Brad Wardell's views about technology, politics, religion, world affairs, and all sorts of politically incorrect topics.

Right now we have N people with insurance and Y doctors.

Obama’s plan would be N+40 million with the same number of doctors.

That doesn’t sound like a good deal to me.

The counter argument is always that we’re already paying for those 40 million people.  Well, if that is truly the case, then problem solved we don’t need to provide them with health insurance.  But in reality, no, those 40 million uninsured don’t have even remotely the same access as those with health insurance. They may get emergency care abut not much beyond that.

So what do you do if you don’t increase the supply of health care providers but do increase the supply of health care consumers? You get rationing. 

The second big problem has to do with who is paying for it.

Right now, people who have health insurance are overwhelmingly paying for it themselves – either through their employer or on their own.

But if we hand over this to the government, then we get back to the top 1% paying for 40% of it.  Sure, it’s a good deal for people who barely pay taxes but for the rest of us, do we really want to get into a situation where “society” is deciding what care we need or don’t need and paying for fundamental personal responsibilities? What’s next? Housing? Food? Clothing?  Why stop at health care?

There are so many other reasons to object to universal health care but those are a couple of the most basic reasons I oppose any government involvement in health care.


Comments (Page 1)
on Jul 25, 2009

I haven't had much interaction with the health care system in the US yet (and would like to keep it that way!), so I can't really make any meaningful comparison between a "government" run healthcare system and a private insurance system.

The one system I have experience with is the French one (not really a perfect example of how to run things, but an useful source of data nonetheless). It's kind of an hybrid system: basic healthcare is provided by the government and there are insurance companies (and quite wealthy ones) if you want more reimbursement for certains items or specific coverage. Most big companies provide that additional coverage so you are basically reimbursed 100% for all your medical needs.

It's financed through people salaries and taxes on interests. Basically everyone with a salary or a saving account pays something. Granted, it's still the top 1% that pays the more, but when you do look at how much it costs per person in the end, it's not only a good deal for people that do not work or get the minimum wage, it's also very interesting for those with salaries up to probably the top 5%, which is most of the workforce.

It's hard to tell whether a 100% privately run healthcare system would be better. In some cases, the state ends up having to spend huge sums of money to prevent healthcare problems with certain populations (illegal aliens usually do not get healthcare), which could have negative repercusions on the rest of the population. If there was no basic healthcare for jobless of low-wage people, that kind of thing might be worse and end up costing more than the cost of providing basic coverage. Unfortunately, it's quite hard to get numbers (especially since it's mostly theorical and we only have data on a very small part of the population).

As for rationing and the government deciding what you can do, that's not the case at all. You can go see any doctor you want (and there are no line or significant waiting involved for a majority of cases) and if you don't like it, nobody is preventing you from getting a second opinion. If you happen to need some sort of operation and do not want to go to a public hospital you can also decide to go to a private clinic and have it there (it's going to cost you more, but you have the choice). For some stuff, you get only reimbursed the basic stuff (dental & optic work comes to mind), but if you want something better you can either have one the private insurance I talked about earlier or pay the bill directly from your own pocket.

In the end, there are problems with this system too and it's not all nice and rosy, but it's nowhere near the apocalyptical hell some people are describing.

 

on Jul 25, 2009

(sorry about the "double" post, I get a bad auth error when trying to edit)

I forgot to add that Europe is mandating that you should be able to choose your healthcare provider so it's possible to get out of the government run system (it's actually not that easy yet, but it's getting better and should be a breeze once France is fined for not respecting his obligations - which happens a lot ). That should get you back probably 80 to 90% of the money you pay to the state. Few people do it though and some of them have gone back when facing the real costs (pre-existing condition, anyone?)

on Jul 25, 2009

Obama’s plan would be N+40 million with the same number of doctors.

That doesn’t sound like a good deal to me.

The demand for doctors may increase, but so too would the supply over time, meaning it would only be a short-medium term problem.

on Jul 25, 2009

aeortar


The demand for doctors may increase, but so too would the supply over time, meaning it would only be a short-medium term problem.

I actually think the supply of Doctors will decrease... it's been on the steady decline for over a decade now.

People aren't majoring in Medicine anymore... they're not putting in the 9+ years of school so they can be sued a dozen times a year for malpractice the second anybody's cough isn't cured over the weekend.  They're majoring in "Business" and "Technology", not Medicine.

Ask any (Medical) doctor how long they went to school, likely the least amount you'll hear is "7 years", that doesn't include Residency or anything... which is easily another 3-5.  During which time, the person is poor and near lifeless because of the amount of studying and time they have to put into work.
(And that's just a general practicianer, try asking a Neuro or Heart Surgeon how much time THEY put in!)

The only way this "plan" would work is if the Government gave some sort of extra incentive to actually BECOME doctors... such as protection from frivolous malpractice suits or discounts on malpractice insurance, which any (Surgical) Doctor's Office will tell you is near half their Operating Cost... and rising!

to recap:
People aren't becoming Doctors. (and giving them healthcare isn't an incentive to start)
Doctors spend a decade + in training. (and today's society doesn't care for that length of time)
There's no reason for people to desire to become Doctors. (and plenty of reasons for them to desire not to)

on Jul 25, 2009

A few years ago I had two teenagers in my care from Bulgaria.  They were in the states going to our local High School and they would stay with me over the course of two years on school vacations and weekends because they couldn't go home. 

One of the girls, extremely bright has a father who is a Doctor.  She's now been accepted to Harvard (free of course) after obtaining and fullfilling a 4 year scholarship  for an undergrad degree in Oregon.

 She told me that during their years under communism he had to go to Africa to work because Doctors were so underpaid.  They were very very poor.  She said the only ones making any money were the ones in the goverment.   Everyone else were extremely underpaid including doctors.  So he would travel for a year or so at a time to Africa using his profession as a doctor.  He would send money home to the family in order to support them. 

Is that where we are headed? 

on Jul 25, 2009

Obama says the cost of healthcare is what's bankrupting our country, that we must reduce the cost of healthcare.

He claims that the proposed government takeover of healthcare is the answer to that problem, that 'greater efficiency' will reduce the cost enough to save us from collapse.  However you slice it, he's wrong.  Increased efficiency is the equivalent of increased productivity - greater output with less labor.  Increased productivity is universally accepted as a good thing, increasing the standard of living.  Not so with healthcare.  An increase in productivity is the last thing they are looking for.

Government believes that in healthcare, efficiency is the enemy of cost control.  That is the only conclusion that can be drawn from what the government has actually done over the past 40 years, as opposed to its rhetoric.  It was simple, straightforward and easy to deliver care in the 60's and 70's and relatively cheap in GDP terms.  The more the government has insinuated itself into healthcare, the faster the cost of healthcare has risen, which has, of course, been blamed on insufficient government insinuation into healthcare and its subsequent expansion.  Rinse, repeat, rinse, repeat, here we are at 20% of GDP (set aside the debate over whether that is a good or bad thing, whether there is a 'right' percentage).

When my father was ill and hospitalized with pneumonia in 1971, our family doctor was able to get an experimental antibiotic flown in from England within 24 hours.  A family doctor, not a specialist, and all he had to do was pick up a phone and request it.  No authorization forms, no 'certification,' nothing more than his judgment about what his patient needed, based on his laborious training and acquired knowledge.  That was efficient, and it simply wouldn't, couldn't, happen now.  Barriers have been erected systematically, relentlessly and with intent to prevent just such efficiency, all in the name of saving money, especially in Medicare.  Private insurers, once they saw how effective 'efficiency control' was for the feds, went & did them one better, with a little subsidy from the feds to be sure they got the market share the feds wanted them to have (you may remember HMO's were paid more because they were 'more efficient' - look how well that worked out).

on Jul 26, 2009

I actually think the supply of Doctors will decrease

Lets assume for a moment you're correct, that even with an increasing demand for doctors, the number of doctors decreases. What would that mean? Well since healthcare is typically something you need (and hence can't cut back on as easily as various luxuries), you will have an excess demand where a doctor has say 2 people they need to treat, but only time to treat 1. In a private system that means those people can get charged more money until there is no longer an excess demand. This happens both from the effect of the increase in cost making people put off treatment, and also because if they raise money, the money doctors earn will in turn increase. This means that rather than a fall in the number of doctors you'd expect a rise, because they would earn more and more money, making it more attractive to become one. With a public system meanwhile you would have to impliment a system of queueing to control the excess demand. The longer the waiting time, the worse it becomes for the politicians, as people demand access to necessary treatment quickly, forcing them to raise wages for the doctors so that more people will want to train.

The time lag between wages rising for doctors causing new people to train as doctors as a result, and then becoming doctors is quite significant, hence why I refered to it as a short-medium term problem, but it is certainly not a long term one.

on Jul 26, 2009

Littleboy


I haven't had much interaction with the health care system in the US yet (and would like to keep it that way!), so I can't really make any meaningful comparison between a "government" run healthcare system and a private insurance system.
The one system I have experience with is the French one (not really a perfect example of how to run things, but an useful source of data nonetheless). It's kind of an hybrid system: basic healthcare is provided by the government and there are insurance companies (and quite wealthy ones) if you want more reimbursement for certains items or specific coverage. Most big companies provide that additional coverage so you are basically reimbursed 100% for all your medical needs.
It's financed through people salaries and taxes on interests. Basically everyone with a salary or a saving account pays something. Granted, it's still the top 1% that pays the more, but when you do look at how much it costs per person in the end, it's not only a good deal for people that do not work or get the minimum wage, it's also very interesting for those with salaries up to probably the top 5%, which is most of the workforce.................

Littleboy, I'm glad you live there because I have been stating that France has one of the better UHC systems.  Go here and scroll down ( http://forums.joeuser.com/358734 )

In France the tax rate is 30% for anyone who makes 25,233 to 67,555 (Euros, I if you go to the link and scroll down I converted everything to dollars) while if you make more than 67,555 your taxs are 40%.  In reality you guys are paying for it and like you stated most of the population is paying for it which is only 62 million people.  (On an unrelated topic, I do like how France is using Nuclear power and I wish the U.S would follow France in this because 3 Mile Island and Chernobel were all human error/ignorance.  The systems are stronger and more secure. We are able to get a butt load of more enegry now than we could from the older Nuclear power plants.  Nuclear power is cleanier and the waste, which is an extreme negative, has become more manageable.  Why can't the States do this instead of the UHC?).  

The United States is almost 5 times larger than Frances' population for the population in the States is either just about 300 million or a little over that. 

If you go to that link, you'll see that.  When I was in Grad School some time ago, I would ALWAYS hear how the U.S is the only industrial nation that does not have a UHC system.  Most people that make that agrument think that some how Canada, U.K., and European countries have the same population size as the U.S. or vice versa.  Truth of the matter is that the States are by far much larger than all of those other countries.

Then I also hear the usually statement: 'think how many people are all unisured in the States.'  I never said this but I thought this (for it is an extreme thought) think of all those unisured in China and India.  I'm not sure about China, but in India I know there is a ton of unisured (yes I know that India isn't on the same level as the other countries we're discussing) yet I'm sure neither of those two countries will ever adopt a UHC system due to the fact people will agree that their population size is too big. 

UHC is more geared to smaller populations.  ON top of that you're almost guranteed to be paying higher taxes.  Just go to that link and scroll down. The U.S tax rate is lower than the usual suspects that get lined in the comparison of UHC systems.  I'm guessing that our tax system is more complex and more imbecilic, though.  Also, our system was probably made from a room full of neonates and anything that they said was put into the tax code hence why its so long and confusing.

on Jul 26, 2009

On a final note, why is it necessary for the entire population to be insured? If people in the U.S would realize is that what is more important than everyone getting insured is that if we had a better system of preventive medicine/health.  This would drastically cut down cost because usually illnesses/diseases ect ect tend to get more expensive to treat in the later stages as that they go undetected compared to if they are caught earlier.

I feel that people including the President are missing the whole reason why the health care system is if you want to call it 'out of control'.  Most people in the U.S only go to the doctor when it is EXTREMELY necessary: ex. I'm coughing up blood now when I've had this prolonged chest pain for about 2 months or something to that nature (again the coughing up blood/chest pain was only an example).

A final example is Supreme Court Justice Ruth Ginsburgh being diagnosed with pancreatic cancer in the very early stages. Which if you know anything about pancreatic cancer it is VERY rare that they find it in the early stages and if it goes undetected (which it most oftenly does) proves to be very fatal and very expensive to treat in the later stages.  How did they find it, Supreme Court Justices all have monthly (or there about) checkups at the U.S. tax payers expense. This is a prime example of the effectiveness of preventive care/medicine.

on Jul 26, 2009

A final example is Supreme Court Justice Ruth Ginsburgh being diagnosed with pancreatic cancer in the very early stages. Which if you know anything about pancreatic cancer it is VERY rare that they find it in the early stages and if it goes undetected (which it most oftenly does) proves to be very fatal and very expensive to treat in the later stages. How did they find it, Supreme Court Justices all have monthly (or there about) checkups at the U.S. tax payers expense. This is a prime example of the effectiveness of preventive care/medicine.

Under Obamacare, she'd be determined 'too old' and denied treatment.  After all, 'we can't continue to pay for things that don't make us well'.  The facts about pancreatic cancer survival, no matter how early it is diagnosed, are grim.  The characteristics of the rare 'long-term' survivors are completely unpredictable and, were she not a Supreme Court Justice, she wouldn't make the cut when her case came up before the 'panel of experts' - not at 76, only 3 years away from her life expectancy, especially once the Federal Coordinating Council for Comparative Effectiveness Research renders a ruling on the management of pancreatic cancer (the FCCCER has already been created, thanks to HR1, the 'stimulus' bill).

 

on Jul 26, 2009

Furthermore, the assertion presupposes that all montly checkups would detect a pancreatic cancer at an early stage, and they wouldn't.  It would be great if everyone got Supreme Court Care with monthly checkups paid for by somebody else, but that ain't what's being proposed.  The amount of money expended to detect one case of pancreatic cancer using that approach would be astronomical.

on Jul 26, 2009

Not so with health care. An increase in productivity is the last thing they are looking for.

I believe some aspects of health care can be  more efficient, such as the administrative areas. I like the electronic medical record concept (though I firmly believe the government and private insurance should not have their hands on this). Go to the doctors office, punch in a pin (or a biometric for emergency service).

When has the government provided exceptional value on anything? The few health services they now provide are either wasteful, inefficient, or corrupt (VA, Medicaid, Medicare). Who in their right mind can possibly believe they will get a national plan right?

I hear a lot of talk about being able to keep my current health plan. Gee thanks! Does that mean that I then don't have to pay for my plan and again via taxes for someone else? Good deal for them I guess. So where is the incentive to pay your own way, when you MUST pay anyway via your taxes? We live in a slackers paradise.

I'm not going to even get into reduced health care for the elderly. Groups like AARP are so glued to Obama's member, sort of like the media,  that they are selling out their constituents by supporting this travesty. Remember the not too distant screams when Bush proposed private retirement savings accounts along side social security? Funny how quiet it is now.

There isn't a day that goes by that I don't see some company hawking health insurance for people that are self-employed or want something other than what their work place provides. Insurance is available. I wonder how many people just are too cheap, or think they are invulnerable to buy it? When I was younger I probably would have forgone coverage just to make my paycheck a little larger, had I not been under military health care. I get that, but it is a personal choice to take it or not. Look at your pay stubs folks, Medicare taken out of your paycheck is not refunded when tax returns are submitted, If if you effectively pay nothing. What are you going to save if this amount increases? Then the choice to risk it is moot, you will pay, and you won't pocket the extra few bucks each payday. Let the people decide.

on Jul 26, 2009

UHC is more geared to smaller populations

How/why?

on Jul 26, 2009

I think that in this case the facts speak for themselves. In Canada, we have universal healthcare -and-

  • Per capita we pay less for healthcare in taxes than someone paying for health insurance in the states (there is no middleman in Canada needing to make a profit like there is with the insurance companies in the states) 
  • All mortality statistics are lower for Canadian citizens than American citizens- we live longer, have lower infant mortality rates, and suffer from less debilitating conditions during said lifespans.
  • If I have a major medical problem, I will get priority treatment -and- do not have to worry about my premiums going up, having to take out a second mortgage or declaring bankruptcy just so that I can have the audacity to keep on living. Also I do not have to worry about having coverage denied because an insurance company decided that I lied about a pre-existing condition or that my treatment is 'experimental' and therefore not covered. In short, the decision about my care is made by my doctor, NOT by a hospital administrator with his eye on his companies bottom line.
  • Adequate healthcare is not affordable by someone making minimum wage in the U.S. Let's run these numbers: A fellow working 40 hours a week for 52 weeks at minimum wage will pull in about 15,800 dollars a year. Now, basic health insurance for a family will cost in the ballpark of 13,200 dollars. So, our fellow working on minimum wage, if he wants to get coverage for his family, will have 2600 dollars a year to live on (just over 200 bucks a month) Now I know this isn't realistic but it serves as a good example. Considering the state of the economy, there's a lot of folks who can't do much better than minimum wage to begin with.
  • Economically universal healthcare is a -GOOD- thing for employers. Both German and Japanese automakers don't have near the  headaches that GM and FORD do. Why? Because they don't have to worry about paying for their workers health care, -OR- for their pensioned retirees healthcare. That's all taken care of by the government in those countries. In the States, with each passing year Ford and GM had ongoing ballooning costs as the number of retirees they had to cover kept going up and up (and as folks get older the amount and cost of care goes up considerably too)

So what is the benefit of having a privatized healthcare system? Those with the means to pay for the "Platinum" package get amazing treatment. Admittedly much better than that offered by a socialized system. However, those who can only pay for the Silver package might be in trouble if they start making too many claims (how dare they!) or run into a problem not covered by their plan.... which really is absolutely ridiculous. How can anyone realistically anticipate what number of possible medical conditions they might run into in a few decades?!? And, if you're like most average joes in the world, you can't even afford the silver package but instead have to shell out dough for the Bronze package, which could be called "Best Effort"

I will maintain to my grave (which statistically I will visit after living more years on this earth than an American) that to include the profit motive in healthcare is simply wrong for several reasons. Yes, healthcare has a cost, as does everything, but that cost should be covered by a public system whose primary motivation is to deliver effective service to everyone -rather than- turning a profit. In short, healthcare should be a service, not a business. And it is for that reason that it should be public, which, it already is in every single industrialized country except for the United States.

on Jul 26, 2009

# Per capita we pay less for healthcare in taxes than someone paying for health insurance in the states (there is no middleman in Canada needing to make a profit like there is with the insurance companies in the states)
# All mortality statistics are lower for Canadian citizens than American citizens- we live longer, have lower infant mortality rates, and suffer from less debilitating conditions during said lifespans.

These would be good points if there were any evidence of a cause-and-effect relationship betweeen them.  Sometimes (in fact, much if not most of the time) bare facts don't speak for themselves.  Understanding the facts requires thought & effort.

Adequate healthcare is not affordable by someone making minimum wage in the U.S. Let's run these numbers: A fellow working 40 hours a week for 52 weeks at minimum wage will pull in about 15,800 dollars a year. Now, basic health insurance for a family will cost in the ballpark of 13,200 dollars. So, our fellow working on minimum wage, if he wants to get coverage for his family, will have 2600 dollars a year to live on (just over 200 bucks a month) Now I know this isn't realistic but it serves as a good example. Considering the state of the economy, there's a lot of folks who can't do much better than minimum wage to begin with.

They already have healthcare paid for by the taxpayers - it's called Medicaid.

I will maintain to my grave (which statistically I will visit after living more years on this earth than an American) that to include the profit motive in healthcare is simply wrong for several reasons. Yes, healthcare has a cost, as does everything, but that cost should be covered by a public system whose primary motivation is to deliver effective service to everyone -rather than- turning a profit. In short, healthcare should be a service, not a business. And it is for that reason that it should be public, which, it already is in every single industrialized country except for the United States.

Niavete, thy name is idealism.  Food has a cost, but shouldn't everyone eat, without 'profit' being taken out by the food industry?  Shelter has a cost, but shouldn't everyone have a house, without 'profit' being taken out by the housing industry?  Cable TV has a cost, but shouldn't everyone be able to watch American Idol, without paying Simon Cowell $22mil?

Meta
Views
» 6167
Comments
» 19
Category
Sponsored Links