Is health care a right?

[dtwpuck]

First off... the argument that "socialized" anything reduces competition and innovation is a strawman.  Just take the Soviet Union as an example.  Over the seventy years of communism, there was absolutely no shortage of innovations and technological advances that came out of that country.  Let's not forget who got into space first.  I am not saying that the system of the USSR should in any way be emulated, please.  However, the promise of material compensation is not the sacred cow of human motivation.  However, it is a very powerful force.  To deny such a thing is silly.

That is not to say that universal health care is incompatible with the promise of material compensation.  However, the only people who should be compensated for genius should, in fact, be the geniuses... not those who happen to be good at marketing or happen to have the capital to invest in distribution.  Profit is OK to make, but not on the backs of the sick.   To me it is, at best, ethically dubious to base a healthcare system on profitability, and, at worst, the basest and worst so-called accomplishment of capitalism.

Ethics are not incompatible with business.    The world of business did not come crashing down because it was once decided that slaves have rights.  It adapted and changed to what was obvious to people of moral character.  The same will happen with this.

 

[aupointillimite]

So, Please stop telling me why I'm "wrong" -- I have close to the same goals as you -- tell me HOW WE DO IT-- or how you think it might happen or anything but why I'm wrong and why we SHOULD get there (because I agree with that point).

Mike

I don't know. 

I don't know.

I don't know.

But I imagine a step in the right direction would be to study... really study... how the implementation of Medicare and Medicaid was acheived (I know quite a few people on Medicaid... and it helps them and their babies... without it, they would be SOL, so I guess how messed up the system is lies in the eyes of the people using it), exactly how the systems in Canada, Australia, and Europe work, and how best to implement that here. 

Why do Americans suddenly become timid when it comes to this?  Everything else we do with gusto...  Walk on the moon?  Hell yeah!  Invade Iraq?  Fuck yeah!  Build interstates?  Where and how fast?  Universal health care?  Um... I don't.. no... can we?

What is that? 

[AlanBama]

good point, puck!

[AustinWesley]

I don't know. 

I don't know.

I don't know.

But I imagine a step in the right direction would be to study... really study... how the implementation of Medicare and Medicaid was acheived (I know quite a few people on Medicaid... and it helps them and their babies... without it, they would be SOL, so I guess how messed up the system is lies in the eyes of the people using it), exactly how the systems in Canada, Australia, and Europe work, and how best to implement that here. 

Why do Americans suddenly become timid when it comes to this?  Everything else we do with gusto...  Walk on the moon?  Hell yeah!  Invade Iraq?  Fuck yeah!  Build interstates?  Where and how fast?  Universal health care?  Um... I don't.. no... can we?

What is that? 

I agree with Benj.   It's not like we are all just proposing some totally incredible idea out of a science fiction movie.    There are plenty of models to look at in various countries.   I'd say compare them and see which is best and take the best ideas from each of these already existing entities and formulate a plan to integrate the system in the US.

[fearless]

Universal health care does not mean government control of everything.

As a society, you decide what the level of health care that each citizen is entitled to, and then you go about funding it. And it can and is done more cheaply and more efficiently than in the private sector. Just look at the facts, in the US you pay twice as much and more per capita for health care as any other industrialised nation in the world, and you get worse outcomes. It ain't working.

Our system is not perfect, but we consider it a right that people have access to a doctor, cheap medicines and hospitals for emergencies and reasonable access at other times. Our system does not cover dental or optical, unless you are on social security or disability. Those on social security or disability, pay much smaller co-pays and those with jobs pay more. It's give and take by the individual, for the greater good of the society.

We also have a thriving private hospital system. If you want private hospital coverage, to have immediate access for elective surgery, you can take out private hospital coverage, the same for optical and dental coverage (about $800-$1000 a year for a family).

In an effort to reduce pressure on the public system, if you earn over 60K (I think) you are compelled to take out private hospital coverage (about $500 per year) as a minimum, or you pay an extra 1% tax for the public system. You can still use the public system if you want.

My doctor is not paid by the government, he runs his own private practice. They charge me a fee and the government reimburses me a certain % of that fee. Doctors are free to compete and the prices fluctuate accordingly. My drgus are manufactured by private companies (Roche etc). They manufactue and sell their drugs just like in the US. There is no government control. But, we don't allow advertising of prescription medicinces to the general public, saving bucketloads of money for them. We have caps on public liability payouts to stop ridiculous amounts being awarded, which saves doctors and heaps on insurance costs. And overall, our admin costs are about 8-10%, instead of 20-25%.

I sit here amazed that you can agree to and fund an interstate highway system, but can't agree on some basic health entitlements. And, I bet you could probably fund a lot of it by spending less on roads and having private companies build toll roads and sharing the profits. Make interstates a user-pay system, and make basic health care a right.

You know it makes sense. 

[Dachshund]

If nothing else the debate about health care will be brought to floor of Congress this year. Here are four national, universal health care proposals before Congress. If anyone was so inclined you could check out the Congressional Record for details of each bill-it's less painful than it sounds. We will have this debate for one reason only...Democratic control of the House and Senate. For the last twelve years Republicans blocked any health care legislation from even reaching the floor. Freed up from their tyrannical Republican masters there is even a bipartisan Senate proposal on the table this year.

Also for the naysayers who continue with the mantra, "it can never happen here," it already has. Mass has passed (MassCare if you are interested) universal health care that all 49 states will be watching. CA, Oregon, Vermont and Maine have pending legislation. I believe Hawaii already offers health care for all. So you see there is movement towards health care and I believe I will see it in my lifetime.

Here are the pending bills:

The United States National Health Insurance Act (H.R.676)
This would replace the existing U.S. insurance industry and all public health care programs with a full-fledged single payer system.

National Health Insurance Act (H.R.15)
This bill would create a new, nationally funded national health insurance plan that would be nationally funded but locally administered and implemented

Medicare for All Act (S.2229 and H.R. 4683)
This plan would expand existing Medicare program to all

Healthy Americans Act (S.334)
This plan ensures all Americans have private health Insurance coverage equal to or better than the coverage provide to members of Congress through a fair, market based system.

So there you have it...and unless Karl Marx rises from the grave with his endorsement, we will have this debate.

[Cliff]

I believe the US will end up with universal health care, which is much different than socialized medicine (which is unlikely to ever happen).  I think Medicare/caid will be expanded to cover portions of the population now excluded from health care coverage.  The remaining population will be covered via new healthcare coverage obligations mandated by the government on employers and employees (i.e., requiring part-time workers to be covered, mandating that all employees must accept coverage, etc..).  How illegal immigrants (which make up almost 25% of uninsured Americans) will be covered is beyond me?  If everyone has (or is required to have) coverage, undocumented workers will stick out like a sore thumb.  But this issue probably isn't unique as many countries don't cover nonresident/illegals.  I would be interested in hearing how those countries deal with that population.

Someone mentioned inequity of income distribution as being an issue.   I agree.  You can't look at this issue in isolation.  Part of American disparities in health outcome (and crime, education, poverty stats, etc..) is directly tied to its extreme income distribution.  Solving that probably will go a long way torwards improving health outcomes for all.  We can only hope that the Democrats will put forth solutions to reverse the trend starting in the 90's, of professionals/high income earners grabbing an even bigger share of the pie.

Health care a right not a privilege.

[poet]

Going back to Mike's question: how?  Again, let's watch what is happening here in Massachusetts.  Four private companies have come out with what they were asked to do: this much coverage, these deductibles, etc.  The problem, which I posted earlier, is that the cost as seen in premiums, seems to be more than legislators can accept.  So the next question is does the state come in as it has with auto insurance and regulate health insurance premiums, does it back off from the free market approach in pricing?  How might it work if you accepted one of the existing programs?  You would pay your premiums to whichever company you wanted and would see the doctors who accept your insurance company as is true now.  What this clearly doesn't answer at this point is what about the paucity of dentists on the Cape where I live who accept MassHealth?  What about the limited number of doctors who accept MassHealth?  Where do these people find medical care, even if they have coverage by this form of insurance?  Win

[gerry]

...

[gerry]

Going back to Mike's question: how?  Again, let's watch what is happening here in Massachusetts.  Four private companies have come out with what they were asked to do: this much coverage, these deductibles, etc.  The problem, which I posted earlier, is that the cost as seen in premiums, seems to be more than legislators can accept.  So the next question is does the state come in as it has with auto insurance and regulate health insurance premiums, does it back off from the free market approach in pricing?  How might it work if you accepted one of the existing programs?  You would pay your premiums to whichever company you wanted and would see the doctors who accept your insurance company as is true now.  What this clearly doesn't answer at this point is what about the paucity of dentists on the Cape where I live who accept MassHealth?  What about the limited number of doctors who accept MassHealth?  Where do these people find medical care, even if they have coverage by this form of insurance?  Win

Win, I'd be very interested to know how it's playing out in Massachussetts.

[Miss Philicia]

I sit here amazed that you can agree to and fund an interstate highway system, but can't agree on some basic health entitlements. And, I bet you could probably fund a lot of it by spending less on roads and having private companies build toll roads and sharing the profits. Make interstates a user-pay system, and make basic health care a right.

Thanks for the additional comments I clipped out, and on what I Ieft just here you highlight a great point.  Americans have retarded priorities, that's the bottom line.  Unencumbered driving is a right... but not healthcare.  Frankly we should be incredibly ashamed.

And frankly I find the repeated charges of "I believe in the right, BUT IT WILL NEVER WORK" about the most frustrating one of all, and flies in the face of the fact that it indeed works all over the world, over and over and over.

[Bartro]

Just some observations of wasted healthcare dollars in my area.

There are four large hospitals in town.  They all have plenty of open beds all the time.  They have all become very competitive to attract patients (customers). 

Some examples.

All have valet parking while their parking lots are all located a few feet from their doors.
Birthing suites with whirlpool baths and an extra room with beds for family members.
One recently remodeled with mahogany trim and panelling throughout most of the facility.
Another has a grand player piano in the lobby with 75 foot ceilings and a bank of glass elevators.
A hotel resides on the top floor of one hospital complete with room service and deeply discounted prices for patients families.

MRI, CT scans and other diagnosics are all available on the same day ordered.  One place will even send a mobile MRI to your home at no extra charge.  Most of these expensive machines sit idle the majority of the time.

Only two of these hospitals accept medical assistance.  When you enter any of these facilities the first procedure is a "wallet biopsy".  If you've accidentally entered a facility that doesn't accept medical assistance they will give you a free ambulance ride to one that does.

Our city is the home to the headquarters of about a half a dozen health insurance companies.  They've tried to outdo each other in their building.  One of the buildings resembles the Crystal Cathedral in Garden Grove California.  The administrative costs of the hundreds of health insurance companies and their thousands of different policies are astronomical.

The cost of all of these things come from health care dollars.  Sure they are nice but unnecessary. 

[Lisa]

Well Hal kinda beat me to the punchline, but my thoughts have been leaning in the direction of simply expanding the Medicaid model(or something like it) to cover any citizen who does not have private insurance. I know that is probably not the best answer, but the system is already in place in every state now, though it is cleverly called by other names, it is still the same program. It can be modified, and updated or transition to another model, if something is more efficient, but the program already exists. Why do so many people believe that we need to sell some new abstract program to the masses, when we have one in place.

I tried to apply for Medicaid a couple of years ago, but was flatly refused because the government had not bestowed a disabled label on me yet, and again my records didn't contain the required terminology. When I went for my appeal hearing, this guy looked down his nose at me when I said I had AIDS, like I was making something up to garner his favor. I felt like something he just scraped off the bottom of his shoe. That was a very uplifting moment.

[libvet]

Some interesting points have been made concerning some of the systems by which we could implement universal health care.

The one issue that republicans (and the insurance lobby) will fight tooth and nail over is that if our country does allow insurance companies to continue to manage our health care in a public/private partnership is regulation. 

A few things that MUST happen in that scenario:

1) Health insurance must be unlinked from employers.

2) Pre-existing clauses MUST be eliminated. (They are pretty much bullshit anyway)

3) Insurances will not be allowed to dump people into high risk insurance, crap coverage insurance pools.

4) Premiums increases must face a regulatory board that takes real costs into account.

5) Insurance companies will not be allowed to cherry pick.

6) Insurance companies will be required to enter into binding arbitration of an independent review commission for any denial of coverage for a specific test or procedure.

7) Corporations that operate in the US will no longer be allowed to claim their headquarters is located at a mailbox in Barbados to avoid paying corporate taxes (such as that one mile stretch in Barbados that has somehow managed to use space so efficiently that 16000 corporate headquarters are located there). 

Open-enrollment must be allowed once a year.

Those are a few things that going to have to happen to make it work.

[libvet]

And frankly I find the repeated charges of "I believe in the right, BUT IT WILL NEVER WORK" about the most frustrating one of all, and flies in the face of the fact that it indeed works all over the world, over and over and over.

Yeah, I find that frustrating as well.  It's the same thing with those who want to dismantle public education.  Every country that is outperforming our students in education is using public education.  So obviously, it's not a matter of something being inherently wrong with having public education, it is something our implementation that must be lacking. 

This whole notion that the private sector does everything better is another thing we need to discard as a bogus idea too.  While it certainly true that the private sector does some things better, I don't fancy the idea of having to hire my own police force, fire department, judges, buy my own roads, etc....

And I'll be really honest, I find 95% of the arguments for dismantling public education (the most often used example of why universal health care will never work in the US) sorely lacking in sincerity and extremely self-serving.  The vast majority of those who want to dismantle public education want to do so for reasons that have less to do academic performance and more to do with not liking the curriculum because it conflicts with their faith (evolution, geography, sex education).

[FiercenBed]

yes!

[northernguy]

... But clearly the government is not the solution. You keep bringing up Canada, My company which has developed a product that has gone from 2% market share to 40% market share in 5 years (The machine really is THAT good) has been unable to sell it in Canada because it wasn't on the government approved list of manufacturers..

Again, a typical bugaboo that those in the USA like to bring up.  Yes, I'm sure your machine is very nice and works better than the previous model.  But what is the real, quantifiable difference to patient care?  The proof would be in the numbers - since Canadian life expectancy is greater than the US (by a significant margin) your scenario doesn't hold.  It would be interesting to drill down to more specific scenarios, ie survival rate for HIV, cancers etc, perhaps someone else cares to do that.  The feeling here is that US doctors in many cases send their patients for unecessary, expensive tests and perscribe unnecessarily expensive drugs.  It might also be noted that malpractice suits here do not reach the outlandish proportions they do south of the border, which takes some financial pressures off docs and their insurers.

[Miss Philicia]

But we're America!  We do everything best!

[RapidRod]

We've done okay here in America. We're not perfect, but we try. 

[northernguy]

This debate ends up being more about national pride than health care.

No, but I am intensely proud that my country puts the health of it citizens before weapons.  And that we were one of the 1st to recognize gay marriage.

A joke here used to be that Bush Sr's "kinder, gentler, America" exists...its called Canada

[Cliff]

The US is more than just Iraq and a fragmented health care system.  When the debate ends up being a pissing contest amongst nations, then it just puts some Americans on the defensive (some being the key word here)....and that leads nowhere (though maybe it makes the Canadians and Europeans feel that much better about themselves and their imperfect systems).  For all this talk about folks loving governmental health care, I find it odd that those who can afford to do so, can't wait to opt out of the system in favor of private health care.  When I received job offers (UK), they all highlighted their private health care schemes.  When I started working for a UK company, that was one of the first things my coworkers helped me set up.  Why?  And I quote ("if you need surgery or have cancer, you don't want to wait on the NHS").

Nope, the US is not perfect.  No federal gay rights.  No universal health care.  More crime.  More poverty.  Yadda, yadda, yadda.  All widely known facts.  But if given a choice, I would choose the US over Canada in a heartbeat.  But maybe that's about pride (and that maybe life is complex).   

I can appreciate that my view is from someone who has always had health insurance, and that maybe my view would be different if I didn't.  But, I can't change that.  And I also can't change the fact that I preferred my US HIV treatment care over what I receive in the UK.  It's great and all (NHS), don't get me wrong.  If I need meds, I can get them.  But I feel like a number, not a person.  I have folks shuffling me from one office to another (i.e., passing the buck between the GP and the HIV clinic).  The government and its rules have too much say over my care (and rightfully so, since they are picking up the tab).  I have little choice (GP must reside in assigned my area....and I'm assigned a HIV doc).  If I need to see the doctor urgently or if I go to the minor emergency centre, I wait all day and still may never see anyone.  If I need to see a specialist it takes ages as there are waiting lists.  The clinics are very old looking and the technology looks outdated.  I had to deal with none of this in the US.  Granted, again, it's probably because I've always had good health insurance....but the fact that most Americans have health insurance and have immediate service is rarely discussed here (and probably factors into why so many are uncomfortable with changing the system radically).  People only focus on those that don't and then assume that the entire system must suck.  It doesn't.  It needs to be fixed, yes.  Much needs to be changed.  But it's not all gloom and doom.  There are some real benefit to the US system.

[Dachshund]

No one is seriously going to argue with the quality of the health care you receive in the U.S if you have the best private insurance or the personal wealth to afford the best health care. I firmly believe that 48 million uninsured Americans would put up with the "inconveniences" of any civilised nations health care system for the security or peace of mind of health care coverage.

You can't compare the systems when America has no system to be compared with. What I can compare is having health insurance and not having health insurance and I will let you guess which one is better. There is nothing more debasing than depending on ADAP for your survival. Nothing more frustrating than not knowing if this time I won't be re-certified because I made fifty dollars more a paycheck this year than I did last year. Nothing more frightening than being refused a catscan because Adap does not cover it. Nothing more humiliating than knowing I might be forced to beg Lisa for my meds.

So try as we might we can continue to compare and contrast...unfortunately here in America we have nothing to compare it with.

[RapidRod]

Dash, but you have the ability to buy additional coverage if you would like. Some of us don't that are on Medicaid and I will tell you my health care has been great and probably better than some of those that have good work provided coverage. I don't get second rate care, I'm not put on a waiting list to get tests ran or medication. Yes, there are some medications that aren't approved, but using the proper channels you can even get them. I just went through that process.

[Miss Philicia]

Basically it's an issue of morality as far as I'm concerned.

[Dachshund]

Dash, but you have the ability to buy additional coverage if you would like. Some of us don't that are on Medicaid and I will tell you my health care has been great and probably better than some of those that have good work provided coverage. I don't get second rate care, I'm not put on a waiting list to get tests ran or medication. Yes, there are some medications that aren't approved, but using the proper channels you can even get them. I just went through that process.

Yes, I looked into that...most plans did not cover pre-existing conditions and the cheapest policy I could find was $1800 a month not counting huge copays and restrictions. Out of pocket would be $8000 before insurance would even kick in. Please forward all the information you have concerning affordable additional coverage, I've never heard of it. I'm glad you have great coverage under Medicaid, just wish we all did and that is what this discussion is about.

[newt]

Being a Brit, I agree with a lot of what Cliff says.  Fact still stands, all residents have access to essential healthcare that's free at the point of need according to need.  True, we pay a shed load of taxes and do a lot of queuing (we like queuing).

Private medicine in the UK, good for routine stuff but when the going gets tough they, er, refer you to the NHS (it's just too expensive to make a profit).  And, bottom line, we live as long if not longer for half the per head spend on healthcare, and all those just-in-case MRI scans and nice chairs are really, medically speaking, unnecessary. 

Things in the UK need to change and improve, first of all the consultants need to get off the golf course on Fridays and do some surgery, and the management in the NHS needs to be management (er, bit more private sector please).  There are flashes of brilliance, like cancer treatment at UCL, where they put you in a nearby hotel suite, cos it's cheaper and less risk of infection, and dimbo stupid stuff like the hospital where the drunk consultant took out the wrong kidney TWICE and was still not struck off.  As ever, there are top hospitals and crap hospitals. And, living in the countryside, well things just suck. Confidentiality in the Shires? hmm....

Its universal access to care, not method of delivery/financing that counts.  There's no way you can compare the UK to the US easily, the perverse incentives in each system are different, and each has its merits/demerits.  But in the UK you will not meet people (legally resident) on the streets dying from OIs because they's uninsured and have no access to care, or (scandal this is) people whose life depends on annual re-approval of something like ADAP.  Indeed, not in Canada, NZ, Oz, France, Germany, Ireland, Brazil, fucking hell even Rwanda....

In the end, health care is a right, not an option, regrdless of system, like defence, water, sanitation.

- matt

[Dachshund]

Dash, but you have the ability to buy additional coverage if you would like. Some of us don't that are on Medicaid and I will tell you my health care has been great and probably better than some of those that have good work provided coverage. I don't get second rate care, I'm not put on a waiting list to get tests ran or medication. Yes, there are some medications that aren't approved, but using the proper channels you can even get them. I just went through that process.

I mean this with all do respect...how can you argue that Americans will never accept universal health care when you are presently covered under Medicaid? Your position on health care confuses me...you testify to great coverage, yet seem to be saying a system like medicaid would never work in America, yet it seems to be working for you.
I swear I am not trying to start an argument, but I must admit I am baffled by your position on this topic.

[RapidRod]

Medicaid is not a universal coverage. It varies from state to state. Ohio just happens to have a good coverage so far. I'll tell you after April how good it is since we have to change and pick a MCP. As of right now we are allowed to go to any doctor, hospital or clinic and after the MCP kicks in we are limited to where we go. I'm just lucky nothing has changed in my care. I keep all the same doctors and clinics. All of the hospitals that are MCP approved are receiving federal money. Private sector for profit hospitals don't and will not be able to accept MCP recipients, for anything other than for life threatening illnesses and injuries.

[AustinWesley]

I mean this with all do respect...how can you argue that Americans will never accept universal health care when you are presently covered under Medicaid? Your position on health care confuses me...you testify to great coverage, yet seem to be saying a system like medicaid would never work in America, yet it seems to be working for you.
I swear I am not trying to start an argument, but I must admit I am baffled by your position on this topic.

I think many people who are presently insured or have other means covering their medical needs or care are afraid if we rock the boat then they will somehow fall out.   

[libvet]

No one is seriously going to argue with the quality of the health care you receive in the U.S if you have the best private insurance or the personal wealth to afford the best health care. I firmly believe that 48 million uninsured Americans would put up with the "inconveniences" of any civilised nations health care system for the security or peace of mind of health care coverage.

Truth to tell, many of those "inconveniences" that you speak of exist for the majority of the insured already.

I can't remember the last time I was sick enough that I felt I needed to see my doctor and actually got to see my doctor the same day.

More often than not, I'll get told "We can get you into see the nurse practitioner in two days".   And this is with good health insurance (United Health) which not only do I pay a goodly portion of premium, last year, they changed it so I actually have a deductible for my lab work before they start to cover that, and THEN after the deductible, I have to pay a percentage of the lab fees.  Two years ago under the same plan, I paid my premium and a co-pay for the office visit and that was it.  It's certainly not breaking my budget at the moment, but it is going further and further toward that.

Last time, I had conjuctivitis so bad I could barely see my computer scree (and that's what I do all my tasks at my job on) and when I called my doctor's office for an appointment, they almost laughed in my face at the notion of me getting in that day.

I ended up going to an in-network minor emergency clinic, had to fill out a shitload of paperwork and pay a co-pay of 50 dollars.   And the truth is, I hear the same kind of stories from people with other doctors and other clinics, so it's not a matter of just switching doctors.

And anyone who claims that there is no waiting in the US is kidding themselves.  When I was first diagnosed with HIV, there were approximately 3 doctors in town that had any experience with treating HIV.  I was able to get an appointment with the one that was the most qualified and recommended by the ASO and had been working with HIV patients since 1987, but it was a 3.5 weeks before they could "squeeze me in" for a full work up.   This was at a time when it was obvious that I was in pretty bad shape (on FMLA for almost 2 months with pneumonia, esophageal candiasis, and weighed 110lbs). 

About 2 years later, I got the joy of having my job outsourced to India.  I looked at COBRA and that was totally a joke...as if I could pay the price they wanted while on unemployment?   Fortunately for me, there was enough warning time of our site closing that I was able to get in on my boyfriend's coverage during open enrollment.

It seemed like every other option than that involved a huge wait.   I even tried applying for Medicare and/Medicaid and was denied because I made too much money in the year before that (as if that really had any impact on what I was making right then).   And I had to be denied that before they could try to put me on the waiting list for any emergency coverage.  We even looked at my veteran status and there is a waiting list there as well.

I managed, but isn't HIV enough of a burden without the joke that health care is becoming in our country? 

The inconveniences that I have heard from people in first world countries with universal health care seem pretty minor compared with my experiences with the so-called "best health care in the world".

When people use that last term, I am sure they are correct in some respect.  There are a few hospitals that can perform a six organ transplant, but how many people actually need that kind of care? 

Most people just need decent affordable health care that doesn't vanish the moment their employer decides to skip town or drops coverage because the premiums are too high.  They don't need the kind of health care one would expect the president of the United States to get.

Then you get things like that lady at Wal-Mart that was fired because a vendor offered to donate some cupcakes to help her raise money for an life saving operation for husband that her insurance wouldn't cover.  Apparently that was viewed as a "kickback" and she was terminated.

Or the elderly lady I work with who was fired because her FMLA ran out one week before she could return to work after extensive chemotherapy.

Or the woman I work with who would leave work for two hours to get her radiation therapy for breast cancer and have to come back and try to make it through the rest of the day so she wouldn't lose her job and health insurance.

I am certainly no attacking your position.  I agree with you...the inconveniences you brought up that we hear from other systems seem to pale in comparison to inconveniences we face right here in this country.

[Cliff]

So try as we might we can continue to compare and contrast...unfortunately here in America we have nothing to compare it with.

Agreed.

Its universal access to care, not method of delivery/financing that counts.

Matt, I agree with everything you just said, except for this one statement.  In an abstract, non-realistic sorta way, universal coverage is the only consideration.  But in the reality, I believe the method of delivery and financing is hugely important.  It is the method of delivery and financing that explains why the US hasn't move towards serious consideration of universal coverage.  Those who have good health insurance (and let's face it, they are the ones who are most likely to vote) do care about how health care will be delivered (to them) and whether or not they will a) pay more to cover others and b) will accept lower standards of care to cover others. 

Saying universal health coverage is a right (and poopooing the US for not having it) is a no-brainer.  Easy target practice America makes....  It's how you get there (and more importantly pay for it) given the current fragmented state of affairs that remains the difficult discussion.

[FiercenBed]

i work w/ doctors and hospitals.....b assured health care in america is in meltdown.

[Ann]

One of the consequences of people being denied basic health care is people being diagnosed with serious conditions further into their development. This ends up costing far more, in many cases, than it ever had to. Especially for conditions that can be cured or slowed down if caught early.

The old saying comes to mind - an ounce of prevention is worth a pound of cure.

Ann

[bocker3]

A few things that MUST happen in that scenario:

1) Health insurance must be unlinked from employers.

2) Pre-existing clauses MUST be eliminated. (They are pretty much bullshit anyway)

3) Insurances will not be allowed to dump people into high risk insurance, crap coverage insurance pools.

4) Premiums increases must face a regulatory board that takes real costs into account.

5) Insurance companies will not be allowed to cherry pick.

6) Insurance companies will be required to enter into binding arbitration of an independent review commission for any denial of coverage for a specific test or procedure.

7) Corporations that operate in the US will no longer be allowed to claim their headquarters is located at a mailbox in Barbados to avoid paying corporate taxes (such as that one mile stretch in Barbados that has somehow managed to use space so efficiently that 16000 corporate headquarters are located there). 

Open-enrollment must be allowed once a year.

Those are a few things that going to have to happen to make it work.

I think you are on to something here (contrary to what some think, I'm not in the "It should but can't happen here").  This sounds like the right way to start this switch.  I'm sure that it would evolve over time -- but of course, first we have to elect some folks to Congress with the balls to serve the people who put them there and not the deep-pocketed corporations.

I would add one more step:
9)  Employers should take what they had been paying for an employees health insurance and either put it in the "pot" to pay for this -- OR give it to the employees as an increase in wages, so help offset the needed tax increase.  Do NOT put it into the company's profits.

Mike

[Dachshund]

Bush's budget proposal for 2008 will request a total of 245 billion to finance the war in Iraq and Afghanistan through 2008. He will propose squeezing about 70 billion in savings from the Medicare and Medicaid health programs over the next five years...if Al Qaeda don't get ya, your cancer will!

[libvet]

Bush's budget proposal for 2008 will request a total of 245 billion to finance the war in Iraq and Afghanistan through 2008. He will propose squeezing about 70 billion in savings from the Medicare and Medicaid health programs over the next five years...if Al Qaeda don't get ya, your cancer will!

I'm going to come right and say it:  I hate that blackhearted bastard in the White House.

Always enough money for Afghanistan and Iraq, never enough for Americans.

I think we could fund a universal health care system by selling tickets to piss on his grave when he finally chokes on his last pretzel.

[squareman]

I find it odd, living in a country which set up its socialised health system with a loan from the US ( after WWII, where, after the Queen, the NHS is our most cherished institution (and biggest employer), that the US has people in need of lifesaving medicine on waiting lists for the drugs.  Re: "personally, I'd be willing to wait a bit more for the price tag", we live as long, if not a bit longer, in the UK compared to the US for half the per head expenditure on healthcare.  I do not say everything is perfect, you can't get an MRI at the drop of a hat, the chairs ain't always comfy, clinics can be a bit shabby etc, but as far as essential medical interventions go, I wouldn't be anywhere else.  Esp. for HIV. Even the most hardline conservative politicians say "if you want to get elected, don't fuck with the NHS".

- matt

Now playing: Radio 4, Today programme

You're right I almost forgot about that. After WWII the whole of western europe got huge loans from the US(Marshall Plan)to rebuild the continent. One of the things that happened in all of western europe during rebuilding was the creation of a social security system. Probably European society at that point could see the benefits very clearly having just suffered tremendously under german oppression. I personally regard social security (and mainly healthcare) as the only good thing to have come out of WWII. It was created and Europeans saw the necessity when they saw 50 million people loose their  lives and twice that number getting injured during WWII.

And I for one am not willing to do away with the system. It does explain however why at that point in time the US society did not see the need for such a system as the war was fought on foreign soil and I guess the military people that got injured did enjoy somekind of healthcare/health insurance.

[Dachshund]

Lawmakers expressed " sticker shock " over President Bush's proposed 2008 budget, which estimates 300 billion in new Iraq spending and 100 billion in cuts for Medicare and Medicaid. The budget also would " provide insufficient extra cash to maintain coverage for poor children currently enrolled in the Children's Health Insurance Program. " Hmmm, I wonder what other programs will be under-funded in the new budget? Care to make a guess?

[Grinch]

Everyone is entitled to an opinion. If you want to hate someone great I understand that. Would I like to see us get out of Iraq? Absolutely.  In fact don't ever vote for me for president because I'd lock down our boarders for a couple years and tell the rest of the world to piss on themselves.  We have our own problems right here.  When and only when our problems are solved would I even think about sending a single dollar to some one else.
 That being said why does everyone on this forum think George Bush is to blame for this? The guy has a finite amount of money to spend.  He chooses to spend it in a manner you disagree with.  OK  I get that.  My issue with your complaints is this.  The problem existed long before Jan 2000. The wonderful Mr. Clinton had the same 8 years to fix it.  He didn't.

  People have talked about our wonderful roads.  Please go visit the big dig OK?
People are claiming how wonderful Social Security is.  Is this the same Social Security that is tapped by every single congress since its inception? Please don't tell me you think there's just a pile of money somewhere that gets handed out as needed.The same Social Security that will likely be bankrupt in a few years. The same Social Security that many members can't get any money from even though they are permanently disabled?

  There is a finite amount of money folks.  Those people that do work can't support any more "government funded" programs.
Every Marxist/communist/Socialist society that has been tried has failed (Yes I know China and Cuba, China has developed a free market system).  It looks great on paper but everyone is forgetting about human nature.  Until you solve that little issue you can't have this wonderful society in which everyone is completely equal. Where no one has something that everyone else in the world doesn't. Aspiring to new heights is what drives us. It's who we are.

   How many people do you know that choose not to go back to work because they make more money on disability?  I know several. That is one of our problems.  We see nothing wrong with that. Before you scream. "See! everyone should make exactly the same money!" Let me ask this.  If your job in the utopian society everyone thinks will exist if we socialize everything is a really sucky job, say... chicken shit scooper upper at the chicken farm.... If that's your wonderful job and 100% of your wage goes to taxes, then the government allows you to live in one of it's houses, and eat it's food, which you're helping provide, If thats it...you can never get a bigger house or car, would you be motivated to go to work every day?  Would you be motivated to invent a better way to scoop chicken shit? Would you be motivated to go to school at night?  Oh wait....you couldn't...you have no money, the government has it all.
 The Universities are only for those that did well in high School or know an official anyway.
If that's your idea of utopia, please I beg you move somewhere that embraces those ideas. For all it's faults I believe in the free market system, I believe in America. If you truly hate this country so badly that you want to change the fundamental way of life, and you want to force those changes on me PM me  I will gladly send you a one way ticket to the utopia of your choice.  You can't ever come back though.
  If however you want to propose a way to ensure health care for those that don't have insurance in a manner that doesn't give the government any more control than it already does.  Please lets hear it.  Maybe we could get a law maker interested.

[Dachshund]

If nothing else the debate about health care will be brought to floor of Congress this year. Here are four national, universal health care proposals before Congress. If anyone was so inclined you could check out the Congressional Record for details of each bill-it's less painful than it sounds. We will have this debate for one reason only...Democratic control of the House and Senate. For the last twelve years Republicans blocked any health care legislation from even reaching the floor. Freed up from their tyrannical Republican masters there is even a bipartisan Senate proposal on the table this year.

Also for the naysayers who continue with the mantra, "it can never happen here," it already has. Mass has passed (MassCare if you are interested) universal health care that all 49 states will be watching. CA, Oregon, Vermont and Maine have pending legislation. I believe Hawaii already offers health care for all. So you see there is movement towards health care and I believe I will see it in my lifetime.

Here are the pending bills:

The United States National Health Insurance Act (H.R.676)
This would replace the existing U.S. insurance industry and all public health care programs with a full-fledged single payer system.

National Health Insurance Act (H.R.15)
This bill would create a new, nationally funded national health insurance plan that would be nationally funded but locally administered and implemented

Medicare for All Act (S.2229 and H.R. 4683)
This plan would expand existing Medicare program to all

Healthy Americans Act (S.334)
This plan ensures all Americans have private health Insurance coverage equal to or better than the coverage provide to members of Congress through a fair, market based system.

So there you have it...and unless Karl Marx rises from the grave with his endorsement, we will have this debate.

You want proposals...here are four I listed for discussion. I really don't know where to begin with the rest of your post but I will try. If you bothered to read all of the posts... no where, and I mean no where, did anyone advocate emulating health care systems of China, Cuba, or any other communist nation. We , for the most part, were comparing Western Europe, Canada and Australia, all which provide health care that is financed both publicly and privately. Yes, there are people on disability who cheat the system, but I doubt they are living the high-life...but the money lost pales in comparison to the corporate welfare cheats located off our fair shores. As for Clinton...seems to me he did bring health care up for discussion, only to have it sand-bagged by corporate controlled Republicans. If by hating someone "great" you mean George W. Bush I will let history judge his greatness. I do consider this budget his fault because it is based on financing of a war he lied us into.

The rest of the silliness you post is so off-base and intellectually dishonest that it does not deserve a response. Now that said, what would be your health care solutions and do you believe health care is right?

[libvet]

Grinch, I haven't heard anyone say that they hated America and if that is all you got from reading this thread, then it doesn't speak well of your reading comprehension.

America's health care system is in trouble.  BIG TROUBLE.   Trouble to the point that 90% of the people I work with in a job in the health care field are facing a pay cut when you match our increases in health care premiums with our pittance of a raise.  Trouble to the point that 47 million Americans have no health care at all and many of those people are working 40-60 hours a week.

And I will never understand people who think government-funded is such a horrible thing.  Does it bother you that our schools our government funded?  Does it bother you that the police and fire department are government funded?  Does it bother you that the roads you drive on are government funded?

In case you didn't bother to read the constitution WE THE PEOPLE are the government.   If we go to a government funded system, WE THE PEOPLE are the ones that are going to be paying for it.  The only difference is that instead of a for-profit insurance company jacking up your health care costs and premiums to enrich themselves at the expense of people who need health care, it will be paid for with our tax dollars. which in turn would be offset by the fact that we no longer are beholden to our employers to provide us with group coverage and make us act like beggars in our society.

And that old chestnut of "China and Cuba" being the propaganda tool to shut down discussion about making positive change to fix a system that is in crisis is a tool that might play well on the Rush Limbaugh show, but not reality.   Canada, Great Britain, Australia, Greece, France, Israel, Ireland, Japan, New Zealand, The Netherlands, Norway, Poland, Portugal, Spain, Austria, and Belgium have somehow managed to make sure that their citizens have access to basic health care, but the richest and most powerful country in the world CAN'T?

Is that really your thesis?

I've been in the position of losing my so-much-better health due losing my job (mostly due to no fault of my own, unless you think that my campus was destroying Microsoft by making an average of 15 dollars an hour to do work they need....most of us with 4 year degrees).    Now I work in a position that I have to see our "great system" in action to the point that I have to send out hundreds of letters a day returning their unfilled prescriptions either due to inability to pay or non-coverage.

Is that your idea of a success story?

As for your detour into some marxist fantasy of everyone getting paid the same regardless, that is just drivel.  No one has suggested anything of the sort.

Try addressing the real issue of people being tied to a job they hate because they can't afford to lose their health care.   Or try addressing the fact that many of us, even with college degrees (and I am one of them) finding more and more and more of our paychecks being sucked up by insurance companies and returning less and less every year.   

And you think you have "choice" now?  The only choice you have is what your company can or will choose to offer for health coverage and what doctors, hospitals, medications, and procedures your coverage currently decides you should get.

Two other things.  People blame Bush (who has been president for more than half a decade) when he wants to funnel money from the most vulnerable and needy in our society and give it his war.  That's not the "Government's money".  It's OUR money.  American tax dollars. The other is I recall Clinton trying to fix our health care problems more than once and he was shut down by the republicans who held congress for the last 12 years.

Further, I would submit that while the rest of us have been openly discussing the problems in our health system as it stands and thinking of ways that it could be streamlined and corrected and changes that might help fix what you yourself admit is a system that has real troubles, you presume to lecture us and call us out as a bunch of commies and America haters for discussing the issue and try to make us feel ashamed for trying to reach that more "perfect union" our forefathers spoke of and trying to better our country's health care, you have offered nothing in the discussion as to how to fix the very real problems that exist in our health care delivery in the United States.

As the right wing talking heads are so fond of saying:  What's your plan?  Keep the status quo that is deteriorating faster and faster?

If you have some ideas to offer, by all means, I am open to hearing them, but I won't be lectured for having the wherewithal to discuss how to make our system more fair and equitable and provide access to all who truly need it.

[RapidRod]

libvet, I've never heard so much crap in my life. You have terrorists on our soil, with suicide bombings and bombings of the tunnels, bridges and rail systems, telecommuncations and health care is going to be the least of our worries because you won't have any of the supplies needed. This country runs on transportation. Now do we fight them there or do we handle it on our soil?   

[Grinch]

I had no intention of calling anyone great.  I meant Ok...great.

Your solution's all call for government controlled health care. I am simply arguing against that.
I at no time personally attacked anyone.  I at no time personally called someone dishonest, stupid or beneath discussion.
I laid out thoughts as I see them.  Why then, when presented with an opposing view must everyone insist on calling names, focusing on grammar and punctuation, or dissecting a post to take things out of context.

Regarding publicly funded police, fire, and schools. They are all pretty bad. In a town of 2000 in the middle of no where our police department insisted they needed the tax payers to buy them M-16s! The fire department... Millions in equipment and overtime, yet they have never saved a single house. Schools? Have you had any high school graduates come work for you lately?

Choice?  I have a choice.  If I don't like the health care offered by my employer I change jobs. My original post stated a federally funded program would drastically slow research and the advancement of technology.  If you take the financial rewards out of the system, advancements slow. There is no incentive. The countries mentioned that have government controlled and run health care have not produced many new technologies or procedures. Where do the worlds leaders come for treatment?  Where would you go for treatment if push came to shove?  I fully believe that if I had been in a heath care system in which my treatment was government controlled I would have died.  I "saw" several people with Burkitts die because the government mandated which chemo regimens they could have.  My doctors could and did try things that were not the "norm".

Why did I delve into Marxism?  Every post suggests that our health care be completely funded by the tax payer. Every day our society tries to add more government control. All these programs take money.  Where does this money come from?  Increased taxes.  I already pay nearly half of my pay to different taxes and "fees".  Where does it stop?  Do you really believe we have enough free cash floating around to provide "free" health care for the world?  How will you prevent anyone from any where in the world from coming here, discovering they need a heart transplant and demanding we provide it?

My thesis is simple, We can't afford "free" health care.  The government does not do much of anything well, or efficiently.  Free health care will stifle progress of new technology, drugs, and procedures by taking away the financial incentive.

[RapidRod]

Grinch, you won't get me to disagree with you, but then, I believe the United States is one of the best places to live. Look at the illegal immigrants, they must think so too. 

[ACinKC]

I always blame Bush.  Everything is his fault.  When are you going to realize this.

The faster this man stops using up my oxygen the happier I will be.

[ACinKC]

Grinch, you won't get me to disagree with you, but then, I believe the United States is one of the best places to live. Look at the illegal immigrants, they must think so too. 

I can make this statement and the following statement and both are true independently of each other as well as concurrent TO each other.

Bush is a douchebag.

[Grinch]

I can make this statement and the following statement and both are true independently of each other as well as concurrent TO each other.

Bush is a douchebag.

Regardless of my position on that statement, I will never argue your right to state this opinion publicly.

[Dachshund]

The argument that universal health care will some how signal the death knell of laissez faire, capitalistic America is ludicrous on its face. In fact, statistics prove it would do just the opposite by freeing up private capital once used to cover sky-rocketing employee health care costs. Most economists and big business agree that health care costs hamper a company's ability to compete globally and would significantly level the playing field. Why do you think foreign car manufacturers continue to out-pace their American counterparts in research and development? The idea that countries with universal health care create a climate of stifled progress is ridiculous...patents for new drugs are being applied for that were developed by European pharmaceuticals...and universal health care has not destroyed their bottom line. Toyota leads the way in the "development" of fuel efficient cars...universal health care didn't strip their creativity. French doctors discovered the virus responsible for HIV all the while under the thumb of universal health care.

However, whenever a thread veers to the right it is always the same, tired ol' argument...immigrants, commies, socialists, terrorists and of course, "true Americans" would never go for this. Did I forget anyone? Oh yes, Bill and Hillary must always be used in the argument...without fail. The other thing that amazes me is when people argue against universal health care and are covered by the same system they argue against. If I believed the argument against these programs I would refuse my government supplied coverage, seek out private coverage and THEN argue the merits of no universal health care coverage for all.

[RapidRod]

That's something that we'll never have to worry about, because it is not going to happen. Terrorists, is something that we have to deal with and we've already have seen it happen.

[Grinch]

I don't believe that comparing cars to medical devices is apples to apples. If you propose giving a free car to every citizen I think you'd see a significant slowing of technological advancement.  If you had the contract to provide all the cars for the country, why would you bother creating bigger, better, more fuel efficient?  Your sales are guaranteed. That is my fear if the government model of health care is adopted.   Why would anyone bother inventing some new unusual feature when there is no one to sell it to?

  Just to clarify. I have a very detailed and working understanding of the process. I am a sitting and voting member of several committees that work with the FDA, Congress and other agencies, that limit and regulate the introduction of new medical devices to the US and World wide market place These committees are made up of a multi-national membership to include nearly every industrialized country in the world.
 There is no conjecture, or guessing on my part. Our biggest challenge is bringing life saving devices to market in a timely manner. These issues are time consuming and expensive in the US.  All but impossible in many countries. Some countries simply wait and see how it works in the US.  The countries that tend to take the wait and see approach are typically those that have "Universal and free health care"

Call me ludicrous if that makes you feel better. Too bad name calling is perfectly acceptable when you argue the "correct" side of an argument but expressly prohibited when you're on the "wrong" side as dictated by the members of this forum.

   I interjected my point, I asked for solutions to the problems present in todays health care system.  I acknowledged there is a problem.  I said, give me an answer that does not include letting the government "solve" the issue.  What I received in return was being called names, being accused of having poor grammar, (this coming from an individual that so idolizes a porn star he uses it for an avatar) and a host of other wonderful things. Bottom line is simple, people like me are making the recommendations to congress while people like you sit and cry about how horrible life is.  I asked for an answer because I really would like a solution, and because I am in a position to possibly help change things. The response was typical. "Let the government do it!  George Bush Sucks! George Bush Hates me!

I'll not bother participating further in this discussion, like every other two sided discussion here, if you don't agree you get called names or ridiculed.  Please go back to the porn discussions, it's what folks here do best.

Thanks for your time.