Aa
Dont Knock our Health System
Canada's system is called Medicare, and is much like Medicare in the U.S. for over-65-year-olds, except that this one treats virtually the entire Canadian population of 33 million.Canadians are setting aside their criticisms of Medicare and rallying to its defense. The reason: Their system has been dragged into the debate over President Barack Obama's health care reform proposals by opponents who say Canada proves Obama is wrong — that Canadians endure long waits for critical procedures, medical rationing, scant resources and heavy-handed government interference.
http://www.the33tv.com/news/nationworld/sns-ap-cn-canada-medicare-for-all,0,5821607.story
http://www.the33tv.com/news/nationworld/sns-ap-cn-canada-medicare-for-all,0,5821607.story
My point had more to do with the actual limit of resources rather than lack of 'money'. We can always print more money - just look at our 'solution' to the current fiscal crisis. But you can roll the printing presses all you want and it won't create more doctors or more medicine. One example of this is our current frantic effort to create flu vaccine. There are countries in SE Asia that will probably do without entirely because their normal supplier, Australia, will be holding on to most of what it produces for itself. Another example is the Midland-Odessa phone book. Last time I looked up 'Physicians' in the yellow pages, an estimated 75% of the doctors were South Asian surnamed. The fact that I only have to make a 450 mile round trip to see a gastro or a neurologist means that somewhere in Pakistan or India there are no specialists available at any price. True, these are global examples, but we will find the same to be true on a national level if "Universal Healthcare" is ever attempted in this country.
I don't have an answer to this. I think it would be great if everyone could have their needs met, but I don't see it happening in my lifetime.
I don't have an answer to this. I think it would be great if everyone could have their needs met, but I don't see it happening in my lifetime.
Oh sigh...I can't help it. I have to comment here.
"As desrt point there will never be enough money "for everyone to get what they need" so its employees can be expected to spend a good amount of their time on the phone explaining the meaning of "not covered". And if people hate hearing that from their HMO they'll really hate hearing it from a bureaucrat."
I don't believe that's true. When you hear that from an insurance company, isn't the thought going through your head that they're only interested in their profit margins and not interested in people at all? When the government tells you it's not covered, it's because they can only cover so much and everybody knows what they're covering is coming from the tax base, not from the backs of people paying co-pays and lining the pockets of insurance company executives so to speak. Yes or no?
"As desrt point there will never be enough money "for everyone to get what they need" so its employees can be expected to spend a good amount of their time on the phone explaining the meaning of "not covered". And if people hate hearing that from their HMO they'll really hate hearing it from a bureaucrat."
I don't believe that's true. When you hear that from an insurance company, isn't the thought going through your head that they're only interested in their profit margins and not interested in people at all? When the government tells you it's not covered, it's because they can only cover so much and everybody knows what they're covering is coming from the tax base, not from the backs of people paying co-pays and lining the pockets of insurance company executives so to speak. Yes or no?
Mike points out one of the weirder inconsistencies in the arguments opposing the public option - if the publicly-administered, unsubsidized, insurance plan will be another hopeless, bureaucratic nightmare how will it possibly outcompete our thriving, efficient, well-managed, private sector ins. cos?
In the end it comes down to who do you trust. Blind faith in free market efficiency may be hazardous to one's survival. Included in Flguy's list of fubars are several (Fannie Mae, privatized 68 re-nationalized-09, GM, Chrysler) examples of the toxic effects of private sector incompetence. And it'll be a quite a while yet before we climb out of the smoking ruins left by the collapse of unregulated derivatized mortgage-backed security markets. To paraphrase Bo Diddley - "who do you trust?".
No sense having rosy illusions about government-administered insurance - it will a large, moderately efficient, somewhat dismal bureaucracy. As desrt point there will never be enough money "for everyone to get what they need" so its employees can be expected to spend a good amount of their time on the phone explaining the meaning of "not covered". And if people hate hearing that from their HMO they'll really hate hearing it from a bureaucrat.
So why enact a public option and universal coverage? It will eliminate the obscene inconsistency of having the world's "best" health system co-exist with 45-million uninsured some desperate enough to camp overnight for the privilege of receiving one-time medical care provided by Drs on a charity basis. Even if you think that's not your problem, there will be benefits.
The pubic option will need to cut costs, and since it is public the source of those costs will FINALLY become transparent. Some costs are obvious : tort/malpractice litigation gets picked on a lot. Equally obvious are ins co executive salaries/bonuses/profits (eg the 78.3 million pocketed by the cigna ceo over the past 5 years along with the 5 year 11% return to cigna stockholders).
http://www.forbes.com/lists/2006/12/0BHA.html
Less obvious and ultimately much more important are the costs of the actual procedures/supplies. To pick a simple example we're all familiar with, last time I checked a sensitive PCR was running around $375 - anyone have any clue what the profit margins in that fee are and whether they constitute a reasonable return? I agree with desrt that there never will enough money to go around. However if health care spending is already at 18% of GDP we need to really understand where that money is going . Trusting H. Hanway (cigna ceo) to "do the right thing" will mean watching it climb to 20, 25, etc.
In the end it comes down to who do you trust. Blind faith in free market efficiency may be hazardous to one's survival. Included in Flguy's list of fubars are several (Fannie Mae, privatized 68 re-nationalized-09, GM, Chrysler) examples of the toxic effects of private sector incompetence. And it'll be a quite a while yet before we climb out of the smoking ruins left by the collapse of unregulated derivatized mortgage-backed security markets. To paraphrase Bo Diddley - "who do you trust?".
No sense having rosy illusions about government-administered insurance - it will a large, moderately efficient, somewhat dismal bureaucracy. As desrt point there will never be enough money "for everyone to get what they need" so its employees can be expected to spend a good amount of their time on the phone explaining the meaning of "not covered". And if people hate hearing that from their HMO they'll really hate hearing it from a bureaucrat.
So why enact a public option and universal coverage? It will eliminate the obscene inconsistency of having the world's "best" health system co-exist with 45-million uninsured some desperate enough to camp overnight for the privilege of receiving one-time medical care provided by Drs on a charity basis. Even if you think that's not your problem, there will be benefits.
The pubic option will need to cut costs, and since it is public the source of those costs will FINALLY become transparent. Some costs are obvious : tort/malpractice litigation gets picked on a lot. Equally obvious are ins co executive salaries/bonuses/profits (eg the 78.3 million pocketed by the cigna ceo over the past 5 years along with the 5 year 11% return to cigna stockholders).
http://www.forbes.com/lists/2006/12/0BHA.html
Less obvious and ultimately much more important are the costs of the actual procedures/supplies. To pick a simple example we're all familiar with, last time I checked a sensitive PCR was running around $375 - anyone have any clue what the profit margins in that fee are and whether they constitute a reasonable return? I agree with desrt that there never will enough money to go around. However if health care spending is already at 18% of GDP we need to really understand where that money is going . Trusting H. Hanway (cigna ceo) to "do the right thing" will mean watching it climb to 20, 25, etc.
Thanks, Trish for the info.
I've always been curious about how it works. As an employee and also as an employer.
All very interesting to me as I was working in healthcare the last time changes came....the first HMOs, PPOs, ect.
I sure hope they don't push anything through too quickly here. Ever the optimist, I am looking for the best of both....universal and private. Betcha I get my little bubble burst on that one,lol!!
Iz
I've always been curious about how it works. As an employee and also as an employer.
All very interesting to me as I was working in healthcare the last time changes came....the first HMOs, PPOs, ect.
I sure hope they don't push anything through too quickly here. Ever the optimist, I am looking for the best of both....universal and private. Betcha I get my little bubble burst on that one,lol!!
Iz
Well, I guess that's what I'm trying to say. You can only do this so perfectly, you know. The underpinning of all of it is that it's simply important to provide healthcare to those that need it and those that need it are sick people. Don't break it down into rich sick people and poor sick people, obese sick people and thin sick people, smoking sick people and non-smoking sick people....just sick people.
Promote healthy lifestyles and all that - but definitely treat the sick. There will always ALWAYS be those who abuse the system. And we ALL abuse the system in various ways if you want to get as granular as the situations I'm poking with a stick.
Put the collective funds in a pot. Let the doctors treat their patients instead of the insurance companies treating the patients. Take care of sick people.
We ALL agree to pay for each other's risk factors. We don't live in bubbles. Just because we live *period* means anyone at any given time is susceptible to illness or injury on a major or minor scale with potentially devastating financial repercussions regardless of income or circumstance.
It will definitely cost you. It will be a headache for many years to come, it will be on every election discussion, it will be debated ongoing for years and there will be issues to be dealt with ongoing. But I can definitely tell you that it will be one thing that you do as a country that will be well worth it. It will change lives. Aside from the extremist rhetoric on both sides of this issue in your country, what matters is that people's concerns are listened to and addressed and at some point...you simply have to go with it. You can't get it perfect from the get-go but you can at least start with something better than what you have. If you could do this on a staged implementation, that would be great. Address the most pressing issues first and then implement in phases.
Promote healthy lifestyles and all that - but definitely treat the sick. There will always ALWAYS be those who abuse the system. And we ALL abuse the system in various ways if you want to get as granular as the situations I'm poking with a stick.
Put the collective funds in a pot. Let the doctors treat their patients instead of the insurance companies treating the patients. Take care of sick people.
We ALL agree to pay for each other's risk factors. We don't live in bubbles. Just because we live *period* means anyone at any given time is susceptible to illness or injury on a major or minor scale with potentially devastating financial repercussions regardless of income or circumstance.
It will definitely cost you. It will be a headache for many years to come, it will be on every election discussion, it will be debated ongoing for years and there will be issues to be dealt with ongoing. But I can definitely tell you that it will be one thing that you do as a country that will be well worth it. It will change lives. Aside from the extremist rhetoric on both sides of this issue in your country, what matters is that people's concerns are listened to and addressed and at some point...you simply have to go with it. You can't get it perfect from the get-go but you can at least start with something better than what you have. If you could do this on a staged implementation, that would be great. Address the most pressing issues first and then implement in phases.
Ouch, stop it, Trish. You're making people think. It hurts.
This is the real 'devil-is-in-the details' reason why healthcare reform should not be rushed through. When you start talking about who should pay for someone else's risk factors it becomes extremely complicated.
It seems simple enough - why should the skinny, vegetarian, jogger pay for the healthcare of the guy sitting in his car with a cigarettte in his hand waiting for his bacon-cheese burger at the drive thru? But obesity is not just a 'life syle choice', there's also a genetic component. Same is also probably true of addiction. Scickle-cell? Certainly. And each day the list grows longer of what diseases we are genetically predisposed to. If you want to be completely fair about it, everyone is going to need to get gene-sequenced and your health risks assigned from that. This is something that is being fought out on the sidelines away from the spotlight of the 'big money' issues of actually paying for this stuff.
Then there is this basic fallacy in thinking that if we can just juggle the numbers right, there would actually be enough doctors, medications, hospitals available for everyone to get everything they need. Ask anyone on a waiting list for a liver transplant what they think about that one.
Oh my aching head.
This is the real 'devil-is-in-the details' reason why healthcare reform should not be rushed through. When you start talking about who should pay for someone else's risk factors it becomes extremely complicated.
It seems simple enough - why should the skinny, vegetarian, jogger pay for the healthcare of the guy sitting in his car with a cigarettte in his hand waiting for his bacon-cheese burger at the drive thru? But obesity is not just a 'life syle choice', there's also a genetic component. Same is also probably true of addiction. Scickle-cell? Certainly. And each day the list grows longer of what diseases we are genetically predisposed to. If you want to be completely fair about it, everyone is going to need to get gene-sequenced and your health risks assigned from that. This is something that is being fought out on the sidelines away from the spotlight of the 'big money' issues of actually paying for this stuff.
Then there is this basic fallacy in thinking that if we can just juggle the numbers right, there would actually be enough doctors, medications, hospitals available for everyone to get everything they need. Ask anyone on a waiting list for a liver transplant what they think about that one.
Oh my aching head.
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