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Excuse me, I just thought I should point out that pretty much everything you just wrote is spectacularily wrong.
I mean, the "EU collapse" was adressed in the post directly above yours. As for "healthcare bankrupting European nations" ...the US spends 18 % of GDP on health care. Other first world nations average 9 %. For comparison, the US military spending is just over 4 % of GDP.
The red bars are public money, coming from taxes. The pink are what citizens spend privatly after that. Notice how Americans pay more tax money towards government health care than the average European? And after those taxes are paid, the Europeans got UHC, the American tax payer has nada, and has to spend the same amount of money again privatly?
The exception, of course, is Norway. Who does not spend any oil money on health care because all the oil money is being saved in a sovereign wealth fund.
Aiming for spending half the money on better results is not exactly "aiming for failiure" As for China, they've tried a market-based health care system, and is retiring it as a failiure. They have looked at how systems work in the developed world, and is currently instituting a UHC system, as the only competitive alternative.
OECD Enough said about "spectacularly wrong!"
Now... Would you like to step out of the realm of agenda-driven blogs, and into the real world? Let's talk about that MARVELOUS healthcare system they have over there in China!
What experience do you base this on? I mean, I've worked in or used health care in the US, UK and Norway.
For choice, I'd rank them Norway -> UK --------> US.
I've got the greatest amount of choice in Norway, where I can use the national health care system, pick my own personal physician, pick the hospital I want to be treated at, public or private and have the trip paid for. Or I can pay out of pocket, which is far cheaper than in the US. Because competition with the government health care has driven prices down to affordable levels. Or I could have gotten insurance, though very few people bother.
In the UK, I could use the NHS, insurance, or pay out of pocket, which was also far cheaper than in the US. (This is why 15 people leave the US for treatment for every one that enters). I'd have less choice inside the NHS than in Norway though.
And in America...I'd need insurance. End of. Couldn't leave my job unless I had a new one with insurance lined up, couldn't start my own business, having a child would be a strain...the amount of freedom I'd have would be far less than any UHC country. In the US, I'd also be paying more in taxes for government healthcare that I'd never see. More than the UK, that is, slightly less than in Norway. But my total taxes in Norway was pretty much the same as they would have been in a high-tax US state.
This is pretty much what orthodox economic theory says, healthcare is unsuited to market delivery without severe regulation.
...and yet, despite all this, you choose to live in the United States. I'm always amused by the people who do nothing but ****** and moan about everything in America, and how awesome everything is everywhere else, but don't leave and go live somewhere else. Pretty much the end of the story, isn't it?
And you conveniently forgot all the "other" options about American healthcare (which, by the way, I am NOT advocating as stellar). For instance, what do all the "poor people" in America do for healthcare? They opt in to one of the 50 states' subsidized healthcare systems. Those living at "poverty level" receive 100% free healthcare. Those living on lower wages receive subsidized healthcare. For instance, MinnesotaCare provides a family of 5, with an annual income of $35,000, with healthcare for less than $150 per month.
Further, the claim that "blah blah blah hundreds of millions of Americans have no healthcare!!!!" is an absolute lie. How many million American military men and their families (current and retired) are covered under VA benefits? The number is in the tens of millions. Then you add the millions of Americans whose income is low enough that their healthcare is completely free, and what do you have?
And let's not forget the FACT that every single emergency room in every single hospital in the United States has a huge sign hanging on the wall, stating that NOBODY can be denied medical help, regardless of who they are, or their ability to pay. So all these worthless gang-bangers get to run around in the middle of the night shooting each other, then drop off the wounded at the local hospital for free healthcare.
THESE are the types of facts that people such as you ALWAYS ignore, and refuse to talk about.
Last edited by Big George; 09-13-2012 at 07:20 AM..
Now... Would you like to step out of the realm of agenda-driven blogs, and into the real world? Let's talk about that MARVELOUS healthcare system they have over there in China!
OECD. The final work on unbiased information. Although WHO is probably more detailed for health care information. But nothing there isn't general knowledge in the health care debate.
And I don't write blogs, I work in health care. As for China, they're moving from a mixed insurance/fee for service system that proved not to work very well. The combination of insurance fees that favored the larger population centers and an absolute lack of resources wasn't very good. Today, they're spending billions on the The New Rural Co-operative Medical Care System (NRCMCS), an NI-type UHC.
No one is saying China is a developed country or a health care model. But for the amount of money the US spends, that system really should compare well with the performance of other first world systems.
OECD. The final work on unbiased information. Although WHO is probably more detailed for health care information. But nothing there isn't general knowledge in the health care debate.
And I don't write blogs, I work in health care. As for China, they're moving from a mixed insurance/fee for service system that proved not to work very well. The combination of insurance fees that favored the larger population centers and an absolute lack of resources wasn't very good. Today, they're spending billions on the The New Rural Co-operative Medical Care System (NRCMCS), an NI-type UHC.
No one is saying China is a developed country or a health care model. But for the amount of money the US spends, that system really should compare well with the performance of other first world systems.
The amount of money the United States spends on healthcare is skewed by the fact that hundreds of billions of dollars per year is already going through the government. And dishonest, agenda-driven people try to use those skewed numbers to say what they do not say.
And by the way, the OECD is NOT the "final word on unbiased information." Not by a long shot! It is a policy-driven & making organization, that is going to do whatever is in its own best interests.
The amount of money the United States spends on healthcare is skewed by the fact that hundreds of billions of dollars per year is already going through the government. And dishonest, agenda-driven people try to use those skewed numbers to say what they do not say.
Health care economics is a real discipline witch quite a lot of people from every part of the political spectrum work with. If you've managed to find hundreds of millions of dollars that none of the specialists have ever noticed, I am sure one of the journals will be rushing to publish your revolutionary work.
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Originally Posted by Big George
...and yet, despite all this, you choose to live in the United States. I'm always amused by the people who do nothing but ****** and moan about everything in America, and how awesome everything is everywhere else, but don't leave and go live somewhere else. Pretty much the end of the story, isn't it?
Why do you think I live in the United States? Why would I? Its not like it offers me and my family very good prospects. Work sometimes. And its pretty easy to see what works better.
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Originally Posted by Big George
And you conveniently forgot all the "other" options about American healthcare (which, by the way, I am NOT advocating as stellar). For instance, what do all the "poor people" in America do for healthcare? They opt in to one of the 50 states' subsidized healthcare systems. Those living at "poverty level" receive 100% free healthcare. Those living on lower wages receive subsidized healthcare. For instance, MinnesotaCare provides a family of 5, with an annual income of $35,000, with healthcare for less than $150 per month.
No, I didn't forget them. In my example, I never qualify for them. They add nothing to my freedom. And those are all part of the things that cause the American taxpayer to pay more for government-run health care than the UK, Canadian, French, German etc taxpayer. But the American taxpayer who makes enough money to pay significant taxes sees no return for that, he still has to get private insurance. Unlike the UHC countries where the government spends less tax money on health care.
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Originally Posted by Big George
Further, the claim that "blah blah blah hundreds of millions of Americans have no healthcare!!!!" is an absolute lie. How many million American military men and their families (current and retired) are covered under VA benefits? The number is in the tens of millions. Then you add the millions of Americans whose income is low enough that their healthcare is completely free, and what do you have?
I have a kludge of government programs that spend more money covering select individual groups than other governments spend covering everyone. Oh, and there are 22 million veterans, with five million patients a year. Costs 43 billion.
Quote:
Originally Posted by Big George
And let's not forget the FACT that every single emergency room in every single hospital in the United States has a huge sign hanging on the wall, stating that NOBODY can be denied medical help, regardless of who they are, or their ability to pay. So all these worthless gang-bangers get to run around in the middle of the night shooting each other, then drop off the wounded at the local hospital for free healthcare.
That is part of the problem. In other developed countries they would have been treated sooner and cheaper, with better outcomes, rather than having to go to an emergency room for the most expensive care. Also, the emergency room just has to stabilized them, not actually cure them.
Quote:
Originally Posted by Big George
THESE are the types of facts that people such as you ALWAYS ignore, and refuse to talk about.
No, they are what I've just talked about. They are the biggest part of the reason why the US wastes such a monstrous amount of money on poor results in health care. The Veterans Health and the emergency rooms are part of the problem.
Today, government health care in America includes Medicare, Medicaid, the Children's Health Insurance Program, Veterans, IH, etc. Each with their bureaucracies, bureaucrats, forms and schemes. Many of which not only do redundant jobs, but often billing and credit checking that is simply not relevant in other first world systems.
For this massive duplication of effort the American tax payer pays -unsurprisingly, more than the average European tax payer does for their single government program and its one set of bureaucrats.
Basically, having loads of departments with different procedures doing the same job each for a limited number of people is much more expensive than having one that does it for everyone. Extending one program to cover everyone costs less than having umpteen different ones to cover umpteen limited groups. Not surprising, since this is a popular strategy in many of the nations that get good results at half the cost.
The people who pay for the redundant jobs bonanza, the American taxpayer (who is healthy enough to get to work and do his job each day) -should be the cheapest ones to insure, it is on average the healthiest group. Instead the American taxpayer gets it coming and going -stuck paying taxes for government health care and and money for insurance.
^ It's interesting that you cite the government-run healthcare, in the United States, as part of the problem. But you also want MORE government-run healthcare.
And still, you refuse to acknowledge that imitating other countries' healthcare systems is absurd. It's apples & oranges, if even that close.
You also refuse to simply say that you do NOT live in the United States.
But mostly, here's the deal. Statistics and numbers are what they are. But dishonest people are ALWAYS twisting and distorting them, telling half-truths with them, and using them to their own advantage. Our recent DNC and GOP conventions are a PERFECT example of that. So save me the "numbers spinning" stuff. It's pretty much all lies anyway.
^ It's interesting that you cite the government-run healthcare, in the United States, as part of the problem. But you also want MORE government-run healthcare.
I am citing fragmentation as part of the problem.
Not government health care in itself, but the fact that the government runs lots of separate programsdoing the same thing. And I am not really advocating more government-run health care. Several countries use private insurance as the delivery vehicle for UHC. Often primarily employer administered. These are known as bismarck-style systems and they include Germany, the Nederlands and Switzerland of the thread title. Bismark-type systems tend to have good results, but to be somewhat more expensive than other UHC systems. they differ from the US in that they have regulations to avoid the out-of-control costs and get everyone into the risk pool. Switzerlands for-profit insurance system may cover everyone, but many years it is also the second most expensive in the world. A distant second after the US, but still.
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Originally Posted by Big George
And still, you refuse to acknowledge that imitating other countries' healthcare systems is absurd. It's apples & oranges, if even that close.
The rough consensus among health care economists is that it would be easiest for the US to move to the German system. The "special snowflake" notion, that the USA is too special to be compared to anyone else isn't something you find in serious discussions. Countries compare themselves all the time. Iceland of 300 000 people compares itself to Norway of 5 million. Which in turn sees no problem comparing itself to Japan of 125 million, or Germany of 80.
Its all fruit, I'm afraid.
Assuming that one is too special to learn from others or compete with others, or even be compared to others is...not a good assumption. It precedes disaster in individuals, businesses and countries.
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Originally Posted by Big George
ou also refuse to simply say that you do NOT live in the United States.
Is it relevant to the discussion?
I am not a fan of invoking personal authority in a discussion. Too many people on the net pretend to be something they are not to give their arguments merit. I'd prefer my arguments to stand on their own.
If it matters, I lived in Wisconsin, graduated high school, went to Uni in the UK, worked in Norway. I've contemplated working back in the US, but it does not offer a good deal any more. It did in the 80s, but today prospects are brighter elsewhere.
Quote:
Originally Posted by Big George
But mostly, here's the deal. Statistics and numbers are what they are. But dishonest people are ALWAYS twisting and distorting them, telling half-truths with them, and using them to their own advantage. Our recent DNC and GOP conventions are a PERFECT example of that. So save me the "numbers spinning" stuff. It's pretty much all lies anyway.
Statistics can be misrepresented. Up to a point. But when the US is spending 18 % of GDP on something and other countries are spending 9 %...with the US having a bigger GDP per person than most and the economics of scale...then you are beyond where they can easily be misrepresented. Then its simple maths. 18 is twice 9, and if the results of 18 aren't very significantly better, something is being wasted somewhere.
What I am saying, is the spending gulf is too huge, and acknowledged by too many specialists on both sides to be a misrepresentation.
You can also have a look at how research studies work. People get "cred" in their areas by pointing out mistakes in other peoples work. So research papers are written knowing they are going to be scrutinized by specialists. Stuff from thinktanks on both sides are far more dubious.
I completely agree with that. Fragmentation and duplication.
Unfortunately, that is one of the by-products of an entire governmental system. Centralized federal, in addition to individual state mandates. And even the federal government has to work within, and accommodate, individual state mandates.
I completely agree with that. Fragmentation and duplication.
Unfortunately, that is one of the by-products of an entire governmental system. Centralized federal, in addition to individual state mandates. And even the federal government has to work within, and accommodate, individual state mandates.
Most governments manage to avoid that, at least avoid the degree it exists in the US. There are four fundamental models for providing health care:
The Beverige Model is your NHS type model, one big government run system. It is used in places like the UK, Spain, New Zealand and Scandinavia. Many, but not all, hospitals and clinics are owned by the government; some doctors are government employees, but there are also private doctors who collect their fees from the government, or completely private ones. Its generally good at controlling costs, and lacks the 600 000 people who work at very good salaries in the insurance industry in the US, providing a gatekeeper function.
The Bismarck model uses an insurance system -the insurers are called "sickness funds"- usually financed jointly by employers and employees through payroll deduction. Unlike the U.S. insurance industry, though, Bismarck-type health insurance plans have to cover everybody, and they don't make a profit. Doctors and hospitals tend to be private in Bismarck countries; Japan has more private hospitals than the U.S. Although this is a multi-payer model -Germany has about 240 different funds- tight regulation gives government much of the cost-control clout that the single-payer Beveridge Model provides.
The Bismarck model is used in Germany, France, Belgium, the Netherlands, Japan, and Switzerland.
The national insurance type has elements of both Beveridge and Bismarck. It uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into. Since there's no need for marketing, no financial motive to deny claims and no profit, these universal insurance programs tend to be cheaper and much simpler administratively than American-style for-profit insurance. The single payer tends to have considerable market power to negotiate for lower prices, Canadas drug prices are one example. NI systems are used in Canada, Taiwan, South Korea etc.
And then there is out of pocket. In rural regions of Africa, India, and South America, hundreds of millions of people go their whole lives without ever seeing a doctor. They may have access, though, to a village healer using home-brewed remedies that may or not be effective against disease. In the poor world, patients can sometimes scratch together enough money to pay a doctor bill; otherwise, they pay in potatoes or goat's milk or child care or whatever else they may have to give. If they have nothing, they don't get medical care.
These four models should be fairly easy for Americans to understand because America has elements of all of them in the fragmented national health care apparatus. When it comes to treating veterans, America is Britain or Cuba. For Americans over the age of 65 on Medicare, Canada. For working Americans who get insurance on the job, Germany.
And for those who have no health insurance, the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you're sick enough to be admitted to the emergency ward at the public hospital. The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody.
And for those who have no health insurance, the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you're sick enough to be admitted to the emergency ward at the public hospital.
This is patently false. Completely and totally untrue.
Several years ago, my uninsured sister-in-law had a partial hysterectomy, followed a year later by a full hysterectomy. State of the art facilities, top-end everything.
The hospital system worked with them on the billing, based on their income. Their bill was reduced by something like 87%, and they were allowed to make reasonable payments. In fact, their monthly payments were considerably lower than it would have been to pay for health insurance.
The bottom line is that the uninsured in America are NOT without top quality healthcare. That is absolutely false. To compare them to those in rural India is absurd.
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