences to them) to give to the sick poor person is not a solution.
I have said that health care will always be limited. The question is whether or not some government wizard should be the one to decide who gets treatment and when.
"Medicaid?"
I don't think people with health insurance qualify for Medicaid. We're not talking about the poorest of the poor here. We're talking about people with jobs and benefits who have the need for a procedure that the insurance company refuses to pay for, just as the government apparently refused to pay for the woman in the film.
Adam said the advantage of our system is you can pay for it yourself. I said that assumes you have the money. If you don't, you don't really have that option. Adam now says he never assumed that, that for some people the real option instead is to die. I think at that point he has failed to show any qualitative difference between the two systems in regard to this particular problem.
"The question is whether or not some government wizard should be the one to decide who gets treatment and when."
Actually, the question is a little bigger than that, because some insurance company wizard is no different from your government wizard bugaboo. And now we've come full circle, and I've started to repeat myself.
"I don't think people with health insurance qualify for Medicaid."
I thought we were talking about people who didn't have insurance and couldn't afford medical treatment.
"You're assuming everyone can get it, even if they don't have it."
I do no such thing. I assume that some people will look at every possible option, if they are given one. As I said, this lady in Canada had NO option, under force of law.
Between 1985 and 1996, I was a caseworker here at the local public aid,,,,,sadly,,,and it has gotten worse with time,,the people that had only a temp need,,,job loss,,,,,acute illness ie; were the very ones that would receive no help. We had a program called Medicaid Spendown,,,,which really mean't deductible. Using a combo of monthly income and assets, a figure was derrived at the said how month in monthly medical expense a person had to receive a medical card,,,some of these amounts were outrageous,even for the elderly on fixed incomes,,actually it was worthless. /After I left there I had the misfortune of working for a rather large local HMO. Until you have seen a casemgmt. nurse hanging out at a hosptial bugging doctors about how soon they ware going to discharge a sick patient,,,,well it was very distasteful,,,,and really an eye openner on managed care.
http://www.earthchangestv.com/biology/June2000/0621controversial.htm
Here's an article on comparing health care systems which is by no means a perfect system. However, many of these countries have longer life expectancies, lower infant mortality and ALL of them spend less than we do.
You all are basically paying $30,000 more for a car that rates worse in EVERY SINGLE CATEGORY and then saying, "There was one woman in Canada who drove that other car and died!"
All of us will drive the American health care system and 100% percent of us will die. Sadly, it will be years before we have to; unless we make a change.
This is the fallacy in Adam's ideology. He seems to have no concept of community health or preventive medicine. He believes that people find cures to make money when the very economic principles at play dictate that researchers target treatments rather than cures.
Let's stop the back and forth real quick and just answer this:
Why pay more for a health care system that makes our lives shorter and worsens our quality of life? Is there ANY circumstance in which this would be a remotely good idea? Are we all complete morons (not directed at anyone here--I mean us in general)?
"I assume that some people will look at every possible option, if they are given one. As I said, this lady in Canada had NO option, under force of law."
And there are people in this country with NO option, under force of reality. Of course people will explore every possible option available, but if the money ain't there, it just ain't there. If the money can not be found, the option does not really exist, regardless of what the law says.
Sorry, not true. You show up to a hospital, they have to treat you. I know one case of someone who got drunk, ran his car into a tree, got taken to a hospital, got fixed up, the found cancer, he got that fixed, and because he's a life long drug addict and alcoholic (and the hospital knew this beforehand) he still got his care taken care of.
I'm not saying its ideal, but with Francis Nelson, the Christian health care clinic which provide routine care for free/cheap, and the hospitals, required by law, to provide care for life-threatening situations, it's hardly like we've got people dying on the curbs outside ERs. I'm not saying it is a good system, but before we can fix a problem, we ought to start from an accurate definition of reality.
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j
Part-Time Pundit
Right, because as long as no one dies on the curbs outside of ERs it means that no one is being denied preventive health care.
"You show up to a hospital, they have to treat you."
That's absolutely not true. Here's what's really true: you show up at an ER with an "emergency," they have to treat you. You get denied a "non-emergency" procedure by your insurance company (just like the lady in Canada was denied by her hospital), and they don't have to give it to you in this country, either. They don't have to do anything until it becomes an "emergency," just as it did for the lady in Canada.
Here's the original point once again: The film clip showed a lady in Canada who was denied a procedure which most reasonable lay people would agree she should probably receive. The clip only explained just enough of the situation to explain how she got there, and to bash a health minister whom the producers felt was at fault. No doctors were quoted or interviewed in the story. Eventually, her situation deteriorated to the point where she lost an organ that she probably didn't have to.
I pointed out that the exact same thing happens in this country all the time. Insurance companies regularly deny their paying clients procedures which their doctors have recommended and which most reasonble lay people would agree they should have. They use a variety of excuses, including contentions that the procedures are "elective." People in this situation often try to pay for the procedures out of their own pockets, but if they're unable to do so, their situations get progressively worse until they eventually require more serious treatment. This is exactly the same as the case in the film clip in Canada.
But Kevin, the only statistic worth comparing is how many people are dying on the curb in the front of the hospital. Otherwise, we are just supposed to sit with our missing organs and be proud that we don't have some commie health care system.
I question why this particular case is so moving. I can see why it is moving, but this same thing happens over and over in the current system in the U.S. Looking at the numbers, far more often in other developed countries. So why do people only care when it fits their polemic?
As you and others said earlier in the thread, we should certainly design our system to be better than the canadian system and avoid these types of situations. Of course, even if we just accepted the Canadian system, it would be a mild improvement.
Onbviously my point of actually looking at what the problem REALLY is as fallen on deaf ears, let us continue then with the rhetorical hyperbole... because that's what really solves problems... spin.
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j
Part-Time Pundit
There were plenty of people looking what the problem REALLY is, but your deaf ears decided to focus on the fact that people aren't dying on the curb in front of the hospital. That was an absurd fixation, so we attacked that. If you genuinely want to discuss what the problem REALLY is, why not just go back to before you diverged the topic:
Let's stop the back and forth real quick and just answer this:
Why pay more for a health care system that makes our lives shorter and worsens our quality of life? Is there ANY circumstance in which this would be a remotely good idea? Are we all complete morons (not directed at anyone here--I mean us in general)?
Why? Freedom.
Now, I'm not saying that freedom leads to worse health care, but even if it did, I would argue that freedom would be a moral reason to not have government-run health care. If you don't like freedom, call it "equal protection under the law".
So one individual is not forced to work for the benefit of another. (kind of like slavery)
Youy talk about health care as if it necessarily is some issue that should be placed in the public policy realm. I mean, we don't talk about what to do with the "toy system" or the "food system" or the "clothes system". It's a good thing we don't have a "food system". In this country, poor people tend to be fatter than the rest. Imagine that being true in a country where there is a "food system".
If concepts of freedom and private property are only valued for "unimportant" things, then I don't think they are valued at all.
"I'm not saying it is a good system, but before we can fix a problem, we ought to start from an accurate definition of reality."
Fine. Here are corrections or clarifications of some competing recent points in this thread:
1. "If you show up at a hospital, they have to treat you." False. As Kevin said, if you show up with a bona fide emergency, they have to treat you. And that treatment is likely to involve some of the least efficient, least effective measures that could have been employed unless you're talking about a gunshot wound or other sort of accident victim. Unfortunately, people without coverage are often forced into this course of action. It doesn't work for the patient, and it certainly doesn't work for the provider.
2. Ask someone at the Frances Nelson Health Center what their current waiting list looks like. It is a critically important place, but it is hopelessly overtaxed. Even Carle and Provena recognize its importance and support it, but it's far from enough.
3. "I assume that some people will look at every possible option, if they are given one. As I said, this lady in Canada had NO option, under force of law." Incorrect (probably, even though as you mentioned, Kevin, we were conveniently not offered all the pertinent facts.) In Canada, if you're dissatisfied with your level of treatment within the system, you can seek alternatives IF you have the means to do so. Just like here.
I read this analogy yesterday - if your house has a roof leak, you don't blow up the whole house and rebuild, you fix the roof.
Does America have a problem with a certain percentage of the population not having adequate access to health care? Yes. But is this a majority of the population? Is there no other way to fix this problem than just letting the federal gov't come in and take over the whole system?
How about some tinkering on the margins - let all health insurance premiums be tax deductible, not just those bought from employer "qualified" plans. How about allowing people to buy insurance from any state, to mitigate the cost effect of state mandates?
xian-
I focused on the absurd hyperventilation on our health care system, the people who are dying are being turned away to die in a gutter. It isn't happening. You're the one issuing, once again, personal attacks. Quite frankly, as far as I'm concerned in political debate, the second you make attacks on a person is the second your ideas and participation in the debate should be rejected.
Comparing nations life expectancies and then making that the sole factor in saying our health care system is failing and killing people off earlier is an absurd and simple-minded explanation. There are many factors well outside the health care system that go into life expectancy. For instance, diet, environmental concerns, likelihood of fatal accidents, crime, diseases that are regional in nature, cultural factors that may prohibit or enhance seeking out health care (even if paid for), lifestyle, working conditions, and I can go on.
It's well known that Americans are fatter than most of the world, which is a leading contributor to heart disease (a leading cause of death) or other obesity related illnesses. Health care doesn't help the fact that Americans eat crappy food to excess, that's why there is all this push to ban transfat and modify the diet in schools. It has nothing to do with access to health care.
And for the criticisms, read the federal law. It's obvious you haven't. You show up to a hospital, they have to give you an examination and stabilize you. They don't have to (but often do) give preventative care. Most health care professionals are decent people and don't want people to die and will do what they can to help. I want you to read this next point very carefully. If health care professionals (and people in general) as a group cannot be trusted to be simply humane but instead will insist people die before they lift a finger, we are having the wrong conversation. The conversation shouldn't be whether or not the government takes over healthcare, the conversation should be whether we repeat the Constitution because we as a people are wholly undeserving of freedom and need to be ruled.
2) Yes, Frances Nelson's wait list is wrong, I didn't say it was ideal, I said it exists. This idea that 50 million people (a number that keeps getting bigger even after it has been exposed as a fraud) simply cannot get health care and are doomed to die at home is false. There are options, they may not be great, but they exist. Let's not pretend they don't. I'm not saying they are good, but pretending they don't exist simply does not address reality. There are things we can do to help Frances Nelson without burning down the entire health care industry.
3) Medicaid is designed to help poor people get healthcare, yet those very same people are lumped in with others who don't have it. If Medicaid has failed, how precisely will a government run HMO, or straight-up government run healthcare be successful. Include into your answer the long-term governmental behavior of dealing with their overspending and waste problem by screwing providers by delaying payments as long as possible and then making them jump through 30,000 hoops to collect. No business can run when they collect payments on a net-450 basis.
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j
Part-Time Pundit
"Medicaid is designed to help poor people get healthcare, yet those very same people are lumped in with others who don't have it. If Medicaid has failed, how precisely will a government run HMO, or straight-up government run healthcare be successful."
I've asked a similar question a few times in here. I don't agree with everything John has written, but I am curious as to why those pushing for government-provided health care for the poor think that Medicaid is unsuitable?
I'm also curious how one would address providers' concerns about underpayment or delayed payment by units of government every time the politicians decide they'd rather spend more on pork.
And don't forget, Medicaid can at least use the open market prices as a basis for reimbursement rates. What if there wasn't an open market price? How much will the gov't decide a triple bypass surgery is worth?
Would national healthcare make it illegal to take cash for medical services?
To answer the reasonable questions, it is my experience that a universal health care system helps alleviate many of the problems that exist with Medicare.
For example, if you have been reading the mainstream articles on the crisis in Chicago, you are familiar that much of the funding problem is caused the strain of categorizing insured and uninsured patients. As a result, many insured patients have their bills footed by the state instead of by the private insurance corporations.
If you say,"Well this is just part of a government run program, nothing works!" consider that there are plenty of societies which pay their bills on time and funding vital programs. You all know my stance on aimlessly spending and strategy-less budgeting. This is why I don't support either our state or national executive officers, who seem to thrive on overspending and then underfunding vital programs.
As to the last post from John, I'm probably going to regret responding at all. He basically says I should be disqualified from speaking with authority, so here is how I see it re-reading the thread. If I'm wrong, I would appreciate if others could message me or post it here. After all, if my opinion is not welcome in these discussions, there are certainly other ways we could all use our time.
1. Points are debated in a civilized manner.
2. John misrepresents the points being made and responds to completely different points in a hostile manner.
3. I use the EXACT same language in John's post to make a point.
4. John accuses me of personally attacking him and saying that I don't deserve to be included in the conversation, and his clearly inferior arguments should reign supreme (despite the fact that he's been refute by others as well) but forgets to use the term "kid's table".
5. He uses the most ridiculous selective quoting yet, in which he takes this sentence:
Here's an article on comparing health care systems which is by no means a perfect system. However, many of these countries have longer life expectancies, lower infant mortality and ALL of them spend less than we do.
and responds with this:
Comparing nations life expectancies and then making that the sole factor in saying our health care system is failing and killing people off earlier is an absurd and simple-minded explanation.
And then goes on this tangent about how it's a bad idea to use only life expectancies. Of course it's a bad idea, that's why I didn't do it and wouldn't dream of doing that. Then he lectures me on the medical system and what doctors can and cannot do despite the fact that I spend everyday around doctors, residents and students who are constantly complaining about these issues, but John seems to think that if they can't perform preventive medicine in the current system, that they are some heartless monsters.
The last sentence of that paragraph seems unintelligible, but I'm probably just missing something cause I don't get it even after correcting for the typo. I'm not sure what you or Adam mean by "freedom". I mean, in my experience, with nationalized health care, I can walk into ANY hospital and experience a shorter wait than I currently do at the single location I am currently required to use under my health plan.
That fits my definition of freedom.
6. Then he goes on telling me stuff I already know and saying I obviously haven't done things which I have. It's not just the snide language, it's the rare combination of bitter condescension and complete misrepresentation. I enjoy a fierce, thoughtful discussion. But when my ideas are completely misrepresented, there's not much room for dialogue.
Me: I love rabbits and frogs and turtles.
John : NEVER trust someone who ONLY loves turtles! Your points will fall on deaf ears!
Me: NEVER trust someone whose ears are too deaf to know whether or not you ONLY love turtles!
John: Personal attack! Turn off his mic!
Me: ....
"For example, if you have been reading the mainstream articles on the crisis in Chicago, you are familiar that much of the funding problem is caused the strain of categorizing insured and uninsured patients. As a result, many insured patients have their bills footed by the state instead of by the private insurance corporations."
I don't follow - are you saying that if there were no people who were privately insured, the costs for Medicaid would go down? How? I'm sure I'm misunderstanding you somehow...
And how would providers be assured that they'll actually be paid a market rate in a timely fashion, rather than them getting screwed every time politicians' priorities change back to funding pork over medical bills?