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Old 01-08-2008, 03:33 PM   #41
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Old 01-08-2008, 03:35 PM   #42
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How does the US fund the war in Iraq? By running huge deficits, of course. I always find it interesting that people don't want to fund universal health care but don't say anything about all of the money that the US spends all over the rest of the world...on wars and military bases and "bribes" to other countries to "do it our way". I'm guessing that health care would still be more expensive than a war in Iraq, but the idea is still the same...why not take care of the people in our own country first instead of blowing the money everywhere else but here?
Careful you do not want to be called a ////.

I guess it would be by mortgaging the future of our children, our grandchildren and their grandchildren to fight the Iraq War and to pay for the brides which you alluded to. As for blowing things up hey that is called col·lat·er·al damage.

When poor people and common folk start giving large amounts of $$$$ and lining the pockets of our elected officials in the White House and in Congress (like the lobbyist and special interest groups) then maybe health care will become a priority. NO $$$$ equals no infleuence and no voice.

We've got to clear some of the room out of the prisons so we can put the bad guys in there, like the pedophiles and the politicians. Kinky Friedman

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Old 01-08-2008, 03:37 PM   #43
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I know there is a nursing shortage. I have no idea if there is a Dr shortage in the US.
There is maldistribution (chasing the high income specialties) and possibly an early real shortage. Primary care is entering early crisis mode: boomers aging and needing more care, primary doctors retiring early , while they have the lowest income, strong responsibility and highest on-call burden.

Generally, in my opinion, a patient with undifferentiated symptoms gets best cared for by starting with primary care doctors (internal medicine, peds, etc.) because they don't feel they have to immediately do every test there is to do -- they can refer if the problem persists or is unclear. (Canada: internal medicine is not generally a primary care area, but more like hospitalists here).

There is a movement afoot to fix some of these issues (e.g. Advanced Medical Home - recognizes reimbursement for prevention, coordination of referrals, front line responsibility, counselling, family conferences, etc.).
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As if you didn't know..If the above message contains medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any purpose. Consult your own doctor for all medical advice.
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Old 01-08-2008, 03:37 PM   #44
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ReWahoo,
At what cost?
There would definitely be a significant cost and how it would impact each of us I have no idea. But I do have one point of reference:

We were at the top of the 15% tax bracket in 2007 and we paid more for health insurance premiums ($5,000 deductible) than we did in income tax. So in my case, our income taxes could double and if we got health coverage out of the deal we wouldn't be any worse off.

YMMV.
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Old 01-08-2008, 03:42 PM   #45
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The uninsured numbers are felt by many to be understated because they require a full year of no insurance. The sequence seems to be: have a job and be insured; get sick; become unable to work; lose insurance. Then comes the sell-off of personal savings or possessions, and finally (in some cases) personal bankruptcy.
This is what is so frustrating. The people with problems are not all (or even mostly) freeloaders who chose their bed and should now lie in it. They are our brothers and sisters, mothers and fathers. Sh** happens but you shouldn't lose everything you have due to health care bills. Other civilized countries don't allow this but we do and the reform nay sayers just blame the victims.
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Old 01-08-2008, 03:48 PM   #46
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Careful you do not want to be called a ////.

I guess it would be by mortgaging the future of our children, our grandchildren and their grandchildren to fight the Iraq War and to pay for the brides which you alluded to. As for blowing things up hey that is called col·lat·er·al damage.

When poor people and common folk start giving large amounts of $$$$ and lining the pockets of our elected officials in the White House and in Congress (like the lobbyist and special interest groups) then maybe health care will become a priority. NO $$$$ equals no infleuence and no voice.

We've got to clear some of the room out of the prisons so we can put the bad guys in there, like the pedophiles and the politicians. Kinky Friedman

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My vote for the most inexplicable and disjointed post of 2008. But the year is young.
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Old 01-08-2008, 03:56 PM   #47
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OK.... here is a small suggestion that I have. Something small.... but I think that the insurance companies could start doing this to bring down the cost of medical care. Imagine that... an actual idea to make things slightly better.
It has always amazed me that a medical insurance company will pay for triple heart bypass surgery, but they will NOT pay for a gym membership. How about the insurance companies start working out deals with gym chains to give discounts and even refunds to folks that are actively participating in going to a local gym? Let's face it, excercise done early enough, cures almost everything. They would have to work out some sort of system to verifiy who is really going etc, but I would think it should not be too hard. And there you go.... people now have an addtional incentive to go to the gym (a lower insurance rate), and the insurance company has an incentive to pay for the gym membership (a much lower chance of medical problems later). Small... simple... far from perfect.... but still a start...
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Old 01-08-2008, 04:26 PM   #48
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Not a bad idea armor99. My BCBS plan pays for gym memberships.

I wouldn't say exercise cures almost everything. We all die anyway.
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Old 01-08-2008, 04:40 PM   #49
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OK, so we get insurance to pay for gym memberships. Will everyone be required to have one? Will everyone be required to prove they use it? Will the Federal Government subsidies it?

Now lets look at what it will cost us. If I am an insurance company and I need to supply a gym membership to all my customers, I am going to go out and find out how much a gym membership cost per year, say $600, then I will add administrative cost on that say $600, and will then charge each of my customers $100 per month more for their health insurance. There is no free lunch.

REWahoo,
Just a guess, but by the time the Government bureaucracy is finished your income tax would triple, that is unless you want the fee gym membership plan.
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Old 01-08-2008, 04:44 PM   #50
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REWahoo,
Just a guess, but by the time the Government bureaucracy is finished your income tax would triple, that is unless you want the fee gym membership plan.
Depends on what the women at the gym look like...
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Old 01-08-2008, 04:48 PM   #51
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Everyone who thinks the poor, sick and old should just die off and make way for the young, wealthy and healthy, raise your hand!
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Old 01-08-2008, 05:05 PM   #52
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Universal/national healthcare would make my FIRE plans easier to plan out, because the variable for health costs would be more predictable. And I would expect the increased predictability would result in an earlier FIRE for me.
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Old 01-08-2008, 06:11 PM   #53
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I'll be depending on my employer allowing me to continue in the group plan after retirement, with me paying the full premium. This makes me a bit nervous -- they've retrenched repeatedly on retiree benefits in the past. So some version of guaranteed availability and some better predictability about cost would make me more comfortable in retiring.

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Old 01-08-2008, 06:26 PM   #54
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Everyone who thinks the poor, sick and old should just die off and make way for the young, wealthy and healthy, raise your hand!
You mean like Logans Run! Cool!
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Old 01-08-2008, 07:19 PM   #55
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Old 01-08-2008, 08:34 PM   #56
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I believe that exactly the same principle works in medicine. Not all doctors are created equal. Some are better than others, and those that do better work, typically charge higher prices.

So now let's say that the govt now runs health care. There is no competition, as they now control the price of medicine, services, salaries, etc. This will have some very dramatic effects immediately.
I think most of the effects you allude to here are already taking place. Insurance companies and HMOs already have strong influence on the price of medicine, as well as on what procedures are allowed and how doctors practice. Consumers are rarely able to shop among competitive providers to gain the benefits you ascribe to other businesses. Nor are they usually able to switch carriers when they get unfavorable rulings, since they are now pre-existing conditions.

Perhaps this trend would be increased under a government program. Or perhaps the worst of the "profit" motives would be reduced and the problems might be reduced accordingly. I think the details of any program proposal will make all the difference.
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Poorer countries than ours already have Nat'l health care
Old 01-08-2008, 08:49 PM   #57
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Poorer countries than ours already have Nat'l health care

Being from Canada originaly, I'm frequently amazed by the conviction that national health care is impossible or unaffordable for the U.S., since the U.S. lays claim to being wealthy, and in fact still has a higher GDP per capita than most industrialized nations. This begs the question as to how other nations, most of which of are poorer than the U.S., have done it. The answer of course is that the U.S. could afford it, but has chosen not to.

This is sometimes presented as a dichotomy between universality and quality. But, when I last looked at the relevant data, Canada spent _less_ money per person on national health care than the U.S. did, managed to cover every single person in the country for all conditions (new and pre-existing), and boasted an average life expectancy three years longer than that of the U.S. So, where are the vaunted superior results of the U.S. system? There may be anecdotes here and there. But, I suspect on the whole this alleged quality advantage is myth, not fact.

With universal health care, taxes _would_ rise. But, the cost of insurance to private citizens, employers, and the atrocious bureaucratic costs to all concerned would likely decline by even more.

I am struck by the fact that private sector U.S. taxpayers seem ok with the fact that they pay for govt insurance for the poor (Medicaid), for those over 65 (Medicare), for all state and federal employees, get no govt health benefits themselves, but believe that the sky will fall if the govt system is expanded to include the people who are already paying for everyone else's health care.

Both countries already massive amounts of govt paid health care. It doesn't seem either radical or strange to me to extend the benefits to people who already pay for this care to be eligible for it themselves. This is the logic employed in _every_ industrialized nation in the world but the U.S. While funding is an issue in those countries, they have worked their way through it. I suspect the U.S. will eventually move in this direction.
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Old 01-08-2008, 09:17 PM   #58
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Lawman,
I have not researched medical research in Canada, so I really don't know the quality of health care in Canada. Do you have a Mayo Clinic, MD Anderson, or an area like Houston's Texas Medical center with 13 renowned hospitals and two specialty institutions, two medical schools, four nursing schools, and schools of dentistry, public health, pharmacy to name a few.

Are we to assume if we go to a Universal Health Care, like Canada, we can expect a 3 year increase in our life expectancy, or could there be other factors that figure into this statistic?

If the US did the Canadian system where would Canadians go that could not get service in Canada?

State and Federal Employees get 'government health care' just like Exon, US Steel and other corporations employees get health care. It is a cost of employment.

The United States is not like the rest of the world, does Canada have 20,000,000+ illegal citizens they provide health care to?
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Old 01-08-2008, 09:47 PM   #59
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Rustic23, I am not positive, but I thought the 20 million aliens number included both legals and illegals.
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Different shouldn't mean worse
Old 01-08-2008, 10:03 PM   #60
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Different shouldn't mean worse

Will attempt to respond to your points one by one.

I don't have a synopsis of all Canadian medical research at my fingertips. But, an anecdote comes to mind. Paul Tsongas of Massachusetts, after receiving considerable campaign financing from the U.S. health insurance industry, boldly asserted that if he'd gotten sick in Canada, he would have died. I then read that the treatment that saved his life was developed in Canada. I haven't researched this further in recent times. But, it wouldn't be the first time that the U.S. health insurance disinformation system had worked its magic on one or another U.S. citizen.

I don't know if the life expectancy of the U.S. would improve solely by implementing national health care. But, it's easier to compare a single number with a single number than it is to compare one set of a million health care outcomes with another million outcomes. Citing this figure comes in response to the U.S. contention that its system is superior to Canada's (at least some people contend that). Citing a a higher Canadian life expectancy is one way to refute this. If more medically specific data is available to support the U.S. system, by all means present it.

I'm sure there are other factors in the life expectancy result. But, will it feel any better to admit that some other factor of American life is the cause? People commonly cite violent crime. But, I've read that while tragic, this is not a statistically significant contribution. I suspect unhealthy living in the form of diet, alcohol, and exercise are probably the other major culprits.

Where would the Canadians go? I've heard of Canadians, with cash in hand, crossing the border south to pay expenses out of pocket to get care in the U.S, and avoid waiting lines in Canada. But, I wonder how prevalent this is. I have literally hundreds of relatives and friends in Canada and have never heard of one crossing into the U.S. to get health care. But, you make a point. A system public or private, has just so many resources to address so many tasks. If one is short of resources, the system will give somewhere. In Canada it results in waiting lines. In the U.S., the price goes up. If you're rich and don't want to wait, the U.S. is the better place to be. If not, Canada is.

Few private sector employees get health benefits that even come close to the state and federal benefits. Some big corporations may have done this in the past. But, you want ER (which this forum is dedicated to), good luck getting free health care for life from your former employer. I've never met anyone with such a benefit. And, the states are going broke paying for such benefits for public "servants" and politicians. There is a massive imbalance there.

The 20 mill or more illegal immigrants do indeed distinguish the U.S. from other countries. But, the U.S., at least a significant part of it, seems to want the cheap labor. I think this helps make my point. These illegals are eligible for free govt health care at least at emergency rooms, while the citizens paying for their are aren't. Are you saying that illegal immigration actually justifies denying free care to taxpaying citizens that when such care is provided to the illegals (who frequently pay little or no tax)??

In Canada it would be the other way around. The citizen would get free (by "free" I mean without a cost in addition to the standard tax level) health care, and the "visitor", legal or not, would have to pay. I know because I once visited Canada while a U.S. resident (though still a Canadian citizen) and had an appendectomy while in Toronto. Since I wasn't covered under the Canadian system at the time, the Canadian hospital demanded, and received, compensation from my Boston area HMO.

This goes to my point that the U.S. already has national health care: the old, the poor, and any penniless person at an emergency room. It's ironic that it's even more "resdistributive" than the Canadian system. Again, in Canada, although middle class people do pay taxes into the health care system, it actually gets them something. It seems to me that American taxpayers, by comparison, are being shafted.
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