UHC vs Privatized Care

[whysoserious]

The options above explain the point of the thread. The results are public, and you may only choose one option.

 

[TheDemSocialist]

How many people on DP do we have that are from countries with UHC?

 

[whysoserious]

I have seen a few from overseas and Canada. I am not sure the exact number, though.

 

[Kandahar]

I want universal health care.

 

[misterman]

I used to oppose a single-payor system, but the more I learned about it through the health care debate the more it just made sense to me, even as the compromise moved further and further away from it.

I wouldn't want a single provider system, where the government ran all health care, though.

 

[Manc Skipper]

The poll needs an "I live in a country with UHC and a private sector" option, because they're not mutually exclusive. I would never personally choose private care because UHC meets all my needs, but the option is there if I wanted it. The basic difference in the UK was in hotel services and waits for elective care. The waits are likely to grow again under the Tory plans.

 

[whysoserious]

The poll needs an "I live in a country with UHC and a private sector" option, because they're not mutually exclusive. I would never personally choose private care because UHC meets all my needs, but the option is there if I wanted it. The basic difference in the UK was in hotel services and waits for elective care. The waits are likely to grow again under the Tory plans.

Yeah, I know what you mean, but I just mean a country has UHC (and any other options) and wants to switch to privatized only.

 

[Boo Radley]

The options above explain the point of the thread. The results are public, and you may only choose one option.

Now, to clarify my answer. I want UHC. But this does not mean an end to privatized care. The system here would and should be a least two tearied, in which those who cna afford more can buy more.

And I want it to be a specific system, a single payer system, with the second teir as I said.

 

[Catawba]

I recently saw a news story about how medical treatments and surgeries are being outsourced to other countries where health care was so much more affordable.
More and more people are being forced to travel outside the US for affordable health care.

Why are we the last industrialized country on the planet to upgrade to UHC?

 

[Temporal]

I'm an American living in Canada and their system is superior to ours. They might have more wait times for non-serious problems but your life won't be financially ruined because of a health complication. Our system needs to change.

 

[WI Crippler]

Why are we the last industrialized country on the planet to upgrade to UHC?

Because of who would be running our UHC. Look no further than the debacle of how they run Medicare services, and then go ahead and extend that model of inefficiency and waste to 100% of the population.

It doesn't matter what you do. Your healthcare is either going to be the subject of profit based motives (private industry), or budget based motives( read: election votes). We would have changes to the UHC system every time an election came up.

Our system, flawed as it is, is a mixed system of pooled risk. Some sectors (poor and elderly) are covered or have the potential to be covered (if they choose) by government programs. The young and typically healthier partake in a private insurance industry pool risk (for the most part). So we already have both here.

What people in this country want is top notch medical care and services extended to everybody. The problem is, nobody wants to pay for it themselves.

 

[Kandahar]

Because of who would be running our UHC. Look no further than the debacle of how they run Medicare services, and then go ahead and extend that model of inefficiency and waste to 100% of the population.

Medicare is more efficient than private insurance. Since it isn't out to make a profit, it saves quite a bit of money right there. Additionally, Medicare spending grew more slowly between 1997 and 2009 than did private health insurance premiums, and the CBO projects that this trend will continue for the next 30 years. Medicare's administrative costs are a mere 2% of its budget, versus 17% for private insurance.
Medicare Is More Efficient Than Private Insurance – Health Affairs Blog

It doesn't matter what you do. Your healthcare is either going to be the subject of profit based motives (private industry), or budget based motives( read: election votes).

In other words, one is accountable to the public (and therefore bases its decisions on what benefits the public, at least in theory) whereas the other is accountable to shareholders (and therefore bases its decisions on what benefits the shareholders).

We would have changes to the UHC system every time an election came up.

So? Do you read your annual policy from private insurance companies? Chances are it changes every year too.

Our system, flawed as it is, is a mixed system of pooled risk. Some sectors (poor and elderly) are covered or have the potential to be covered (if they choose) by government programs. The young and typically healthier partake in a private insurance industry pool risk (for the most part). So we already have both here.

What people in this country want is top notch medical care and services extended to everybody. The problem is, nobody wants to pay for it themselves.

See the graph I posted at the beginning of the thread. The notion of needing to spend more to "pay for it" is erroneous, as the US already spends FAR more per capita than any country with universal health care, despite getting results that are, to put it charitably, no better than theirs. So then, what are we buying with all that extra money we spend?

 

[nonpareil]

Yeah, I know what you mean, but I just mean a country has UHC (and any other options) and wants to switch to privatized only.

It distorts the reality. There are very few countries without privately provided healthcare services (maybe Cuba and N.Korea?) and there is also the difference in provision and payment. In the UK, the NHS provides most of the services and pay for those who qualify, whereas in other countries, it could be provided by both public hospitals and private clinics, and the government pays the private clinics for individuals that qualify. And then there are systems where the individuals are forced to save like in Singapore, or buy insurance like Switzerland, and the government subsidies those who qualify for the subsidies. The combinations are varied, it's not one or the other.

I prefer a country in which access to healthcare is secured for all citizens (whether though tax, forced savings or insurance mandate). I much prefer the European welfare version over Singapore's, and definitely over the US.

 

[Keridan]

Medicare Is More Efficient If You Ignore Its Inefficiencies

Just some interesting reading.

 

[WI Crippler]

Medicare is more efficient than private insurance. Since it isn't out to make a profit, it saves quite a bit of money right there. Additionally, Medicare spending grew more slowly between 1997 and 2009 than did private health insurance premiums, and the CBO projects that this trend will continue for the next 30 years. Medicare's administrative costs are a mere 2% of its budget, versus 17% for private insurance.
Medicare Is More Efficient Than Private Insurance – Health Affairs Blog



In other words, one is accountable to the public (and therefore bases its decisions on what benefits the public, at least in theory) whereas the other is accountable to shareholders (and therefore bases its decisions on what benefits the shareholders).



So? Do you read your annual policy from private insurance companies? Chances are it changes every year too.



See the graph I posted at the beginning of the thread. The notion of needing to spend more to "pay for it" is erroneous, as the US already spends FAR more per capita than any country with universal health care, despite getting results that are, to put it charitably, no better than theirs.

What results? Life expactancy? That's an erroneous stat, if that is what you are going to march out as the "results".

You only see healthcare as it relates to consumer and payor (government or private company). There is a third market in this, and that is the provider. If you think Medicare decisions are made with the "publics interests" in mind, you are mistaken. When I treat patients on Medicare part A, my treatments and my day revolves around minutes spent with the patient, not necessarily what is appropriate for the patient. When I work with patients in outpatient care clinics on private pay, or private insurance I have much more leeway to treat as the situation dictates (I still have to work within a plan of care dictated by an M.D. in either case) and I don't have to "get minutes" with a patient to make sure the reimbursement is worth the amount of overhead it costs the facility and my company to keep a patient there. It seems all nice and fluffy from the outside, but it drives patient care to be delivered in a way that is based on their reimbursement schedules, which are time based, not resource based.

 

[Kandahar]

What results? Life expactancy? That's an erroneous stat, if that is what you are going to march out as the "results".

Is there a measure of general healthiness that you prefer which shows the United States routinely outperforming countries with UHC? The most common stats (e.g. life expectancy, infant mortality, all-cause DALY, etc) all point to the same conclusion: the United States is, at best, middling among developed countries when it comes to measures of wellbeing.

You only see healthcare as it relates to consumer and payor (government or private company). There is a third market in this, and that is the provider. If you think Medicare decisions are made with the "publics interests" in mind, you are mistaken. When I treat patients on Medicare part A, my treatments and my day revolves around minutes spent with the patient, not necessarily what is appropriate for the patient. When I work with patients in outpatient care clinics on private pay, or private insurance I have much more leeway to treat as the situation dictates (I still have to work within a plan of care dictated by an M.D. in either case) and I don't have to "get minutes" with a patient to make sure the reimbursement is worth the amount of overhead it costs the facility and my company to keep a patient there. It seems all nice and fluffy from the outside, but it drives patient care to be delivered in a way that is based on their reimbursement schedules, which are time based, not resource based.

This is a minor issue that in no way negates the economic and social harm that our private health care system does. Is there a reason that Medicare couldn't simply be structured like that as well? If Medicare is not structured optimally then it should be changed, but this doesn't change the fact that a government-run system simply produces better results on the whole than a private system.

 

[whysoserious]

It distorts the reality. There are very few countries without privately provided healthcare services (maybe Cuba and N.Korea?) and there is also the difference in provision and payment. In the UK, the NHS provides most of the services and pay for those who qualify, whereas in other countries, it could be provided by both public hospitals and private clinics, and the government pays the private clinics for individuals that qualify. And then there are systems where the individuals are forced to save like in Singapore, or buy insurance like Switzerland, and the government subsidies those who qualify for the subsidies. The combinations are varied, it's not one or the other.

I prefer a country in which access to healthcare is secured for all citizens (whether though tax, forced savings or insurance mandate). I much prefer the European welfare version over Singapore's, and definitely over the US.

Everyone has to pay into a UHC system. At no point does the question say, "A UHC system with no private option available", it just says a UHC system. Why would anyone assume otherwise?

*Edit:

I guess in the poll I could have put "I live in a country with UHC and I would never want a privatized-only system". That's the only discrepancy I can think of. But we're a fairly educated crowd (right?) so I think most of us understand the question and its context.

 

[whysoserious]

You guys can argue that validity of UHC all you want as that is what the thread is for, but I'd really love to hear from those who live in a country with that system and their opinions on the treatment they receive and the benefits/downsides of it. Also, I'd like to know whether they would prefer to switch to a privatized-only system (for the few members that are not in the US).

 

[bowerbird]

The options above explain the point of the thread. The results are public, and you may only choose one option.

Your "options" are too limiting

Like a LOT of Aussies I live in a country with UHC but I have private health insurance as well. Why? Because UHC does not cover me for things like dental and podiatry for a start. Plus if I want an "elective" operation/procedure I can bypass the normal waiting lists. For everything unexpected and deadly serious there is the public system, which despite having private cover I do trust more.

And mate - you really want to talk to me

I not only subscribe to both but have worked as a nurse in both

 

[whysoserious]

Your "options" are too limiting

Like a LOT of Aussies I live in a country with UHC but I have private health insurance as well. Why? Because UHC does not cover me for things like dental and podiatry for a start. Plus if I want an "elective" operation/procedure I can bypass the normal waiting lists. For everything unexpected and deadly serious there is the public system, which despite having private cover I do trust more.

That's fine. I mean a private-only system. Apparently I did a ****ty job clarifying that, and I apologize.

Yes, the first two questions should read:

"I live in a country with UHC and I would never want privatized-only medicine"
"I live in a country with UHC and I do want privatized-only medicine"

*Edit:

In fact, any mod that reads this and is feeling froggy, I would much appreciate if all of the places that say "privatized" be changed to "privatized-only". Thanks for your help if you do help!

 

[WI Crippler]

Is there a measure of general healthiness that you prefer which shows the United States routinely outperforming countries with UHC? The most common stats (e.g. life expectancy, infant mortality, all-cause DALY, etc) all point to the same conclusion: the United States is, at best, middling among developed countries when it comes to measures of wellbeing.



This is a minor issue that in no way negates the economic and social harm that our private health care system does. Is there a reason that Medicare couldn't simply be structured like that as well? If Medicare is not structured optimally then it should be changed, but this doesn't change the fact that a government-run system simply produces better results on the whole than a private system.

The "harm" of private healthcare is overstated. People always talk about what it doesn't provide, instead of seeing what it does provide, on a daily basis. For instance, people always focus on what isn't covered or what was rejected. They don't care to spend the time to research the services that were provided, the treatments that do occur, etc.....

I've been on all 3 sides of this debate. As a consumer, an insurance agent, and now as a healthcare provider. If you seriously think that there is just one solution that benefits everybody then you aren't seeing the big picture. You have to balance the idea of maintaining an advanced research and development of medical equipment, techniques, etc... The best way for that to happen is a profit based model. That creates revenue for those things. You have to keep the consumers healthy to start with, that is a role I would like to see the government expand a bit. Preventative treatments/screenings/education. You have a moral obligation to your seniors who carried the nation, again a government/societal role, and you have to make sure that providers are able to afford to have careers to efficiently deliver healthcare, which both private and government models can provide through profit based models for increasing pay, and licensure/verification by the government to make sure that the healthcare pool does not become oversaturated with incompetent providers.

There is no reason to eschew on for the other. Both models should be used for what they can provide to the entire healthcare model. There is more at stake than just tax payer dollars, or insurance premiums. There are industries, jobs, and careers on the line as well.

 

[bowerbird]

That's fine. I mean a private-only system. Apparently I did a ****ty job clarifying that, and I apologize.

Yes, the first two questions should read:

"I live in a country with UHC and I would never want privatized-only medicine"
"I live in a country with UHC and I do want privatized-only medicine"

*Edit:

In fact, any mod that reads this and is feeling froggy, I would much appreciate if all of the places that say "privatized" be changed to "privatized-only". Thanks for your help if you do help!

That is OK I read your replies after I had posted

Now I not only live with both I have worked in both - as a nurse the one group you really really want to ask about which system is better.

Private:- If you like fancy foyers and pretty glossy brochures fine. Also good if you want free TV, bigger nicer menu and free newspapers and internet connection, and a private room where you do not have to put up with the derelict in the bed next door. Good for minor and simple ops

Public - for anything serious what so ever. Advantages - for a start more than one bloody doctor (which can also be a disadvantage if you are stuck with the wet behind the ears junior trying to be a nurses nightmare) but they have access to the states best infection control specialists to review your antibiotics if need be, they can call on other experts at a seconds notice without you having to spend an extra dime. Example - my worst Night Duty EVER! I had eight medical officers including two heads of department in my ICU at 2 am in the morning as a woman with crappy heart valves was trying to have a baby! This poor woman did not speak English but an obscure foreign dialect and we were watching and gnawing our fingers to the bone - if she could have managed it it would have been safer for her to have had a natural birth - less stress on the heart but the second we had foetal distress we got her out of there and into the theatre to do a caesar

This would not have happened in the private system

 

[Redress]

Moderator's Warning:

Poll options edited at users request.

 

[Catawba]

Because of who would be running our UHC. Look no further than the debacle of how they run Medicare services, and then go ahead and extend that model of inefficiency and waste to 100% of the population.

Medicare is well run. It is the underlying problem that private health care insurance providers also face, the most expensive health care system in the world. Do you think completely privatizing the HCS would eliminate the unaffordable cost problem for Americans???? Private health care insurance is already unaffordable for 1/6 of the country. No other industrialized country in the world excludes 1/6 of its population from affordable health care.

It doesn't matter what you do. Your healthcare is either going to be the subject of profit based motives (private industry), or budget based motives( read: election votes). We would have changes to the UHC system every time an election came up. Our system, flawed as it is, is a mixed system of pooled risk. Some sectors (poor and elderly) are covered or have the potential to be covered (if they choose) by government programs. The young and typically healthier partake in a private insurance industry pool risk (for the most part). So we already have both here.

As has been pointed out, we can have a two tiered system that includes both public and private. Its obvious though we cannot continue with a system that is unaffordable for 1/6 of our fellow citizens.

What people in this country want is top notch medical care and services extended to everybody. The problem is, nobody wants to pay for it themselves.

No one is expecting a free lunch, just not being forced to travel outside the country to receive affordable health care.

 

[Boo Radley]

Because of who would be running our UHC. Look no further than the debacle of how they run Medicare services, and then go ahead and extend that model of inefficiency and waste to 100% of the population.

It doesn't matter what you do. Your healthcare is either going to be the subject of profit based motives (private industry), or budget based motives( read: election votes). We would have changes to the UHC system every time an election came up.

Our system, flawed as it is, is a mixed system of pooled risk. Some sectors (poor and elderly) are covered or have the potential to be covered (if they choose) by government programs. The young and typically healthier partake in a private insurance industry pool risk (for the most part). So we already have both here.

What people in this country want is top notch medical care and services extended to everybody. The problem is, nobody wants to pay for it themselves.

Much like those who try to compare US to Canada or England, this too is an imporper comparison. Medicare is a system that houses only those most likely to need care. That makes it much more difficult to run. A proper single payer system would not eliminate the need for medicare and medciad, but have the entire population as particpants. This makes in much easier to manage. It would save money and allow for greater access. And as it can be two teired, thus not hindering care or the right to spend more if you have it and want it, there is little doubt the overall the system would be better for everyone.