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Forums - General Discussion - US Universal Healthcare: How are we going to pay for it?

famousringo said:
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.

You missed a vital part of information in there.

According to Patrick Walsh, professor of urology at Johns Hopkins, the British data probably understate the number of people who have died from prostate cancer in Britain. Some prostate cancer-related deaths in the U.K. were classified as deaths from pneumonia before 1984 and after 1992.

 

Additionally what is being ignored is that the United States accounts for over 70% of the worlds medical research.  How does anyone plan replace all that private spending that will dry up from the lack of profits?

To use cancer as an example... how many more years would we have to wait for gold nanorods to replace other more dangerous treatments?

 



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TheRealMafoo said:
FaRmLaNd said:
Dismantle the US governments hundreds of overseas bases and stop policing the world. Withdraw from all non UN warzones etc.

This would save a load of money.

While I agree with this 100%, we need to do this without healthcare. If we did this, we would still be running a deficit with today's spending.

True, the deficit would still exists, but at least the US governments expenditure would be going towards helping US citizens improve their health instead of going towards killing people from both the US and the world, not to mention creating all the mental and post-warzone medical issues that soldiers suffer from.

But I agree, I've been looking at the US's debt and its getting crazy (and only going to get worse), unless some serious efficiencies and reductions of red tape can be made the US probably can't afford universal health care. Which sucks considering I'm very pro-universal health care. But then again my government wasn't in debt before the ecenomic crash and will be able to pay it off regardless since Australia is experiencing growth again (aslong as they restrain themselves, lets hope they have some sense).



highwaystar101 said:
CommunistHater said:
It would cost over 3 trillion a year. You have to double every tax.

Lemme guess, did FOX news tell you that bullshit? The NHS only costs £94 Billion in 2008/9 (source) and that served the entire of England. So how is a country that has 7 times the population going to cost 30 times more to run?!?!?

Do yourself a favour and stop listening to the right wing on this subject for just a second and think for yourself.

Perhaps not $3 trillion but pretty close.

£94 billion = $155 billion USD.

$155 billion x 7 (population diference) = $1.085 trillion.

$1.085 trillion x expensiture difference of 2.45 = $2.659 trillion.

 

See the chart back on page 1?  Notice the total expenditures per person between the US and UK.   So your £94 billion health care would cost us $2.659 trillion.



The rEVOLution is not being televised

Cut costs! Cut down the amount of BS red tape and administration that clog the system (this goes for the schools too), get the money into the hands of the people that need it to make things work. I would be all for universal health care if I was convinced the government would do a good job of it, I just am not sure they will. I actually would be fine with paying more taxes if I knew every American was getting health care. Heck, between my premiums and copays per month I pay 10% of my wages towards health care as it is. If the gubment could make it so I pay that to them and everyone gets good, efficient health care and levels the playing field a bit, I'm all for it.

One of the major problems a lot of people that look at the numbers forget is that it is not a level playing field. Everything is rather easy for me, I'm a white kid that grew up middle class, my parents were hard workers, I had a really good role model. What if that wasn't the case? What if my dad was an alchololic? The only male 'role models' that were around were thugs? But at the same time I was a fundementally decent kid with a 180 IQ and the ability to diagnose an illness just by looking at the person. But none of that matters because none of my mothers jobs supply health care she could afford so I die of an undiagnosed (except by me of course) illness that my mom game me some Tylenol for because she couldn't afford to bring me to the ER. I don't think that we need to support everyone monitarily for everything, but sometimes people need a little help to get to the same point where I started from. Or do we just give up on the 50 million people without healthcare because they "just need to work harder"? We need something! Maybe not universal, but someone needs to shake things up and get the costs down! Damn, I'm all worked up now! Sorry everyone!



Actually what's wrong with the US school system is Summer Vacation believe it or not.

It's why the poor falls behind. I mean look at how well KIPP schools do in the US... there is an education gap between the rich and poor... however studies have shown this comes during the summer breaks.

Where richer and middle class children are encouraged to read, are put in summer camps etc.

While poor children are left to their own devices... often by themselves in single parent households or "regular" households where both parents work.

http://www.jhu.edu/~gazette/2007/16apr07/16vaca.html



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Kasz216 said:
Actually what's wrong with the US school system is Summer Vacation believe it or not.

It's why the poor falls behind. I mean look at how well KIPP schools do in the US... there is an education gap between the rich and poor... however studies have shown this comes during the summer breaks.

Where richer and middle class children are encouraged to read, are put in summer camps etc.

While poor children are left to their own devices.


Right on man! I was just saying to some friends that Japan's kids are already back in school after their <1 month vacation. You are absolutely right about the poor kids being abandoned in the summer time, nothing against their parents but they lost their babysitter, and when you are taking care of kids by yourself you really just don't have the time you need to be as awesome of a parent as you can.



The reality is that the medical industry in the United States is not functioning under the influence of capitalist pressures. If functions as a monopoly and a conspiracy at the same time. That is what is driving up the costs too many people exploiting the system to their maximum benefit. The system needs to run like any other business where providers must vie for patronage.

Five things that need to be done.

Legal reform there is no getting around it fuck the malpractice lawyers. What we need is medical arbitration botched procedures need to be corrected, and lost income needs to be recovered. The lawyers contribute nothing to the situation and spur on costs for insurance. No lawyers, and you can start to save shit loads of money on red tape. The paper work alone will start to vanish. It is only there to cover asses in the eventuality. Malpractice suits need to be made illegal for the public welfare. There you cut ten to fifteen percent right off of the top. Shit nurses will be able to spend more time treating patients then doing paper work. The same for doctors. By the way the Republican party has pushed this forever they should be pushing this now. They can make this happen.

Maximum wage legislation for medical practitioners. Some of these hourly rates are simply put unethical. You can't be providing a needed service that people must purchase, and abuse the situation to this extent. Your not competing with one another. Your functioning as a monopoly. This is where we are really taking the hit at hospitals and doctors. I am sorry how the hell does a ten minute checkup equal out to a hundred dollars. We have a minimum wage it is obvious we need a maximum one for necessary providers.

Insurance lets face it you don't have a choice who your provider will be. Your employer is trying to cut the best deal possible, but they can't possibly evaluate the quality on a personal level. We need to make package deal health care illegal, and impose a don't ask don't tell mandate. What we need is a voucher system to enforce competition. I get a voucher he gets a voucher, and then we get to individually choose our provider. Let health insurance be sold out of a store front on main street. I show up with my work voucher or my government voucher, and say what do you got for me to choose from. I guarantee when they have to compete like that their margins will slim way down. No more management making ten billion dollars a year. You rip customers off, and they will tell their family, and friends. You won't be in business for long doing that.

Prescription filling needs to be both specific and chronic. It is one thing to write a script for a drug that will only be needed for a short time, but those with chronic conditions are going to be taking these drugs for years or decades. They are perpetually trapped in the comeback. How many doctor visits does this cause per year. How many phone calls must be fielded as a patient with a chronic ailment needs to get a refill. It is obviously recommended that you visit a doctor for a annual checkup, but once a patient is diagnosed chronic they need to be given a permanent refill on their medication. Be it once a month or whatever. We are wasting time and money here.

Equipment certification through the government. Just run this shit through the FDA. There is a lot of profiteering going on here. I am sorry but a pair of crutches cannot cost as much as a guitar. I say if I can make it for less then twenty bucks how the hell are your selling it to me for $150. You are gouging plain and simple. Once again these aren't luxury items. They are necessities. When they submit their product to the FDA, and honestly much of it won't need to be tested. They will also have to provide price documentation. Then the justice department can go after gougers.

There is a lot of places to save money where the system is being abused for personal gain, and by doing so you make it a lot more efficient. Do things to kill the red tape, and doctors can treat more patients. Limit the necessity of going to the doctor, and the doctors time will be even more productive. Force providers to compete, and that will drive costs down. Drive out the leaches that contribute nothing, and drive up the costs and you save even more money.

The system is just so full of waste, and it will keep piling up until you gut it of some these really antiquated practices that just don't work.



take it out of military defense, 50% or more is ridiculous.



“When we make some new announcement and if there is no positive initial reaction from the market, I try to think of it as a good sign because that can be interpreted as people reacting to something groundbreaking. ...if the employees were always minding themselves to do whatever the market is requiring at any moment, and if they were always focusing on something we can sell right now for the short term, it would be very limiting. We are trying to think outside the box.” - Satoru Iwata - This is why corporate multinationals will never truly understand, or risk doing, what Nintendo does.

Sending these sick parasitic shit licking motherfuckers to the unemployment line is a good way to start.
How many people did they MURDER for that filthy lucre?

Stephen J. Hemsley UnitedHealth CEO
2007 Compensation $13.2 million
2008 Compensation $3,241,042
Total Value of Unexercised Stock Options $744,232,068!!!!!!!!!!!
2009 Options Exercise $127,001,281


Edward Hanway CIGNA CEO
Five-Year Compensation, as of April 30, 2008
$120.51 million
Total Value of Unexercised Stock Options
$28,881,000


Michael McCallister Humana CEO
2007 Compensation $10.3 million
2008 Compensation $1,017,308
Five-Year Compensation Total $15.1 million
Total Value of Unexercised Stock Options $60,865,194
2006 Options Exercise $22,294,710


Ronald A. Williams Aetna CEO
2007 Compensation $23 million
2008 Compensation $24,300,112
Total Value of Unexercised Options $194,496,797


Allen Wise Coventry CEO
2004 Compensation $13,052,799
2006 Sale of Stock $14,458,251
2006 Options Exercised $2,895,000
2005 Sale of Stock $46,410,695
2005 Options Exercised $6,709,564
2004 Sale of Stock $12,826,756
2004 Options Exercised $4,798,000


Angela Braly WellPoint CEO
2007 Compensation $9,094,271
2008 Compensation $9,844,212
2006 Sale of Stock $4,858,585
2006 Options Excerise $4,566,124




Switch: SW-5066-1525-5130

XBL: GratuitousFREEK

NinjaguyDan said:
Sending these sick parasitic shit licking motherfuckers to the unemployment line is a good way to start.
How many people did they MURDER for that filthy lucre?

Stephen J. Hemsley UnitedHealth CEO
2007 Compensation $13.2 million
2008 Compensation $3,241,042
Total Value of Unexercised Stock Options $744,232,068!!!!!!!!!!!
2009 Options Exercise $127,001,281


Edward Hanway CIGNA CEO
Five-Year Compensation, as of April 30, 2008
$120.51 million
Total Value of Unexercised Stock Options
$28,881,000


Michael McCallister Humana CEO
2007 Compensation $10.3 million
2008 Compensation $1,017,308
Five-Year Compensation Total $15.1 million
Total Value of Unexercised Stock Options $60,865,194
2006 Options Exercise $22,294,710


Ronald A. Williams Aetna CEO
2007 Compensation $23 million
2008 Compensation $24,300,112
Total Value of Unexercised Options $194,496,797


Allen Wise Coventry CEO
2004 Compensation $13,052,799
2006 Sale of Stock $14,458,251
2006 Options Exercised $2,895,000
2005 Sale of Stock $46,410,695
2005 Options Exercised $6,709,564
2004 Sale of Stock $12,826,756
2004 Options Exercised $4,798,000


Angela Braly WellPoint CEO
2007 Compensation $9,094,271
2008 Compensation $9,844,212
2006 Sale of Stock $4,858,585
2006 Options Excerise $4,566,124


Probably less (per capita) then the people running healthcare in the UK.  Which is the issue i have.  Rationing healthcare is just bad buisness.  Laws can be made to stop insurance companys from screwing you over.  Some states have them.   Others could use more.

Nobody can really stop the government from saying "We only have so much money... so lets not treat this.  And lets give an alternative treatment to women over 60 since they've lived full lives anyway and it's 100,000 per treatment."  etc.