[quote=“TainanCowboy”][color=RED]WHERE DOES THE MONEY TO PAY FOR IT COME FROM?[/color]
…can you say…taxes?..sure you can…:beatnik:
How many people elect a politician to raise your taxes?[/quote]
Canadians have universal health care coverage. We have superior care overall to Americans. But our per capita federal spending on health care is lower than in the U.S., where spending is limited to those over 65 and certain other programs. Why is this? It’s kind of a mystery to me.
Keeping people healthy is cost-effective. Forcing those with lower incomes to either avoid going to the doctor and thereby ending up sick, or paying exorbitant amounts which they cannot afford for health care thereby pushing them into ruinous debt, is not only ethically intolerable, but is just plain stupid. Most of the world figured this out in the 20th century. It still astounds me that the U.S. is the only first world country that fails to provide health care to it citizens.
Only citizens or landed immigrants get healthcare. Others, such as travellers or people in the country illegally, do not. End of story. What’s the problem?
Only the richest of the rich in the U.S. get instant access to any surgery as it stands now. The bureaucratic labyrinth that your average American is faced with for surgery (does my “HMO” cover this or that surgeon or hospital? Availability is when? How am I transported here or there? Which therapy is covered, and where?) sounds positively frightening to me.
porcelainprincess -
You really appear to have scant to no knowledge of the “health care” system in the USA.
I do not mean to launch into a personal diatribe against you, as it seems that a few other Canadians on this board labor under the same misconceptions and willingness to promote this fallacies as facts.
Anyone who needs some type of “immediate” or “emergency” surgical procedure needs do no more than present them self to an emergency room. Thats it.
Paperwork - of course there is. This goes on during and after the medical procedure. The medical procedure is not, by law cannot be delayed, due to the “paperwork.”
“Only citizens or landed immigrants get healthcare. Others, such as travellers or people in the country illegally, do not. End of story. What’s the problem?” Whats the problem? The problem is that this stated is pure absolute poppycock. Or in Americanese, its Bll Sht. Again, this reflects poorly on your knowledge in this area. (I lived for 13 years in southern California, you’re wrong)
The USA does provide “health care” to all of its citizens. All they have to do is go to the clinics and see the Dr. Medicare, Medicade and a host of other State, Federal and local programs see to this service being available.
" We have superior care overall to Americans. But our per capita federal spending on health care is lower than in the U.S., where spending is limited to those over 65 and certain other programs" Oh my oh my…
That superior health care is certainly news to the thousands, if not 10s of thousands Canadians who flock south to see American Doctors rather than die while waiting for the “Superior Canadian Health Care” to give medical service. As to the 2nd part about “…limited to those over 65…” more BS. But you did leave an out by including “…and certain other programs” in your spiel. Yeah, its those “certain other programs” that make all the difference.
I have no problem with those who say that the US Health Care system could be made better. Of course there is always room for improvement in services in such a vital areas as this. But to come to the table with stuff like this does your side no good. Get some facts and present those, then a respectful discussion can proceed. Just repeating fallacies, hear-say and half-truths doesn’t work.
TainanCowboy, surely you’re taking the piss with your impersonation of the Ugly American?! I mean, c’mon, I know you’re on the far right, but this is too much!
[quote=“TainanCowboy”]porcelainprincess -
You really appear to have scant to no knowledge of the “health care” system in the USA.[/quote]
Sorry for being Canadian. Erm, am I supposed to know all of the ins and outs of the system in the USA?
[quote=“TainanCowboy”]I do not mean to launch into a personal diatribe against you, as it seems that a few other Canadians on this board labor under the same misconceptions and willingness to promote this fallacies as facts.
Anyone who needs some type of “immediate” or “emergency” surgical procedure needs do no more than present them self to an emergency room. Thats it.[/quote]
Same thing in Canada. Where did I say anything different?
What do you mean “of course there is?” Where else in the civilized world do you have to go through as much bureacracy as in the United States for your healthcare? C’mon! Fill out these ten forms, then choose your “HMO-approved” doctor for this or that, but you can only receive this approved treatment in St. Louis (unfortunately, you live 250 kms away) from this particular doctor who’s happens to be on vacation until next Tuesday…but of course, if you have $5,000 in ready cash for the procedure then you can get it done tomorrow. That’s American healthcare.
Whats the problem? The problem is that this stated is pure absolute poppycock. Or in Americanese, its Bll Sht. Again, this reflects poorly on your knowledge in this area. (I lived for 13 years in southern California, you’re wrong)[/quote]
Again, what’s with this assumption that I should have such incredible knowledge about the US medical system? I was talking about Canada, and I was talking about the way it should be for you in California (in response to Jeff), fer crissakes. Obviously. If you’re a citizen or a landed immigrant you can walk into any doctor’s office and produce your health card to receive treatment. If you go to Emergency, they don’t turn you back, even if you’re a Martian. This is how it is in Canada. This is the most logical and reasonable setup there is. If this isn’t the way it is in California, or wherever in the U.S., then too bad for the people there, and hopefully you’ll catch up to where the rest of the first world left off in the 20th century.
Oh, so everything’s hunky dory in the USA in terms of healthcare? Well, what’s all the hubbub about then?
That superior health care is certainly news to the thousands, if not 10s of thousands Canadians who flock south to see American Doctors rather than die while waiting for the “Superior Canadian Health Care” to give medical service. As to the 2nd part about “…limited to those over 65…” more BS. But you did leave an out by including “…and certain other programs” in your spiel. Yeah, its those “certain other programs” that make all the difference.[/quote]
Funny, I’m living in Canada right now, and while there are certainly improvements to be made to our system, I’m wondering just who these “thousands if not 10s of thousands” of Canadians are who are flocking to the U.S. at risk of death!! That’s gotta be lifted directly from one of those rightwing nutbar radio dipshits like Rush Limbaugh or something. People with money certainly do go south to get certain treatments right away instead of waiting for two months. Just as Americans with money get certain treatments right away instead of waiting for two months. In fact, exactly in the same way. And never mind the 50 million freakin’ Americans (Canada’s population: 35 million) who can’t freakin’ afford to have that freakin’ surgery.
There certainly are procedures done in the USA that are very advanced, probably the most advanced in the world. And do 300 million Americans have access to them? Erm, no. Rather, you have the highest infant mortality rate in the first world. In that light, keeping a 68-year-old multimillionaire alive for an extra few weeks due to some spectacular procedure instead of keeping more infants alive in lower-income neighbourhoods seems kinda dumb.
porcelainprincess -
Sorry, I’m not going to lower myself to the taunts and baits you feel necessary to make your points.
[quote]Medi-Cal funds 100,000 illegal births This story appeared in the Antelope Valley Press on Saturday, January 13, 2007.
The intractable problems caused by illegal immigration consist of many facets.
California taxpayers are hit hard, giving up a substantial part of their earnings to fund government programs that provide services to undocumented people who brazenly cross the borders into our tarnished Golden State.
The state Medi-Cal program is now paying for the delivery of about 100,000 children born to illegal immigrants each year.
Such births and related expenses account for more than $400 million of the nearly $1 billion Medi-Cal spends annually on health care for undocumented people, covering everything from pregnancy tests to postpartum checkups.
The fact that children born here have a U.S. citizenship “birthright” angers anti-illegal immigration groups.
They say such largesse provides an incentive for illegals to invade our state.
In Los Angeles County’s public and private hospitals, undocumented women accounted for 41,240 Medi-Cal births in 2004. That accounting came to about half the deliveries covered by the public program.
In the four county-run hospitals alone, undocumented women and their newborns will receive more than $20 million in delivery, recovery, nursery and neonatal intensive care unit services this year.
Prenatal care is one of the most controversial aspects of providing health care to illegal immigrants.
While labor and delivery long have been considered emergencies and presumably are entitled to some federal reimbursement, federal officials often have balked at covering prenatal care.
Generally, the state and federal governments share the cost of Medicaid programs, called Medi-Cal in this state.
Those who support such coverage say it’s cheaper to pay for prenatal care than risk complications that could cost the government immense medical bills.
Illegal immigration is one of the loudest discussion topics among radio talk-show hosts, government officials and millions and millions of U.S. citizens, many of whom entered the country legally and gained their citizenship through lawful channels.
Despite all the continuing outraged conversations, virtually nothing is being done to stem this tide of newcomers sneaking into the United States and raiding our coffers with impunity. avpress.com/n/13/0113_s12.hts[/quote]
Just one example of what California faces everyday. And who pays for this? The taxpayers.
Wherever you are in Canada, how would your health network respond to the financial strain of paying for 100,000 illegal births in a single year?
And this is only 1 state here. Its happening all over the USA.
Screw that other thread you started MTK, this is where the action/honesty is.
Let me restate my challenge: How do you justify a free market in health care? It’s just too obvious that there are significant collective benefits to be gained from a range of health services being provided by the government. There’s an important debate to be had about where the cut-off line occurs, but frankly I’m not interested in having this dialogue if you (or your conservative comrades) don’t accept apriori that the public sector has a fundamental role to play in health provision. The way I look at it, if you deny the basic necessity of public health care, then the onus is you to explain why the alternative is preferable. So tell me, why would you adopt a free market in health services if you didn’t have to? It seems like utter lunacy. Enlighten me.
EDIT: on second reading, this post comes across as narky. Sorry. The truth is, however, I’d like a straight answer. One that doesn’t start off with a critique of government (heath provision) - I know that story already.
[quote=“TainanCowboy”]porcelainprincess -
You really appear to have scant to no knowledge of the “health care” system in the USA.[/quote]
Dear TC,
This isn’t a personal attack, but really, you seem to have little knowledge of the current US health care system, or else your political blinders don’t allow you to see it. I recently returned to the USA after living in Taiwan for 22 years, so I have some good recent perspective on this. Without a doubt, I much preferred Taiwan’s National Health Insurance.
The US health care system is so bad that I’m considering moving to the Mexican border so that I can go south anytime I need to see a doctor. I actually know quite a few Americans who make an annual trip to Mexico to see doctors and dentists and buy medications. Quite a few people go to Canada too, at least to buy medications, which are about 1/5 the price north of the border.
Apparently, you have (or had) health insurance when you lived in the USA. I do not have health insurance, nor can I buy it, because I have a “pre-existing condition.” Sure, I could buy health insurance for maybe US$2000/month, which I can’t afford, and then they still wouldn’t cover my existing health problems anyway since that would be excluded. But let’s get to some of your other “facts”…
Sure you can present yourself at any emergency room, and by law they cannot turn anybody away. You will also be sent a bill that would bankrupt the average worker without health insurance. Thanks to the new bankruptcy law that Bush and his Republican co-conspirators pushed through last year, declaring bankruptcy doesn’t get you out of paying your medical bills, regardless of your inability to pay. Of course, you can do what illegal aliens do - present a fake ID, and disappear to avoid paying. This happens quite a lot, and that’s why many hospitals are closing their emergency rooms. Those that still have emergency rooms practice a kind of triage, where those who have insurance jump the queue and get admitted, while those who don’t spend six hours waiting before they get minimal attention and sent home.
[quote=“TainanCowboy”]
2. Paperwork - of course there is. This goes on during and after the medical procedure. The medical procedure is not, by law cannot be delayed, due to the “paperwork.”[/quote]
No real argument there. But I can say that with Taiwan’s National Health Insurance, I can’t recall ever filling out any paperwork beyond applying for the NIH card, which was very simple. Once you’ve got the card, all you’ve go to do is present it whenever you show up at a hospital or doctor’s office - no forms to fill out.
[quote=“TainanCowboy”]
4. The USA does provide “health care” to all of its citizens. All they have to do is go to the clinics and see the Dr. Medicare, Medicade and a host of other State, Federal and local programs see to this service being available.[/quote]
What utter nonsense. Ever tried applying for Medicare or Medicade? I’d love to get it. I’d even be willing to pay a monthly premium to get it. No such luck. Indeed, I personally know a number of people who are walking around with serious illnesses that require surgery, and they’ve been desperately applying for all sorts of government assistance, and told politely to “get lost.” If you believe what you just said above, you are dreaming.
I’ll make a suggestion to you TC. Go to this web site:
It’s a forum like Forumosa, for people with various health problems. I post there pretty often. Although it’s an international forum, the vast majority of the posters are Americans. You should read all the posts by people with serious illnesses who can’t get treatment because they don’t have insurance, or they have insurance but the insurance company refuses to pay, or they’ve been dropped by the insurance company, etc. They apply for Medicare, Medicade, etc, and get rejected. Some of them talk about committing suicide.
[quote=“TainanCowboy”]
5. “We have superior care overall to Americans. But our per capita federal spending on health care is lower than in the U.S., where spending is limited to those over 65 and certain other programs” Oh my oh my…
That superior health care is certainly news to the thousands, if not 10s of thousands Canadians who flock south to see American Doctors rather than die while waiting for the “Superior Canadian Health Care” to give medical service. As to the 2nd part about “…limited to those over 65…” more BS. But you did leave an out by including “…and certain other programs” in your spiel. Yeah, its those “certain other programs” that make all the difference.[/quote]
I don’t know much about the Canadian health care system, so I don’t want to comment. However, I also suspect, TC, that you don’t know much it either. I could be wrong, but I have the nagging feeling that you’re just reflexively repeating the propaganda spewed by the Washington Times, National Review, Rush Limbaugh, and other right-wing mouthpieces for the US insurance industry.
[quote=“TainanCowboy”]
I have no problem with those who say that the US Health Care system could be made better. Of course there is always room for improvement in services in such a vital areas as this. But to come to the table with stuff like this does your side no good. Get some facts and present those, then a respectful discussion can proceed. Just repeating fallacies, hear-say and half-truths doesn’t work.[/quote]
Good advice TC. And may I suggest that you do the same.
[quote=“TainanCowboy”]
4. The USA does provide “health care” to all of its citizens. All they have to do is go to the clinics and see the Dr. Medicare, Medicade and a host of other State, Federal and local programs see to this service being available.[/quote]
Yes, as long as someone with a family of four makes total household income of under $1100 USD or so per month. Anyone who makes slightly more may qualify for subsidized health care, but the paperwork you’d have to go through just to prove it is overwhelming. Trust me. And for the rest who make too much to be subsidized, but too little to be able to pay out of their pockets, you are, as the British are wont to say, royally fucked.
Of course, this only applies, in many states, if you are a parent of a child under the age of 16 or are over the age of 65 or have a medical disability. Otherwise, again, royal fuckation.
Perhaps you are the one in need of a primer in American health care systems, TC…
[quote=“TainanCowboy”]Wherever you are in Canada, how would your health network respond to the financial strain of paying for 100,000 illegal births in a single year?
And this is only 1 state here. Its happening all over the USA.[/quote]Curious, is this another example of the Christian ethic of charity in the modern American state?
[quote=“Jaboney”][quote=“TainanCowboy”]Wherever you are in Canada, how would your health network respond to the financial strain of paying for 100,000 illegal births in a single year?
And this is only 1 state here. Its happening all over the USA.[/quote]Curious, is this another example of the Christian ethic of charity in the modern American state?[/quote]
I suppose you could say that, as that’s essentially what’s already happening in California. I believe that officially including undocumented aliens in the UHC will make matters worse.
In my earlier reply to TC, I sited the form healingwell.com and all the posts from desperate people in the USA who couldn’t afford health insurance. But I failed to point to any specific posts, so I thought I should include one. Here’s an example just from today:
Posted by aimee27: HELP i cant get any insurance because i have cd, depression, and migrains. My local social servies has my sare of cost for my medi-cal at $1928.00 how that is possable i dont know but there seams to be no help for my because they say i make too much money. (FUNNY TO ME) im lost and dont know what to do please someone help
Further down the same page:
i work at a gas station parttime and and my husband drives a fule truck but the insurance with our jobs would cost us 600.00\month that is just insane and we live in a town that has 3000 people not much work around here you kind of take what you can get. We have a clinic but its no good and dont help my dr is 100 miles away i get my deprssion meds through a program but cant get my pentasa im just so stuck in a hole
[quote]That’s gotta be lifted directly from one of those rightwing nutbar radio dipshits like Rush Limbaugh or something.[/quote]This man certainly does inspire fear in a lot of a certain type of people…lol.
[quote]In that light, keeping a 68-year-old multimillionaire alive for an extra few weeks due to some spectacular procedure instead of keeping more infants alive in lower-income neighbourhoods seems kinda dumb.[/quote]WTF?[quote]I recently returned to the USA after living in Taiwan for 22 years, so I have some good recent perspective on this. Without a doubt, I much preferred Taiwan’s National Health Insurance.[/quote]Perfectly understandable. Taiwans is cheaper and more redily accessed. But let me ask you this - After 22 years away from the US why are you in such a financial state as to not be able to afford health care?
[quote]The US health care system is so bad that I’m considering moving to the Mexican border so that I can go south anytime I need to see a doctor. I actually know quite a few Americans who make an annual trip to Mexico to see doctors and dentists and buy medications. Quite a few people go to Canada too, at least to buy medications, which are about 1/5 the price north of the border.[/quote]I am very well aware of the cross-border price difference in pharmaceuticals. I think the prices for meds charged in the US is outrageous. While living in so cali I have gone with a friend to TJ for her meds and when I lived in south Texas did the same thing across the border into Mexico, so I know about this and agree that it is a terrible burden on the American peoples.[quote]Apparently, you have (or had) health insurance when you lived in the USA. I do not have health insurance, nor can I buy it, because I have a “pre-existing condition.” Sure, I could buy health insurance for maybe US$2000/month, which I can’t afford, and then they still wouldn’t cover my existing health problems anyway since that would be excluded.[/quote]As I indicated in my previous post, Yes I did have private insurance - I think it was Blue Cross/Blue Shield - maybe different, as well as VA coverage. I lived about 10 minutes south of the Long Beach VA Hospital, a great veterans facility.
You have a pre-existing condition which is causing you a problem with insurance. What can be done to alleviate this problem? I don’t know any magic words to tell you. I don’t think you are the only one out there in a situation like this. You have this problem - You deal with it. Yo don’t make excuses . You don’t whine about life, the universe and how the “man” is keeping you down. Sorry, life can be a bitch. I can tell some sad sad stories also about me, my family and friends. But it doesn’t do any good.
I could be wrong, but I have the nagging feeling that you’re just reflexively repeating the propaganda spewed by the Washington Times, National Review, Rush Limbaugh, and other right-wing mouthpieces for the US insurance industry.[/quote]Yeah, you’re wrong. And there is the "obligatory “Rush Limbaugh” mention, you guys are too funny. You’ve never been around me when I was writing out my 6 month checks for auto, motorcycle, health insurance and condo insurance. Be glad of that.[quote]Perhaps you are the one in need of a primer in American health care systems, TC…[/quote]Unlike some I am always open to learning. I also am very careful of the sources that “learning” comes from.
Dogs Breakfast -
We obviously have different views on this subject. In my personal opinion I would like health/medical care for Americans to be easily within the grasp of all. But the unfortunate facts are that its am imperfect world. While I think pre-natal care should be mandatory for all expectant mothers - what about the 18 yr old dropping her 3rd child? What about the illegal who uses the ER like a clinic. Somebody has to pay for these things. And that somebody boils down to the taxpayer. Could the system be different? Yeah, probably. What can be done to effect those changes? I have no idea, I really don’t.
You tell me, what changes can be made?
[quote=“TainanCowboy”][quote]Apparently, you have (or had) health insurance when you lived in the USA. I do not have health insurance, nor can I buy it, because I have a “pre-existing condition.” Sure, I could buy health insurance for maybe US$2000/month, which I can’t afford, and then they still wouldn’t cover my existing health problems anyway since that would be excluded.[/quote]As I indicated in my previous post, Yes I did have private insurance - I think it was Blue Cross/Blue Shield - maybe different, as well as VA coverage. I lived about 10 minutes south of the Long Beach VA Hospital, a great veterans facility.
You have a pre-existing condition which is causing you a problem with insurance. What can be done to alleviate this problem? I don’t know any magic words to tell you. I don’t think you are the only one out there in a situation like this. You have this problem - You deal with it. Yo don’t make excuses . You don’t whine about life, the universe and how the “man” is keeping you down. Sorry, life can be a bitch. I can tell some sad sad stories also about me, my family and friends. But it doesn’t do any good.[/quote]TC, I don’t see that as whining. I see it as a valid argument in favour of universal health care, or at least for tighter regulation of private provision. In the UK, Taiwan, continental Europe and Canada, pre-existing conditions are not something which prevent people from getting treatment for those conditions. It might take a little while in the UK, but treatment is eventually given.
I hope you don’t mind if I say this: You’re an intelligent and often thoughtful man, and I believe you have a great deal of integrity. But these kinds of kneejerk comments really don’t do you any favours. The IP forum would be so much better if people (on all sides) could forget about all the partisan stuff and concentrate on the policy issues.
Joesax -
Point taken. In reference to DB’s comments, perhaps “whineing” was not the most appropriate word. I can be a bit harsh sometimes without intending to be so. But life can be even more harsh.
I wish I had an answer or a suggestion or a course that DB could take to overcome his problem. But I don’t. And that frustrates me also.
[quote=“TainanCowboy”]Joesax -
Point taken. In reference to DB’s comments, perhaps “whineing” was not the most appropriate word. I can be a bit harsh sometimes without intending to be so. But life can be even more harsh.
I wish I had an answer or a suggestion or a course that DB could take to overcome his problem. But I don’t. And that frustrates me also.[/quote]Well, if I read it correctly, DB’s point was that universal health care is at least a partial solution to this problem. Though it can be inefficient and sometimes slow, people do get treatment for their conditions, regardless of past medical history and ability to pay.
I’m aware of the arguments against universal health care, and I’m open-minded to the possibility that a system based on private provision could work. But I don’t believe that such a system has worked up to now. Privatising public services is supposed to make them more efficient. But, in the UK at least, it seems to have made them less efficient. This is particularly the case with the National Health Service, which is being privatised from the inside out as it were. Most UK healthcare professionals I have met agree that the system is not working as well as it used to.
The US is way ahead of any other developed country in terms of cash spent on health services - both as a percentage of GDP (just under 15%) and nominal dollars per year per capita PPP (US$5,267). Americans may just be a sick lot that choose to spend a greater proportion of their income on health. This is highly unlikely. The big human killers (TB, Malaria, infant mortality) are all below the international averages, though the US is in the middle of the pack for some of the standard “first world” ailments (cancer, car accident deaths). And not all Americans participate in the health market. Around 17% have no insurance cover, so some people are spending a disproportionately huge chunk of their incomes on health to keep the numbers up.
This should be cause for concern. Around the world, many countries simply treat health the same way they (and the US) treat defense - as a public good - and regulate the industry. Price caps and compulsory/universal insurance are two of the most commonly used approaches to dealing with the kind of cost and participation issues the US faces. Why are Americans so attached to a model that excludes these policy tools (or opts for the “second best” options on these tools and pays a premium as a result)? Again, to rephrase an earlier question: Why would you choose a free market in health services if you didn’t have to?
[quote=“guangtou”]Why would you choose a free market in health services if you didn’t have to?[/quote]For the average Joe?
Ideological commitment.
Distrust of gov’t.
Lack of political will/ Influence of special interests.
Mistaken belief that r&d would move elsewhere, as though there weren’t incentives enough to remain in the US without turning the market over to these robber barons.
Mistaken belief in one’s ability to beat the odds, or misapprehension of one’s ability to access top-level care and derive benefit from a skewed system.
None of which speak to the delivery of quality care; well, save for that last hopeful position.
Screw that other thread you started MTK, this is where the action/honesty is. Let me restate my challenge: How do you justify a free market in health care?[/quote]
Well… because I think it would be the most efficient model for distribution of scarce resources.
First off, I don’t yet label myself as conservative or liberal. If anything I’ve thought myself liberal (just because my mom was.)
I’m new to this whole debate but, off hand, I’d say the govertments role in health care would be “policing.” Left to the open market, people would get the care they could afford and there are MORE options, not less.
This is what happens when things are forced (from the other thread):
Sort of what Gov. Howard Dean did in Vermont: He pushed legislation that prohibited insurance companies from refusing coverage due to pre-exisiting medical conditions. Result? Every company except Blue Cross promptly left the state. Thanks for nothing, Howard.[/quote]
Trying to force things to be cheaper, will actually COST more. Less insurcance companies to choose from, reduced quality in coverage (I’m guessing), etc. If companies are left to operate in the free market, the public will get a better price (at a lower cost.)
I’m sorry if I come across as preaching “free market healthcare” as being better. I’m not. What I’m trying to point out is the economics of health care. Making the price of things artificially low, brings the the price of something else up (taxes for business, people, products, etc.) If businesses can not stay profitable under new government regulations, they leave, close, lay people off, whatever.
Also artificially reducing the price, raises the demand. So more people want (and get) something at an unprofitable price. Things just can not last like this. The additional costs not reflected in price MUST turn up somewhere (longer wait times, lower quality service, etc.) It’s just economics.
I don’t think it’s healthy that health care is viewed as a right in the minds of the public. I’d LOVE to see a system that greatly reduces pain and suffering for as mnay people as possible, but HATE that it’s used as a political tool to get people in office. What happens is one man makes promises that the next won’t be able to keep (the adverse effects of businesses leaving, longer wait times etc, may not be seen until after the elected office is long gone.)
If I go home and find out good health care is going to cost me 500US a month (or 2000), then I’ll have to do what it takes to make that much (AKA hustle, just like “the good ol’ days”) or I’ll have to seek alternatives that are within my budget.
If you haven’t noticed I’m actively investigating ways to help ease these pains (barter-exchanges, complimentary/community currencies, etc.) that would allow a person to get medical attention (or many other things) and then serve the community pay for the service.
Hope that was all straight enough. I was lucky enough to have a mother that was fully in the system (a public school teacher with kick ass insurance) and a father that knew how to work it (sometimes “homeless”, sometimes workings, sometimes not.) As cool as “universal health care” sounds, I believe it would create more system abusers. I don’t think it’s the system abusers fault. They just do what’s most economical for them (abusing the system.)
That system abuse is a very unefficient use of resources. I wanted to wait until I was home to write that (better spellcheck facilities and all that), but… there ya go
[quote]guangtou wrote:
It’s just too obvious that there are significant collective benefits to be gained from a range of health services being provided by the government. There’s an important debate to be had about where the cut-off line occurs, but frankly I’m not interested in having this dialogue if you (or your conservative comrades) don’t accept apriori that the public sector has a fundamental role to play in health provision.[/quote]And frankly, by saying that unless we adopt only a socialist/marxist POV from the outset, you are excluding any meaningful debate on this issue.
Keep in mind here that this thread is referring to California, one of 50 states in the USA. Any realistic model suggested for the improvement of the current healthcare system must fit into the social/political framework extant here.
[quote=“TainanCowboy”][quote]guangtou wrote:
It’s just too obvious that there are significant collective benefits to be gained from a range of health services being provided by the government. There’s an important debate to be had about where the cut-off line occurs, but frankly I’m not interested in having this dialogue if you (or your conservative comrades) don’t accept apriori that the public sector has a fundamental role to play in health provision.[/quote]And frankly, by saying that unless we adopt only a socialist/marxist POV from the outset, you are excluding any meaningful debate on this issue.
Keep in mind here that this thread is referring to California, one of 50 states in the USA. Any realistic model suggested for the improvement of the current healthcare system must fit into the social/political framework extant here.[/quote]
That post was kind of narky; you were right to bring me up on it. I actually enjoy your contributions TC and respect the fact MTK has at least raised the issue for discussion. My baggage is this: there is always talk in Australia about pulling apart our UHC system, but the alternative is never elaborated as a comprehensive policy. What we get from many conservatives is a critique of the established system, which for me just simply isn’t enough. Refine and adjust yes, but dump it? What would you replace it with?
The problem is, of course, both markets and administrative allocation in the health sector have negative efficiency consequencies. I had this thrust in my face today actually (quite literally). Dental work is largely outside the UHC system in Oz and the price of getting your teeth looked at can be quite high. With no limits on prices and the patient (or their insurance company) bearing the full cost, the only thing holding back a dentist from giving you root canal work when you need a filling is their professional integrity.
About 6 months before coming back to Taiwan in early 2005 I chip my front tooth. My dentist says I need a cap - A$2,000 plus consultation fees and I’m not insured for this kind of work. I don’t know if the guy is just out to get a new set of golf clubs, so I opt for a filling (note: the patient-dentist relationship involves a serious information asymetry - classic market failure problem). Well the filling fell out a couple of weeks back and I’ll never know if it’s just because the dentist did a sloppy job on it, or because he was right - i.e. the tooth needed a cap.
So I go to my dentist in Taipei today and tell him my tooth could need capping. Socialist Taiwan covers most essential dental work on the jianbao scheme and if my tooth “needed” capping, then the public sector would pick up the tab. My dentist looks at the tooth and says “absolutely not, that just needs a filling. We’ll look at a cap down the track.” I’ll never know if he just couldn’t be f-ed going through the tortured jianbao paperwork of a more expensive and time-consuming procedure, or if he looked at me and thought “this guy is about to turn into a regular” (note: over and under-servicing are common problems of all UHC systems).
The bottom line is that both dentists had strong incentives to avoid giving me the health service I actually needed. To my mind that’s a rationale for a mixed system that includes administrative components (price caps and universal cover) for “essential” procedures and markets for elective work. What’s deemed essential will obviously shift over time, and the resulting mixed system will inevitably incorporate the worst of pure market and command allocation, but that’s just the nature of the beast. Basing your system design on a market model that delivers computer chips and bread with grace and efficacy is just muddle headed. The fact that health economics is a key subfield of the discipline is testament to the reality that health is out there on its own.
Australia does OK with its hybrid system in my view - health costs the Oz economy about 9% of GDP. These is much debate about who should foot the bill for long term injuries or if expensive cancer treatment for smokers is “fair” on the public. I really don’t know the answer to these questions, other than to say that equity is probably the least of my concerns here. I’m not a socialist - I always prefered Adams and Ricardo over Marx. But whenever someone gets sick or becomes incapacitated, a lot of money changes hands. My primary concern is with seeing that cash spent as effectively as possible, and common sense tells me that when it comes to health services, neither the market nor government can guarrentee that.
