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Old 07-09-2007, 06:35 PM   #41
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I can't imagine why anyone who is on this board would be against a universal health care (except for those who work for the health insurance or big pharma industries)- a guaranteed health coverage is certainly a major issue for all who are retired and those who plan to.

I can tell you who would be a afraid - all those companies that treat their employees like dirt because those employees would wake up and realize they don't have to stay with them just for the health insurance. It would be a boon to the average man/woman. I can't wait.
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Old 07-09-2007, 11:41 PM   #42
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As much as I would like to think that the reason we will end with universal care is because of a desire on the part of the politicians(and people who already have coverage) to do what is right (i.e. figure out a way to pay for care for everyone), we will get universal care, but we will get it because big business is waking up to the idea and they would like nothing better than to stop providing it to their employees (who can blame them with costs going up 10-15% per year every year)...

When corporate america finally decides they want it, they will hire the right lobbyists, buy the right politicians, and *voila* it will come to pass.

So , it will be for the wrong reason, but ultimately we will get it.
I agree on the mechanics, though I'm not sure universal care/single payer will necessarily be the result. Once it becomes clear that American businesses can't compete against foreign companies if they have to support one of the most inefficient health care funding systems in the world, US businesses will push for changes that will transfer these costs to taxpayers. But, if change doesn't come quickly enough, then businesses will simply choose, as a matter of survival, to further scale back/stop funding worker health care. They may offer increases in wages in order to keep skilled workers, and workers might end up buying their own private or bundled policies (at least the healthy ones who can get coverage). Either way, we'll wind up with either increased government involvement or increased dependence on privately-purchased policies.

Also, it's interesting to note that we got this curse of employer-supplied health care delivery as a result of a previous government policy (wage caps during WW-II, but no caps on medical care and other fringe benefits, so businesses provided health care and other benefits as a means to attract qualified employees in the face of government interference. The subsequent unfair tax treatment of these benefits ever since has perpetuated the problem).

The rest of the world benefits tremendously from the inefficient US system. The most significant advances in pharmaceuticals, diagnostics, etc come from US companies and foreign companies hoping to sell in the US market because there's a TON of money to be made in the US from these improvements. We pay tremendously for these cutting-edge improvements, and the rest of the world gets in cheap. While it would certainly benefit US consumers if we shut down the gravy train, we should expect the pace of medical advances to slow as a natural result (since capital investment and talent will be redirected to other areas with greater profit potential). On balance, reigning in our costs will still be a big net benefit for US consumers of health care, but it might not feel that way to the guy dying for lack of the drug that was never developed.
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Old 07-10-2007, 09:57 AM   #43
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but it might not feel that way to the guy dying for lack of the drug that was never developed.
Sam, nice post ... but I have to point out that many of these expensive drugs do no more than prolong an uncomfortable life for a few more months.

In my opinion this is neither humane nor cost-effective.

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Old 07-10-2007, 10:18 AM   #44
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Kinda like the 5000 dollar dose of TPA during a heart attack that is no better than 25 DOLLAR streptokinse.
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Old 07-10-2007, 04:48 PM   #45
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Old 07-10-2007, 07:09 PM   #46
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Old 07-10-2007, 07:29 PM   #47
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Kinda like the 5000 dollar dose of TPA during a heart attack that is no better than 25 DOLLAR streptokinse.
http://http://www.chestjournal.org/cgi/reprint/114/5/441S.pdf

Well, maybe not quite the same. Of patients having a heart attack and receiving either tPA or streptokinase, 12% fewer of the tPA patients die. So, by this math, if you believe your life is worth less than $41,700 you should get the streptokinase, save the $5000 and take you chances. Many of us would choose (or like the freedom to have available) the extra measure of effectiveness tPA offers.

In Europe, (socialized medicine) streptokinase is more popular. In the US, a patient is more likely to get tPA. This is a good example of the different care options that are before us.

(In fairness, the decision between the two drugs isn't quite so clear as above, as those receiving tPA have a higher risk of hemorrhagic stroke. But, overall, tPA comes out ahead in overall survival rates.)

Hmm. Both Social Security and Medicare will benefit financially if Gramps and millions like him don't pull through from their heart attack. Now the folks who'll decide what type and how much care they'll get as they age will also be green eyeshade wearers in the government. Nope, don't see even a potential problem with that. "How old is he? 77? The rules say no tPA or streptokinase. Give him a bottle of aspirin and send him home. Nope, he can't buy his own shot--that wouldn't be fair and will only drive up the cost for deserving patients."
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Old 07-10-2007, 07:42 PM   #48
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http://http://www.chestjournal.org/cgi/reprint/114/5/441S.pdf
In Europe, (socialized medicine) streptokinase is more popular. In the US, a patient is more likely to get tPA. This is a good example of the different care options that are before us.

...and yet those "socialized medicine" countries all have longer average lifespans than the US and spend a fraction of what we do...they must be doing something right.
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Old 07-10-2007, 09:11 PM   #49
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...and yet those "socialized medicine" countries all have longer average lifespans than the US and spend a fraction of what we do...they must be doing something right.
Look at their caloric intake. (Walk through the streets of Prague--you'll see very few obese people. Now, look around any US mall). Look at the amount the people in these countries walk. Look at the lower vehicle-related deaths/morbidity (they walk or are on public transportation). Look at the rates for death by homicide. The real testament to the quality of US health care is that our average lifespan is as long as it is despite the unhealthy lifestyle the average American leads.

Plus, the lifespan figures are sometimes highly suspect (e.g. Some countries don't even count infant deaths before age 2 in their mortality figures.)

There's a lot more to "average lifespan" than health care. In fact, the major increase in lifespan over the last 200 years in this country and Europe has a lot more to do with plumbing, public sanitation, and nutrition than with improvements in health care.
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Old 07-10-2007, 09:14 PM   #50
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When a topic like universal healthcare comes up to politicians, they spend all their energy pointing out how it won't work, rather than actually discussing how it could be made to work. In other words, they have an agenda of keeping the status quo, even if a system that is potentially flawed in different ways might still be better.


And to CFB, I don't feel bad about being an American. I love my country even while I mourn that we have lost sight of everything our ancestors died to create. Several members of congress have committed acts that our founding fathers would have hung them for.
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Old 07-11-2007, 10:27 AM   #51
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Plus, the lifespan figures are sometimes highly suspect (e.g. Some countries don't even count infant deaths before age 2 in their mortality figures.)
Statistics are available for lifespan as of age 15. This gets past the infant death issue. I read a JAMA article sometime ago which showed that the US remained behind 20+ industrialized countries on lifespan of males over age 15 and second to the last for females over age 15.

Obesity and poor eating habits are likely a factor. But then again, smoking rates in Europe are far higher than in the US.
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Old 07-11-2007, 11:18 AM   #52
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And to CFB, I don't feel bad about being an American.

Since you're the second person to bring it up that way, its not how I meant it. So far I dont think i've ever felt bad about being an american; my point is that sometimes I think the fat bastard who makes himself feel better by tearing into other people michael moore movies are keyed to create that feeling.

I'm often disappointed with some of the decisions made by some of our leaders. I'm disappointed we're not the best educated, lowest poverty, most respected, healthiest nation in the world. Because we oughta be. And in a lot of categories we dont even crack the top ten.

Thats stupid.

But I'm still awfully proud.
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Old 07-11-2007, 11:53 AM   #53
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Since you're the second person to bring it up that way, its not how I meant it. So far I dont think i've ever felt bad about being an american; my point is that sometimes I think the fat bastard who makes himself feel better by tearing into other people michael moore movies are keyed to create that feeling.

I'm often disappointed with some of the decisions made by some of our leaders. I'm disappointed we're not the best educated, lowest poverty, most respected, healthiest nation in the world. Because we oughta be. And in a lot of categories we dont even crack the top ten.

Thats stupid.

But I'm still awfully proud.
I think the other factor is that the US has racial mix that is different than many of the other countries it is being compared to. And this might be a factor in many of the health statistics. There are unintended side effects. For example, making abortion more available to single moms leading to lower homicide rates. (There are statistics and damned lies too.)

Also being big and successful is always as sure way of becoming a target. Nobody picks on Bangladesh. This is no reason to relax but it does cut some slack.
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Old 07-11-2007, 12:52 PM   #54
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Old 07-11-2007, 01:03 PM   #55
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It would be interesting to know how many of those on this thread have actually personally experienced universal healthcare.

I have lived the last few years with universal healthcare. The differences in quality are not even in the same ballpark. If you want a hospital that looks like a ward from the 60s with no air conditioning then sign yourself up for the universal plan. A GP (family doc) to tell you that if you still have that earache in 3 months come back - get on the list. Given a prescription "close" to the one you had in the US - which made you sick and they think might have caused a blood clot (necessitating the trip the nasty hospital). FWIW-all of these instances were in the UK, I'm not brave enough to try Russia's system.

I'm fortunate enough to have worldwide private insurance - which meant that if I didn't want to go to the NHS hospital (which is gross) I had access to the private hospital. This employer provided insurance was considered a great benefit by the local employees as well.

Did I mention the 40% tax withholding to pay for the rubbish system?

I by no means think the US system doesn't have flaws - it does - they all do.

There is a big difference between healthcare for everyone and good healthcare for everyone. If anyone expects that they will receive the same level of care under a government system IMO it is frankly naive.
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Old 07-11-2007, 01:16 PM   #56
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I just wish they would make health care affordable.

THings like paying 30 bucks for a tylenol in the hospital, or paying 3 grand to get a needle stuck in your butt are insane.

I am for as little gov control as possible, but I do think they need to regulate pricing in the health care system especially things like ER visits. Just because we have no choice.

I once told a doctor that charged me 3k for a kidney stone (just to get a shot and x-ray), I said, what if you came in my store, and my store was the only place you could eat, and if you did not eat there you would suffer horrible pain, and possible have kidney failure, and I said sure I will make you some food, but it will cost you 3,000 bucks.

I would have no problem paying reasonable amounts to a hospital, but the system is just outa control.

I also think it is nuts that they charge a billion dollar insurance company 15% of the actual bill or even less, yet they would charge a person with 10k a year income, and no insurance, FULL price.

As far as feeling ashamed to be American sometimes, I must say that there are many times that I do, after dealing with the general public and how rude they are, and how toddler like 50 year olds in America can act. I think of these people going to other countries to visit, and think, well no wonder they hate Americans. I traveled quite a bit during the Marines and after, and I can say without a doubt, Americans are the rudest people I have ever met in my life. And believe me, it pains me to say that. I wish it were not true
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Old 07-11-2007, 01:30 PM   #57
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I can say without a doubt, Americans are the rudest people I have ever met in my life.
You must never have been to Russia. Honestly, anyone on vacation is a bad example of their country. Ask the people on the Costa del Sol (Spain) how they feel about British tourists. I agree about the toddler like behavior of some older Americans - especially on tour groups. I cringe everytime I see them, because I live overseas and they're a bad reflection on Americans.

I agree the prices are out of control. This is where there should be limits. Healthcare is not an industry where the market system will work. People can't just choose not to frequent your hospital because your prices are too high.

However, I think there is usually a smaller "cash price" for services than what would be billed to the insurance company.
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Old 07-11-2007, 02:11 PM   #58
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Ask the people on the Costa del Sol (Spain) how they feel about British tourists...
Even the British expats who live there feel the same way about the tourists.
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Old 07-11-2007, 02:15 PM   #59
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...However, I think there is usually a smaller "cash price" for services than what would be billed to the insurance company.
That makes perfect sense, but it is not true. The insurance companies get a huge discount.
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Old 07-11-2007, 02:15 PM   #60
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It would be interesting to know how many of those on this thread have actually personally experienced universal healthcare.

I have lived the last few years with universal healthcare. The differences in quality are not even in the same ballpark. If you want a hospital that looks like a ward from the 60s with no air conditioning then sign yourself up for the universal plan. A GP (family doc) to tell you that if you still have that earache in 3 months come back - get on the list. Given a prescription "close" to the one you had in the US - which made you sick and they think might have caused a blood clot (necessitating the trip the nasty hospital). FWIW-all of these instances were in the UK, I'm not brave enough to try Russia's system.

I'm fortunate enough to have worldwide private insurance - which meant that if I didn't want to go to the NHS hospital (which is gross) I had access to the private hospital. This employer provided insurance was considered a great benefit by the local employees as well.

Did I mention the 40% tax withholding to pay for the rubbish system?

I by no means think the US system doesn't have flaws - it does - they all do.

There is a big difference between healthcare for everyone and good healthcare for everyone. If anyone expects that they will receive the same level of care under a government system IMO it is frankly naive.
I spent two years under the NZ health care system and thought it was great. I never had any serious medical issues, but then again I've never had any in the US either. For the minor issues and check ups that I went to a doctor for in NZ, I would say that the quality of care at least equaled the US and attentiveness (i.e. face to face time with a real doctor) far exceeded the US.
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