Poor people, health care, and the United States

[Richard]

Poverty and Spending on Health Care

http://www.techcentralstation.com/050505C.html

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Liberals of the United States of America, why the hell are you whining, with the silver spoon in your mouth?  Your government spends MORE per capita on health care on those below the poverty line than the Canadian government spends on ALL people in Canada in our universal health care system.

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Interesting, eh?

[opebo]

Level of spending isn't the only criteria for judging health care - I can go to the doctor here for about $4 to $5. 

Of course I'm skeptical of your source, but if there is some spending on the poor for health care it is due to liberal programs such as Medicaid.  Thanks, Democratic Party!

[David S]

I don't know where they are getting their data but the amount spent on Medicaid is more than twice that amount. Possibly they are using only Federal or state expenditures but not both.
http://www.cms.hhs.gov/researchers/pubs/datacompendium/2003/03pg4.pdf

[The Duke]

Level of spending isn't the only criteria for judging health care - I can go to the doctor here for about $4 to $5. 

Of course I'm skeptical of your source, but if there is some spending on the poor for health care it is due to liberal programs such as Medicaid.  Thanks, Democratic Party!

A doctor in Thailand is $4 because the cost of living is so much lower than in the US.

[opebo]

Level of spending isn't the only criteria for judging health care - I can go to the doctor here for about $4 to $5. 

Of course I'm skeptical of your source, but if there is some spending on the poor for health care it is due to liberal programs such as Medicaid.  Thanks, Democratic Party!

A doctor in Thailand is $4 because the cost of living is so much lower than in the US.

Correct..  and my point was that those other countries Richius was comparing to the US may have a variety of differences such as this.

You know there is a lot of medical tourism to Thailand, particularly to Bumrungrad in Bangkok - it is a world class hospital staffed by Thai doctors who were educated at Harvard, Johns Hopkins, that sort of place.  A boob job is only $2,200 there - for both boobs!  You can get it for half that at a normal hospital here.
http://www.bumrungrad.com/

[○∙◄☻¥tπ[╪AV┼cVê└]

Why are we whining that half of the money spent on health care on this country is wasted, and that providing health care to everyone Canadian style would actually save a lot of money? Yeah, I have no idea.

[David S]

Why are we whining that half of the money spent on health care on this country is wasted, and that providing health care to everyone Canadian style would actually save a lot of money? Yeah, I have no idea.

The thing is that the current government run healthcare programs in the US, Medicare and Medicaid, already spend over $5000 per person. Why does anyone expect that the cost per person will go down 50% if the government covers everyone?

[TheresNoMoney]

Why does anyone expect that the cost per person will go down 50% if the government covers everyone?

For the trillionth time, it will go down because of billions saved on paperwork, actuarial costs, and other overhead. In addition, it will go down through cost controls on prescription drugs and medical procedures.

Why is that so hard to understand?

And for the record, it won't go down 50%, but it will go down.

[ATFFL]

Why does anyone expect that the cost per person will go down 50% if the government covers everyone?

For the trillionth time, it will go down because of billions saved on paperwork, actuarial costs, and other overhead. In addition, it will go down through cost controls on prescription drugs and medical procedures.

Let me get this straight:  You claim turning everything over to the government will reduce paperwork? 



Do you honestly believe the govnerment will have less overhead than a for profit company with the aim of reducing costs to increas profit will?

[TheresNoMoney]

Let me get this straight:  You claim turning everything over to the government will reduce paperwork? 

Do you honestly believe the govnerment will have less overhead than a for profit company with the aim of reducing costs to increas profit will?

Dude, do a little research and get back to me. The current health insurance industry is the most wasteful and inefficient industry in the country. You don't understand how the health insurance industry competes (hint: it's not about reducing overhead, it's about decisions to accept or turn down patients and hospital charges). The health insurance industry competes on a different basis than just about any other industry in America. 

Every non-partisan study shows that we will save upwards of $300 billion a year if we had universal single-payer coverage. You have no idea how wasteful the health insurance industry is.

[ATFFL]

Let me get this straight:  You claim turning everything over to the government will reduce paperwork? 

Do you honestly believe the govnerment will have less overhead than a for profit company with the aim of reducing costs to increas profit will?

Dude, do a little research and get back to me. The current health insurance industry is the most wasteful and inefficient industry in the country. You don't understand how the health insurance industry competes (hint: it's not about reducing overhead, it's about accepting and turning down patients and hospital charges). The health insurance industry competes on a different basis than just about any other industry in America. 

Every non-partisan study shows that we will save upwards of $300 billion a year if we had universal single-payer coverage.

Right.  Let's take a look at how the government is currently doing with Medicare, shall we?

"Effremov, who treats about eight Medicare patients daily, says things have gotten so bad that she now spends more time on Medicare paperwork than on patient care.

Effremov’s paperwork woes are not an isolated case. More than 699,300 physicians across the country treat Medicare patients. Each physician must take into account more than 110,000 pages of Medicare rules and regulations, which is roughly six times the size of the Internal Revenue Service code. To make matters worse, the physicians are required to keep current with constant rule changes, which are mailed to them each month in a 12-page brochure." 
(From NYU)

"When a doctor submits a bill to the Medicare bureaucracy, he frequently is paid an amount prescribed under the Medicare fee schedule, but that is the start, not the end, of the Medicare bureaucracy's dealings with the physician. Years after a bill has been submitted and paid for, the Medicare bureaucracy can conduct a post-payment review leading to inquiries, investigations, and audits. Years after the service has been provided and the physician has been paid, it can question the reasonableness and necessity of the service, the billing code used for the service, the sufficiency of medical records documenting the service, and the extent to which the service is covered or non-covered, among many other bases for Medicare reimbursement demands."

(From The Heritage Foundation)

Now, a case can be made that these costs are not passed on to the consumer the way costs for health insurance are.  This is true.  Problem is that doctors decide to stop treating Medicare patients to eleimate the cost from their practice.  If we went to a single payer system doctors would have to accept the massive bureacracy or quit practice.  If it is a choice between leaving medicine or going bankrupt, what do you think they will do?

[True Federalist (진정한 연방 주의자)]

I don't know where they are getting their data but the amount spent on Medicaid is more than twice that amount. Possibly they are using only Federal or state expenditures but not both.
http://www.cms.hhs.gov/researchers/pubs/datacompendium/2003/03pg4.pdf

In their data, they indicate that they are excluding persons in nursing homes and other institutions.  They probably did so since a significant fraction of nursing home expenditures are non-medical.  Nursing homes are expensive tho, and are where a significant fraction of Medicaid and Medicare spending go to.  As long as they are comparing apples to apples within their study, I don’t see any problems withtheir doing so.

[David S]

Why does anyone expect that the cost per person will go down 50% if the government covers everyone?

For the trillionth time, it will go down because of billions saved on paperwork, actuarial costs, and other overhead. In addition, it will go down through cost controls on prescription drugs and medical procedures.

Why is that so hard to understand?

And for the record, it won't go down 50%, but it will go down.

For the trillionth time from me show me the numbers. Why will the paperwork for Medicaid and Medicare be less if the program applies to 295 million people instead of 90 million people?

You talk about cost controls. That means wage and price controls. Getting the costs down to where they are comparable with Canada would require a 50% cut. So you just have to tell the doctors, nurses, floorsweepers and everyone else in the medical field that their salary has been cut in half. Now that I think of it maybe that's not bad since it would probably cause all of them to become Libertarians.

[??????????]

Let me get this straight:  You claim turning everything over to the government will reduce paperwork? 

Do you honestly believe the govnerment will have less overhead than a for profit company with the aim of reducing costs to increas profit will?

Dude, do a little research and get back to me. The current health insurance industry is the most wasteful and inefficient industry in the country.

Yes! Give it to the government because as we all know the government isn't wasteful or inefficient. lol

[Fmr. Gov. NickG]

Why does anyone expect that the cost per person will go down 50% if the government covers everyone?

For the trillionth time, it will go down because of billions saved on paperwork, actuarial costs, and other overhead. In addition, it will go down through cost controls on prescription drugs and medical procedures.

Why is that so hard to understand?

And for the record, it won't go down 50%, but it will go down.

For the trillionth time from me show me the numbers. Why will the paperwork for Medicaid and Medicare be less if the program applies to 295 million people instead of 90 million people?

You talk about cost controls. That means wage and price controls. Getting the costs down to where they are comparable with Canada would require a 50% cut. So you just have to tell the doctors, nurses, floorsweepers and everyone else in the medical field that their salary has been cut in half. Now that I think of it maybe that's not bad since it would probably cause all of them to become Libertarians.

Overall health care costs aren't going to be reduced to Canada's level just by changing the way health care is funded.  That's because Americans just aren't as healthy on average as Canadians.

But we can reduce costs dramatically by setting price controls on drugs if nothing else, or better yet, nationalizing the entire pharmaceutical research industry. 

Most of the truly innovative drug research is already done by the government; it is mostly just minor modifications that are done by private companies, largely just to establish an intellectual property claim to a drug.   The money wouldn't be taken away from doctors and nurses, but from drug company profits and drug lobbyists and advertisers.  Most drugs are incredibly inexpensive to reproduce...there is no reason why they shouldn't be cheap and plentiful to everyone except for collusion on the part of drug companies, and a desire to protect the profitability of their patents.

[The Duke]

Why does anyone expect that the cost per person will go down 50% if the government covers everyone?

For the trillionth time, it will go down because of billions saved on paperwork, actuarial costs, and other overhead. In addition, it will go down through cost controls on prescription drugs and medical procedures.

Why is that so hard to understand?

And for the record, it won't go down 50%, but it will go down.

For the trillionth time from me show me the numbers. Why will the paperwork for Medicaid and Medicare be less if the program applies to 295 million people instead of 90 million people?

You talk about cost controls. That means wage and price controls. Getting the costs down to where they are comparable with Canada would require a 50% cut. So you just have to tell the doctors, nurses, floorsweepers and everyone else in the medical field that their salary has been cut in half. Now that I think of it maybe that's not bad since it would probably cause all of them to become Libertarians.

Overall health care costs aren't going to be reduced to Canada's level just by changing the way health care is funded.  That's because Americans just aren't as healthy on average as Canadians.

But we can reduce costs dramatically by setting price controls on drugs if nothing else, or better yet, nationalizing the entire pharmaceutical research industry. 

Most of the truly innovative drug research is already done by the government; it is mostly just minor modifications that are done by private companies, largely just to establish an intellectual property claim to a drug.   The money wouldn't be taken away from doctors and nurses, but from drug company profits and drug lobbyists and advertisers.  Most drugs are incredibly inexpensive to reproduce...there is no reason why they shouldn't be cheap and plentiful to everyone except for collusion on the part of drug companies, and a desire to protect the profitability of their patents.

No sh**t they want to profit off their patents, given that they spent hundreds of millions on each new drug, they damn well need to make some money back.  Or did you not realize that price controls will kill investment in new drugs and reduce the supply of pharmaceuticals, leaving patients screwed?  Do liberals not learn from their idiotic rent control experiments?

I'm simply going to assume that you were speaking in jest when you suggested nationalizing the drug industry, as their is no other rational explaination for that comment.  Speaking of which, have you been taking your medication?

[True Federalist (진정한 연방 주의자)]

The pharmacuetical industry has consistently been one of the most profitable industries to be in.  Yes, it has its risks, which is why it has consolidated to only a few firms so as to smooth out those risks.  It is highly dependent upon patent protection and advertising to make those high profits, altho that advertising has come back to bite the industry a lot because they have touted products that turned out to have rather severe side effects and thus have added to their litigation costs.  The government does have a rather blunt tool to control the drug industry by changing the lifetime of a patent, altho it is hard to say whether that should be increased or decreased.  A decrease would cut profits and thus halth care costs in the short term, but an increase would enable the industry to be less concerned about me-too drugs whose only advantage over existing drugs is that they will still be under patent when the original is not, thereby reducing research and advertising costs.

I don’t know what the solution is, but those high profits indicate a problem that needs solving, since in an ideal economy there should not exist sectors that consistently achieve higher profits than others.

[Shira]

Level of spending isn't the only criteria for judging health care - I can go to the doctor here for about $4 to $5. 

Of course I'm skeptical of your source, but if there is some spending on the poor for health care it is due to liberal programs such as Medicaid.  Thanks, Democratic Party!

Again and again:
The key numbers by which a health care system is evaluated are life expectancy and infant mortality. These numbers in our country are substantially worse than those in Japan, Australia, Canada and West-Europe.

[Shira]

And the solution is simple and obvious:

Extend Medicare:

1 - Medicare should provide the subscribed medications.

2 - Medicare should be extended to the whole population.

The above is far from being revolutionary or bold. That's more or less what exists in the UK and in other civilized countries.
In all these countries the healthcare cost per-capita is lower than in the US.
So, this solution is also the least expensive

[A18]

As we've already established, no one wants sh**tty Canadian health care.

As has also been established, life expectancy is not directly correlated to quality of health care, and is not at all relevant here.

[MissCatholic]

Quality of life has no effect on life expectancy. to be brutally honest its better if people die around 70-80 than everyone going on to 90.

Social Security was set up so long ago that many people used to die before or after the first few years. The solvency issue has to be resolved. I`m not interested in people that cant be bothered to get a job and contribute to society. we have a place for them - its called prison!

healthcare is in crisis. my concern is that people who are good citizens but cant afford it dont have it. its these people that i want to help.

[Shira]

As we've already established, no one wants sh**tty Canadian health care.

Canada is a democracy. If people there did not like their Health Care system they would have replaced their government. One PM (I forgot his name) tried to reduce (not to cancel) the Health Care system.  Immediately in the next election he was voted out.

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It is hard for me to decide whether you are stupid, wicked or ignorant. I tend to think that you are an ignorant, at least on this issue.

[Shira]

My concern is that people who are good citizens but cant afford it dont have it. its these people that i want to help.

In the citizen-government relations there are two elements:
The “Give” – what’s the government gives you or provides you with:  different services.
The “Take” – what you give to the government or what the government takes from you: taxes.

The “Give” system should be egalitarian.
The “Take” system should be progressive.

There are some ultra-conservatives and Libertarians who would love the equation:

“Give”=”Take”=0 

[David S]

healthcare is in crisis. my concern is that people who are good citizens but cant afford it dont have it. its these people that i want to help.

As I pointed out before the government spends over $5000 per person on Medicaid. The money to pay for that comes from working people, who in many cases cannot afford healthcare insurance, but are not poor enough to qualify for Medicaid benefits. How fair is that?

[David S]

The pharmacuetical industry has consistently been one of the most profitable industries to be in.  Yes, it has its risks, which is why it has consolidated to only a few firms so as to smooth out those risks.  It is highly dependent upon patent protection and advertising to make those high profits, altho that advertising has come back to bite the industry a lot because they have touted products that turned out to have rather severe side effects and thus have added to their litigation costs.  The government does have a rather blunt tool to control the drug industry by changing the lifetime of a patent, altho it is hard to say whether that should be increased or decreased.  A decrease would cut profits and thus halth care costs in the short term, but an increase would enable the industry to be less concerned about me-too drugs whose only advantage over existing drugs is that they will still be under patent when the original is not, thereby reducing research and advertising costs.

I don’t know what the solution is, but those high profits indicate a problem that needs solving, since in an ideal economy there should not exist sectors that consistently achieve higher profits than others.

When I go to my local drug store looking for over the counter medicine, I find a huge array of products for various conditions and from many manufacturers. The prices are shown and I can pick the one that meets my needs and my pocketbook. Those products are safe and effective. They are also very inexpensive compared to the Prescription drugs. Why is that? Its because those products are sold in a competitive free market. The Prescription drugs are not sold that way. You don't know the price until the druggest has already filled the prescription. You don't see competitive products. Prices are rarely advertised so you don't know which pharmacy has the best prices or which manufacturer has the least expensive product. That's not a free market. That's a government controlled monopoly and it will always result in high prices.