US Universal Healthcare: How are we going to pay for it?

[famousringo]

HappySqurriel said:

It’s disingenuous to argue that you could increase the number of people who are covered by the healthcare system, maintain people’s access to healthcare, and maintain the average quality without seeing noticeable cost increases without dramatically decreasing the number of preventable illnesses and injuries (and the massive cost associated with bureaucracy).

With that said, I expect the United States will probably "pay for" government run services by rationing services and from the revenue generated from cap-n-trade; and I wouldn't be surprised to see higher taxes introduced on Tobacco, Alcohol and Junk Food.

 

Edit: Since I want to preempt the claim that there are no problems associated with other Government run healthcare systems around the world, I will just let the statistics I saw earlier today from the government of Saskatchewan do the talking for me. The following website tracks the wait times associated with surgical procedures that are performed after the surgery has been scheduled by a specialist; and, while it is not tracked on this site, the wait time to see a specialist in Canada typically ranges from 1 to 6 months. Please note that a biopsy is considered a seperate surgical procedure, and if a doctor schedules a biopsy the surgical wait time begins after the biopsy is completed.

http://www.sasksurgery.ca/wli-wait-list-info.htm

Just because I was doubted earlier when I suggested that the primary reason why Americans have such better survival rates when it comes to prostate cancer than other nations was because of how efficient and high quality the American healthcare system is. In Saskatchewan only 15% of men can get a Prostatectomy within 6 weeks of it being scheduled, and over 45% wait 4 months or more; and when you factor in wait times for seeing a specialist, and any time associated with diagnostic surgery, this translates to (roughly) 50% of prostate cancer patients waiting 6 months or more for a Prostatectomy. If you're an individual who was unfortunate enough to have your cancer found late it is highly likely that you will die unless you do what so many Canadians do, and that is travel to the United States and pay for healthcare to save your life.

This hit a bit of a nerve with me, since my grandfather spent a couple decades fighting off cancer that started in his prostate before succumbing to it at the respectable age of 86, all in Saskatchewan. Prostate cancer is used often in these examples, because it is a slow-growing cancer and can often be left to wait with little consqeunce, so jurisdictions looking to save a little money do exactly that. It seems that US cancer survival rates might not be all they're cracked up to be:

http://blog.washingtonpost.com/fact-checker/2007/10/rudy_miscalculates_cancer_surv.html

The latest official figures for five-year "survivability" rates for men diagnosed with prostate cancer are around 98 per cent in the United States and 74 per cent in England.

More importantly, the survivability figures tell us little about the differences in the quality of treatment received by prostate cancer patients in the United States and Britain. Doctors in the two countries have different philosophies about how to treat prostate cancer, and these differences have greatly influenced the "survivability" statistics.

In the United States, there has been a big emphasis since the early 1990s on early screening through PSA (prostate-specific antigen) testing. Five-year survivability rates have increased simply because men are being diagnosed with prostate cancer at a very preliminary stage of a slow-developing disease. If you are diagnosed early on, your chances of surviving for another five years are close to 100 percent. Britain is several years behind the United States in the widespread use of PSA testing.

"When you introduce screening and early detection into the equation, the survival statistics become meaningless," said Howard Parnes, chief of the Prostate Cancer Research Group at the National Cancer Institute. "You are identifying many people who would not otherwise be diagnosed."

Another way of comparing treatment of prostate cancer in the U.S. and Britain is to look at the mortality rates from the disease. Here the two countries are much closer. The graph below shows deaths per 100,000 males in each country. About 25 men out of 100,000 are dying from prostate cancer every year in both the U.K. and the U.S.

Brantley Thrasher, chairman of the Department of Urology at the University of Kansas, said it was "impossible to say" on the basis of the statistics whether a prostate cancer patient had a better chance of surviving under a "capitalistic" or "socialistic" medical system. American doctors tend to be more "interventionist" and more likely to advocate surgery than their counterparts in Britain or Canada, where greater emphasis is put on "active surveillance." In the United States, a patient with a good health care plan is "more empowered to make decisions" for himself.

"You can't say that it's better to have prostate cancer here or in some other country," with a developed health care system, said Dr Thrasher, who also serves as a spokesman for the American Urological Association.

While doing this research, I also turned up this surprising study which shows that the US health system actually offers fewer services in many categories than other OECD countries (fewer doctors, nurses, bed), despite paying so much more:

http://www.medicalnewstoday.com/articles/27348.php

My answer to the thread topic itself is a combination of rationing, price controls, and improved efficiency. Increased tax revenues shouldn't even be necessary, though it's always an option. The United States already spends more public money on health as a share of GDP than Canada, and it obviously isn't getting enough value for that money if so much more private money gets spent along side. If the governments of Canada can provide universal coverage for 6.84% of GDP, I see no reason why the US shouldn't be able to for 6.88% of GDP, except perhaps a lack of political will.