Mandatory Health Insurance part 3

[Irvine511]

Originally Posted by ryancoke71

I am sure you are not implying that the US is the only country to be innovative when it comes to medicine.

Of course our health care system is possible minus the US healthcare system. Are you implying that we rely on you when our care isn't enough, or am I misunderstanding? I have yet to have any member of my immediate or extended family ever seek any type of medical treatment outside of Canada.

while i don't agree with INDY, the argument being put forth is that the vast majority of health care advances and innovations come from the US. many of the drugs and procedures you enjoy were developed and perfected here, and that the best and the brightest -- from all over the world, though much talent is homegrown -- are attracted to the US because there are big profits to be made on the health care system. that profit is a motivator and innovator.

i think that's problematic in many ways, but it's not totally incorrect.

there's a reason the Mayo Clinic is in the US.

[Moonlit_Angel]

Originally Posted by INDY500

1) How many of those counties have 300 million people to insure? What works in Canada or Sweden does not necessarily work here.

I too don't get how the population amount matters. We can't possibly find a way to figure out how to insure every last citizen of our country? It's not my fault I happened to be born in a more populated country whose number of citizens keeps increasing-I'm SOL because trying to cover 300 million people would be too difficult to achieve?

Originally Posted by INDY500

2) How many of those countries have the extra $ GDP to spend on health care because the USA picks up most of the tab to defend them and the world? Who defends us if we slash our military budget to spend on social programs?

Ooh, we may have to cut our defense budget a bit! 'Cause we all know every last dime that goes to that budget currently is being used wisely, right?

And who defends us? Um...our allies? Their budgets may not be as big as ours, their military may not be as flashy as ours, but crazy enough, I still think they could get the job done to help us out if need be.

(Hell, with the amount of people running out and buying massive quantities of guns (and really big deal types of guns, no less) in recent years, I'm pretty sure the citizens of this country could do a fine enough job of defending themselves if it came down to it. Since apparently that's where we're headed in their eyes, or something)

Originally Posted by INDY500

3) How many of those countries rely on the expensive new innovations in medicine, medical procedures and equipment developed and funded by the US health care system?

In short, are all these exemplary healthcare systems even possible minus the US private healthcare system, US defense budget and US economy?

And so as not to come off as just pounding my chest, much of what makes our healthcare system so great is that people come from all around the world to study and to work and to do research and to practice here because they want the freedom, the cutting edge technology and to be rewarded for their work and talent.

I'll just refer you to the other posts regarding this. Yes, we have some brilliant innovative minds here in the U.S. working in medicine and technology, and I am beyond thankful for that. But other countries have their share of brilliant minds, too, and working together, we might actually get somewhere amazing.

The United States is one of the younger nations in the world overall. We're like the little sibling...every once in a while it wouldn't hurt to learn something from the people who are older and have been around the block a few hundred times. I know we like to think we're the best and everything, but other countries aren't so bad, either.

[popshopper]

Originally Posted by anitram

There are people here who will suggest that we have some kind of third world healthcare, that we're all flocking to the US for good care (because the odd person here or there going to the Mayo Clinic is representative), that we are forced to see doctors that the government mandates (I have been asked by a poster here how I got "assigned" my doctors or specialist, no joke), and so on. All without ever having lived a day here or ever made use of the system. Because some right winger on Fox News told them that's what it's like.

Don't even bother with bringing up the NHS in the UK else you'll be told that this is why the British have bad teeth. I joke, but only a little bit.

Remove the very few Americans on Cadillac healthcare plans (these are your executives and so on) and the ultra-wealthy who can afford the best of the best, and all of the rest of you are worse off than everyone living north of the border. But heaven forbid hordes of Republican voters accepted the idea that anyone can do it better.

The biggest laugh about Dental care in the NHS is that Dental care in the UK is privatised. The only people who get free dental care in the UK are the elderly, children, the disabled and the unemployed. The care is provided via private dentists who are paid via the state.

It's actually the part of the NHS which most resembles the US system.

[popshopper]

Originally Posted by INDY500

1) How many of those counties have 300 million people to insure? What works in Canada or Sweden does not necessarily work here.

2) How many of those countries have the extra $ GDP to spend on health care because the USA picks up most of the tab to defend them and the world? Who defends us if we slash our military budget to spend on social programs?

3) How many of those countries rely on the expensive new innovations in medicine, medical procedures and equipment developed and funded by the US health care system?

In short, are all these exemplary healthcare systems even possible minus the US private healthcare system, US defense budget and US economy?

And so as not to come off as just pounding my chest, much of what makes our healthcare system so great is that people come from all around the world to study and to work and to do research and to practice here because they want the freedom, the cutting edge technology and to be rewarded for their work and talent.

The US spends more of it's GDP on healthcare than any other country, for uniformly terrible results (as a nation the US lags behind most other developed countries in the major health indicators; in 2006 the US was 39th for infant mortality, 43rd for adult female mortality, 42nd for adult male mortality, and 36th for life expectancy despite being the highest spender in healthcare both in total sum and in % of GDP ).

In short, you have a terribly expensive system which fails to work for the majority of your population.

The innovation argument is overblown, NIH contributes more money to research than any other single entity worldwide (over 28% of US Biomedical research) and it's centrally funded via Congress, and has nothing to do with private nature of the US healthcare market. The idea research and investment dries up in a single payer system is ridiculous. The CT scan was a product of the single payer NHS model. Of the worlds 5 biggest drug companies, only 2 are US, 2 are Swiss, 1 is British.

[BVS]

Originally Posted by INDY500

1) How many of those counties have 300 million people to insure? What works in Canada or Sweden does not necessarily work here.

2) How many of those countries have the extra $ GDP to spend on health care because the USA picks up most of the tab to defend them and the world? Who defends us if we slash our military budget to spend on social programs?

3) How many of those countries rely on the expensive new innovations in medicine, medical procedures and equipment developed and funded by the US health care system?

In short, are all these exemplary healthcare systems even possible minus the US private healthcare system, US defense budget and US economy?

And so as not to come off as just pounding my chest, much of what makes our healthcare system so great is that people come from all around the world to study and to work and to do research and to practice here because they want the freedom, the cutting edge technology and to be rewarded for their work and talent.

1. You're smarter than this.

2. Maybe we should quit waging wars of choice.

3. Actually a lot of medical innovations are coming out of these "socialist" countries that you speak of... Sweden and Germany are two of the leaders right now in implant innovations. Actually a lot of the medical research and innovations done in the states are being done at the university and research hospital level, not the glorious alter of the free market.

You might want to keep up...

[anitram]

Originally Posted by Irvine511

while i don't agree with INDY, the argument being put forth is that the vast majority of health care advances and innovations come from the US. many of the drugs and procedures you enjoy were developed and perfected here, and that the best and the brightest -- from all over the world, though much talent is homegrown -- are attracted to the US because there are big profits to be made on the health care system. that profit is a motivator and innovator.

i think that's problematic in many ways, but it's not totally incorrect.

there's a reason the Mayo Clinic is in the US.

Except that it's just flat out wrong to describe it in this way.

Take a look at the top 10 or so most profitable drugs on the market right now and do a count as to how many of them hail from Euro-based pharma companies. I think you'd be surprised and the "vast majority" argument would be made to look ridiculous.

You also have facilities in places like Switzerland that are on the level of the Mayo Clinic - it's just that Mayo is the most famous and in US centric media, the one and only.

The R&D argument is an old and incorrect one. R&D abroad is outstanding these days. One good example is stem cell research, an area in which the US has been left largely behind.

Does that argument hold some weight? Yes, but considerably less so than people like INDY make it seem.

As for the defence argument - frankly, when you have the type of US foreign policy that you do, certain defence costs flow from it. It is also a matter of US choice to keep their military at the levels that it's at and keep sending their forces around the world in misadventures like Iraq. Canada wisely kept out of that and there is no doubt that such a decision is but one factor for our considerably better financial situation.

At the end of the day, it does come down to priorities. So in a way INDY is right - if the US prioritizes other things over universal healthcare, then that is fine, the goal is being achieved. And if that is what's going to be widely accepted by US citizens, then in a way, you really can sit on your hands like the GOP does and not bother putting forth major reform proposals.

[ryancoke71]

^Very well said!

Originally Posted by Irvine511

while i don't agree with INDY, the argument being put forth is that the vast majority of health care advances and innovations come from the US. many of the drugs and procedures you enjoy were developed and perfected here, and that the best and the brightest -- from all over the world, though much talent is homegrown -- are attracted to the US because there are big profits to be made on the health care system. that profit is a motivator and innovator.

i think that's problematic in many ways, but it's not totally incorrect.

there's a reason the Mayo Clinic is in the US.

I didn't disagree, that is why I asked him if I was misunderstanding. It seemed as if he might have been saying that Canadian citizens flock to the US when our own system fails them. Of course the US has made great strides in medicine. I just didn't like the implication that the US was the only country that has, while the rest of us just sit back and take advantage without contributing anything ourselves.

Case in point:


Sickkids - hospital


"SickKids is one of the world's largest and most respected paediatric academic health sciences centre, offering comprehensive services across a wide range of clinical specialties."




While I was there with my son, there were people from all over the world who brought their children to SickKids. Yes, even American citizens.

[anitram]

Sick Kids is routinely ranked 3rd or 4th in the world. I used to work for their research institute years ago.

[Irvine511]

Originally Posted by anitram

You also have facilities in places like Switzerland that are on the level of the Mayo Clinic - it's just that Mayo is the most famous and in US centric media, the one and only.

and Switzerland has a health care system quite different from other European countries and actually resembles Obama care in many aspects. and which is the most profitable market for these countries no matter where they reside? the US market.

The R&D argument is an old and incorrect one. R&D abroad is outstanding these days. One good example is stem cell research, an area in which the US has been left largely behind.

but due to political resistance from the insane Republican right, which isn't related to profit but certainly could become a reason for some research to take place outside of the United States where fanatical Christians don't have the same sway.

Does that argument hold some weight? Yes, but considerably less so than people like INDY make it seem.

which is all i was saying.

At the end of the day, it does come down to priorities. So in a way INDY is right - if the US prioritizes other things over universal healthcare, then that is fine, the goal is being achieved. And if that is what's going to be widely accepted by US citizens, then in a way, you really can sit on your hands like the GOP does and not bother putting forth major reform proposals.

to play devil's advocate, what i think INDY is saying is that the US is quite unique in that it has responsibilities on a global level that other countries don't and rely upon the US to fulfill in a way that only it can (we can agree that Iraq wasn't a responsibility, but that's not always the case). and i think we can also say that it's a vastly greater challenge to cover 310m Americans than 4m Kiwis or 30m Canadians. direct country-to-country comparisons between health systems don't seem to be terribly applicable -- maybe we could compare New Zealand to Massachusetts?

my sense is that the best way to look at it is to see how much more expensive our privatized health care system is compared to the rest of the developed world (as a % of GDP) to see that we are paying more to get about the same results.

[anitram]

Originally Posted by Irvine511

my sense is that the best way to look at it is to see how much more expensive our privatized health care system is compared to the rest of the developed world (as a % of GDP) to see that we are paying more to get about the same results.

Agreed on the methodology.

With the caveat that you're getting worse results not "about the same" results.

[Irvine511]

given the size and scope of the US, and it's wild geographic and cultural differences, i think "about the same" is actually pretty good -- can't think of too many other countries with 300m people that incorporate areas with populations as different as those from, say, the Mississippi delta and Northern California.

California vs. Switzerland seems fair, the US vs. Switzerland does not. maybe the US vs. the EU.

[anitram]

Originally Posted by Irvine511

given the size and scope of the US, and it's wild geographic and cultural differences, i think "about the same" is actually pretty good -- can't think of too many other countries with 300m people that incorporate areas with populations as different as those from, say, the Mississippi delta and Northern California.

If that were a good way of doing it, you'd have to essentially have states at the top which vastly outperform their comparator group (likely EU/Canada/Australia/NZ/Japan) in order to compensate for the vast underperformers at the bottom (poorest US states considerably worse off than worst Euro states), with likely some in the middle.

I just don't really see that the math would add up - think you'd still be way short overall.

But it would be an interesting way of looking at it - wonder if there is a statistical analysis somewhere of something like it.

As somebody who's lived and worked in both places (and with what would be considered a Cadillac plan in the US), it takes me about 0.2 seconds of thought to decide which I'd rather have. My point is not to pile on the US, but I just find something a bit disturbing about a large swath of Americans being completely averse to taking a long look and considering that, in fact, there are some things that are done better elsewhere. It's almost like sacrilege to suggest it. And that is a large barrier to reform and innovation because it shows a deep inflexibility.

[Irvine511]

the main point is that it's pointless to compare small, homogenous European nations to something as massive as the US.

possibly one could do that based upon GDP. the state of California is the 7th largest economy in the world. one could go from there as a basis of comparison.

[anitram]

The problem with that is that you can’t have even that type of comparison because it is not sensical to compare per capita spending in a place where there are uninsured people with one where everyone is ensured. For example, as seen in the article below, in 2009, per capita spending (by insurers, government agencies and individuals) in California was $6,238 per resident. This is, by the way, among the lowest in the nation.

Conversely, in Canada, a country with about the same population as California, and roughly the same standard of living, and actually a lower GDP (1.6 trillion v. 1.9 trillion, roughly) per capita in 2006 was $3,895. I can’t find the 2009 data, but given that there were no significant expenditures or cuts up here in the intervening years I’d imagine it’s relatively accurate.

So that leaves us with a rather wide disparity, and you have almost double the spending in a comparable state all the while 1/7th of that state is uninsured (as compared to 100% insurance in Canada). My point is just that this comparison which slightly favours California on two grounds (GDP and insurability rates) doesn’t seem “about the same” even with that type of comparison. If you adjusted for the numbers, the difference would be even more stark.

California healthcare spending per person among lowest in U.S. - Los Angeles Times

[digitize]

I don't fully understand the "America is big, so universal health care won't work" argument. Is it impossible to scale a system up? If so, why? The United States has some national welfare systems (social security, medicare, medicaid) that they manage to scale out well, sometimes using the states as partial administrative units... I'm not sure I really understand why it's impossible to scale universal health care up. I've heard a lot of vague talk about it, but not any discussion of actual obstacles that would present themselves.

[Irvine511]

Originally Posted by digitize

I don't fully understand the "America is big, so universal health care won't work" argument. Is it impossible to scale a system up? If so, why?

because there are big differences between different states, so it's not like the US is like any other medium-sized country, just bigger, it's that it's a very big country comprised of a highly diverse population spread over a continent and made up of 50 different governments. a one-sized solution may not work as well for 300m people spread over a continent than it does for 10m relatively homogenous Swedes. lifestyles are very different in Mississippi than they are in the Bay Area.

as for comparisons for California and Canada, the comparison was not about price but about overall quality of health as we'd established that the US system if much more expensive than in places with a single-payer system. perhaps the US, due to it's population, is simply much more expensive to keep healthy.

i have no solutions, i think Obamacare is a step in the right direction. my instinct is towards a single-payer system financed by slightly higher taxes because it seems to be the only way we'll be able to control costs as the population ages.

it's just that, in the way that some people get irritated (with justification) and think, "why does the US always think it does it right," i in turn think, "why do small, wealthy countries think we can even begin to make these comparisons?"

[anitram]

Originally Posted by Irvine511

i have no solutions, i think Obamacare is a step in the right direction.

I give him credit for doing something. There are parts of Obamacare that are good and necessary. But the constitutional issue is bothersome and I think people who are saying that if the SCOTUS strikes this down it will be a victory for Obama are a bit deluded to be honest. Almost half the population hates him, and these people are going to be told that a president who was a constitutional law professor passed an unconstitutional bill forcing them into socialism. It's a disaster.

Maybe it would be a good thing in the long run, maybe you'd get something better down the road. But in the short run it would be seen as a pretty bad defeat IMO.

it's just that, in the way that some people get irritated (with justification) and think, "why does the US always think it does it right," i in turn think, "why do small, wealthy countries think we can even begin to make these comparisons?"

Which would be a nice theory if the US wasn't ahead of every other Western democracy in terms of GDP per capita except for Norway. So the idea that somehow everyone else is sitting with buckets of money and passing judgment of a poorer nation doesn't stand up to scrutiny.

[digitize]

Originally Posted by Irvine511

because there are big differences between different states, so it's not like the US is like any other medium-sized country, just bigger, it's that it's a very big country comprised of a highly diverse population spread over a continent and made up of 50 different governments. a one-sized solution may not work as well for 300m people spread over a continent than it does for 10m relatively homogenous Swedes. lifestyles are very different in Mississippi than they are in the Bay Area.

I get that. But how does that actually translate into a tangible obstacle to implementation? Lifestyles may be different, but the types of health care that people seek aren't really that different.

All I'm seeing is descriptions on what the US is, but I've never found anyone give a specific example of how it translates into an actual policy roadblock.

[Pearl]

Don't know if I should post this here or in the Personhood Amendments thread, but here you go:

Barack Obama's hometown Archbishop, Cardinal George, has issued a dire warning: if Obama's regulations on health insurance are allowed to stand, all Catholic hospitals and schools will be destroyed through fines, sold-off to non-Catholics, or closed down within two years. He says that the Church will be "despoiled of her institutions" be stripped of its "voice in public life," because Obama's regulations of health insurance force Catholics to act against their faith.
The regulations which go into effect next year require religiously affiliated charities, hospitals, and universities to purchase insurance for their employees that includes contraception, sterilization and 'morning after' pills. For Catholics this amounts to "material cooperation" with an objectively sinful act.
Francis Cardinal George wrote about the choices Obama is forcing on the Church in his column this week:
What will happen if the HHS regulations are not rescinded? A Catholic institution, so far as I can see right now, will have one of four choices: 1) secularize itself, breaking its connection to the church, her moral and social teachings and the oversight of its ministry by the local bishop. This is a form of theft. It means the church will not be permitted to have an institutional voice in public life. 2) Pay exorbitant annual fines to avoid paying for insurancepolicies that cover abortifacient drugs, artificial contraception and sterilization. This is not economically sustainable. 3) Sell the institution to a non-Catholic group or to a local government. 4) Close down.
George has been warning of the state's intrusion into religious affairs for a long time. In 2010 he predicted, “I expect to die in bed. My successor will die in prison, and his successor will die a martyr in the public square.”

Read more: Chicago's Archbishop: Obama Will 'Steal' Or Close Down All Catholic Hospitals Within Two Years - Business Insider

Its insane for some people to think Obama would make the U.S. another Soviet Union. It's also insane for a religious institution to not go along with birth control when 90% of its female adherents use it.

[ladyfreckles]

Originally Posted by Pearl

Don't know if I should post this here or in the Personhood Amendments thread, but here you go:


[/B]

Read more: Chicago's Archbishop: Obama Will 'Steal' Or Close Down All Catholic Hospitals Within Two Years - Business Insider

Its insane for some people to think Obama would make the U.S. another Soviet Union. It's also insane for a religious institution to not go along with birth control when 90% of its female adherents use it.