National Healthcare System?

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

Yes, I agree and it sounds like a great idea. My cousins wife had a terrible stomach bacteria that ate the lining of her stomach and the only way she lives is from drugs she gets from Canada because for some reason the FDA has yet to get around to making it available in the U.S.

[DumbStupidRedneck]

The FDA is so dumb my Mom has been waiting for years for them to release a trial version of a cancer drug that has been used for 10 years in Europe.  The FDa is a piece of sh**t.

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

Excellent idea there ma'am. It's to bad the government is so deadlocked that we all have to suffer for it.

[Huckleberry Finn]

I have got enough about Finnish public health care system. Few days ago I noticed itching and in one of my mole. As women usually my wife feared worst (skin cancer in this case) and I called to the public healthcare station.  They said that it would take a week to get general doctor. A week!! Then I called to the health station of my university. Three weeks! Then I called a private clinic. I got reservation for specialist in two days. (She said that there is NO signs of cancer. A bill was just 50 euros)

Al, It was hard to believed that the public healthcare in England could be better than private. It just sounds impossibility. Have other British member any view?

I still tend to favour idea of the universal healthcare. But I strongly support a solution where it is produced by private companies. In Finland we are moving more and more toward this model. People use more and more private sector. Sooner and later that will force the government shift money to benefits for those who use private companies. Then it’s time to privatize most public health services. Of course Conservatives should be in power again before this all could happen

[Platypus]

my dad has recently been diagnosed with a disease called Polyarteritis Nodosa. Her in Australia, we have a fantastic but expensive private system, and a great and cheap public. Whilst we had private cover, it only constitutes 70% or so of the bill, so we chose to go public. This means that, along with cheap rates, the government covers half the bill. The service is just as good, and it's cheaper. So, why not go public?

I'm just so glad that we live in one of only ten or so countries in the world that a citizen would choose to go public over private.It's good to know that people who cant afford the private care can get public care. Sure, the cues are a couple of hours longer. But that means a three hour wait, instead of one-that isn't much in the grand scheme of things.

The joy of having a safety net uis extreme. I wish everyone could shatre it. there is nothig wrong with socialist healthcare policies. They work, for everyone. Why oppose?

[Swing low, sweet chariot. Comin' for to carry me home.]

What about us folks making 30 - 35k a year. Healthcare costs are killing us. My family pays 50 dollars a week for healthcare on a 80/20 plan with a 350 dollar deductible.

Yet you still have better healthcare than any generation in the history of mankind.  So what's the problem?

The only socialized medicine I support is immunization for 100% of US children.

[Swing low, sweet chariot. Comin' for to carry me home.]

What about us folks making 30 - 35k a year. Healthcare costs are killing us. My family pays 50 dollars a week for healthcare on a 80/20 plan with a 350 dollar deductible.

Seriously, until you have given up all luxuries like (cable TV, eating out, internet service, etc), basically until you're down on the bare essentials (food, clothing, and shelter), how is your medical bills a concern to society as a whole?

[KEmperor]

No to any government interference in health care.

[opebo]

No to any government interference in health care.

Yes!  I couldn't agree more.

[Tory]

I believe that goverment should provide health care only to the neediest individuals.

[pieman]

The problem with the healthcare industry is that we have eliminated a marketplace that balances cost with value.

The patient doesn't care what the procedure costs because his insurance is paying for it. The patient is merely looking for the best care they can get, because the cost is the same no matter what the level of care they receive.

The doctor doesn't care what the procedure costs, his primary motivation is to get reimbursed by the insurance company. As long as he provides the standard of care in the industry, he can avoid getting sued for malpractice and has a reason to submit it to the insurance company without hassle.

The insurance company is the only one that cares about the cost. The only problem is, they don't care if its a good value or not or if it is helpful or not. They are just trying to pay the minimum possible while still appearing to meet the basic obligations of their policy. We now have nurse practicioners at insurance companies making decisions on what get covered and therefore what the doctor will prescribe.  

None of the three entities balance cost with value.

Therefore, medical device and pharmacuetical companies are left with two conclusions:

First, before getting any return for a product they msust first do R&D and clinicals to the point where they have to prove to the insurance companies that their products are the standard of care.  

Second, they have found out that price is NOT a determining factor in acceptance and use. This is because doctors prescribe what they can get reimbursed for and patients request the best care available. The insurance company is required to pay as long as its the standard of care, no matter the COST.

The result is that healthcare companies have to continue to meet the expectations of patients for the best care as well as expend huge amounts of money for R &D and clinicals to prove that the product is standard care. Healthcare companies have found that the only way to survive in this environment is to continually improve products and charge enough to recoup R &D and clinical costs.

Is it any wonder that healthcare costs continue spiraling upward?

Universal Healthcare does not address the root problem of disconnect between cost and value. The only way to do that is to get the patient to balance cost and value.

I would propose healthcare savings accounts along with getting the insurance companies out of the medical procedure approval business. If insurance were used only for catastrophic care, it would be possible to put the doctors back in charge of deciding what is acceptable care and what is not. I would require insurance companies to pay for anything prescribed by a licensed doctor subject to fraud review.  

The new medicare law has some provisions for health care savings accounts already.

[WMS]

I favor some form of universal coverage through some mix of public and private agencies. No, I don't have details, I'm afraid...health care got confusing around the time of "Hillarycare" and has only gotten harder to follow. HOWEVER, I don't support the status quo because we spend more on health care per capita per person than anywhere else in the world, and we still have lots of uninsured and even more people - like myself - who use it rarely because of cost concerns. Can we say "cost-benefit analysis", people? There has got to be a better way of doing this...

[The Duke]

No to any government interference in health care.

I have to support goverment intervention, the private sector failed.  It is too hard to start up a new insurance company, so we now have a cartel of sorts that can charge whatever it wants.  I'm not mad at them, they just want to get paid and I undestand that, but we all need to recognize that a system that allows them to do this is not a good one.

[The Duke]

What about us folks making 30 - 35k a year. Healthcare costs are killing us. My family pays 50 dollars a week for healthcare on a 80/20 plan with a 350 dollar deductible.

Yet you still have better healthcare than any generation in the history of mankind.  So what's the problem?

The only socialized medicine I support is immunization for 100% of US children.

He'd have better health care than any generation of Americans, but not better than anyone ever.  Japan and Australia tend to have better systems of care.  Some European countries, too, but some in Europe have problems.

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

What about us folks making 30 - 35k a year. Healthcare costs are killing us. My family pays 50 dollars a week for healthcare on a 80/20 plan with a 350 dollar deductible.

Yet you still have better healthcare than any generation in the history of mankind.  So what's the problem?

The only socialized medicine I support is immunization for 100% of US children.

Drugs are way overpriced as well as medical services. We do need price control. The doctors are owned by the Drug Companies.

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

What about us folks making 30 - 35k a year. Healthcare costs are killing us. My family pays 50 dollars a week for healthcare on a 80/20 plan with a 350 dollar deductible.

Yet you still have better healthcare than any generation in the history of mankind.  So what's the problem?

The only socialized medicine I support is immunization for 100% of US children.

He'd have better health care than any generation of Americans, but not better than anyone ever.  Japan and Australia tend to have better systems of care.  Some European countries, too, but some in Europe have problems.

I may have overall better care but half the time I end up having to do half to 3/4 of THEIR footwork. The Insurance Companies and Hospitals don't work together and half the time it ends up becoming one big cluster fudge for me to deal with. I still occasionaly get a bill that's 2-3 years old.

[KEmperor]

No to any government interference in health care.

I have to support goverment intervention, the private sector failed.  It is too hard to start up a new insurance company, so we now have a cartel of sorts that can charge whatever it wants.  I'm not mad at them, they just want to get paid and I undestand that, but we all need to recognize that a system that allows them to do this is not a good one.

Actually the private sector was doing pretty good until the government got involved a couple of decades ago.  Now, thanks to government intervention, we have this system of HMOs which is naturally causing the prices to skyrocket, on top of the frivilous lawsuits that are not being thrown out of court causing many doctors to go out of business.

[muon2]

No to any government interference in health care.

I have to support goverment intervention, the private sector failed.  It is too hard to start up a new insurance company, so we now have a cartel of sorts that can charge whatever it wants.  I'm not mad at them, they just want to get paid and I undestand that, but we all need to recognize that a system that allows them to do this is not a good one.

... The constitution says "Provide for the general welfare". I base a healthcare system on that premise.

Pieman makes some excellent observations on the disconnect between the patients and the payers. Let me start with some comments on the patient side.

The great success of modern health care over the last 50 years have greatly raised expectations by the public. I disagree that mere economic pressure will cause the consumers of health care to become sufficiently educated in their choices. Without that, the market fails. I also agree with John D. Ford's rough analysis of the impact on business - we do pay a price in competition because companies place this extra cost on their labor. This is another example of expectations getting so high that the market fails. A draconian solution would lead to a market crash - a collapse of the health care industry and the level of care that the country expects.

An analogy that might be useful is to compare health care to police security. If there is a crime, people expect an immediate and complete response from local government. They expect the use of best technology used to its complete extent by trained professionals. They recognize the limits of a locality to provide all the latest gadgetry, but expect that keeping up with national standards remains a high priority. Local residents also know that security can be augmented with higher government agencies and private suppliers of alarms and security personnel. Large companies may find it more cost effective to make extensive use of the private sector, even as local police forces are available and come when called. Oh, and did I mention accountability - local elected officials are usually very accountable.

What if medicine followed the same model? Counties or cities (maybe some states) could support the level and types of service that is appropriate for their residents. Counties and cities frequently run health departments now. The new expanded role would be in the form of a primary payer to government or private doctors and hospitals. Federal and state support for groups like the poor and elderly would provide some balance between counties with large indigent populations. Direct private insurance and health providers would still exist as enhancements available to those who choose the extra service.
The public as a whole would get the kind of improvement they expect without having to become expert consumers.  Doctor could work in the public or private sector. The big insurers would seem to be the losers, but there would be nothing that prevents them from selling insurance products to governments providing the health care. Many governments maintain insurance for their varied activities now.

This might be an easier method to implement as well. Many existing structures would remain. Initial taxes would probably come from a mix of sources, but corporate taxes would be an important source since the goverment would be relieving the companies of the need to provide health insurance. The local nature of service allows smaller scale implementation, and avoids many pitfalls of national systems that are sometimes proposed. Even the EU doesn't provide a single health care system across all of Europe.

[angus]

No to any government interference in health care.

Yes!  I couldn't agree more.

you're a bunch of tightwads.  I have to admit that I am too.  With the possible exception of federally subsidized abortions for the very poor (which would save us billions on all the WIC, welfare, clothing, high school textbooks, etc., for an unwanted child) I think the government should not be grown large enough to muck around in health care.  

And yes, we wouldn't even need that if the government had completely stayed out of this business.  Kemperor points out in a subsequent post that until a couple of decades ago (more like four, actually) we began an experiment in federal involvement which has artificially grown the price of all aspects of health care.

Solution:  Fire every one in the department of Health and Human Services.  Legalize ALL drugs and let me decide which ones I need, whether for therapy or recreation.  And otherwise keep your government on a short leash.

[TeePee4Prez]

The FDA is so dumb my Mom has been waiting for years for them to release a trial version of a cancer drug that has been used for 10 years in Europe.  The FDa is a piece of sh**t.

That is true.  The FDA needs to loosen up a large bit on that.  However I can see the governemnt to some extent, like in StatesRights proposal.   The FDA seems to rush destructive fad diet drugs on the market real quick, but cancer or autoimmune drugs take forever!  I wonder about them sometimes.

[angus]

No, I think it is the opposite with the fda.  guys with aids, cancer, even emphysema will try most anything to get better.  but drugs are still considered experimental (which is probably advisable in some cases the fda is overly cautious, and its bureaucracy is inefficient.  that's one of the departments I was talking about nixing and starting afresh.

[angus]

Ha.  Imagine a new bumper sticker:

keep your laws off of my retrovirus!

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

If you are poor you get all the good benefits of goverment. If you are rich you can afford it so it doesnt matter. But if you are stuck on the lower middle end like I am you are basically screwed. Just my opinion.

[muon2]

If you are poor you get all the good benefits of goverment. If you are rich you can afford it so it doesnt matter. But if you are stuck on the lower middle end like I am you are basically screwed. Just my opinion.

I agree. The line the separates poor from lower middle is completely arbitrary and contribute to the broken health care market. The lifetime employment with a single firm assumed for the current health care system is hopelessly out-of-date.

I think that a US-wide system will be overly cumbersome with too many inefficiencies. A plan with a local element will better respond to the needs of residents.

[WMS]

This is very interesting! I like muon2's idea quite a lot, although Ford and States have good points as well. Which brings me to my main point...

Why, with all these good ideas about health care floating around - and all from Republicans, at that - are we continually locked in a debate between the left-wing 'Single-Payer Canadian System NOW!' and the right-wing 'NO To Socialized Medicine!' positions?!

What's up with this, anyway? There's more clever fixes in this thread than have been produced by the last fifty years of Congressional and Presidential debate! Why can't America settle this issue?
-a perplexed WMS