Question for universal health care advocates
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Saw11_2000
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« Reply #25 on: August 19, 2007, 09:55:42 PM »

With government running healthcare, there is no competition.  Competition drives down costs.  Just look at Public vs. Private schools.  The schools that don't have a free check to use actually need to fight to stay afloat.

So, essentially, we'd be paying way more for subpar service.
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snowguy716
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« Reply #26 on: August 19, 2007, 10:24:16 PM »

I'm just wondering, even if you think our health care system needs to be changed, why do you think the government can sucessfully manage it? Hasn't the government already proven that it can't even count votes or keep bridges safe? Why do you think the government will take care of your health any better through a single-payer system?

Conservatives claim that government doesn't work.  Then they get elected and prove it.

My state is the closest of any to universal health care with only 8% uninsured and we have pretty generous state-run healthcare programs that are much easier to deal with than private insurance companies.

And I don't like the way you couple "universal health care" and "single payer" together.  Universal health care simply means that everybody has access to adequate health care.  I would advocate a system where the government should insure all children under 18 and college students under 25, the elderly, the disabled, those who have no access to or cannot afford coverage, and those that are considered uninsurable.

Healthy people between 25 and 64 are responsible for finding their own insurance, and they must have it by law.  Doctors should prescribe what patients need and what they prescribe should be legally binding to insurance coverage.  Since hte highest risk people (elderly, disabled, poor) would not be privately insured, the insurance companies would be able to take more risks with healthy middle-aged individuals and so making the doctor the boss in the whole equation would be best.

Government does not tell you what is right for you, you don't tell you what's right for you, and your insurance company doesn't decide what's best for you.. your doctor does.  He/she didn't go through over a decade of college to be sidelined by the financial interests of your insurance company.

What makes you so sure that private insurance companies can handle your health, Southpark?
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Bacon King
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« Reply #27 on: August 22, 2007, 08:51:57 PM »

With government running healthcare, there is no competition.  Competition drives down costs.

You do know that Canadians pay less, per person, for healthcare, right?
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Bandit3 the Worker
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« Reply #28 on: August 22, 2007, 10:16:56 PM »

Because bad health care is better than no health care. We can keep the private system for people who can pay. A common misconception is that universal health care means ONLY government-health care, because that's the system in Canada, the one Americans are most familiar with, but Canada is the only country in the world with such a system.

Also, if the government fails at something, the people can vote them out of office. People can't vote a corporation out of office.
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Lief 🗽
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« Reply #29 on: August 22, 2007, 10:31:28 PM »

With government running healthcare, there is no competition.  Competition drives down costs.  Just look at Public vs. Private schools.  The schools that don't have a free check to use actually need to fight to stay afloat.

So, essentially, we'd be paying way more for subpar service.
Then why are healthcare costs increasing?
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Verily
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« Reply #30 on: August 22, 2007, 11:30:47 PM »

With government running healthcare, there is no competition.  Competition drives down costs.  Just look at Public vs. Private schools.  The schools that don't have a free check to use actually need to fight to stay afloat.

So, essentially, we'd be paying way more for subpar service.

Service has little to nothing to do with the costs of health care, which are taken up by the insurance companies, not the doctors themselves. Government paying the doctors v insurance companies paying the doctors doesn't change levels of competition at all; the doctors still compete for business.
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Chuck Hagel 08
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« Reply #31 on: August 23, 2007, 12:17:12 AM »

Also, if the government fails at something, the people can vote them out of office. People can't vote a corporation out of office.

Well, not directly. Someone could "vote" for Walmart over Costco by shopping there. If a corporation fails to make a profit, which can be obtained by having enough "votes", then they go out of buisiness. Conversely, corporations that make profits by having enough "votes" prosper. Presumably, people will "vote", as in buy from, for the corporation that provides the lowest cost and the best customer service. Considering that this happens on a quarterly basis (because that is when corporations get their profits), while government elections happen on a two year cycle, that would mean that corporations reflect the electorate 8 times better than the government.
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Smash255
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« Reply #32 on: August 23, 2007, 01:29:06 AM »

Also, if the government fails at something, the people can vote them out of office. People can't vote a corporation out of office.

Well, not directly. Someone could "vote" for Walmart over Costco by shopping there. If a corporation fails to make a profit, which can be obtained by having enough "votes", then they go out of buisiness. Conversely, corporations that make profits by having enough "votes" prosper. Presumably, people will "vote", as in buy from, for the corporation that provides the lowest cost and the best customer service. Considering that this happens on a quarterly basis (because that is when corporations get their profits), while government elections happen on a two year cycle, that would mean that corporations reflect the electorate 8 times better than the government.

However,  if a corporation can make the higher profit by having higher costs and fewer customers as opposed to more customers and lower cost they will, and that is the line they are going down.  They realize by having prices as high as they are they may have less customers than they would if their prices were lower, but they can still make a higher profit.  Decisions should be based on how it can help people, not how it helps corporate fat cats bottom line.
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Nym90
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« Reply #33 on: August 23, 2007, 09:50:04 AM »

Also, if the government fails at something, the people can vote them out of office. People can't vote a corporation out of office.

Well, not directly. Someone could "vote" for Walmart over Costco by shopping there. If a corporation fails to make a profit, which can be obtained by having enough "votes", then they go out of buisiness. Conversely, corporations that make profits by having enough "votes" prosper. Presumably, people will "vote", as in buy from, for the corporation that provides the lowest cost and the best customer service. Considering that this happens on a quarterly basis (because that is when corporations get their profits), while government elections happen on a two year cycle, that would mean that corporations reflect the electorate 8 times better than the government.

True, but the problem is that not everyone has equal numbers of "votes" of course; the wealthy get a far larger say than the poor or middle class.
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Small Business Owner of Any Repute
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« Reply #34 on: August 23, 2007, 10:44:42 AM »

With government running healthcare, there is no competition.  Competition drives down costs.  Just look at Public vs. Private schools.  The schools that don't have a free check to use actually need to fight to stay afloat.

So, essentially, we'd be paying way more for subpar service.

A completely false analogy.  Wow, where to begin?

First of all, if government was "running healthcare," there would most definitely be competition.  Because government isn't "running healthcare"—it's just paying for it.  We're not talking Soviet Russia here.  You would still be able to choose your own doctor, what hospital you want your surgery at, and what pharmacy you get your prescriptions filled at.  And under some plans, you could even pay a little extra per month for VIP treatment at these facilities.

There's no way that would be different from "competition" now.  I mean seriously—what competition is there now that we'd be giving up?  I have the choice of one health care plan through my employer, and Massachusetts doesn't even allow me the "choice" of not having health insurance even if I didn't want it.  There's no price competition here: the co-pay is the same regardless of where I go.  And I can only visit the doctors approved by my plan—universal healthcare would actually add to my options, not decrease them.

Like I said, the comparison to private/public schools is a fallacy.  You can't easily choose a public school.  You can easily choose a doctor.  If the doctor is bad, why would people continue going to see him?  After all, a good doctor costs the same as a bad one under universal healthcare.  They still make their money based on the number of patients they see.  The ones who are the friendliest and offer the best level of care are going to be the ones who are the most successful.

Would you like to know one of the key reasons why health care costs so much in this country?  It's called "free care," and every hospital in the country is obliged to offer it.  If you don't have money or insurance, and you show up to the emergency room, they have to treat you.  Even if you give them a fake name and address.  Who pays for this?  Well, everyone else who's dumb enough to pay for medical care, of course—gotta make up for the freebies somewhere.

It's getting so bad that when I ran up a $500 co-pay bill for surgery, the hospital called me up and offered to take $120 off the top if I'd just pay the damn thing at once rather than set up a billing plan.  I guess it seems that most people who wind up running up medical bills—even those with insurance—just can't pay them.  What a surprise.
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« Reply #35 on: August 23, 2007, 11:09:51 PM »

Also, if the government fails at something, the people can vote them out of office. People can't vote a corporation out of office.

Well, not directly. Someone could "vote" for Walmart over Costco by shopping there. If a corporation fails to make a profit, which can be obtained by having enough "votes", then they go out of buisiness. Conversely, corporations that make profits by having enough "votes" prosper. Presumably, people will "vote", as in buy from, for the corporation that provides the lowest cost and the best customer service. Considering that this happens on a quarterly basis (because that is when corporations get their profits), while government elections happen on a two year cycle, that would mean that corporations reflect the electorate 8 times better than the government.

However,  if a corporation can make the higher profit by having higher costs and fewer customers as opposed to more customers and lower cost they will, and that is the line they are going down.  They realize by having prices as high as they are they may have less customers than they would if their prices were lower, but they can still make a higher profit.  Decisions should be based on how it can help people, not how it helps corporate fat cats bottom line.

I am talking about the ideal capitalistic health care system, not the only partially capitalistic system we have currently. Under a free market, market incenive will be have more customers for lower cost. Only under a government subsidized system that we currently have can the opposite happen. Under government subsidies, corporations don't have to consider customer satisfaction because they make money no matter what. In a truly capitalist society, what benefits a corporation will also benefit the lower and middle classes. It is truly in the best interests of corporate fat cats to have socialized health care because they don't have to spend money to insure customer satisfaction. It is the lower and middle classes who suffer in a socialized system.
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Smash255
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« Reply #36 on: August 24, 2007, 02:14:23 AM »

Also, if the government fails at something, the people can vote them out of office. People can't vote a corporation out of office.

Well, not directly. Someone could "vote" for Walmart over Costco by shopping there. If a corporation fails to make a profit, which can be obtained by having enough "votes", then they go out of buisiness. Conversely, corporations that make profits by having enough "votes" prosper. Presumably, people will "vote", as in buy from, for the corporation that provides the lowest cost and the best customer service. Considering that this happens on a quarterly basis (because that is when corporations get their profits), while government elections happen on a two year cycle, that would mean that corporations reflect the electorate 8 times better than the government.

However,  if a corporation can make the higher profit by having higher costs and fewer customers as opposed to more customers and lower cost they will, and that is the line they are going down.  They realize by having prices as high as they are they may have less customers than they would if their prices were lower, but they can still make a higher profit.  Decisions should be based on how it can help people, not how it helps corporate fat cats bottom line.

I am talking about the ideal capitalistic health care system, not the only partially capitalistic system we have currently. Under a free market, market incenive will be have more customers for lower cost. Only under a government subsidized system that we currently have can the opposite happen. Under government subsidies, corporations don't have to consider customer satisfaction because they make money no matter what. In a truly capitalist society, what benefits a corporation will also benefit the lower and middle classes. It is truly in the best interests of corporate fat cats to have socialized health care because they don't have to spend money to insure customer satisfaction. It is the lower and middle classes who suffer in a socialized system.

Not exactly.  In a truly capitalistic system profit by these corporations are still put above anything else, thats all they will care about.  Highest profit possible, and that often leads to policies and costs that leave the middle and lower class either unable to afford it, or pay it and lose something else that is needed.  decisions will still be made on a pro-profit basis and that is exactly what is wrong with our current system.
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Chuck Hagel 08
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« Reply #37 on: August 24, 2007, 09:58:05 PM »

Also, if the government fails at something, the people can vote them out of office. People can't vote a corporation out of office.

Well, not directly. Someone could "vote" for Walmart over Costco by shopping there. If a corporation fails to make a profit, which can be obtained by having enough "votes", then they go out of buisiness. Conversely, corporations that make profits by having enough "votes" prosper. Presumably, people will "vote", as in buy from, for the corporation that provides the lowest cost and the best customer service. Considering that this happens on a quarterly basis (because that is when corporations get their profits), while government elections happen on a two year cycle, that would mean that corporations reflect the electorate 8 times better than the government.

However,  if a corporation can make the higher profit by having higher costs and fewer customers as opposed to more customers and lower cost they will, and that is the line they are going down.  They realize by having prices as high as they are they may have less customers than they would if their prices were lower, but they can still make a higher profit.  Decisions should be based on how it can help people, not how it helps corporate fat cats bottom line.

I am talking about the ideal capitalistic health care system, not the only partially capitalistic system we have currently. Under a free market, market incenive will be have more customers for lower cost. Only under a government subsidized system that we currently have can the opposite happen. Under government subsidies, corporations don't have to consider customer satisfaction because they make money no matter what. In a truly capitalist society, what benefits a corporation will also benefit the lower and middle classes. It is truly in the best interests of corporate fat cats to have socialized health care because they don't have to spend money to insure customer satisfaction. It is the lower and middle classes who suffer in a socialized system.

Not exactly.  In a truly capitalistic system profit by these corporations are still put above anything else, thats all they will care about.  Highest profit possible, and that often leads to policies and costs that leave the middle and lower class either unable to afford it, or pay it and lose something else that is needed.  decisions will still be made on a pro-profit basis and that is exactly what is wrong with our current system.

You seem to think that capitalism is a zero-sum game. There is a point on the graph where the corporation will make more profits by selling at a lower price, which is also good for the lower and middle classes. IN a truly capitalist system, insurance wouldn't pay for 6/7ths of your health care costs and prices would be cheaper.
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minionofmidas
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« Reply #38 on: August 25, 2007, 07:08:34 AM »

Decisions will actually be made on how it could impact someone's else, not how it impacts some Corporate fat cat's bottom line. 

No, they will start being made on how they impact the bureaucrat's bottom line's. If you want them to be made on how they affect people, you have to give people control, not the government or third party payers.
Unfortunately, that is all too true. But at least, the bureaucrat's interests are not diametrically opposed to your own - just completely out of sync with yours.
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David S
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« Reply #39 on: August 28, 2007, 11:19:47 AM »

Let’s look at how the two main government run healthcare programs are doing. In 1967 Medicare and Medicaid together cost $4.7 billion. In 2006 they cost $500 billion. That’s a 100 fold increase. If you adjust that for inflation it still works out to a 17 fold increase in only 40 years. That certainly doesn’t seem like a shining example of effective cost control.

So how well are they working? Well Medicaid was designed to provide coverage for the poor. But if it’s working then why do we hear constant complaints of 40 million people who can’t afford health care coverage?

How about Medicaid?
Following are some of the conclusions of the Association of American Physicians and Surgeons:  ( http://www.aapsonline.org/medicare/medrep.htm )

1. INCREASING FEAR OF PROSECUTION OR GOVERNMENT RETALIATION HAS HAD A NEGATIVE IMPACT ON MEDICARE PATIENTS' ACCESS TO DOCTORS AND THEIR ABILITY TO RECEIVE CERTAIN SERVICES SUCH AS SURGERY:
Almost 25% of doctors refuse to treat new Medicare patients;
20% of those who refuse to accept new Medicare patients, do so because of hassles and/or threats from Medicare carriers;
More than one-third of doctors have trouble finding referral doctors for Medicare patients;
More than one-third of doctors surveyed are restricting services to Medicare patients;
Almost one-fifth of doctors give Medicare patients a lower priority for appointments;
More than 80% of doctors have an increased fear of investigation or prosecution;
More than one-fourth of doctors are restricting services to Medicare patients because of hassles/threats from Medicare.
 
2. COMPLIANCE WITH MEDICARE REGULATIONS TAKES A SIGNIFICANT AMOUNT OF DOCTORS' TIME AWAY FROM PATIENT CARE
The cost of compliance with regulations is high--
Doctors and their staff spend a full one-fifth (22%) of their time on compliance issues. It costs an average of $14.70 to process a Medicare Claim, vs $11.15 for a private claim -- more than 27% more.


What does the future look like?
According to the Treasury Department’s 2006 financial report Medicare is under-funded by $29 trillion over the next 75 years. Yes that’s trillion not billion. (  http://www.fms.treas.gov/fr/06frusg/06frusg.pdf Table 3.)
OMB director Rob Portman put it like this: "The burden on future generations will be overwhelming if we don't face the unsustainable growth in important programs like Medicare, Medicaid and Social Security….” (   http://www.treas.gov/press/releases/hp202.htm )


Given that sort of dismal performance why would anyone want to put the whole country under a similar system?
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Fmr President & Senator Polnut
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« Reply #40 on: August 28, 2007, 12:00:04 PM »

There has needed to be a serious overhaul of both medicare and medicaid.

Sadly the actual infrastructure needed to make such a scheme work is virtually non-existant. You can throw money at something all you like, but you can't make it stick.  This started primarily under Reagan's destruction of the great society programs, and sadly carried on by all his successors.

That's the problem, medicaid isn't working. The 40 million number are largely the "working poor" people who don't earn enough to afford health insurance (let alone have it included in work packages), but not poor enough to qualify for federal assistance.


Firstly medicare and medicaid had been only running since 1965/6 - one year later is certainly not a decent enough time frame, since it required people to sign on etc etc. Sometimes cost effectiveness isn't the issue look at the defence bugets between 1978 and 1982 - a 75% jump in 4 years, with only a 9% increase in hardware.

What needs to happen, IMHO (supporting doctors, patients, and reducing costs)
1) Increase the income thesholds.
2) Cap medical malpractice suit payments for pain and suffering, work with insurance companies to reduce the Doctor's premiums by 25%
3) Reduce government interferrence into medical practices.
4) REDUCE the red tape and bureaucracy. Streamline communcation between doctors and bureaucrats.

Universal healthcare is expensive, but you'll find that one of the bigger costs is in the fact the bureaucracy running it. You cannot really adapt the present system to fit Universal healthcare, it would collapse. You need a massive overhaul and genuine healthcare reform.
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snowguy716
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« Reply #41 on: August 28, 2007, 12:16:56 PM »

Also, if the government fails at something, the people can vote them out of office. People can't vote a corporation out of office.

Well, not directly. Someone could "vote" for Walmart over Costco by shopping there. If a corporation fails to make a profit, which can be obtained by having enough "votes", then they go out of buisiness. Conversely, corporations that make profits by having enough "votes" prosper. Presumably, people will "vote", as in buy from, for the corporation that provides the lowest cost and the best customer service. Considering that this happens on a quarterly basis (because that is when corporations get their profits), while government elections happen on a two year cycle, that would mean that corporations reflect the electorate 8 times better than the government.

Wow.  You read like an economics text book.  Unfortunately, the real world operates a bit differently.  But I applaud you for actually believing what you just wrote.  That takes guts.
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« Reply #42 on: August 30, 2007, 12:13:53 PM »

Also, it should be pointed out that we have government-run health care in one industry, and it was disasterous. Does Walter Reed ring any bells?
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« Reply #43 on: August 30, 2007, 07:20:31 PM »

Yes. That's what happens when government programs are under-funded and lack accountability. That's what happens when conservatives call government the problem and refuse to fund it to the point that it can't fix bridges and can't treat the troops.
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« Reply #44 on: August 31, 2007, 06:47:20 AM »

A great deal of the price inflation in health care is because they are even covered by private insurance or Medicare. The relation between rising premiums coinciding with rising medical costs is already known.

Not having health insurance in this case is not an escape from the inflated prices, since hospitals charge uninsured patients even more than they do the insured ones. And if the uninsured one can't pay, the hospital charges it off to a collection agency. Joy.

Contrast that to the almost nationwide stability of the prices of elective surgeries not covered by insurance. For example, breast augmentation -- from Hollywood to Manhattan, the price of one is about $6000. The free market has determined that this is the price plastic surgeons are willing to charge a patient for her pair of new brand-new boobs for her 16th birthday.

If private or governmental insurance (a concept I dislike on principle) should exist in health care at all, it should cover only catastrophic injuries that can deplete one's life savings in an instant.

As for tropes like "BlueShieldArklahoma shall cover 80% of the cost of three (3) yearly mammograms ... " that nonsense should be abolished completely.
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Gustaf
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« Reply #45 on: August 31, 2007, 09:07:33 AM »

A system where the government pays for health care but the individual can choose which producer to use (a voucher system) gives the benefits of competition while avoiding the unfair aspects of getting different price segments. So that's what I'd support.
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