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Universal Health Care: from someone who lived under both ...

enacting a first world health care access model is going to require voting out a lot of naysayers. that's the only clear path to it that i see.
 
Slavister said:
... one big reason why Universal Health Care is sane - time and worries saved

A good article here comparing what it's like.
Click to expand...

I've experienced both healthcare systems (UHC and the cluster****/hodgepodge patchwork that is the American healthcare system) as a dual national (Canadian/American).

I vastly prefer the Canadian healthcare system, and find US healthcare utterly baffling in its waste, expense and inefficiency, and an obvious product of profit motive married to systemic political corruption (otherwise known as campaign finance and lobbying).
 
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Checkerboard Strangler said:
I can't help it you didn't bother to specify. If we're talking about Uncle Sam, it's a lot different than talking about state and local governments. For instance, when tiny, almost microscopic Vermont tried their own UHC it failed, because it is such a small risk pool that the math wouldn't work.

Canada however, has a system even more involved than the single payer model most Americans seem interested in, among those who are looking at alternate models.
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You are not recognizing the problem. The problem is provider prices not the cost of insurance. The reason it didn't work in
Vermont is not because of the small risk pool. It didn't work because Vermont has to pay 10k per person per year, whereas Canada only has to pay 5k per person per year.
 
aociswundumho said:
You are not recognizing the problem. The problem is provider prices not the cost of insurance. The reason it didn't work in
Vermont is not because of the small risk pool. It didn't work because Vermont has to pay 10k per person per year, whereas Canada only has to pay 5k per person per year.
Click to expand...

And how do you suppose the prices get cut in half for Canada?
 
How much gets siphoned off to the government labor unions, making it a slush fund for leftist political candidates? That's the REAL motivator for government health care.


Northern Light said:
People are going to have to pay for health care either way. The difference is that when government is the payer, the government can negotiate for lower costs because the profit motive is much less. This keeps households solvent, which helps the economy.

This idea of "your health care isn't free, someone still pays for it" is oversimplified. Of course someone pays for it, but they pay less, and costs are distributed over an aggregate population instead of a multi-tiered one. Household bankruptcy is a bane on domestic economy and lack of health insurance is a prime reason for it.
Click to expand...
 
aociswundumho said:
You are not recognizing the problem. The problem is provider prices not the cost of insurance. The reason it didn't work in
Vermont is not because of the small risk pool. It didn't work because Vermont has to pay 10k per person per year, whereas Canada only has to pay 5k per person per year.
Click to expand...

Whether it is $5K/person annually is not the issue - obviously the typical (median income) 4 person household is not going to be paying "only" $20K/year since 1) that is not affordable (on a median household income of $60K that is a 30% tax for medical care alone) and 2) that leaves no surplus to subsidize those required to pay less than that $5K/person annually - keep in mind that Medicare premiums are now (typically) under $2K/person annually.
 
How much does malpractice insurance figure into those provider prices?

aociswundumho said:
You are not recognizing the problem. The problem is provider prices not the cost of insurance. The reason it didn't work in
Vermont is not because of the small risk pool. It didn't work because Vermont has to pay 10k per person per year, whereas Canada only has to pay 5k per person per year.
Click to expand...
 
aociswundumho said:
You got it backwards. Prices don't get cut in half in Canada, they get doubled in the US.
Click to expand...

How do you suppose this happens? Would it have anything to do with the fact that Canada is able to exercise more leverage re prices?
 
Slavister said:
... one big reason why Universal Health Care is sane - time and worries saved

A good article here comparing what it's like.
Click to expand...

Ok but they are basing their judgment on out of pocket expense. If I shattered my elbow and needed surgery, I would likely have it within a day, two at the most and not have to live two weeks with a shattered elbow. My perpetually uninsured brother shattered his foot about 4 pm and underwent surgery the following morning. Sure he got a giant bill for it, but he never paid it. He lost his job because he couldn't work with a broken foot so they didn't have anything to do a garnishment on. He didn't own anything they could put a lien on. Eventually they just gave up trying to collect anything from him.
 
Drawdown said:
Ok but they are basing their judgment on out of pocket expense. If I shattered my elbow and needed surgery, I would likely have it within a day, two at the most and not have to live two weeks with a shattered elbow. My perpetually uninsured brother shattered his foot about 4 pm and underwent surgery the following morning. Sure he got a giant bill for it, but he never paid it. He lost his job because he couldn't work with a broken foot so they didn't have anything to do a garnishment on. He didn't own anything they could put a lien on. Eventually they just gave up trying to collect anything from him.
Click to expand...

If you have a bone fracture in the UK you do not wait for two weeks with it. Not in Canada either.
And your perpetually uninsured brother took a monster hit to his credit rating, so maybe that's part of the reason why so many in this country are in bad financial shape despite all the record jobs, despite the monster stock market numbers, despite everything.

Forty percent of working Americans and legal residents do not have enough savings to handle a four hundred dollar emergency.

Anyway, universal health care does not equal living with a shattered elbow for two weeks.
MYTH.
 
Slavister said:
... one big reason why Universal Health Care is sane - time and worries saved

A good article here comparing what it's like.
Click to expand...

Yea, lets just completely ignore the Supreme Law of the Land that prohibits the federal government from involving itself in our healthcare, right? I mean, who needs restrictions on government? We all want an all-powerful fascist government stealing our liberties and dictating how we should live, right? :doh

Nobody ever accused the anti-American left of being particularly bright.
 
Checkerboard Strangler said:
How do you suppose this happens?
Click to expand...

I'm going to do a post on it in the healthcare section soon.

Would it have anything to do with the fact that Canada is able to exercise more leverage re prices?
Click to expand...

Well, you're on the political left. Healthcare is a service, it's all labor. Is driving down the salaries of doctors and nurses and every other cartel member who works in a price-gouging American hospital something you would support? Typically the left stupidly supports "the worker" and the associated labor cartels.
 
Checkerboard Strangler said:
If you have a bone fracture in the UK you do not wait for two weeks with it. Not in Canada either.
And your perpetually uninsured brother took a monster hit to his credit rating, so maybe that's part of the reason why so many in this country are in bad financial shape despite all the record jobs, despite the monster stock market numbers, despite everything.

Forty percent of working Americans and legal residents do not have enough savings to handle a four hundred dollar emergency.

Anyway, universal health care does not equal living with a shattered elbow for two weeks.
MYTH.
Click to expand...

The OP says clearly, "My NHS surgeon was able to schedule me in for the three-hour surgery less than two weeks after my fall,..." and if your click on the link for the whole story you will find, "The comparative ease and security of the NHS is why the system retains such high levels of support from the British public, despite frustrations with wait times and other aspects of service provision.

As for that particular brother, I imagine this was just another drop in the bucket as far as his bad credit. Whenever some garnishes his wages, he just quits and goes somewhere else until they track him down, rinse and repeat.....
 
aociswundumho said:
I'm going to do a post on it in the healthcare section soon.



Well, you're on the political left. Healthcare is a service, it's all labor. Is driving down the salaries of doctors and nurses and every other cartel member who works in a price-gouging American hospital something you would support? Typically the left stupidly supports "the worker" and the associated labor cartels.
Click to expand...

I've already posted (earlier in the thread) maybe a half dozen links that point out that as many as 80 million or more are financially strapped due to healthcare costs. I'm not sure that you're aware of what nurses make, it is doubtful that they will get much pay docked, if any.
Doctors in single payer countries are poor? Is that what you're really attempting to say?

QUORA: Will a single-payer healthcare system significantly decrease doctors' salaries in the U.S.?
Peter Clark, Family physician with ALS - -

"My solo family practice grew over the 25 years I had it. It did not grow in terms of enrolled patients or patient visits. In grew in terms of staff to address CLIA - Clinical Laboratory Improvement Amendments, PQRI -Physician Quality Reporting Initiative, PQRS - Physician Quality Reporting System, PCMH - Patient Centered Medial Home, ICD-10 - International Classification of Disease Version 10, MU - Meaningful Use which required not only adoption of an EHR, but engaging patients in its use when not in the office, participation in an ACO - Accountable Care Organization, participation in a PHO - Physician Hospital Organization. Having dozens of insurers means jumping through hoops set differently for each one. It means different formularies for each one with those changing annually or more frequently. Twenty years ago I told the Medical Director of the biggest insurer in our area that I would take Medicare’s much inferior payments provided that he followed Medicare rules. He was not open to this.

Over the same 25 years there has been a marked increased in staff levels in US hospitals. Sadly that has not meant more nurses; it has meant more administrators and their support staff."
Click to expand...
 
Drawdown said:
The OP says clearly, "My NHS surgeon was able to schedule me in for the three-hour surgery less than two weeks after my fall,..." and if your click on the link for the whole story you will find, "The comparative ease and security of the NHS is why the system retains such high levels of support from the British public, despite frustrations with wait times and other aspects of service provision.

As for that particular brother, I imagine this was just another drop in the bucket as far as his bad credit. Whenever some garnishes his wages, he just quits and goes somewhere else until they track him down, rinse and repeat.....
Click to expand...

Wait times do not apply to things which generally fall under emergency surgery, like a bone fracture.
Wait times for specialty referrals are longer. Those who are willing to pay an extra premium may be able to access private sector care faster.
 
QUORA: Will a single-payer healthcare system significantly decrease doctors' salaries in the U.S.?


[FONT=q_serif]Dan Munro[/FONT][FONT=q_serif], Author of Casino Healthcare and Forbes Contributor - -[/FONT]

[FONT=q_serif]As we continue toward universal coverage (more a question of when - not if), other changes to our system are likely - including what med school costs - and how that's funded. Other countries (France for example) have a system whereby med students graduate with $0 debt. We could do that as well - and we might have to. Graduating with $160K (average) student debt is insane - and leads to other systemic problems. Most notably this one where there's a shortage of primary care physicians (nationally) and where specialists are overpaid. It's an artificial imbalance that's largely created by student debt.

[/FONT]
Click to expand...

SEE ATTACHED GRAPHICS
[FONT=q_serif]Dan Munro[/FONT][FONT=q_serif], Author of Casino Healthcare and Forbes Contributor[/FONT]
 
Checkerboard Strangler said:
QUORA: Will a single-payer healthcare system significantly decrease doctors' salaries in the U.S.?
Peter Clark, Family physician with ALS - -

"My solo family practice grew over the 25 years I had it. It did not grow in terms of enrolled patients or patient visits. In grew in terms of staff to address CLIA - Clinical Laboratory Improvement Amendments, PQRI -Physician Quality Reporting Initiative, PQRS - Physician Quality Reporting System, PCMH - Patient Centered Medial Home, ICD-10 - International Classification of Disease Version 10, MU - Meaningful Use which required not only adoption of an EHR, but engaging patients in its use when not in the office, participation in an ACO - Accountable Care Organization, participation in a PHO - Physician Hospital Organization. Having dozens of insurers means jumping through hoops set differently for each one. It means different formularies for each one with those changing annually or more frequently. Twenty years ago I told the Medical Director of the biggest insurer in our area that I would take Medicare’s much inferior payments provided that he followed Medicare rules. He was not open to this.

Over the same 25 years there has been a marked increased in staff levels in US hospitals. Sadly that has not meant more nurses; it has meant more administrators and their support staff."
Click to expand...
Click to expand...

...but those are almost examples of federal rules or Medicare initiatives. And they're generally good things. Not sure why any would go away under single-payer.
 
Greenbeard said:
...but those are almost examples of federal rules or Medicare initiatives. And they're generally good things. Not sure why any would go away under single-payer.
Click to expand...

A lot of it would become much more streamlined.
 
Slavister said:
... one big reason why Universal Health Care is sane - time and worries saved

A good article here comparing what it's like.
Click to expand...

Yes, I've also lived under both.

The UK spends LESS per capita than the US Federal government spends on healthcare.

Imagine, the US govt spends only half of what is spent in the US.

7% of spending goes on INSURANCE COMPANIES to tell you that you can't be treated. Great, thanks. They also tell you "your premium will increase on average 3% each year." Twenty percent in the last two years in not three percent a year, no matter how bad you are at math.

Hospitals are charging people for nonsense. They're encouraging people to stay in hospital when they don't need it.

I cut the tip of my finger off. I was told I'd need to stay in hospital for a few days. I was like "**** off" and was back at work that evening. You seriously don't need to be in hospital after having stitches on the top of your finger.

Doctors are on the game too, they're handing out pills like crazy.

The World Medicines Situation: Chapter 4. World pharmaceutical sales and consumption

In 1976 the US consumed 18.4% of the world's pharmaceuticals. 220 million population from 4.1 billion or 5.3% of the world's population.
In 2000 the US consumed 50.9% of the world's pharmaceuticals. 282 million population from 6.1 billion, or 4.6% of the world's population.

Why? Why would the US increase it's consumption in this period?

Japan saw it's pharmaceuticals increase by 50% as a proportion of the world's consumption. But the US had an increase of around 250%. Insanity. And all done because people know that they can easily leech off the system.
 
Checkerboard Strangler said:
Wait times do not apply to things which generally fall under emergency surgery, like a bone fracture.
Wait times for specialty referrals are longer. Those who are willing to pay an extra premium may be able to access private sector care faster.
Click to expand...

The author did not say that she got her surgery immediately or even the same week. You are a fan of the NHS or whatever, and that is fine. It is not a flawless system. There is a reason most Canadians have private insurance as well. Socialized medicine countries generally do not have the stand by capacity as the US both in terms of empty beds, readily accessible diagnostic equipment, etc. There are also reasons a lot of veterans don't use tricare or go to the VA.

In the end, we are talking about needing to get coverage for the last 10% of Americans with no insurance. We can certainly continue to whittle away at that number without completely disrupting the 90% who do have coverage.
 
Drawdown said:
The author did not say that she got her surgery immediately or even the same week. You are a fan of the NHS or whatever, and that is fine. It is not a flawless system. There is a reason most Canadians have private insurance as well. Socialized medicine countries generally do not have the stand by capacity as the US both in terms of empty beds, readily accessible diagnostic equipment, etc. There are also reasons a lot of veterans don't use tricare or go to the VA.

In the end, we are talking about needing to get coverage for the last 10% of Americans with no insurance. We can certainly continue to whittle away at that number without completely disrupting the 90% who do have coverage.
Click to expand...

TriCare uses the private sector as well as VA facilities. That is because TriCare is a health care program of the United States Department of Defense Military Health System, not the VA.
VA honors certain TriCare recipients.
There are well over half a dozen different types of TriCare.

The author did not say but you have already heard from at least one or two Canadian users of their system.
Shall I drag a Brit over here to confirm what I said about fracture patients also not being put on waiting lists?

If a Brit confirms this, will you believe it or will you continue to do the equivalent of saying "fake news" ?
I am not a fan of the NHS because I am unable to use it, but I know a ton of people who have or who still do at this present time.

No system is flawless, straw man alert :alert
There are many reasons both Canadians and Brits might have private insurance and why they might use private sector medical.
For instance, if you need reconstructive nose surgery because you have difficulty breathing, the public system accommodates your needs. If you need WANT reconstructive nose surgery because you don't like the way it looks, you need to use private sector providers.

As for the VA itself, are you a veteran and do you or have you or anyone you know used the VA system?
Both my wife and I have.

I already commented on the VA earlier.

PS: Many people wind up waiting to have corrective surgery for an elbow up to two weeks here in the USA with private sector providers. But they get their fracture set and stabilized in hours, just as it also happens in CA and UK.

No one walks around for two weeks with open unstabilized fractures in the UK or Canada.
Let me know if you require further confirmation from actual Brits.

I can get you a Brit by 3:00 PM just as surely as Walter Sobchak can get you a toe with nail polish on it.

 
Drawdown said:
The author did not say that she got her surgery immediately or even the same week. You are a fan of the NHS or whatever, and that is fine. It is not a flawless system. There is a reason most Canadians have private insurance as well. Socialized medicine countries generally do not have the stand by capacity as the US both in terms of empty beds, readily accessible diagnostic equipment, etc. There are also reasons a lot of veterans don't use tricare or go to the VA.

In the end, we are talking about needing to get coverage for the last 10% of Americans with no insurance. We can certainly continue to whittle away at that number without completely disrupting the 90% who do have coverage.
Click to expand...

Private insurance in Canada is almost exclusively supplemental rather than primary in nature; hearing aids, glasses, certain prescription meds (which cost way less by the way), cosmetic surgery and so on; it does not grant you an especial level of care or the ability to circumvent triage/jump to the front of the line.

Moreover, uninsured rates are 8.7-15.5% depending on methodology. Underinsured rates are much higher, again with variance depending on methodology, ranging from 29% to 37%. Cumulatively at these high ends that I've seen, a combined under and uninsurance rate of 52.5%, or over half the population, is obviously of serious concern. Even on the lower end, 36.7%, more than a third is still unacceptable.

Consistently in terms of performance/outcomes, the US doesn't rank anywhere near the top among wealthy industrialized countries save with respect to survival rates for certain cancers; clearly it is not getting anywhere close to good value for its money given the huge increment of expenditure per capita.

Given facts, the glaring problem with US healthcare should be abundantly clear.
 
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