On January 08 2011 03:36 t3hwUn wrote: Most top leaders and ambassadosr or anyone who holds a decent governmental job comes to the US for major operations. That is a fact.
Let us assume this is correct. It still does not say anything about the quality of your healthcare system No one doubts the skill of US physicians. The core problem is that the majority of people do not have access to quality healthcare (bceause they have no insurenace or becuase they have one that does not want to cover their expenses) or if they do, the relation between cost and obtained service is worse than in many other countries.
As I mentioned earlier, the problems within the US medical system will never be fixed by central gov't control and regulation. That will only increase the cost and reduce the quality of care.
The problems with the US healthcare system are related to outrageous malpractice insurance practices causing medical practitioners to spend many factors more than they otherwise would for a treatment.
Doctors have to: a) pay malpractice insurance, the likes of which are easily several hundred thousand dollars even for a general practitioner/pediatrician. I talk to my doctor about this sometimes, and it's not a myth. b) run extra tests/procedures to cover their asses against any unlikely but possible scenario, because if they don't people can sue them for incompetency. This drives up the cost of healthcare a ton. c) avoid getting sued at all costs. Getting sued successfully usually ends their career, since they get kicked out of the AMA. This is the true cost of malpractice lawsuits, so doctors have to spend everything they can to avoid them.
When you say that the majority of people do not have access to quality healthcare because they have no/poor insurance you are outright lying. I believe around 85% of this country has insurance, and lets keep in mind a good bunch of uninsured Americans are uninsured by choice. Many young, healthy people choose to remain uninsured because they believe it's not worth the cost. Many people who are not college/high school graduates and who don't have steady jobs are not insured either. Unemployed people have trouble getting insurance at a reasonable rate, but why wouldn't they? They're not working, so the motivations to insure them over someone who is working a stable job are not the same.
The media likes to glorify insurance horror stories and take shots at big business in general for being the culprit. The truth is that while sometimes bad things happen and people get screwed, the large vast majority of policyholders never experience something that bad. The average joe is going to perhaps have to call up their company to fix a billing error every now and then, but that's no reason to abandon our system altogether.
In fact, capitalism ensures that if a company is being abusive, corrupt, or malicious people will just leave. It happens all the time. Employers, under pressure from employees, will switch providers. What happens if the gov't is being abusive, corrupt, or malicious? What if they're just not up to par in quality? The people cannot switch to a new provider. That's why socialist systems are so dangerous - they don't fix themselves.
I think there are much better ways to improve our system than turning to gov't control. When the gov't starts acting as a free market entity it breaks the mechanics of capitalism and often makes things much much worse.
Just remember, it's life, liberty, and happiness. It's not life, liberty, happiness, and healthcare =D
I work in the healthcare product development...and with lots of doctors. You nailed one of the biggest problems on the head: Malpractice. The AMA was pretty pissed that malpractice caps were not introduced in the healthcare bill. One surgeon I work with pays over $100,000 per year in malpractice. He got sued once (pretty pathetic case) and his insurance settled out of court for $40,000...and then tacked that on to his next annual bill. Ridiculous.
Look up what Canada did to malpractice insurers. They suffocated them in their infancy by having the government fight every single suit tooth and nail. The business did not become profitable, and so it mostly died out. Malpractice in Canada costs, to my knowledge, around $3k a year for your average physician. Ridiculous. Especially since I am in med school, it makes me want to GTFO of this country.
The second problem is most definitely product development costs. And this problem is a Catch-22. Anyone who knows anything about medical device regulations knows that the FDA is the most strictest of all regulators (minus Japan's FDA equivalent). In fact, most new medical products start out in Europe, since the CE mark is much cheaper and faster to get for emerging products (ie drugs, surgical tools).
You can get a CE mark in under a year. FDA approval of a Class III medical device, or a drug, can take 5-10 years. And costs well over $250 million on average for the company. You have massive, multi-armed trials, which are very costly. Which is exactly why they charge massive amounts to the customer. You think that bottle of amoxicillin really costs 30 bucks? It costs the pharmacy companies like 5 cents to make. And your neighborhood pharmacy buys it for like 3 bucks. But the company has to charge those insane rates, because they have to make back that initial investment (and they only have a few years to do so before the generics hit the market). And this fucks patients. Want another example? Look at a heart pump (called a VAD) like the Heartmate II. Costs around $10k for the titanium based ones. Charged to the patient for over $100k. And that doesn't include surgery. Ouch.
Sure, FDA approved products are generally safer, but they haven't been without their foul-ups (Vioxx?). And most products in the EU are generally as safe. And definitely more cutting-edge. Some of the new-age anticoagulants for patients with heart disease are still only available in EU. Check Dabigatran (although this was recently, conditionally approved for a very limited population in the US).
I'm all for reducing FDA regulatory requirements. They are suffocating the industry and the medical technology is quickly rushing to European markets. The cost-benefit ratio is worth it, IMHO. Most of the advances in medicine were made decades ago. John Gibbons Heart lung machine? Debakey's Roller pump? All made by doctors who were literally winging it. With minimal regulations. In fact, most devices didn't have heavy regulations until 1990 (!).
The joke in the medical product development community is that Penicillin would not be approved by the FDA if it was run through today.
Cut malpractice, scale back the FDA a little bit (of course not entirely!), and it would have a major impact on healthcare in the US.
my mind is blown that some people really can think of Obama as a socialist. i dont want to offend you, really. but please stop listening to right wing media propaganda and read a serious book on the topic. it's complete nonsense. and it is complete nonsense that there is socialism in europe. not in the slightest...
It is still the best healthcare system in the world though. The quality of care, the quality of medication, the variety of doctors and medicines available, and of course the wait times for surgeries and procedures are phenomenal and unobtainable through a gov't health care system.
Not to be rude, but that is one of the most ignorant things I've heard regarding the United States on these forums.
The USA isn't even in the top 30 countries regarding health care, and for such a developed nation your life expectancy isn't even in the top 10.
There are many, many many many European countries in particular with superior health care systems, and any survey from a reputable and unbiased organization will give you lists of them. I'll save you the trouble of a google search...
1 France 2 Italy 3 San Marino 4 Andorra 5 Malta 6 Singapore 7 Spain 8 Oman 9 Austria 10 Japan 11 Norway 12 Portugal 13 Monaco 14 Greece 15 Iceland 16 Luxembourg 17 Netherlands 18 United Kingdom 19 Ireland 20 Switzerland 21 Belgium 22 Colombia 23 Sweden 24 Cyprus 25 Germany 26 Saudi Arabia 27 United Arab Emirates 28 Israel 29 Morocco 30 Canada 31 Finland 32 Australia 33 Chile 34 Denmark 35 Dominica 36 Costa Rica 37 United States of America
Please please please don't make claims based off of patriotism. The United States is not and has not been at the top of the world for many years regarding health, democracy, living conditions, and other related topics.
It is very easy to feel like your country is the best when it's all you've ever known, experienced, or had the care to research... but it is also very stupid.
I am very happy to be Canadian, perhaps even proud, but I do not suffer from the illusion that Canada is the best country in the world.
To the people thinking the black vote has historically gone to Democrats because they are selfish or whatever: It's actually because the historical Republican strategy is "fuck black people." See http://en.wikipedia.org/wiki/Southern_strategy
Are you insane? Abraham Lincoln was a Republican and the Democrats historically wanted to keep slaves.
As for ignorant non-economist who talk about Tea-Party and Reps suck because they want to cut taxes and at the same time balance the budget. You think that rich people pay a lot of taxes even if we raised it on them? Get real. They have so many loopholes, lawyers, and accountants. Increased taxes will always have the middle-class and small business owner paying the bulk.
Purely on economics, cutting taxes does help the economy. (Yes, I do have strong education in economics.) The private sector creates all the growth in the US. The government is the biggest destroyer of wealth. Look at social security, the post-office, and the DMV. They all run deficits even though they have a monopoly. You think they are going to fix health-care, get real.
You bleeding hurt liberals make me sick. Go take a macro-economic class based on math. Keynesian economics is a joke.
To the people thinking the black vote has historically gone to Democrats because they are selfish or whatever: It's actually because the historical Republican strategy is "fuck black people." See http://en.wikipedia.org/wiki/Southern_strategy
Are you insane? Abraham Lincoln was a Republican and the Democrats historically wanted to keep slaves.
As for ignorant non-economist who talk about Tea-Party and Reps suck because they want to cut taxes and at the same time balance the budget. You think that rich people pay a lot of taxes even if we raised it on them? Get real. They have so many loopholes, lawyers, and accountants. Increased taxes will always have the middle-class and small business owner paying the bulk.
Purely on economics, cutting taxes does help the economy. (Yes, I do have strong education in economics.) The private sector creates all the growth in the US. The government is the biggest destroyer of wealth. Look at social security, the post-office, and the DMV. They all run deficits even though they have a monopoly. You think they are going to fix health-care, get real.
You bleeding hurt liberals make me sick. Go take a macro-economic class based on math. Keynesian economics is a joke.
Vote Ron Paul 2012!
I have hard these arguments so many times before. Just privatize everything and soon the world is a happy paradise. We tried that in Germany with public transport and with energy providers. Guess what. Train rides are becoming more epensive every year and the only thing that has changed is that the trains arive late more often and that their climatization stops working when its more then 33°C outside (to save money, of course).
The energy sector is even better. Privatization has lead to four big companies dividinv the majority of the market and creating quasi-monpolies. Although these corporations sacked a lot of employees and althogh they have frequently profited from better oil/gas prices, proces for the consumers have about doubled in the last 10 years. However, these companies are now among those with the most profit in Germany and their CEOs are the best-earning.
Since you are so well-educated in economics, do you think it is a good idea to allow monopolies or oligopoles in markets with low to no elasticy?
Go take an economy class based on behavioral economics. Homo oeconomicus is as real as santa, so better start incorporating the idea that markets don't work as you propagate they do.
Yeah, nice trick. If you do not like the outcome of an analysis, complain about the dependent variable to maintain your unrealisitic opinion. Shakes head. I do not know about you, but the WHO can probabaly considered somewhat expert in these matters, don't you think?
Edit: Just to give you one more thing to think about: How much profit doe your private healthcare sector generate each year? Take that number and imagine you spent that on medical personnel, medicine and equipment and you have the standard a "socialist" health care system would provide.
“I don’t mean to imply that all people who work for health insurance companies are greedier or more evil than other Americans,” he writes. “In fact, many of them feel — and justifiably so — that they are helping millions of people get they care they need.” The real problem, he says, lies in the fact that the United States “has entrusted one of the most important societal functions, providing health care, to private health insurance companies.” Therefore, the top executives of these companies become beholden not to the patients they have pledged to cover, but to the shareholders who hold them responsible for the bottom line.
On January 08 2011 21:48 TributeBoxer wrote: I dont know why all these Europeans are in here complaining about the US. Your countries will be Islamic Republics in your lifetimes.
Yeah, right. Take some time and check what "we Europeans" are complaning about. It is not the US but rather some people from the US stating - contrary to all obtainable objective facts - that the US is #1 in all imaginable fields. Imagine a fat kid among a lot of well-trained ones who brags that he is the most sportiest and ridicules the others for not being as sporty as he is, would you take that kid sriously? Didn't think so.
On a side note, I am pretty sure that you do not have nay clue about Islam in Europe, do you? In Germany there are probabaly 30,000 muslims who are member or extreme Islamist groups out of about 4,000,000 muslims living here. That is even less than the percentage of the Germans voting for the NPD (Neonazi party), so i guess our muslims are pretty sane people who enjoy their freedoms as much as the average bloke.
“I don’t mean to imply that all people who work for health insurance companies are greedier or more evil than other Americans,” he writes. “In fact, many of them feel — and justifiably so — that they are helping millions of people get they care they need.” The real problem, he says, lies in the fact that the United States “has entrusted one of the most important societal functions, providing health care, to private health insurance companies.” Therefore, the top executives of these companies become beholden not to the patients they have pledged to cover, but to the shareholders who hold them responsible for the bottom line.
This pretty much sums it up and is exactly what I said before. Corporate greed is the problem in a privatized healthcare system. If all the money that is deducted as profit went directly into the system, I would probabaly move ot the US instantly and anticipate a good 120 years long life.
To the people thinking the black vote has historically gone to Democrats because they are selfish or whatever: It's actually because the historical Republican strategy is "fuck black people." See http://en.wikipedia.org/wiki/Southern_strategy
Are you insane? Abraham Lincoln was a Republican and the Democrats historically wanted to keep slaves.
As for ignorant non-economist who talk about Tea-Party and Reps suck because they want to cut taxes and at the same time balance the budget. You think that rich people pay a lot of taxes even if we raised it on them? Get real. They have so many loopholes, lawyers, and accountants. Increased taxes will always have the middle-class and small business owner paying the bulk.
Purely on economics, cutting taxes does help the economy. (Yes, I do have strong education in economics.) The private sector creates all the growth in the US. The government is the biggest destroyer of wealth. Look at social security, the post-office, and the DMV. They all run deficits even though they have a monopoly. You think they are going to fix health-care, get real.
You bleeding hurt liberals make me sick. Go take a macro-economic class based on math. Keynesian economics is a joke.
Vote Ron Paul 2012!
I have hard these arguments so many times before. Just privatize everything and soon the world is a happy paradise. We tried that in Germany with public transport and with energy providers. Guess what. Train rides are becoming more epensive every year and the only thing that has changed is that the trains arive late more often and that their climatization stops working when its more then 33°C outside (to save money, of course).
The energy sector is even better. Privatization has lead to four big companies dividinv the majority of the market and creating quasi-monpolies. Although these corporations sacked a lot of employees and althogh they have frequently profited from better oil/gas prices, proces for the consumers have about doubled in the last 10 years. However, these companies are now among those with the most profit in Germany and their CEOs are the best-earning.
Privatising a monopoly and giving it to a private company is just slack, at least sell it off to as many firms as you can and or deregulate that market so as others can jump in.
On January 08 2011 22:06 ShroomyD wrote: Privatising a monopoly and giving it to a private company is just slack, at least sell it off to as many firms as you can and or deregulate that market so as others can jump in.
Yes, that is what should have been done. Free markets are beautiful and good when they work but, sadly, they so rarely do.
On January 08 2011 21:26 Balthasar wrote: Purely on economics, cutting taxes does help the economy. (Yes, I do have strong education in economics.) The private sector creates all the growth in the US. The government is the biggest destroyer of wealth. Look at social security, the post-office, and the DMV. They all run deficits even though they have a monopoly. You think they are going to fix health-care, get real.
You bleeding hurt liberals make me sick. Go take a macro-economic class based on math. Keynesian economics is a joke.
I really don't know whether to take this seriously, but I'll bite.
1. You claim to have a strong education in economics; did you seriously just advocate a strong belief in trickle down economics? Cutting taxes may help the economy, but it depends strongly on where the cuts are. The current cuts that are being extended do nothing to help the economy. All philosophical debate about the wealth of individuals and the need to keep grubby government hands away from it, they do nothing to help the economy.
2. The debate that rages on now have absolutely nothing to do with macroeconomics. As much as I love economics (my major), I realise that the macroeconomics side is deeply flawed, especially if you try to take it as a precisely correct model of the real world. Every school of macroeconomics has its issues. The one thing I have to say is that don't try to make it out like either parties economic policies make a great deal of economic sense. The Republican rhetoric on the "free market" and its miracles worry me greatly for their impact on the rest of the world. I haven't decided where to cast my "vote" as it were in the macroeconomics world, though before I am preempted I'll agree that Keynesian economics has its failures, which I personally believe come from their interpretation of Keynes himself. Modern macroeconomic models fails in several assumptions, such as money illusion (and you're really pushing it if you try to argue people don't suffer from it), and a lack of adherence of principles of methodological individualism which would go a long way to further discussion of economics as a 'scientifically rigourous' subject.
I want to leave with one last comment: correct me if I'm wrong but is there not a current running around that monetary policy should be taken out of the hands of the central bank? This is several Republicans seeming advocacy of the Gold Standard make me really, really worry that they've taken control of the largest economy in the world. There's a reason the world moved on from the Gold Standard, and a reason why monetary policy lies outside the hands of politicians. I just want to stress on the second point; the independence of monetary policy from government is a hallmark of economic liberalisation in the world, why? Because technocrats job do a better one than self-serving politicians. I'll be happy to argue this point if anyone cares to disagree.
On January 08 2011 21:35 Electric.Jesus wrote: I have hard these arguments so many times before. Just privatize everything and soon the world is a happy paradise. We tried that in Germany with public transport and with energy providers. Guess what. Train rides are becoming more epensive every year and the only thing that has changed is that the trains arive late more often and that their climatization stops working when its more then 33°C outside (to save money, of course).
You guys also tried socializing everything and you got East Germany. More free-market, the more successful the country.
On January 08 2011 21:39 Electric.Jesus wrote: Just to give you one more thing to think about: How much profit doe your private healthcare sector generate each year? Take that number and imagine you spent that on medical personnel, medicine and equipment and you have the standard a "socialist" health care system would provide.
First of all, don't try to argue with me in a language you can barely speak. I don't maintain US health care does not have its problems. But, so does many social health care programs in Europe and in Canada. I'm not totally free-market to say you can't have socialized health-care and it will not work. You have to first be able to afford it. Increased deficit spending is not the answer. Most countries that are somewhat successful in socialized health-care run low deficits as a percentage of GDP compared to U.S. I wish we all everything had free including health-care, however we can't afford it.
On January 08 2011 23:44 Croaker wrote: Modern macroeconomic models fails in several assumptions, such as money illusion
Personally, my school of economics is Neo-classical and Austrian. Those do not really suffer from money illusion, actually it protects from it. Most economic majors are full of crap anyways. Unfortunately, most economic majors are math illiterate, sure they know some, but they study too much theory and history without the math behind it. You only get half the picture at best.
On January 08 2011 23:44 Croaker wrote: Correct me if I'm wrong but is there not a current running around that monetary policy should be taken out of the hands of the central bank? This is several Republicans seeming advocacy of the Gold Standard make me really, really worry that they've taken control of the largest economy in the world.
You say your major is in economics, don't you know your economic history? The currency was supposed to be backed up by gold and that was our promise to the world during Bretton Woods, so we wouldn't be printing money of out of thin air without anything backing it up, which is going on right now. This is what everyone wanted, a solid currency without crazy inflation. Unfortunately, we reneged on the agreement during Vietnam and that's why we have crazy rising prices and huge deficit. Gold is boring and limits what we can do financially, but it keeps governments more honest about their accounting. I agree with you on one thing that politics and monetary policy should not be mixed, just honest and straightforward.
On January 09 2011 07:34 Balthasar wrote: You guys also tried socializing everything and you got East Germany. More free-market, the more successful the country.
Being from what you may know as West Germany I don't get the point - if there is any - in your remark.
First of all, don't try to argue with me in a language you can barely speak.
Now you are just being a prick. Have I done anything to deserve this insult? We can continue in German if you wish. I promise not to insult you if your german is not perfect.
I don't maintain US health care does not have its problems. But, so does many social health care programs in Europe and in Canada. I'm not totally free-market to say you can't have socialized health-care and it will not work. You have to first be able to afford it.
But were there not enough sepcialists who did some math and showed that "Obamacare" would save the US about half a billion dollars a year? Basically offering a state-run alternative forces free-market competitors to lower their prices while maintaining the level of service which leaves cutting profits as the only alternative.
Increased deficit spending is not the answer. Most countries that are somewhat successful in socialized health-care run low deficits as a percentage of GDP compared to U.S. I wish we all everything had free including health-care, however we can't afford it.
You know, this is the weirdest thing. The numbers I researched show that the US has, by far, the highest healthcare cost as measured in percent of the GDP. I have linked an interesting graph from the respective wikipedia-entry HERE.
What I find surprising is that all other countires that are in this graph behave basically the same, that is you get a strong linear relation between healthcare spending and life expectancy. The US is the only country to totall differ from that pattern. Frankly said, compared to how much money you spend on healthcare, you get a pretty crappy product, on average (note: on average. Rich people are pretty well cared-for, I bet.).
1. Praising the medical practise for the increase in life expectancy? Hah hoh heh hih. Try sanitation, lower crime rates, penicillin, and that we can deliver babies without killing them as much now. The differences between life expentancies between countries nowadays has nothing to do with healthcare. Which brings me to my next point:
2. Medical spending has no correlation with health. There's been numerous studies and experiments about this, most notably the RAND experiment by the US government. Results show that extra spending on medicine gives *no* benefits.
There are more important things than medicine for health, like diet and exercise. Food is even necessary to live. But we don't go to a government funded building to eat, but yet we need just that for our healthcare?
On January 09 2011 09:18 Mayfly wrote: 1. Praising the medical practise for the increase in life expectancy? Hah hoh heh hih. Try sanitation, lower crime rates, penicillin, and that we can deliver babies without killing them as much now. The differences between life expentancies between countries nowadays has nothing to do with healthcare. Which brings me to my next point:
2. Medical spending has no correlation with health. There's been numerous studies and experiments about this, most notably the RAND experiment by the US government. Results show that extra spending on medicine gives *no* benefits.
There are more important things than medicine for health, like diet and exercise. Food is even necessary to live. But we don't go to a government funded building to eat, but yet we need just that for our healthcare?
I would like to see evidence that differences in life expetancy have nothing to do with healthcare. I think that is utter bullshit but I am happy to be convined otherwise by reliable data. Could you link to the source your statement is based on so I can check it? The data I linked above seems to suggests otherwise: unless there is some severe confound, it suggests that there is in fact a strong colletation between healthcare spending and life expectancy.
Maybe whjat you say is accurate within the US system. If so, then the study you talk about is pretty meaningless in this context since you talk about a within-system-analysis while I am referring to a between-systems-comparison.
Also, the US has an unusually high infant mortality (6.7 out of 1000) compared with other industrialized countries (ranging from 2.6 to 5.0). So even if you use one of the alternative indicators of health-care quality you proposed, the US still scores badly which, again, makes me think you pay too much for too little in return.
On January 09 2011 09:18 Mayfly wrote: 1. Praising the medical practise for the increase in life expectancy? Hah hoh heh hih. Try sanitation, lower crime rates, penicillin, and that we can deliver babies without killing them as much now. The differences between life expentancies between countries nowadays has nothing to do with healthcare. Which brings me to my next point:
2. Medical spending has no correlation with health. There's been numerous studies and experiments about this, most notably the RAND experiment by the US government. Results show that extra spending on medicine gives *no* benefits.
There are more important things than medicine for health, like diet and exercise. Food is even necessary to live. But we don't go to a government funded building to eat, but yet we need just that for our healthcare?
I would like to see evidence that differences in life expetancy have nothing to do with healthcare. I think that is utter bullshit but I am happy to be convined otherwise by reliable data. Could you link to the source your statement is based on so I can check it? The data I linked above seems to suggests otherwise: unless there is some severe confound, it suggests that there is in fact a strong colletation between healthcare spending and life expectancy.
Maybe whjat you say is accurate within the US system. If so, then the study you talk about is pretty meaningless in this context since you talk about a within-system-analysis while I am referring to a between-systems-comparison.
Also, the US has an unusually high infant mortality (6.7 out of 1000) compared with other industrialized countries (ranging from 2.6 to 5.0). So even if you use one of the alternative indicators of health-care quality you proposed, the US still scores badly which, again, makes me think you pay too much for too little in return.
Actually, the US has higher rates of other things that are contributing to most of those low life expectancies obesity teenage pregnancy* significant reason for the high infant mortality violence/accidents
Which indicates that people in the US aren't using their health care to live longer, they are using it to live fatter or have their babies early or do extreme sports or live in a violent area (although that last is much less of a choice). This doesn't mean the healthcare is worse, it just isn't producing the same type results. (Like saying an SUV isn't a good buy since it has poor gas milage, or a bike is a poor transportation option because it has poor towing capacity)
However, While I Agree that "privatizing" by itself is not a good idea... the key is to break up monopolies, regardless of control by the state or otherwise.
On January 09 2011 10:48 Krikkitone wrote: Actually, the US has higher rates of other things that are contributing to most of those low life expectancies obesity teenage pregnancy* significant reason for the high infant mortality violence
Which indicates that people in the US aren't using their health care to live longer, they are using it to live fatter or have their babies early or live in a violent area (although that last is much less of a choice). This doesn't mean the healthcare is worse, it just isn't producing the same type results. (Like saying an SUV isn't a good buy since it has poor gas milage, or a bike is a poor transportation option because it has poor towing capacity)
Tanks for the info. I had not taken that into account. However, with regards to obesity we are quickly catching up to you guys. ^^
However, While I Agree that "privatizing" by itself is not a good idea... the key is to break up monopolies, regardless of control by the state or otherwise.
This! Its all about creating frameworks in which markets can actually work the way they are supposed to.
EPT
