NationStates Jolt Archive

The improvement of the American health care system is the number one concern on my mind in the November elections, and is my number one priority in general when it comes to political issues. I used to think that I could find common ground with Democrats and American liberals on this issue, but now I'm not so sure. The left seems to quite largely favor a single payer, entirely government-managed system. I personally cannot see how anyone who favors free markets of any sort can support such a system. It lacks any incentives for innovation, has no concept of supply and demand, and promotes inadequate funding by its very nature. In other words, it fails for the very reasons that command economies lag behind market ones.

At the same time, an entirely private health care system favors the wealthy and harms the lower classes. So I find myself in a conundrum. I want common sense reforms -- vouchers for employees instead of employer-provided insurance; subsidization for low income individuals and families; tax credits for all middle class and working class tax payers. And yet, the conservatives who would appear to be allies to my views seem disinterested in reform measures. So what to do? How can the left, who are so focused on health care, be convinced that more government control is not the answer, and the right be motivated to take action?

It seems to me that health care is an issue that is brimming with bullshit from both sides in the United States. The entirety of the debate is focused on either a.) the wonderful "benefits" of a single payer system and b.) what's wrong with such a system. How can the discussion be re-focused to center on common sense, realistic reforms, and not epic political battles about socialism and Hillary Clinton?

What are everyone's thoughts on this issue? Are we right to focus soley on the single payer issue? What are the best reform strategies? Do we need reform?

Here is the best system for the US.

take IRS reported income levels.
Use those levels to determine a certain amount of money the goverment will pay for you to have insurance.
Let the insurance company's handle all that paper work shit.
Want more coverage then the goverment give you then pay for it.
Want just what the goverment gives then fine.

leaves choice to the individual and allows private companies.

My idea would be similar to subsidization for low-income families. The government would basically act as another insurance company. Not everyone would have to take the government-funded plan, as some candidates would suggest. The government would go into a sort of co-pay with low-income patients that would have the patient pay a given amount it can afford based on its standard of living, then the government cover the rest as needed at the time. Then, the patient would pay back the rest of the cost over time, like a loan, at minimal to no interest. Patients who default would be penalized if not given a good reason. Patients who can afford other insurance can choose another insurance plan that may give them a better deal, but are still offered the government plan.

Whatever healthcare the government provides should be a safety net for those who otherwise couldn't afford basic care, not a replacement for the industry in general. That could mean expanding medicare or medicaid - I wouldn't oppose that.

Most people don't even know about the programs available to them in the U.S. right now. I had no idea that I could apply for medical services that my provider doesn't cover (in my case, an MRI) which I couldn't afford, until my most recent doctor informed me that the program existed. So I applied and was accepted. Not bad. More of that sort of thing is preferable to a massive new bureaucracy, thanks. :p

Here is the best system for the US.

take IRS reported income levels.
Use those levels to determine a certain amount of money the goverment will pay for you to have insurance.
Let the insurance company's handle all that paper work shit.
Want more coverage then the goverment give you then pay for it.
Want just what the goverment gives then fine.

leaves choice to the individual and allows private companies.

That would essentially be a government takeover of the insurance industry, because all of the funding would be coming from the government. With all of the funding coming from the government, the insurance industry would have no autonomy any more. In essence, it would be a single payer system with an unnecessary middleman.

Why make it so that health care is funded soley through taxes? Why shouldn't people pay at least some of their health care costs individually, especially when many can afford to?
The government would go into a sort of co-pay with low-income patients that would have the patient pay a given amount it can afford based on its standard of living, then the government cover the rest as needed at the time. Then, the patient would pay back the rest of the cost over time, like a loan, at minimal to no interest.
It would be a lot cheaper for low income people to have subsidized insurance. With health care costs so high (inflation of 7% last year), in your scenario, the government would be footing a huge bill that could be partially covered by an insurer. I do, however, like the idea of government loans. It would help those with insurance get the funds they need for necessary medical procedures denied coverage by their insurance plans, and give them the ability to pay off the debt with low interest and elected representatives to complain to.

That would essentially be a government takeover of the insurance industry, because all of the funding would be coming from the government. With all of the funding coming from the government, the insurance industry would have no autonomy any more. In essence, it would be a single payer system with an unnecessary middleman.

only the bottom 10% of people would get a damn dime.
and even most of them would want to contribute some to their own health care.
all the corporation is doing is taking a clients income level and filing it with he goverment to see how much the goverment will give. Sort of like how those chairs on wheels companies fill out the paper work for old people with Medicare.


Why make it so that health care is funded soley through taxes? Why shouldn't people pay at least some of their health care costs individually, especially when many can afford to?

.

It is not funded solely through taxes the amount of assistance you get is determined by income and family size.

only the bottom 10% of people would get a damn dime.
and even most of them would want to contribute some to their own health care.
all the corporation is doing is taking a clients income level and filing it with he goverment to see how much the goverment will give. Sort of like how those chairs on wheels companies fill out the paper work for old people with Medicare.


It is not funded solely through taxes the amount of assistance you get is determined by income and family size.

Forgive me, I misread your post. So what you're basically advocating is subsidized government insurance. Sounds good. Still, more steps are needed to control prices and such. That's why I would advocate expanded competition.

It lacks any incentives for innovation, [...] it fails for the very reasons that command economies lag behind market ones.


Yeah, just like China.

oh SHI-

First off, the ONLY incentive you should EVER need for creating innovative medical technologies is that you're helping people. You shouldn't need a 9 digit salary in order to find that cure for that disease.

If Command economies really did lag behind market ones, then China shouldn't be a raising superpower, and the USSR should never have been a threat to a juggernaut market economy like the USA. The problem with your comparison is that the vast majority of Command economies spend most of their time focused inward, where as market economies spend most of their time looking outward.

China, for example, spent a very long time being almost completely inwardly focused, until their government was over thrown and the new Government wanted to bring China on par with the rest of the world. Thus, we have the modern Chinese economy, which is developing at a breakneck pace, and will soon out do the American economy.

You see, unlike most Americans, the Chinese feel that they should better themselves for the sake of bettering themselves. And not because if they do they'll be super rich, or powerful.

Back to the original issue, however;
The vast majority of first world countries have some sort of socialized health care, in fact, the USA is the only nation that lacks it, and the majority of systems work very well.

only the bottom 10% of people would get a damn dime. .

Then you miss the main problem demographic at the moment, which is the second 25% or so who are too rich for medicare and too poor for health insurance.

Plus it still leaves the main problem with the current privatised healthcare systems, namely that people try and avoid using them due to costs incurred and so don't go until whatever they have is at a serious stage, when preventative medicine is much more efficient.

Yeah, just like China.

oh SHI-

China's economy took off when they switched from being a command economy to being a free market.

First off, the ONLY incentive you should EVER need for creating innovative medical technologies is that you're helping people. You shouldn't need a 9 digit salary in order to find that cure for that disease.

and a farmer is supposed to grow food and be happy he is feeding people ?
Or the guy at the power plant should be willing to work for free because he provides energy to people.
Scientist who develop new medical treatments deserve to pay just as much as the scientist who invent a new more energy efficient light bulb.

If Command economies really did lag behind market ones, then China shouldn't be a raising superpower, and the USSR should never have been a threat to a juggernaut market economy like the USA. The problem with your comparison is that the vast majority of Command economies spend most of their time focused inward, where as market economies spend most of their time looking outward.

there were several reasons for the USSR's prolonged survival.
using the Czar's gold stash, selling the Czar's art, melting down the gold in the Russian churches, convincing the Spanish goverment to give them their gold for help in the civil war, aid during WWII, Stripping down all the factories in East Germany, eastern Europe, Manchuria and sending them back home to Russia, Us dollar crisis in the 60's and 70's (investors fled the dollar and extracted and bought commodities from Siberia). The Soviet economy was mostly a black hole that money and gold went into but no real production came out of.

funny I don't recall Afghanistan, Poland, East Germany, North Korea being internal matters for the Soviet Union.

China, for example, spent a very long time being almost completely inwardly focused, until their government was over thrown and the new Government wanted to bring China on par with the rest of the world. Thus, we have the modern Chinese economy, which is developing at a breakneck pace, and will soon out do the American economy.

If you want to call Deng Xio Peng's rise to power an over throw then I suppose you can. though technically it was in line the the Chinese constitution at the time so it is a bit like saying Bush over threw Clinton.
The dream of China being on par with the rest of the world had been one of chairman Mao's ambitions. It just took Deng Xio Peng to actually make it work. And we will see how the economy last when the current workers retire, and due to the one child policy they have few workers to take their place and support them.


You see, unlike most Americans, the Chinese feel that they should better themselves for the sake of bettering themselves. And not because if they do they'll be super rich, or powerful.

The Chinese economy didn't get anywhere until the goverment allowed people to do it for the money just like the US.

Back to the original issue, however;
The vast majority of first world countries have some sort of socialized health care, in fact, the USA is the only nation that lacks it, and the majority of systems work very well.

and the US system also works well. The vast majority of studies I have read have failed to take into account Demographic differences between the US and europe ( higher immigrant population, different age groups ETC.).

Then you miss the main problem demographic at the moment, which is the second 25% or so who are too rich for medicare and too poor for health insurance.

Plus it still leaves the main problem with the current privatised healthcare systems, namely that people try and avoid using them due to costs incurred and so don't go until whatever they have is at a serious stage, when preventative medicine is much more efficient.

funny because I am that demographic and I have no problem paying for health care.

Just FYI. I can't believe this is happening in the world's richest country. But there you go.

http://news.bbc.co.uk/1/hi/world/americas/7420744.stm

Medical charity helping US poor
By Jonathan Beale
BBC News, Tennessee

Stan Brock is like a 21st-Century Florence Nightingale. He started a charity - Remote Area Medical (RAM) - more than 20 years ago to bring relief to those cut off from healthcare.

Originally it was to help poor tribes in the former British colony of Guyana, South America...But now Stan spends most of his time bringing relief to the richest country in the world. Some 60% of RAM's work is now carried out in the United States.

On a wet, spring weekend he lands his vintage World War II aircraft - once used to drop American troops on D-Day - in Lafayette, Tennessee. He bought the plane to parachute medics into the jungle. Today he is unloading dentists' chairs from the plane into a pickup truck.

By eight o'clock on Friday evening the first patients have arrived after travelling hundreds of miles. They start queuing. For one weekend RAM has turned a high school into a hospital. Classrooms have become consulting rooms and the sports hall has been transformed into a production line to fill or extract painful teeth.

Volunteer nurses, doctors and dentists have flown in from all over the country to man the stations. Like Stan, they are not getting paid.

By five o'clock on Saturday morning the line is snaking round the school. State troopers are on standby to help. The patients are handed numbers as they wait in the pouring rain.

Most of those I speak to seem to have jobs, but cannot afford healthcare. For one reason or another they do not have insurance. They call themselves the "working poor".

And then Stan Brock arrives with a loudspeaker to call the first batch in. Once inside there is more queuing and waiting. The patients slowly make their way to tables with yet more volunteers, who take blood pressure and medical history.

Among the sea of faces is Donna Pollard. She wants a mammogram to check out a lump on her breast, as well as dental work and new eye glasses. For her, this service is nothing short of a lifeline. Healthcare is a luxury when you are struggling to pay the bills.

Then there is Ken Barbee. At 64, he has been working for most of his life. But recently he had to give up his job as a truck driver to look after his sick wife. By the time I catch up with him he has already got his new glasses - now he hopes to have his last few teeth removed. Ken calls it "a shame" that people have to resort to charity for their healthcare in the world's most prosperous country.

He feels let down: "We're just pushed out there and told to do the best y'can."

And this is just the tip of the iceberg. Some 47 million Americans have no health insurance. Millions more are under-insured. It is no wonder that healthcare is now such a big issue in the presidential race.

For a stoical Stan Brock, organising these clinics is both rewarding and depressing. Come Sunday when it is time to pack up, he will be turning people away. He watches over the whole operation wearing a neatly pressed khaki uniform, carrying a clipboard and pen, looking like a figure from the old British empire. He has given his life to all this. He takes no salary, and lives in an old school building in Knoxville, Tennessee, from where he plans RAM's expeditions.

As for his views on America's healthcare, Stan says: "We need to fix it... fall into line with Britain and France. Here in this country if you're poor - you don't have much of a shot."

In this one short weekend, RAM treated 550 people - 416 teeth were extracted, more than 200 pairs of glasses handed out. The estimated value of this free treatment was nearly $1m (£500,000). So Stan Brock will continue flying in healthcare to rural Appalachia as well as the developing world.

He is also seriously thinking of returning to Britain - with a team of RAM volunteers. He has heard his old country has a shortage of NHS dentists.

"I am sure we'll get just as large a crowd as we're getting here in the US," he says.

You do realize how much innovation in health care has come from the government even under the current system?

I personally cannot see how anyone who favors free markets of any sort can support such a system. It lacks any incentives for innovation, has no concept of supply and demand, and promotes inadequate funding by its very nature. In other words, it fails for the very reasons that command economies lag behind market ones.

only this hasn't happened in the rest of the industrialized world, course I won't let silly things like the rest of the planets experience sway you

SNIP

dentists at school?! :eek:

The improvement of the American health care system is the number one concern on my mind in the November elections, and is my number one priority in general when it comes to political issues. I used to think that I could find common ground with Democrats and American liberals on this issue, but now I'm not so sure. The left seems to quite largely favor a single payer, entirely government-managed system. I personally cannot see how anyone who favors free markets of any sort can support such a system. It lacks any incentives for innovation, has no concept of supply and demand, and promotes inadequate funding by its very nature. In other words, it fails for the very reasons that command economies lag behind market ones.

At the same time, an entirely private health care system favors the wealthy and harms the lower classes. So I find myself in a conundrum. I want common sense reforms -- vouchers for employees instead of employer-provided insurance; subsidization for low income individuals and families; tax credits for all middle class and working class tax payers. And yet, the conservatives who would appear to be allies to my views seem disinterested in reform measures. So what to do? How can the left, who are so focused on health care, be convinced that more government control is not the answer, and the right be motivated to take action?

It seems to me that health care is an issue that is brimming with bullshit from both sides in the United States. The entirety of the debate is focused on either a.) the wonderful "benefits" of a single payer system and b.) what's wrong with such a system. How can the discussion be re-focused to center on common sense, realistic reforms, and not epic political battles about socialism and Hillary Clinton?

What are everyone's thoughts on this issue? Are we right to focus soley on the single payer issue? What are the best reform strategies? Do we need reform?
I don't support even a government SUBSIDZES health care system. It's just not the government's job *Shrugs*.

I don't support even a government SUBSIDZES health care system. It's just not the government's job *Shrugs*.

the government has a job now? :eek:

the government has a job now? :eek:

In the Us it does. we just don't let our goverment sit there collecting welfare cheeks getting fat, and making babies like you Europeans do.

the government has a job now? :eek:
Yeah, looking for terrorists used to be a hobby :p

I am in this industry and know some of the costs associated with health care very well. This is what we are looking at. There is no way we can do universal health care in the US with our current system. It would bankrupt the nation. Now if they decided to try it then you will see hospitals close. Doctors will close their offices and a general downgrade of our care as a whole. Reason being is they have to cut costs. The best way to do this is to consolidate resources and basically not buying the newest equipment. We will dip to substandard care like you see in other nations as a comparison to US equipment and availability of beds.

I know some will say but we have the best care here in Canada or the UK or insert your own name. I am here to say you don't. I have lived under the UK system and it is far worse then the current US one. So my point is you can't have your cake and eat it too. Best health care available now vs mediocre health care but cheaper under universal.

I am in this industry and know some of the costs associated with health care very well. This is what we are looking at. There is no way we can do universal health care in the US with our current system. It would bankrupt the nation. Now if they decided to try it then you will see hospitals close. Doctors will close their offices and a general downgrade of our care as a whole. Reason being is they have to cut costs. The best way to do this is to consolidate resources and basically not buying the newest equipment. We will dip to substandard care like you see in other nations as a comparison to US equipment and availability of beds.

I know some will say but we have the best care here in Canada or the UK or insert your own name. I am here to say you don't. I have lived under the UK system and it is far worse then the current US one. So my point is you can't have your cake and eat it too. Best health care available now vs mediocre health care but cheaper under universal.

The US has the best healthcare for those who can afford it. If you average the level of healthcare available to all of the people of the US then it is not so good.

Private healthcare can still exist for those who want to pay extra, I'd guess private UK hospitals are better than the NHS certainly though how they'd relate to US hospitals

It comes down to if you believe that there is a minimum standard of health care people should have. If yes then accept that the current system is failing and that socialised healthcare, while not as good at the top end provides a better all round service for the country as a whole (with the opt out of private healthcare). If no then be happy you can afford it while the poor die untreated or get themselves into huge debt for basic healthcare.

funny because I am that demographic and I have no problem paying for health care.
You're a whole demographic? Cool.

I am in this industry and know some of the costs associated with health care very well. This is what we are looking at. There is no way we can do universal health care in the US with our current system. It would bankrupt the nation. Now if they decided to try it then you will see hospitals close. Doctors will close their offices and a general downgrade of our care as a whole. Reason being is they have to cut costs. The best way to do this is to consolidate resources and basically not buying the newest equipment. We will dip to substandard care like you see in other nations as a comparison to US equipment and availability of beds.

I know some will say but we have the best care here in Canada or the UK or insert your own name. I am here to say you don't. I have lived under the UK system and it is far worse then the current US one. So my point is you can't have your cake and eat it too. Best health care available now vs mediocre health care but cheaper under universal.
Your argument is rather oversimplified. Whilst I agree that with the current system the US could never operate a socialised medical system purely because your costs are extortionately high.
I don't think there can be any argument that the equipment provided by the US system is, generally, of a higher quality than that provided by, say for ease of argument the British NHS, however the US system as is also doesn't receive the same number of people attempting to utilise that system as the NHS.
The easiest system for the US to implement would be to introduce State provided hospitals providing a standard of health care that is high but not as quick as the private system. This would be purely because more people would be utilsing the system even when compared to current US levels, but to maintain the current private system for those who want to pay. Or the US could introduce a similar system as some UK PCT's (Primary Care Trusts) have done and provide private health care in separate wards within the same hospital. These wards tend to cost the patient more, but have the advantage to the patient that there are generally more staff on hand. The advantage to the system as a whole is that those staff do not work solely in the private sector and can be called upon should their assistance be required within the NHS wards in emergencies.
The UK NHS costs less to operate than the private US system does but does provide a comparable service provision considering the numbers of patients utilising the system.

Yeah, just like China.

oh SHI-
The reason that China is succeeding is because they instituted market reforms...That's basic common knowledge.

First off, the ONLY incentive you should EVER need for creating innovative medical technologies is that you're helping people. You shouldn't need a 9 digit salary in order to find that cure for that disease.
And where does the incentive lie for finding those cures?
And yet, there seems to be little incentive to perform better when you don't receive any rewards (i.e. raises, etc.) for doing your job well.


China, for example, spent a very long time being almost completely inwardly focused, until their government was over thrown and the new Government wanted to bring China on par with the rest of the world. Thus, we have the modern Chinese economy, which is developing at a breakneck pace...
Because of market reforms...Do you know anything about the history of China's economic take-off, just out of curiosity?

Back to the original issue, however;
The vast majority of first world countries have some sort of socialized health care, in fact, the USA is the only nation that lacks it, and the majority of systems work very well.
That's untrue. People sit on waiting lists for months -- my friend had to wait 12 months for an MRI in Canada. Meanwhile, the lack of medical innovations are apparent -- cancer survival rates in Europe lag behind those in the United States.

I am in this industry and know some of the costs associated with health care very well. This is what we are looking at. There is no way we can do universal health care in the US with our current system. It would bankrupt the nation.
Untrue. We spend 15% of our GDP on health care, while every other country in the world that offers coverage to every citizens spends 10% or less. Much of the money in that figure comes from unnecessary underwriting costs by insurance companies, and a lack of competition among providers. The truth is that we can cover every individual in this country and reduce the amount of money spent on health care.

Now if they decided to try it then you will see hospitals close. Doctors will close their offices and a general downgrade of our care as a whole. Reason being is they have to cut costs. The best way to do this is to consolidate resources and basically not buying the newest equipment. We will dip to substandard care like you see in other nations as a comparison to US equipment and availability of beds.
Increased competition, which would occur if we repealed the HMO mandate and other mandates that put constraints on competition (such as banning speciality hospitals), would actually lower costs naturally while increasing the quality of care provided.

The easiest system for the US to implement would be to introduce State provided hospitals providing a standard of health care that is high but not as quick as the private system. This would be purely because more people would be utilsing the system even when compared to current US levels, but to maintain the current private system for those who want to pay.
We already have public hospitals paid for by government dollars. They have essentially become money-making schemes. Studies show that they charge the uninsured many times the amount that they charge the insured who visit them for the same medical procedures. Furthermore, they profit to the tune of tens of millions of dollars, all the while providing less free care.
Or the US could introduce a similar system as some UK PCT's (Primary Care Trusts) have done and provide private health care in separate wards within the same hospital. These wards tend to cost the patient more, but have the advantage to the patient that there are generally more staff on hand. The advantage to the system as a whole is that those staff do not work solely in the private sector and can be called upon should their assistance be required within the NHS wards in emergencies.
The UK NHS costs less to operate than the private US system does but does provide a comparable service provision considering the numbers of patients utilising the system.

That would entail people having to pay for health care twice -- in their tax dollars and later. Why do so when we can create one system that functions effectively? Government subsidization and increased private competition is the answer to cover everyone and lower costs.

Here's what it comes down to: a fully private health care system is wrong and disadvantageous to many people. At the same time, a socialized system is disfunctional as well (US citizens need look no further than our neighbor to the north). The answers, in my mind, lie in market reforms mixed with government assistance. The HMO mandate should be repealed -- employers should instead be entitled to provide the money they would contribute to such health plans directly to their employees. This would allow individuals to take their health care dollars and shop for the insurance plans and doctors that are best for them. Since insurance companies and the providers within the managed care plans would no longer have monopolies over employees in the businesses that they contract with, they would be forced to provide better prices and better quality to attract consumers. Meanwhile, expanded tax credits for working families and individuals would further help to lower costs. Innovations should also not be quelled -- speciality hospitals should be allowed to open, thus increasing quality and competition. Finally, the same protections that are afforded to people with employer-provided insurance should be extended to those who buy it themselves: automatic elligbility despite pre-existing conditions and fair premium prices, among others. All of these reforms would cut costs and increase the quality of care all the while avoiding the pitfalls of a socialized system and a fully private system.

Yeah, just like China.

oh SHI-

First off, the ONLY incentive you should EVER need for creating innovative medical technologies is that you're helping people. You shouldn't need a 9 digit salary in order to find that cure for that disease.

If Command economies really did lag behind market ones, then China shouldn't be a raising superpower, and the USSR should never have been a threat to a juggernaut market economy like the USA. The problem with your comparison is that the vast majority of Command economies spend most of their time focused inward, where as market economies spend most of their time looking outward.

China, for example, spent a very long time being almost completely inwardly focused, until their government was over thrown and the new Government wanted to bring China on par with the rest of the world. Thus, we have the modern Chinese economy, which is developing at a breakneck pace, and will soon out do the American economy.

You see, unlike most Americans, the Chinese feel that they should better themselves for the sake of bettering themselves. And not because if they do they'll be super rich, or powerful.


You don't seem to understand Humans. Most Humans need a material reward to do something. Are you going to give up your hard-earned money to every beggar on the street? You don't? Then you're not bettering mankind.

Back to the original issue, however;
The vast majority of first world countries have some sort of socialized health care, in fact, the USA is the only nation that lacks it, and the majority of systems work very well.
Thank God we don't. I'm happy that we're not adopting a socialized health-care system. Sorry for liking Capitalism.

Thank God we don't. I'm happy that we're not adopting a socialized health-care system. Sorry for liking Capitalism.

It's not about liking capitalism, it's about the fact that free market reforms are the only way to naturally lower costs and improve quality.

It's not about liking capitalism, it's about the fact that free market reforms are the only way to naturally lower costs and improve quality.
What do you mean by that? By moving AWAY from the free-market, or TOWARDS one in the reforms?

Look there is nothing wrong with the European(to way over simplify) Health care system.

It is just not what we want to do in the US. can Europe please allow us to solve our own internal issues?

You do realize how much innovation in health care has come from the government even under the current system?

Government contracts to private companies have always rubbed me the wrong way. Not in theory, but how in practice the contracts often seem more forgiving to the producers than they should be in a "free" market. I wouldn't mind some nationalization of them.

I don't support even a government SUBSIDZES health care system. It's just not the government's job *Shrugs*.

QFT. Since when is it "society's" job to take care of everyone? I did my job. I got health insurance for myself to cover catastrophic emergencies, and I pay cash for what it doesn't cover. Din't be telling me that you need to tax the hell out of me to cover those who are too lazy or stupid to take care of themselves. If there is no incentive to work (need for food, shelter, etc.) there is a very large section of the population that will not work.

Our system here in America is not free market capitalism. We have many highly subsidized industries, regulations up the wazoo, unions that no longer work for the worker, and government contracts that stifle competition. Let's quit the half-assed system we have now and either go back to a free market or drop the pretensions and go socialist/fascist so we can revolt and put things to rights again.

That's untrue. People sit on waiting lists for months -- my friend had to wait 12 months for an MRI in Canada. Meanwhile, the lack of medical innovations are apparent -- cancer survival rates in Europe lag behind those in the United States.

Yes, waiting lists are longer unless you want to pay, but you don't get blackholes of no coverage.

Cancer Survival rates lag behind because in the US those with coverage will have insurance companies pay for highly priced new drugs big companies develop, and can afford to do this because they're not paying for the poorest who have relatively higher illness rates. It's nothing to do with medical innovation it's to do with profit margins.

Socialised healthcare is not as good as privatised healthcare in terms of quality for those who can afford private healthcare. But everyone gets covered. If you want everyone covered it's the best way of doing it.

Look there is nothing wrong with the European(to way over simplify) Health care system.

It is just not what we want to do in the US. can Europe please allow us to solve our own internal issues?

On the contrary, there's a lot wrong with the health care systems European countries have adopted, just as there is a lot wrong with our system. What we should be doing is look between numerous systems and make a judgement on what the best formula is.

Yes, waiting lists are longer unless you want to pay, but you don't get blackholes of no coverage.
Which is why the need for reform is necessary, but not reform that entails new problems, such as waiting lists.

Cancer Survival rates lag behind because in the US those with coverage will have insurance companies pay for highly priced new drugs big companies develop, and can afford to do this because they're not paying for the poorest who have relatively higher illness rates. It's nothing to do with medical innovation it's to do with profit margins.
That's flat-out wrong. As I've already said, the United States spends more of its GDP (15%) than every country with socialized medicine (10% and under) -- so the issue is not the we have less people to cover and therefore, spend less money. It has everything to do with the fact that we have market wiggle room for companies to develop new drugs and better treatments.

Socialised healthcare is not as good as privatised healthcare in terms of quality for those who can afford private healthcare. But everyone gets covered. If you want everyone covered it's the best way of doing it.

Apparently you haven't read any of my posts pointing to sensible market reforms and government mandates.

We already have public hospitals paid for by government dollars. They have essentially become money-making schemes. Studies show that they charge the uninsured many times the amount that they charge the insured who visit them for the same medical procedures. Furthermore, they profit to the tune of tens of millions of dollars, all the while providing less free care.

Here's what it comes down to: a fully private health care system is wrong and disadvantageous to many people. At the same time, a socialized system is disfunctional as well (US citizens need look no further than our neighbor to the north). The answers, in my mind, lie in market reforms mixed with government assistance. The HMO mandate should be repealed -- employers should instead be entitled to provide the money they would contribute to such health plans directly to their employees. This would allow individuals to take their health care dollars and shop for the insurance plans and doctors that are best for them. Since insurance companies and the providers within the managed care plans would no longer have monopolies over employees in the businesses that they contract with, they would be forced to provide better prices and better quality to attract consumers. Meanwhile, expanded tax credits for working families and individuals would further help to lower costs. Innovations should also not be quelled -- specialty hospitals should be allowed to open, thus increasing quality and competition. Finally, the same protections that are afforded to people with employer-provided insurance should be extended to those who buy it themselves: automatic eligbility despite pre-existing conditions and fair premium prices, among others. All of these reforms would cut costs and increase the quality of care all the while avoiding the pitfalls of a socialized system and a fully private system.

I agree with your premise that neither a fully private system nor a simple single-payer system would work for the US, but I don't think your solution is as simple as you make it sound.

The idea that increased competition reduces costs is bedrock economics, but it's based on a perfect-information or near-perfect-information marketplace. In a health-insurance marketplace, you've got two huge barriers to perfect information. The first is that insurance products are generally difficult to understand for the non-insurance-specialist, and the second is that individuals are extraordinarily bad at evaluating information about uncertainty and risk even when the terms are explained clearly. Emotions get in the way of clear thinking, and expecting people to be emotionally disinterested in their health risks is, erm, silly. (Old and new evidence from neuroscience suggests that lousy risk-evaluating processes are a basic weakness of the species, not an affliction of a few weak minds.) Considering this, I don't think that giving money to individuals and hoping that they make the best choices is the wisest strategy.

Could you clarify what you mean by "specialty hospitals should be allowed to open?" As far as I know, they already are, which is why we have hospitals that specialize in cancer care, in pediatrics, etc. Even old-fashioned we-deal-with-everything hospitals develop and advertise their specializations. I also think you've painted public hospitals with too broad a brush -- there are some which have done very well financially, and there are also others which have shut their doors because they treated too many uninsured patients who were too poor to pay.

The idea that increased competition reduces costs is bedrock economics, but it's based on a perfect-information or near-perfect-information marketplace. In a health-insurance marketplace, you've got two huge barriers to perfect information. The first is that insurance products are generally difficult to understand for the non-insurance-specialist, and the second is that individuals are extraordinarily bad at evaluating information about uncertainty and risk even when the terms are explained clearly. Emotions get in the way of clear thinking, and expecting people to be emotionally disinterested in their health risks is, erm, silly. (Old and new evidence from neuroscience suggests that lousy risk-evaluating processes are a basic weakness of the species, not an affliction of a few weak minds.) Considering this, I don't think that giving money to individuals and hoping that they make the best choices is the wisest strategy.
Putting dollars into the hands of consumers, instead of having their employers offer them one-size-fits-all insurance plans with limited providers will naturally force lower prices and better quality. Though you are right that many people will make unwise decisions, the sheer fact that insurance companies and providers will not have the convience of employer-footed monopolies will naturally guarantee that they will lower prices and offer better services. I would also note that better quality has been shown to be driven by marginal consumers -- those who make the best decisions -- and followed by the average Joe.

Could you clarify what you mean by "specialty hospitals should be allowed to open?" As far as I know, they already are, which is why we have hospitals that specialize in cancer care, in pediatrics, etc. Even old-fashioned we-deal-with-everything hospitals develop and advertise their specializations. I also think you've painted public hospitals with too broad a brush -- there are some which have done very well financially, and there are also others which have shut their doors because they treated too many uninsured patients who were too poor to pay.
You're probably right that I've painted public hospitals with too broad a brush. Nevertheless, many problems exist with them -- they are clearly not the answer to our problems, as another poster mentioned they might be.

Speciality hospitals have much regulation on them thanks to lobbying from wealthy public hospitals. While some may exist, there are constraints on how many can open in what area, and so on and so forth. Lifting these regulations would encourage them to spring up and provide better care.

Which is why the need for reform is necessary, but not reform that entails new problems, such as waiting lists.
There is no silver bullet out there. If you want to give healthcare to everyone then you're either going to have to spend an absolute shedload of money and neglect other areas, or ration it in some way.


That's flat-out wrong. As I've already said, the United States spends more of its GDP (15%) than every country with socialized medicine (10% and under) -- so the issue is not the we have less people to cover and therefore, spend less money. It has everything to do with the fact that we have market wiggle room for companies to develop new drugs and better treatments.

Non sequitur, amount spent does not equal number of people. Every UK citizen has health coverage, it's a fact that not every US citizen has coverage, that coverage is lacking mainly among the poorer and the poorer tend to have more health problems and more serious ones than the wealthier.

You spend more, apparently have a system with more wiggle room for companies, and yet rank lower than the EU average which includes several countries much poorer than the US and much lower than other comparable companies like Canada, France, Sweden, to name but a few. link (https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html) Not doing so well for such a great system.



Apparently you haven't read any of my posts pointing to sensible market reforms and government mandates.

such as



Increased competition, which would occur if we repealed the HMO mandate and other mandates that put constraints on competition (such as banning speciality hospitals), would actually lower costs naturally while increasing the quality of care provided.

Problem with free market healthcare, it only covers those whom it makes a profit on. It's in their interest to discourage people to use their services to keep their costs down. If someone's going to be expensive to treat then the laws of the free market dictates that the companies will refuse the transaction.

That means people try and go on as long as they can with diseases before seeking treatment to keep their premiums down. That means if you have a serious/chronic/expensive/etc illness you're not going to be able to get health care.

Compare it to car insurance, you have an expensive car that will cost a lot to replace, your premium is sky high. Except in this case you don't get to choose how expensive your car is. And if you can't afford it you're screwed.

QFT. Since when is it "society's" job to take care of everyone? I did my job. I got health insurance for myself to cover catastrophic emergencies, and I pay cash for what it doesn't cover. Din't be telling me that you need to tax the hell out of me to cover those who are too lazy or stupid to take care of themselves. If there is no incentive to work (need for food, shelter, etc.) there is a very large section of the population that will not work.


Ah, the "I'm alright Jack" approach. Hardly surprising. I've listed above why in a free market system people won't be able to get coverage because it won't benefit the companies to insure them.

There is no silver bullet out there. If you want to give healthcare to everyone then you're either going to have to spend an absolute shedload of money and neglect other areas, or ration it in some way.
Says who? The only option is not an NHS, which is what causes waiting lists.

Non sequitur, amount spent does not equal number of people. Every UK citizen has health coverage, it's a fact that not every US citizen has coverage, that coverage is lacking mainly among the poorer and the poorer tend to have more health problems and more serious ones than the wealthier.
That's untrue. Wealthy people are just as prone to chronic illnesses and serious medical conditions as poor people -- it's just that the poor can't afford to have them treated.

If poor people were given the opportunity to pay into the system at rates they can afford, then insurance companies could add even more to their hundred billion dollar revenues, and they would have no trouble covering the costs of expensive new drugs. Money is not an issue, though it is relevant to the number of people covered. If European countries can cover all of their citizens with less than 10% of their GDP spent, then the United States can cover all of its citizens with good quality when we spend 15% of our GDP on health care currently.

Furthermore, if we were to repeal the HMO mandate which favors existing insurance behemoths, as well as regulations on buying insurance, new insurance companies would spring up. This would allow for more opportunities for patients to be covered.

You spend more, apparently have a system with more wiggle room for companies, and yet rank lower than the EU average which includes several countries much poorer than the US and much lower than other comparable companies like Canada, France, Sweden, to name but a few. link (https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html) Not doing so well for such a great system.
This entire post was started based on my belief in the need for reform because it is not currently functioning correctly. How you pulled the idea that I think we have a great system out of that belief is beyond me.

Problem with free market healthcare, it only covers those whom it makes a profit on. It's in their interest to discourage people to use their services to keep their costs down. If someone's going to be expensive to treat then the laws of the free market dictates that the companies will refuse the transaction.
That's why we need high risk pools -- government-sponsored plans that work with insurance companies to cover such individuals. Furthermore, we need mandates on the insurance industry to make sure that people get the coverage that they require. A totally free market system is bad in its drive for profit -- that's why I want a sensible mix of market and government reforms.

On the contrary, there's a lot wrong with the health care systems European countries have adopted, just as there is a lot wrong with our system. What we should be doing is look between numerous systems and make a judgement on what the best formula is.

All systems will have their negatives and positives.
Europe has Chosen a socialized health care system and chosen to accept the negatives that come with that.
Likewise the US has chosen Private Health Care and accepts the negatives that come with that.

All systems will have their negatives and positives.
Europe has Chosen a socialized health care system and chosen to accept the negatives that come with that.
Likewise the US has chosen Private Health Care and accepts the negatives that come with that.

That's the stupidest thing I've ever heard in a debate about health care. You act as if there can only be two options without a shred of evidence to back this up. In fact, the USA is proof that there are more than two options -- you really want to tell me that the USA is a fully private system when we have Medicare, Medicaid, and the HMO mandate, not to mention numerous rules and regulations about health care?

Maybe you're okay settling for a sub-par system, but I'm not.

EDIT: Your comments are continually among the the most asanine, misinformed garbage that I've ever read. They strike me as something coming from the mouth of an affluent 6th grader whose political views are entirely based on what he hears his daddy barking about.

That's flat-out wrong. As I've already said, the United States spends more of its GDP (15%) than every country with socialized medicine (10% and under)
And yet covers no one, well except crappy coverage for old people and poor children, and full, unequaled coverage for politicians.

And yet covers no one, well except crappy coverage for old people and poor children, and full, unequaled coverage for politicians.

Uh...I'm not old or poor, and last time I checked, I have health care coverage.

Uh...I'm not old or poor, and last time I checked, I have health care coverage.
Not from the federal government you don't.

Not from the federal government you don't.

Uh...no shit.

Pandabearmd has talked about the problems with the US system... and the reasons why the proposed solutions won't work with us. Hes far more eloquent than me, so I'll leave it to him.

http://pandabearmd.com/blog/2007/06/30/screw-cuba-how-about-them-albanians-and-other-musings/


Screw Cuba, How About Them Albanians? (And Other Musings)

June 30, 2007 |

One More Time…

Let me try to explain this again. American medical care is expensive for everyone because the costs are shifted from one set of consumers to another. Most of us are not sick and except for the odd hospitalization for something unexpected don’t really require that much doctoring. There is, however, a small but significant subset of the population who use a terrifically disproportionate amount of health care. I write about this group extensively on my blog and they include the living dead vegetating in pre-death staging areas nursing homes, the multiply comorbid, and people who make bad lifestyle choices resulting in a state of perpetual symbiosis with the local hospital. Upon this group of people is brought to bear the full might of our technologically sophisticated but extremely expensive medical arsenal.

I treated a 79-year-old man the other day who has, I kid you not, eight stents in his coronary arteries, a history of three pulmonary emoblisms (emboli?), a greenfield fiter in his unamputated leg, diabetes, peripheral vascular disease, renal failure, a colostomy, a PEG tube, senile dementia, emphysema, and a string of minor strokes before the Big One that knocked out what looked like the entire left hemisphere of his brain. I have no doubt that the cost of his health care just in the last few years would be enough to pay for the health insurance of an entire Cuban province and probably runs into the millions of dollars, not one cent of which he or his family have paid or even expect to pay because you are picking up the tab with your outrageous health insurance premiums and twenty-dollar aspirins. Maintaining an ICU bed, for example, costs a typical hospital several thousand dollars a day and this gentlemen has spent months in the ICU while his family urges us to keep his heart beating regardless of the cost.
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In Europe, this patient would have died fifteen years ago, probably after his first heart attack. Maybe he would have gotten the first heart catheterization, maybe he wouldn’t, but as his comorbidities snowballed the Freeloader Kingdoms would have cut their losses and, while advanced treatments are theoretically available, the reality of rationed care would have finished him off. A Greek doctor of my acquaintance related to me that even what we consider routine critical care would be considered extremely heroic and almost unheard of over there.
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The argument goes that if this poor son of a bitch only had access to good primary care he wouldn’t have found himself in these dire straits requiring this level of care. Putting aside the obvious fact that many such patients in the United States have had excellent access to primary care (many of my ICU patients are retired from GM), and the dubious belief that primary care will keep people from cramming the metaphorical pie into their notional gob-holes, let’s asume that cheap primary care would have made this guy well and allowed him to live comfortably and productively into his golden years requiring nothing but a couple of inexpensive pills and a few doctor’s visits to manage relatively benign complications of his well-controlled medical problems. If this is the case and if all that is required to make the United States a Cuban-style health care paradise is cheap primary care, why should the government have to pay for it at all? In other words, if it’s cheap, why can’t people buy it themselves? A doctor’s visit here or there and a few pills probably costs less than most people spend on cable television. I know for a fact that one of my frequent patients can afford a thirty dollar a day marijuana habit (but won’t scrape together a couple of bucks for antibiotics at the local Wal Mart which practically gives away a long list of generic drugs) so a couple hundred a year for his doctor visits is a trivial amount.

Primary care is cheap. It’s so cheap that it makes no sense giving it away for free, particularly when to give it away is going to require the massive bureacracy typical of all government solutions, a bureacracy that will inevitably stifle everything that is good about American medicine and turn us into just another society with excellent access to health care unless you really get sick at which point it is hasta la vista, baby. For the sake of your fear of cutting into your blunt money, you are willing to turn over close to twenty percent of the economy to people whose only talent is that they have no talent for anything but government.
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Still, nothing is really going to change. All we’ll be doing is throwing bad money before good because while a small percentage of patients who are destined for the comorbidity jackpot may have a come to Jesus moment where they decide to modify their behavior, most will continue as if nothing happened and arrive on schedule, after hitting all the expensive milestones, to thier fabulous yet terminal month in the ICU.

It’s not as if the public will actually accept rationing of care for their demented granny. Any politician who suggests that to control costs we need to put her down like a dog (so to speak) is destined to go down in flames. What is will happen is that we will continue to spend fantastic amounts of money on health care and when the numbers get too alarming, measures will be taken to control costs that, by removing the incentive for productivity, will make the problem worse.

Or Look At it Like This…

Consider the American military in comparison to the typical European military. The American military is an expensive, technologically sophisticated organization that is twenty or thirty years ahead of anything the Europeans can field. We almost can’t share the same battlefield because of the speed and sophistication of American weapons, command and control, intelligence, and logistics. The American military can do things and go places. The Europeans have difficulty doing anything including finding reasons to maintain the militaries that they have.

But the Europeans do spend less and they do get whatever it is they want from their armed forces. And yet the capability to transport a couple of Marine Regimental Combat Teams or an Army Armored Brigade anywhere in the world on short notice doesn’t come cheap, nor are carrier battle groups operated on a shoestring. You get what you pay for. A primary care military with conscripted soldiers who don’t expect to do much is fairly inexpensive and looks pretty good until you have to make it do something. A working war machine isn’t pretty and to make it do something requires the dedication of motivated troops and frightening amounts of money.

Life Expectency

With the exception of Japan, the average life expectency of every country in the developed world hovers around 80 years. The average life expectency in the United States is 78 years. In the European Union it is about 79 years. The difference is nothing to get excited about and seems to be unrelated to per capita expenditure on health care. Those cheese eating surrender monkeys (the French I mean) may be healthier than Americans but they only live, on average, a couple of years longer than we do. It may be true that they only spend half on a per capita basis what we spend on health care but perhaps past a certain point there is no relationship between life expectancy and health care expeditures. Sure, you’re screwed if you’re from Namibia (average life expectancy of 40 years) but you’d be hard pressed to make the case that we get all all that much of a bang for our bucks or that European health care is better based on a a few months difference in life expectency.
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I mean, the Albanians spend next to nothing on health care (36 bucks per head per year) and they still live almost as long as the typical citizen of the European Union. How on Earth is this possible? Albania is a shit hole. The only Third World country in Europe. Do French politicians propose that the EU go to the Albanian system to save money?

Perhaps because life expectency in part depends on cultural factors which have nothing to do with the medical care, it is a poor indicator for its quality. I have travelled extensively in Europe and I have never seen anything remotely close to the five and six hundred pound behemoths that hardly raise an eyebrow in our hospital. But this is more a result of the thirty buffet-style restaurants within two miles of the place than some hard-to-define shortcoming of our health care system. I know for a fact that many of these monsters will enjoy terrific access to health care untill the day their bad heath finally catches up to them and they become a statistic dragging down our average life expectency. If you look at it this way, and factor in things like gang violence which decreases the life expectency of black men to 67 years, the premature babies who we try to save at gestational ages which would make the Europeans laugh contemptuously, and half a dozen other cultural factors which have nothing to do with health insurance it is a wonder that we live, on average, as long as we do. Apparently, for every Tupac harvested early to the Lord we have a ninety-year-old vegetable sucking life through plastic tubes bringing up our average.

Addendum: I propose the following thought experiment. I live in an average Midwest city with a population of around 200,000. Let us charter a bunch of airplanes and exchange the non-medical population of the city with the population of a similar-sized French city, say Toulon. Let us then follow the two cities for the next couple of years and see how they fare in regard to health care costs. I predict the following: We will get a much deserved vacation, working at our hospital will be a cake walk, and those poor French bastards will reap the adipose whirlwind as their health care costs skyrocket and they feverishly brush up on their atrophied critical care skills. Either that or when we switch back we are going to be minus a lot of our citizens.
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Next: The annual “Welcome to Intern Year” article. I promise.

That's the stupidest thing I've ever heard in a debate about health care. You act as if there can only be two options without a shred of evidence to back this up. In fact, the USA is proof that there are more than two options -- you really want to tell me that the USA is a fully private system when we have Medicare, Medicaid, and the HMO mandate, not to mention numerous rules and regulations about health care?

Maybe you're okay settling for a sub-par system, but I'm not.

EDIT: Your comments are continually among the the most asanine, misinformed garbage that I've ever read. They strike me as something coming from the mouth of an affluent 6th grader whose political views are entirely based on what he hears his daddy barking about.

as stated before i am simplifying the statement. otherwise we need 3 pages to list
to talk about the times the Us system is not privatized. and the Europeans will need three pages to explain where their system is not socialized from each different country.

it is just easier when comparing advantaged say the Us is largely a private Health care system and Europe is largely a socialized health care system.

to my knowledge the closest thing to a 100% socialized health care system is Canada.

It seems to me that health care is an issue that is brimming with bullshit from both sides in the United States. The entirety of the debate is focused on either a.) the wonderful "benefits" of a single payer system and b.) what's wrong with such a system. How can the discussion be re-focused to center on common sense, realistic reforms, and not epic political battles about socialism and Hillary Clinton?

What are everyone's thoughts on this issue? Are we right to focus soley on the single payer issue? What are the best reform strategies? Do we need reform?
I'm not going to compare the U.S. with any European or Canadian scheme for providing health care. The systems are just too different to make a one-to-one comparison. There is something that can be done -- and HAS been done in the U.S to improve access to basic health insurance/health care plans.

Florida has passed reforms that make sense and make a great example of what can be done without upsetting the system that has given us the best medical care in the world. The state has about 3.8 million people without insurance, or about 21% of the population, the fourth-highest rate in the country. The "Cover Florida" plan hopes to improve those numbers by offering access to more affordable policies.

The plan moves the government out of the health-care marketplace. Insurance companies will be permitted to sell stripped-down, no-frills policies exempted from the more than 50 mandates that Florida otherwise imposes, including for acupuncture and chiropractics. The new plans are designed to cost as little as $150 a month, or less.

People can buy what they need and no more. Insurance is meant to protect people from loss, not provide "free" service.

http://www.ama-assn.org/amednews/2008/06/02/gvsb0602.htm

There's one more step that needs to be taken. That's for the government to allow individuals the same tax incentives for buying health insurance that business has. My business gets a deduction for what I pay on my employees health insurance, but I can't (short of being a contractor paid on a 1099 form) get that same deduction for my personal taxes.

The improvement of the American health care system is the number one concern on my mind in the November elections, and is my number one priority in general when it comes to political issues. I used to think that I could find common ground with Democrats and American liberals on this issue, but now I'm not so sure. The left seems to quite largely favor a single payer, entirely government-managed system. I personally cannot see how anyone who favors free markets of any sort can support such a system. It lacks any incentives for innovation, has no concept of supply and demand, and promotes inadequate funding by its very nature. In other words, it fails for the very reasons that command economies lag behind market ones.

At the same time, an entirely private health care system favors the wealthy and harms the lower classes. So I find myself in a conundrum. I want common sense reforms -- vouchers for employees instead of employer-provided insurance; subsidization for low income individuals and families; tax credits for all middle class and working class tax payers. And yet, the conservatives who would appear to be allies to my views seem disinterested in reform measures. So what to do? How can the left, who are so focused on health care, be convinced that more government control is not the answer, and the right be motivated to take action?

It seems to me that health care is an issue that is brimming with bullshit from both sides in the United States. The entirety of the debate is focused on either a.) the wonderful "benefits" of a single payer system and b.) what's wrong with such a system. How can the discussion be re-focused to center on common sense, realistic reforms, and not epic political battles about socialism and Hillary Clinton?

What are everyone's thoughts on this issue? Are we right to focus soley on the single payer issue? What are the best reform strategies? Do we need reform?

My opinion is that we need to adopt a voucher system for poor people. That is, the health care market becomes completely privatized and the government gives money to poor people who need drugs and surgeries.

Now the big problem with that plan is that some poor individuals, are idiots, who do things like overdose on meth, destroy their thyroid gland, and need you to pay for their thyroid medication the rest of their life. Or they watch tv all day, drink soda, eat chips and then they can't pay for insulin or test strips when they get diabetes. I used to work in a pharmacy and I saw all kinds of people who completely fucked themselves up and needed their fellow taxpayers to help them out. Its the sort of situation, where you ask these idiots how much help they need, and they are just programmed to say "more, more, more," because they know some naive democrat will listen to them. I am almost in favor of a Darwinian, survival of the fittest approach at this point. At least it gets rid of suffering idiots and promotes self-responsibility.

My opinion is that we need to adopt a voucher system for poor people. That is, the health care market becomes completely privatized and the government gives money to poor people who need drugs and surgeries.

Now the big problem with that plan is that some poor individuals, are idiots, who do things like overdose on meth, destroy their thyroid gland, and need you to pay for their thyroid medication the rest of their life. Or they watch tv all day, drink soda, eat chips and then they can't pay for insulin or test strips when they get diabetes. I used to work in a pharmacy and I saw all kinds of people who completely fucked themselves up and needed their fellow taxpayers to help them out. Its the sort of situation, where you ask these idiots how much help they need, and they are just programmed to say "more, more, more," because they know some naive democrat will listen to them. I am almost in favor of a Darwinian, survival of the fittest approach at this point. At least it gets rid of suffering idiots and promotes self-responsibility.
I like the thought, but it's a little too cold to seriously suggest to a legislator. We also have Medi-something for poor people. Hang out in the Grady ER for a couple hours and you can see how well that works. The gap is in not-so-poor people that would like insurance, but can't afford it. That's where cleaning up the mess that the government has made will do the most good.

I don't think we can do much more than we are to prevent drug abuse, but I wonder if we could do more on the nutrition side for folks that just don't know how to eat. Maybe make nutrition classes mandatory for receiving food stamps? Maybe cash incentives for low blood pressure, low cholesterol, and good A1C tests?

I like the thought, but it's a little too cold to seriously suggest to a legislator. We also have Medi-something for poor people. Hang out in the Grady ER for a couple hours and you can see how well that works. The gap is in not-so-poor people that would like insurance, but can't afford it. That's where cleaning up the mess that the government has made will do the most good.

I don't think we can do much more than we are to prevent drug abuse, but I wonder if we could do more on the nutrition side for folks that just don't know how to eat. Maybe make nutrition classes mandatory for receiving food stamps? Maybe cash incentives for low blood pressure, low cholesterol, and good A1C tests?

Health is largely a genetic thing too. Some people just have naturally high blood pressure, and I know people who work out everyday and they are still a little chubby. I don't know about cash for good health, but I like the idea of mandatory health classes for people who want food stamps. Although I doubt most people will listen or try to learn.

Myrmidonisia, you make me hot. Will you rock my world tonight? ;)

Health is largely a genetic thing too. Some people just have naturally high blood pressure, and I know people who work out everyday and they are still a little chubby. I don't know about cash for good health, but I like the idea of mandatory health classes for people who want food stamps. Although I doubt most people will listen or try to learn.

Myrmidonisia, you make me hot. Will you rock my world tonight? ;)
Sorry. It's BINGO night at the VFW hall.