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Author Topic: Public-option to Single-payer?  (Read 3432 times)
politicaladdict
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« on: October 05, 2009, 07:31:10 pm »
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http://blog.heritage.org/2009/08/03/still-not-convinced-the-public-option-is-a-trojan-horse-for-single-payer/


http://www.youtube.com/watch?v=dT4mV3R7vu4&feature=player_embedded
Schakowsky tells her Health Care for America Now audience: “And next to me was a guy from the insurance company who argued against the public health insurance option, saying it wouldn’t let private insurance compete. That a public option will put the private insurance industry out of business and lead to single-payer. My single-payer friends, he was right. The man was right.”


http://www.youtube.com/watch?v=f3BS4C9el98&feature=player_embedded
Frank tells a member of Single Payer Action: “I think that if we get a good public option it could lead to single-payer and that is the best way to reach single-payer. Saying you’ll do nothing till you get single-payer is a sure way never to get it. … I think the best way we’re going to get single-payer, the only way, is to have a public option and demonstrate the strength of its power.”


http://www.youtube.com/watch?v=FElipqE_Dl4&feature=player_embedded
Klein tells his netroots audience: “They have a sneaky strategy, the point of which is to put in place something that over time the natural incentives within its own market will move it to single-payer.”


http://www.youtube.com/watch?v=t7WNxrySFQA&feature=player_embedded
Krugmans tells his audience: “[T]he only reason not to do [single-payer] is that politically it’s hard to do in one step…You’d have to convince people to completely give up the insurance they have, whereas something that lets people keep the insurance they have but then offers the option of a public plan, that may evolve into single-payer, but you can do it politically…

Krugman would know, he's an economist!


All of these Obama allies support a “public option” because they believe it will eventually lead to a single-payer system. Conservatives are against the “public option” because, like everybody quoted above, we also believe that a “public option” will inevitably lead to single-payer health care. There is one person, however, who vehemently disagrees with everyone quoted above about the effect a public option would have on private health care. President Barack Obama told the AMA June 15th:


http://www.youtube.com/watch?v=p-bY92mcOdk&feature=player_embedded
But does President Obama even believe his own words here? Watch this video and decide for yourself:
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« Reply #1 on: October 05, 2009, 07:36:10 pm »
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If only this were the case.

Neither will happen.
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The idea of parodying the preceding Atlasian's postings is laughable, of course, but not for reasons one might expect.
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« Reply #2 on: October 05, 2009, 07:43:07 pm »
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If only this were the case.

Neither will happen.

GOOD!

Now the next would be to get these suckers out of office by 2010, hopefully!
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« Reply #3 on: October 07, 2009, 11:34:29 am »
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If only this were the case.

Neither will happen.

Sad to say, I am starting to agree.
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« Reply #4 on: October 07, 2009, 09:44:22 pm »
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Why would you oppose it so much? I fail to see how single-payer is bad- every advanced country in the world has it besides us, and every advanced country spends less on health care than us, with better results.

Perhaps you're concerned the poor insurance companies would have to not gouge prices as badly, since a public option/single payer would indeed affect the free market. "Oh no, the benevolent people at the insurance companies can't deny me my rights for bad reasons anymore!"

Perhaps you're afraid the government bureaucracy would mess up health care, which would be a somewhat valid concern. That is, if the private equivalent wasn't insurance companies, which, you guessed it, have horribly inefficient bureaucracies themselves. The only difference is that private industry intentionally screws the consumer- they actively seek to avoid their duty. You do not have this problem with a government run option.

But I think the reason you are so opposed is because you, quite honestly, don't care about the people who desperately need this reform in order to carry on with their lives. You really only care about one thing- your money. You don't care that this system could save lives, could lower costs, could make America a better place. You just care because you are, God forbid, being asked to help ensure that every American can have a long and healthy life. Rationally, it is worth giving up a small monetary amount for the good of the people.

So I ask you now- if not a public option or single payer, what is it we should do? How do we fix our broken system? I'm quite curious.
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« Reply #5 on: October 23, 2009, 01:49:41 am »
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Ok, let's at least get straight what a single-payer system is, who has one, and what the differences are between various models of health care financing.  (This info comes from T.R. Reid's new book The Healing of America, which is worth reading.)

The so-called "single-payer" system is also known as a "National Health Insurance" model.  In this system, the providers (hospitals, clinics, doctors) are private.  The only insurance plan available is run by the federal or provincial government; it collects premiums and pays all claims, and negotiates costs with providers.  However, such National Insurance plans do limit the kinds of procedures they cover on a case-by-case basis, and thereby create those famous waiting lists.  Canada is the best known example, but Taiwain and South Korea adopted versions too.

The Beveridge Model enables the government both to own hospitals and employ or pay providers as well as pay all medical bills, and it is financed through tax payments.  In such a system, the government determines which treatments may be given in which circumstances and how much various procedures and medicines cost.  This kind of system is found in Great Britain, Italy, Spain, Scandanavia and Hong Kong.

The Bismarck Model features both private providers and insurance companies, and compaines collect their premiums largely through employer payroll deductions.  However, the insurance companies must by law in this system be non-profit, and where profits are collected by offering special coverage to the wealthy or coverage for special services, those profits, apart from modest bonuses given to executives, must be reinvested in the company.  While providers are also private, the procedures they offer as well as their costs, along with the costs of medicines, are heavily regulated by the government.  This is a "multi-payer" system, and is found in countries like Japan, Germany, France, Belgium and Switzerland.  In contrast to other systems, waiting times in many countries with the Bismarck model are shorter, in Japan's case much shorter, than American waiting periods.

As Reid points out in his book, some parts of the fragmented health care financing system in the U.S. are patterned after some of these models: Medicare works like the Canadian National Insurance model (and is even named after it), medical coverage for active-duty military personnel and the VA works like the Beveridge model.  

I lived in Germany for a year and a half and in Japan for a year and a half, and personally, I like the Bismarck model a lot.  I think, if we ever do move to a different model of health care financing in the U.S., it will look more like the Bismarck model than the "single-payer" or NIH models, largely because Americans are accustomed to getting health insurance through their employers and are more comfortable with privately owned companies and providers.  The biggest change here would be getting next to the idea that insurance companies should be non-profit entities.  I for one happen to believe that it's just fundamentally wrong for health care financing to be administered by for-profit companies, because for these, the most effective cost-cutting measure is the denial of coverage, and I think this is almost barbarically unjust.  What's more, all the actuarial and administrative costs associated with coverage-denial in for-profit companies represents a large portion of high premium rates--in other words, we pay extra in this country so that we can get screwed out of coverage when we need it.

Is the public option a slippery slope to "single-payer?"  Well, the financing structure is more like Canada's, with the government health plan collecting premiums to pay for medical bills, and unlike the Beveridge system that finances health care through taxes.  But public option-style health coverage will not be able to control provider costs nearly as much as in other systems, and because there are elligibility requirements for the public option, it will not drive for-profit private insurers out of buisness.  So, both those who want the public option to creep toward "single-payer" and those who fear that it will are both wrong, IMO.  
« Last Edit: October 23, 2009, 02:12:04 am by anvikshiki »Logged

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« Reply #6 on: October 23, 2009, 09:26:30 am »
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Ok, let's at least get straight what a single-payer system is, who has one, and what the differences are between various models of health care financing.  (This info comes from T.R. Reid's new book The Healing of America, which is worth reading.)

The so-called "single-payer" system is also known as a "National Health Insurance" model.  In this system, the providers (hospitals, clinics, doctors) are private.  The only insurance plan available is run by the federal or provincial government; it collects premiums and pays all claims, and negotiates costs with providers.  However, such National Insurance plans do limit the kinds of procedures they cover on a case-by-case basis, and thereby create those famous waiting lists.  Canada is the best known example, but Taiwain and South Korea adopted versions too.

The Beveridge Model enables the government both to own hospitals and employ or pay providers as well as pay all medical bills, and it is financed through tax payments.  In such a system, the government determines which treatments may be given in which circumstances and how much various procedures and medicines cost.  This kind of system is found in Great Britain, Italy, Spain, Scandanavia and Hong Kong.

The Bismarck Model features both private providers and insurance companies, and compaines collect their premiums largely through employer payroll deductions.  However, the insurance companies must by law in this system be non-profit, and where profits are collected by offering special coverage to the wealthy or coverage for special services, those profits, apart from modest bonuses given to executives, must be reinvested in the company.  While providers are also private, the procedures they offer as well as their costs, along with the costs of medicines, are heavily regulated by the government.  This is a "multi-payer" system, and is found in countries like Japan, Germany, France, Belgium and Switzerland.  In contrast to other systems, waiting times in many countries with the Bismarck model are shorter, in Japan's case much shorter, than American waiting periods.

As Reid points out in his book, some parts of the fragmented health care financing system in the U.S. are patterned after some of these models: Medicare works like the Canadian National Insurance model (and is even named after it), medical coverage for active-duty military personnel and the VA works like the Beveridge model.  

I lived in Germany for a year and a half and in Japan for a year and a half, and personally, I like the Bismarck model a lot.  I think, if we ever do move to a different model of health care financing in the U.S., it will look more like the Bismarck model than the "single-payer" or NIH models, largely because Americans are accustomed to getting health insurance through their employers and are more comfortable with privately owned companies and providers.  The biggest change here would be getting next to the idea that insurance companies should be non-profit entities.  I for one happen to believe that it's just fundamentally wrong for health care financing to be administered by for-profit companies, because for these, the most effective cost-cutting measure is the denial of coverage, and I think this is almost barbarically unjust.  What's more, all the actuarial and administrative costs associated with coverage-denial in for-profit companies represents a large portion of high premium rates--in other words, we pay extra in this country so that we can get screwed out of coverage when we need it.

Is the public option a slippery slope to "single-payer?"  Well, the financing structure is more like Canada's, with the government health plan collecting premiums to pay for medical bills, and unlike the Beveridge system that finances health care through taxes.  But public option-style health coverage will not be able to control provider costs nearly as much as in other systems, and because there are elligibility requirements for the public option, it will not drive for-profit private insurers out of buisness.  So, both those who want the public option to creep toward "single-payer" and those who fear that it will are both wrong, IMO.  

Dude awesome analysis.
After hearing "those who oppose UHS support death and holocaust" for almost a week from other forumites it's good to hear a rational voice that lists exactly what each different type of healthcare is. I have a friend from Brazil who says that they have both a public and private option and that the private option is actually cheaper than our private option because the private hospitals have pressure to lower costs to compete with the government.
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« Reply #7 on: October 25, 2009, 10:23:33 am »
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Dude awesome analysis.
After hearing "those who oppose UHS support death and holocaust" for almost a week from other forumites it's good to hear a rational voice that lists exactly what each different type of healthcare is. I have a friend from Brazil who says that they have both a public and private option and that the private option is actually cheaper than our private option because the private hospitals have pressure to lower costs to compete with the government.

Thanks.  
Yeah, Brazil is an interesting case.  Their government coverage is financed through federal, state and local taxation, and so follows the National Health Insurance model.  However, an interesting and very democratic wrinkle in Brazil's system is that the public basically gets to vote on what sorts of coverage for given procedures should be offered under national insurance.  But, the system also allows citizens to opt out of the national coverage and buy insurance from (pretty heavily regulated) private companies, and tax rebates are available for citizens who opt to buy from the private maket.  I think the current ratio of Brazilians under government coverage as opposed to those under private coverage is at about 80-20.  The Brazilian system would at first glance seem to support the idea that a public option (assisted by its large pool of customers, bargaining power with providers and government regulations) does force private insurers' rates down.  However, the current form of a public option being conceived in the U.S., unlike the Brazilian version, would have means-tested eligability requirements, and so, while its customer pool would be large, it would not rival Brazil's and would not have nearly the amount of leverage with providers that exists in other systems.  This just goes to show you that the currently crafted U.S. public option, for all the improvements I do think it would offer to American health care financing, would be relatively small potatoes compared to public funding in other countries with more unified systems.

But, one problem in Brazil, as in all countries with a universal health care system, is that the providers (hospitals, clinics, doctors) get pretty uniformly low  rates for their services, and this does in certain ways compromise care quality (even though these counties still outperform the U.S. in many types of care).  If these countries would only increase payment rates to providers by a few percent, maxing out total health care expenditures at 10-11% of GDP instead of the standard (6-9%), this problem could be greatly alleviated.

In Reid's analysis, which I think is largely on target, there are several pillars to a successful national health care system.  1.) universal coverage, which creates pools of maximum size to enhance insurers' bargaining power with providers; 2.) a significant degree of available non-profit financing of health care; 3.) as unified a system of finacing as is possible between public and private insurers so that automation of health records can be easily acheived.

« Last Edit: October 25, 2009, 10:30:55 am by anvikshiki »Logged

Coburn In 2012
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« Reply #8 on: October 31, 2009, 01:23:26 pm »
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http://blog.heritage.org/2009/08/03/still-not-convinced-the-public-option-is-a-trojan-horse-for-single-payer/


http://www.youtube.com/watch?v=dT4mV3R7vu4&feature=player_embedded
Schakowsky tells her Health Care for America Now audience: “And next to me was a guy from the insurance company who argued against the public health insurance option, saying it wouldn’t let private insurance compete. That a public option will put the private insurance industry out of business and lead to single-payer. My single-payer friends, he was right. The man was right.”


http://www.youtube.com/watch?v=f3BS4C9el98&feature=player_embedded
Frank tells a member of Single Payer Action: “I think that if we get a good public option it could lead to single-payer and that is the best way to reach single-payer. Saying you’ll do nothing till you get single-payer is a sure way never to get it. … I think the best way we’re going to get single-payer, the only way, is to have a public option and demonstrate the strength of its power.”


http://www.youtube.com/watch?v=FElipqE_Dl4&feature=player_embedded
Klein tells his netroots audience: “They have a sneaky strategy, the point of which is to put in place something that over time the natural incentives within its own market will move it to single-payer.”


http://www.youtube.com/watch?v=t7WNxrySFQA&feature=player_embedded
Krugmans tells his audience: “[T]he only reason not to do [single-payer] is that politically it’s hard to do in one step…You’d have to convince people to completely give up the insurance they have, whereas something that lets people keep the insurance they have but then offers the option of a public plan, that may evolve into single-payer, but you can do it politically…

Krugman would know, he's an economist!


All of these Obama allies support a “public option” because they believe it will eventually lead to a single-payer system. Conservatives are against the “public option” because, like everybody quoted above, we also believe that a “public option” will inevitably lead to single-payer health care. There is one person, however, who vehemently disagrees with everyone quoted above about the effect a public option would have on private health care. President Barack Obama told the AMA June 15th:


http://www.youtube.com/watch?v=p-bY92mcOdk&feature=player_embedded
But does President Obama even believe his own words here? Watch this video and decide for yourself:


one of the more imformitive posts ever on the forum thank you.  The whole health care debate  has only one good side to it and thats that it is bring the democRAT party down in flames.
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« Reply #9 on: October 31, 2009, 01:27:27 pm »
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Why would you oppose it so much? I fail to see how single-payer is bad- every advanced country in the world has it besides us, and every advanced country spends less on health care than us, with better results.

If every 'advanced' country legalised throwing children into pits of acid, would you support that too?
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« Reply #10 on: October 31, 2009, 04:16:30 pm »
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Why would you oppose it so much? I fail to see how single-payer is bad- every advanced country in the world has it besides us, and every advanced country spends less on health care than us, with better results.

If every 'advanced' country legalised throwing children into pits of acid, would you support that too?

Now where have I seen that strawman before?
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« Reply #11 on: October 31, 2009, 04:36:13 pm »
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Why would you oppose it so much? I fail to see how single-payer is bad- every advanced country in the world has it besides us, and every advanced country spends less on health care than us, with better results.

If every 'advanced' country legalised throwing children into pits of acid, would you support that too?

You missed the second part of my argument, where I pointed out it was better elsewhere as compared to America.

But I bet the thrown child would be taken care of better than they would be if that situation existed in America.
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« Reply #12 on: October 31, 2009, 04:46:20 pm »
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Why would you oppose it so much? I fail to see how single-payer is bad- every advanced country in the world has it besides us, and every advanced country spends less on health care than us, with better results.

If every 'advanced' country legalised throwing children into pits of acid, would you support that too?

You missed the second part of my argument, where I pointed out it was better elsewhere as compared to America.

But I bet the thrown child would be taken care of better than they would be if that situation existed in America.

America also spends the most on healthcare, yet it has the lowest life expectancy out of the G8.
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« Reply #13 on: October 31, 2009, 04:48:21 pm »
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« Reply #14 on: October 31, 2009, 04:49:37 pm »
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Why would you oppose it so much? I fail to see how single-payer is bad- every advanced country in the world has it besides us, and every advanced country spends less on health care than us, with better results.

If every 'advanced' country legalised throwing children into pits of acid, would you support that too?

You missed the second part of my argument, where I pointed out it was better elsewhere as compared to America.

But I bet the thrown child would be taken care of better than they would be if that situation existed in America.

America also spends the most on healthcare, yet it has the lowest life expectancy out of the G8.

We have the highest cancer survival rate.

Life expectancy isn't even related to health care necessarily.
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« Reply #15 on: October 31, 2009, 04:50:27 pm »
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You also have the highest infant mortality rate.
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« Reply #16 on: October 31, 2009, 04:50:44 pm »
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Why would you oppose it so much? I fail to see how single-payer is bad- every advanced country in the world has it besides us, and every advanced country spends less on health care than us, with better results.

If every 'advanced' country legalised throwing children into pits of acid, would you support that too?

You missed the second part of my argument, where I pointed out it was better elsewhere as compared to America.

But I bet the thrown child would be taken care of better than they would be if that situation existed in America.

America also spends the most on healthcare, yet it has the lowest life expectancy out of the G8.

We have the highest cancer survival rate.

We've been over this, you fool.
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« Reply #17 on: October 31, 2009, 04:51:07 pm »
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We spend alot of money on health care because this is the country where alot people spend alot of money. We are or were the most richest nation.
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« Reply #18 on: October 31, 2009, 04:52:19 pm »
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Why would you oppose it so much? I fail to see how single-payer is bad- every advanced country in the world has it besides us, and every advanced country spends less on health care than us, with better results.

If every 'advanced' country legalised throwing children into pits of acid, would you support that too?

You missed the second part of my argument, where I pointed out it was better elsewhere as compared to America.

But I bet the thrown child would be taken care of better than they would be if that situation existed in America.

America also spends the most on healthcare, yet it has the lowest life expectancy out of the G8.

We have the highest cancer survival rate.

We've been over this, you fool.

Well, it looks like some morons still don't get it, especially you!
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« Reply #19 on: October 31, 2009, 04:52:57 pm »
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Did you read the heading? As a percentage OF GDP. It's not a measure of each country's actual real spending.
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« Reply #20 on: October 31, 2009, 04:54:11 pm »
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Yeah, I don't know why politicaladdict finds this so hard to understand.

Also he's incredibly uninformed if he thinks a public option is the same as medicaid or medicare.

I'm uninformed? Why do we need a public health option for the poor and elderly if we already have medicare and medicaid?

YOU DOPE!

We don't, dope, and that's why the public option is for people who don't have either. The public option is NOT an entitlement program. It's a government-owned/run corporation that would sell health insurance to consumers.

What difference is it gonna make to have a so-called option  if medicare, gov program, ain't covering certain people?

Are you saying medicaid ain't enough and instead we need to add more gov programs and increase the bankruptcy like medicare and medicaid and social-security are?

Oops, I think you're literally retarded!

I bet you are!

This doesn't answer the question about the highest cancer-survival-rate liberals generally don't want to talk about.

Single payer health insurance is a common-sense, centrist policy throughout the rest of the industrialized world.

And the cancer rate is 5 times higher to boot.

Source?

http://www.ncpa.org/pub/ba649

First of all, the cancer rate certainly isn't five times higher, universally or with specific cancers, so it's disingenuous to say it's five times higher and then present a source without directly citing something backing that up. Aside from that, however, I suspect your more general point was that the cancer rate is still very high in other areas of the world that have single payer of government healthcare plans. But this still has a few caveats. (And by caveats I mean important things you leave out or dismiss that totally discredit this notion.)

Cancer survival rates are totally random, and are, in fact, not always lower than the United States. I was doing some random googling and wiki'ing while I was waiting for my headache to (never) subside, and I came across an article from 2007 that was addressing a study done about the exact same thing you're talking about, cancer survival rates and the like.

Quote
The phrase "near the bottom" is the tip-off that McCaughey's reasoning is faulty. All 23 countries in the survey were European, and virtually all of them provide universal health care. If there were something inherently wrong with the ability of socialized medicine to deliver cancer treatment, one would expect to see a dramatic difference between U.S. survival rates and survival rates in all of these countries. But it's clear from the study (actually a series of papers published in the September 2007 Lancet Oncology) that this isn't so. The Lancet papers aren't available free of charge online, but this chart from a news account of the study in the Daily Telegraph tells the story. For women, cancer survival rates are 61.8 percent in Iceland, 61.7 percent in Sweden, 61.6 percent in Belgium, and 61.1 percent in Finland. That's just a whisker behind the 62.9 percent survival rate in the United States. For men, cancer survival rates are 60.3 percent in Sweden, 57.7 percent in Iceland, 55.9 percent in Finland, and 55.4 percent in Austria. That's a more sizeable gap, but it's doubtful one can attribute it to socialized medicine. How could universal health care be good for women who have cancer but bad for men who have cancer?

Nowhere in the Lancet is it suggested that differences among cancer survival rates are attributable to whether a country provides universal health care or not (though an editorial does make the obvious point that something would appear to be seriously amiss with the management of the National Health system in the United Kingdom). The significant differences observed in the study resulted not from a country's relative adherence to market principles in its health-care system, but rather from its relative wealth. "Countries with higher national expenditures on health … generally had better all-cancer survival." Survival rates tended to be highest in northern and Central Europe, middling in southern Europe, dreadful in the United Kingdom, and abysmal in Eastern Europe. Except for the anomalous poor survival rates in the U.K., these findings track with the relative wealth of the countries surveyed.
http://www.slate.com/id/2174722/pagenum/2

And it makes perfect sense. People come to the United States and our survival rates are higher because we're a wealthy country. The survival rates for certain cancers seem random, and there's nothing here that specifically makes the connection between universal and/or government healthcare itself, and the survival rates of the cancers. The NHS is poorly managed, but aside from that anomaly, there's nothing to suggest that the introduction of a government healthcare plan would do anything to lower the survival rates of cancer.

While I'm on this "Caveat" I'd like to take just a few sentences for one of the points in your source. "Fact" 10 in your article talks about how America is the center of innovation, research, and development. This again has nothing to do with the healthcare system itself. There is, again, nothing to suggest that universal healthcare leads to less innovation, and in fact, this again has more to do with the wealth of the United States than our private healthcare system. We've been the world's only superpower for almost six decades! We're the richest nation in the world, and the center of influence and power (economically and militarily) of the world. It makes sense that we would also be the research and development capital of the world when it comes to medical innovations. This has nothing to do with the healthcare itself.
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politicaladdict
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« Reply #21 on: October 31, 2009, 04:55:48 pm »
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You also have the highest infant mortality rate.

This covers some truth on the infant-mortality and life-expectancy rate.
http://www.nationalcenter.org/NPA547ComparativeHealth.html
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k-onmmunist
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« Reply #22 on: October 31, 2009, 04:57:12 pm »
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You also have the highest infant mortality rate.

This covers some truth on the infant-mortality and life-expectancy rate.
http://www.nationalcenter.org/NPA547ComparativeHealth.html

Those are the best measures we have, and they're certainly more extensive than cancer survival rates. I'm no fan of UHC, politicaladdict, but I think you're glossing over the facts.
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politicaladdict
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« Reply #23 on: October 31, 2009, 04:58:52 pm »
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You also have the highest infant mortality rate.

This covers some truth on the infant-mortality and life-expectancy rate.
http://www.nationalcenter.org/NPA547ComparativeHealth.html

Those are the best measures we have, and they're certainly more extensive than cancer survival rates. I'm no fan of UHC, politicaladdict, but I think you're glossing over the facts.

It looks like you from Britain, you probably like single-payer, right?
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Deldem
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« Reply #24 on: October 31, 2009, 05:01:03 pm »
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Why would you oppose it so much? I fail to see how single-payer is bad- every advanced country in the world has it besides us, and every advanced country spends less on health care than us, with better results.

If every 'advanced' country legalised throwing children into pits of acid, would you support that too?

You missed the second part of my argument, where I pointed out it was better elsewhere as compared to America.

But I bet the thrown child would be taken care of better than they would be if that situation existed in America.

America also spends the most on healthcare, yet it has the lowest life expectancy out of the G8.

Wait, so you think there should be some kind of government run health care too?

Though now that I look at it, my wording was a little odd. I'm saying elsewhere, where they have single-payer or some other kind of government-run system, would be better than America, which has nothing public whatsoever. Therefore, it would be better to be hurt outside America if you want better care.
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JCP-Texas for Atlasia.
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