How would national health plan affect ER? - Page 4

Shawn · 01-08-2008, 10:06 PM

Quote:

Originally Posted by Trek

Everyone who thinks the poor, sick and old should just die off and make way for the young, wealthy and healthy, raise your hand!

Why are they poor and why are they sick? My heart does not go out to people who pay for groceries with food stamps, and then use cash to buy beer and/or cigarettes. This is not an exception. It happens all the time. It's the norm. My sympathies go with their children, not with them. By and large, adults put themselves into non-ideal situations. It is their choices that cause them to be obese, have lung cancer, or be addicted to drugs or alcohol. A significant fraction of health care costs are devoted to these issues. No, everyone who is poor or sick doesn't "deserve it." However, how much should the government subsidize people so they can make bad decisions? It would be much more efficient for the government to address the cause, not the symptoms.

**Rich_in_Tampa** · 01-08-2008, 10:13 PM

Canadian health care is equal to or better than health care in the USA in my opinion (32 years experience in academic and hospital medicine, trained here and did intense postgraduate training in Canada at McMaster). You are less likely to receive unhelpful but expensive high tech diagnostic testing in Canada and outcomes are similar.

Overall it is a bit more spartan in atmosphere and there are some unpleasant waits for certain procedures. Both systems have major flaws and both care capable of delivering state-of-the-art medicine.

While individual anecdotes abound in either direction, I was not able to discern any substantial difference in quality overall. Just my informed opinion.

I'll leave the issues of accessibility, uninsured patients, and similar issues related to health care funding and delivery for another post.

Shawn · 01-08-2008, 11:04 PM

Quote:

Originally Posted by DallasGuy

And my implied answer was....stop spending our money everywhere else in the world and spend it on universal health care (or something simliar) instead.

Good point, but why pick on the Iraq war when there are better targets? American's spend more on alcohol per year, both direct and indirect, than the estimated cost for universal health care. Alcohol is responsible for many health care problems (and is responsible for more deaths than in Iraq). So lets stop spending our money on booze and instead spend it on universal health care. I'm certain all the people who drink would be more than willing to give up their vice to pay for universal health care. Or would that be too big of a sacrifice? Better raise my taxes instead.

**Rich_in_Tampa** · 01-09-2008, 08:31 AM

Quote:

Originally Posted by Shawn

Good point, but why pick on the Iraq war when there are better targets? American's spend more on alcohol per year, both direct and indirect, than the estimated cost for universal health care. Alcohol is responsible for many health care problems (and is responsible for more deaths than in Iraq). So lets stop spending our money on booze and instead spend it on universal health care. I'm certain all the people who drink would be more than willing to give up their vice to pay for universal health care. Or would that be too big of a sacrifice? Better raise my taxes instead.

Good point, but a bit ironic in that alcoholism is a disease. Can't really prohibit a disease in order to provide universal coverage for diseases.

In fairness, though, there are many drinkers and smokers where there is a discretionary component to their usage. We can tax the heck out of it, along with cigarettes and other nasties which have some element of choice. That income would help pay for coverage and act as a disincentive.

**Martha** · 01-09-2008, 08:35 AM

Amazing how addictive smokes and booze are. I know people who sell blood for cigarettes.

Rustic23 · 01-09-2008, 08:55 AM

I was at a Canadian Air Show and a Capt. ask me 'How many F-111's does the U.S. Air Force have' I told him 450 or so. He said 'No.. I mean just F-111's' I said '450 or so'...... 'My God! We don't have that many aircraft in our entire Air Force'

Canada and the US are different countries. Go to your Parliament and tell them the good news! You have convinced the US to do Canadian Health Care and they are going to reduce the Space and Military budgets to the same spending as Canada. Watch the horrid expression on their face.

I also knew you would come up with some research done in Canada. You missed the point. It is not that the US has come up with one or two new procedures, or that we have one or two Mayo Clinics, but that this type of health care exist through out the country.

I have little (but still just a little) argument with Martha's point of view as to who she would like covered. I don't want to see a system that impacts the quality of research and development that goes on in this country, and it goes on because of a profit motive. Drug companies sell drugs cheaper in Canada than in the US. To me that means we subsidies Canada's medical system, at least as far as drugs are concerned.

armor99 · 01-09-2008, 10:03 AM

Quote:

Originally Posted by Shawn

Why are they poor and why are they sick? My heart does not go out to people who pay for groceries with food stamps, and then use cash to buy beer and/or cigarettes. This is not an exception. It happens all the time. It's the norm. My sympathies go with their children, not with them. By and large, adults put themselves into non-ideal situations. It is their choices that cause them to be obese, have lung cancer, or be addicted to drugs or alcohol. A significant fraction of health care costs are devoted to these issues. No, everyone who is poor or sick doesn't "deserve it." However, how much should the government subsidize people so they can make bad decisions? It would be much more efficient for the government to address the cause, not the symptoms.

Good points shawn.... I completely agree with your analysis and reasoning. There are others who believe that everyone is a victim of some sort or another. Masters of blaming everyone and everything from "society" (whatever that really means), to govt failure, bad parents, the rich, lack of intelligence. And the list goes on pretty much forever. At some point, reguardless of the unfortunate things that have or have not happened to you, you need to take ownership of you own life. Sadly, some will never do this, and will continue to flounder their way through life, blaming any percieved injustice on just about anyone.... as long as it is not "themselves". Still others believe that if we "just gave these unfortunates enough money then the problems would go away....". Sadly, this is just not so. Personally I think education is the key. Change the mindset from... "there is nothing I can do so why should I try".... to... "these are things that I can do to better my situation". Mindset is everything....

lawman3966 · 01-09-2008, 10:13 AM

You are correct that the U.S. does a massive share of the world's research on new drugs, and it would be a negative to oppose that process. Some drugs are unnecessary and overprescribed, but that doesn't defeat the fact that others are highly successful. But, this seems like a separate issue from how one funds medical treatment in hospitals and outpatient facilities. National health care, and profit-motivated private drug research can co-exist. They do in Canada; and with the U.S. Medicare drug plan, do in the U.S. as well.

So why does Canada get lower drug prices? Because the Canadian health care system, as nearly every other in the world, negotiated with the U.S. companies who hold the patents for these drugs, and reached agreement on prices. The parties came to the table, negotiated, and reached agreement. That not only sounds fair, it sounds about as capitalist as one can get. From what I've read, the VA in the U.S. did the same thing, without being accused of undermining the capitalist system. I don't see anything wrong with that.

You seem to assume that the drug companies oppose govt funding for health care and/or prescriptions. But, they in fact lobbied hard for the Medicare prescription plan in 2004.

Moreover, upon passing this plan, the congress declined to negotiate a volume discount, resulting in a windfall for the drug companies (who, according to various congressmen present, _wrote_ the bill using their lobbyists). This also imposed a massive tax burden on the public, which if my reading is right, comes to about 100 Billion per year.

The pharma companies in fact increased their market dramatically by having the govt foot the bill for high-priced drugs.

My theme remains intact. It's not purely a choice between private and public health care, though this is case sometimes. In many cases, as between the U.S. and Canadian systems, it's a choice between piecemeal, inefficient national health care and comprehensive and reasonably efficient national health care.

To advance the narrative a little, I suspect a multi-tiered system could be implemented, as is done with education. That is, middle class to affluent people, having paid taxes for the public system would have the right to access it if they wish. However, upon paying more, they could access a more privileged system. Canada actually has the beginnings of that, as one now sees small private clinics sprouting up for people willing to pay $50 to see a doctor quickly rather than wait for hours in a public hospital.

Rustic23 · 01-09-2008, 10:24 AM

Here is the problem with a two tier system and the educations system shows it. In Houston there is HISD the public school system and hundreds of private schools. I don't have the exact number but less than 10% of HISD are white upper/middle class students. They go to private schools. The better teachers, private schools. The public schools are marginal at best otherwise. I think the same thing will happen in Canada. More and more folks will go to the private clinics, as this happens folks begin to care less for the quality and quantity of public clinics. A two tier system develops. Good quality health care for those with money, poor quality/quantity for those that can not.

Notmuchlonger · 01-09-2008, 12:42 PM

Quote:

Originally Posted by Martha

Amazing how addictive smokes and booze are. I know people who sell blood for cigarettes.

Speaking of addiction. Wow I seen a special on Meth last night regarding some town in Tennessee. Holy cow that is scary stuff.

Rescue Earth · 01-09-2008, 01:43 PM

I'm supposedly retired but actually spend my days helping folks without prescription drug plan get free meds from the drug manufacturers. There are somewhere between 55 million (govt. figures) and 108 million (industry figures) people who do not have drug insurance and cannot affort their medications. We offer 1,632 name-brand drugs for $15 per month. I only make a few bucks at this, but the work is extremely rewarding, and my average patient saves $790 per month.

That said, national healthcare initiatives would put me out of a job and I say HOORAY! There are so many in need and many must choose to spend their money on food and heat vs. meds they need to live, usually because lack of food and/or heat will kill them slightly faster than going without essential meds.

I don't know if the politicians can find a way to provide universal healthcare while we're in the throes of a recession and spending bazillions in foreign countries, but I would support anyone that could make it happen!

Caoineag · 01-09-2008, 01:43 PM

If I had access to guaranteed health insurance, I would be able to retire early. Without it, I will never retire until Medicare is available no matter how much money I am able to save.

Unlike some of the people discussing this thread, I have been without health insurance (not by choice). I have paid for my own dentists visits, my doctor's visits, prescriptions and x-rays. I was extremely lucky. I never had to have surgery, chemo, or an emergency room visit when I was uninsured. I was also lucky that even if I had needed these things, my local hospital was willing to cover me for free ( I was registered through a non-profit as not having sufficient funds) because its a non-profit. Most hospitals are not non-profits anymore and so don't have a similar program.

Cancer runs in my family at an early age and that could have been very expensive for the hospital and life threatening to me.

I currently have what would be referred to as a "cadillac" policy that my employer pays for despite being from a small firm. I am all for a change to our current system.

Oh and one more anecdote. My friend had a wonderful job with no benefits that she just gave up for a boring one with health insurance. Why? She has crone's disease which is fatal without proper care and she's been without insurance for 4 years thanks to getting a college degree. Oh and we are both in our 20's...

ziggy29 · 01-09-2008, 02:39 PM

Well, this thread got seriously hijacked.

Back to the original question: For those who are close to being able to retire early but keep w*rking primarily for the health insurance, it could be the last kick in the butt they need to convince themselves to hang it up. Depending on the details and how it's paid for, I might be able to move my FIRE clock forward as much as 10 minutes if the 800 pound gorilla known as early retiree health insurance jumped off my back.

cute fuzzy bunny · 01-09-2008, 06:04 PM

Eh, minor hijack. I didnt break out the Empire State Hitler building, we didnt come to the conclusion that there are 3 billion people in the united states, and we havent referenced any sites that cater to UFO/zombie aficionados.

And of course, nobody mentioned a dairy product.

Pretty tame.

Notmuchlonger · 01-09-2008, 06:57 PM

Quote:

Originally Posted by cute fuzzy bunny

Eh, minor hijack. I didnt break out the Empire State Hitler building, we didnt come to the conclusion that there are 3 billion people in the united states, and we havent referenced any sites that cater to UFO/zombie aficionados.

And of course, nobody mentioned a dairy product.

Pretty tame.

We did have a mention of Logan's Run

Meadbh · 01-09-2008, 07:13 PM

I have turned down job offers in the US because of the absence of health insurance after retirement.

cute fuzzy bunny · 01-09-2008, 09:01 PM

Quote:

Originally Posted by Notmuchlonger

We did have a mention of Logan's Run

Very good point. Thats a severely underutilized 70's movie for vague humorous references if you ask me.

DangerMouse · 01-09-2008, 10:45 PM

As someone who comes from a country that has a national health system (Australia) I have to say that it is only because of it's existence that we will be in a position to RE in our 40s.

As to those who believe it would be cost prohibitive to introduce a similar system in the US I have to say I believe it could be done if the will was there. I vaguely remember back in the 70s when the national health system was not in existence in Australia. My parents were low income and struggled to pay their health insurance. However, I am sure someone is better at researching these things than I am, but I am certain that our personal income tax rates have fallen dramatically since the introduction of the national health system. As someone who has always been reasonably healthy and a non-user of the system, I have to say that I am happy to pay the extra 1.45% that is required to cover Medicare, knowing that everyone is able to see a Dr if required.

I believe the key in the US would be to cease the litigation and cut out the BS that the insurers are allowed to play. If I see a Dr privately in Australia I pay his bill on the spot and I take the bill to the insurer who is required to pay me then and there. None of the silly games that are allowed here in the US.

The standard of medical care is higher in the US than Australia, however that is probably due to the fact that we don't have enough people to get the top people to stay or develop their careers.

clifp · 01-10-2008, 04:39 AM

There are only two thing I am 100% sure about regarding overall health system in the US. First is there is huge remove for improvement system and second anybody who tells you they have perfect solution to fix it is either a fool or a liar.

One of the things I really like about the US system of government is we can use individual states as giant labs to try different approaches. I hope that we pay careful attention to what various states try before deciding on a national system.

01-08-2008, 10:13 PM	#62
Rich_in_Tampa Moderator Join Date: Feb 2006 Location: Tampa Posts: 5,882	Canadian health care is equal to or better than health care in the USA in my opinion (32 years experience in academic and hospital medicine, trained here and did intense postgraduate training in Canada at McMaster). You are less likely to receive unhelpful but expensive high tech diagnostic testing in Canada and outcomes are similar. Overall it is a bit more spartan in atmosphere and there are some unpleasant waits for certain procedures. Both systems have major flaws and both care capable of delivering state-of-the-art medicine. While individual anecdotes abound in either direction, I was not able to discern any substantial difference in quality overall. Just my informed opinion. I'll leave the issues of accessibility, uninsured patients, and similar issues related to health care funding and delivery for another post. __________________ Rich Tampa, FL (10% retired) As if you didn't know..If the above message happens to contain medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any medical purpose whatsoever. Consult your own doctor for all medical advice.

01-09-2008, 08:35 AM	#65
Martha Moderator Join Date: Feb 2004 Location: minnesota Posts: 9,794	Amazing how addictive smokes and booze are. I know people who sell blood for cigarettes. __________________ . Do not rely on the information provided--my posts are not to be taken as legal advice. Needless to say you must consult with your legal representative. I am not responsible for errors. If I offended you with cya I apologize. If I did not, I tried.

01-09-2008, 10:13 AM	#68
lawman3966 Dryer sheet wannabe Join Date: Jan 2008 Posts: 11	Subsidizing Canada You are correct that the U.S. does a massive share of the world's research on new drugs, and it would be a negative to oppose that process. Some drugs are unnecessary and overprescribed, but that doesn't defeat the fact that others are highly successful. But, this seems like a separate issue from how one funds medical treatment in hospitals and outpatient facilities. National health care, and profit-motivated private drug research can co-exist. They do in Canada; and with the U.S. Medicare drug plan, do in the U.S. as well. So why does Canada get lower drug prices? Because the Canadian health care system, as nearly every other in the world, negotiated with the U.S. companies who hold the patents for these drugs, and reached agreement on prices. The parties came to the table, negotiated, and reached agreement. That not only sounds fair, it sounds about as capitalist as one can get. From what I've read, the VA in the U.S. did the same thing, without being accused of undermining the capitalist system. I don't see anything wrong with that. You seem to assume that the drug companies oppose govt funding for health care and/or prescriptions. But, they in fact lobbied hard for the Medicare prescription plan in 2004. Moreover, upon passing this plan, the congress declined to negotiate a volume discount, resulting in a windfall for the drug companies (who, according to various congressmen present, _wrote_ the bill using their lobbyists). This also imposed a massive tax burden on the public, which if my reading is right, comes to about 100 Billion per year. The pharma companies in fact increased their market dramatically by having the govt foot the bill for high-priced drugs. My theme remains intact. It's not purely a choice between private and public health care, though this is case sometimes. In many cases, as between the U.S. and Canadian systems, it's a choice between piecemeal, inefficient national health care and comprehensive and reasonably efficient national health care. To advance the narrative a little, I suspect a multi-tiered system could be implemented, as is done with education. That is, middle class to affluent people, having paid taxes for the public system would have the right to access it if they wish. However, upon paying more, they could access a more privileged system. Canada actually has the beginnings of that, as one now sees small private clinics sprouting up for people willing to pay $50 to see a doctor quickly rather than wait for hours in a public hospital.

01-09-2008, 01:43 PM	#71
Rescue Earth Confused about dryer sheets Join Date: Jan 2008 Location: Edina, MN and Flagstaff, AZ Posts: 2	I'd Lose My Job, But That's OK I'm supposedly retired but actually spend my days helping folks without prescription drug plan get free meds from the drug manufacturers. There are somewhere between 55 million (govt. figures) and 108 million (industry figures) people who do not have drug insurance and cannot affort their medications. We offer 1,632 name-brand drugs for $15 per month. I only make a few bucks at this, but the work is extremely rewarding, and my average patient saves $790 per month. That said, national healthcare initiatives would put me out of a job and I say HOORAY! There are so many in need and many must choose to spend their money on food and heat vs. meds they need to live, usually because lack of food and/or heat will kill them slightly faster than going without essential meds. I don't know if the politicians can find a way to provide universal healthcare while we're in the throes of a recession and spending bazillions in foreign countries, but I would support anyone that could make it happen!

01-09-2008, 02:39 PM	#73
ziggy29 Thinks s/he gets paid by the post Join Date: Oct 2005 Location: Texas Hill Country Posts: 2,328	Well, this thread got seriously hijacked. Back to the original question: For those who are close to being able to retire early but keep wrking primarily for the health insurance, it could be the last kick in the butt they need to convince themselves to hang it up. Depending on the details and how it's paid for, I might be able to move my FIRE clock forward as much as 10 minutes if the 800 pound gorilla known as early retiree health insurance jumped off my back. __________________ FIRE Clock: Retired*. Since it feels like I'll never be now. waiting for the government to privatize the gains and socialize my losses in my 401K...

01-09-2008, 08:55 AM	#66
Rustic23 Thinks s/he gets paid by the post Join Date: Dec 2005 Location: Lake Livingston, Tx Posts: 1,018	I was at a Canadian Air Show and a Capt. ask me 'How many F-111's does the U.S. Air Force have' I told him 450 or so. He said 'No.. I mean just F-111's' I said '450 or so'...... 'My God! We don't have that many aircraft in our entire Air Force' Canada and the US are different countries. Go to your Parliament and tell them the good news! You have convinced the US to do Canadian Health Care and they are going to reduce the Space and Military budgets to the same spending as Canada. Watch the horrid expression on their face. I also knew you would come up with some research done in Canada. You missed the point. It is not that the US has come up with one or two new procedures, or that we have one or two Mayo Clinics, but that this type of health care exist through out the country. I have little (but still just a little) argument with Martha's point of view as to who she would like covered. I don't want to see a system that impacts the quality of research and development that goes on in this country, and it goes on because of a profit motive. Drug companies sell drugs cheaper in Canada than in the US. To me that means we subsidies Canada's medical system, at least as far as drugs are concerned.

01-09-2008, 10:24 AM	#69
Rustic23 Thinks s/he gets paid by the post Join Date: Dec 2005 Location: Lake Livingston, Tx Posts: 1,018	Here is the problem with a two tier system and the educations system shows it. In Houston there is HISD the public school system and hundreds of private schools. I don't have the exact number but less than 10% of HISD are white upper/middle class students. They go to private schools. The better teachers, private schools. The public schools are marginal at best otherwise. I think the same thing will happen in Canada. More and more folks will go to the private clinics, as this happens folks begin to care less for the quality and quantity of public clinics. A two tier system develops. Good quality health care for those with money, poor quality/quantity for those that can not.

01-09-2008, 01:43 PM	#72
Caoineag Recycles dryer sheets Join Date: Nov 2007 Location: Denver Posts: 102	If I had access to guaranteed health insurance, I would be able to retire early. Without it, I will never retire until Medicare is available no matter how much money I am able to save. Unlike some of the people discussing this thread, I have been without health insurance (not by choice). I have paid for my own dentists visits, my doctor's visits, prescriptions and x-rays. I was extremely lucky. I never had to have surgery, chemo, or an emergency room visit when I was uninsured. I was also lucky that even if I had needed these things, my local hospital was willing to cover me for free ( I was registered through a non-profit as not having sufficient funds) because its a non-profit. Most hospitals are not non-profits anymore and so don't have a similar program. Cancer runs in my family at an early age and that could have been very expensive for the hospital and life threatening to me. I currently have what would be referred to as a "cadillac" policy that my employer pays for despite being from a small firm. I am all for a change to our current system. Oh and one more anecdote. My friend had a wonderful job with no benefits that she just gave up for a boring one with health insurance. Why? She has crone's disease which is fatal without proper care and she's been without insurance for 4 years thanks to getting a college degree. Oh and we are both in our 20's...

01-09-2008, 06:04 PM	#74
cute fuzzy bunny Give me a museum and I'll fill it. (Picasso) Give me a forum ... Join Date: Dec 2003 Location: Losing my whump Posts: 22,527	Eh, minor hijack. I didnt break out the Empire State Hitler building, we didnt come to the conclusion that there are 3 billion people in the united states, and we havent referenced any sites that cater to UFO/zombie aficionados. And of course, nobody mentioned a dairy product. Pretty tame. __________________ Many an optimist has become rich by buying out a pessimist

01-09-2008, 07:13 PM	#76
Meadbh Thinks s/he gets paid by the post Join Date: Jul 2006 Posts: 1,516	Looking at it the other way..... I have turned down job offers in the US because of the absence of health insurance after retirement.

01-09-2008, 10:45 PM	#78
DangerMouse Full time employment: Posting here. Join Date: Jan 2007 Location: So. Cal. Posts: 626	As someone who comes from a country that has a national health system (Australia) I have to say that it is only because of it's existence that we will be in a position to RE in our 40s. As to those who believe it would be cost prohibitive to introduce a similar system in the US I have to say I believe it could be done if the will was there. I vaguely remember back in the 70s when the national health system was not in existence in Australia. My parents were low income and struggled to pay their health insurance. However, I am sure someone is better at researching these things than I am, but I am certain that our personal income tax rates have fallen dramatically since the introduction of the national health system. As someone who has always been reasonably healthy and a non-user of the system, I have to say that I am happy to pay the extra 1.45% that is required to cover Medicare, knowing that everyone is able to see a Dr if required. I believe the key in the US would be to cease the litigation and cut out the BS that the insurers are allowed to play. If I see a Dr privately in Australia I pay his bill on the spot and I take the bill to the insurer who is required to pay me then and there. None of the silly games that are allowed here in the US. The standard of medical care is higher in the US than Australia, however that is probably due to the fact that we don't have enough people to get the top people to stay or develop their careers. __________________ I be a girl, he's a boy. Semi-FIRED July 08. Mid 40s, no kidlets.