The US has the best health care in the world?

[Al68]

Ah... so as Huck and I both have said now, you are just using the word "theft" to make your argument seem self evident.

No, I used the word theft to make clear that that was why I opposed universal health care, not for the variety of other nonsensical reasons normally attributed to detractors. Have we become so government dependent that we can't even conceive of a word like theft to have any meaning independent of government policy?

The reason I, and many others, oppose "universal health care" is because we think it's wrong to steal. We think it's wrong to steal even if the majority approve and it's legal. That's the reason, plain and simple. Everyone knows what the words theft and steal mean in this context, despite the pretense to the contrary.

Is there another word I could use instead to convey the same meaning?

 

[Huckleberry]

Did you really think that I was claiming that "legalized theft" was "illegal theft"?

No, I didn't think that. I was using it as a counterpoint to isolate the source of the argument as your personal opinion.

Is there another word I could use instead to convey the same meaning?

We aren't disagreeing on the meaning of theft. We are disagreeing on what is morally correct, and whether the word applies at all.

Have we become so government dependent that we can't even conceive of a word like theft to have any meaning independent of government policy?

The problem isn't conception of the use of a word, but agreement on if the word is applicable. Democratic government policy is the best we can do to agree. The policy becomes the reality that we live by.

Your logic is good. If one accepts your premise then you are right that these taxes are theft. I understand why you believe that. Someone starting from a different premise will arrive at a different conclusion that is just as valid to them as yours is to you. Not everyone considers universal health care as theft. Can you understand that? If you can then our argument is back to where it began, which seems like a good place to conclude it. There will be no resolution to a moral argument.

 

[j93]

What is the point of arguing if one side starts from the premise that taxes are inherently theft, before arguing if a certain program is a good use of tax revenue everyone should agree in that in the idea of taxes.

 

[D H]

Many people do not think that this particular program is a good use of tax revenue.

This whole theft thing is a side-issue that obscures the main questions, to wit

1. Is health care a problem? Ivan started this thread with a reference to a WHO study that others have pointed out was deeply flawed.
2. If it is a problem, is it one that government has any business solving? Our government was founded on the two potentially conflicting principles: inalienable rights and limited government interference. Is health care an inalienable right? If not, what is the rationale for this government takeover?
3. If a government takeover is appropriate, will doing that solve the problem? Are there approaches that are more in line with our basic principles that could solve the problem?

 

[drankin]

Many people do not think that this particular program is a good use of tax revenue.

This whole theft thing is a side-issue that obscures the main questions, to wit

1. Is health care a problem? Ivan started this thread with a reference to a WHO study that others have pointed out was deeply flawed.
   
   
2. If it is a problem, is it one that government has any business solving? Our government was founded on the two potentially conflicting principles: inalienable rights and limited government interference. Is health care an inalienable right? If not, what is the rationale for this government takeover?
   
   
3. If a government takeover is appropriate, will doing that solve the problem? Are there approaches that are more in line with our basic principles that could solve the problem?

Excellent summary. Ultimately, we will be taxing the working class to provide health care to those who do not work. Those of us who currently do work but do not have insurance pay for our health care directly. It has been this way long before health insurance was ever created. Health insurance is not a right.

In the end, the government will be the ones denying or delaying health care as well as creating an immense and expensive bureaucracy to disperse it.

 

[j93]

Excellent summary. Ultimately, we will be taxing the working class to provide health care to those who do not work.

If this is true this is a problem with the taxing structure not the program which means that argument is off-topic because it is based on a totally different problem.

Those of us who currently do work but do not have insurance pay for our health care directly.

This is obviously false unless you define working as having health insurance and employment.

 

[TheStatutoryApe]

Is health care an inalienable right?

I believe the idea that all people should benefit from the aid of medicine has been at the core of medical ethics for a couple thousand years now. Arguably any civilized society ought to take measures to insure this whether or not you title it an "inalienable right".

Excellent summary. Ultimately, we will be taxing the working class to provide health care to those who do not work. Those of us who currently do work but do not have insurance pay for our health care directly. It has been this way long before health insurance was ever created. Health insurance is not a right.

In the end, the government will be the ones denying or delaying health care as well as creating an immense and expensive bureaucracy to disperse it.

We already pay for people who do not work to get medical treatment. Often this comes in the form of expensive emergency room visits for people who should have gotten medical attention earlier (for cheaper) but could not afford it. The people who are getting screwed currently are the one who have jobs and make enough money to not be elegible for free medical treatment but do not make enough to afford health insurance. The idea that denying universal health care would protect the working class from having to pay for lazy non-working bums seems inaccurate.

 

[Al68]

No, I didn't think that. I was using it as a counterpoint to isolate the source of the argument as your personal opinion. We aren't disagreeing on the meaning of theft. We are disagreeing on what is morally correct, and whether the word applies at all. The problem isn't conception of the use of a word, but agreement on if the word is applicable. Democratic government policy is the best we can do to agree. The policy becomes the reality that we live by.

Your logic is good. If one accepts your premise then you are right that these taxes are theft. I understand why you believe that. Someone starting from a different premise will arrive at a different conclusion that is just as valid to them as yours is to you. Not everyone considers universal health care as theft. Can you understand that? If you can then our argument is back to where it began, which seems like a good place to conclude it. There will be no resolution to a moral argument.

I agree with all of this. Maybe I misunderstood something you said along the way.

 

[Al68]

Our government was founded on the two potentially conflicting principles: inalienable rights and limited government interference. Is health care an inalienable right?

I think the word "entitlement" might fit better for health care, since at the time our nation was founded, the words right and entitlement were not used interchangeably. The word right refers to liberties while the word entitlement refers to something provided by other people, and was not a founding principle. The potential conflict is between limited government interference and "entitlements", not inalienable rights.

 

[mheslep]

I believe the idea that all people should benefit from the aid of medicine has been at the core of medical ethics for a couple thousand years now. Arguably any civilized society ought to take measures to insure this whether or not you title it an "inalienable right"...

I agree with the initial premise there - 'should', 'benefit', traditional practice - as this is the language responsibility. You lose me though in the indifference to labelling health care a right, since a right is a radically different thing from responsibility, most importantly in who owns which.

A 'right', at least in the sense the US Constitution uses it, is that which can not be taken from any citizen in good standing, not taken by anyone, and especially not taken by the government. In that sense, calling a health care a right wrecks the chances for rationale approach to the health care problem before it begins. That discussion begins, reasonably, with matters of efficiency, quality, distribution, cost, i.e. economics - all of which are completely antithetical to the idea rights. There is no resource scarcity applicability to free speech rights, or to the right to be free from illegal search and seizure. So we end up with a schizophrenic debate. Moreover, since I agree I have a responsibility to help my neighbour, having the recipient call that help a right - something I must provide to him without infringement - poisons the well.

 

[mheslep]

Thanks for grabbing the wheel and placing us back between the lines. My take below, perhaps redundant:

Many people do not think that this particular program is a good use of tax revenue.

This whole theft thing is a side-issue that obscures the main questions, to wit

1. Is health care a problem? Ivan started this thread with a reference to a WHO study that others have pointed out was deeply flawed.

1. 
   Quality of medicine for those who have access to it is not a problem. Cost (9-10% increase a year), and access (10-20million who really can't get it) are the US problems.
   
   

   [*]If it is a problem, is it one that government has any business solving?

   Very good question. Informed govt. plan advocates will concede that though we don't have free market heath care, http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/" with health care because a) illness can't be planned, b) when catastrophic illness does occur almost nobody has the means to pay for it, and therefore c) the system requires insurers (third parties). To the extent the 3rd party is involved the buyer and the provider are separated there is no market, they would say, and bad things like adverse selection and moral hazard happen. There are some valid points in these arguments, though there are institutions (e.g. coops) that have evolved to counter these problems. But here's what those advocates miss: they don't provide a good argument that government solves these problems.
   

   [*]If a government takeover is appropriate, will doing that solve the problem?

   I believe the evidence is overwhelming that it will not. Edit: That is, it will not provide the same quality care for lower cost. Typically, single payer forces costs down and limits care (rationing: fewer specialists, less new equipment investment, wait lists, etc)
   

   Are there approaches that are more in line with our basic principles that could solve the problem?

   I believe so. The McCain plan during the campaign was a good articulation, and now Wyden Bennett has some good ideas.

 

[TheStatutoryApe]

I agree with the initial premise there - 'should', 'benefit', traditional practice - as this is the language responsibility. You lose me though in the indifference to labelling health care a right, since a right is a radically different thing from responsibility, most importantly in who owns which.

I was not intimating that health care may, or ought to be, labelled a right but responding to the post referencing a responsibility, or limititation, on the part of the government only to protect rights.

 

[mheslep]

I was not intimating that health care may, or ought to be, labelled a right but responding to the post referencing a responsibility, or limitation, on the part of the government only to protect rights.

Ok I suspect we're not far apart, though I wouldn't have used protect for the case of the federal government. In its charter, the language concerning rights is entirely about restricting how government may act. Its all about No. The Congress shall pass No law. As in, No, no, no, no, govt. shall not. The only original protection responsibility of the federal government was foreign defense. Since the 14th amendment that roll was extended to restriction of actions of state governments.

I indulged in a couple of sentences there to build the case that if government is used to provide healthcare, it should not do so on the grounds that it is protecting its citizens. That's is not its primary role (Federal).

 

[Count Iblis]

http://news.bbc.co.uk/2/hi/americas/7420744.stm"

 

[Evo]

http://news.bbc.co.uk/2/hi/americas/7420744.stm"

No one is contesting the fact that the US has very remote, poor areas that have little in the way of medical facilities. But this is a miniscule drop in the bucket of people in the country. What, in all of these areas around the country we're talking about a few thousand people, out of a population of over 303 million?

 

[turbo]

Bill Moyers did a very interesting interview with Wendell Potter, who was once the top PR man at Cigna, regarding the tactics of the health insurance companies and the way that they will scuttle health-care reform. About 1/2 way through, Potter points out that of every dollar spent on Medicare, 3% goes to administrative costs and overhead, vs 20% on administrative costs and overhead for private insurers. He also explains how insurance companies deny claims, drop patients, and get rid of whole employer programs if someone in such a program gets a catastrophic illness, to keep the "medical loss ratio" at 80% or less. I have seen this stuff play out for years as a network administrator/programmer/IT guy in a large medical practice, but some folks here seem to pooh-pooh that experience. Here it is from a guy who was Cigna's top communications officer - please watch this. If you think that a public health insurance option is a horrible idea, then PLEASE watch this.

http://www.pbs.org/moyers/journal/07102009/watch2.html

To address the OP: The US has the capability of providing the best health care in the world, but only if you can get access to it, and there are about 50 million people who have no insurance, and many more that have plans that cover so little that their "coverage" is a joke. The two most profitable surgeons in our ophthalmic practice were the retinal surgeons because retinal procedures are tricky and $$$$. The two surgeons with the most expensive deferred or denied reimbursements were those same two surgeons. When someone had a retinal detachment, they operated (invasively, with lasers, a combination, etc) to try to save the person's vision. If the patient was uninsured or their insurance company dropped them or denied the claim, the practice had to eat those losses.

 

[j93]

Im slightly confused it seems like the thought seems to be that the level of medical care that those without insurance receive or in some cases do not receive is good enough yet at the same time people believe they would die if their was a government program ala medicare.

 

[mheslep]

http://news.bbc.co.uk/2/hi/americas/7420744.stm"

Closing:

...He has heard his old country has a shortage of NHS dentists.

"I am sure we'll get just as large a crowd as we're getting here in the US," he says

.

 

[mheslep]

The 3% overhead Medicare numbers are bogus, as has been shown in this thread. They are propaganda that the Medicare staff like to encourage.

Yes, private insurance has some lousy service and denials, therefore the public option must be good? C'mon. Let's first nationalize all the paper mills and see how that works out. Or all the lawyers. Heck, effective legal representation is something the constitution actually does give us a right to.

I still have hopes that the '50 million' figure will vanish from the discussion: For the illegals and Medicaid eligibles included in that number, no public plan on the table is going to cover them any better than they are now.

 

[turbo]

Did you watch the interview, mheslep? Potter is credible, detailed and an insurance insider.

BTW, nay-saying Medicare's 3% overhead does not equate to proving the number wrong. Michelle Bachman is railing against a public health-care plan because she claims that it would be 30-40% cheaper than private plans. She's probably right, but that is no reason to reject a public plan, unless you are a sadist.

 

[mheslep]

...

http://www.pbs.org/moyers/journal/07102009/watch2.html

For the Wise, WVa clip, how many people there all already eligible for the government Medicaid plan now? Why isn't that working now? Don't people understand that the government pays half of all health dollars, now?

 

[mheslep]

On Michael Moore's Sicko clip from Moyers: "I thought he hit the nail on the head". Good grief.

Here's another video on Canadian health care:
http://pajamasmedia.com/blog/pjtvs-hidden-camera-team-exposes-canadas-socialized-health-care/

 

[turbo]

Working people in low-paying jobs generally don't qualify for Medicaid, but they can't afford private insurance, either. Those are likely the people that drove from several states away to attend the Wise event. This is not a black-and-white issue. There are lots of people who can't get any coverage, and there are lots of people who are dropped like hot potatoes when they get sick. If my wife lost her job, I wouldn't qualify for any private health insurance due to some pre-existing conditions. As Potter said, it's easy to talk about number of policies and claims until you realize that they are people - men, women, and children who are being denied health care.

 

[Al68]

Michelle Bachman is railing against a public health-care plan because she claims that it would be 30-40% cheaper than private plans. She's probably right, but that is no reason to reject a public plan, unless you are a sadist.

That's a gross misrepresentation of what she said. She never said the total cost would be less. She said that since 30-40% of the public plan insurance premiums would be subsidized by taxpayers, an individual would pay 30-40% less for coverage (after subsidization) by switching from their employer's plan to the public plan.

The reason they would save 30-40% is not because the public plan actually costs less than the private plan, but because they would be forced to help pay (by taxes) 30-40% of the public plan whether they switched or not.

 

[mheslep]

Did you watch the interview, mheslep?

Yes, the entire thing.

Potter is credible,

On the insurance industry maybe, and in particular about health lobbying as PR was his job, but not on much else in my opinion.

detailed

On our public proposals, or on, say, Canada's plan, or on people in need in Wise, WVA, he provides absolutely none, not a word of detail. Instead he spews slogan's like "oh yeah, I think he hit the nail on the head".

and an insurance insider.

Yes. Another a guilt ridden rich guy. Yes the private insurance system is a broken, rigged game. It was the government that set it up that way post WWII and in the 70s. The only thing worse would be a broken, rigged, government plan.

BTW, nay-saying Medicare's 3% overhead does not equate to proving the number wrong.

I did not just simply nay say it, I provided references earlier, and I'm tired. The 3% numbers just reflect Medicare's internal, government employee costs. Medicare hires additional -guess who- private insurer help to administer those claims, and they do not include those costs in the 3%. Furthermore, Medicare is rife with fraud, up to $60B / year as reported by the US Attorney General, because in part they don't employ nearly enough staff to vet claims properly, and they don't want to do so. It is far better politically for the Medicare program to suffer losses blamed on random outside crooks than to risk having an adequate staff that properly vets claims, and then having rejected nose job complaints go back up the political ladder with a name on each end. Run a whole country that way and we'll break it.

 

[turbo]

On Michael Moore's Sicko clip from Moyers: "I thought he hit the nail on the head". Good grief.

Here's another video on Canadian health care:
http://pajamasmedia.com/blog/pjtvs-hidden-camera-team-exposes-canadas-socialized-health-care/

I have friends in Canada, since except for our western border with NH, we are surrounded by Canada, and lots of my family originally came from there. My wife and I are very close to a couple with a large brood of kids in Nova Scotia who are operating a gas-station, convenience-store, auto repair business near Truro and they LOVE the Canadian health-care plan. Same with the family who used to be our closest neighbors, but whose applications for permanent residency were turned down by the US gov't during the Bush administration. She is a medical technician, and he is a well-respected graphic artist. They moved here to get to a more temperate climate (central Ontario is pretty frigid) and they loved Maine. We got to be great friends. Their biggest complaint with the US was the limited access to health-care and the cost of insurance. The guy and his daughter were in good health, but the wife is epileptic, and her medications were very expensive here. The reason they bought a house in our neighborhood is that we were a 5-minute walk from the hospital so she could walk to work, and it was a nice quiet neighborhood on a cul-de-sac where their young daughter could spend lots of time outdoors with her dog, Moon. I hated to see them get refused residency. Both were very nice, hard-working people and their daughter was a joy to have around.

 

[mheslep]

And I love my plan(s), and the doctors, and the hospitals. Has taken good care of my family over multiple trips to the hospital; never had a serious problem w/ a payment. Some 70-80% of Americans say the same thing. I have friends in the UK, they won't touch NHS anymore. Had an American friend living in Belgium for awhile, got seriously ill, got right into see a GP, was told to she'd have to wait many months to get specialist help and she flew home.

 

[wildman]

There was a breakdown of how much each country's government spent on health care on physicsforums a while ago (maybe someone can find that breakdown and point a link to it). That breakdown showed that the US was no where near the bottom of the pile as far as spending on socialized medicine went.

Why do we apparently get so little for our socialized medicine as compared to other countries? Why isn't everyone covered one way or another when we are apparently spending more than enough to cover everyone?

 

[mheslep]

Timelymedical, a Canadian company that arranges for, among other things, Canadians to receive surgery in the US has this list (Canadian public vs Canadian private):

http://www.timelymedical.ca/waitlist-public-versus-private.html
#Wait to see a specialist for initial consultation
* Public: 6 - 12 months
* Private: 10 days

# Wait for diagnostic imaging (excluding X-Rays) after seeing surgeon

* Public: 4 - 8 months
* Private: 24 hours

# Wait for a biopsy (if necessary)

* Public: 2 months
* Private: 4 days

# Wait for pathological analysis of tissue

* Public: 14 days
* Private: 1 - 3 days

# Wait for follow-up visit to surgeon to discuss results of diagnostics

* Public: 1 - 3 months
* Private: 7 days

# Wait for a surgical/hospital date to be set

* Public: 6 - 18 months
* Private: 1 day

# Wait for surgery after date is set

* Public: 6 - 10 months
* Private: 7 days

 

[Evo]

There was a breakdown of how much each country's government spent on health care on physicsforums a while ago (maybe someone can find that breakdown and point a link to it). That breakdown showed that the US was no where near the bottom of the pile as far as spending on socialized medicine went.

Why do we apparently get so little for our socialized medicine as compared to other countries? Why isn't everyone covered one way or another when we are apparently spending more than enough to cover everyone?

Fraud. Incompetance in government run programs.

Supposedly the plan Obama is proposing will be a "no frills" alternative to private insurance. He said that Americans can still use their private insurance for the best care. Or they can buy the government controlled insurance options with lower quality care, maybe that's not fair, in his speech I believe that he used the words "not the most expensive care". He said the care won't be the best, but it will be adequate. I'm just wondering how much this adequate care will cost? Since it is an option and comes at a cost, I'm not quite getting where the poor get it free, but supposedly there is an option for them. I'm still waiting to see the details.

 

[lisab]

Timelymedical, a Canadian company that arranges for, among other things, Canadians to receive surgery in the US has this list (Canadian public vs Canadian private):

http://www.timelymedical.ca/waitlist-public-versus-private.html
#Wait to see a specialist for initial consultation
* Public: 6 - 12 months
* Private: 10 days

# Wait for diagnostic imaging (excluding X-Rays) after seeing surgeon

* Public: 4 - 8 months
* Private: 24 hours

# Wait for a biopsy (if necessary)

* Public: 2 months
* Private: 4 days

# Wait for pathological analysis of tissue

* Public: 14 days
* Private: 1 - 3 days

# Wait for follow-up visit to surgeon to discuss results of diagnostics

* Public: 1 - 3 months
* Private: 7 days

# Wait for a surgical/hospital date to be set

* Public: 6 - 18 months
* Private: 1 day

# Wait for surgery after date is set

* Public: 6 - 10 months
* Private: 7 days

Seems that if these wait times are correct, there should be a noticeable difference in life expectancy...but the https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html" that the US system results in longer life.

Obviously it's because so many of my fellow citizens don't have health insurance. Maybe the title of the thread should be, Insured citizens of the US have the best health care in the world (http://www.medscape.com/viewarticle/567737" ).

I wonder if there are any data available that show life expectancy of insured vs. uninsured in the US, to compare to those who live with socialized medicine.

 

[mheslep]

There was a breakdown of how much each country's government spent on health care on physicsforums a while ago (maybe someone can find that breakdown and point a link to it). That breakdown showed that the US was no where near the bottom of the pile as far as spending on socialized medicine went.

http://apps.who.int/whosis/database/core/core_select_process.cfm?countries=all&indicators=nha
US govt heath spending per cap: $2862 (PPP dollars)
US total health spending per cap: $6350 (most expensive in the world by a large margin)

France govt health spending per cap: $2646
France total per cap: $3314

Why do we apparently get so little for our socialized medicine as compared to other countries? Why isn't everyone covered one way or another when we are apparently spending more than enough to cover everyone?

Good question.

 

[Evo]

Seems that if these wait times are correct, there should be a noticeable difference in life expectancy...but the https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html" that the US system results in longer life.

Obviously it's because so many of my fellow citizens don't have health insurance. Maybe the title of the thread should be, Insured citizens of the US have the best health care in the world (http://www.medscape.com/viewarticle/567737" ).

I wonder if there are any data available that show life expectancy of insured vs. uninsured in the US, to compare to those who live with socialized medicine.

My mother uses Medicare (no private insurance) and the "public" Canadian figures seem to mirror her wait times. Of course in the US if you have no insurance and don't qualify for Medicare or Medicaid, you get same day care for all of those things in ER, and it is covered mostly by charities. The Evo Child's ex-bf had no insurance and had a chronic condition that required him to go to the ER every 3 months and then costs were always covered by the hospital's alternative coverage plans.

Socialized medicine in Italy. They killed my ex-fiancee's father. Misdiagnosed him. Then put him on a 6 month waiting list to use 1 of the 2 MRI's in the country and he had to fly from Sicily to Milan, to boot (and this was only after I made him raise hell to get a SCAN, the Italian doctors didn't want to do it). By the time they properly diagnosed him the cancer was too advanced. First they almost killed him by administering the wrong chemotherapy at 20 times the dose. He died 6 months later.

 

[GeorginaS]

Timelymedical, a Canadian company that arranges for, among other things, Canadians to receive surgery in the US has this list (Canadian public vs Canadian private):

You don't think that a company that sells health services to Canadians to go out of country would have any sort of bias in their reporting, now do you?

I could give you a step-by-step account (But anecdotal evidence doesn't count for much, right? Except for the fact that I live here and live with the system.) of the time-line of a good friend of mine being diagnosed with colorectal cancer at the end of May as a result of a colonoscopy to the various further diagnostic tests he had, and radiation treatments performed, and surgery to remove the growth in the second week of July. There's no way a system could have moved any faster or better. And my friends didn't have to mortgage their home to care for him.

But, that's anecdotal from my home last week and the above are stats from a "company".

 

[wildman]

Of course in the US if you have no insurance and don't qualify for Medicare or Medicaid, you get same day care for all of those things in ER, and it is covered mostly by charities.

I thought that the ER costs in the end are mainly picked up by the government and that was one of the reasons of our out of control government health care spending. Or am I mistaken? That is what my wife has told me. Could someone in the health field give us some expert input?