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Thread: Should The U.S. Have National Health Care?

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    Should The U.S. Have National Health Care?

    Health care for all — an elusive goal that has tantalized presidents and governors for decades — is roaring back this year with ambitious proposals in a handful of prominent states.
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    The promise: Cover millions of uninsured adults and children. Improve the quality of care at hospitals and doctor's offices. Rein in rising costs that are eating up workers' wages, company profits and state budgets.

    The problem: Someone's got to pay. And getting those with a stake in health care — doctors, insurers, hospitals, workers, employers, government — to agree on who and how much won't be easy.

    The most influential effort is undoubtedly in California, the nation's most populous state, where GOP Gov.
    Arnold Schwarzenegger this month introduced a bold plan that would provide health care coverage for 6.5 million residents without insurance.

    With less fanfare, Pennsylvania has proposed a similar step and a half-dozen more states are actively debating the idea. All are building on a Massachusetts program that began this year — it likens health insurance to car insurance, making it a requirement for everyone.

    If successful, the states could carve out a long-sought path for universal health care, a goal that's been politically dead since the Clinton administration. But that's a big "if" — passage won't be easy and the programs aren't cheap.

    The Associated Press looked at proposals in front of state legislatures to break down the contentious issue.

    ___

    WHY HEALTH CARE IS HOT NOW: It's been talked about and debated for years, but wide agreement is emerging over the problem of health care's rising costs, which swallow wage increases and have threatened to overtake state spending on primary education. Businesses say they're at a disadvantage with global competitors.

    The system can't survive another few years on the same track without collapsing, said Pennsylvania Gov. Ed Rendell, a Democrat.

    "If California, Pennsylvania and Massachusetts prove it's doable — and Maine has already to some extent — it will create an unstoppable momentum," he said.

    Maine brought the issue back in 2003, with a law seeking to provide universal coverage.

    Massachusetts' law last year — guaranteeing universal coverage — jump-started the action in state capitols.

    In the last month, governors, legislative leaders and blue-ribbon commissions have declared universal coverage an attainable goal in Iowa, Kansas, Minnesota, New Mexico, Oregon, Washington state and Wisconsin. Massachusetts and Vermont are to put their programs into effect this year, while Maine is tweaking its existing system. Many more are considering significant expansions.

    ___

    HOW UNIVERSAL HEALTH CARE COVERAGE WOULD WORK: The overall goal is to get everyone, or nearly everyone, health insurance. The plans also aim to cut costs by improving efficiency, and to improve the quality of care. The plans being discussed would accomplish that in the following ways.

    • All would build on the existing public and private insurance system to provide insurance and health care access to most or all the uninsured in their states — now some 46 million people nationwide.

    • All aim to expand existing Medicaid programs to cover more of the poor and working poor who don't have insurance. They would require employers who don't provide insurance to do so. They seek some financial contributions or savings from doctors and insurers.

    • They would establish a state mechanism that creates an insurance product, or sets up a marketplace, so that small businesses and individuals can get reasonably priced insurance.

    • Some plans mandate that every individual must have insurance — not unlike mandatory auto insurance for every driver — with financial help for those too poor to buy it outright.

    ___

    THE BIGGEST BARRIER: The biggest stumbling block is money. Who pays?

    In California, doctors and hospitals are already unhappy with Schwarzenegger's plan to levy a 2 percent fee on doctors and a 4 percent fee on hospitals. He would cap profits for insurers by requiring that 85 percent of revenue be devoted to treating patients: That idea alone sent the stock of health insurer Wellpoint Inc., with 34 million members, down 3.5 percent.

    "He made enemies of every doctor and hospital in California when he did that," said Helen Darling, president of the National Business Group on Health, a consortium of companies trying to lower health costs.

    In California, Pennsylvania, Massachusetts and Maine, state leaders said they were spreading the pain to every player, so every critic should stay on board.

    "That's always been the biggest challenge in health care reform. There is no pain-free solution," said Drew Altman, president of the Henry J. Kaiser Family Foundation, a Washington-based health group.

    ___

    CHANCE OF SUCCESS: The next few months will determine whether enthusiasts like Rendell or Schwarzenegger win the argument.

    In Minnesota, GOP Gov. Tim Pawlenty warns that simply focusing on getting everyone insurance ignores deeper problems, even as some leaders of the Legislature's new Democratic majority say this is the year for universal health care.

    "Many policymakers around the country are so fixated on more access, they're losing sight of the need to simultaneously focus on cost and quality," Pawlenty said. "Expanding access to a broken system is no solution. ... In the long run, that will be a failure."

    He wants universal coverage, he insisted, but warns that government can't end up with the bill. His plan would broaden coverage to more uninsured children and have the state create a marketplace where insurers can provide a more affordable product. It wouldn't mandate that everyone get coverage.

    There are even deeper philosophical differences in other parts of the country, particularly more conservative states which have emphasized cutting Medicaid costs rather than expanding coverage.

    But the new ideas are even getting an airing there.

    In Florida, where the biggest health care change under former Gov.
    Jeb Bush emphasized cutting costs of Medicaid, the new surgeon general talked enthusiastically of Massachusetts' universal health coverage law — and new GOP Gov. Charlie Crist said he wouldn't rule out considering something along those lines.

    ___

    FLASH IN THE PAN? How the Massachusetts program and high-profile proposals do also will decide the staying power of health care as a political issue. After
    President Clinton's health care reform attempt failed in the 1990s, the issue went dormant for years.

    "Once you pass these programs and start the implementing, it only gets harder," said Maine Gov. John Baldacci, a Democrat. "Because then you're talking about real dollars and real decisions."

    Maine hasn't met its ambitious goals, with fewer businesses signing on to the state program. But Baldacci and state leaders are trying to fix the flaws.

    "Hopefully," he said, "the chambers of commerce, the unions, the businesses will recognize we need a solution."
    Health care has been a hot button issue for some time now, and with Ms. Clinton's presidential hopes, it is again in the spotlight (she's been a proponent of this.) Where do you stand: private or universal health care?

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    I am sceptical that the US system really is "private" in the true sense.

    Ron Paul on health care: http://www.lewrockwell.com/paul/paul339.html

    For decades, the U.S. healthcare system was the envy of the entire world. Not coincidentally, there was far less government involvement in medicine during this time. America had the finest doctors and hospitals, patients enjoyed high-quality, affordable medical care, and thousands of private charities provided health services for the poor. Doctors focused on treating patients, without the red tape and threat of lawsuits that plague the profession today. Most Americans paid cash for basic services, and had insurance only for major illnesses and accidents. This meant both doctors and patients had an incentive to keep costs down, as the patient was directly responsible for payment, rather than an HMO or government program.

    The lesson is clear: when government and other third parties get involved, health care costs spiral. The answer is not a system of outright socialized medicine, but rather a system that encourages everyone – doctors, hospitals, patients, and drug companies – to keep costs down. As long as “somebody else” is paying the bill, the bill will be too high.



    Anyway, I have no complaint in my dealings with the National Health Service in England. I would say though that I prefer private health care, paying for treatment when one needs it. In the old days, people kept themselves in trim shape and took greater personal responsibility. At the moment we get govt propaganda on for example obesity, but the govt system will still bail people out. This is bad. Private health care will focus minds more.

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    Quote Originally Posted by OneEnglishNorman View Post
    I am sceptical that the US system really is "private" in the true sense.

    Ron Paul on health care: http://www.lewrockwell.com/paul/paul339.html

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    Anyway, I have no complaint in my dealings with the National Health Service in England. I would say though that I prefer private health care, paying for treatment when one needs it. In the old days, people kept themselves in trim shape and took greater personal responsibility. At the moment we get govt propaganda on for example obesity, but the govt system will still bail people out. This is bad. Private health care will focus minds more.

    Exactly, privet can be better for many reasons. The real problem these days is not privet doctors but out of control insurance and pharmaceutical companies.
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    If I were a healthy American surrounded by masses of ugly obeses, I would for sure not want a universal health care system which forces me to contribute to expand these unfits' life span.

    Here in Canada, and especially in Québec, our greatest problem is that we are a heavily ageing society combined with a theoretical 100% public health system. With less people working, more and more retiring and spending their painful days taking a pill each 5 minutes. I foresee a major change in this utopian paradigm in the next decades, if not years.

    A private health care system is the West's last eugenics measure, though the whole scheme is not directly thought to be so.
    "The heavenly motions... are nothing but a continuous song for several voices, perceived not by the ear but by the intellect,
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    in the immeasurable flow of time."

  5. #5
    America's system is half private - half public, and the half that is public is very poorly organized.

    Strict control of prices by the government has shown repeatedly to lead to collapse of the market. Governments are the most layered, ineffective institutions in any society because there are too many checks and balances and not enough at the same time. It remains the final authority and doesn't concern itself with outside questioning because it has no true regulator. How long will claims take to get passed, and why would the government be more willing to pay up than a private company? A private company provides a contract that strictly lays out what can happen given one's individual circumstances. I doubt the government would ever offer that sort of leniency.

    The minute the government takes over health care, inefficiency within hospitals sky-rocket, there will be a loss of contributing bright minds who are in the medical field or who would go into the medical field ("brain drain"), post-catastrophic therapy would cease to exist and overall negligence would rise.

    People fail to realize what they are losing by adopting a system of universal health care. Just as an example, I'll use the lower drug costs argument. Like anything, there are trade-offs. People might receive lower prices for some prescription drugs, but the fact is that research and development cost a huge sum of money and pharmaceutical companies are not going to bother a) investing in research that will not get them some sort of profit or b) offer such things in an area where the regulated price is so low, that it pretty much makes that research non-profitable and a waste of time and money. Essentially, you either end up with a lack of companies investing in any sort of new drugs, and then when a company does finish researching and developing a new drug, they aren't going to aim for a less profitable market. It annihilates the incentive for introducing new drugs to the market.

    Universal health care basically combines tremendous inefficiencies, and when someone's livelihood is on the line, I don't think that's exactly a good idea. There are a multitude of other reasons why universal health care fails in regards to quality and progress in light of private health care.

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    To put it bluntly, if I were an American and someone tried to coerce me into paying for their "right", they'd be in serious need of healthcare...

    Anyway, on the matter of the US' "private" system:

    http://www.economist.com/finance/dis...ory_id=9407716

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    THe US healthcare system is heavily regulated. Much of the cost of healthcare is administrative cost. Some doctors will give you a heavy discount if you pay yourself instead of making them pursue your HMO for payment. As for hospitals many of them provide care regardless of ability to pay. Some of them are required to do so. They pass the cost along to their insured patients which increases the cost of health insurance. Several hospitals in recent years have gone bankrupt & closed because of the cost of treating the uninsured - particularly illegal immigrants. Tort law is also a problem, with much of the cost of healthcare going to purchase malpractice insurance.

    The truth is that even the uninsured in America receive medical treatment free of charge. When they get ill they go to a free clinic or to an emergency room. As I pointed out above many hospitals are required to provide treatment regardless of ability to pay. This doesn't mean the uninsured will get the best of medical care or all the treatment they need. If you need an appendectomy you will receive it but if you need a liver transplant you'll have to come up with the cash to pay for it. A pregnant woman in labor can show at a hospital and have her child delivered free of charge but no hospital will treat a woman for infertility problems free of charge.

  8. #8
    How do you non-Americans who have posted above feel about America's gun laws? Should our guns be taken away, yes or no? All we are asking for is to take the gun pointed at our heads out of the hands of the doctors and insurance companies. Here, we subsidize medical schools with tax payor dollars. Yet, these young doctors never quite get around to repaying society for this gift, instead, they set up shop in Beverly Hills as gynocologists and rake in the big bucks. Or they do as I described and demand hundreds of thousands of dollars to save you life. Nobody can afford to go to a doctor unless really ill, and nobody can afford medical "insurance" (I was quoted $577.00 per month for myself and wife). Insurance companies decide which treatement you get even with insurance and believe me, you wait a couple months to see a doctor on an insurance plan. Even with insurance, before the doctor or hospital will treat you, they want a full disclosure of all your assets so that they can collect the money in civil court from you should your insurance company decline payment or should you exceed your policy limits.

    There are four types of "Health Care" under consideration:

    1. Health Insurance for all, somehow.
    2. Employer pays for health insurance.
    3. Single payor system as in Canada.
    4. Medical savings accounts/tax credits

    Only number three is health care. The insurance industry keeps trying to push number one and to confuse health insurance with health care. Number two is great if you are single but will not pay for your wife or children. To get this through an employer, you must pay full boat on the open market which is just too expensive now. Number three is the Michael Moore system. This is what I favor. Number four is advocated by the Bush regime. Who could possibly afford to save enough money to pay for serious medical care? A doctor or hospital will not treat you based on a promise of tax credit. A tax credit can only be taken for $3,000.00 per year. To recover $20,000.00 to $100,000.00 for a surgical procedure, you would need a lifetime.

    In California, much discussed above, you cannot get a home loan without insuring the lender, and you cannot drive a car without auto insurance. These types of insurance are manditory and enforced by state law. If everyone were required to get on a single payor health care program, the cost would be spread across all age groups and affordable. It is funny the the insurance industry can force you, though their unrestricted lobbying of our state officials, to purchase their auto and homeowners insurance at whatever price they want to charge yet any talk of mandating health care is "cummunist".

    When are politicans going to start legislation FOR the people in this country?

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    Quote Originally Posted by Dr. Solar Wolff View Post
    It is funny the the insurance industry can force you, though their unrestricted lobbying of our state officials, to purchase their auto and homeowners insurance at whatever price they want to charge yet any talk of mandating health care is "cummunist".
    The insurance industry is not against mandatory health insurance - they're actually for - what they are opposed to is a government ran system. If health insurance is mandatory & remains private the insurance companies will have a bonanza. Presumably the federal or state governments would have to purchase insurance on the private market for individuals who cannot afford it themselves.

    The HMOs, AMA, the pharmaceutical companies & hospitals are against any kind of univeral healthcare system that would regulate how much they could charge for services - that would be communism. However, the Veterans Administration for example has negotiated drug prices with the pharmaceutical companies which saves the VA a lot of money. However Medicare (the federal healthcare system for the elderly in the US) is forbidded by law from negotiating lower prices with the pharmaceutical companies - this is a law the drug companies lobbied for and will not give up easily.

    Private HMO do negotiate fees with hospitals. But the system isn't working very well as I pointed out in my previous post that much of the cost of healthcare is associated with administrative cost. Also, hospitals will charge a person without health insurance - and presumably will have more trouble paying - more for the same services they charge insured patiences who's HMO has negotiated lower fees.

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    The cost of health care was not a problem before the government got involved.

    After decades of government meddling and massive regulation, the cost is insanely high. And the government proposes to fix the problem by... you guessed it, more regulation and meddling.

    The government will not propose a solution which leaves them without a job and without control of people's lives.

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