Should America give in to a National Healthcare system? (dictator, Walmart, election)

[Wardendresden]

Originally Posted by Mircea

No, they haven't.

"In the past 20 years, our overriding philosophy has been that the health system cannot spend more than its income." -- Franz Knieps German Minister of Health (2009)

The only thing they've done is figure out to give access to nearly everyone, but that access comes with the price of rationing health care.

By 2020, the average EU country will need to raise the tax rate to 55 percent of national income to pay promised benefits.

■ By 2035, a tax rate of 57 percent will be required.
■ By 2050, the average EU country will need more than 60 percent of its GDP to fulfill its obligations.

ISBN #1-56808-197-9
www.ncpa.org/pub/st/st319/st319.pdf

European countries are hampered by the same problems the US in terms of demographics. There is no escaping it, and they are unable to fund their health care systems. That is why they privatizing their systems.



I already debunked that.

Your care and the quality of your care is superior. It is the metrics that are flawed.



You posted it, you take ownership of it, unless you present a caveat pointing out any flaws in the arguments or information presented.



You do not have rationing.

Your misunderstandings about the health care system have caused you to conflate cost containment with rationing. They are not the same thing...

Cost containment is defined as the effort to limit a payer’s or insurer’s healthcare expenditure to a predetermined, usually budgeted or capped sum for a given period of years.

Cost containment must be understood as it relates to the definition of insurance....

Black's: Insurance is a contract whereby for a stipulated consideration, one party undertakes to compensate the other for loss on a specific subject by specified perils.

You purchase $500,000 worth of life insurance for a fixed fee or monthly premium. How much life insurance do you get?

$1 Million? $10 Million? Um, no, you get $500,000.

If you want $1 Million, then you will have to pay more.

The average around the US to insure a $250,000 home is $2,000 per year. Why would so-called "health insurance" be any different? If you're paying $5,000 per year and they pay $500,000 and then cut you off, that is not rationing, that is cost containment. If you want more than $500,000 worth of coverage, then common sense and sheer logic dictates that it will cost more than $5,000 per year.

Rationing exists when...

1] Scarcity of physical resources and a perceived need for their allocation
2] Waiting lists and long waiting times
3] Denial of treatment
4] Discrimination between patients regardless of need

Those definitions stem from....

Allocating resources when their supply is limited (EIU Healthcare International)

The displacement of the interests of one group of patients by another (Spiers, J., The Realities of Rationing: ‘Priority Setting’ in the NHS, London)

How many of a given intervention will be provided, to whom, at what cost, and under what circumstances (Rationing Health Care, Brit. Medical Bull. 51)

Die kuenstliche Verknappung eines durchaus vorhandenen Angebots --- The artificial curtailment of supply when it is actually available (Cueni, T., Rationalisieren oder Rationieren?)




Figure 5 VA’s Expenditures on Health Care Services per Enrollee, by Priority Group, 2008

P1 $9,000
P2 $3,900
P3 $3,100
P4 $15,000
P5 $5,200
P6 $1,900
P7/8 $2,200
----------------
$5,757 = average cost per year (in 2010 US Dollars).

Page 18



I don't have to......but just for the hell of it....

Liberalisation, privatisation and regulation in the German healthcare sector/hospitals Thorsten Schulten, Wirtschafts-und Sozialwissenschaftliches Institut (WSI) November 2006

The privatisation of hospitals in Germany is mainly driven by the large budget deficits of public authorities at regional and municipal level.

That's on Page 1.

Between 1991 and 2004 the proportion of private hospitals increased from 14.8% to 25.4% (Figure 1). At the same time the share of public hospitals decreased from 46% to 36% while the proportion of non-profit hospitals remained relatively stable.

That's on Page 4.

[emphasis mine]



That is irrelevant.

You might want to avail yourself of on-line dictionaries and learn the difference between "compare" and "contrast."

In the alternative, there's very nice Sesame Street video you can watch.

One compares things that are similar. The US is similar to....Russia.

One contrasts the US with every country on Earth, except Russia....because the US and Russia are similar with respect to geographic size, geography, geology, demographics and, um, most importantly....population.

So you can make all the silly references to culturally homogenous nation-States with populations of 7 Million people all you want.....but such comparisons are invalid due to the very obvious fact that they US is not similar to any country on Earth.....except Russia.

Why, yes, Economy of Scale is a very, very real thing, and it really does play a role in all things economic, and that does include health care.

When the population of Switzerland grows from 7.9 Million to 314 Million then we may compare the US and Switzerland.



Health care is important, but you want to ration it. That makes absolutely no sense at all.



That study was thoroughly debunked by multiple sources.

For anyone who filed bankruptcy and had medical debts discharged, they were automatically included in the study in NAZI-like attempt to skew the data to bolster their cries for a national health care system.

No one files bankruptcy over a $289 medical debt. Be real.

Come back when you have some relevant facts.

Debating....

Mircea



That question should be obvious....you cannot.

Nearly every single method of cost-control in your health care system has been negated. Obamacare actually makes things worse, because the only barrier now is co-pays.

Presently, Obamacare dictates that annual limits are $2 Million.

What that means is that previously if an health plan provider had to fork out $1 Million on a person in one single year, they could cut that person off. Now they can't cut that person off unless they hit $2 Million in one year, and after January 1, 2014, there are no limits.

That means if an health plan provider has to spend $5 Million on one person in year, then they have to do it.

As of January 1, 2014, there are no more life-time limits either.

Used to be that if you sucked up $12 Million worth of health care in your life-time, you would be cut off. Now Obamacare says that if an health plan provider has to pay $100 Million then they have to pay $100 Million.

For one person in a life-time.



Private enterprise is always the best method of management, provider there's no interference.

Rationally....

Mircea

To "debunk" every argument you've made, Why isn't the private enterprise system working in America? Read a few other threads and come up for air. You are one an extreme minority that thinks our healthcare system is working. And since my wife WORKS in the system (as a middle manager, currently in a non-profit)--both profit and non-profit system, she says the more privatized it is, the worse the care and the more the cost. Further, the CEO of her hospital also came from the same private system she works for and agrees that non-profits have a long way to go, but the profit system is simply killing American healthcare.

You can continue to smoke that pipe if you want, but I believe you must have a significant amount of stock in for profit hospitals or in pharmaceuticals, so that you have a vested interest in the for profit system. Those who stand the most to lose in going to a socialized system or even a controlled privatized system are always the profit pigs that squeal the loudest.

[MrRational]

(1) whether we really believe we can afford to PAY FOR providing the same level of care
to everyone regardless of anything

Originally Posted by Mircea

That question should be obvious....you cannot.

On that we agree.

Private enterprise is always the best method of management, provider there's no interference.

But there's always interference. Isn't there?
At that actuarial level though I'm far less confident of private enterprise being effective.

Either way though... the far harder part is establishing the guidelines.

[nicet4]

Originally Posted by Wardendresden

Now don't believe me---just google "quality of healthcare in VA hospitals" for an eyeopener. Read several of the different articles. The VA has gone from being the absolute worst in the nation...

Yeah, I've been waiting for an appointment since September 24, 2012.

Thank God I don't have to depend on them and I don't.

[markg91359]

Private enterprise is always the best method of management, provider there's no interference.

We know you're a libertarian. We know that its axiomatic for you and others of your persuasion to say that the free market is always better.

The problem is that sometimes its just not true. The administrative costs for Medicare are about 2% of the revenue collected. This compares with private health insurance plans where large efficient ones use up 7% of the revenue for administrative costs and inefficient individual plans where 30% of premiums pay for administration.

PolitiFact | Barbara Boxer says Medicare overhead is far lower than private insurers' overhead

Canada's health insurance plan is very much like Medicare. The only difference is that everyone in the country is on Medicare. The issue about administrative costs is one reason why Canadians pay about 2/3's per capita of what Americans do for healthcare.

The number of Canadians coming to America for medical care is relatively small. Its also not unexpected when one realizes that more services are likely to be available in a country with 10X the population that Canada has.

[Wardendresden]

From Physicians for a National Healthcare Program:

"based on financial filings by virtually all U.S. hospitals, found that administration accounted for 24.5% of total costs at non-profit hospitals vs. 34% at for-profits, while payroll costs for clinical personnel were 7 percentage points higher at non-profits."

For-Profit Hospitals are Costlier Than Non-Profits | Physicians for a National Health Program

Uh, administration costs include gigantic bonuses for CEO's

[Wardendresden]

From The Raw Story:

"Wellness," penned the Chicago Business Journal last week, "the new marketing slogan of Blue Cross & Blue Shield of Illinois, also applies to the pocketbooks of the insurer's top executives."

The Raw Story | Despite economic slowdown, healthcare CEO's bonuses are blooming

[Wardendresden]

Mircea, what do OUR physicians think of OUR system:

"Doctors in the United States were more likely to report problems with the country's healthcare system than were their international peers in a new 2012 survey. "

"The Commonwealth Fund, a nonprofit research foundation, found that just 15 percent of U.S. primary-care physicians say the healthcare system works well and only needs minor changes.

Study: US docs most negative on healthcare system - The Hill's Healthwatch

This was a Novemer/2012 article

[Wardendresden]

Over half of physicians surveyed have reached a tipping point and plan to make changes to their practices. Many intend to take one or more steps likely to reduce patient access to their services, limiting physician availability at a time when doctors already are in short supply.
findings of the survey include:

Over three quarters of physicians – 77.4 percent – are somewhat pessimistic or very pessimistic about the future of the medical profession.

Over 84 percent of physicians agree that the medical profession is in decline.

The majority of physicians – 57.9 percent -- would not recommend medicine as a career to their children or other young people.

Over one third of physicians would not choose medicine if they had their careers to do over.

Physicians are working 5.9% fewer hours than they did in 2008, resulting in a loss of 44,250 full-time-equivalents (FTEs) from the physician workforce.

http://www.physiciansfoundation.org/...ial_Survey.pdf[

[Wardendresden]

From a relatively old Time article about how improved VA healthcare has been achieved while REDUCING employees and INCREASING patient load:

And all that was achieved at a relatively low cost. In the past 10 years, the number of veterans receiving treatment from the VA has more than doubled, from 2.5 million to 5.3 million, but the agency has cared for them with 10,000 fewer employees. The VA's cost per patient has remained steady during the past 10 years. The cost of private care has jumped about 40% in that same period.


Read more: How Veterans' Hospitals Became the Best in Health Care - TIME

[Wardendresden]

Government healthcare, when run by a competent official, is cheaper AND better:

"Government health care" is often characterized as wasteful and inefficient. But here too the VA's experience suggests otherwise. In 2007, the nonpartisan Congressional Budget Office (CBO) released a report (PDF) that concluded that the VA is doing a much better job of controlling health care costs than the private sector. After adjusting for a changing case mix as younger veterans return from Iraq and Afghanistan, the CBO calculated that the VA's average health care cost per enrollee grew by roughly 1.7% from 1999 to 2005, an annual growth rate of 0.3%. During the same time period, Medicare's per capita costs grew by 29.4 %, an annual growth rate of 4.4 %. In the private insurance market, premiums for family coverage jumped by more than 70% (PDF), according to the Kaiser Family Foundation.

READ THE WHOLE ARTICLE, Mircea, and get an idea of what GOOD healthcare can really be like:
'Socialized' or Not, We Can Learn from the VA | RAND