Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
John R. Battista, M.D.
Prepared for Grand Rounds, New Milford Hospital, New Milford, CT
April 6, 2008
It is commonly asserted that the United States has the best health care system in the world. Yet, the United States ranks in the lower third of industrialized nations in terms of the two universally accepted measures of health care system efficacy: infant mortality and life expectancy. In addition, the United States health care system ranks at the bottom of the industrialized world in terms of efficiency (efficacy per dollar spent). Finally, the United States health care system ranks last in the industrialized world in terms of satisfaction. Thus, one could more readily argue that the United States has the worst health care system in the industrialized world rather than the best in the world. In fact, when the World Health Organization ranked world health care systems in 2000, the United States ranked 37th, the worst in the industrialized world.
The poor efficacy of the American health system is generally understood in terms of poor access to health care for the uninsured and the Medicaid populations. The uninsured avoid clinical care because of the cost involved. They seek less care, do so later in the course of an illness, have less continuity of care, use more emergency services, die younger, and are more ill than the insured population. The poor have problems accessing care because the low reimbursement rate makes of Medicaid makes it difficult for them to find willing providers. This population tends to be more ill than the general population, although some of this illness may be a consequence of poverty rather than just limited access to health care. In addition, poor efficacy in the American health care system is a function of being treated through a managed care insurance program and being treated in a for-profit facility. However, in general, the poor efficacy of the United States health care system appears to be more the result of limited access to health care in some parts of the American population than the poorer quality of care associated with managed care and being treated in for-profit facilities. This conclusion is consistent with the fact that there are fewer outpatient visits and hospital days in the United States per person than in other industrialized countries.
As a result, most people and health care experts accept that universal health insurance improves a health care systems efficacy. International experience supports this conclusion. For example, when Canada passed its universal health insurance program 30 years ago it had poorer efficacy data than the US. Now, 30 years later, it has better efficacy data than the US.
As a consequence, the vast majority of the public, physicians, and politicians support universal health insurance. The US debate about health care no longer centers on whether we should have universal health insurance, but rather how to get it, which really becomes a debate about how to pay for it, or how to make it affordable for the average person, and particularly the working poor, who dominate the uninsured population in the United States.
Extraordinarily high cost is the most striking characteristic of US health insurance, and the main reason why we have so many uninsured in this country. The United States spends twice as much per capita on health care than other industrialized countries, and 30% more than the second most expensive country in the industrialized world.
Why is the cost of health insurance so high in the United States relative to other industrialized countries? Two factors have been identified to account for this disparity: high administrative costs and the high cost of prescription medications.
Administrative costs in the United States are at least 25% of total health care expenses while they are under 10% in other industrialized countries, despite the fact that other countries do much more than we do in terms of community health care education and outreach. In fact, administrative billing expenses in other industrialized countries, which is what characterizes administrative expenses in the United States, are only 3% of total health care costs.
The cost of prescription medications is about twice as much in the United States as other industrialized countries. That is why some Americans seek to purchase their medications from Canada. The main reason medications are less expensive in other industrialized countries is because they negotiate the price of prescription medications, or bulk purchase them, something which is absent in substantial aspects of the US health care system such as traditional Medicare.
The magnitude of these differences in administrative and prescription medication costs is profoundly significant. For example, Physicians for a National Health Insurance Program has shown that by decreasing administrative costs and the cost of prescription drugs through a single payer mechanism enough money would be saved to provide comprehensive health insurance for the entire population, without co-pays, without changing anything about the health care delivery mechanism, and without increasing expenditures.
Why are administrative costs so high in the United States relative to other industrialized nations? Our higher administrative costs are directly related to having multiple insurance companies, and allowing these insurers to operate for-profit. First, multiple insurers with multiple plans increases the cost of marketing, leads to increased costs associated with changing insurance plans, and makes it more time consuming and costly for providers to deal with insurers. Second, allowing insurers to manage care increases administrative costs for both insurers and providers. Third, allowing insurance companies to operate for-profit increases administrative costs both through the profit generated and the higher salaries associated with for-profit corporations. As a consequence, for-profit Medicare, is 10 to 20% more expensive than not-for-profit Medicare. Procedures in for-profit health care facilities are 10 to 30% more than the same procedure in a not-for-profit health care facility. Overall, the administrative costs of for-profit insurers are strikingly higher than not-for-profit insurers. For example, the administrative overhead of Medicare is about 3% while most for-profit insurers have administrative overhead of between 15 and 30%.
Other industrialized countries have lowered costs for health insurance by six basic means: 1) guaranteeing or mandating health insurance, thereby avoiding increased expenses associated with the uninsured, 2) minimizing the number of insurers and minimizing the number of insurance plans available through them, 3) insisting these insurers operate not-for-profit, 4) negotiating the price of prescription drugs and bulk purchasing prescription medications, 5) capitating the expenses of hospitals and physician services instead of billing for these services, and 6) utilizing community standards and income, rather than risk standards, as the basis for determining the cost of health insurance.
The sixth and final point, paying for insurance as a function of income rather than a function of risk, is crucially important in being able to critically evaluate the current political debate about universal health insurance for the United States. In the United States, the insurance pool is fractionated into groups or individuals, and the cost of their insurance is calculated by assessing the health risk of that group or individual. The factors involved are typically age and illness history. As a result, health insurance is more expensive the older and sicker you are. This makes health insurance unaffordable for the near elderly, people who are ill, and people who are hourly workers. In the rest of the industrialized world, the cost of health insurance is calculated in relationship to community standards rather than individual or group risk. The total cost of health insurance for everyone in the population is determined and divided among the population so that each person, or employer, pays the same percent of their income, or payroll, for insurance (in some countries this is capped). The result is health insurance becomes much more affordable than in the United States. The young, the healthy and the wealthy subsidize the cost of health insurance for the old, the ill, and the poor. Such a system, where all people pay the same percent of their income for health insurance, appears to be much more ethical than the American system where the poor, ill and close to aged must pay more than the young, healthy and wealthy, although some conservatives argue the situation the other way around.
The problem for the United States is that such a income based health insurance financing system requires health insurance to be paid for through a public tax mechanism rather than a private billing mechanism. In addition, in order to be effective, such a public funding mechanism has required the stringent regulation, or the elimination, of the private insurance industry. This can be seen from studying the three types of universal health insurance which have been utilized by other industrialized countries: socialized medicine, as per Great Britain and Spain; single payer systems, as per Canada and many Scandinavian countries; and multi-payer health insurance pools, as per Germany and France.
In socialized medical systems the population is insured through public funds obtained through an income tax and value added tax. The government owns the health care facilities and physicians are paid a salary to work in hospitals, and a capitated rate to treat outpatients. Hospitals operate on a global budget. There is no billing for services. Great Britain and Spain allow individuals to opt out of the system by going into a private health care system. Such systems tend to be underfunded and have some waiting lines associated with them for non-acute services. They are much less costly than the US system while delivering comparable outcomes. They are quite similar to the VA System and the Kaiser System in the United States. There is little or no support for such a system for the United States where there is a strong belief that physicians should be paid fee for services and there should be free choice of health care providers, which is not characteristic of a socialized health care system.
The second model involves insuring the entire population with comprehensive health insurance paid through a single payer. Funding is accomplished through public funds for the unemployed, poor and retired in combination with a health care tax levied on families and employers, and a payroll tax on employers. These funds go into a health care fund that is administered by a regional public office in accord with national policy. Rates and coverage are set by the regional administrator in negotiation with health care providers. Health care workers are paid fee for service. There is no managed care. There is free choice of health care providers.
This is the system most health care reformers advocate for the United States. However, they suggest the single-payer system be administered by a not-for-profit trust controlled by a board of health care providers, health care advocates and taxpayers reportable to government rather than administered by the government itself. With such a system it is predicted that it would be possible to have comprehensive health insurance, without co-pays, for all Americans with a 6.5% income tax and a 6.5% payroll tax while maintaining the current funding for the Medicaid and CHIPS programs. Medicare would be eliminated. There would be no managed care. Physicians would be able to negotiate fees for services on a yearly basis. The vast majority of families and corporations that currently provide insurance for their employees would save substantial amounts of money under a single payer system, and Americans would have far more comprehensive and superior health insurance than they currently have.
Critics argue that the comprehensive insurance of a single payer system would force people to pay for services they dont want or need. It would penalize the young, the healthy and the wealthy. Others falsely argue this would be socialized medicine or constitute additional government control.
This model is supported by about 60% of the population and physicians, but has little support among politicians or corporations, who wish to sustain the private insurance industry that would be eliminated under this model. Such a single payer system is currently under consideration by the US Congress in the form of House Bill 676, introduced by Representative Conyers with 80 co-sponsors. This particular bill utilizes a rather radical form of funding in which individuals and corporations essentially pay 3.5% of their income and payroll for insurance and the remainder of the funding is obtained from the top 5% of wage-earners in combination with public funds for the poor and near-poor. It has little of no chance of passage.
The third form of universal health insurance involves putting workers into large insurance pools. France utilizes three pools, and Germany close to 200. As a consequence this health care insurance system has higher administrative costs than single payer or socialized systems, although still much less than the United States. In any case, these not-for-profit insurance pools are highly regulated, quasi-public institutions that share profits and losses, and offer only comprehensive health insurance. They are funded through a health care tax, an employer payroll tax, public funds for the unemployed and retired, and other taxes such as taxes on activities detrimental to health. These insurance pools have little or no resemblance to the for-profit insurers. They are not publicly traded companies who have a responsibility to stockholders. They are not-for-profit quasi-public institutions who have a responsibility to the people they insure and negotiate on their behalf with health care providers for fees and services. Such a system, does have co-pays associated with it, most of which are covered by private supplemental insurance. However, there is a mandated cap on these co-pays to insure that there is no bankruptcy associated with health care. There is no managed care. There is free choice of health care providers. In France, there is a lower rate of physician reimbursement, and physicians tend to earn a lower income relative to the general population than in the United States. This is compensated, in part, by the fact that medical school is free so that physicians enter practice without educational debt.
American politicians, who predominantly support universal health insurance, but wish to maintain private insurance companies, have been interested in altering the multi-payer system of Germany and France to the United States by mandating the purchase of private health insurance and leaving the private, for-profit, insurance system intact. This idea of a mandate on individuals is commonly combined with a mandate on employers to either provide health insurance for their workers or pay into a public fund which would assist such workers in obtaining health insurance.
Mandate systems, which do exist in Germany for example, can result in close to universal coverage. However, it appears this can only be accomplished when the payment for such a system is accomplished through a public means, such as a payroll or income tax, with the government taking up responsibility for the non-employed population. In addition, a mandate system would need to mandate a comprehensive health insurance program including preventative and outpatient services to solve the efficacy problem in the United States. Bare bones or major medical insurance, without outpatient coverage, will do little to solve the efficacy problem for the United States. Similarly, unless the insurance limits co-pays and avoids caps on total expenses, it will do little or nothing to solve the problem of bankruptcy associated with major medical illness. In addition, if the United States were to continue to utilize for-profit insurance companies, with their higher administrative rates and risk based accounting methods, mandated insurance would continue to be much more expensive than what could be obtained through a public funding mechanism. As a consequence, a mandate system in which the private insurance system is maintained would have serious cost problems associated with it and require substantial public subsidy. In the end, this approach would constitute a subsidy for the insurance industry with public funds. Although such subsidizes of corporations have become common in this era of corporate capitalism, such a mandated health care system would continue to be opposed by the majority of health care advocates who believe a single payer system would be much more ethical, effective, and cost-efficient, while maintaining the fee for service culture of traditional American medical practice and traditional, free market, enterprise.
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 3:14 PM
The Case For Single Payer, Universal Health Care For The United States
Outline of Talk Given To The Association of State Green Parties, Moodus, Connecticut on June 4, 1999
By John R. Battista, M.D. and Justine McCabe, Ph.D.
Why doesnt the United States have universal health care as a right of citizenship? The United States is the only industrialized nation that does not guarantee access to health care as a right of citizenship. 28 industrialized nations have single payer universal health care systems, while 1 (Germany) has a multipayer universal health care system like President Clinton proposed for the United States.
Myth One: The United States has the best health care system in the world.
Fact One: The United States ranks 23rd in infant mortality, down from 12th in 1960 and 21st in 1990
Fact Two: The United States ranks 20th in life expectancy for women down from 1st in 1945 and 13th in 1960
Fact Three: The United States ranks 21st in life expectancy for men down from 1st in 1945 and 17th in 1960.
Fact Four: The United States ranks between 50th and 100th in immunizations depending on the immunization. Overall US is 67th, right behind Botswana
Fact Five: Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank below Canada and a wide variety of industrialized nations.
Conclusion: The United States ranks poorly relative to other industrialized nations in health care despite having the best trained health care providers and the best medical infrastructure of any industrialized nation
Myth Two: Universal Health Care Would Be Too Expensive
Fact One: The United States spends at least 40% more per capita on health care than any other industrialized country with universal health care
Fact Two: Federal studies by the Congressional Budget Office and the General Accounting office show that single payer universal health care would save 100 to 200 Billion dollars per year despite covering all the uninsured and increasing health care benefits.
Fact Three: State studies by Massachusetts and Connecticut have shown that single payer universal health care would save 1 to 2 Billion dollars per year from the total medical expenses in those states despite covering all the uninsured and increasing health care benefits
Fact Four: The costs of health care in Canada as a % of GNP, which were identical to the United States when Canada changed to a single payer, universal health care system in 1971, have increased at a rate much lower than the United States, despite the US economy being much stronger than Canadas.
Conclusion: Single payer universal health care costs would be lower than the current US system due to lower administrative costs. The United States spends 50 to 100% more on administration than single payer systems. By lowering these administrative costs the United States would have the ability to provide universal health care, without managed care, increase benefits and still save money
Myth Three: Universal Health Care Would Deprive Citizens of Needed Services
Fact One: Studies reveal that citizens in universal health care systems have more doctor visits and more hospital days than in the US
Fact Two: Around 30% of Americans have problem accessing health care due to payment problems or access to care, far more than any other industrialized country. About 17% of our population is without health insurance. About 75% of ill uninsured people have trouble accessing/paying for health care.
Fact Three: Comparisons of Difficulties Accessing Care Are Shown To Be Greater In The US Than Canada (see graph)
Fact Four: Access to health care is directly related to income and race in the United States. As a result the poor and minorities have poorer health than the wealthy and the whites.
Fact Five: There would be no lines under a universal health care system in the United States because we have about a 30% oversupply of medical equipment and surgeons, whereas demand would increase about 15%
Conclusion: The US denies access to health care based on the ability to pay. Under a universal health care system all would access care. There would be no lines as in other industrialized countries due to the oversupply in our providers and infrastructure, and the willingness/ability of the United States to spend more on health care than other industrialized nations.
Myth Four: Universal Health Care Would Result In Government Control And Intrusion Into Health Care Resulting In Loss Of Freedom Of Choice
Fact One: There would be free choice of health care providers under a single payer universal health care system, unlike our current managed care system in which people are forced to see providers on the insurers panel to obtain medical benefits
Fact Two: There would be no management of care under a single payer, universal health care system unlike the current managed care system which mandates insurer preapproval for services thus undercutting patient confidentiality and taking health care decisions away from the health care provider and consumer
Fact Three: Although health care providers fees would be set as they are currently in 90% of cases, providers would have a means of negotiating fees unlike the current managed care system in which they are set in corporate board rooms with profits, not patient care, in mind
Fact Four: Taxes, fees and benefits would be decided by the insurer which would be under the control of a diverse board representing consumers, providers, business and government. It would not be a government controlled system, although the government would have to approve the taxes. The system would be run by a public trust, not the government.
Conclusion: Single payer, universal health care administered by a state public health system would be much more democratic and much less intrusive than our current system. Consumers and providers would have a voice in determining benefits, rates and taxes. Problems with free choice, confidentiality and medical decision making would be resolved
Myth Five: Universal Health Care Is Socialized Medicine And Would Be Unacceptable To The Public
Fact One: Single payer universal health care is not socialized medicine. It is health care payment system, not a health care delivery system. Health care providers would be in fee for service practice, and would not be employees of the government, which would be socialized medicine. Single payer health care is not socialized medicine, any more than the public funding of education is socialized education, or the public funding of the defense industry is socialized defense.
Fact Two: Repeated national and state polls have shown that between 60 and 75% of Americans would like a universal health care system (see The Harris Poll #78, October 20, 2005)
Conclusion: Single payer, universal health care is not socialized medicine and would be preferred by the majority of the citizens of this country
Myth Six: The Problems With The US Health Care System Are Being Solved and Are Best Solved By Private Corporate Managed Care Medicine because they are the most efficient
Fact One: Private for profit corporation are the lease efficient deliverer of health care. They spend between 20 and 30% of premiums on administration and profits. The public sector is the most efficient. Medicare spends 3% on administration.
Fact Two: The same procedure in the same hospital the year after conversion from not-for profit to for-profit costs in between 20 to 35% more
Fact Three: Health care costs in the United States grew more in the United States under managed care in 1990 to 1996 than any other industrialized nation with single payer universal health care
Fact Four: The quality of health care in the US has deteriorated under managed care. Access problems have increased. The number of uninsured has dramatically increased (increase of 10 million to 43.4 million from 1989 to 1996, increase of 2.4% from 1989 to 1996- 16% in 1996 and increasing each year).
Fact Five: The level of satisfaction with the US health care system is the lowest of any industrialized nation.
Fact Six: 80% of citizens and 71% of doctors believe that managed care has caused quality of care to be compromised
Conclusion: For profit, managed care can not solve the US health care problems because health care is not a commodity that people shop for, and quality of care must always be compromised when the motivating factor for corporations is to save money through denial of care and decreasing provider costs. In addition managed care has introduced problems of patient confidentiality and disrupted the continuity of care through having limited provider networks.
Overall Answer to the questions Why doesnt the US have single payer universal health care when single payer universal health care is the most efficient, most democratic and most equitable means to deliver health care? Why does the United States remain wedded to an inefficient, autocratic and immoral system that makes health care accessible to the wealthy and not the poor when a vast majority of citizens want it to be a right of citizenship?
Conclusion: Corporations are able to buy politicians through our campaign finance system and control the media to convince people that corporate health care is democratic, represents freedom, and is the most efficient system for delivering health care
What you can do about this through your state Green Party
Work to pass a single payer, universal health care bill or referendum in your state. State level bills and referenda will be most effective because a federal health care system might in fact be too bureaucratic, and because it is not politically realistic at this time.
Bills or referendum must be written by and supported by health care providers for the legislature to take them seriously. It is thus imperative to form an alliance with provider groups. The most effective provider group to go through is Physicians For A National Health Program which has chapters in every state (see hand out for partial listing of contact people). A number of states already have organized single payer efforts: Massachusetts, California, Washington, Oregon, New Mexico, and Maryland. Join with them.
A first step is to contact state representatives from PNHP and offer to join with them to write and support a bill bringing single payer, universal health care to your state if this has not already been done. The Connecticut and Massachusetts Bills can be used as models to make this task easier (email us at riverbnd@javanet.com and we will send you copies of the bills). A referendum is another way to go, in which case the California referendum can be used as a model.
A second step is to contact state legislators and find a group who are willing to sponsor such a bill.
A third step is to create a coalition of groups to work together to support and publicize this work, or to try to bring together existing groups to work together on this project. Labor unions, progressive democratic groups, Medicare/Senior Advocacy groups, the Labor Party, the Reform Party, UHCAN, existing health care advocacy groups, and state health care provider groups are all imporatnt to work with and get to join such a coalition. The state medical society and state hospital association are critical to work with in order to get any legislation passed. Try to get them to work with you to design a new model for health care delivery. They will be particularly concerned about who will control the system, and be very mistrustful of government. A public trust model with participation by providers, hospitals, business, the public and government is like to be much more acceptable to them than a pure government system. Emphasize doing away with managed care, and get them to try and work with you to find other ways to control costs (necessary to convince politicians) such as quality assurance standards, which will also protect them from malpractice
A fourth step is to give talks in support of your bill or referendum where ever possible. Senior groups, medical staffs, church groups, high school assemblies, and labor unions are particularly good sources. Excellent materials including slides, a chart book and videos are available through PNHP.
A fifth step is to raise money through fund raisers, contributions and benefits held by entertainers. Benefits are particularly useful in bringing out people who you can inform about single payer, universal health care and your efforts.
A sixth step is to develop media access. The creation of videos that can be shown on local cable access TV stations is very effective. Newspaper articles, letters to the editor, and articles by the press are critical. Radio interviews and radio talk shows are important.
Getting the public to write and call their state representatives in support of a proposed bill is critical, as is coordinating testimony at a public hearing.
Because the data about single payer universal health care are so revealing of the problems with corporate America, and because the US citizenry is so concerned and dissatisfied with our health care system these efforts may yield surprisingly positive results and be helpful in establishing the Green Party in the US as a party of the people, by the people and for the people.
We would be happy to help you. Contact us by email at riverbnd@javanet.com, by phone at 860-354-1822, or by mail at 88 Cherniske Road, New Milford, CT 06776
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 3:49 PM
well I was listening to our one and only senator today and she said that if other parts of the country followed the Mayo Clinic's (not exactly a quacks organization) protocols for end of life care, the nation would save 50 billion dollars across a four year budget cycle. Apparently other regions of the country are not as honest as the Midwest and run lots of unneeded consults and tests to fatten them selves at the trough. This is what the worship of money brought in by the Atwater conservatives led by their morally bankrupt stalking horses Ronnie (the deaf liar) Reagan and Rush (much divorced drug addict) Limbaugh leads to, the notion that if you can grab a dollar you should with out regard for right and wrong.
"If a nation expects to be ignorant and free, in a state of civilization, it expects what never was and never will be." -- Thomas Jefferson
We live in a society exquisitely dependent on science and technology, in which hardly anyone knows anything about science and technology. - Carl Sagan
I believe that every right implies a responsibility, every opportunity an obligation; every possession, a duty. - John D. Rockefeller, Jr.
there is a distinction....the difference is what bankrupts the industry.
people don't want to pay for their own maintenance....they want their neighbor to pay for their own lives...that is theft when forcing the neighbor to pay through the guns of government
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 5:10 PM
Yeah buddy, just turn the whole thing over to the people who run the DOD, Amtrak, and the Post Office. That's the ticket... gus
I am not aware of a plan in which the government would run hospitals, clinics and doctors' offices. The focus is how to get people on health insurance plans.
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 7:10 PM
I am not aware of a plan in which the government would run hospitals, clinics and doctors' offices. The focus is how to get people on health insurance plans.
Really? How's that working out for you so far with the auto companies?
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 7:51 PM
The US debate about health care no longer centers on whether we should have universal health insurance, but rather how to get it, which really becomes a debate about how to pay for it, or how to make it affordable for the average person, and particularly the working poor, who dominate the uninsured population in the United States.
I can agree with this.
Regarding the higher cost of prescription drugs in the U.S., are there any Canadian companies incurring drug R&D costs?
are there any Canadian companies incurring drug R&D costs?
I get 2 of my Rx drugs from Canadian pharmacies, and so far the prices are still FALLING. For instance, I pay exactly half of what an ADVAIR inhalor would cost here in the USA by buying it in Canada. Two years ago, I paid 2/3 of the cost of an ADVAIR inhalor in Canada.....so their price has fallen in the last two years.
This message has been edited by pphhrogg on May 20, 2009 8:09 PM
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 8:23 PM
I don't know. That's why I ask. My point is simply that there are millions of dollars and years spent developing those drugs, obtaining FDA approvals and in obtaining patents.
...you are simply asuming that CANADA is the one who is taking these drugs and selling them at the "expense" of our drug companies? That is ridiculous. BIG PHARMA sells those drugs to Canada, y'know......and makes a tidy PROFIT, too. BIG PHARMA sells those same drugs to Americans (in America) at the exhorbitant prices for which you buy them. They are nothing but greedy bastards (most of them).
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 8:29 PM
I don't know. That's why I ask. My point is simply that there are millions of dollars and years spent developing those drugs, obtaining FDA approvals and in obtaining patents.
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 9:20 PM
If I follow the thead, what the rightwing is saying is that the American customer bears all the cost of drug development and the Canadian customer gets a free ride, perhaps because the Canadian government goes to bat for its citizens and negotiates them lower prices. I suggest that if the American government did likewise, at worst the price would rise in Canada and drop here as the development cost is shared in both markets. As things are now why the hell would drug companies hold out for costs in Canada when they've got chumps here in the States forced by the prehistoric health care system to carry their load and the the Canadian's et al besides?
"If a nation expects to be ignorant and free, in a state of civilization, it expects what never was and never will be." -- Thomas Jefferson
We live in a society exquisitely dependent on science and technology, in which hardly anyone knows anything about science and technology. - Carl Sagan
I believe that every right implies a responsibility, every opportunity an obligation; every possession, a duty. - John D. Rockefeller, Jr.
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 10:39 PM
Typical liberal thinking requires health insurance for everyone.
So everyone is insured. Now what?
Where are all of those extra doctors, nurses, and hospitals that are needed coming from? Are you gouing to tell us that the same number of doctors, nurses and hospitals are going to care for an addition 50 million patients that it handles wh=ith the current staff and facilities?
Do you relly believe that your health care will be as good as that of Congress just because you have everyone insured.
The obvious scam is that everyone will be insured, but no one will have helth care improvement because the system needs to be adjusted. But guess what happens? More government control that steals from the people. Just as they are doing in the auto industry.
Heuy, if they can close dealerships, they can close hospitals. Don't you just love it when the government replaces your rights with theirs.
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 11:29 PM
Where are all of those extra doctors, nurses, and hospitals that are needed coming from? Are you gouing to tell us that the same number of doctors, nurses and hospitals are going to care for an addition 50 million patients that it handles wh=ith the current staff and facilities?
The doctors and hospitals won't have to pass the cost of the uninsured on to the rest of us. Why do you assume that here will be a huge explosion of people running to the doctors just because they have insurance?
Re: Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
May 20 2009, 11:44 PM
Where are all of those extra doctors, nurses, and hospitals that are needed coming from? Are you gouing to tell us that the same number of doctors, nurses and hospitals are going to care for an addition 50 million patients that it handles wh=ith the current staff and facilities?
Well poetse, I suppose you could politely ask those 50 million previously uninsured poor people to do the right thing for their country and stay sick and/or just die. Hell fire they're poor after all. Not like they have a reason to live.
(sarcasm)
Current Topic - Why Health Insurance Should Be Publicly Funded and Publicly Guaranteed
