<p>
</p>
<p>Please help me understand the context, then. (I’m a literal reader, and ‘free’ to me means just that, i.e., no charge.)</p>
<p>Collegialmom-- </p>
<p>3000+ in today’s dollars, after tax, is much more than the average family lives on. I’m just not seeing the problem. On a lower than average pediatrician’s salary, with loans, we got by just fine. In an inner suburb, ten miles from NYC, we had a house with about an 850/mortgage. We will happily sell it to you now for 220K, which should give you a mortgage well under your 3000/month guesstimate, even with no down payment. Actually I checked a calculator, and with no down payment, and a 7% rate, it’d come to a little over 1400/month. Interested?</p>
<p>Maybe you’re just talking about a different lifestyle than what we think is necessary.</p>
<p>Free means that when you go into use it, you don’t pay. </p>
<p>Like a highway or a bridge without tolls. (Yes, I know someone pays for highways or bridges; I’m not stupid, and neither is Michael Moore.) Free as in I don’t take out my wallet, and the doctor’s office doesn’t accept Visa, checks, or cash (and no health insurance company collects premiums.) Free as in MasterCard doesn’t get a rake-off. Free, as in it is much, much cheaper than what we do now. </p>
<p>But it makes no sense without the other two legs of the stool.</p>
<ol>
<li><p>No health insurance companies. If you provide “free, universal health care”, making it available to all residents, but keep the health insurance companies, all you’ve done is create a new (and huge) profit center for them, without changing the incentives in the system, and without necessarily improving anyone’s health as a result.</p></li>
<li><p>Regulate pharmaceutical companies strictly, like a public utility. If you do either or both #1 or #2 without number three, all you’ve done is fuel massive growth for the private phamaceutical industry, without necessarily improving anyone’s health.</p></li>
</ol>
<p>Once there is agreement on the three principles, there are literally hundreds of ways to carry them forward, as so many other countries have successfully demonstrated.</p>
<p>I have a question, mini, concerning #3. How do you build in incentive for research and development if it’s a regulated industry? Sure, there are regulated industries that have R&D, but let’s face it, there’s nothing that works like profit to encourage invention.</p>
<p>It seems to me that R&D would turn into a political issue. Where do we want to focus our efforts? I saw the space industry collapse 30 years ago because no one thought it was important. Now, I’m not comparing human health to space, interms of importance I know health beats space exploration, but eventually isn’t it going to come down to a political decision? Allocate resources to fight breast cancer vs alzhiemers vs AIDS vs urinary incompetence vs melanoma vs heart disease vs…</p>
<p>EDIT: My fear is the “stem cell research” fiasco will play itself out day after day after day…</p>
<p>"3000+ in today’s dollars, after tax, is much more than the average family lives on. I’m just not seeing the problem. On a lower than average pediatrician’s salary, with loans, we got by just fine. In an inner suburb, ten miles from NYC, we had a house with about an 850/mortgage. We will happily sell it to you now for 220K, which should give you a mortgage well under your 3000/month guesstimate, even with no down payment. Actually I checked a calculator, and with no down payment, and a 7% rate, it’d come to a little over 1400/month. Interested?</p>
<p>Maybe you’re just talking about a different lifestyle than what we think is necessary."</p>
<p>The mortgage calculators actually don’t add in the insurance and the state and local property taxes. The taxes alone in NY or much of NJ would be about $1500/month above the mortgage, and homeowner’s iinsurance would add about another $300. So even at your theoretical house at $220,000 (not possible in NYC, Long Island, Westchester Co, or much of NJ try about $400,000-500,000 starting price to live in a safe neighborhood wth good schools), we are now at $850 + 1500 + 300 a month = 2650. That leaves very little for health insurance, transportation, food, utilities, etc etc etc.</p>
<p>Now you may think that a standard of living akin to a McDonald’s or Burger King or WalMart worker is OK for a doctor, but considering the same student’s options besides medicine, I don’t think that they would be happy with that standard of living.</p>
<p>Maybe we should go to the Stalin style of living and that would solve all of this. No division of classes except for the leaders. Who would be politicians.</p>
<p>“It seems to me that R&D would turn into a political issue. Where do we want to focus our efforts? I saw the space industry collapse 30 years ago because no one thought it was important. Now, I’m not comparing human health to space, interms of importance I know health beats space exploration, but eventually isn’t it going to come down to a political decision? Allocate resources to fight breast cancer vs alzhiemers vs AIDS vs urinary incompetence vs melanoma vs heart disease vs…”</p>
<p>Actually there are very few vaccine manufactutuers, since the Clinton administration began negotiating very low bulk government prices for the free federal vaccines. The number of manufacturers has gone from about 18 to 4. They are price-shifting to private doctors, which is one reason that primary care doctors are often not financially able to give vaccines anymore.</p>
<p>“They’re not required to treat but to medically stabilize an ER patient before transfer. That was frequently an issue in the town where I used to live. Three hospitals, two of them religious-affiliated and non-for-profit, the third for-profit. All level 2 trauma centers. The for-profit was notorious for dumping uninsured ER patients. Their definition of stable was notably more fluid than the other two hospitals’.”</p>
<p>The ERs that I know about are very conscious of not “dumping” and never transfer unless they really cannot provide a service, such as a particular type of surgery. There is too much risk involved. What part of the country do you live in? I think that some areas with high numbers of uninsured illegals may do try to do these transfers more, but I don’t have experience in those areas.</p>
<p>By the way, mini, are all people in the US, regardless of legal status, included in your (free) universal health plan?</p>
<p>I am petrified that govt regulated, universal health care would become like social security…at first, beneficial to some/most recipients…as the years go on, people begin to realize the warts…but you can’t get out from under it…the price goes up and up and up and the payouts get smaller and smaller relative to the price…and eventually everyone (within a couple generations) is dissatisfied but there’s NOTHING you can do about it because it’s the HOLY GRAIL.</p>
<p>Doubleplay, our premiums go up and up, and the payouts are less and less with the current system. Currently, our premiums are nearly as bad as paying for college education on an annual basis, but it there is no financial aid for those premiums. One can only pay for less coverage (to a point), and then perhaps live (or die) regretting that decision.</p>
<p>I agree northeastmom,
but I’m talking about a policy change that will never be reversed. It will affect our great grandchildren and on and on and on. Crossing over into government takeover of health care will be permanent. </p>
<p>Don’t misunderstand me, I’m not arguing one way or another. I can’t say that I like the current system. It just scares the crap out of me to think of the permanence of universal healthcare policy. Forever. In perpetuity. <em>Gasp</em> It is kind of frightening.</p>
<p>Oh, it has to be set up well. What is going on today with respect to health care, long term care for the aged, and public college education costs in this country is scary.</p>
<p>I really feel sorry for our children’s generation. My older son has actually told me that he does not want to have children. He could very easily change his mind, but he is responsible with the few dollars that he has earned (as well as any money that we give him). He sees some of the costs of raising a family, and says that starting one would ruin his life.</p>
<p>I hope my son does not feel the same way about having a family. :)</p>
<p>Any rate, despite the hassles and heartache of college and healthcare costs, I still feel like my husband and I (and our kids) have enjoyed a much higher standard of living than I did growing up. And relatively speaking, my dad was in a much higher income job than my husband is in currently (me- I just teach music on the side for self-gratification). In spite of our fears and frustrations, we still manage to provide experiences that I would have never dreamed of having as a kid. Hopefully that will continue on to the next generation. I have hope.</p>
<p>Our kids will be paying down the debt accrued during the past five or six years for most of their adult lives. I don’t expect their standard of living to match their parents. Just a hunch.</p>
<p>
In the South, in a town without a large population of illegals. In this case, uninsured =/= illegal.</p>
<p>doubleplay, It is nice to hear that your family currently has a better standard of living than you did as a child. Perhaps there is hope.</p>
<p>quote: “The French system is somewhat better, but would the American public tolerate the high taxes designed to cover health care?”</p>
<p>Let’s think about this. We pay for health insurance and the companies we work for also pay for it - those companies consider it part of our salaries. So, if we didn’t have to pay for the insurance - we would have that 10% of our salary that is being sucked up by the insurance company back. Sure it will go to extra taxes, BUT remember, once we have insurance that isn’t the end of our payments in America - we still have to pay deductables and co -pays…and often our claims are denied all together, thereby leaving us to foot the bill anyway. What a freaking rip off. Not only that, but just try to get an appointment with a specialist in a major city in America. Your wait could easily be 3 - 6 months (dermatologist…neurologist) even with the best insurance possible. And medications? Why does Walmart charge $58 for the SAME perscription that Sams charges $7??? Walmart and SAMS are the SAME freaking company. </p>
<p>In Russia they had a poor national health care system, but at least there you could pay a physican on the black market to come to your home and treat you. Good grief, even with money in the US, we can’t get a decent doctor. There is a reason for that too - they limit the number of students that are able to go to medical school. It’s to keep the numbers of physicians low so salaries stay high. There isn’t a shortage of qualified students - there is a shortage of open spaces in med school, and the powers that be like it that way.</p>
<p>“Not only that, but just try to get an appointment with a specialist in a major city in America. Your wait could easily be 3 - 6 months (dermatologist…neurologist) even with the best insurance possible.”</p>
<p>This has nothing to do with insurance. It’s a shortage problem.</p>
<p>And what would be VERY INTERESTING about this time, is for a representative from the medical school establishment to come on here and explain why there is a shortage.</p>
<p>“It’s to keep the numbers of physicians low so salaries stay high. There isn’t a shortage of qualified students - there is a shortage of open spaces in med school, and the powers that be like it that way.”</p>
<p>There are actually several new medical schools opening up in the US. It is very difficult to get the appropriate amount of training facilities (hospitals and clinics) and staff and funding to set up medical schools. If they are set up quickly or shoddily, you really will see the quality of care go down. </p>
<p>It seems as if everyone on this forum has had disasterous results with medical care. Are you all still alive by being healthy and exercising, with BMIs less than 25? Or are only the people who have disasterous health care experiences posting here? Have you EVER found ANYTHING good about American medicine? If not, if everyone just stops using the health care system, then it will be less stressed (and apparently so will most of you!)</p>
<p>Remember, the best way to avoid the health care system is to get up and off of your computers and go exercise, quit smoking and cut down on unhealthy foods.</p>
<p>collegialmom,
Why is funding and resources a problem for med schools? Are they funded through state governments?
We (Florida) are getting several new med schools starting up, finally. And we already have quite a few. How about other states? How do public universities fund med schools?</p>
<p>Collegialmom–you keep trying to tell me what I pay in the area I live in, and you’re wrong. 1500 a month for property taxes? divide that by 4 to be accurate. 300 a month for insurance? More like per year.</p>
<p>In the end, your answer shows what I’ve been saying–you think a doctor “deserves” a nicer house and better schools than my doctor-H’s family has, and I don’t. We’ll just have to disagree…</p>