Most political and media discussions of medical care have an air of unreality reminiscent of Alice in Wonderland. There is an abundance of catch-phrases but remarkably few coherent arguments.
Let's start at square one. Why is there alarm about American medical care? The most usual reason given is because its cost is high and rising.
That is certainly true. We were not spending nearly as much on high-tech medical procedures in the past because there were not nearly as many of them, and we were not spending anything at all on some of the new pharmaceutical drugs because they didn't exist.
This general pattern is not peculiar to medical care. Cars didn't cost nearly as much in the past, when they didn't have air-conditioning, power steering and high-tech safety features. Homes were cheaper when they were smaller, had fewer bathrooms and lacked such conveniences as built-in microwave ovens.
We would like to have all these things without the rising costs that come with them. But only with medical care is such wishful thinking taken seriously, with government regarded as a sort of fairy godmother who will give us the benefits without the costs.
A cynic is said to be someone who knows the price of everything and the value of nothing. If so, then it is political cynicism to point to other countries that spend less on medical care, including some countries where there is "universal health care" provided "free" by their governments.
Just as medical care, houses and cars were all cheaper when they lacked things that they have today, so medical care in other countries is cheaper when they lack many things that are more readily available in the United States.
There are more than four times as many Magnetic Resonance Imaging units (MRIs) per capita in the United States as in Britain or Canada, where there are government-run medical systems. There are more than twice as many CT scanners per capita in the United States as in Canada and more than four times as many per capita as in Britain.
Is it surprising that such things cost money?
The cost of developing a new pharmaceutical drug is now about a billion dollars. Neither political rhetoric nor government bureaucracies will make those costs go away.
We can, of course, refuse to pay these and other medical costs, just as we can refuse to buy air-conditioned homes with built-in microwave ovens. But that just means we pay attention only to prices and not to the value of what we get for those prices.
We can even refuse to pay for so many doctors. But that just means that we will have to wait longer to see a doctor-- as people do in countries with government-run medical systems.
In Canada, 27 percent of the people who have surgery wait four months or more. In Britain, 38 percent wait that long. But only 5 percent of Americans wait that long for surgery.
Surgery may well cost less in countries with government-run medical systems-- if you count only the money cost, and not the time the patients have to endure the ailments that require surgery, or the fact that some conditions become worse, or even fatal, while waiting.
A recent report from the Fraser Institute in Canada shows that patients there wait an average of ten weeks to get an MRI, just to find out what is wrong with them. A lot of bad things can happen in 10 weeks, ranging from suffering to death.
Politicians may talk about "bringing down the cost of medical care," but they seldom even attempt to bring down the costs. What they bring down is the price-- which is to say, they refuse to pay the costs.
Anybody can refuse to pay any cost. But don't be surprised if you get less when you pay less. None of this is rocket science. But it does require us to stop and think before jumping on a bandwagon.
The great haste with which the latest government expansion into medical care is being rushed through Congress suggests that the politicians don't want us to stop and think. That makes sense, from their point of view, but not from ours.
I flagged the title of this because it is clearly a non-member advertising on the board. Thought I'd point it out to you, Todd, rather than deleting it.
I'm not sure about all that, Syrgot. I'm thinking its somebody who is a current or former member of the board with a conservative opinion and wanting to have their say - and summarily being ignored.
Really? You think it SUPPORTS the anon's position on government health care, Caps? That's interesting, seeing as the anon didn't say anything about it whatsoever. They posted an article, with a link at the end. No opinions. Not a word.
The story comes from a small online magazine that generates revenue through AdSense as well as donations. I think if it were someone wanting to see a discussion about it, they would have done more than post a link. If that makes me presumptuous, so be it.
I didnt change the content of the post. I simply pointed out that it was nothing more than advertisement to another website.
And no where did I say you shouldn't have the right to post, anon. Instead, I flagged the title of the thread for the admin to look at - because I don't think the purpose of this board is to advertise a relativity unheard of magazine.
I think folks usually source their stuff Joyfully.
The speed of it all worries me, but I gotta say - delay is death in Washington. Having lived through 1992, I'm inclined to pass something and fix it rather than dither around trying to get it completely right.
I kinda think the Patriot Act was the Republican equivalent. They successfully argued that it wasn't perfect, but we needed to start protecting ourselves against terrorism right away. I disagreed, for the record, so I respect your right to disagree in this case.
Our Health Care system has done more damage to American interests across the board than a brazillion Talibans ever could.
If the addition of high-tech is the cause of the rise in health care cost, why is it that high-tech devices in general have become more powerful and less costly over time?
Cars are more costly because of additional gadgetry? really?
The average price of a car in 1999 was $21,100. At the same time the median income was $40,810. So the price of a new car averaged 51.7% of a person's income.
In 1950 the average price of a car was $1510, while the median income was $3210. So the cost to buy a new car, for the average person in 1950 was about 47% of their income.
That's an increase of only 4.7% for a slew of additions and innovations.
Compare that to the rise in health care costs. I could only find data going back to 1970, but in the period from 1970 - 2007 (37 years, opposed to 49 years above) the cost of health care, for the average individual has increased from $352/year (1860, inflation adjusted) to $5711, or an increase of 300%!
Now to be fair, we're living longer and spending a lot more money near the end of our lives for health related problems. So it's reasonable that the percentage of cost would rise, but 300%? It's just a ridiculous notion that the rise in cost is a direct result of high-tech innovation, when that model has not proven true in any other industry.
This message has been edited by mevin on Jul 21, 2009 7:07 PM
Personally, I think there hasn't been a really good debate about this subject- not enough to have a popular consensus one way or another. Unfortunately, we will get whatever they decide we will get- just like the Patriot Act, the Economic Stimulus Package and the Bank Bailout. We will be stuck paying the bill and have to live with the consequences without having a voice.
Fortunately, nothing in our Democracy is written in stone! Our laws and our Constitution are living documents that can be changed to reflect advances in circumstance and knowledge!
We need Health Care reform now. I support getting something done. Today's post has some good analysis that works to counter the fear-mongering of the other side.
I can't pretend to understand all the intricacies of a government health plan, but the basic premise that only the well off are entitled to good health care is so appalling to me. Shouldn't health care be a basic right?
And since when does the edit privilege mean board members can edit for content??
I was under the impression that the edit privilege was given SOLELY for the purpose of deleting Gunfever's posts, when he spammed the board with them and there were hundreds coming up at a time, too quickly for Todd to delete.
This type of thing (editing the title) absolutely did not need to be done.
Getting a bit too big for your britches there, Davey.
Why stop at health care? Why shouldn't everyone, specially the poor people be entitled to housing and a job? Government should provide for their basic needs. Let government create jobs to give them!
You can't argue with people that take this tack. It's like trying to argue religion with a zealot. There's no reasoning, only "HOW DARE YOU TAKE FROM ME TO GIVE TO LESS FORTUNATE!!!!!!!" Or, as they would say instead of less fortunate "SCUMBAGS THAT SHOULD HAVE GOTTEN BETTER JOBS!!!." Welcome to the board, Sean Hannity. Blarg.
So Apalled, you don't think Housing and a Job to care for your family are basic rights? Government should provide these also! And I'm serious, once a government, any government takes that road, it should embrace it. And it's a virtuous cycle in itself! Building homes for everyone creates jobs, paid for by government and taxes that come from those rich people that have enough money to spare.
Squid, I was never a supporter of the Patriot Act.
I'm always impressed by the lack of foresight at those who don't think basic healthcare should be available for all.
An ounce of prevention is far cheaper than a pound of the cure. And if someone has no $$ for the prevention, who pays for the cure? Not the person with no money.
First of all, the deletion powers need to be revoked, period. Requiring a login will stop most of the GF nonsense and if you need to post "anon for this" you can make up an alternate login.
It's perfectly acceptable to post articles anonymously. I understand where David is coming from. Spamming the board has been a problem, but it's usually dealt with through ridicule and just plain ignoring it.
Now as far as the health care question goes, here's a question for the "It's not the government's job to provide health care to everyone" camp: Would it be acceptable to you to deny someone emergency care and let them die, because they had no insurance and could not pay? If your answer is yes, then at least you're consistent with your thinking. But if your answer is no, then you have to take things a step further and think about the wastefulness associated with treating the poor via the most inefficient and costly way possible, rather than implementing a fiscally responsible program of preventative care.
There's been a lot of talk about the enormous cost of providing UHC. But what about the savings we'd surely see, by shifting huge percentages of people away from the ER and into normal, outpatient environments? In addition, what about the increased productivity of 30 million working poor who would have access to health care to treat small problems, before they evolve into debilitating and catastrophic conditions?
One thing I'm sure of, this one is too important to just have angry knee-jerk reactions to. The instinct to scream Socialism and government paternalism completely ignores how profoundly important to capitalism a fix for this system is.
I am shocked at Appy -- health care is not a right -- neither is housing. You make your choices in life, if you choose poorly, sorry. I am sitting here right now without health insurance, but there is no way in hell I want socialized medicine.
Whoa, whoa, whoa, back to an ignorant anon -- you think government is responsible for providing housing and jobs?? What the hell are you smoking? You're one of those that just want a free ride. What ever happened to working hard??
"I am sitting here right now without health insurance, but there is no way in hell I want socialized medicine."
So do us all a favor. Next time you become gravely ill, please just stay home and wait for death. Because going to the ER is evil socialism and you wanna make sure you walk the talk, all the way to a pine box. Provided of course that you bought life insurance that pays for such things as pine boxes.
No one has answered my question: If Health care is a 'right', why not housing (a shelter to protect me and my family) and a job (to provide for the well being of my family)? Government should provide those too. Who defines what a 'right' is?
And remember, we're here talking about medical insurance (health care), not about medical attention...
The in ability for the government to do anything efficiently makes me wonder if UHC should be contracted out. Wonder what Halliburton is up to now-a-days...
Is socialized medicine the same as the 'single payer' system? I think that this part confuses me and would appreciate if somebody knowledgeable could make it clearer. If we have a universal health care that includes private insurers (this is what Obama wants?) instead of 'single payer', isn't that the opposite of socialism?
Under Medicare, some estimate over 10% of the charges in NYC are fraudulent. That means that $4 Billion of government money is going to the hands of crooks.
One of these doctors claimed and got paid for something like 52 colonoscopies a day.
Oh, ok. I thought that socialized medicine meant a nationalization of the industry or at least the insurance industry. There was a disconnect in my head between 'socialized' and 'private insurers'. Maybe taking it to literally.
Cause you're gonna get sick, you're knees will become tricky, your back will go out, you'll get fat, bald, itchy, smelly and you'll have thick, wiry hair growing in places where you didn't used to have places... next year. THAT'S what your age has to do with health care, my friend. Oh and if you're anything like me, you'll also become very, very angry!
I like this thread.
I support UHC, however making it actually work effectively for most people is where I get nervous. I know it can't be perfect for all people. It will be abused by scumbags who pull scams for a living. I would also like to see costs held in check with responsible and efficient oversight.
As far as to the question "should the government provide housing? Which was never actually asked, in a straight forward, honest way...
The state should provide the things that:
A. Are pragmatic for a government to do. I think our government has an obligation to step in, since private industry, contrary to true, competitive, capitalistic models, has failed miserably to provide good service at a fair price.
B. Take care of those who cannot take care of themselves. So in the realm of housing, the state should provide minimum shelter for physically disabled, or mentally ill people who cannot otherwise provide their own housing.
It's not unreasonable to expect the richest nation in the world to provide the basic necessities for those who cannot help themselves. Otherwise, what's the point of all the wealth?
Also, this whole notion that we have to go all one way or another is balderdash. We can and should vacillate between libertarian principals and socialistic services. It's good and healthy to constantly question what the role of government and private industry should be. What works for some, may not work for others and we need to remain flexible.
I have a LOT of personal feelings about health care. The majority of these stem from raising a child with Hemophilia. Drug companies, research, fund raising, INSURANCE, etc etc.
There isn't enough space in all the interwebs for me to diatribe about what I know and have learned from this experience. So I just say, yes I agree with Mev - a mixed solution done well would be the best.
ETA: I avoid responding on these threads because I feel that my opinion is so incredibly biased by what I have experienced that I cannot be objective.
This message has been edited by AnnyBoo on Jul 22, 2009 7:42 PM
Yet my bias comes from a very tiny portion of the medical community that never even got a second glance until Ryan White in the 80s and an Elton John song. Even though this disease has ancient roots.
Someone on this thread said earlier about the drug companies making more money off the disease than the cure. Yep. That fits for Hemophilia.
Someone asked who decides what the rights are. And although I know many americans don't like the UN.. the UN has been in the business of deciding rights for a while now. The right to housing, food, water, are included in those rights.
A case in S. Africa (I believe) tested whether the state's duty was a positive or negative obligation to provide housing (i.e. should they actively make sure everyone has a home, or just not prevent people from getting it) Their supreme court decided that the govt had a positive duty to uphold those rights.
Of course, the general trend is that in countries where there isn't food, shelter, or water, the people there are more concerned about those being recognized as rights, than they are about their right to vote.
I would like to go on record as stating that there is no reason that David couldn't have offered his opinion that the original post is spam as a comment instead of an edit. This method has worked for almost a decade. Where does one draw the line? Virtually all on-line news sites make their money from ad revenue. The small percentage that don't are subscription-based, and what would be the point in linking to that? I've stated before that copying and pasting an article without offering commentary is lame, but that battle is long lost
stepping off my soapbox now...
The reality is that right now, the insured are paying for themselves and the uninsured. Coming up with a plan that makes individual health care affordable would lead to this country being competitive in the marketplace again. Right now, entrepreneurship is a luxury of the young who don't recognize their mortality. Would Bill Gates or Steve Jobs have jumped ship to start their own businesses if they had pre-existing medical conditions? Something needs to be done to keep jobs in this country and to encourage innovators to quit their corporate day jobs. Providing basic care for everybody could potentially generate revenue instead of taxing us further.
What disappoints me in the Obama administration's discussions on health care is that it doesn't address the needs of the under-insured. I have friends that have insurance but can't afford the co-pays, the prescriptions and the out-of-pocket expenses. If there is a minimum standard that an employer is expected to provide, I haven't seen it. If there is, there's too many ways around it. On the flip side, employers who do provide excellent coverage have to make up the cost somewhere. It's called wages. I'd rather see my money go to some government plan than to a soul-less insurance company. Just saying.
"I'd rather see my money go to some government plan than to a soul-less insurance company."
Interesting. The government's plan is somehow full of "soul"? Millions of people currently working and employed by insurance companies are rote automatons making all of their decisions based on profit and not based on the contracts people have signed with them?
You do realize who is picking up the tab for all the people that are currently uninsured, don't you? Yes, insurance companies who are being charged inflated rates that providers have to charge in order to stay in business and cover the expenses of those who they provide for that don't pay.
To bastardize a Team America song:
Healthcare isn't free
No there's a hefty fuckin' fee
and if you don't throw in your buck o' five, who will?
Healthcare costs a buck o' five.
My question is: If a govt. healthcare plan goes through and suddenly all medical bills are in fact paid - does that mean the medical providers will reduce their fees since they'll have all this new $$$ hanging around. Don't hold your breath.
To utterly demonize health insurance companies and assume the same bad decisions won't be a problem - possibly a bigger problem - under a government run program is a bad argument.
Currently, a number of health care providers do charge less if you pay cash. Significantly less, because they pass on the savings when they don't have to bill the insurance company for something that was pre-authorized at a set amount, wait and see how much they actually get, call them and find out why they didn't pay the agreed upon amount, re-submit, wait, see how much they get, bill you the difference, wait and see if you'll pay, send a reminder, etc. It is entirely plausible that they will charge less if the government plan agrees to pay a fixed amount for a service and they pay it with a minimum of waiting and drama. Those are very big "if"s, of course and I'm just as skeptical as the next person.
