The Health Care Debate

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The Health Care Debate

Post by Highlander » Sun Jan 21, 2007 7:38 am

Interesting discussion about National Health Care in the KC Star's opinion page.  This is sure to be a hot topic in the next national election.  In the third letter the author paints a far more rosy picture of European socialized medicine than what I have experienced living here over the past nine years.  For those Americans with decent health insurance, a European-type system would be a dramatic drop in the quality of their health care and would be unacceptable to most.  What most do not realize is that socialized medicine care is the same as rationed health care.

On the other hand, our system (or lack of one some would say) leaves a lot of people out of the loop and is far too expensive to be sustainable. 

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Re: The Health Care Debate

Post by Tosspot » Sun Jan 21, 2007 8:05 am

speaking as someone who nearly died due to the incompetence of an HMO, a little socialized medicine is called for.
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Re: The Health Care Debate

Post by Roanoker » Sun Jan 21, 2007 9:39 am

Tosspot wrote:speaking as someone who nearly died due to the incompetence of an HMO, a little socialized medicine is called for.


Incompetence can rear its ugly head under any circumstance. My husband was told he had cancer and given a list of equally unacceptable choices. He did his own research, found a specialist in New York, flew there twice (big expense), had lab slides sent to the specialist, and learned he did not have cancer. The specialist reported his findings to the original lab. The first so-called doctor suddenly retired. Coincidence, I'm sure.
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Re: The Health Care Debate

Post by Joemoney » Sun Jan 21, 2007 9:58 am

I'm going to say it, and people don't like to hear it, but it's true.

The US is a very diverse country.  With that, we have some people who are very poor.  Poor people in general seem to have a habit of consistently making poor personal health choices.  Smoking, drinking, drugs, chronic obesity, and a number of other small things.

The US is not a whitebread Euro nation.  We simply cannot afford to give some people health insurance.  Some people cause too many problems for themselves.  The cost to give these people healthcare so they can chain smoke and eat McDonalds well into their golden years is just too costly.
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Re: The Health Care Debate

Post by Roanoker » Sun Jan 21, 2007 10:09 am

Joemoney wrote:We simply cannot afford to give some people health insurance.


I don't know what other companies do, but the one I work for charges lower premiums for employees who do not smoke. They also offer a program to help smokers quit their habit.
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Re: The Health Care Debate

Post by Joemoney » Sun Jan 21, 2007 11:02 am

Roanoker wrote:I don't know what other companies do, but the one I work for charges lower premiums for employees who do not smoke. They also offer a program to help smokers quit their habit.


Not sure what you're getting at.
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Re: The Health Care Debate

Post by Roanoker » Sun Jan 21, 2007 11:15 am

Joemoney wrote:Not sure what you're getting at.


Sorry about that. I was focusing on the concept that poor choices are too expensive for more people than those making said choices. Corporations such as the one I work for and at least the insurance company that I pay premiums for are trying to shift the expense burden more toward those who tend to raise the financial bar for all the rest of us because of their lifestyle selections. That's all.  :)
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Re: The Health Care Debate

Post by Highlander » Sun Jan 21, 2007 11:46 am

Joemoney wrote:I'm going to say it, and people don't like to hear it, but it's true.

The US is a very diverse country.  With that, we have some people who are very poor.  Poor people in general seem to have a habit of consistently making poor personal health choices.  Smoking, drinking, drugs, chronic obesity, and a number of other small things.

The US is not a whitebread Euro nation.  We simply cannot afford to give some people health insurance.  Some people cause too many problems for themselves.  The cost to give these people healthcare so they can chain smoke and eat McDonalds well into their golden years is just too costly.


It was my understanding that we do already pay for the poor/elderly via Medicaire/Medicaid.  It's the people that are lost in the middle (self-employed, work for companies too small to provide health care, independent contactors...e.g., real estate agents, or between jobs) that are highly exposed to financial ruin. 

Having said that, please define "whitebread Euro nation"?  European nations are diverse and include people that have every vice/condition on your list. 

Our system is broken and inefficient.....it puts a lot of pressure on employees (my father offers health care to his employees although he legally does not have and it has a major impact on his ability to compete with larger companies), it is just too expensive to be sustainable, and it leaves a lot of working people vulnerable to financial ruin.  I am not advocating a european-style health system, there are a lot of horror stories that come with that too, but the current system absolutely must be improved.

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Re: The Health Care Debate

Post by Gretz » Sun Jan 21, 2007 1:00 pm

Highlander wrote:Interesting discussion about National Health Care in the KC Star's opinion page.  This is sure to be a hot topic in the next national election.  In the third letter the author paints a far more rosy picture of European socialized medicine than what I have experienced living here over the past nine years.  For those Americans with decent health insurance, a European-type system would be a dramatic drop in the quality of their health care and would be unacceptable to most.  What most do not realize is that socialized medicine care is the same as rationed health care.

On the other hand, our system (or lack of one some would say) leaves a lot of people out of the loop and is far too expensive to be sustainable. 

I have lived in the UK and Norway (who's system is much better than Swedens) and can honestly say that I have no idea where Lena Kalicak gets here information.  Serious problems in the UK and Norway tend not to be aggressively treated and what she does not mention is that you will wait for at least months if not years to see a specialist. 

I'd be interesting in seeing how this all plays out in the US election.     


These broad platitudes (I assume drawn largely from anecdotal evidence) tend to oversimplify a very complicated issue.  There isn't a) social medicine vs. b) private medicine with a) exhibiting X characteristics and b) Y characteristics.  There are many different degrees and forms of socialization in healthcare.  Our healthcare is largely socialized through medicare, medicaid and tax subsidies to insurers, employers and individuals.  Per this weeks Economist, 53% of our medical spending is supplied by government.  Also, few fully socialized systems exist, as supplemental insurance is offered and held by varying proportions of people in most western European nations (with a couple of exceptions, I believe Denmark is among them, where it is banned).  The fact of the matter is that there are large differences in the quality of care between AND within countries with and without socialized medicine.  For instance, the UK is generally considered to have one of the most overburdened systems, and compares unfavorably in many ways to many continental systems.  But even within the UK there are regional differences, differences of quality of and accessibility to care based on the type of treatment required, and differences between social services and private care, which is used by a large proportion of affluent and even middle-class Britons.  It is all a matter of need, priorities and total resources devoted.

One generalization that it is fair to make about our system, is that it has some of the best care in the OECD and some of the worst.  The differences between quality of and access to care for the well insured, the under-insured and the uninsured here is massive.  Also geographical differences in care are more pronounced here than in most of the affluent industrialized nations of the world, with care in many rural and less-affluent urban facilities being consistently rated far more poorly than that received by Western Europeans.  On the other hand, institutions catering to the well-insured, affluent portions of our society are consistently rated among the best. 

One shocking thing, is how much more we spend on healthcare than most other developed economies and how much more expensive comparable treatments are here than in other rich nations.  The US spends around 50% more on healthcare measured as a proportion of GDP than most affluent OECD nations.  On a per capita scale this is MUCH higher than 50% more, as we are around 1/3 richer than most western european nations/Japan/Australia.  Higher needs accounts for some of this, as some diseases are more prevalent here than in Japan or western Europe (such as heart disease and diabetes), but much of it is the result of a lack of access to preventative care and ineffeciencies in our system.  1/6 of Americans are uninsured and do not have access....shit got to go.  I'll post up some more later.

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Re: The Health Care Debate

Post by phxcat » Sun Jan 21, 2007 1:04 pm

Highlander, I was hoping that you might adress Joemoney's conception of the diversity of Europe!  

I think that our system is pretty screwed up right now, but an advantage of being in this situation is that when developing a national health care system, we have to opportunity to look at the experiences of other countries, analyze what works and what doesn't, and then develop the best system possible.   We shouldn't emulate Europe, but we also shouldn't run from their systems.

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Re: The Health Care Debate

Post by Highlander » Sun Jan 21, 2007 1:27 pm

phxcat wrote:Highlander, I was hoping that you might adress Joemoney's conception of the diversity of Europe!  


Yea, that's why I asked him what he meant by that statement.

Europe is in some ways a much more diverse place than the US.  What Europe is not is a melting pot offering assimulation of different cultures into what is basically a hybrid immigrant culture like the US. 

In Europe, things are a bit different.  Those nations that had extensive colonial holding generally have large minority populations from the former colonies.  Even nations that did not, like Sweden and Germany, have allowed large minority populations to enter the country to bolster the workforce.  In most European countries, these groups have not assimilated well into the population.   Second generations do better but are still self segregate themselves from the rest of society.  There are some pretty large minority populations in Europe and they outpace the native population by a huge margin in birth rate.  And to add to that, the European economic union is expanding bringing slavic and other eastern europeans into western Europe at very high rates and we may see the scale tipped towards homogenization of societies here too.  .....but I am not sure what difference any of this makes to health care.         

Now back to the health care issue.  Gretz, I work with a lot of well paid brits and almost none of them have supplemental insurance and most rely on NHS.....but there is private insurance available and I or my family have a problem requiring a specialist, I use it.  In Norway, more people did have supplemental insurance because it got them past the protracted waits and is a way to get around the health care rationing issue. 
Last edited by Highlander on Sun Jan 21, 2007 1:59 pm, edited 1 time in total.

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Re: The Health Care Debate

Post by KCMax » Sun Jan 21, 2007 1:38 pm

Its interesting, Europeans think we have millions of people who don't get any kind of medical care, and Americans think Europeans have to wait 18 months for a medical procedure. Neither is true.

That being said, we do have a problem. Just a starting point for discussion, but I think a good start would include:

Government covering all catastrophic health care - major medical costs that go over a certain amount - the hundred of thousands of dollars. There's no reason why a medical malady should force you into bankruptcy.

Government covers preventative health care - everyone gets one doctor's visit a year for free.

The rest - you're on your own. Premiums would be lower since the catastrophic costs are out of the picture and preventative care would reduce other long term and emergency costs. Health Savings Accounts could be an option. Instead of Medicare and Medicaid, perhaps give govt subsidies to insurance companies that cover the poor and the elderly at drastically reduced premiums. By pooling those high-risk individuals with the general population, you can spread the risk better.

The key is reducing overall health care costs. I think this can be done by relying more on preventative care, pooling groups of insured to disperse risks, and by having more standardized procedures for testing, so that expensive testing equipment isn't used unnecessarily. Also, bringing hospitals and clinics to the 21st century when it comes to record keeping could save a lot of money. I'm still amazed KU Med hasn't been able to fully integrate electronic medical records.
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Re: The Health Care Debate

Post by Tosspot » Sun Jan 21, 2007 1:57 pm

If it wasn't for the mass proliferation of lawyers and pettifoggery in the USA, we might not have such financial problems concerning health care.
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Re: The Health Care Debate

Post by KCMax » Sun Jan 21, 2007 2:06 pm

Don't blame us lawyers! Its the insurance companies. Lawyers are you're only weapon against them!
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Re: The Health Care Debate

Post by Highlander » Sun Jan 21, 2007 2:07 pm

KCMax wrote:Its interesting, Europeans think we have millions of people who don't get any kind of medical care, and Americans think Europeans have to wait 18 months for a medical procedure. Neither is true.



Almost everything you say is true...but I have lived in Europe for nine years and the one point I want to get across is that you WILL wait far longer than you want to for certain health care procedures.  I know that is the case, I have lived it.  If it's dire, yea, its not that bad but most things will take longer than most Americans are willing to wait.....1 year is not that uncommon.  A second point to get across, is that socialized medicine as practised in Europe is medical rationing, there simply are not enough resources for everything so tough choices are constantly having to be made.      

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Re: The Health Care Debate

Post by Highlander » Sun Jan 21, 2007 2:11 pm

Tosspot wrote:If it wasn't for the mass proliferation of lawyers and pettifoggery in the USA, we might not have such financial problems concerning health care.


You are going to take a lot of flak for that comment but I think it is partly correct.  Lawyers certainly have their hands in the health care till and their involvement does impact the way medicine is practised which drives up the cost.  My opinion is that the more you can reduce the cottage industries that tax the health care system, the more efficient the system will be. 

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Re: The Health Care Debate

Post by Joemoney » Sun Jan 21, 2007 2:44 pm

Highlander wrote:It was my understanding that we do already pay for the poor/elderly via Medicaire/Medicaid.  It's the people that are lost in the middle (self-employed, work for companies too small to provide health care, independent contactors...e.g., real estate agents, or between jobs) that are highly exposed to financial ruin. 

Having said that, please define "whitebread Euro nation"?  European nations are diverse and include people that have every vice/condition on your list.


We do pay for much of the healthcare for the poor, but not all of it.  If we gave them full fledged insurance, they would be more likely to use it regularly, thus increasing the strain.  And those people in the middle should know better.  They're not poor.  You can get decent healthcare for under $100 a month, no reason why they shouldn't have any.

And for the whitebread comment, look up the stats.  We have much much large black and an ever increasing Hispanic population.  And the minorities we do have, are much worse off than the ones in Europe.  We still have people (white and black) living in tin roofed shacks.  The US is just far far more diverse economically than most western European countries.
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Re: The Health Care Debate

Post by Joemoney » Sun Jan 21, 2007 2:47 pm

Roanoker wrote:Sorry about that. I was focusing on the concept that poor choices are too expensive for more people than those making said choices. Corporations such as the one I work for and at least the insurance company that I pay premiums for are trying to shift the expense burden more toward those who tend to raise the financial bar for all the rest of us because of their lifestyle selections. That's all.  :)


Yes I understand what you mean, but this is irrelevant to creating a national healthcare system.  Shifting burdens wouldn't make a different because this is not something that is bought, it's something given away.

But then if you're implying they should tax you based on your personal health habits, that would never fly.  The left wingers are intent on making one group of people pay for the mistakes of another group of people, and that would defeat the entire idea of their healthcare system.
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Re: The Health Care Debate

Post by KCK » Sun Jan 21, 2007 3:04 pm

Universal health care to me would seem to destroy a large part of the US economy, and I am not talking about insurance companies. Who exactly would foot the bill for new and innovative medical procedures? What happens to the millions of people who work in the healthcare industry when the govenment starts regulating their wages? Who will pay to open new hospitals, clinics, etc if the profit margin is tightly regulated? The result will be much worse care, especially for those of us who already have insurance.
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Re: The Health Care Debate

Post by nota » Sun Jan 21, 2007 3:29 pm

Gretz wrote:
One shocking thing, is how much more we spend on healthcare than most other developed economies and how much more expensive comparable treatments are here than in other rich nations.  The US spends around 50% more on healthcare measured as a proportion of GDP than most affluent OECD nations.  On a per capita scale this is MUCH higher than 50% more, as we are around 1/3 richer than most western european nations/Japan/Australia.  Higher needs accounts for some of this, as some diseases are more prevalent here than in Japan or western Europe (such as heart disease and diabetes), but much of it is the result of a lack of access to preventative care and ineffeciencies in our system.  1/6 of Americans are uninsured and do not have access....shit got to go.  I'll post up some more later.



A big part of it is because we sue for the slightest reason, settlement amounts are beyond belief and medical providers have to cover themselves. We pay for it.

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