[speechlesstx]

Hello again, El:

YES, until you can show me more than ONE right wing American website that debunks this report that the ENTIRE WORLD thinks is right. I'm not as easy as you. It takes more than ONE source to convince me of anything. You? Not so much.

excon

I didn't exactly quote a "right wing" website, I think Cato calls themselves "market liberals" or something like that.

[ETWolverine]

Hello again, El:

YES, until you can show me more than ONE right wing American website that debunks this report that the ENTIRE WORLD thinks is right. I'm not as easy as you. It takes more than ONE source to convince me of anything. You? Not so much.

excon

Fine. Then the next time you have a medical issue, I expect you on the first plane to Costa Rica or Colombia. Their care is better than ours and you deserve the very best, right? And the WHO report is telling you which countries give the best medical care.

Otherwise, don't claim to believe a report that you KNOW is is wrong and use it as a basis for your entire position on health care.

Elliot

[spitvenom]

Forget Costa Rica and Columbia. Lets talk about number 1 and number 37 because they are the only two numbers that matter right now. Read this link if you like.

France's model healthcare system - The Boston Globe

[tomder55]

France Fights Universal Care's High Cost - WSJ.com

[spitvenom]

Seems like just like in the US the French people are very loyal to the way things are according to that report.


On a different note did Rupert Murdoch ever buy the Wall Street Journal?

[ETWolverine]

Forget Costa Rica and Columbia. Lets talk about number 1 and number 37 because they are the only two numbers that matter right now. Read this link if you like.

France's model healthcare system - The Boston Globe

Wait a second... we're supposed to believe that a report that got so many things wrong between #37 and #2 managed to get # 1 correct?

On what basis?

But if we're going to look at France's health care system, then let's do so. Let's talk about the fact that most French pay over 65% of their wealth to the government in the form of taxes for their "free" health care.

Let's talk about the fact that the French system is institutionally committing acts of racism by limiting care to certain "unwelcome" ethnic groups while giving that same care to "real French". There is a MASSIVE inequality of care in France based on ethnicity and religion.

Let's discuss the fact that France's MEDICAL OUTCOMES are not better than those of the USA. The USA actually beats France on survival and recovery rates for EVERY DISEASE, ILLNESS and THERAPY you would care to name.

Let's talk about prevetinve care... the fact that the USA beats France in providing preventive care. More of our women get breast cancer screenings, pap smears, etc. More of our men get colo-rectal-cancer screenings, pancreatic cancer screenings, prostate cancer screenings, etc. More people in the USA get regular checkups. More people in the USA get annual stress tests and annual EKGs to monitor heart health.

In short, the French system does NOT privide better care than the USA by any reasonable criterion, from equality of care, to access to preventive care, to medical outcomes. And it COSTS MORE than ours in terms of what the average person pays in taxes in France, vs what we pay here in premiums.

Is that the model you support?

(My statements about accessibility of preventive care and medical outsomes comes from a study by Lancet comparing medical care in various countries to the USA's system. My statements about equality of care come from the Eurocare-4 report on the state of health care in Europe.)

Elliot

[spitvenom]

Et if your employer doesn't give you Health Insurance in America How much wealth do people spend on it?

Stand outside a McDonald's or really anywhere in America and you have the answer to why the US does more EKG's and stress test.

It hasn't been all that long since certain people were denied care in hospitals in America.

[ETWolverine]

Et if your employer doesn't give you Health Insurance in America How much wealth do people spend on it?

For an individual? Probably $500/month. For a family about $1500/month.

That's $18,000/year for a family. Assuming a $45,000 average salary, that's roughly 40% of income. Add the current 20% tax braket for middle-income wage earners, and between taxes and health insurance premiums, the average person would be paying 60% of their salary. STILL less than the 65% of the French.

However, here's the kicker... 85% of all Americans DO get health insurance from an employer for which they pay much less than 100% of the cost. Which means that the actual cost to 85% of Americans is MUCH LESS than the 65% the French pay.

The cost of health care to individuals is LOWER in the USA than it is in France.

Stand outside a McDonald's or really anywhere in America and you have the answer to why the US does more EKG's and stress test.

No. That is the reason they NEED them. The reason we are able to do them is better accessibility.

And guess what... in the USA, thin people can get stress tests and EKGs too. You don't even have to be sick OR fat to get it. It is called PREVENTIVE care.

It hasn't been all that long since certain people were denied care in hospitals in America.

True. EMTALA was enacted in 1986. But it is the law now. France has no such law... and takes advantage of certain people because of it.

So again I ask, is that the model you are willing to support over ours?

Elliot

PS: I happen to know the cost of out-of-pocket health insurance because I happen to be paying out of pocket right now for my coverage. This information is very much a part of my existence right now.

And despite shelling out $1500/month, I'd STILL take our system over France's any day of the week and twice on Sunday.

[NeedKarma]

ET,
Why don't you help people with the knowledge you have? You could help here: Health Insurance - Ask Me Help Desk

[spitvenom]

I had a feeling you did so I knew you would give a straight answer. So you put out 1500 a month. Doesn't it make you a little mad that you still have to pay co-pays, get generic drugs not name brand, and still could be denied some type of treatment. You are paying for something and you still may not get what you want.

True skinny people do get Stress test etc. But if a third of the country wasn't obese I think we would have a lot less.

I am not saying get Frances health care system here and run with it. I am saying look at what works and how it can be applied here. Look at all the health care system and pick what works and what doesn't.

[ETWolverine]

ET,
Why don't you help people with the knowledge you have? You could help here: Health Insurance - Ask Me Help Desk

Answer: I'm not a licensed insurance guy. I'm an analyst and a policy guy. My wife, who holds an MPA in Public Health Administration wouldn't be able to give much help there either, because she's ALSO not a licensed insurance person.

I don't know product. I know POLICY. I know statistical analysis. I know historical data. But I would be completely useless in helping people determine what products they need or how much life insurance they should buy.

(Personally I just go with 10x salary for life insurance, but the experts have more in-depth ways of determining how much insurance you need. That's why they're licensed and I'm not.)

I know what I know and I stiock to it.

As Clint Eastwood says, "A man's got to know his limitations."

Elliot

[ETWolverine]

I had a feeling you did so I knew you would give a straight answer. So you put out 1500 a month. Doesn't it make you a little mad that you still have to pay co-pays, get generic drugs not name brand, and still could be denied some type of treatment. You are paying for something and you still may not get what you want.

Yes, it sometimes does.

However, the alternative with government-run single-payer insurance is that if I am denied, I HAVE NO OPTIONS.

In the current system, if my insurance denies me the service or product I need, I have the option of buying that service or product myself. Or obtaining it through a charity. There are options. Those options may be expensive, and paying the extra cost may piss me off.

But in a single-payer system, if I am denied that product or service I have no other option to obtain it. If the seervice or product is delayed due to long lines, I have no other option for getting it.

I would rather have a system where I am forced to pay more than I really want in order to get what I need to stay healthy or get better than have a system where I cannot obtain what I need no matter what I'm willing to pay.

There's a reason that so many Canadians come over the border to the USA for their medical care. If they were denied the care in Canada, they have no other way of obtaining it. If they are being forced to wait on lines until the treatment becomes available, they STILL have no other way of obtaining. The only one allowed to pay for a medical service in Canada is the government.

Whereas, if I am denied care by my insurance, I can STILL get that treatment by paying for it myself. Yes, I'll be angry about it. And I will probably challenge my insurance company on it. And if I don't get satisfaction, I might change insurance companies.

But better the option of being angry than no option at all.

True skinny people do get Stress test etc. But if a third of the country wasn't obese I think we would have a lot less.

I HOPE not. Hopefully if 1/3 of the country wasn't obese, we'd just have fewer stress tests that come back POSITIVE and more that come back NEGATIVE. I would hope that the country getting healthier didn't result in a reduction of preventive health care.

I am not saying get Frances health care system here and run with it. I am saying look at what works and how it can be applied here. Look at all the health care system and pick what works and what doesn't.

That I can agree with.

But here's the kicker... any part that has the government involved is the part that doesn't work.

Australia has a good two-tier government/private system. So does Israel. The government system covers CATASTROPHIC CARE ONLY, maybe with a few odds and ends added in after that. But basically it's catastrophic care. Anything over and above that, you pay for private/supplemental insurance.

I would be willing to look at government-run catastrophic care.

But we already HAVE catastrophic care in the USA. Between the EMTALA law and the provisions of Medicaid (for the impoverished) and Medicare (for the elderly and disabled), free clinics (some of which are government-run), charitable foundations for medical aid, the COBRA laws, etc. we already have a pretty good catastrophic-care option in place. And I'm all in favor of improving that catastrophic care by fixing the rules in Medicare and Medicaid and COBRA and EMTALA to help those who fall through their cracks.

But I am against giving the government more power than that. When a government has more power than that, that's when we, the average joes have historically gotten screwed by the government.

True health care reform, as I have said before, has to come from other places.

We need tort reform. Tort reform alone would lower the costs of medical care by as much as 60%. We could use the Texas model, which created a panel that decides whether medical malpractice cases have merit BEFORE they ever get to trial. In the past two years, this has resulted in an influx of doctors into Texas, lower malpractice insurance premiums, a decrease in defensive medicine, and an across-the-board decrease in medical expenses.

We can lower the cost of health care instantly by making health costs (including insurance premiums, copays, out of pocket costs, etc.) tax free. That equates to a roughly 30% decrease in the cost of health care in real dollars.

We can increase health insurance portability between states and open up insurance companies to competition. Right now someone living in a state can only buy medical insurance in that state. Some states only have one or two insurance companies. That limits competition and drives up costs. By changing those rules, we increase competition and lower insurance premium costs almost instantly... and can count on better service as well.

We can change the laws to allow for "build-your-own-policy" insurance systems. You pay a basic (very low) amount for catastrophic care, and then buy the additional options you want for yourself and your family. You pay ONLY for what you need, and get only what you want. If you want wellcare visits for your children, but don't want to pay for massage therapy that you're never going to use, you can do that, and end up paying less than for a policy that has "everything" except the option to opt out. That would make at least catastrophic or basic care MUCH MORE ACCESSIBLE to low income families and decrease the number of uninsured.

We can lower taxes in general in order to increase disposable income, and make insurance more affordable to everyone.

We need to look at DEREGULATING the medical industry not increasing the regulations. The largest cost to any hospital, health care provider, etc. after medical malpractice costs is the cost of compliance with government regulations. I spent 3 years working for a large NY State-run hospital in Hospital Administration. I saw the numbers. It was stagering how much a hospital, even a well-run hospital, spends on complaince issues. Ditto for drug companies, and insurance companies. I'm not saying we should have NO regulation, but what we've got now is overkill, and it's hurting the American people. We need to lower those regulatory costs.

We need to DE-UNIONIZE the hospitals. Right now, a union-shop hospital essentially has the same problem that GM and Chrystler had before their banruptcies. Union hospitals pay for THREE WORKFORCES: The one that is currently working, the pensions for the ones that retired in the past 20 years, and the pensions of those who retired MORE than 20 years ago. Plus the union payments they have to make. Plus the cost of redundancy of employment required by union contracts. (Unions force employers to have two employees for some positions where just one employee would be sufficient. That's one of the tricks unions use to keep their annual dues up.) The health care employment costs associated with unions is astronomical, and just as that model could not be sustained by GM and Chrystler, it cannot be sustained by the medical community either. This needs to be reformed.

Since private insurance is cheaper when you have group coverage, let everyone who is collecting unemployment insurance in every state form their own group via the state unemployment office. This group can then find the group coverage that suits them best. Even if they have to pay out of pocket, they'll be paying group rates that are cheaper than trying to pay the individual rate. (Or as an alternative, allow the formation of insurance co-ops NOT RUN BY THE GOVERNMENT, which amounts to essentially the same thing.) This is a VERY viable option for lowering costs, especially in these economic times.

As an ABSOLUTE LAST RESORT, the government could give uninsured citizens a stipend to pay for their health insurance (adjustable based on family size). It could be in the form of a check or in the form of a health care voucher accepted by insurance companies. This stipend would have a time limitation built in so that it doesn't become an "evergreen" welfare program. But it will give families some time to get their feet back under them after a job loss that lasts more than a couple of months by allowing them to purchase the insurance plan of their choice. It is NOT meant to be a permanent benefit and should have a cut-off of, say, 18 months or 2 years. After that, you're on COBRA and pay for your insurance yourself.

You see, there are a lot of options to look at other than government-run health care models. We need to stop looking at France, the UK, Canada, Belgium and any other country for our "model" and build our OWN model based on good, strong, effective free-market principals. We don't need to model ourselves on other countries, and we CERTAINLY don't have to completely change a system that works over 90% of the time for over 90% of the people. The sledgehammer approach to fixing health care (destroy the entire system in order to replace it with a new one) can't work. But we have options that CAN work and have worked in the past when they were allowed to and weren't interfered with from the outside.

I'm not against reforming our health care system, Spitvenom. I'm against THE PROPOSALS COMING FROM THE LEFT, because there are better, more effective reforms available that allow more personal freedom and still lower cost and increase accessibility.

Elliot

[tomder55]

Yup health care is so expensive but ,so is food... how much of a typical family budget goes to food and shelter . Yet no one argues that the tax payer should pay for the food my family eats or to put a roof over my head .

What makes health care the exception ? I don't get it .

Yes ;there are programs in place for those who cannot provide for themselves ,There is no reason for anyone in this country to not have food shelter and health care . The safety nets are in place for those who cannot do for themselves.

Despite the constant drum beating about the number of uninsured ;it is not a true number . Less than 10% of the population are the permanently uninsured . Many of them need to be directed to the programs in place . But if we assume that the system neglects 10% of the population ,it still doesn't justify taking a wrcking ball to the existing system.

That's the way I see it .

Oh ;btw ,did you know that tucked into HR3200 is a provision to provide $10 billion so unionized workers from the zombie auto industry can keep the same gold plated health care benefits that helped destroy the industry in the 1st place .But the cool part is that the gvt. Will assume 80 cents on the dollar of benefits... get that?? We get to use our hard earned money to pay for them keep their top of the line coverage .
Now you know the quid pro quo the Dems promised for labor support .

[ETWolverine]

yup health care is so expensive but ,so is food ....how much of a typical family budget goes to food and shelter . yet no one argues that the tax payer should pay for the food my family eats or to put a roof over my head .

Two words:

FOOD STAMPS

[inthebox]

Here is the only thing I look at. According to the World Health Organization the US is ranked 37. Something needs to be fixed. If France is ranked number 1 then maybe we should check out what they are doing. The link below shows all the rankings.

The World Health Organization's ranking of the world's health systems

The methodologic flaws for the WHO rankings have been exposed.


If you really want specific MEDICAL evaluation of care try this [ it may help your insomnia ]


The Quality of Cancer Care: Does the Literature Support the Rhetoric? by Bruce E. Hillner and Thomas J. Smith - Institute of Medicine


Page 26

In contrast,
The British have focused on system factors associated with their national health system that show
Disturbing variation and have been the impetus for a national reorganization of cancer care.

Page 27-28

An important recent report from Canada addressed care between 1983-1990 at five Edmonton
Hospitals of 683 patients treated by 52 surgeons for rectal cancer. 89 Five surgeons had specific
Fellowship training in colorectal surgery. After adjusting for known clinical factors, the
Multivariate analysis showed that local recurrence and disease specific survival were both
Adversely affected by being cared for my a non-specialty trained surgeon or low-volume surgeon
Page 27 of 80
(less than an 3 cases per year on average). Local recurrence is an especially strong indicator of
Surgical technique and a much more disastrous (essentially untreatable) event than local
Recurrence in breast cancer. The hazard rates for local recurrence were 2.5 and disease free
Survival of 1.4-1.5 if not specialty trained or a low-volume surgeon.

Only 5 of 52 Canadian surgeons had enough cases and training in surgery for cancer and this leads to worse outcomes.


And if you think the IOM is some right wing organization funded by the health insurance industry


Saving 100,000 lives | Health Care > Health Care Facilities from AllBusiness.com




G&P

[tomder55]

Two words:

FOOD STAMPS

Yup that is part of the safety net I described . Still the argument being forwarded by those who want universal coverage is the equivalent that everyone in the country is entitled to those food stamps.

[inthebox]

IF the public option or co-op or whatever name they tag to government / non- private health insurance gets passed: I predict that
1] private health insurance will still survive and maybe flourish
2] the inequities in healthcare will widen between those on public vs private insurance.

Why?


The privates will "cherry pick" the most healthy, and or the wealthiest [ those that can afford private insurance and pay taxes to the public system at the same time ]. If congress does not stop them from doing it.

The less wealthy will make the calculation to save by being on the public system. The very sick and those with chronic illnesses will also decide this way. The public system will be overwhelmed by new enrollees, less doctors [ there already is shortages and many already do not accept medicaid and or medicare ], and increases usage [ that comes when nothing or relatively little comes out of pocket when using a service ], This will lead to rationing and longer and longer wait lines. Then those that can, will pay for private insurance to alleviate the shortcomings in the public system.
HOw do I know this? People already pay for supplemental insurance even though they are on medicare. Veterans that can, have private insurance. Some go to VA only for meds or to "stay in the system."






G&P

[paraclete]

At least doctors take oaths to do no harm.

Great pity they don't extend that to the purse of their patients

[paraclete]

IF the public option or co-op or whatever name they tag to government / non- private health insurance gets passed: I predict that
1] private health insurance will still survive and maybe flourish
2] the inequities in healthcare will widen between those on public vs private insurance.

why?


The privates will "cherry pick" the most healthy, and or the wealthiest [ those that can afford private insurance and pay taxes to the public system at the same time ]. If congress does not stop them from doing it.

The less wealthy will make the calculation to save by being on the public system. The very sick and those with chronic illnesses will also decide this way. The public system will be overwhelmed by new enrollees, less doctors [ there already is shortages and many already do not accept medicaid and or medicare ], and increases usage [ that comes when nothing or relatively little comes out of pocket when using a service ], This will lead to rationing and longer and longer wait lines. Then those that can, will pay for private insurance to alleviate the shortcomings in the public system.
HOw do I know this? People already pay for supplemental insurance even though they are on medicare. Veterans that can, have private insurance. Some go to VA only for meds or to "stay in the system."

G&P

Great pity you are so cynical. I live under a dual system and it is not the end of the Earth. I remember 30 years ago when The government took over health care. It was to be the end of the world as we know it. But the funds still survive and everyone can afford medical care. Yes the funds are smaller than perhaps they once were but everyone makes a contribution in some form unless they are unemployed. The cost of insurance isn't thousands of dollars a year.The funds in a dual system can't afford to be too selective if they want to stay in business, in fact competition has sharpened their game. The way it works is this, you need a elective surgery right away and you are insured you go to a private hospital, There is no haggling about the standard of care or what procedure you need, if you need emergency you go to emergency and if you can't afford insurance and you need elective surgery you wait for a bed in a public hospital, otherwise you see you local doctor and the cost is covered. Now what is wrong with something like that where you are. Could this system be better, of course it could, the hospital system is a little streached but there is no excuse for not getting medical care

[inthebox]

Great pity you are so cynical. I live under a dual system and it is not the end of the Earth. I remember 30 years ago when The government took over health care. It was to be the end of the world as we know it. But the funds still survive and everyone can afford medical care. Yes the funds are smaller than perhaps they once were but everyone makes a contribution in some form unless they are unemployed. The cost of insurance isn't thousands of dollars a year.The funds in a dual system can't afford to be too selective if they want to stay in business, in fact competition has sharpened their game. The way it works is this, you need a elective surgery right away and you are insured you go to a private hospital, There is no haggling about the standard of care or what procedure you need, if you need emergency you go to emergency and if you can't afford insurance and you need elective surgery you wait for a bed in a public hospital, otherwise you see you local doctor and the cost is covered. Now what is wrong with something like that where you are. Could this system be better, of course it could, the hospital system is a little streached but there is no excuse for not getting medical care

I'm glad it works down there.

Obama has changed his language to portray private health insurance as the bad guys, when they are not always that. His plan may have the ironic unintended effect of making the private health insurance industry wealthier.

I don't know if a dual system would be acceptable to the liberals here in the US. They cannot get beyond playing the class envy card to actually accept that to some degree you can buy yourself better care, Michael Jackson notwithstanding.

I'm not being cynical, but realistic, because a good percentage of people on Medicare or the VA system do feel the need to have private insurance.

In addition, Australia has a smaller population, and probably less ethinic diversity, so accurate direct comparisons would be difficult to make.





G&P