<p>“Then at 40 Hypertension, 42 Diabetes.” </p>
<p>How easy is it to change insurance plans with these preconditions?</p>
<p>
Not baseless. If I need a hip replacement I can choose the doctor I want to see, see the doc in a reasonable time, obtain MRIs and X-Rays almost immediately, schedule the surgery at the hospital in a resonable timeframe, and have the joint replaced in a reasonable time. This isn’t necessarily true for folks in the UK unless they end up going the private healthcare route. </p>
<p>What private healthcare in the UK? Why would there be private healthcare when the universal provides it ‘for free’? Well, there must be a reason for the demand. I’m mentioning the UK system since the UK is closer to the population of the USA than other countries with a much smaller population and I have colleagues in the UK who don’t speak very highly of the system and get frustrated by having to pay for private healthcare if they want what they consider reasonable healthcare (depending on circumstances).</p>
<p>I also am willing to forego buying ‘stuff’ and spend my money on adequate healthcare insurance for my family. Not everyone is. I imagine those who choose not to pay for healthcare are part of the stats you cite. But maybe not, so if you have a pointer to the study you cite I wouldn’t mind reading it.</p>
<p>If the universal healthcare in Canada works well, then great. Even if it does, it doesn’t mean that it would scale well to a country with the population of the USA.</p>
<p>Well, you folks are just discussing how to get existing health care technology - the current meds, therapies, surgeries, diagnostic acumen. If you drive it down to the lowest possible price and “cover” everyone - where will the funds come to foster future innovation so that our kids can benefit from medical technology that is more effective, more individualized, less invasive than what we now have. </p>
<p>Lets not forget that health care is not a commodity. It is the quintessential “knowledge product” that evolves through risk and tremendous talent and effort. Those always are expensive. Someone somewhere has to pay. Or we simply don’t get it.</p>
<p>And another thing - all those super duper socialized medicine countries mooch off America for the innovation. They take our drugs, our devices, our discoveries but they don’t pay their share of their cost.</p>
<p>While the US populations is approximately 10 times that of Canada, there is no reason to believe that that is some kind of insurmountably difficult thing. Once you’re administering a universal healthcare system for 30 million people, you’ve met basically all of the issues of large scale rollout in a healthcare system.</p>
<p>mammall: You keep bringing up this point, and I always wonder if you just haven’t thought it through. Firstly, the government drives a lot of the innovation in medical care. Second, even that innovation that is supported by the private sector would continue to occur under a public healthcare system. As I said before when you brought this question up, a pharmaceutical company cares not whether it is a single payer government system buying their fancy new drug, or some private healthcare provider.</p>
<p>So unless you’re suggesting that a universal healthcare system would by default include less cutting edge technology (a view for which there is some support, though even in private healthcare cutting edge therapies have trouble being paid for), I don’t get where you’re coming from.</p>
<p>As for the “mooching”, there is plenty of medical innovation outside of America. But it’s not the private insurers that are driving innovation; it’s not the government eiether. It is private companies. And those private companies will continue to innovate, as long as there is a market for their products in America or elsewhere. And that will be true, socialized medicine or not.</p>
<p>1of42 - last time I consulted my college class in economics it seemed as if one payer means that payer sets the price and that means there is essentially no competition. What is the point of taking on the risk and research and development cost to produce a new and better healthcare widget if the government is the only purchaser and has total control over what it will pay you? Sorry, I am at a loss as to what part of this point you find difficult to grasp.</p>
<p>Dunno when the last time you consulted your college economics class was, but it must have been a while ago, because that analysis is simplistic at best. Here’s why:</p>
<p>A single payer system, if there were no private alternatives (and we KNOW there would be, it’s blatantly obvious), would indeed be a monopoly. So yes, potentially, if you were a medical technology developer selling to that market, the single-buyer system would remove competition, in that one entity would control demand. That does not mean you would be worse off, but it means you could potentially be.</p>
<p>However, in reality, not only would there still be at least monopolistic competition due to private alternatives that would, remember, still exist alongside the single payer (this is the same kind of market competition that the healthcare market has now, since there are limited insurance alternatives, and they are different in limited ways), you are forgetting one very important thing: the US is not the only country in the world. These big healthcare technology companies sell all over the world. If your assertion were truly valid, and a single payer system inevitably screwed over companies trying to produce healthcare innovation, then healthcare companies would be in pretty dire straits right now, only being able to make money in America. But that is not the case - even if the healthcare market is a monopoly, companies selling inputs to that market (health tech companies) can still make excellent profits.</p>
<p>So I disagree with your analysis.</p>
<p>dntw8up: I don’t think health care is an “entitlement” – I think one should do something for it. But I equate health care in many ways to education: Just as having well-educated people creates a good country and a smart citizenry, so does having healthy people who don’t have all sorts of public health problems. In this country, like all industrialized countries, we have decided that attending school until a certain age should be a legal requirement, and that it’s the government’s role to provide free, public education. I don’t see how health care is different. I think there should be minimal health care provided by the government (gasp! She said it!!), and those who choose can buy in to additional coverage (just like “buying in” to private school or to college).</p>
<p>VeryHappy: Do you plan to only cover children, as we do with public education? If so, I would agree; children are a special case and just as we provide taxpayer funded breakfast and lunch on weekdays during the school year, to help meet the nutritional needs of children whose parents can’t provide for them, so too should we provide basic vaccinations and prevention of disease that could become a public health concern. </p>
<p>Taxpayer funded health care for adults is another matter altogether. The assumption in the U.S. is that a taxpayer funded K-12 education prepares people to be self-supporting. Taxpayers subsidize the college educations of the poorest among us, through Pell grants and the like, but even that ends around age 22. At what age should taxpayer funded health care end? And between birth and the age taxpayer subsidized health care ends, are there any limitations to what will be provided? Is it just immunizations and public health issues? Should those with cancer or chronic disease, which generally aren’t public health issues, be given a disproportionate amount of the available health services, or is it more just to spend where the least amount helps the greatest number, like fluoride treatment?</p>
<p>Lastly, it is in our collective best interest to ensure that the wealthiest among us are the healthiest among us, because all of us rely on their tax dollars to fund our communal needs. Thus, odd as it seems, perhaps the wealthiest among us, like children, are a special case that should enjoy the benefit of taxpayer funded health care.</p>
<ul>
<li>Opinion piece by a Canadian Doctor: [Who’s</a> Really ‘Sicko’
In Canada, dogs can get a hip replacement in under a week. Humans can wait two to three years.](<a href=“http://opinionjournal.com/editorial/?id=110010266]Who’s”>http://opinionjournal.com/editorial/?id=110010266)</li>
</ul>
<p>*[Canadian</a> has rare identical quads](<a href=“http://news.bbc.co.uk/2/hi/americas/6951330.stm]Canadian”>BBC NEWS | Americas | Canadian has rare identical quads): </p>
<p>
</p>
<ul>
<li><p>[The</a> Top Ten Things People Believe About Canadian Health Care, But Shouldn’t](<a href=“http://www.heritage.org/Research/HealthCare/hl856.cfm]The”>http://www.heritage.org/Research/HealthCare/hl856.cfm)</p></li>
<li><p>[British</a> healthcare may be rationed:](<a href=“http://www.physorg.com/news97738082.html]British”>British healthcare may be rationed) </p></li>
</ul>
<p>
</p>
<ul>
<li>Page 126-127 of [The</a> Undercover Economist](<a href=“http://www.amazon.com/Undercover-Economist-Exposing-Poor-Decent/dp/0195189779/ref=pd_bbs_sr_2?ie=UTF8&s=books&qid=1201487905&sr=8-2]The”>http://www.amazon.com/Undercover-Economist-Exposing-Poor-Decent/dp/0195189779/ref=pd_bbs_sr_2?ie=UTF8&s=books&qid=1201487905&sr=8-2) by Tim Harford ([link</a> to Google Books online with readable text](<a href=“The Undercover Economist: Exposing Why the Rich Are Rich, the Poor Are Poor ... - Tim Harford - Google Books”>The Undercover Economist: Exposing Why the Rich Are Rich, the Poor Are Poor ... - Tim Harford - Google Books)) discusses the idiotic rationing of eye surgery in England (Harford is an Oxford-trained economist very familiar with his country’s healthcare system. (Don’t miss the ‘NICE’ irony):</li>
</ul>
<p>
</p>
<p>VeryHappy:</p>
<p>How would you define “minimal health care”? At what point would you deny a service unless one ‘bought in’?</p>
<p>StitchInTime: I want to clarify something. While Canada’s system does many things well, elective orthopedic surgeries are probably what it does worst. I should know - my father is waiting for one.</p>
<p>The main reason this is the case is that private care is illegal in Canada, and private care is often the very best at elective orthopedics. Meanwhile, the public system is focusing on more necessary procedures, and since there is no alternative, the procedure just takes a very long time.</p>
<p>As for that list of myths, some are true and some aren’t. What they all obviously are, though, is biased. For example, in his section about the “myth” that Canadians are happy with Medicare, every statistic is examined except the one that most Canadians do not want private healthcare available - a statistic that I think is sad, but unfortunately true.</p>
<p>We are having our own debates over healthcare in Canada, but the way that site presented the state of debate is disingenuous, and to post it here does not serve anyone well.</p>
<p><a href=“%5Burl=http://talk.collegeconfidential.com/1059826890-post31.html]#31[/url]”>quote</a> …While Canada’s system does many things well, elective orthopedic surgeries are probably what it does worst. I should know - my father is waiting for one.</p>
<p>The main reason this is the case is that private care is illegal in Canada, and private care is often the very best at elective orthopedics. Meanwhile, the public system is focusing on more necessary procedures, and since there is no alternative, the procedure just takes a very long time…
[/quote]
</p>
<p>There’s the rub…“more necessary”** in who’s opinion?..a government bureaucrat?!?**</p>
<p>BTW, Why isn’t there 1 Candaian pharmaceutical company [listed</a> in the world’s top 50](<a href=“http://en.wikipedia.org/wiki/List_of_pharmaceutical_companies]listed”>List of pharmaceutical companies - Wikipedia)? Could it be that:</p>
<p>
</p>
<p>…I’m sorry, are you suggesting that diagnostic cancer surgeries, other life-saving procedures, and so forth are less necessary than a procedure that for most people is an elective one done to reduce pain, or are you trying to make a rhetorical point about resource allocation?</p>
<p>In this case, the healthcare policy setters decide which types of procedures necessitate increased resources, taking into account a variety of factors. These policy setters include doctors, public health specialists, and all kinds of other people.</p>
<p>Most of the basis for saying we get lower quality healthcare for more cost in the US rests in two items–infant mortality and lifespan. The problem is most of those dragging down our results in those areas don’t have standard health insurance and have hosts of other problems. If you look at typical working people with insurance our results are as good as any and probably better when you consider having choice and lots more alternatives in care. So let them study people covered by US insurance vs other systems and see how they stack up. Right now they are comparing apples and oranges.</p>
<p><a href=“%5Burl=http://talk.collegeconfidential.com/1059827070-post33.html]#33[/url]”>quote</a>…are you suggesting that diagnostic cancer surgeries, other life-saving procedures, and so forth are less necessary than a procedure that for most people is an elective one done to reduce pain…
[/quote]
</p>
<p>I’m stating emphatically that this country’s public policy should not leave it up to anyone (“doctors, public health specialists”, bureaucrats, et al.) but the individual suffering to determine the timing when the pain will be addressed. </p>
<p>Rationing in the hands of government run healthcare is wielded like a chainsaw rather than a scapel.</p>
<p>
Why not do both - “more necessary” as well as necessary? Since your father is waiting for orthopedic surgery you probably realize the extreme amount of pain and debilitation things like arthritically worn out joints can cause. My mother has had both hips and both knees replaced. If she were to have to wait years to have the procedures done her life would be miserable although I’m not sure she would have survived being confined to a wheelchair at her age.</p>
<p>The fact that the system is picking and choosing which services to offer at adequate service levels (by bureaucrats no doubt), speaks volumes.</p>
<p>Why is it that CEO of Aetna, one of the largest health insurers in the U.S., says that waiting lists for CANCER surgery in the U.S. (for those WITH insurance) are now longer than waiting lists for elective surgery in Canada?</p>
<p>Is he some kind of commie pinko?</p>
<p>"
[quote]
And as you said, you wouldn’t go in unless there was gushing blood or something broken… and you’re not alone. I’m sure that’s a large contributor to high healthcare costs.[/q]</p>
<p>Yes, and more importantly, it’s also a large contributor to the results of the health outcome studies that provide “evidence” that Americans pay more $ for less health.?</p>
<p>Blue, but here’s the rub, no matter who the provider IS, the habits (or culture) of the average american is such that costs no matter single or multiple player, will continue to rise. We’re blaming insurance companies rather than ourselves for costs. Costs rise because we want our self created problems to be fixed. </p>
<p>"Dstark,</p>
<p>“Then at 40 Hypertension, 42 Diabetes.” </p>
<p>How easy is it to change insurance plans with these preconditions?"</p>
<p>Very. I live in a portability state. As long as I have insurance, I can change plans. Small group is “experienced” across the entire enrollments of small group. So as long as I am willing to pay premiums, I have coverage and the ability to switch. Where it is difficult for people here in WA is when they haven’t paid anything or owned insurance and then get sick. Then they have the high risk pool. So they still can get coverage, but they will pay more for it. Which in all honesty, is fine with me. They gambled they wouldn’t need insurance and chose not to purchase. Now after the fact, they want to be fixed. Yes, they should pay a little more because they paid nothing before.</p>
<p>The US system is broken and needs fixing. It does some things well and other things not so well. I am using a combination of private and public health care. It works very well and isn’t just for the over 65s. It depends on how much money you make. My company pays for all of my private health care since it isn’t as expensive as in the states though the doctors are all trained there or in the UK or Germany. The state picks up all the cancer expenses. The bottom line is that I pay very, very little out of my pocket for a few things. The good thing is that I am not afraid to go to the doctor, to have heart check ups, thyroid check ups, see a dietician. I can afford it on a very low salary. It is not perfect in the EU, but it works much better here for me.</p>
<p>Here is just a little example that you can most understand. My son had wisdom teeth out for $600 which was all paid for by insurance. From my understanding that would cost a whole lot more in the US. Something is way out of whack with the pricing in the states. My insurance covers me when I travel to the states for short trips but if I was to stay there for awhile I would have to pay a lot more in premiums. Any other country I am covered for any length of time. Why is this?</p>
<p>My Mom’s cardiologist here graduated from Oxford and then did his residency at Georgetown and practiced for years in Connecticut. He made house calls for her for $65. She didn’t need to have insurance here and could afford treatment at home or in a hospital out of pocket because the costs are so much lower. Her drug bills were cheaper than what she paid in the states and she had medicare for her drugs in the states.</p>
<p>“Why is it that CEO of Aetna, one of the largest health insurers in the U.S., says that waiting lists for CANCER surgery in the U.S. (for those WITH insurance) are now longer than waiting lists for elective surgery in Canada?”</p>
<p>a better question to ask mini is why has the us government allowed Aetna to swallow health care companies across america, creating along with united healthcare and a few others… monster providers? Why has the government allowed this? Guess who is going to be running your single player system mini… I’ve seen it coming for years. Big giant megas that will be assigned regions of the country to provide our government healthcare. That was part of the original Health plan that was shot down. The thing is, nobody bothered to stop the take over after take over. </p>
<p>I hate the Aenta ceo actuallly more than you. Because he has removed choice from the marketplace, all with government approval. If you notice, they give to both parties.</p>