How would national health plan affect ER?

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

Coach
 
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.
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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.
 
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.
 
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?
 
Rustic23, I am not positive, but I thought the 20 million aliens number included both legals and illegals.
 
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.
 
Trek said:
Everyone who thinks the poor, sick and old should just die off and make way for the young, wealthy and healthy, raise your hand! :rolleyes:
Click to expand...
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.
 
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.
 
DallasGuy said:
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.
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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.
 
Shawn said:
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.
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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.
 
Amazing how addictive smokes and booze are. I know people who sell blood for cigarettes.
 
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.
 
Shawn said:
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.
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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....
 
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.
 
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.
 
Martha said:
Amazing how addictive smokes and booze are. I know people who sell blood for cigarettes.
Click to expand...

Speaking of addiction. Wow I seen a special on Meth last night regarding some town in Tennessee. Holy cow that is scary stuff.
 
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!
 
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...
 
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.
 
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.
 
cute fuzzy bunny said:
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.
Click to expand...

We did have a mention of Logan's Run :'(
 
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