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Old 08-15-2009, 09:31 PM   #61
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With the exception of the US and Greece, every country on the list has the majority of their health care paid for by the government.
Per this very interesting link provided by M Paquette on another thread, the Swiss spend slightly less of their GDP on health care than we do, have nearly universal coverage, and "the government" (i.e. taxpayers) pick up only 25% of the cost (vs 44.7% in the U.S.) . And, it's a market-based system--100% private insurance.
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Old 08-15-2009, 11:04 PM   #62
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I fully agree our present system is not just immoral it is insane. The maddening thing is that we got here through government intervention. The first step was when FDR locked health insurance to employment. Then in the 1960s when we started this ponzi scheme that we now have with medicare and medicaid. At that point market forces were simply destroyed and the cost of medicine started this upward spiral. The feds were poring tax payer money and borrowed money into the system. Like sharks to blood the trial lawyers started circling and are now one of the biggest contributors to reelection campaigns. Obama flatly came out and said he has no intentions of restricting law suits. For profit organizations took over most hospitals. Health insurance companies became giants and working through the government have basically held us all hostage. The unintended consequences are really starting to be felt by every one now and every one is in a panic. Which is kind of silly because we have all known for a long time that this that this is where we are going. We're Broke

Now the very same people who got us in this mess are offering to fix it by giving us a double dose of the medicine that we took the first time. Wow that's truly brilliant. We as a country have been brain washing into thinking that the only answer for any of our problems has to come from the Federal government. That is silly. The government is far far more often the cause of problems rather than the answer.

This system 1,000 + pages in the house and 600+ pages in the Senate that is going to rammed down out throats is going to do nothing more than make our problems worse in the long run. In the short run it is going to feel great. In the long run as a nation we are going to pay a terrible price.

I keep hearing over and over again about how other countries have such wonderful medical systems. I just don't see any one fleeing the US to get medical care in any of those countries ??

I do know this for a fact my mother in law got a combination Heart/ Liver transplant when she was 67. She is 70 now happy healthy , robust and enjoying life. My children see their grandmother often. That simply would have been impossible under the new plan proposed and it would be impossible in almost every other country in the world except for the US.

Hang on and hope.
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Old 08-15-2009, 11:31 PM   #63
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I keep hearing over and over again about how other countries have such wonderful medical systems. I just don't see any one fleeing the US to get medical care in any of those countries ??
Some here go to Mexico and other countries for dental care. Not for quality reasons, but for cost reasons. Medical tourism is becoming more popular. Of course though you still need enough money to go to where you want for the care. But in general, people tend to and want to stay close to home for their medical care. And you can't always predict when you will need it and may not be in a condition to travel when you do.

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I do know this for a fact my mother in law got a combination Heart/ Liver transplant when she was 67. She is 70 now happy healthy , robust and enjoying life. My children see their grandmother often. That simply would have been impossible under the new plan proposed and it would be impossible in almost every other country in the world except for the US.
I do not believe that this is the case. Good to hear your mother is doing well.
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Old 08-16-2009, 12:15 AM   #64
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II keep hearing over and over again about how other countries have such wonderful medical systems. I just don't see any one fleeing the US to get medical care in any of those countries ??
Anyone can get care in most foreign countries. They'll just have to pay for it.

In the Swiss system, for example, essentially all Swiss citizens have insurance that covers 90% (10% copay) with a deductible from around 300 to 2000 Swiss Francs (279-1860 US dollars), depending on policy. (There are around 85 insurance companies, and they compete on policies offering benefits beyond the basic mandated level.)

You can use their hospitals and other medical services. If you as a foreigner don't have insurance they will expect a substantial deposit before they'll proceed beyond emergency care and stabilization. They ARE capitalists, after all.

http://healthcare-economist.com/2008...d-switzerland/

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I do know this for a fact my mother in law got a combination Heart/ Liver transplant when she was 67. She is 70 now happy healthy , robust and enjoying life. My children see their grandmother often. That simply would have been impossible under the new plan proposed and it would be impossible in almost every other country in the world except for the US.
Are you sure this would be impossible under the proposed new plan? I can't find anything in it that would prevent this.

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Old 08-16-2009, 06:56 AM   #65
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The problems here are ultimately political; politicians, special interests and constituents protecting what they have. We can blame others all we want (and they're certainly not helping), but it's the mainstream voters that ultimately perpetuate our health care mess. Aside from that (difficult I know) - tell me why structurally the system in Canada, the UK, Switzerland, Germany or Taiwan could not work in the US? All are considerably less expensive than the US and the citizens by and large of those countries seem to think they have good health care systems. It's maddening, and what's being proposed sounds like institutionalizing our already costly system and adding the ponzi aspect to it even further.
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Old 08-16-2009, 08:18 AM   #66
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Aside from that (difficult I know) - tell me why structurally the system in Canada, the UK, Switzerland, Germany or Taiwan could not work in the US? All are considerably less expensive than the US and the citizens by and large of those countries seem to think they have good health care systems. It's maddening, and what's being proposed sounds like institutionalizing our already costly system and adding the ponzi aspect to it even further.
I think the U.S. is far more balkanized and divided culturally than most developed nations, for one thing. That's also a hurdle when it comes to our education system, I think.
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Old 08-16-2009, 08:35 AM   #67
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Paquette--Switzerland pays almost as much as we do of their per capita income on health care.

Midpack--structurally anything can be passed. I think what many people are concerned about is cost vs wait times. Are we willing to give up almost immediate care to save less than a couple thousand dollars per year? It sounds like many are not. Even if we were able to drop our costs 4% to match the Canadian or German systems it only works out to about $1800 per person in savings.

Not long ago on this very forum people were complaining about having to wait a few days for prescriptions to be filled. It turned out that most of these people were buying their drugs from places like Sam's, Costco, Walmart, basically the cheapest places they could find. They weren't paying for the customer service (being immediately available supplies) when they could afford the extra few dollars for it, then they were complaining that they weren't getting the customer service.
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Old 08-16-2009, 08:43 AM   #68
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Midpack--structurally anything can be passed. I think what many people are concerned about is cost vs wait times. Are we willing to give up almost immediate care to save less than a couple thousand dollars per year? It sounds like many are not. Even if we were able to drop our costs 4% to match the Canadian or German systems it only works out to about $1800 per person in savings.
I get the sense that the wait time issue is somewhat exaggerated by opponents. While I assume wait time would increase, I get the sense the UK and Canada have gotten a better handle on wait times since moving toward universal care. It is all too common for opponents in any debate, not just health care, to 'prove their point by exception.' It's easy to find failures with any system, and trotting out one or two horrifically disturbing cases is easy to do - and unfortunately persuasive with the uninformed masses. A broader view should dominate the debate, not exceptions. We can all find cases in the US where excessive waits or other issues has resulted in the death of someone. If automobiles weren't already accepted in the mainstream, I'd imagine opponents could really stir up the masses nowadays with a few choice lethal accident videos.

This may be biased, but it was informative to me news + public affairs player: video
Yes, I have posted this link before and others have undoubtedly seen it.
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Old 08-16-2009, 11:29 AM   #69
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Paquette--Switzerland pays almost as much as we do of their per capita income on health care.
In the 2000 survey, Switzerland spent the most per-capita of all European countries, US $3,216, compared to the US spending at US $4,631. By GDP, in 2000 the US spent 13.2% of GDP on healthcare, while Switzerland spent 10.3%. In the 2005 survey the US spent 15.4% of GDP while Switzerland spent 11.4%.

Wait times and quality of treatment are considered to be similar or slightly better than in the US.

I find comparing the Swiss system to the US to be interesting because they just recently (1997) moved from a system very much like what the US had to a system relying on non-government insurance coverage, with mandated coverage for all. The government specifies the basic services to be covered, and what a basic policy must look like in terms of copay, deductible, and maximum out of pocket. Any company offering insurance has to offer a policy meeting those standards, but may also offer other policies, with different deductibles, additional covered services, etc.

They don't have the morass of government healthcare plans (Medicare/Medicaid/TRICARE/SCHIP, etc), instead providing a simple subsidy for those who could not otherwise afford coverage to bring the cost below about 10% of income.

The insurers have a guaranteed market, in exchange for meeting regulatory requirements on plans that they offer.
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Old 08-16-2009, 12:07 PM   #70
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In the 2000 survey, Switzerland spent the most per-capita of all European countries, US $3,216, compared to the US spending at US $4,631. By GDP, in 2000 the US spent 13.2% of GDP on healthcare, while Switzerland spent 10.3%. In the 2005 survey the US spent 15.4% of GDP while Switzerland spent 11.4%.
Three words: Lower physician salaries.
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Old 08-16-2009, 01:10 PM   #71
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One thing I learned from decades of managing people is that if you screw 'em all equally, they don't like that but will probably get over it. But if you screw some and not others, those screwed will rebel and fight you and hate you to the end of your days.
But really, isn't that the essence of a modern "democracy"? Give some highly targeted privileges to the the group, mostly Wall Street, that funds your campaigns and spinmeisters, and give cash awards and services to a large mostly non-taxpaying group that provides your votes.

Screw heavily anyone not in either of these groups. They are what BHO would call the rich, but I would call the middle class backbone of the economy and society.

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Old 08-16-2009, 01:53 PM   #72
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In the 2000 survey, Switzerland spent the most per-capita of all European countries, US $3,216, compared to the US spending at US $4,631. By GDP, in 2000 the US spent 13.2% of GDP on healthcare, while Switzerland spent 10.3%. In the 2005 survey the US spent 15.4% of GDP while Switzerland spent 11.4%.

Wait times and quality of treatment are considered to be similar or slightly better than in the US.

I find comparing the Swiss system to the US to be interesting because they just recently (1997) moved from a system very much like what the US had to a system relying on non-government insurance coverage, with mandated coverage for all. The government specifies the basic services to be covered, and what a basic policy must look like in terms of copay, deductible, and maximum out of pocket. Any company offering insurance has to offer a policy meeting those standards, but may also offer other policies, with different deductibles, additional covered services, etc.

They don't have the morass of government healthcare plans (Medicare/Medicaid/TRICARE/SCHIP, etc), instead providing a simple subsidy for those who could not otherwise afford coverage to bring the cost below about 10% of income.

The insurers have a guaranteed market, in exchange for meeting regulatory requirements on plans that they offer.
You can use GDP if you'd like, I prefer to use per capita income vs per capita health care expenditure. I feel it brings the amounts down to a personal level and shows what each person in the society would be spending. Granted these are strictly averages, but since we are talking about a much larger population and variety of personal choices in America neither is really all that accurate. In Washington DC for example, the per capita expenditure for health care subtracting admin and several other costs (I think should be included) is still over 8k per year. Conversely in the state I live it is more around 4k per year.

Using WHO's stats from 2006. The per capita income for the US was $44070 and for Switerland it was $40840. Total per capita expenditure at average exchange rate for health care is $6714 for the US and $5878 for Switzerland. Figure out the percentage of per capita income spent on per capita expenditure for health care and your results will be very similar to 15.2% for the US and 14.4% for Switerland, less than 1% difference.
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Old 08-16-2009, 02:09 PM   #73
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Switzerland seems like such a wonderful country. I hope one day to visit there. I think it is important when we start doing comparisons between our systems and theirs that we remember that they are a small country with a very homogeneous population. I was surprised that their entire population is less than 8 million people. We have to remember that that we have more illegal aliens, by a big margin in this country than the entire population of Switzerland! In fact we have almost as many people in prison, on parole, or probation as Switzerland has citizens.

Never the less their private system seems much more efficient than ours. In fact any fee for service system will be much more efficient than this monstrosity that the Feds have mandated to us. If we could move to the state level with health care programs and get the Feds out of the mix I think that some of the smaller states might successfully go to a Swiss type system. Having the Federal government mandate profoundly complex plan to to every State and person in the country is a mistake of huge proportions.

Never the less unless basically every tax payer in the country steps up to oppose this monstrosity coming through the congress. We are going to get it shoved down our throats and we are just going to have to live with it for a while. Or at least until the Chinese and Japanese don't show up for the Treasury auctions. We are BROKE as a nation. Or government can not send out the checks it is printing as we speak with out massive borrowing. How we are going to pay for all this with out starting to raid 401K's and massive tax increases is beyond my under standing. All we can do now is

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Old 08-16-2009, 02:23 PM   #74
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Switzerland seems like such a wonderful country. I hope one day to visit there. I think it is important when we start doing comparisons between our systems and theirs that we remember that they are a small country with a very homogeneous population. I was surprised that their entire population is less than 8 million people. We have to remember that that we have more illegal aliens, by a big margin in this country than the entire population of Switzerland! In fact we have almost as many people in prison, on parole, or probation as Switzerland has citizens.
The US is a 3rd world country, with a small group of very wealthy oligarchs at the top, and below a huge underclass of uneducated and economically disabled illegals, criminals, welfare clients and others who will never produce at the level that the nation spends to support them and their children.

Sandwiched betwee these two groups is a shrinking productive middle class.

Much as I dislike it, I think that our problems will never be solved. In principle it could be done; but it will never happen.

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Old 08-16-2009, 02:26 PM   #75
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The US is a 3rd world country, with a small group of very wealthy oligarchs at the top, and below a huge underclass of uneducated and economically disabled illegals, criminals, welfare clients and others...
Where do 'pessimistic old curmudgeons' fit in this classification?
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Old 08-16-2009, 04:02 PM   #76
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Actually I think HaHa has a point. Though I don't consider us a third world country and there are a couple of other segments of our population I think he left out. I just don't claim to know the percentages. I had an eye opening experience last week when my housekeeper came to my house. (She is a white US Citizen - not illegal) I asked her her feelings on the health care debate.
She told me she was opposed to it. I asked her why and she responded to me “BECAUSE IT’S FREE” I was puzzled by her answer, so I asked her what did she mean: Its Free?

She then told me she never has paid for health care and she raised three kids without spending one penny on health care. She told me she just goes down to the Community Center and fills out a yellow paper and takes it to the Emergency Room, and she is treated free of charge for whatever she needs. She told me she has had several procedures done and so have her boys at no cost to her what so ever.

I told her it wasn’t free. That the cost of her FREE treatment was being passed down to the rest of us who are paying for their insurance and this has caused an unsustainable problem for the rest of us . She stated, and I quote. “I am sorry. If the government is stupid enough to pay for it and let it happen, why shouldn’t I take advantage of it? Everyone I know does this. None of my friends or family has ever had health insurance and they all get treated for whatever they need.” Then she went on about her best friend who was in a bad auto accident and needed extensive treatment, including rehabilitation therapy.. She did mention that she had to go see a special attorney who got all the charges dismissed for her.

So this is a segment of the population who would not qualify for medicade but yet don't earn enough money to pay the premiums for health insurance. The feeling I got from her however, was even if she did have the money, she wouldn't pay for it, cause as she says "It's Free". That is why I feel that the population as a whole must be forced to carry insurance. It could be prorated according to income, but you still need to contribute some amount to the pot. I don't know the number of people my housekeeper represents. But I do know that a provision for mandatory insurance is necessary to elliminate this problem to be able to pay for the money going out in claims

I am very much in favor of health care reform. I want to see something pass that has a chance of working. But I think we need to take the "Free" out of the equation.
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Old 08-16-2009, 04:02 PM   #77
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If we could move to the state level with health care programs and get the Feds out of the mix I think that some of the smaller states might successfully go to a Swiss type system.
The states could do this now. With the exclusion of Mass., nothing has happened.

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Having the Federal government mandate profoundly complex plan to to every State and person in the country is a mistake of huge proportions.
Besides the obvious rejoinder, why would this be true? If not the Feds, who?

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Never the less unless basically every tax payer in the country steps up to oppose this monstrosity coming through the congress.
I wrote my Congressling asking for universal health care with no underwriting.
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Old 08-16-2009, 04:27 PM   #78
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A Modest Proposal

Senator Franken might not like this, but in the interest of preserving the truly competitive capitalist free market our great country is founded on, I'd like to make a modest proposal.

Make health care and medical insurance illegal.

Let's face it. Private health insurance is socialism, worse, privatized Marxism. It takes from each employer according to their ability, and distributes to each claimant according to their need. Oh there's a little capitalism on the top as profits are skimmed off the cashflow, but it's fundamentally a wealth redistribution tax levied on employers and the rare individual buying insurance.

This would naturally have an impact on the health care industry. Health care would become a Pay As You Go service. If you can't pay, you don't get service. Oh, this would probably have some social impact, but the market will inevitably adjust. Some relaxation of current laws, such as the Emergency Medical Treatment and Active Labor Act, along with the revocation of laws and regulations favoring special interest groups such as the AMA might be needed to permit a proper free market to develop.

Those of us who have prudently saved for a rainy day, and set aside funds to address the inevitable infirmities of old age will of course be able to enjoy the services we have become used to. Indeed, as the customer base shrinks relative to the available supply of health care services, the Invisible Hand of the marketplace will act to lower our expenses.

As for the remainder of the populace, again the inevitable forces of the marketplace will make adjustments. Alternatives to traditional medical practices will arise to serve these communities, with more affordable lower-cost providers appearing. Barbers, for example, may resume the traditional practices of removing tumors, pulling teeth, stitching wounds, and of course, bloodletting, in addition to their tonsorial activities. Hospital services for those who cannot afford modern medical care will have to rely on charitable organizations. Those organizations with a low labor cost, such as religious orders, may become the predominant operator of such facilities. Benedictine Hospital may become a good franchise organization to seed this market.

The differences in care, and resulting health, well-being, and lifespan may result in the return of class distinctions, as casual observation will readily reveal the nature of care that a mature adult has received over the course of their life.

Novel economic opportunities may arise from this partitioning of care. For example, a person in the traditional market needing modern medical care for themselves or a family member, but unable to pay for this in cash, may be able to engage in barter for a needed service. They might be able to barter a kidney or liver lobe in exchange for treatment of leukemia in a child. Again, a relaxation of certain anticompetitive laws may be necessary to permit a healthy free market to develop.

This proposal completely eliminates any concerns over a public vs private insurance conflict, insurance portability, coverage of pre-existing conditions, pre-approval of treatment, or other insurance difficulties. The proposal should satisfy all those who want no government interference in their health care coverage, as it establishes an essentially unregulated free market. If no one has insurance, they can hardly be turned away because of a lack of insurance.
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Old 08-16-2009, 06:12 PM   #79
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Senator Franken might not like this, but in the interest of preserving the truly competitive capitalist free market our great country is founded on, I'd like to make a modest proposal.

Make health care and medical insurance illegal.

.
Excellent.

An alternative based on another famous writer's very popular sentiment.

The first thing we do is kill all the lawyers the second thing we do is kill all the politicians, doctors, and insurance company execs and start over.
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Old 08-16-2009, 06:39 PM   #80
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Three words: Lower physician salaries.
Actually it's more than that. We pay considerably higher administrative fees (insurance providers et al) than any other country for starters. There are other differences...
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