Seriously, why do you fear Universal Healthcare as a solution for US?

We spend more on healthcare than any other industrialized country, $9,990 per person for 2015, and get the least for it. Healthcare has become the proverbial political football of our nation, and yet here we are again, arguing over semantics and how to pay for it, despite all the evidence that our for-profit system is falling apart.

What is it about Universal Healthcare that scares us so much? Is this just an ideological issue?

Here's some more facts about how we compare:

• There are fewer physicians per person than in most other OECD countries. In 2010, for instance, the U.S. had 2.4 practicing physicians per 1,000 people — well below below the OECD average of 3.1.
  
• The number of hospital beds in the U.S. was 2.6 per 1,000 population in 2009, lower than the OECD average of 3.4 beds.
  
• Life expectancy at birth increased by almost nine years between 1960 and 2010, but that’s less than the increase of over 15 years in Japan and over 11 years on average in OECD countries. The average American now lives 78.7 years in 2010, more than one year below the average of 79.8 years.

No denying, the US leads in medical research, but what good is that if you can't even afford to see your doctor to get diagnosed. The ACA has made great strides in changing this, but it's not perfect. Critics love to cite Obama's broken promises, but conveniently forget that costs were rising exponentially before 2010 and essential healthcare was becoming plutocratic.

So I ask you, why is the concept of essential basic healthcare for everyone a threat?

 

Are you paying for our health care? If not....

No.

 

What has risen is the cost of insurance which has risen as the government has gotten more involved in what is or is not to be covered more stuff covered the higher the cost goes.

Fewer beds is a function of bureaucratic red tape, fewer doctors is a function of far fewer medical schools per capita and far fewer graduates, and extreme vetting requirements to get in to medical school.

Life expectancy is a silly way to measure the success of your medical system. Especially when life expectancy is determined by a whole host of factors that the medical community has little or no control over.

 

You have anything to back up your assertions?

 

As stated in my original post, we all wind up paying. Maybe you can't, or don't want to make the mathematical connections, but they exist.

It's an issue of making it more cost effective.

 

What? Do you live in Antarctica or something? Obviously not in the US.

What he posted is true, like death and taxes.

The US is a litigious society. Malpractice claims raise costs significantly. A pile of these claims are against foreign doctors, ones not vetted and trained in the USA. Drug costs suffer the same fate as well as FDA strangleholds on bringing drugs to market in the US.............thus affording insane amounts of protection time of the patents.........the losers here are us. Don't blame pharma for that one. FDA and ambulance chasers get the credit. You need to ask yourself, why would a person go through 8-10 years of being a serf and end up hundreds of thousands of dollars in debt to become a doctor if there was zero chance of catching lightning at the end of the tunnel? I already know your rebuttal. We'll all end up with substandard care and attention. We're done here.

 

Good lord, I swear, some of you folks think because you can fart the loudest that we should applaud you for expressing your opinion.

I asked what his opinion is based on. Surely he, or you, should be able to point to something legitimate to back up your opinion, but in the absence of such, I will chalk it up to more glorified right-wing flatulence grounded in nothing more than recycled hot air.

 

For me, it's an issue of not paying for other people.

But maybe you're correct in a way. The way it's been cobbled together so that everybody at the hospital gets paid, whether they have patients on medicare or patients who can't afford the food, let alone surgery means that when we do get the bill, we're wondering why the hell it's so expensive.

Your idea seems to be to lump all the money we pay for medical care in one big pile and then figure out how to make that pile a bit smaller. My idea is to put my bills in a pile on my side of the table, and your bills on your side. Then we dig deep and cough up what we owe individually. In other words, let's go Dutch, shall we?

 

But..........he want's to Bogart and slide his bills to your side of the table. Hey look! There's a bird out the window!

You look outside, and then down at your pile of invoices, and suddenly you have two extra bills you didn't see before. Hmmmm

 

What makes you think we get the least for it?

Using life expectancy is a horrid way to judge the quality of care as American society is VERY unhealthy, despite the care and advice we receive. You also have to factor in unnatural causes of death in our violent society.

Can't use infant mortality rates as not every country records these statistics the same.

Happiness isn't going to work. Way too subjective to hold any real value.

If you use outcomes, the US leads the way in every category I have ever seen.


Cost is a major issue and will require massive changes in our healthcare, legal, and educational systems to address. There are so many issues I won't go into specifics but 2 of the major drivers are medicare/Medicaid and pharmaceuticals.

Access is the biggest issue, but also one with the easiest fix as the free markets have already started to address them. The US has a massive shortage in primary care physicians. Trying to get an non emergency appointment is nearly as long of a wait as getting into the dentist office. I see this issue being more or less solved for most people with the emergence of urgent care clinics.

Lastly, I don't want nationalized health care because of how poorly the govt handles everything they get their hands on. The more we can get govt put of end user regulation the better it is, and the cheaper it gets.

 

I appreciate your honest answer.

So what if we were to extend your Dutch approach to everything else? Roads, water, infrastructure, etc., you think you'd be okay with that?

Keep in mind that for the vast majority of Americans, their introduction to health insurance has been via their employer. This custom of employer provided healthcare isn't that old really. It began around the 1930s when industrialists started figuring out how much production losses were due to sick employees. This is how Henry J. Kaiser met with Dr. Sydney Garfield, and together they wound up creating one of the largest medical organizations in the US, all because he wanted to create a healthier workforce to keep his production high.

Now the reason I bring this up is because the economic model you seem to adhere to is just not very realistic at all. In fact, our history in the United States is littered with examples of the self-centered approach of many industrialists producing both good and bad results in a fairly rhythmic pattern. Stock markets rise and crash based on the eternal tug of war between opposing forces, but they never go backwards.

We cannot go Dutch now because healthcare is deeply interwoven into our nation's GDP, and I am not just talking about the industry itself, but the very nature of the labor force, even as we are still defining what a labor force looks like in the 21st century. Now I admit I'm no economist by a long shot, but it seems to me if Trump is making all these changes to our economy and banking on the expectation he can get there with a projected GDP growth of 3% to 4%, then it would seem to me that healthcare would be vital to a labor force. Of course, Trump really hasn't provided much details to how this GDP growth will come about, just as the details of this "terrific" GOP healthplan also seem to lack a safety net for the working class.

I just find it funny, not in a ha ha sense, but in a pathetic sense, that countries like Canada, England, Australia, have gotten beyond this "Dutch" way of thinking (something tells me the Dutch would find it unsettling too) about healthcare. Whether you like it or not, we are a country of 320 million people, no man is an island, and if we cannot find a way to provide basic healthcare for all, we will be doomed as a nation.

I don't mean to say any of this as a hyperbole. There is a segment of the population which views healthcare as a privilege, not a right. "If you cannot afford it, too bad". This sort of thinking is very myopic. We are living in dangerous times from a medical standpoint. Our interconnectedness with the world makes us far more vulnerable to global pandemics, and even though many on the right refuse to admit it, climate change is a serious agent in this biological threat.

ALL of this is related and interwoven with the very fabric of our country. It is not just an issue of health, but of economics, defense, and morality.

So, no, we cannot go Dutch. No one has that luxury, because fortunes can be loss and the tables flipped and I would still share my pile with you.

 

Many politicians will hate one solution to bring the cost of healthcare down.

The pharmaceutical companies raised prices when Obamacare rolled out. One good example was the epipen price hike. Defended by the company because they felt the price for their product was undervalued. Since it saves lives and people had insurance they jacked up the price.

The problem is lack of competition. They have no one to compete with particularly for medicine to treat rarer medical problems.

In part it is the FDA's fault and the unwillingness for politicians to ignore the money pharma is capable of spending to counter or support their campaigns.

Open the market up at least allow Canadian companies to sell in the US and there would likely be a price drop.

I am also curious to see what happens with hospitals' margins when the ACA gets replaced. They were having difficulty with unpaid medical bills from uninsured patients then had to jack up prices to compensate prior to ACA. With ACA they have a much steadier income but seems they were reluctant to start lowering prices. Not surprising for any business. If a price is accepted by the market it is really no incentive to lower them.

 

Care to elaborate?

Big Pharma is in essence a Drug Cartel. Competition will not lower prices in general. The industry cannot regulate itself. They are driven by greed. What the FDA should do, is ban them from advertising. They spend over $30 Billion annually on direct to consumer advertising.

 

Perhaps those who favor the "dutch" approach should consider what it would be like if you didn't pay for your neighbor's schools via your taxes.... The guy who fixes your car learned to read and write (usually) in a public school. The guy who framed your house did the same thing. And yes, the guy who draws blood was likely the product of a public school system.

Its quite easy to think everyone should be on their own. I think those who hold such a view would be shocked to see what their taxes have actually paid for. For most Americans, it would be a few miles of roadway or maybe part of a navy destroyer. According to a Forbes article, those making $100K will pay about $1.4 million in federal taxes. Lets say you pay 4x that in sales taxes and the like. Just to be on the safe side, then double that amount... That is about $20M you pay over a lifetime. It would not have paid for the fuel for a single space shuttle launch or perhaps 10 or 20% of a modern high school.

The "dutch" folks are wrong to think the collective is somehow weaker than the individuals.

 

We already do in many ways. Gasoline is taxed to help pay for the roads, bridges collect tolls, public transportation costs, etc. etc. etc.

Why not with health care?

It will still be included in the GDP.

The typical rebuttal to this is that you're looking at healthcare as if it is fundamentally different from any other product or service. Sorry, but those other countries can do what they want, but there are all sorts of things that we need to maintain a decent standard of living, and those aren't free. Why healthcare?

Do we really need that entire 320 million people? I remember when it was 250 million. I think we'll do just fine going dutch. It weeds out the lazy and useless, and makes us a stronger nation of independent free individuals.

 

Unless doctors become barbaric enough to let somebody die in front of them, going dutch won't work. The poor person will not afford insurance, be unable to pay their healthcare bills, declare bankruptcy, and then the hospital will charge you more to compensate. All of this will occur unless the poor person makes it to 65 without a major hospitalization, and then they do get a form of universal insurance that the elderly fight for, medicare.

 

“If they would rather die,” said Scrooge, “they had better do it, and decrease the surplus population.”—from Charles Dickens’ A Christmas Carol

 

Most 1 year olds are lazy and useless. Should we just let them die? Why spend the money unless you know it's a sure thing that little Timmy is going to be productive and "useful".

 

A life time of experience. And watching the bureaucracy choke everything to death in a vain exercise to make things better for one at the expense of everyone else. And the one is usually themselves. We've actually lost hospital beds over the last few years as small town hospitals have gone belly up. Defensive medicine killed most of them.

 

Let me put this as delicately as I can.

The main reason we here in America do not have a more efficient system for our healthcare costs...is because a great deal of the American conservative movement, which exerts a huge force on our social agenda, is comprised of barbarians. Their social thrust essentially is: I've got mine...screw you.

A large percentage of the American conservatives who are not actually barbarians...are naive, useful idiot, puppets who will pretty much do as their masters dictate. In another time and setting, they would be the peasants who assert that the barons are barons by divine decree...and that we are obligated to defend their right to be barons over us.

If you have some ideas for how to deal with that problem, Lucifer, please share them. We need the help.

 

Every other consumer good service is provided cheaper and with better quality through the private market. Why do you believe that the government can and will change that trend with health care? Also, name another industry with such heavy involvement from government? The areas medical treatments in which government isn't so involved are very competitive where services become better quality and more economical year after year.

 

The comment enlarged in your post sounds to me to be self-serving.

Can you substantiate it...or do we have to take your word for it?

And are you suggesting it to be true for all governments...or just for ours?

 

The problem with medical school is cost. We can't fill all the slots we have. Medical schools all over the world cost less than 1/10th of US costs.

Hospital beds? Corporate hospitals like Tenet and Columbia HCA bought up rural hospitals right and left and closed them to create economies of scale for themselves.

 

Because it's never "basic" and it costs too much. The ACA was a 'test model', wasn't it? The Europeans are generally able to do it, because as Trump noted: Significantly lowered defense spending. We could of course, lower our defense spending too but to do that, we'd have to have a major overhaul of foreign policy that isn't happening anytime soon.

So we must find a way to lower the cost of health care with regards to government involvement, lest we be taxed to high heavens. And not for my "benefit", but for others.

 

Currently, more than one-quarter of physicians and surgeons in the United States are foreign-born. In addition to physicians, roughly one-fifth of nurses and home health and psychiatric aides, and more than one-sixth of dentists, pharmacists and clinical technicians in the United States were foreign born in 2010. When foreign-born professionals account for 16% of all civilians employed in healthcare occupations and one-fourth of practicing physicians, the system really does depend on a functioning immigration system. There are simply not enough native-born healthcare workers to meet the growing demand--especially in the geographic areas with the greatest need.

https://www.forbes.com/sites/nicole...n-reform-solve-our-doc-shortage/#1f506a53155f