Healthy? Insurers don't buy it

[mykidslovedogs]

Originally Posted by F M All

Stop throwing around ill informed anecdotes to support your case, instead research some facts. The UK system is one to consider but it has many faults, look at other nations and try to develop an answer that combines the better aspects of each. The German and Dutch systems are nationalised medicine combined with private insurance for the better off, both systems are far superior to the current mess in the US. You cannot get away from the simple facts that the US system is incredibly wasteful, is a failure for a large percentage of the population, and is the most inefficient on cost per head basis. This nation is heading for a health crisis.

I have no problem with hybrid systems, with plenty of choices for those who want better or alternate choices through private policies (including tax incentives for those who choose to "buy down" from the "nationalized" plan, however, in discussing those ideas in prior threads, I was chastized by those who think it is unfair for there to be a two-tiered system with the lower-income folks getting stuck with the short end of the stick.

Some of the solutions proposed by the democratic party leave much to be desired and leave a lot of questions unanswered. (Sentator Wyden's Plan, for one - the national plan is too rich and will do nothing to prevent overutilization; It doesn't give any choices to American people to buy down if they want to, nor any tax incentives for those who want to go with higher deductible options. It doens't address the possibility that small employers may tend to cut back on employment in order to offset the additional cost of being required to provide benefits. It also doesn't take into consideration the unemployed, which I am sure make up a very large portion of the uninsured. If the purpose of the plan is to reduce or eliminate the uninsured, then the unemployed and part-time workers who are ineligible for benefits need to be addressed.)

I have also heard of other plans regarding nationwide Medicaid with premiums paid on a sliding scale. (Could work, but what kind of effect will that have on the supply of medical providers in the long run?)

I do have a problem with purely socialized systems and believe that they lead to poorer quality of service. There is no "utopian medical system". Where one system has its strengths, another system will have weaknesses in the same area. I lean towards a capitalistic solution or at the very least, a hybrid system, because I think that there is less risk of the majority of people being disadvantaged in the long run.

Right now, there is no doubt that we need some kind of reform. I have talked about the positive aspects of consumer-driven health plans and even provided factual data on some of the successes (I'll bet no-one even looked at that link), yet there hasn't been even one positive response from this board about that.

As far as antecdotes go...I was only sharing with you an actual conversation I had with a friend of mine who is from Britain. The conversation was not BS. I shared his exact thoughts and comments on the system there (no lies or exaggerations). That particular person happens to be an architectural designer for the medical industry. He has seen many hospitals in the USA as well as abroad, and his opionions were interesting to me.
Maybe my comments weren't based on some major study, but they were the legitimate opinion of someone who has lived in that country for much of his life.

[Peter]

Originally Posted by mykidslovedogs

Maybe my comments weren't based on some major study, but they were the legitimate opinion of someone who has lived in that country for much of his life.

Complaining about the NHS is a national sport in the UK. Doesn't mean that the system is inherently bad.

I can tell you that when my mother was hospitalized recently after a stroke, the care she received, and the hospital she was in, were both far better than my late wife had at Stanford University Medical Clinic. And now Mom is out of hospital, she gets regular home visits from her GP and also from a physiotherapist every other day.

All this for a cost per head of population that's less than half what we pay in the USA. Hmmmm ...

Peter

[califdreamer]

Originally Posted by mykidslovedogs

I have no problem with hybrid systems

There is no "utopian medical system". Where one system has its strengths, another system will have weaknesses in the same area.

Right now, there is no doubt that we need some kind of reform.

Yup.

[F M All]

Yes, Peter, good points.

Mykids, your conversation may not have been BS but your post was. I do not wish either to write an "in-nords-inately" long post or cause you to leave the board (as if I could )- I don't have the time for the first (I'm FIRE ) and I believe that within your scope of experience you have some valuable opinions for this board. Suffice to say my comments are based on being British, therefore I have long first- hand experience of the UK National Health Service, and I have also lived, worked, paid for health coverage and used the health systems in Germany, Netherlands and the US. I agree with Bernie Sanders (article on BBC website today) when he says:-

"We spend three times as much per capita on health care as the UK, and 48 million Americans have no health insurance,". "Our system is faulty and inefficient," , and the reason is clear to him: "It is designed to make money, not to provide quality health care."

[brewer12345]

Originally Posted by F M All

"We spend three times as much per capita on health care as the UK, and 48 million Americans have no health insurance,". "Our system is faulty and inefficient," , and the reason is clear to him: "It is designed to make money, not to provide quality health care."

A nice summation.

Let me point out that arguing with MKLD is like trying to teach a pig to sing. He will go to absurd lengths to protect what he sees as the legitimacy of his gravy train. Don't waste your time.

[F M All]

Brewer,

I grew up with Pinky and Perky.

http://www.pinkyandperky.com/frames/index.htm

[mykidslovedogs]

Originally Posted by F M All

Yes, Peter, good points.

Mykids, your conversation may not have been BS but your post was. I do not wish either to write an "in-nords-inately" long post or cause you to leave the board (as if I could )- I don't have the time for the first (I'm FIRE ) and I believe that within your scope of experience you have some valuable opinions for this board. Suffice to say my comments are based on being British, therefore I have long first- hand experience of the UK National Health Service, and I have also lived, worked, paid for health coverage and used the health systems in Germany, Netherlands and the US. I agree with Bernie Sanders (article on BBC website today) when he says:-

"We spend three times as much per capita on health care as the UK, and 48 million Americans have no health insurance,". "Our system is faulty and inefficient," , and the reason is clear to him: "It is designed to make money, not to provide quality health care."

It seems that both parties are in agreement that we need to reduce the cost of care.

The extreme liberals would like to fix the problem by doing a better job of cost shifting or having the evil "rich" subsidize the innocent "poor" who have no personal responsibilty for the situation they are in. IMO, these solutions will get more people covered, but they won't do much for reducing the amount of inflation in the industry...they just spread the cost around more and create heavy tax burdens on the people. In their "utopian" system, the government would just take care of us all at the taxpayers expense. This may help cut back inflation, but what sacrifices will we have to make regarding quality and innovation? I don't know the exact answer, but common sense tells me that when there are no monetary incentives such as the ability to make a profit, there is little or no incentive to compete for business, explore new technology or to make improvements and new discoveries.

The extreme conservatives would have it the other way....pure capitalism with no regard for the ones who are left by the wayside.

Niether is a good solution. There is a happy medium in there somewhere, and both sides will eventually have to make compromises. There is no doubt something needs to be done to stifle inflation in the industry.

New legislation regarding HSAs, HRAs and consumer-driven health plans are a good start at getting to the heart of the problem as 3-Way described it: inelastic demand combined with consumers who have been sheltered from the actual cost of their care for many many many years. Consumer-driven plans help make coverage more affordable to MANY more people without stifeling competition. The compromise is higher deductibles and a requirement for people to save money to take some responsibility for their own healthcare costs. Medicaid reform is also necessary. It's not right that people of particular incomes slip through the cracks. As a taxpayer, I am more than willing to help subsidize basic care for these folks. The compromise here may be higher taxes, and some inequality between lower and higher income people.

That's my opinion and I'm sticking to it!

[brewer12345]

See what I mean?

[F M All]

[mykidslovedogs]

A better look at the root cause of the American Healthcare Crisis:

http://doctordurante.com/Socialized_medicine.html

I thought this data was interesting and helps explain why other touted socialized healthcare systems have not yet entered crisis mode, like we here in the USA have: (The OBVIOUS solution! Looks like we all need to pay more taxes!)

Tax burdens around the world
Country Single, no kids Married, 2 kids

Australia 28.3% 16.0% Korea 17.3% 16.2%
Austria 47.4% 35.5% Luxembourg 35.3% 12.2%
Belgium 55.4% 40.3% Mexico 18.2% 18.2%
Canada 31.6% 21.5% Netherlands 38.6% 29.1%
Czech Republic 43.8% 27.1% New Zealand 20.5% 14.5%
Denmark 41.4% 29.6% Norway 37.3% 29.6%
Finland 44.6% 38.4% Poland 43.6% 42.1%
France 50.1% 41.7% Portugal 36.2% 26.6%
Germany 51.8% 35.7% Slovak Republic 38.3% 23.2%
Greece 38.8% 39.2% Spain 39.0% 33.4%
Hungary 50.5% 39.9% Sweden 47.9% 42.4%
Iceland 29.0% 11.0% Switzerland 29.5% 18.6%
Ireland 25.7% 8.1% Turkey 42.7% 42.7%
Italy 45.4% 35.2% United Kingdom 33.5% 27.1%
Japan 27.7% 24.9% United States 29.1% 11.9%

Source: OECD, 2005 data

[F M All]

Mykids,

why do you suggest that this shows that the US should spend more on Healthcare via increased taxes?

Other data on this board shows that the US already vastly outspends all other nations on healthcare for a worse result. I do not buy the super stressful lifestyle argument for US malaise, it is, in part, due to the strength of the food industry lobby which promotes unhealthy, highly profitable, factory farmed and processed food on an ill informed population.

We know that US healthcare is not funded via taxes - this data does not compare healthcare costs across nations.

Also, I have not researched the source of your data but can you tell me if the figures quoted for the UK include National Insurance contributions? National insurance is an additional tax which supports the NHS and Social Security in the UK. Do you know how healthcare is funded in any of the other countries cited? In order to do a proper comparison you need to know this.

[mykidslovedogs]

Originally Posted by F M All

Mykids,

why do you suggest that this shows that the US should spend more on Healthcare via increased taxes?

I was actually being a little sarcastic about the extra taxes. Of course we spend three times as much as other countries...because we haven't figured out how to price control/ration the Medicare system yet, so we still have unlimited demand with no incentives for providers to cut prices (providers don't need to compete on price, because the government is paying for half of the nation's care, and they can still make up for the difference by charging higher and higher prices to the private sector - noticed by us in the form of higher health insurance premiums). (see more explanation in the attached article above). Other nations probably have price controls in place combined with extra income taxes to pay the bill (...and there is no large private sector in other countries that the providers can look to for additional income).

I'm pretty sure the data I pasted above are income taxes only. The article I had attached is worth reading and gives some insight as to how costs could have gotten so out of control in the first place. It makes very good sense to me. It doesn't really address any good solutions for dealing with the whole situation we have gotten ourselves into though, other than reversing the process. I still think we need a happy medium in there somewhere.

[ladelfina]

Japan 27.7% 24.9%
United States 29.1% 11.9%

Let's assume that's actually the tax burden. Yet the Japanese couple and their kids are covered, but the US family isn't. When I left the US I was paying (for a couple, no kids) a "family" HMO rate of something like $720/month. [Why 2 adults pay the same as a couple with 3 kids, or 10, I have no idea.. let's not even go there for now... 2 single plans = cheaper but not an option.]. That's $8600/year which at the time was almost 15% of our income. Math: 11.9% + 15% = 26.9%. Retirees here are talking about plans now that are $10-12k p.a. Under the Japanese system, not only would I pay less, but I'm also saved the stress of shopping around, being possibly denied coverage, and so on.

The single Japanese person also gets off paying less than his US counterpart, who'd be shelling out $200-300/month on top of his 29% tax burden.

My 26.9% puts me right in league with places where I would expect excellent care, like Denmark or the Netherlands..

I guess I don't see what would be so wrong with adding an extra 5%, 7% 10% in taxes for everyone, and then covering everyone...

We have to also consider whether these tax differences in all these cases are due SOLELY to health care, or also to generous national pension plans or other types of "socialist" government spending. Also unexamined is what the average salary is that is being taxed.. 11% of $40k USD = $4400; 35% of €20,000 = about $9000. So if health care is the only difference, it's "costing" the European $4600 for what I was paying $8600 for.

---

the innocent "poor" who have no personal responsibilty for the situation they are in.

I guess this was supposed to be sarcastic, but only a small %age of health issues can be chalked up to "personal responsibility." If your kid has a brain tumor, or leukemia, is that a Calvinist defect of character?? WTF?

---
and I will chime in to dispute the meaning of these figures on pharma research:

USA: 45%
France: 3%
Sweden: 4%
Belgium: 5%
Others: 6%
Japan: 7%
Germany: 7%
Switzerland: 9%
UK: 14%

Maybe we should be modelling Switzerland seeing as they have 1/5 our level of research, yet only 1/40th the population!!!!!! .. eight times our level of investment per capita.

[Rich_in_Tampa]

Originally Posted by ladelfina

and I will chime in to dispute the meaning of these figures on pharma research:
Maybe we should be modelling Switzerland seeing as they have 1/5 our level of research, yet only 1/40th the population!!!!!! .. eight times our level of investment per capita.

Good points, Ladelfina. The credibility gap in this case is vast.

[brewer12345]

Originally Posted by Rich_in_Tampa

Good points, Ladelfina. The credibility gap in this case is vast.

Very polite, Rich. I would have said that our man is obviously full of bull excrement.

Request: Can we agree to put the kibosh on political stuff in this part of the forum?

[lets-retire]

Originally Posted by brewer12345

Very polite, Rich. I would have said that our man is obviously full of bull excrement.

Request: Can we agree to put the kibosh on political stuff in this part of the forum?

As long as people insist on bringing up the hope for socialized medicine, it is doubtful.

[lets-retire]

ladelfina--The second set of numbers you posted is the total percentage of new drugs developed not the level of research.

[brewer12345]

Originally Posted by lets-retire

As long as people insist on bringing up the hope for socialized medicine, it is doubtful.

Ah, but we have moderators equipped with the power to move threads...