People may look at me strangely when I advocate a single-payer system like Canada's, but I honestly cannot ethically hold another position.

So, you would prefer a bureaucrat in DC to decide on your treatment plan for, say, cancer, rather than have your local doctor take a holistic view of your body and your health views before deciding on a personalized treatment plan?

Vernaltemptress fucked around with this message on 10-24-2009 at 02:06 PM.

Fly Me To The Moon fucked around with this message on 10-24-2009 at 02:21 PM.

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Vernaltemptress still thinks SARS jokes are topical, as evidenced by:
So, you would prefer a bureaucrat in DC to decide on your treatment plan for, say, cancer, rather than have your local doctor take a holistic view of your body and your health views before deciding on a personalized treatment plan?

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Um, Canada's system doesn't determine treatments; doctors and other healthcare providers are still private employees, in most cases. The government determines the rates doctors are paid for treatments provided. You're actually trying to strawman Britain's healthcare system, wherein the NHS provides both health insurance and the actual care (meaning that the doctors themselves are in the employ of the government).

However, all that aside, I'd rather take guaranteed treatment than run the risk of my insurance company saying, "Fuck you, we're not paying because some information from your last physical is missing," running up hundreds of thousands of dollars of debt in medical expenses, and losing my house and most of my and my wife's worldly possessions in the ensuing bankruptcy.

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Karnaj had this to say about (_|_):
The government determines the rates doctors are paid for treatments provided..

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There's your big problem. Any system where price is centrally determined will result either in a surplus of doctors (too high - a waste of money, mis-allocation of talent to the overpaid operation, etc) or a shortage of doctors (if the price is too low). And since health care has effectively zero cost for the patient, there will be a surplus of people wanting care for things they don't need a doctor for, or being less careful with themselves so they'll need doctors more.

So, basically, you're willing to trade a handful of heartstring-tugging stories so that everyone else gets shittier care? The one out of 40 million gets better off, and the other 39,999,999 get shafted? If you want to prevent things like this, then make the insurance companies fulfill their contracts. Seems like something that could be done without breaking everything else.

I'm not saying that our current system allocates anything relatively well, because a system of low-deductible insurance is almost as bad. If people were actually able to shop around (on non-emergency services), and doctors were actually able to price compete, we wouldn't have the absurd costs we do.

But to claim that you have to believe in a single-payer system because it's the only ethical system is a crock.

Both of our posts are equally worthless, though, between your made up statistics and my complete lack of them!

Kegwen fucked around with this message on 10-24-2009 at 04:55 PM.

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Kegwen smells kinda like pancakes:

whatever I'll let Karnaj do it, but I'm pretty sure you're vastly underestimating the number of people that get screwed over by inadequate healthcare coverage. I also think your nightmare scenario where people will get into car wrecks just because someone else is paying for it is pretty silly, too

Both of our posts are equally worthless, though, between your made up statistics and my complete lack of them!

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Obviously I made up that statistic, but the fact that these stories get so much attention - and are usually overstated - is because they are the exception, rather than the rule. Even if it's 1/100 people, it's still completely breaking the system for a few people you feel bad for.

And what are you claiming? People have absolutely no control over their health care costs? So the skier who decides to try out the backside of the mountain, or the biker who decides not to wear a helmet, or the person who doesn't watch what he eats will have the same health care costs as the more prudent person? Give me a break. Beating up strawmen is truly worthless.

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Vernaltemptress needs the precioussses:
* looks askew at Karnaj *

So, you would prefer a bureaucrat in DC to decide on your treatment plan for, say, cancer, rather than have your local doctor take a holistic view of your body and your health views before deciding on a personalized treatment plan?

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So you would prefer a bureaucrat in Vermont to decide on your treatment plan for, say, cancer, rather than have your local doctor take a holistic view of your body and your health views before deciding on a personalized treatment plan?

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Loosely translated, Kinanik says "Kill the whales":
There's your big problem. Any system where price is centrally determined will result either in a surplus of doctors (too high - a waste of money, mis-allocation of talent to the overpaid operation, etc) or a shortage of doctors (if the price is too low). And since health care has effectively zero cost for the patient, there will be a surplus of people wanting care for things they don't need a doctor for, or being less careful with themselves so they'll need doctors more.

So, basically, you're willing to trade a handful of heartstring-tugging stories so that everyone else gets shittier care? The one out of 40 million gets better off, and the other 39,999,999 get shafted? If you want to prevent things like this, then make the insurance companies fulfill their contracts. Seems like something that could be done without breaking everything else.

I'm not saying that our current system allocates anything relatively well, because a system of low-deductible insurance is almost as bad. If people were actually able to shop around (on non-emergency services), and doctors were actually able to price compete, we wouldn't have the absurd costs we do.

But to claim that you have to believe in a single-payer system because it's the only ethical system is a crock.

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Ok, I better get France, Germany, Denmark, Spain, Italy, Canada, Portugal, Japan, Korea, Poland, and the Czech Republic on the horn and inform them that their system doesn't work. Boy will they be surprised!

Having socialized police services is leading people to be careless about being murdered because their families won't have to pay to find and punish the murderer.

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Bent over the coffee table, Blindy. squealed:
Ok, I better get France, Germany, Denmark, Spain, Italy, Canada, Portugal, Japan, Korea, Poland, and the Czech Republic on the horn and inform them that their system doesn't work. Boy will they be surprised!

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It depends upon how you define "works." France's system, for example, is expensive, slow, and so overcrowded people who could otherwise be treated routinely die simply for lack of hospital beds.

Not to mention the taxation required to implement even the worst systems.

Want to know how government health care works in the US? Look at the VA...and then ask yourself if that's what you want.

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Channeling the spirit of Sherlock Holmes, Blindy. absently fondled Watson and proclaimed:
Hey guys, having socialized fire departments is leading people to be careless about setting their houses on fire because someone else will pay to have them put out.

Having socialized police services is leading people to be careless about being murdered because their families won't have to pay to find and punish the murderer.

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Now you're just being stupid.

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Bloodsage needs to learn to type:
It depends upon how you define "works." France's system, for example, is expensive, slow, and so overcrowded people who could otherwise be treated routinely die simply for lack of hospital beds.

Not to mention the taxation required to implement even the worst systems.

Want to know how government health care works in the US? Look at the VA...and then ask yourself if that's what you want.

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America's system, for example, is so expensive people who could otherwise be treated routinely die simply for a lack of ability to pay for their treatments, but not until after they go bankrupt and lose their house and leave their families with hundreds of thousands of dollars in unsecured debt.

Blindy. fucked around with this message on 10-24-2009 at 06:18 PM.

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Channeling the spirit of Sherlock Holmes, Blindy. absently fondled Watson and proclaimed:
America's system, for example, is so expensive people who could otherwise be treated routinely die simply for a lack of ability to pay for their treatments, but not until after they go bankrupt and lose their house and leave their families with hundreds of thousands of dollars in unsecured debt.

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So?

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Bloodsage Model 2000 was programmed to say:
So?

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quotin dis

At a typical military medical center, if they have a sick call(emergency room services) at all, you're looking at waiting for five to seven hours before you are even triaged, unless you're missing a limb or gushing blood. If you have an appointment, you are cycled through in a schedule of only 10 minutes alloted per patient, ideally. In reality, your appointment will be between thirty minutes to two and a half hours behind schedule on average because the schedules are not followed. Getting the same doc each time is hit or miss, getting a doc who gives a damn even more so - they get the same paycheck regardless of whether they make you feel better or not. In order to access any care that requires something extra, such as physical therapy, chiropractic, or what have you, you must be seen, convince the doc of your issue, and then await a referral to another practicioner out in town. When they sent me to physical therapy, the doc they sent me to was in a city two hours away and I was unable to change the referral without going through the whole process again.

The government cannot so much as fill a prescription on time, either. It took three hours on top of a lunch break, where medical virtually shut down operations for an hour and a half, for them to fill a prescription of cough syrup and tylenol for me during the work day, where I was in uniform and had priority.

They cant do a good job with government health care for two hundred thousand people who are trained to sit back and take it. Where's the logic in thinking they can implement a system for a society that is largely bent on personal gratification at all, much less in the timeframe they wish to do it?

Blindy. fucked around with this message on 10-24-2009 at 08:35 PM.

As a society here in the United States we have let ourselves go down a dangerous road when it comes to our personal health. We're obese, we don't exercise, and we take a poor view of living healthy. We complain fiercely at the cost of health care, yet as a whole do little to reduce the costs.

On the flip side of that, someone is trying to profit from whatever health condition a person may have. They really don't care if you live or die, so long as they make a buck. There is nothing in that business model that would reduce costs if we as a society decided to reverse current health trends, if anything they would go up to maintain profit levels.

I tend to agree with Karnaj on this, the rampant abuse of sick people by a for profit insurance industry needs to stop. Since patients cannot negotiate reduced rates for care, like the insurance companies can, they are at a huge disadvantage when trying to obtain reasonably priced care. Unfortunately a single payer system is the only thing I can think of that will really fix this, other than outright saying that it's ok for the ill and infirm to die in the street if they cannot pay.

This is something that hits home hard for me, as currently I am uninsured, even though my employer offers insurance. About twelve years ago I was diagnosed with a malignant melanoma (an aggressive skin cancer), it required surgery and about a years worth of treatment all of which was covered by my insurer at the time. When I took my current job several years ago, I applied for the company health insurance, and disclosed all previous treatments. Even though I had been cancer free for more than a decade, and was in excellent health, I was denied coverage due to my "pre-existing" condition. That denial of coverage acted as a black mark, and it has been impossible for me to obtain reasonably priced insurance privately. 1,700 dollars a month to cover just myself with a 1,000 dollar deductible is just beyond my means, and certainly beyond the means of anyone who makes less money than I do.

So far I have been lucky, I have enough saved to cover any minor injury or illness like a broken bone or my yearly bout with a sinus infection. If I were to have a re-occurrence of my caner though, it would break me. I work with a local Melanoma support group, and the treatment I had would today cost a person out of pocket over 15,000 dollars. During a recent discussion a young lady brought in the paperwork from her recent treatment and we discovered that her insurance had negotiated with the hospital an end to end treatment price for melanoma of just under 2,000 dollars.

So as far as I am concerned the question here isn't if we need a single payer system, but how do we pay for it, because enough is enough.

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Tyewa Dawnsister was naked while typing this:
This really all comes down to if you think "being able to maintain good health" is a right or a privilege.

...

On the flip side of that, someone is trying to profit from whatever health condition a person may have. They really don't care if you live or die, so long as they make a buck. There is nothing in that business model that would reduce costs if we as a society decided to reverse current health trends, if anything they would go up to maintain profit levels.

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Replace 'maintain good health' with 'eat' and you'll see why the argument doesn't hold much water. Farmers don't much care whether I starve to death, but for whatever reason the grocery stores always have food stocked at a reasonable price for me. Just so they can make a buck.

The problem comes when we let insurance companies renege on their contracts. If you agree to pay a company to pay for your health care in case of emergency, and they don't, that should be a breach of contract, which should be punishable by law. That insurance companies can get away with it is a fault of the justice system, not the fault of them trying to make a buck.

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Kinanik had this to say about (_|_):
Replace 'maintain good health' with 'eat' and you'll see why the argument doesn't hold much water. Farmers don't much care whether I starve to death, but for whatever reason the grocery stores always have food stocked at a reasonable price for me. Just so they can make a buck.

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I think you're failing to see what really needs to happen. It is not that everyone needs to get free health care, but that health care becomes affordable like those carrots your farmer is selling at the grocery store.

If I want to "opt out" of the food market, I can just grow potato, tomato, and soy in my backyard to feed myself. The skills and time required to sustain just myself are reasonably obtained even if the price of those goods skyrockets on the open market. Health care is another beast entirely, I cannot reasonably obtain that service or learn to provide it to myself if I choose to "opt out" of the insurance racket.

I want to pay for my health care, I do not want to pad the pockets of an insurance underwriter. I want to be able to afford my health care, and for hospitals to compete for my business when I get sick. The reality is that this is currently impossible with the profit driven managed care we are stuck with today. You only allowed to "choose" hospitals with which your insurer has negotiated with, the only competition is between insurers not those who are actually providing the service.

If you know of a way that this can be fixed without moving to a single payer system, even if it means migrating to a true market system later, please let the world know.

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The propaganda machine of Tyewa Dawnsister's junta released this statement:
If you know of a way that this can be fixed without moving to a single payer system, even if it means migrating to a true market system later, please let the world know.

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There actually is a way, and I believe it's in either Denmark or Holland. It's this: all insurance providers are forced to compete on a national level in an open marketplace for customers. All customers(read: citizens) are mandated to buy health insurance from one of these providers or pay a fine(excepting, of course, those below the poverty line and/or on social welfare, who receive a subsidy to purchase health insurance). Because of this forced competition, companies are constantly undercutting one another and, accordingly, healthcare costs remain low. Of course, I'm sure profit margins are razor thin for these providers, as they are unable to establish regional monopolies, but at least most everyone gets affordable healthcare.

Of course, implementing a national marketplace in the US means destroying the regional monopolies of existing healthcare providers, which will ruin profit margins and cause mass apoplexy amongst shareholders. The insurance industry would, of course, vigorously fight any move in this direction, probably to great effect.

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Karnaj attempted to be funny by writing:
There actually is a way, and I believe it's in either Denmark or Holland. It's this: all insurance providers are forced to compete on a national level in an open marketplace for customers. All customers(read: citizens) are mandated to buy health insurance from one of these providers or pay a fine(excepting, of course, those below the poverty line and/or on social welfare, who receive a subsidy to purchase health insurance). Because of this forced competition, companies are constantly undercutting one another and, accordingly, healthcare costs remain low. Of course, I'm sure profit margins are razor thin for these providers, as they are unable to establish regional monopolies, but at least most everyone gets affordable healthcare.

Of course, implementing a national marketplace in the US means destroying the regional monopolies of existing healthcare providers, which will ruin profit margins and cause mass apoplexy amongst shareholders. The insurance industry would, of course, vigorously fight any move in this direction, probably to great effect.

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This will lower insurance premiums due to competition, but it will not prevent carriers from denying coverage unless there is a mandate that coverage for a reasonable cost cannot be denied. Otherwise I'd just get fined for being unable to afford 1700 dollars a month for insurance. Collusion within the insurance industry is already out of control, regulation would have to be stiff and unforgiving in order for this to work.

It also will not stop insurers from negotiating with regional health networks thus again making putting health care out of reach for the uninsured. Double Whammy!

Maybe a better way to put this is that in the United States we are beyond the point that insurance reform/migration is going to be effective.

Tyewa Dawnsister fucked around with this message on 10-25-2009 at 01:21 AM.

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Quoth Blindy.:
Do you actually have trouble comprehending the difference between health care that is provided by the government to a captive audience, and health care that is provided by private industry to a open market, and only paid for by the government?

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There will end up being no practical difference. If the government is paying for it, the temptation for bureaucrats to impose ever more silly restrictions and caveats and forms and exceptions and guidelines for care will be too strong to resist. After all, they will have to Be Seen To Be Doing Something To Control Costs. Further, just like Defense, cost will skyrocket and quality will plummet, since there will be no incentive for anything else to happen.

Honestly, you're smoking rope if you think that--just for this one issue--government bureaucracy will suddenly stop behaving like government bureaucracy.

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Karnaj startled the peaceful upland Gorillas, blurting:
And getting a bit on topic, I ask this of Kinanik, Bloodsage, et al.: Do you defend the right of insurance companies to deny coverage to women who have been raped and, because of this, received post-exposure HIV prophylaxis as part of the treatment regimen for the rape?

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There is no perfect system. Sure, this is an emotionally-charged example, but how is it different from denying coverage to anyone else who has been exposed to a disease? Hepatitus, for example, from a food service worker who lied on his or her employment questionnaire?

The truly relevant point is whether we should adopt an even more deeply flawed system simply to correct problems on the margin of the current one. If you think equally egregious things don't happen in places with national health care, you haven't done your due diligence.

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Tyewa Dawnsister has funnier quote texts than me:
This really all comes down to if you think "being able to maintain good health" is a right or a privilege.

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wikipedia:
The Universal Declaration of Human Rights, adopted by the United Nations in 1948, states that “everyone has the right to a standard of living adequate for the health and well-being of oneself and one’s family, including food, clothing, housing, and medical care.”[53] In addition, the Principles of Medical Ethics of the American Medical Association require medical doctors to respect the human rights of the patient, including that of providing medical treatment when it is needed.[54] Americans' rights in health care are regulated by the US Patients' Bill of Rights.

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Liam fucked around with this message on 10-25-2009 at 11:36 AM.

tia

The big point of contention is this right here:

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Bloodsage had this to say about Tron:
So?

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For some people, the idea that citizens of rich and powerful countries can have their lives ruined by the financial impact of cancer (in addition to dealing with it even if it were paid for) is basically inexcusable

Kegwen fucked around with this message on 10-25-2009 at 04:39 PM.

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Liam startled the peaceful upland Gorillas, blurting:
i don't see how your opinion on the UN invalidates the president's signature on the declaration

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The point is that General Assembly resolutions are essentially meaningless. They're not binding in any way, and there are no consequences to "violating" them. Few people, for example, would not sign up to, "Wouldn't it be nice if everyone had a basic level of health care, a loving family, and a puppy dog named Spot." Far fewer people, however, would sign up to paying for all of that, or sacrificing their own well-being to provide those things to others, or to being punished should they not take meaningful steps to ensure those things came to pass.

UN General Assembly resolutions are like the first one.

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Quoth Kegwen:
Some people would rather have a bloated and far too expensive system that in theory allows you to get treatment without ruining your life with debt (the government) vs a bloated and far too expensive system that has proven itself to arbitrarily deny treatment based on things that are often not preventable

The big point of contention is this right here:

For some people, the idea that citizens of rich and powerful countries can have their lives ruined by the financial impact of cancer (in addition to dealing with it even if it were paid for) is basically inexcusable

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You misunderstand why I wrote, "So?"

It's not that these situations aren't a bad thing; it's just ironic to that Blindy pointed out that the current system has the same type of problem as the one he proposes we switch to...as a reason to change. It doesn't follow.

Emergencies don't wait at all unless the hospital is clogged up with more emergencies, and even then it's not long. Besides, deaths in the ambulance bays are comparatively easier to clean up.

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Pvednes startled the peaceful upland Gorillas, blurting:
Emergencies don't wait at all unless the hospital is clogged up with more emergencies, and even then it's not long. Besides, deaths in the ambulance bays are comparatively easier to clean up.

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That's why there was a national scandal this summer in France with several high-profile incidents of people dying because their ambulances spent hours going from hospital to hospital being turned down due to lack of space. Yep: emergencies don't wait at all in these systems.

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If only Bloodsage hadn't said this:
You misunderstand why I wrote, "So?"

It's not that these situations aren't a bad thing; it's just ironic to that Blindy pointed out that the current system has the same type of problem as the one he proposes we switch to...as a reason to change. It doesn't follow.

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I pointed out that the current system has the same type of problem as the one I propose we switch to to illustrate that your example is not a reason to stay the same.

All things being equal, we pay 40-50% more per person as a country on health care than France. 16% of the GDP goes to health care. If we are able to get our health care down to similar costs and still have the same quantity of problems then we've improved our situation.

But I don't think we'd have the same quantity of problems. When people die because they can't get into a hospital on France, that's BIG NEWS. It causes protests! When people die because they can't afford health care here, that's not even in the local papers, because it happens all the time.

Blindy fucked around with this message on 10-26-2009 at 08:57 AM.