universal health insurance

[pirana 0]

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BTW - in Sweden, the "sucky" healthcare lends itself to their citizens living three years longer (on average) than in the US, half the infant mortality of the US, 50% more doctors per person than the US and 10% more nurses, all at a cost of 60% per capita of what the US pays.

Now you have hit on a salient point; the supply of doctors. Guess who controls that? Give you a hint - it's not the insurance companies.

As with most issues, follow the money to find the answers. Who beneifits financially by putting a false ceiling on the number of doctors allowed to practice medicine? Who benefits by restricting the number of candidates allowed to enter medical school? In neither case is it the insurance companies.

The benefactors of such restrictions are doctors and the people teaching them. Oh, what a surprise, the teachers are also doctors.

At some point the public needs to be woken up to the real cost of health care. An employer sponsored system was a great way to get things started back in the 40's and 50's; but it is a seriously out-of-date model. It hides the real cost of care.

Many docs and legislators and uninformed people have jumped on the bash-the-insurance-company bandwagon. All that shows is their ignorance of the topic. Truth is, in the not-for-profit segment of the business; admin costs are about 10 to 12%. So eliminate the insurance companies and depending on utilizattion trends for that year you might not see a rate increase that year. (That is of course if you can find someone to do all the administrrative work for free). Then of course there is the year after, and the year after, and so on and so forth.

Bottom line is that the cost of care, the actual costs incurred per patient per year has been going up on average double digit percentages per year while insurance admin costs have been going down. Some of it is utilization trend, some of it is cost per encounter, some of it is institutional overcapacity, some of it is new drugs and technologies, some of it is malpractice liability, some of it is an aging population, and so on.

Contrary to falsely held beliefs, it would be far worse without the insurance companies. The automation of administrative systems and the reimbursement agreements between providers and insurance companies are actually putting downward pressure on costs.

An anecdote for an ending here. I had a surgery 2 summers ago. I was in the system for 24 hours. About 2 hours under the intensive care of 4 people, a couple more hours under 1 on 1 not-so-intensive care, and about 20 hours of someone stopping in to say hello every couple hours. The billed charges came to $44K.

The insurance company cut the bill just about in half based on their contractual agreements for reimbursement. I paid my $2K annual out-of-pocket, and the insurance paid $20K. But for someone paying cash, the bill would have been $44K. That is fucking ridiculous.

The real culprit folks is the cost of care, and someday our insurance companies and legislators are going to have to face that, take off the gloves, and go after the actual providers of care to change the supply side of the equation - despite how politically dangerous it will be to do so.

The alternative is a cost of care that is rising so fast it is going to price the average person right out of routine health care in our lifetime.

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[gregpso 1]

You still have not addressed what happens to people who cannot afford or cannot get health insurance .. thrown on out the door of hospitals. Watch SICKO many examples. What about the poor soul who sawed his finger off 6000 dollars to pay. In Australia free immediate fix with a top neuro surgeon in a public hospital.

Re OK its not free ... it is for people who do not earn enough to pay the medicare levy. Once you reach around $45000 per year you pay a levy. SO IT IS FREE FOR A LOT OF PEOPLE.

RE YOU COULD GET A BLADDER TEST TOMMORROW IF YOU WANTED ONE So can I and pay around $100 if I so desired.

RE IF THE GOVERNMENT REALLY CARED ABOUT YOUR HEALTH WHY DID I HAVE TO WAIT Simple we do not have unlimited resources here so things not considered urgent (decision made by doctor not govt official) take a litle while longer So what ! it gets done unlike the poor USA citizen who cannot get health insurance.

re spending the 3 trillion a year The defence budget would take a fair whack of that and yeah you have some good social programs so why not universal health care.. because the insurance lobby is afraid they will loose money thats why.

if universal health care is good enough for the rest of the civilised world why not the USA.

RE THE 9 PERCENT SUPPERANNUATION SO THAT IS TAKEN OFF YOUR SALARY Actually no its not .. the employer pays an addittional 9 per cent into your super fund on top of your salary.

Beginning to sound pretty good I is it not ?

We get all the cable USA news over here so I do know a lot about your system Do not get me started about Fox news Fair and Balanced My ARSE !!! or as you would say My ASS !!!!

As stated I like Amercians and alot of the culture and entertainment (thanks for that) its just the political system that is different. (Your right of course) Enjoying the debates thanks Greg

ps we get a laugh over here about Fanny May (the company gone broke) Over here Fannie means a female sexual organ where over there its just a rear end. Good luck

I tend to be a bit different. enjoyed my time in the sport or is it an industry these days ??

[gregpso 1]

Well said my friend

I tend to be a bit different. enjoyed my time in the sport or is it an industry these days ??

[pirana 0]

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The problem with the American debate over universal health insurance is that those Americans opposed to it presume that it necessarily MUST be exactly like the Euro-style system, warts and all; and then there's also the psychological hurdle of jingoistic, ideological sloganeering: it's given the label "socialism", and that's a dirty word in the US. So there's simply impasse.

But rather than tossing the baby out with the bath-water (gasp! - a cliche'!), why not view the Euro-style model as the "beta version" - subject not to disposal, but improvement - and craft a hybrid system that addresses Americans' needs for a safety net, but also addresses their concerns that the US's current health care infrastructure would degrade.

Decades ago, when devices like the minimum wage, Social Security retirement, Social Security disability, Medicare and unemployment comp were first introduced, they were fought against tooth-and-nail by fiscal conservatives, as well as derided bitterly as "socialism" or "communism" by ideological conservatives. And yet now, many decades later, they're simply taken for granted as accepted parts of our social fabric.

So here's a modest proposal: let's do this in small increments. For starters, how about a program that employs an unemployment comp-style safety net: if people who currently get their health insurance through their jobs lose their jobs, they get limited government-provided health insurance for as long as they qualify for unemployment comp income. That way, there's still a certain safety net in place, but people still will ultimately have the incentive to get themselves re-employed in order to get (or afford) private health insurance once their unemployment comp runs out.

IMO, those things mostly suck. True, they are now taken for granted; in other words, they have all become entitlements. They all need overhauling.

But, you make some good points on where we go from here. Trying to mimic or transplant a system that works elsewhere, in a place that is very different than the US, is a bad idea.

Freedom of choice is big here. So is a healthy distrust of wholsale turnover of our health care system to the government.

What would work well here is guaranteed coverage, choice of products based on what people want to spend, a sliding scale of premiums for low income families, and incentives for healthy behavior. It is a good mix of safety net and accountability.

Linking to my previous post though, none of it means anything until we get a handle on cost of care.

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[normiss 848]

nice timing!
This story out today

Docs now seem fed up with the system too!

[TomAiello 26]

Interesting article on CNN.com today.

I know a lot of doctors. Most of them would prefer to leave medicine. What if they did?

Now, there's a healthcare crisis.

-- Tom Aiello

Tom@SnakeRiverBASE.com
SnakeRiverBASE.com

[kelpdiver 2]

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Decades ago, when devices like the minimum wage, Social Security retirement, Social Security disability, Medicare and unemployment comp were first introduced, they were fought against tooth-and-nail by fiscal conservatives, as well as derided bitterly as "socialism" or "communism" by ideological conservatives. And yet now, many decades later, they're simply taken for granted as accepted parts of our social fabric.

Are they? Minimal wage increases are fiercely debated every time. Medicare and SS retirement are known ticking time bombs for the national debt.

[Rookie120 0]

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You still have not addressed what happens to people who cannot afford or cannot get health insurance .. thrown on out the door of hospitals.

What about the people who come to this country, get fucked up then bail on the bill? Hell this is a post from one of our own.


http://www.dropzone.com/cgi-bin/forum/gforum.cgi?post=3387993;search_string=lax%20customs;#3387993

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Watch SICKO many examples.

Is that where you get your opinions from? Michael Moore? Oh come on.

If you find yourself in a fair fight, your tactics suck!

[kallend 2,106]

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And by the way, it's not their excellent health care that lends itself to Swedes outliving Americans by three years, it's their Diet.

There's always an excuse for poor performance by the USA, whether it be homicides or healthcare.

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The only sure way to survive a canopy collision is not to have one.

[mnealtx 0]

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And by the way, it's not their excellent health care that lends itself to Swedes outliving Americans by three years, it's their Diet.

There's always an excuse for poor performance by the USA, whether it be homicides or healthcare.

Oh, you mean like blaming homicides on guns and health on lack of insurance?

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[kallend 2,106]

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Better look at how Sweden calculates their infant mortality - iirc, the baby has to live longer than 3 months before it counts.

Sounds like a made-up fact to me - have a reference?

Ever hear of google? You talk a lot of smack about people not having info, when it's obvious you haven't done much research.

Bad case of POT there, Mike!

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Excerpt from a Health/Human Services study:

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Due in part to medical research, public health and social services supported by HHS, infant mortality has declined considerably during the past three decades. Overall, the nation's infant mortality rate has fallen from 20 deaths per 1,000 live births in 1970 to 6.9 deaths in 2003 (preliminary data). The 2002 rate of 7.0 deaths, based on complete data, was higher than the 2001 rate (6.8), but has fallen 8 percent since 1995 and 24 percent since 1990. In 2002, the leading causes of infant mortality were congenital anomalies, disorders related to immaturity (short gestation and unspecified low birthweight), SIDS, and maternal complications.

Snippet from a US News and World Report piece about infant mortality:

Oh, so Sicko isn't allowed, but USN&WR is

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First, it's shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates. For this very reason, the Organization for Economic Cooperation and Development, which collects the European numbers, warns of head-to-head comparisons by country.

Infant mortality in developed countries is not about healthy babies dying of treatable conditions as in the past. Most of the infants we lose today are born critically ill, and 40 percent die within the first day of life. The major causes are low birth weight and prematurity, and congenital malformations. As Nicholas Eberstadt, a scholar at the American Enterprise Institute, points out, Norway, which has one of the lowest infant mortality rates, shows no better infant survival than the United States when you factor in weight at birth.

Ummm - where was SWEDEN mentioned?

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The only sure way to survive a canopy collision is not to have one.

[kallend 2,106]

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And by the way, it's not their excellent health care that lends itself to Swedes outliving Americans by three years, it's their Diet.

There's always an excuse for poor performance by the USA, whether it be homicides or healthcare.

Oh, you mean like blaming homicides on guns and health on lack of insurance?

So you admit the USA performs poorly in these areas. Progress!

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The only sure way to survive a canopy collision is not to have one.

[pirana 0]

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nice timing!
This story out today

Docs now seem fed up with the system too!

Strange slant in that article. It seems to be coming from the perspective of a private practice doc, or a very small operation. That is a very rare thing these days, at least in this part of the country.

Most medical care today is provided in clinics that are of the scale that lends itself to professional support staff who take the paperwork out of the docs hands. My doc writes notes in my chart. That is the extent of his paperwork. (And even that will soon be electronic).

Interesting too that the shortage is mostly in GP. Since that is the area of practice least likely to have their claims scrutinized for irregularities; pointing at the insurance companies sounds to me like a lazy excuse. Apparently the paperwork is not scaring away specialists; whose offices are guaranteed to see more paperwork than that of a GP.

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[kallend 2,106]

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You still have not addressed what happens to people who cannot afford or cannot get health insurance .. thrown on out the door of hospitals.

What about the people who come to this country, get fucked up then bail on the bill? Hell this is a post from one of our own.


http://www.dropzone.com/cgi-bin/forum/gforum.cgi?post=3387993;search_string=lax%20customs;#3387993

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Watch SICKO many examples.

Is that where you get your opinions from? Michael Moore? Oh come on.

Try this one then:

www.reuters.com/article/vcCandidateFeed2/idUSN12299426

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The only sure way to survive a canopy collision is not to have one.

[pirana 0]

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You still have not addressed what happens to people who cannot afford or cannot get health insurance .. thrown on out the door of hospitals.

What about the people who come to this country, get fucked up then bail on the bill? Hell this is a post from one of our own.


http://www.dropzone.com/cgi-bin/forum/gforum.cgi?post=3387993;search_string=lax%20customs;#3387993

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Watch SICKO many examples.

Is that where you get your opinions from? Michael Moore? Oh come on.

Try this one then:

www.reuters.com/article/vcCandidateFeed2/idUSN12299426

That's not a study, it's a survey. Way too much room for interpretation. I'll bet they even had questions asking them how certain things made them "feel."

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[kelpdiver 2]

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Oh, so Sicko isn't allowed, but USN&WR is

Even Faux News is more factual ('fair and balanced') then a Michael Moore mockumentary.

[kallend 2,106]

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You still have not addressed what happens to people who cannot afford or cannot get health insurance .. thrown on out the door of hospitals.

What about the people who come to this country, get fucked up then bail on the bill? Hell this is a post from one of our own.


http://www.dropzone.com/cgi-bin/forum/gforum.cgi?post=3387993;search_string=lax%20customs;#3387993

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Watch SICKO many examples.

Is that where you get your opinions from? Michael Moore? Oh come on.

Try this one then:

www.reuters.com/article/vcCandidateFeed2/idUSN12299426

That's not a study, it's a survey. Way too much room for interpretation. I'll bet they even had questions asking them how certain things made them "feel."

My doctor usually asks me how I feel. Maybe she's just conducting a survey.

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The only sure way to survive a canopy collision is not to have one.

[pirana 0]

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My doctor usually asks me how I feel. Maybe she's just conducting a survey.

That she is; and one that is relevant to the topic at hand - which would be your health.

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[riddler 0]

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Depends on your intrepretation. What do you think cost per capita is? Is it how much an individual spends on healthcare? Is it a total of all costs? Does it factor in taxes? Not enough info there for me to draw a solid conclusion with the exception being the personal tax rate is nearly double that of the US. Thanks, but no thanks.

There's no room for interpretation here. Cost Per Capita is a definitive term. Cost = US Dollars. Per Capita = per person (from the Latin "per head"). How it's paid for is outside the scope of that number. Whether the way it's paid for is right or wrong, whether or not you think it's better, Sweden has a healthcare cost per capita that is less than the US.

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A quick google shows Sweden's system is in trouble.

You're right. I'm sure Sweden's healthcare system will collapse tomorrow

Trapped on the surface of a sphere. XKCD

[riddler 0]

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That is absolute bullshit! 90%? Absolute crap!

Secondly, tell me the name of the 2 or 3 doc clinic that has a person submitting claims full-time. If someone told you this, it is an outright lie or they are the slowest worker bee on the planet. With today's systems it takes seconds to submit a claim, and almost all are submitted electronically.

Lots of unsubstantiated claims

Your total lack of knowledge is showing badly. Even if an electronic claim has to be printed, scanned, or whatever and becomes a piece of paper - it is 1 page long. So the page 3 comment is totally bogus.

Get to know the topic before you blast away from the hip with outrageous bullshit claims.

Well, my wife worked for a chiropractor group (of 2 chiropractors) which had one person full-time submitting claims to insurance companies. I also had a neighbor that worked for a health-clinic (about 5 doctors) where it was her full time job. Maybe they're liars, but as I actually know them, and you do not, I doubt it.

Here's a survey from 2006 that says 75% of claims are submitted electronically, which is pretty good, but a far cry from "almost all":

http://www.ahip.org/content/pressrelease.aspx?docid=16454

With regard to by "total lack of knowledge", I am definitely not an expert on health claim submissions. That is why I cite references - those references say something completely different than what you're saying, but you haven't really proven anything except that you're passionate about the subject.

Trapped on the surface of a sphere. XKCD

[TomAiello 26]

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It seems to be coming from the perspective of a private practice doc, or a very small operation. That is a very rare thing these days, at least in this part of the country.

It depends a lot on where you are.

Plus, one of the reasons that solo and small group practices are disappearing is because of the need to share overhead when retaining big support staffs.

Regardless, it's a bona fide fact that a very large percentage of doctors in the USA today are unhappy in their work, and would change professions if they could. My wife (who is a doctor) looked at that article, kind of shrugged, and said "that's news?"

One of the reasons that GP's are less happy is probably pay. All the "overpaid" doctors you hear about are specialists (mostly surgeons), and even then I'd argue that they are often not really overpaid.

GP's are often making salaries in the low 100's or less, but having to service huge debts from years of medical school. If you average out lifetime earnings for a typical pediatrician, and assume a modest savings rate, they'll typically make less than someone in a skilled trade (carpenters or plumbers, for example) over their lifetime.

-- Tom Aiello

Tom@SnakeRiverBASE.com
SnakeRiverBASE.com

[kelpdiver 2]

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Depends on your intrepretation. What do you think cost per capita is? Is it how much an individual spends on healthcare? Is it a total of all costs? Does it factor in taxes? Not enough info there for me to draw a solid conclusion with the exception being the personal tax rate is nearly double that of the US. Thanks, but no thanks.

There's no room for interpretation here. Cost Per Capita is a definitive term. Cost = US Dollars. Per Capita = per person (from the Latin "per head"). How it's paid for is outside the scope of that number. Whether the way it's paid for is right or wrong, whether or not you think it's better, Sweden has a healthcare cost per capita that is less than the US.

With that thinking, yes, any division metric is a simple one.

But it's never so simple.

The denominator is either all citizens, or all people including aliens, or all people paying, or all people period. A little bit of fuzziness. Sweden likely doesn't have 10M undocumented people using their health care system, given their entire country's population is 9M.

The numerator is far more difficult to identify - you have health insurance costs, opportunity costs, tax subsidies at the federal and state level.

Divide those two and you get a number, but you still don't have an effective measure of comparison between two different systems. The money isn't being spent on identical populations.

[kallend 2,106]

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My doctor usually asks me how I feel. Maybe she's just conducting a survey.

That she is; and one that is relevant to the topic at hand - which would be your health.

And the study (aka survey) I quoted is about the nation's health.

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The only sure way to survive a canopy collision is not to have one.

[airdvr 210]

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There's no room for interpretation here

That's funny. If you look at the rest of the numbers it doesn't add up. If the government pays 85.2% of the tab and they are 45% less expensive than here in the U.S., yet there's only one more nurse per 1000 people, and slightly less than 1 more doctor per 1,000 people I'll submit someone's not getting paid very much.

Oh that's right....there's no profit, and I'd suspect very little being paid for R & D because there's no incentive to do those things.

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A quick google shows Sweden's system is in trouble.
--------------------------------------------------------------------------------
You're right. I'm sure Sweden's healthcare system will collapse tomorrow

In the 1990s, Sweden set about reforming its health care system by introducing aspects of privatization. These reforms were limited, however, and the old problems with waiting lists and rising costs had re-emerged by the beginning of this decade.

The experience of Sweden demonstrates that when a nation adopts market-oriented reform for its health care system, the reforms will fail if the market is not permitted to work.
http://www.nationalcenter.org/NPA555_Sweden_Health_Care.html

Please don't dent the planet.

Destinations by Roxanne

[kallend 2,106]

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There's no room for interpretation here

That's funny. If you look at the rest of the numbers it doesn't add up. If the government pays 85.2% of the tab and they are 45% less expensive than here in the U.S., yet there's only one more nurse per 1000 people, and slightly less than 1 more doctor per 1,000 people I'll submit someone's not getting paid very much.

Oh that's right....there's no profit, and I'd suspect very little being paid for R & D because there's no incentive to do those things.

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A quick google shows Sweden's system is in trouble.
--------------------------------------------------------------------------------
You're right. I'm sure Sweden's healthcare system will collapse tomorrow

In the 1990s, Sweden set about reforming its health care system by introducing aspects of privatization. These reforms were limited, however, and the old problems with waiting lists and rising costs had re-emerged by the beginning of this decade.

The experience of Sweden demonstrates that when a nation adopts market-oriented reform for its health care system, the reforms will fail if the market is not permitted to work.
http://www.nationalcenter.org/NPA555_Sweden_Health_Care.html

About as unbiased a source as Michael Moore.

The National Center for Public Policy Research is a communications and research foundation ... dedicated to providing free market solutions to today's public policy problems...

In 1982, we started The National Center to provide the conservative movement with...

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The only sure way to survive a canopy collision is not to have one.