To answer you last Q, Case, the answer is basically, any of them. Or all of them. You see this graph? this is a graph of health care spending per capita among OECD nations. Speaks for itself. It's pretty obvious to me from this graph that we have made a bad draw. And it doesn't make you a bad republican to admit reality here....IMO. Edit: I should add this is all adjusted for PPP
On Capitalism and health care: Not everything in a capitalist country is run by the private sector, nor should it be. Police forces aren’t privatized. Fire departments aren’t privatized. Water and sewage isn’t privatized, etc. Many of these services were once privatized but were taken over by governments over time as it came to be understood that governments could provide these services much more efficiently and economically. The same is true for basic health care. On the system: A single payer system with universal coverage is the proven way to go, imo, but there are lots of modifications that can be made. One that works well in Canada is having the programs managed by the provincial governments. In Canada both the federal and provincial governments pay for the health care system but they have different roles in it. The federal government sets certain basic minimum standards while essentially all the other decisions are made by the provinces. This means that provinces are able to structure their programs in a way that addresses local concerns. It also means that each province decides things like how and how much it will pay its doctors, and if one province falls behind in giving its doctors raises they will eventually start moving to other provinces. The provinces also decide how many specialists they will hire, and this determines whether or not there are any wait lists to see these specialists. If the wait lists start to become longer than the federal minimum standards allow, however, then the federal government can threaten to withhold its funding. In a sense there are 13 competing systems in Canada that not only compete to set pay levels but also learn from each other. Each province has a minister of health, who is political person responsible for the system, and typically each province is divined up into regions, but this structure varies from province to province. The one here in Calgary is the Calgary Health Region. http://www.calgaryhealthregion.ca/ The CHR is one of the regions governed by Alberta Health Services. http://www.albertahealthservices.ca/ In a US system you might perhaps want to make the state head of such a system an elected position, or you may even want to elect the regional heads, or you may want to just appoint them. You can do some creative thinking with this at this stage because you’re starting with a clean slate. The key point I’m trying to make here is that the system doesn’t need to be just a mysterious black box administered by people far away in Washington. Basic health services would likely be delivered by the Houston Health Region, which would be run by a Houstonian, and it would have services that were designed specifically for Houstonians. Maybe you’d choose to have a number of mobile units that could drive around to the different schools in disadvantaged neighbourhoods to make sure that every child got a yearly check-up, or some other idea. Whatever works for Houston you could do, because it would be a community run system.
You could buy them out and then prohibit them, at least as far as basic services go. You can buy medical insurance in Canada for traveling abroad and for things that aren't covered by our basic health care system. You just can't buy health care insurance to cover basic services. We don't have a two tiered system in Canada. Everyone is covered by the same system as far as basic health care goes. Here's an example of the kind of extra health insurance you can buy. https://www.ab.bluecross.ca/individ3.html
Willful blindness is not cute. I would venture to say 90% of the population of the USA could not afford a hospital stay to the tune of 150K$ Rocket River
That was largely done for the purpose of the film, but the first two at least are issue that have occurred in the past. The third may be a Quebec thing but I'm not familiar with it here. In the late 90s and the early part of the 00s governments were trying to cut back on their spending and some were pinching their health care budgets to do it, and as a result wait lists were growing. The short of the story is that it got to a point were there was a loud public outcry and the governments responded by putting more money into the system. A government could easily lose an election over that kind of issue here. The second has been a problem in recent years because we've had a shortage of doctors, but I believe that it's also a problem in a lot of countries right now. There are several key contributing factors in Canada, however. http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20030319/doctor_shortage030319?s_name=&no_ads= http://www.cfpc.ca/cfp/2004/Mar/vol50-mar-letters-1.asp http://www.readersdigest.ca/mag/2004/08/doctors.html
Well several of them have crappy care which is why they cost less. So you squeeze the middle class into a worse system to save cash in order to give everyone healthcare? Thats jacked up.
I don't understand how I get accused of being a republican. If I was a republican I would probably own a business and want universal health care so it would let me off from paying 75% of my employees stuff. Meanwhile I would just go to my private Dr. and use a private insurance while raking in the extra profit. It is the middle class that gets screwed here.
The middle class is being screwed in the current system where health care costs rise 15-20% per year while incomes go up 2-3% per year. That's a collision course to disaster.
The costs will continue to go up. 15-20% is total BS. Look at total costs. not "I paid 10 bucks for a copay last year and now its 20. Thats 100%!!" The middle class will be paying for the lower class non-working to get medical coverage. The upper class will go private.
It looks like it's slowed over the past year, but in the mid-2000's, my annual premium for health insurance was rising 15-20% annually for my small business. The latest data shows over the entire decade: http://www.nchc.org/facts/cost.shtml # Since 1999, employment-based health insurance premiums have increased 120 percent, compared to cumulative inflation of 44 percent and cumulative wage growth of 29 percent during the same period.2 # Health insurance expenses are the fastest growing cost component for employers. Unless something changes dramatically, health insurance costs will overtake profits by the end of 2008.5 # According to the Kaiser Family Foundation and the Health Research and Educational Trust, premiums for employer-sponsored health insurance in the United States have been rising four times faster on average than workers’ earnings since 1999.2 # The average employee contribution to company-provided health insurance has increased more than 120 percent since 2000. Average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits rose 115 percent during the same period.6 Regardless of the specific numbers, having health costs rising at 3-4 times worker's earnings is an unsustainable system.
There generally isn't an option to go private. Overall the single payer system is about 30% cheaper and it covers 100% of a country's citizens. In other words, everyone who was paying will save an average of 30%, and everyone who wasn't paying covered as well. Weren't you the one who was promoting the Taiwanese system?
The middle class is always screwed, but we're being extra screwed at the moment with the current system.
No, actually a large part of the cost savings can be attributed to the much lower administrative costs in these systems and corresponding efficiency gains.
Does this control for foreigners coming to the US for healthcare? It wouldn't take many Saudi sheiks spending $1 million on an operation in Houston to skew our numbers high and lower their numbers. And we don't just have a few Saudis. Many of the world's wealthiest come the US for major healthcare and especially elective healthcare.
Fixed that for you. The lowered administrative costs don't correspond to efficiency gains for healthcare. Massachusetts found that out quickly.
LOL, how can you argue that something that both costs more overall and spends more on administrative costs, while not delivering superior performance (and in many cases inferior performance) is more efficient? You should turn in your libertarian card immediately. Sorry bro, but you could give the entire House of Saud sex reassignment surgery and it wouldn't come close to making a dent in our annual health care expenditure (15% of GDP = 2 trillion)
You can still have your private care if you want it. We have Metro, but you don't have to ride the trains or buses...you can buy and maintain a car all you like. What we're doing isn't working. It's breaking people. And small businesses are struggling to provide any sort of health care at all to employees. It's a burden that has zero to do with running a business.
I'm not. But virtually every time a government has socialized their healthcare system, they have done so claiming that it would reduce administrative costs (many times pointing to our Medicare as an example) and thus increase efficiency. They found out quickly that the reducing administrative costs part was easy, but it still ended up costing more than it did before. So they did the predictable thing and started rationing. (Giving the entire House of Saud a sex-change would be entertaining, though.)
How is rationing any different from a private insurer denying coverage to boost its share price? Regardless - do you have a data set that shows this? Mass's program is nice but it's still pretty fragmentary - a public/private mix of programs in many cases would create an even worse set of incentives than before.
1) You usually have more recourse against the private insurer. 2) You can usually change private insurers. In a single-payer system, you're stuck with going to the US to get operations that the NHS won't cover. There's more, but here's an example: http://www.boston.com/news/health/articles/2008/02/03/subsidized_care_plans_cost_to_double/
