H/T to John Cole for finding this. I can testify to the Japanese system-I’ve been treated by it myself and I went with the S.O. to her doctor’s appointments. Of course the piece he doesn’t tell is the challenge of being a Gaijin who doesn’t speak Japanese-and not being in a major city like Tokyo. That can be a frightening experience. However, folks I knew who had babies at Japanese hospitals were pretty fine with every thing about-except the food.
5 Myths About Health Care Around the World
By T.R. Reid
Sunday, August 23, 2009
As Americans search for the cure to what ails our health-care system, we’ve overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they’ve found ways to cover everybody — and still spend far less than we do.
I’ve traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:
1. It’s all socialized medicine out there.
Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others — for instance, Canada and Taiwan — rely on private-sector providers, paid for by government-run insurance. But many wealthy countries — including Germany, the Netherlands, Japan and Switzerland — provide universal coverage using private doctors, private hospitals and private insurance plans.
In some ways, health care is less "socialized" overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands, seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet’s purest examples of government-run health care.
2. Overseas, care is rationed through limited choices or long lines.
Generally, no. Germans can sign up for any of the nation’s 200 private health insurance plans — a broader choice than any American has. If a German doesn’t like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.
In France and Japan, you don’t get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment — and insurance has to pay.
Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.
As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations — Germany, Britain, Austria — outperform the United States on measures such as waiting times for appointments and for elective surgeries.
In Japan, waiting times are so short that most patients don’t bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. "Why don’t you just drop by?" the receptionist said. That same afternoon, I was in the surgeon’s office. Dr. Nakamichi recommended an operation. "When could we do it?" I asked. The doctor checked his computer and said, "Tomorrow would be pretty difficult. Perhaps some day next week?"
3. Foreign health-care systems are inefficient, bloated bureaucracies.
Much less so than here. It may seem to Americans that U.S.-style free enterprise — private-sector, for-profit health insurance — is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.
U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for nonmedical costs, such as paperwork, reviewing claims and marketing. France’s health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada’s universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.
The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.
4. Cost controls stifle innovation.
False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who’s had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.
Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)
5. Health insurance has to be cruel.
Not really. American health insurance companies routinely reject applicants with a "preexisting condition" — precisely the people most likely to need the insurers’ service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer’s "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business.
Foreign health insurance companies, in contrast, must accept all applicants, and they can’t cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits. The big Swiss insurer Groupe Mutuel promises to pay all claims within five days. "Our customers love it," the group’s chief executive told me. The corollary is that everyone is mandated to buy insurance, to give the plans an adequate pool of rate-payers.
The key difference is that foreign health insurance plans exist only to pay people’s medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.
In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we’re Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we’re Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we’re Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we’re Burundi or Burma: In the world’s poor nations, sick people pay out of pocket for medical care; those who can’t pay stay sick or die.
This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. All the other developed countries have settled on one model for health-care delivery and finance; we’ve blended them all into a costly, confusing bureaucratic mess.
Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don’t. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.
Given our remarkable medical assets — the best-educated doctors and nurses, the most advanced hospitals, world-class research — the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about health-care administration from the other industrialized democracies.
T.R. Reid, a former Washington Post reporter, is the author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care," to be published Monday.
Frankly, I didn’t bother to read the shite, let’s try America’s attempts at socialized healthcare shall we?
MEDICAID – Broke. Insolvent. Pushing the states to ruin.
MEDICAIRE – Broke. Insolvent. Pushing the United States to ruin.
Tennessee’s lovely socialized health care scheme – Broke. Out of business
Massachusetts lovely socialized health care scheme – Broke, ruining the late great state.
Hawaii – Keiki Care or whatever it was – Broke. Out of business.
Maine – A complete disaster. Broke, insolvent, covering 3550 people instead of the 28,000 initially planned. Costs ballooned because it was a free ride for the worst off.
Don’t drink the cool aid. Look at the facts. Don’t drag in the nation states that emasculated themselves to pay for their socialized health care.
For Christ’s sake, it’s not like people haven’t tried this ponzi scheme before.
How come other countries make it work then?
Couldn’t have anything to do with tax cuts that were unnecessary could it? Besides, I’ll say it again-there are nations that have made private plans work. Singapore is a good example. Just learn to live on 65% of you income while you pay for your health care and fund your retirement. And your civil services.
And even if those state systems are broke-they are not “socialist”. Go back and read the whole article.
I really hope this proposed health care bill fails. If it passes, then the cost for treating all those misinformed insane Americans is going to massive and those poor Shrinks wont be able to spend 4 out of 5 working days on the golf course due to workload. 🙂
A major reason for any Government to exist is to care for the people as best as it can. The USA is really failing in this and any example of being the best in the world at brain surgery or hip replacements is false if its not available to everybody.
Not sure of the accuracy of the article, but for the UK and I imagine lots of other nations. State run hospitals run freely alongside private care should you wish to use that.
Skippy,
Every single one of those socialist utopian plans is BROKE.
Live on just 65% of your salary…….Planet dude. Which one are you living on? Fed takes 40% and state and local take 15% with no end in sight.
WTF is Singapore paying for the common defense? Our Common Defense happens to be subsidizing the entire ratbag world of socialist losers who bemoan…..well to be honest, those socialist hags in Europe don’t care what minority group gets massacred wholesale and see no reason for the US to bother itself in attempting to stop more genocides. No doubt that’s because Europe has never seen a genocide it didn’t really support at a basic level….kill Armenians, kill Jews, kill Gypsys, kill fags, kill niggers, kill muslims….European socialists don’t give a shit just as long as they have their socialized medical plans.
Skippy, JUST WHAT DO YOU CALL SOMEONE TOO DAMNED IGNORANT TO LEARN FROM OTHER PEOPLE’S EXPERIENCE?
Me, I refer to them as democrats but I think that they’re just too stupid to learn from their mistakes.
It wouldn’t matter if Singapore is paying a lot for defense-their health insurance is privately funded. You just don’t have a choice about whether to pay for it is all-neither do employers. I think that’s a good way to go for the long run.
Here is Hicksville our tax burden is much less. Then again-our schools are not the best either. You get what you pay for.
Thanx for the post. Most of us in health care say the 5 myths are well known and have been for some time. Our non-system is unfair and inefficient and too expensive. No reason we cannot implement a systme that works.
With healthcare costs in the US running above 7 000/ person and rest of develpoed world around half that for better metrics means we could save about 1.155 Trillion/year implementing reform. Sounds like a very ficsally conservative approach to me with added benefit of better outcome metrics.
Unless you are an insurance company in the USA.
Foggy, you blithely, as usual, skipped over the issue I raised which is that all socialized systems run by governments are totally broke or broken and you trill that somehow I can save 1.155 TRILLION $ PER YEAR if I just turn over health care to the people that lose 7 billion per year running a post office monopoly.
HOW AM I SAVING MONEY I’M NOT SPENDING YOU JACKASS? MY FUCKING USELESS GOVERNMENT IS NOT SPENDING 1.155 TRILLION $ PER YEAR ON HEALTH CARE, we are! That’s our right you stupid fascist. We get to spend the money we earn on the things we want. We don’t need you and the other fascists deciding to steal our money that we would otherwise spend on healthcare and spend it in creating a US Postal version of a medical system.
What part of that don’t you understand?
Curtis,
Why is it, that you have to lose your temper? No one who comments here is a fascist, a socialist, or anything else but a commenter who has a right to express his opinion.
I, for one, am tired of hearing from so many useful idiots, that if I have opinion that is in opposition to theirs-I’m a (fill in the blank). Argue you the issues all you want-but, please, don’t attack my guests. You would not like it if I called you a jackass, would you?
For the record, I expect my taxes to go up in the coming year-at least until I move back overseas next year. My expenses will be less then-so I expect that my “bubble” where I have room to live comfortably will balance out OK. The good news is that I will have decent public transportation at my beck and call which will save me the cost of an automobile.
Also for the record- I support a system similar to Singapore’s where approximately 35% of you income goes to fund three things: your taxes, your retirement, and your health care. You don’t have a choice to opt out in the Singaporean system-and neither does your employer as far as paying their share. Its about a 60 /40 split between employer and employee. The CPF which is the retirement scheme is fully funded because its your money from the gitgo-and I would support allowing the same thing the Sings do-you can use it as collateral against a house loan. ( Which for most folks is really a decent apartment).
Failing that-I would support a mixed public / private scheme like they have in Japan.
We have a saying here in the (deep) south, “we don’t care how you do it up north”. And I don’t care how they do it in other countries. For a while longer I hope that this country will remain capitalist so I can still have a choice. I for one like it when corporations make a profit.
USAA sends a dividend check when they do well. My HSA premium went down last year.
Cy,
Why not adopt an idea if its has worked overseas? As I pointed out earlier-this insistence on a unique “American” solution is a big part of the problem. If we adopted any of the solutions I have suggested-it would not do anything that would make the country less capitalist-that’s why I object so much to the “socialist” tag. Mandatory private insurance is not “socialist”.
Skippy,
I’m still confused, What is so wrong with people paying for their own health care, out of their own pockets? I routinely (daily) see patients who have cell phones, , smoke a pack a day, have manicured nails and drive new cars who ask me “can I get samples” (of meds) because they don’t have health insurance and don’t want to pay the $40-$50 for an antibiotic to get them healed. They have problem paying for HBO and Showtime on their digital HD plasma TV but for some reason they don’t think they should contribute to their health care. Same for dental care. I have seen hundreds of patients with horrible, rotten, infected teeth who when I ask “do you see a dentist” respond “I don’t have insurance”. If I have time and feel like engaging them I often resppond with ” You don’t need insurance to see a Dentist, just pay the bill, quite smoking, and that will more than pay for 2 dental visits a year”. As for British care, they have a dual system, the NHS for the masses, and a seperate private system for people with the means to get in. As an aside, friend’s father-in-law (you know him… RN AEW exchange NFO) was in the NHS system, no other insurance, waited 18 months for a heart valve replacement, could of had it done here within 2 weeks, I’m guessing the NHS was waiting to see if he went into failure and died before the 18 months was over.
NY Times Global edition, yesterday, had an article about the Japanese health care system.
The South still hasn’t gotten over the civil war.
Stein,
The proposed system most discussed is based upon the Swiss model. Private insurance is basis of the program. With government subsidies and guarantees of coverage. Problem here is mainly wiht inabilty to get insurance or to afford it. I am considered uninsurable because of prior diagnosis of a malignancy- totaly cured,But still uninsurable unless could get a group plan. Had to form a group to get coverage which exceeded 25K/year for two person group. That is what thereform seeks to cure.
A new blog from The New York Times that tracks the health care debate as it unfolds.
More Health Care Overhaul News
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The Conscience of a Liberal: The Public Option as a Signal (August 17, 2009) Readers’ Comments
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Professor Hawking, who was born in Britain, has lived there all his life, and has been well cared for by the National Health Service, was not amused.
Besides being vile and stupid, however, the editorial was beside the point. Investor’s Business Daily would like you to believe that Obamacare would turn America into Britain — or, rather, a dystopian fantasy version of Britain. The screamers on talk radio and Fox News would have you believe that the plan is to turn America into the Soviet Union. But the truth is that the plans on the table would, roughly speaking, turn America into Switzerland — which may be occupied by lederhosen-wearing holey-cheese eaters, but wasn’t a socialist hellhole the last time I looked.
Let’s talk about health care around the advanced world.
Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken.
In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false. Like every system, the National Health Service has problems, but over all it appears to provide quite good care while spending only about 40 percent as much per person as we do. By the way, our own Veterans Health Administration, which is run somewhat like the British health service, also manages to combine quality care with low costs.
The second route to universal coverage leaves the actual delivery of health care in private hands, but the government pays most of the bills. That’s how Canada and, in a more complex fashion, France do it. It’s also a system familiar to most Americans, since even those of us not yet on Medicare have parents and relatives who are.
Again, you hear a lot of horror stories about such systems, most of them false. French health care is excellent. Canadians with chronic conditions are more satisfied with their system than their U.S. counterparts. And Medicare is highly popular, as evidenced by the tendency of town-hall protesters to demand that the government keep its hands off the program.
Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies.
In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured. And the most common form of health insurance in America, employment-based coverage, actually has some “Swiss” aspects: to avoid making benefits taxable, employers have to follow rules that effectively rule out discrimination based on medical history and subsidize care for lower-wage workers.
So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.
If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.
But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.
So we can do this. At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.
•
Correction: In Friday’s column I mistakenly asserted that Senator Johnny Isakson was responsible for a provision in a House bill that would allow Medicare to pay for end-of-life counseling. In fact, he is responsible for a provision in a Senate bill that would allow a different, newly created government program to pay for such counseling.
Roger Cohen is on vacation.
An analysis of why free market does not work for medical care from Paul Krugman,
July 25, 2009, 5:07 pm
Why markets can’t cure healthcare
Judging both from comments on this blog and from some of my mail, a significant number of Americans believe that the answer to our health care problems — indeed, the only answer — is to rely on the free market. Quite a few seem to believe that this view reflects the lessons of economic theory.
Not so. One of the most influential economic papers of the postwar era was Kenneth Arrow’s Uncertainty and the welfare economics of health care, which demonstrated — decisively, I and many others believe — that health care can’t be marketed like bread or TVs. Let me offer my own version of Arrow’s argument.
There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care — but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery, not routine visits to the doctor’s office; and very, very few people can afford to pay major medical costs out of pocket.
This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care. And you can’t just trust insurance companies either — they’re not in business for their health, or yours.
This problem is made worse by the fact that actually paying for your health care is a loss from an insurers’ point of view — they actually refer to it as “medical costs.” This means both that insurers try to deny as many claims as possible, and that they try to avoid covering people who are actually likely to need care. Both of these strategies use a lot of resources, which is why private insurance has much higher administrative costs than single-payer systems. And since there’s a widespread sense that our fellow citizens should get the care we need — not everyone agrees, but most do — this means that private insurance basically spends a lot of money on socially destructive activities.
The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. (“I hear they’ve got a real deal on stents over at St. Mary’s!”) That’s why doctors are supposed to follow an ethical code, why we expect more from them than from bakers or grocery store owners.
You could rely on a health maintenance organization to make the hard choices and do the cost management, and to some extent we do. But HMOs have been highly limited in their ability to achieve cost-effectiveness because people don’t trust them — they’re profit-making institutions, and your treatment is their cost.
Between those two factors, health care just doesn’t work as a standard market story.
All of this doesn’t necessarily mean that socialized medicine, or even single-payer, is the only way to go. There are a number of successful health-care systems, at least as measured by pretty good care much cheaper than here, and they are quite different from each other. There are, however, no examples of successful health care based on the principles of the free market, for one simple reason: in health care, the free market just doesn’t work. And people who say that the market is the answer are flying in the face of both theory and overwhelming evidence.
Re the VA health system. Personal experience in dealing with them on a weekly basis is less than impressive. Long waits, and poor follow up , not willing to take care of their own patients and dumping them in the civilian ED. I can state for a fact that I have never, in 7 years of emergency medicine practice, been able to get a single VA physician on the phone to discuss a patient. So pointing at the VA a a model for more government involvement doesn’t work, for me.
I know several MDs from GB and Canada who are practicing here but never met a US MD who moved to GB, there my be some but few and far between. 40% less per patient there than here, my vote is less care, limiting resources
Let’s see… Dr Stephen Hawking, the greatest mind of the generation, winner of the Nobel Prize, was it math or physics? Can’t imagine why the NHS was good to him, Wonder if the Royal family waits in a NHS clinic?
18 month waits for cardiac surgey, 2.5 year waits for psychiatrist appointments are the norm in GB, not exceptions.
The vast majority of US citizens (I don’t care if illegals have insurance) are covered by their jobs, Medicare or Medicaid, We don’t need to revamp, destroy and rebuild a system that provides great care to over 200 million people. Tweek Medicare/Medicaid and lets see how that does, come back in a few years and re look at it all, but don’t try and force me to accept a plan that NOBODY in DC has read.
there has to be a better way then ramming this down our throats.
Skippy,
In response to your questions: largely because both you and your friend Foggy are dishonest. Happy? I usually feel a very strong contempt for the dishonest. It doubles when they leap out of the woodwork to assure me that their dishonest little plan works fine elsewhere when manifestly it does not work here. I cited you several examples in my first post but you and your dishonest jackass friend totally failed to refute them.
It’s your blog, you’re emmigrating, God knows what continent your friend the fog lives but why don’t you man up and address the various “free” systems that have been effected in the United States and come up with some reasonable justification for why they don’t work and are all broke. DEFEND YOUR LAME ASS ARGUMENT! Right here in River City! Don’t tell us it works in communist/socialist hellholes, tell us how it worked/works here where it has been tried!
MAN UP! Go back to my first post and answer the damned question!
Stein,
I don’t have a problem with people paying for their own health care-save for the fact that I also think employers should have a responsibility to contribute to keep premiums reasonable. I could also support a system where you got a tax credit for what you paid in health insurance premiums. The Singapore system I like is a private system. Show me a way to eliminate exclusions for pre-existing conditions and companies dropping people when they get sick and a private option might work fine-provided it became mandatory to get health insurance. That, by the way is the main reason there is an public option-not one, NOT ONE of the insurance company CEO’s said they would stop excluding people on those grounds. As for spending money for HBO etc, instead-I’m not going to disagree with you about that. However, that’s a result of our national conditioning. If there is one thing I have learned from the last ten years is that there is actually room to live inside a smaller income bubble.
Curtis-I don’t understand how you say I am being dishonest. Seems to me that you are being dishonest with yourself. The simple truth is-the examples cited work-not a 100% but they are not necessarily broke either. Our system would not be as broke-if we had a tax level that supported our expenditure rate. Or we stopped spending money on wars we don’t need to be involved in. Now THAT’s what is dishonest.
Here is the bottom line, under the status quo. Costs are going to go up. The number of insured is going to go down.
“Our system would not be as broke-if we had a tax level that supported our expenditure rate”
And there is the problem. It is that our “progressive” government, federal, state and local think that we working class people are a unending well of money to continue there never ending social engineering.
Mandated private insurance is an oxymoron!
Exactly! If we can only get the peasants to pay ALL of their income to the state then the state can guarantee them their right to free good health care.
WHERE DOES IT STOP? With you communist utopians I’m sure you have a plan that will require us to earn 15% more every year that can be taxed away from us in order to pay for all the free shit that you decide is our right.
I see your friend is one of the 10%ters who presents an interesting dilemma to private insurers in that he/it has a pre existing condition that he describes as wholly benign. How can he get insurance? Duh, he’s demanding that all the rest of us subsidize him. That works fine if you’re the state and believe that you have the authority to COMPEL all of the rest of to behave like abject little slaves and pony up our money but doesn’t work so well in the free market. My advice to him is to promptly move to Canada, France, Britain, Cuba or Switzerland where they have compelled their slaves to pay for all healthcare. This is the United States, with a Constitution that I read as prohibiting the state from compelling the citizens as if we were just moneybag endowed slaves.
Push off and go live in your socialist paradise. The US is not a socialist nation.
The US will become more “socialist” no matter who is in the White House-because the alternative will become unsustainable. It will take time to realize that, and even more so as long as people persist in the faux intelligence that permeates right wing orthodoxy. That’s why Sarah Palin survives-as significant portion of the population is stupid.
Health insurance reform is not “socialist”-like the rest of our political labels the term is so overused, that people do not know what it means really. However, like it or not-we are all more dependent on what happens to someone else than you realize. That’s why some type of reform is necessary. Problem is, we will never discuss a middle ground solution-some of which has been measured here-because people are too wrapped up in arguing about the lies instead of the facts.
Here’s a fact. Without reform, the number of uninsured who are going to cost you and I money is going up. Here’s the best estimates of what the future looks like 10 years from now:
“* Premium and out-of-pocket expenses for medical care going up at least 46 and as much as 68%. If your individual insurance plan costs you $411 per month now, imagine it at $700.
* We hear a lot of whining about Medicare rates, and not enough about uncompensated care for hospitals – which the American Hospital Association pegged as $43 billion in 2008. This picture gets substantially worse. The early estimates for 2009 are already $62 billion. Urban Institute predicts a range of $107 to $141 billion by 2019. Yes, that’s per year. And yes, that means many hospitals will go under.
* Why? We’re due for a dramatic increase of the uninsured. 53 million is the “best case” scenario. 68 million is the worst.
Here’s food for thought – we’re more or less maxed out for low-income Americans who are uninsured. The only way that number will increase is if state and federal governments start cutting Medicaid and SCHIP. That means most of this growth comes from the middle class: “The report makes clear that the biggest effects of not having health reform would be felt by families with moderate incomes, who have less access to public coverage. Under the model, the number of middle-income earners without insurance would increase sharply from 12.5 million in 2009 to as many as 18.2 million in 2019.”
So you can imagine all the scary futures if health care passes that you want. If your family is uninsured, or if you lost your benefits with your job, the present is at least as scary enough. The future looks like more of the same.
That is the selfish vision for the future over at tea-bagger central.
Their so good at predicting the future, they can not predict the deficit 90 days out.
I’ll take my chances with the private sector anyday over what this group wants to ram down our throats.
That is a private sector forecast, by the way.
Again I’ll ask the question, if this is so bad-(and you know the Senate is going to do something very different), what is the alternative? At a minimum, what would be wrong with passing what the insurance companies have asked for: The companies have agree to stop rejecting applicants with pre-existing health conditions if the government will mandate health coverage, creating vast new markets?
Have a tax credit for the insurance premiums-similar to the house insurance write off.
Skippy,
I notice that you and your friend continue to not answer the first commenter. You probably don’t have an answer. No problem.
You asked why I get angry when I respond to some of the communist schemes you and foggy support. And let’s be very honest here, you are insisting that we all fall in line and deliver “from each according to his ability to each according to his need.” Frankly you are proposing the very heart and soul of communism. Why is it that you believe that you have a right to reach into my pocket and take out my money and spend it on what you think is important? That was NOT a power that the founders gave our government. In fact, they specifically forbade it. I’d never propose anything that would force you to give up all the money in your wallet anytime I wanted to buy something.
I’ll callously add here that if you are indigent and show up at a hospital I’m prepared to offer an aspirin and push you out into the snow. You see, you have to understand that I DON’T THINK YOU OR ANYBODY HAS A RIGHT TO UNIVERSAL HEALTHCARE. You get what you pay for. TANSTAAFL.
You write about scores of millions who will be unable to afford health care in a few years time but that somehow the federal government can save them (from what?) if we just agree to give 98% of our money to the feds and let them run/manage the same sort of thing that gave us FANNIE MAE and FREDDIE MAC, banks too “big” to fail, Chrysler turned over to the union and not those with the legal paper, the aforementioned USPS and the $800 billion porkulus bill.
This is a fight worth fighting….against. Rant off, I’m going to spend an hour or two watching bowmen invade America and make off with the quadium bomb.
I’ve answered you about thee different times.
I disagree with your fundamental premise. There is no fundamental right to be selfish and when you come right down to it your arguments are built around selfishness. I believe with all of my heart that THERE IS A RIGHT TO HEALTH CARE AS A PRIVILEGE OF CITIZENSHIP. That doesn’t make me a communist or a socialist-it does make me a person who recognizes the fundamental unfairness that unrestrained capitalism can cause.
No one is proposing that you give up all of your money. They are asking that government provide for the benefit and welfare of its citizens-the Constitution did empower the government to do that.
Americans are so willing to spend money on ambitious overseas adventures, and yet so reluctant to pay taxes for roads, bridges, better schools, and health care here in the United States. Its a failing that brought us to the brink of depression-and the only reason we are not in one is because of stimulus spending. Could it have been done better-yes. But you are smoking dope if you think it would have been better if we just let those big institutions fail.
Ah to heck with it. Raise taxes anyway-if only for the purpose of making teabaggers whine!
Well I can see why we have this challenging difference of opinion. You view our citizenship as some sort of privilege whereas I view it quite differently. I was born American with rights that are written into the Constitution. Nowhere in that document does it say my rights can be sold out in the name of some disagreement about what privileges I enjoy as a citizen.
You claim healthcare is a universal right but then you back off and state that it should be restricted to just American citizens but does that mean that you, like me, will kick to the curb all the indigent illegal aliens in the land since they are not citizens? I guess you’re starting to see that healthcare shouldn’t be/couldn’t be a universal right which at least takes off the table your earlier pronunciations that healthcare is a universal human right and I owe it to Zimbabwe to give them free health care too.
What about a human right to food? You’ll die without it. Do you and I owe every human or just American citizens 1200 calories a day? Should we dispossess the kulaks and peasants of their food and leave them starve if we need to feed the urban populations?
What about legal assistance. Is that a human right. Should we nationalize all law firms and get those bloodsuckers to work for us for minimum wage and set their fees by fiat?
For me, the interesting part of this more civil debate is that you really don’t see yourself as Joe Stalin reincarnated. You cheerfully admit that you want to do to healthcare what Stalin did to the kulaks because there are others who deserve what they have earned more than those kulaks did.
So I’ll ask you and your friend what distinguishes you from Stalin and his approach to the “human right” of the urban poor to have property that belongs to another?
What distinguishes me from Stalin-a lot of things. Two primarily.
1) What ever insurance reform that comes will be done through a legal and constitutional process. No one is imposing this on you-your elected representatives are discussing it-because its part of what last years election was about. Sorry you don’t like their choices-you can vote against them in the next election, but you cannot dictate word for word what choices they make till then.
2) Second, I’ve offered several different private sector ways to get to the same goal. I’m not a socialist just because I think we could learn from other private systems.
Actually I do believe that access to quality health care is a fundamental human right. But I can’t solve the Zimbabwe problem and neither can you. I can solve the US problem. I made the statement about it being a right of citizenship because I think the US needs to do something about its illegal immigration issues. In the short term I think it would start with improved border security, increased legal immigration quotas and more checkpoints that would catch illegals and send them home. At some point though we will have to deal with the 12 million already here. I favor a guest worker with time limit visas that have to be renewed by returning to the home country for six months at least. Visa overstayers get booted. That probably also requires a national passport system of some kind. But for this discussion its a red herring.
Futhermore health care and legal representation are two different things. In theory you can get through life without ever seeing a lawyer-not so with health care. That’s a moral obligation, that I can’t simply ignore because I want to be selfish.
Your last quote is simply incorrect- I cannot and will no believe what has been proposed will “destroy” health care in this country. Greedy insurance and pharamceutical CEO’s will however-and quickly.
Skippy,
Stalin had the full and complete backing of the Soviet Party and Duma as he:
The vast majority of the population in Russia were peasants, earning their living from farming. However, not enough food was reaching the cities to feed the workers, partly because the government only offered low prices for the grain they bought, and partly because the peasants were keeping food to feed themselves better. In 1929 to solve the problem of the shortfall, Stalin announced that farms would be collectivised. This meant that instead of each individual family working their own farm, groups of 50-100 families would work a collective farm. It was hoped that this would be more efficient, and allow more modern methods, such as tractors, to be used. The peasants would not be allowed to sell grain for a profit, but would instead sell their grain to the government at a fixed price.
Stalin knew that the richer peasants, known as Kulaks, would oppose this idea, so he deported about 1.5 million of them, many of whom later died from cold or starvation. However, many other peasants opposed collectivisation, which took away their incentive to produce more food, since they could not sell it for profit. They destroyed animals, crops and machinery in protest, and this led to a serious drop in food production. As a result of collectivisation 5-6 million people starved to death in the following three years.
Constituent Assembly
In November 1917 elections were held for the Constituent Assembly, which was to give Russia a new constitution. They were the first free elections in Russia’s history, and the Bolsheviks won only a quarter of the seats. When it met in January 1918, the Bolsheviks, realising it was a threat to their power, immediately closed it.
Five Year Plans
Russia was a very backward country compared to the rest of Europe, and Stalin realised that if communism was to survive then it had to modernise quickly. A series of five year plans were introduced with the aim of rapidly increasing Russia’s industrial production. Though the plans did not always achieve the targets that had been set, it is undoubtedly the case that Russia’s industrial capacity grew enormously as a result. By 1940 Russia had overtaken Britain in production of iron and steel. However, although some workers, such as the Stakhanovites worked hard out of patriotism, others only worked out of fear – failure to meet production targets could result in a labour camp sentence.
The Great Purge, Show Trials and the Terror
In 1935, following the assassination of Kirov, an important member of the Party, Stalin launched a purge of the Party, aimed at expelling unreliable members. Anybody could be denounced for being Trotskyites or counter-revolutionaries, even on the evidence of a single comment. Millions were expelled from the party and sent to labour camps. In 1936 the Show Trials began, where important Party members were put on public trial, found guilty and executed. In 1937 the armed forced were also purged – by 1939 every admiral, three of the five top army commanders, and about half of all officers had been shot. By now the whole of Russia was living in terror. Children were encouraged to denounce their parents, and some did, and you could even be arrested for failure to denounce suspicious people. The terror undoubtedly ensured Stalin’s domination of the country, but both the economy and the armed forces suffered from the loss of so many experienced leaders.
It’s uncanny how communists motivated by their great moral principles can decide to take everything from the peasants and justify it in the name of either morality or the “common good.”
You guys with your great moralistic plans to steal from my pocket and use that money in a moral and principled way to pay for abortions are all alike. If your morality drives you to treat health care as a great moral requirement, become a doctor or PA or RN and volunteer with Doctor’s Without Borders or make a huge pile of money and donate it but don’t come at me with your moral BS and say that WE have a moral requirement to empty our wallets to pay for your moral beliefs which turn out to be pretty bogus.
You did, above, toss the illegal indigent poor into the snow didn’t you? You know, right next to the Somalis, Zimbabweans and Burmese?
Those who adopt a moral underpinning for their arguments need to understand that morality is not driven by circumstance, nationality, etc. As our friends the missionaries know, morality is morality.
This is not Russia and levying taxes on you is not stealing.
And I did not toss illegal immigrants into the snow since I did not advocate changing the compassionate care laws. Immigration reform has to be dealt with-the problem of illegal immigration, like health care reform is one we have kicked down the road too long.
Comments on this post are now closed. I’m moving on and this post is moving off of the front page.