Hoop, hurdles and health care in US

[Martha]

[quote=mykidslovedogs;530500I've already been through this discussion before. Life expectency has very little to do withe the healthcare system and is more related to socio-economic issues like crime, divorce rates, teen pregnancy rates, racial oppression, etc...so that statistic does nothing to convince me that we need to socialize medicine in the USA.[/quote]

Interesting that Europeans smoke much more than we do in the US. . . yet they have a longer life expectancy.

And don't forget that insurance is an economic issue.

[mykidslovedogs]

Quote:

Originally Posted by Martha Interesting that Europeans smoke much more than we do in the US. . . yet they have a longer life expectancy. And don't forget that insurance is an economic issue.

But America has a lot more problems with minority racial oppression, violent crime, divorce, teenage crime, teenage pregnancy, drugs, alcohol abuse, etc...

Plus life expectancy also seems to have a lot to do with what race you were born into...For example, Asian women tend to live very long lives, while people of other races tend to die younger....America is a melting pot, so if life expectancy has any kind of relation to the race you are born into, then our average numbers will inherently be lower, since America has races of every kind living here.

Not only that, but there is evidence that life expectancies were similar between the US and Canada even before Canada nationalized. In other words, Canada had higher life expectancy rates than the USA BEFORE they nationalized their healthcare systems, and comparatively, life expectancy rates are still the same now as they were back then. How do you explain that? If socializing the healthcare system had a direct cause and effect relationship with life expectancy, then one would have expected Canada's life expectancy rates to be better after socializing than they were before socializing, and they are not.

We also have huge problems with Obesity, which is highly coorelated to causing diseases related to premature death.

[mykidslovedogs]

Here is an interesting article about life expectancy and infant mortality rates. It seems to be very unbiased and very informative..Here is one small piece from it:

"Yet the United States has the highest GDP per capita in the world, so why does it have a life expectancy lower than most of the industrialized world? The primary reason is that the U.S. is ethnically a far more diverse nation than most other industrialized nations. Factors associated with different ethnic backgrounds - culture, diet, etc. - can have a substantial impact on life expectancy. Comparisons of distinct ethnic populations in the U.S. with their country of origin find similar rates of life expectancy. For example, Japanese-Americans have an average life expectancy similar to that of Japanese.

A good deal of the lower life expectancy rate in the U.S. is accounted for by the difference in life expectancy of African-Americans versus other populations in the United States. Life expectancy for African-Americans is about 72.3 years, while for whites it is about 77.7 years.11 What accounts for the difference? Numerous scholars have investigated this question.12 The most prevalent explanations are differences in income and personal risk factors. One study found that about one-third of the difference between white and African-American life expectancies in the United States was accounted for by income; another third was accounted for by personal risk factors such as obesity, blood pressure, alcohol intake, diabetes, cholesterol concentration, and smoking and the final third was due to unexplained factors.13 Another study found that much of the disparity was due to higher rates of HIV, diabetes and hypertension among African Americans.14 Even studies that suggest the health care system may have some effect on the disparity still emphasize the importance of factors such as income, education, and social environment."

And here is the link to the whole article:

Don't Fall Prey to Propaganda: Life Expectancy and Infant Mortality are Unreliable Measures for Comparing the U.S. Health Care System to Others

[califdreamer]

MKLD,

You have some great info on navigating the insurance maze. I agree that some market mechanisms have their place in our medical system. I think it is very clear that a pure market system has obvious shortcomings in the health care arena. Maybe your quarrel is with advocates of a purely socialistic system. I think arguments against reforming the current system that involve trotting out the excesses of socialism are the proverbial straw man. We need to respond to the needs of the population creatively even if it means abandoning cherished principles held by ideologues from both the right and the left. Some market-based principles can be used to exert efficiency. Some socialistic principles can be used to widen access and assist those who've been dealt a bad hand in life. I see absolutley nothing wrong in integrating thinking from both sides of the ideological spectrum. It seems to me we should have the capability to "walk and chew gum at the same time."

I have to say I grow tired of the links to sites (like the last one you posted) that complain about Harry Reid driving a gas guzzler to a meeting about energy efficiency. You must understand how such a source can be viewed as having such a strong bias that it is hard to view it as objective at all.

I'm not saying I disagree with some of your views but, my God, your deification of free markets regarding healthcare and economics in general leaves me exhausted and dumbfounded.

[mykidslovedogs]

Calif -

Yes, I think some reform is necessary. I feel a single payor system will destroy our healthcare system over time. Right now, about 1/2 of the money America spends on healthcare is already spent in the public system, so we already have a true hybrid system, yet it doesn't seem to be helping to get everyone covered. Why? Because America doesn't understand and will never understand the concept of price controls like other countries do. If we did, we could keep our costs from spiralling out of control, too. - but we don't! Culturally, we wan't our cake and we want to eat it, too!

Our gov't puts limits on healthcare spending for people who use the public system...so what do Americans do?... we simply simply shift costs to the private market so we can keep on spending! Somehow, the market has been able to bear that up until recently, so costs just keep going up and up. How in the WORLD do you fix a problem like that? There are only two ways...one is to completely socialize the system - once the gov't has total control, they can stop spending and stop the inflation (but there are consequences to that - ie...rationing, loss of suppliers of care, et.) The other way is use market forces and the psychology of human nature to influence people to spend more wisely and spend freely, as they choose, while at the same time giving them the basic necessities that they need at a reasonable cost to society. I think method number two is more sensible and has a better fit with American culture. (the consequence to method number two is that people will have to be responsible for some of their own healthcare costs, and for some people (probably a minority), the affordability of personal responsibility might present a problem.)

I predict that inflation is going to flatten starting now. Why? Because the market can no longer bear the heavy inflation. Insurance companies have already begun changing plan designs to create more affordable options that give people higher out of pocket responsibility. We are naturally shifting to major medical plans with preventive care because it's the only thing we can afford anymore. At some point, Insurance companies will have to stop raising out of pocket maximums or people will just stop buying the products....we are very close to that point...You see, the market is already working to fix the problem. The next step is to get some basic and catastrophic protection for the uintentionally uninsured market. How that will be done remains to be seen, but I really hope we don't resort to a single payor system to make that happen.


That last article I posted, IMO, seems to be very unbiased - the title might not sound unbiased, but if you read the whole thing, it makes a lot more sense than using the connection between life expectancy and infant mortality rates as a sure sign that we need to socialize. It goes over the scientific reasoning as to why we can't make an absolute connection between life expectancy, infant mortality and the healthcare system. I'll bet you didn't read through the article. If you did, you'd see what I mean. There is no hypocrisy in the article...and not even one bashing of the views of the other side. It is simply information about the scientific reasoning as to why the statistics are not reliable.

Like you, I get tired of listening to people complain about America and what a terrible country we have. I get sick of looking at statistics such as life expectancy and infant mortality rates as proof that we need to socialize. Most countries don't even calculate infant mortality rates in the same manner as we do...some leave out thousands, perhaps even millions, of babies that were not viable at birth, while America counts those babies in their statistics. If an apples to apples comparison is not being made, then the statistics are useless as a measurement of the sucess of a healthcare system.

[Zoocat]

Let's examine the idea of "rationing" which MKLD and others use to demonize single payer systems that are used in other countries. The definition of rationing is to limit, control, restrict, put a ceiling on, etc. In our country where people cannot get covered for pre-existing conditions, they are forced into rationing their own medical care if they cannot afford treatments. My skin cancer is not covered by my insurance. Do I run to my dermatologist to get every suspicious spot checked out? NO. I cannot afford that. Do I run some risk, no doubt. If I had coverage I would not have that risk. That's the breaks. Too bad for me. Similarly, those without medical/dental insurance who cannot afford care are forced to limit treatment or do without.

My brother, a blue collar worker, could not afford to hire a dentist to repair his broken molar and so, with all the pain, he decided his best course of treatment was to remove the molar himself using alchohol as his anesthetic, just like back in the old days of the last century! That's where we are headed with our current Darwinian system.

Those who rail against the single payer health insurance system because they think it will "ration" health care are, IMHO, only thinking about themselves and are inhumanely disregarding a huge portion of Americans who are suffering under the current system.

[mykidslovedogs]

Quote:

Originally Posted by Oldbabe Let's examine the idea of "rationing" which MKLD and others use to demonize single payer systems that are used in other countries. The definition of rationing is to limit, control, restrict, put a ceiling on, etc. In our country where people cannot get covered for pre-existing conditions, they are forced into rationing their own medical care if they cannot afford treatments. My skin cancer is not covered by my insurance. Do I run to my dermatologist to get every suspicious spot checked out? NO. I cannot afford that. Do I run some risk, no doubt. If I had coverage I would not have that risk. That's the breaks. Too bad for me. Similarly, those without medical/dental insurance who cannot afford care are forced to limit treatment or do without. My brother, a blue collar worker, could not afford to hire a dentist to repair his broken molar and so, with all the pain, he decided his best course of treatment was to remove the molar himself using alchohol as his anesthetic, just like back in the old days of the last century! That's where we are headed with our current Darwinian system. Those who rail against the single payer health insurance system because they think it will "ration" health care are, IMHO, only thinking about themselves and are inhumanely disregarding a huge portion of Americans who are suffering under the current system.

I guess you didn't read my statements above, because I said that I support a certain level of basic care at a reasonable cost to society combined with the use of market forces to encourage smart usage of healthcare dollars. What I do not support is unlimited access at the expense of taxpayers - which is the idealism behind gov't sponsored healthcare.

[Meadbh]

Quote:

Originally Posted by mykidslovedogs Quote: It really irritates me that people from abroad spend money for medical supplies in the USA.

Why? They put money in the US economy and reduce your trade deficit. US medical device manufacturers are very capable of responding to customer demand in a free market system.

[mykidslovedogs]

Quote:

Originally Posted by Meadbh Why? They put money in the US economy and reduce your trade deficit. US medical device manufacturers are very capable of responding to customer demand in a free market system.

Because when people from abroad spend money for medical services and supplies in the USA, those dollars get added into our per capita health expenditures, and then advocates of socialized medicine use those skewed numbers to PROVE that we are spending too much, when in reality, wealthy people from other countries come here for services when they can't get those same services in their own countries due to waiting lists or rationing...yet some of them are the first ones to criticize our system.

It's fine that it helps our economy, but it's not fine that advocates of socialized medicine use our per capita expenditure numbers as a reason why we should socialize, especially when those figures don't exclude international commerce.

[Meadbh]

Quote:

Originally Posted by mykidslovedogs Because when people from abroad spend money for medical services and supplies in the USA, those dollars get added into our per capita health expenditures

That's an accounting problem for which you cannot blame foreigners. Per capita health expenditures need to be calculated on domestic sales. I presume this is one reason why, when I have purchased health items, whether covered by insurance or not, I ahve been asked for my provincial insurance number.

[califdreamer]

Quote:

Originally Posted by mykidslovedogs That last article I posted, IMO, seems to be very unbiased - the title might not sound unbiased, but if you read the whole thing, it makes a lot more sense than using the connection between life expectancy and infant mortality rates as a sure sign that we need to socialize. It goes over the scientific reasoning as to why we can't make an absolute connection between life expectancy, infant mortality and the healthcare system. I'll bet you didn't read through the article. If you did, you'd see what I mean. There is no hypocrisy in the article...and not even one bashing of the views of the other side. It is simply information about the scientific reasoning as to why the statistics are not reliable.

Late last night when I posted I did not read through the article. I was curious about the source so I went to their website and saw the article about Harry Reid and other right-leaning write-ups. So it seems the organization has an agenda and is interested in turning up evidence to bolster its case.

I read the article this morning and my suspicions were confirmed. I think the article is correct in asserting that infant mortality and life expectancy are not perfect measures but the author overstates the power of his argument. He certainly didn't convince me that there is nothing to be learned from the variations among countries in those two measures.

I got a chuckle from his first criterion for evaluating healthcare systems (people have to interact directly with a doctor, nurse or healthcare professional for their health situation to be relevant to measuring the performance of the healthcare system). Of course that would exclude ACCESS TO HEALTHCARE IN THE FIRST PLACE as a reason for poor performance of our system. Again, publications like this have an agenda so they're very clever about setting up an argument in their favor.

In summary, I don't entirely disagree with the free market message regarding healthcare but slanted sources like that one don't motivate me to embrace it any more enthusiastically.

[mykidslovedogs]

Quote:

Originally Posted by Meadbh That's an accounting problem for which you cannot blame foreigners. Per capita health expenditures need to be calculated on domestic sales. I presume this is one reason why, when I have purchased health items, whether covered by insurance or not, I ahve been asked for my provincial insurance number.

I don't blame foreigners for our accounting problems. I just think it's hypocritical to criticize the USA health system (which a lot of foreigners do) and then turn around and use it when they can't get access to the services they want in their own country....and then they turn around and criticize the USA for spending so much on healthcare.

It's much easier for foreign countries to calculate expenditures on domestic sales, because very few people utilize the private sector, so the biggest portion of the figure is whatever the govt's budget for healthcare spending that year was.

In the USA, we can't just subtract international commerce from doctor's salaries in order to get an accurate figure. We just add up all the bills and divide it by the number of people in the USA, not considering that a big chunk of utilizers of our system are people from all over the world. Other countries cap their Dr's salaries so it's easy to compute cost without including international commerce into the mix.

[mykidslovedogs]

Quote:

Originally Posted by califdreamer In summary, I don't entirely disagree with the free market message regarding healthcare but slanted sources like that one don't motivate me to embrace it any more enthusiastically.

I didn't see any slant in the story. It seemed to be well-researched and very informative. Just because the author tends to lean to the right doesn't mean that his arguments have zero validity. Who doesn't have an agenda when trying to write a convincing story? If the author had failed to give reference to the materials he used to support his arguments, then I would have criticized him for that too, but his arguments, IMO, were intelligent and sensical, and for the most part, believable. I've seen plenty of "left-leaning" posts on healthcare on this forum, and very few of them are ever criticized by readers as having an "agenda".

I haven't seen anything from the other side that has given me a more convincing argument to support their agenda regarding life-expectancy, infant-mortality and in their view, the direct cause and effect relationship between the two. When I do, I'll take it into consideration. The simple fact that our numbers are higher are not enough to convince me that we need to socialize in order to solve the problem.

[califdreamer]

Quote:

Originally Posted by mykidslovedogs I didn't see any slant in the story. It seemed to be well-researched and very informative. Just because the author tends to lean to the right doesn't mean that his arguments have zero validity. Who doesn't have an agenda when trying to write a convincing story? If the author had failed to give reference to the materials he used to support his arguments, then I would have criticized him for that too, but his arguments, IMO, were intelligent and sensical, and for the most part, believable. I've seen plenty of "left-leaning" posts on healthcare on this forum, and very few of them are ever criticized by readers as having an "agenda". I haven't seen anything from the other side that has given me a more convincing argument to support their agenda regarding life-expectancy, infant-mortality and in their view, the direct cause and effect relationship between the two. When I do, I'll take it into consideration. The simple fact that our numbers are higher are not enough to convince me that we need to socialize in order to solve the problem.

As Robert DeNiro would say, "Are you talking to me?"

I never said what the author wrote has "zero validity." I just thought he overstated the strength of his argument.

I guess you think I'm on the "other side" on this issue. I have never said I think a purely socialized single payer system is the answer. I think I've always said a hybrid system would serve us best, though even that will be imperfect.

I like some of your ideas. I disagree with others. I suppose my greatest frustration in communicating my thoughts to you is things tend to get reduced to black-and-white.

I've said more than enough. No hard feelings just different perspectives.

[mykidslovedogs]

Quote:

Originally Posted by Oldbabe Let's examine the idea of "rationing" which MKLD and others use to demonize single payer systems that are used in other countries. The definition of rationing is to limit, control, restrict, put a ceiling on, etc. In our country where people cannot get covered for pre-existing conditions, they are forced into rationing their own medical care if they cannot afford treatments. My skin cancer is not covered by my insurance. Do I run to my dermatologist to get every suspicious spot checked out? NO. I cannot afford that. Do I run some risk, no doubt. If I had coverage I would not have that risk. That's the breaks. Too bad for me. Similarly, those without medical/dental insurance who cannot afford care are forced to limit treatment or do without. My brother, a blue collar worker, could not afford to hire a dentist to repair his broken molar and so, with all the pain, he decided his best course of treatment was to remove the molar himself using alchohol as his anesthetic, just like back in the old days of the last century! That's where we are headed with our current Darwinian system. Those who rail against the single payer health insurance system because they think it will "ration" health care are, IMHO, only thinking about themselves and are inhumanely disregarding a huge portion of Americans who are suffering under the current system.

Olbabe, I don't know your personal situation, or why you decided to retire early, so I don't want to sound insensitive or critical, but wouldn't it have been your choice to retire early and accept a policy without coverage for skin cancer versus staying employed with benefits until age 65 when Medicare would kick in and cover your skin cancer? IMO, the desire to retire early doesn't seem like a good reason to me to socialize healthcare.

While I feel bad for your brother's pain, it's hard for me to believe that, even as a blue collar worker, he couldn't muster up $45 bucks for a tooth extraction. Choosing not to purchase a cheap, dental discount plan for $12/mo in order to get basic dental care does not sound like a societal problem to me.

Heres a link to a dental discount plan and schedule of benefits - maybe your brother could benefit from this.

Colorado Group Dental Insurance and Dental Plan - Dental Insurance Home- Beta Health Association Colorado

[Martha]

Quote:

Originally Posted by mykidslovedogs I didn't see any slant in the story. It seemed to be well-researched and very informative. Just because the author tends to lean to the right doesn't mean that his arguments have zero validity. Who doesn't have an agenda when trying to write a convincing story? If the author had failed to give reference to the materials he used to support his arguments, then I would have criticized him for that too, but his arguments, IMO, were intelligent and sensical, and for the most part, believable. I've seen plenty of "left-leaning" posts on healthcare on this forum, and very few of them are ever criticized by readers as having an "agenda". I haven't seen anything from the other side that has given me a more convincing argument to support their agenda regarding life-expectancy, infant-mortality and in their view, the direct cause and effect relationship between the two. When I do, I'll take it into consideration. The simple fact that our numbers are higher are not enough to convince me that we need to socialize in order to solve the problem.

Interesting that the author speaks approvingly of the Commonwealth Fund and its efforts to improve cross-nation measures of health care effectiveness. I often provide information from the Commonwealth Fund to show issues with health care delivery in the US. But you once called it the "communist fund."

Of course health care problems are mulitifaceted. They are not all due to lack of health insurance. Nevertheless, there are 46 million without health insurance in the US and about 18,000 uninsured who die each year because they did not get health care due to inability to pay for it. There are many more who are insured but are underinsured and fail to get needed care.

[Martha]

Forty-five dollars for a tooth extraction?! I had a broken tooth last year and it cost me hundreds of dollars to have it removed.

I know some ex-addicts with "meth mouth" who are on waiting lists to see a dentist and get teeth pulled. The waiting list is more than a year long. But I suppose it is their own fault so no one cares but me and a few volunteer dentists.

Some are only barely out of the teenage years.

[cute fuzzy bunny]

Martha - you're a volunteer dentist?

[Martha]

My secret life.

[Zoocat]

[quote=mykidslovedogs;530931]Olbabe, I don't know your personal situation, or why you decided to retire early, so I don't want to sound insensitive or critical, but wouldn't it have been your choice to retire early and accept a policy without coverage for skin cancer versus staying employed with benefits until age 65 when Medicare would kick in and cover your skin cancer? IMO, the desire to retire early doesn't seem like a good reason to me to socialize healthcare. ]


What a silly thing to say. No, you don't know my situation at all. I'm not retired. I do work. Like millions, it's not my choice to be without job related health benefits.