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Falling
Canada11354 Posts
On March 29 2012 06:29 lOvOlUNiMEDiA wrote: I may be wrong, but I don't think such promises would get anywhere because he couldn't get a bill like that through the house or the senate. Yeah, halfway through I began how much easier it is to deadlock things than to govern in the US. If it was a parliamentary system, it would be much easier. | ||
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liberal
1116 Posts
On March 29 2012 06:30 Defacer wrote: And I think you have the lowest life-expectancy and highest infant mortality rate out of the G20/first world countries. You guys need to do something. Perhaps they could stop including the millions of both legal and illegal immigrants from poor nations around the world in their mortality statistics? If you want to talk about life expectancy, you can't simply assume that every nation on the planet has the same demographics and the same heterogeneity. There are some specifics we can mention regarding infant mortality as well. First, the U.S. strictly adheres to the World Health Organization's definition of live birth (any that "breathes or shows any other evidence of life"), counting even the extremely premature and most fragile. In contrast, the WHO Bulletin noted the "common practice in several (Western European) countries to register as live births only those infants who survived for a specified period." Because the most premature are least likely to be recorded, the effect is dramatic. One researcher showed that the mortality rate can vary by 50% depending on the definition, while another proved that terminology caused up to a 40% variation and a 17% false reduction in non-U.S. infant mortality rates. Second, three-fourths of the world's neonatal deaths are counted by highly unreliable five-yearly household surveys, instead of by health care professionals. Surveys frequently misclassify what were really live births as "stillbirths," thereby excluding most neonatal deaths. Third, premature birth, the main risk factor for neonatal death, is far more frequent in the U.S. than any developed country — 65% higher than Britain, for instance. Whether that's due to aggressive in vitro fertilization or harmful behaviors during pregnancy, the National Center for Health Statistics concluded that premature birth is "the primary reason for the United States' higher infant mortality rate when compared with Europe." Fourth, racial and ethnic minorities have far higher infant mortality, whether in the U.S. or under government-run systems such as Canada's and the United Kingdom's. Population heterogeneity disadvantages the U.S. — not because U.S. mortality is worse, but because racial-ethnic heterogeneity in the U.S. is four to eight times higher than in countries such as Sweden, Norway, France and the U.K. In fact, the U.S. has superior infant mortality rates for newborns with the highest risk of dying who actually need medical care — the best in the world outside of Sweden and Norway — even without correcting for obvious population and risk-factor differences deleterious to U.S. statistics. Ultimately, infant mortality rankings reflect deviations in terminology, reporting accuracy and populations — all of which are unrelated to health care quality and selectively disadvantage the U.S. The peer-reviewed literature proves it. | ||
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xDaunt
United States17988 Posts
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BadgerBadger8264
Netherlands409 Posts
Yeah, using those statistics to say that the US has a horrible health care system is ridiculous. If you have insurance or are otherwise able to pay for care in the US, the care that you actually get is top notch. I've had to get care or be closely involved with someone else's care on multiple occasions, ranging from emergency care, to surgery, to child birth, and I have never had a complaint about the quality of the care that was given. Anecdotal evidence doesn't really work when you're talking about health care of a country with 320 million residents. According to multiple studies conducted across the entire US, health care across the US is, on average, below western world standards, and that is if you can afford it. The funny (in a shocking way) is that the US actually spends much, much more on health care per capita than any other western country, and doesn't even get close to their money's worth. | ||
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Lockitupv2
United States496 Posts
On March 29 2012 06:24 Falling wrote: I wonder if this get's struck down are Obama's contenders so weak that he can turn this into an election issue? As in full on promising universal (not socialized) healthcare? Publically funded, privately provided and given to the states to administer given x guidelines. Block transfer payments or something like that. Because if it did become a campaign issue and he wins on it, it gives him a little more strength to try something similar even if Obamacare ends up being the sacrificial lamb. I wanted to say it would give Obama a strong mandate, but then I remembered the entire system is so hamstrung that no-one can actually do anything. If his opponents were strong, it wouldn't work. "Commy's are coming" and all that. But without a real challenger, it could work. Edit And yeah, for Canadians 'somehow' getting the money for our healthcare. Per capita our healthcare is half that of the Americans. So much for private enterprise being the cheapest for value. But the thing is, it isn't government running our healthcare. They just fund it (fee for service) and lay out guidelines like the Canadian Healthcare Act. Doctors aren't state employees. Hospitals are autonomous institutions often run by regional health boards. And provinces can individualize it. Which I think is probably the path of least resistance for America. I don't think you could have a centralized healthcare like the UK as US is just as spread out as Canada and states are just as concerned with provinces with giving up power to the federal government. US health care is private enterprise? Haha, thats a pretty funny joke. | ||
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sunprince
United States2258 Posts
On March 29 2012 06:51 xDaunt wrote: Yeah, using those statistics to say that the US has a horrible health care system is ridiculous. If you have insurance or are otherwise able to pay for care in the US, the care that you actually get is top notch. I've had to get care or be closely involved with someone else's care on multiple occasions, ranging from emergency care, to surgery, to child birth, and I have never had a complaint about the quality of the care that was given. We have a horrible health care system in terms of overall outcomes for the average citizen. However, this is a really incomplete way of looking at it, because the reality is that upper/upper-middle class Americans have top notch health care better than most G20 citizens, while other Americans have awful health care. This is also the reason that costs seem too high, because those of us fortunate to have means spend a lot for marginal improvements. It's like you have two groups of 100 people each. Group A (Americans) includes 15 people with Lamborghini's and 85 people with Yugo's. Group B (Europeans) includes 100 people with Toyota Camry's. On average, Group A pays $60,0000 for 150 horsepower, while Group B pays $22,000 for 180 horsepower. Yet that analysis misses the forest for the trees. It's not as useful to say that the mean citizen has awful healthcare, because then it overlooks the real problem with American health care: it's not that we have inferior doctors, technology, and infrastructure (in fact, the opposite is true), but the fact that many Americans don't have access to them. | ||
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INeedSpoons
Colombia41 Posts
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DeepElemBlues
United States5079 Posts
We have a horrible health care system in terms of overall outcomes for the average citizen. However, this is a really incomplete way of looking at it, because the reality is that upper/upper-middle class Americans have top notch health care better than most G20 citizens, while other Americans have awful health care. This is also the reason that costs seem too high, because those of us fortunate to have means spend a lot for marginal improvements. Half true, but the half that isn't true is more important than the half that is. In terms of overall outcome for the average citizen, America has a fine health care system. The average American has healthcare through his employer which is at the least comparable to that of any other First World country. The upper middle class and upper class can afford to pay $3000+ a month premiums for the highest level of coverage and get an overall outcome superior to that in any other country in the world. It is the 10-15% of the population who does not have an employer that offers health insurance or cannot afford premiums at any level and is reliant on state-provided health insurance, which gets limited (in the sense that the amount of money needed overall would bankrupt state governments and the federal government will not give enough funds to bridge the gap) federal help from Medicare/Medicaid, that is worse off compared to other First World countries. One of the main reasons American healthcare spending is so much higher than that of other countries is the over-65 group who have an extremely generous deal in the form of Medicare, a deal that allows them to essentially get whatever care they want almost entirely cost-free. A good example would be the Part D reform passed under George W. Bush, which, while being largely successful at not turning into a runaway spending train, is still a very, very generous entitlement system for prescription drugs. This is the whole reactive as opposed to preventative care problem; whether you have private or public health insurance, you can rack up fully covered (or with very minimal co-pays) visits and services almost without limit that only bring marginal benefits, which leaves not enough money for catastrophic or long-term care. You can go visit your doctor 3 times a month (or more) at a thousand dollars a pop to the insurance company indefinitely, for basically no real medical benefit to yourself, and people wonder why premiums are high. | ||
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logikly
United States329 Posts
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Defacer
Canada5052 Posts
On March 29 2012 08:51 DeepElemBlues wrote: Half true, but the half that isn't true is more important than the half that is. In terms of overall outcome for the average citizen, America has a fine health care system. The average American has healthcare through his employer which is at the least comparable to that of any other First World country. The upper middle class and upper class can afford to pay $3000+ a month premiums for the highest level of coverage and get an overall outcome superior to that in any other country in the world. It is the 10-15% of the population who does not have an employer that offers health insurance or cannot afford premiums at any level and is reliant on state-provided health insurance, which gets limited (in the sense that the amount of money needed overall would bankrupt state governments and the federal government will not give enough funds to bridge the gap) federal help from Medicare/Medicaid, that is worse off compared to other First World countries. One of the main reasons American healthcare spending is so much higher than that of other countries is the over-65 group who have an extremely generous deal in the form of Medicare, a deal that allows them to essentially get whatever care they want almost entirely cost-free. A good example would be the Part D reform passed under George W. Bush, which, while being largely successful at not turning into a runaway spending train, is still a very, very generous entitlement system for prescription drugs. This is the whole reactive as opposed to preventative care problem; whether you have private or public health insurance, you can rack up fully covered (or with very minimal co-pays) visits and services almost without limit that only bring marginal benefits, which leaves not enough money for catastrophic or long-term care. You can go visit your doctor 3 times a month (or more) at a thousand dollars a pop to the insurance company indefinitely, for basically no real medical benefit to yourself, and people wonder why premiums are high. The Canadian and American healthcare systems are a contrast in philosophies. Canada addressed the problem of providing everyone with the best healthcare we could afford first, and has been gradually trying to improve services and benefits and make it more efficient over time. And to be honest, I don't know any Canadians that have serious issues with the quality of their care. Americans have excellent health care ... if they can afford it. Without an individual mandate, it seems as though health coverage will always be limited, or prohibitively expensive. It seems like there is no incentive to be more cost-effective. Is that a fair characterization? | ||
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Lockitupv2
United States496 Posts
On March 29 2012 08:37 INeedSpoons wrote: Is it unconstitutional to pay for police, even though you are not a victim of crime? No, that's constitutional. Federal Police on the other hand...not so much. | ||
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alpinefpOPP
United States134 Posts
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sunprince
United States2258 Posts
On March 29 2012 08:51 DeepElemBlues wrote:In terms of overall outcome for the average citizen, America has a fine health care system. The average American has healthcare through his employer which is at the least comparable to that of any other First World country. The upper middle class and upper class can afford to pay $3000+ a month premiums for the highest level of coverage and get an overall outcome superior to that in any other country in the world. Perhaps I was unclear. What I mean is, the average outcome is horrible in terms of cost-effectiveness. The example I provided was hyperbolic, but the main point I was trying to get across is that the stats are really skewed if you look at it only in terms of the means, instead of seeing what's really going on. On March 29 2012 08:51 DeepElemBlues wrote: One of the main reasons American healthcare spending is so much higher than that of other countries is the over-65 group who have an extremely generous deal in the form of Medicare, a deal that allows them to essentially get whatever care they want almost entirely cost-free. A good example would be the Part D reform passed under George W. Bush, which, while being largely successful at not turning into a runaway spending train, is still a very, very generous entitlement system for prescription drugs. This is the whole reactive as opposed to preventative care problem; whether you have private or public health insurance, you can rack up fully covered (or with very minimal co-pays) visits and services almost without limit that only bring marginal benefits, which leaves not enough money for catastrophic or long-term care. I agree. Medicare reform would be crucial to bringing down costs. | ||
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forgottendreams
United States1771 Posts
On March 29 2012 06:45 liberal wrote: Perhaps they could stop including the millions of both legal and illegal immigrants from poor nations around the world in their mortality statistics? If you want to talk about life expectancy, you can't simply assume that every nation on the planet has the same demographics and the same heterogeneity. There are some specifics we can mention regarding infant mortality as well. + Show Spoiler + First, the U.S. strictly adheres to the World Health Organization's definition of live birth (any that "breathes or shows any other evidence of life"), counting even the extremely premature and most fragile. In contrast, the WHO Bulletin noted the "common practice in several (Western European) countries to register as live births only those infants who survived for a specified period." Because the most premature are least likely to be recorded, the effect is dramatic. One researcher showed that the mortality rate can vary by 50% depending on the definition, while another proved that terminology caused up to a 40% variation and a 17% false reduction in non-U.S. infant mortality rates. Second, three-fourths of the world's neonatal deaths are counted by highly unreliable five-yearly household surveys, instead of by health care professionals. Surveys frequently misclassify what were really live births as "stillbirths," thereby excluding most neonatal deaths. Third, premature birth, the main risk factor for neonatal death, is far more frequent in the U.S. than any developed country — 65% higher than Britain, for instance. Whether that's due to aggressive in vitro fertilization or harmful behaviors during pregnancy, the National Center for Health Statistics concluded that premature birth is "the primary reason for the United States' higher infant mortality rate when compared with Europe." Fourth, racial and ethnic minorities have far higher infant mortality, whether in the U.S. or under government-run systems such as Canada's and the United Kingdom's. Population heterogeneity disadvantages the U.S. — not because U.S. mortality is worse, but because racial-ethnic heterogeneity in the U.S. is four to eight times higher than in countries such as Sweden, Norway, France and the U.K. In fact, the U.S. has superior infant mortality rates for newborns with the highest risk of dying who actually need medical care — the best in the world outside of Sweden and Norway — even without correcting for obvious population and risk-factor differences deleterious to U.S. statistics. Ultimately, infant mortality rankings reflect deviations in terminology, reporting accuracy and populations — all of which are unrelated to health care quality and selectively disadvantage the U.S. The peer-reviewed literature proves it. Do you plan on citing the source next time? To add to this... I think people should understand we have the highest obesity rate in the developed world, it plays into the life expectancy rate significantly. | ||
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liberal
1116 Posts
Now when a woman gets charged $1,200 for an ambulance ride that was less than a mile, what goes into the costs? If we take the AHA number and mandate absolutely everyone has insurance, the cost drops 6%. So instead of $1,200 for a half mile ambulance ride, we pay $1128. There isn't a person on this forum who would argue that in a truly free market, we couldn't provide an ambulance ride for less than a thousand dollars. It is not a free market, it is not capitalism, it is not free enterprise. It's not socialism either. It's a completely broken system of government regulation, inefficiency, and mismanagement. It is a system of escalating costs due to licensing restrictions, fraud, excessive lawsuits, government mandates... price is not dictated by supply and demand, because the price is all paid third party, and the means to pay is fourth party, in the case of employers. Spreading the cost to more people is not a reduction in cost. The inherent costs are still there, it's just been spread over more people. The individual mandate does absolutely nothing to address the fundamental problems with this system. And the majority of the problems are government made, not market. In December 2011, the outgoing Administrator of the Centers for Medicare & Medicaid Services, Dr. Donald Berwick, asserted that 20% to 30% of health care spending is waste. He listed five causes for the waste: (1) overtreatment of patients, (2) the failure to coordinate care, (3) the administrative complexity of the health care system, (4) burdensome rules and (5) fraud. Since forgottendreams asked for sources: http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCIQFjAA&url=http://www.aha.org/content/00-10/10uncompensatedcare.pdf&ei=FaxzT42NIsOC2AXGxKz6Dg&usg=AFQjCNFqnuLrSgD8AVx42jpViiGtglmdYQ http://www.ems1.com/ambulances-emergency-vehicles/articles/1046116-Ambulance-ride-cost-angers-Calif-patient/ http://www.urban.org/uploadedpdf/412045_cost_of_uncompensated.pdf http://www.nytimes.com/2011/12/04/health/policy/parting-shot-at-waste-by-key-obama-health-official.html?_r=2&emc=eta1 | ||
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Happylime
United States133 Posts
On March 29 2012 06:26 xDaunt wrote: Whether Massahcusetts can pass an individual mandate is irrelevant to whether the US can do so. The federal and state governments operate under different rules. There is no explicit Supreme Court ruling that governs whether the individual mandate is Constitutional. If you want to have a look at the lay of the land concerning recent commerce clause jurisprudence, go read the Lopez, Morrison, and Raich decisions. If you want to see the most expansive reading of the commerce clause issued so far, go read Wickard v. Filburn. As I have said repeatedly, the sum of these decisions and the current composition of the Court make it far more likely than not that the individual mandate will be found to be unconstitutional. http://en.wikipedia.org/wiki/Malloy_v._Hogan and http://en.wikipedia.org/wiki/Gideon_v._Wainwright Would both seem to imply that States do not have special rights that the federal government does not have. The constitution applies to both the federal government and the states. States' rights does not hold up. Thus a State can't be passing laws that are deemed unconstitutional at the federal level. | ||
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liberal
1116 Posts
On March 29 2012 10:03 Happylime wrote: http://en.wikipedia.org/wiki/Malloy_v._Hogan and http://en.wikipedia.org/wiki/Gideon_v._Wainwright Would both seem to imply that States do not have special rights that the federal government does not have. The constitution applies to both the federal government and the states. States' rights does not hold up. Thus a State can't be passing laws that are deemed unconstitutional at the federal level. Yes, they both must follow the constitution, but the constitution itself declares that state's have rights which extend beyond the federal level. Just read the tenth amendment. Honestly, this stuff should be taught the first year of a political science or US history class... | ||
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xDaunt
United States17988 Posts
On March 29 2012 10:03 Happylime wrote: http://en.wikipedia.org/wiki/Malloy_v._Hogan and http://en.wikipedia.org/wiki/Gideon_v._Wainwright Would both seem to imply that States do not have special rights that the federal government does not have. The constitution applies to both the federal government and the states. States' rights does not hold up. Thus a State can't be passing laws that are deemed unconstitutional at the federal level. No, that's not what those cases stand for, and they have nothing to do with the Commerce Clause. Gideon and Malloy are part of a line of cases ("Incorporation") in which the Supreme Court ruled that states are bound by various amendments of the Bill of Rights (meaning the federal government and the state governments have to honor the protections within the Bill of Rights). The DC gun rights case (I'm forgetting the name right now), which dealt with the Second Amendment, was the latest of these cases. That the States have additional powers and rights that the federal government does not, is an elementary principal of Constitutional law (the converse is also true -- ie the federal government has powers and rights that States do not). Have you ever read the Constitution? It's all written right in there. The Constitution enumerates federal powers and reserves the rest to the States. In short, your assertion that "a State can't be passing laws that are deemed unconstitutional at the federal" is entirely incorrect. This happens all of the time because States have a general police power and the federal government does not. | ||
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Minitmaid
United States1 Post
On March 24 2012 02:18 Stratos_speAr wrote: I hate hearing every other clueless conservative on the internet say, "Well I come from a poor background, and if I can do it, everyone can do it!" Either you are quite fortunate or just straight up lying. Someone has to be pretty damn oblivious to say that everyone is able to simply work hard and get themselves out of horrible living conditions. The world just does not work like that. That is naive, childish thinking. This is the huge problem with overly-conservative fiscal thinking - you are all in dream land where your hypothetical true market fixes everything. Unfortunately, very few markets in the U.S. are true (competitive) markets. Take cable TV as an example. In most areas in the U.S., you have one option for a provider. If you don't like them, you settle for satellite TV, or you're more or less screwed. Just a really basic example but many markets are in the same vein - having only one or very few providers, giving the consumer little actual choice. So it takes a clueless conservative to work hard and get out of horrible living conditions? I don't understand what you mean here. I've worked hard to put myself through school working places I thought I never would. I have worked in the underground coal mines in order to put myself through college. Im an electrical engineering student and I will be graduating soon. How can it be impossible for anyone to work hard in order to get away from bad living conditions? Granted you may not be able to have everything you want, BUT you can make it better on yourself and give your children a better shot than you had. Also I find it very demeaning of you to say that anyone who says this is straight up lying or very fortunate. I know I am fortunate, and I also know this is due to what I have done. Nobody was going to pay for me to go to school and I knew better then to sit around and wait for that to happen. I took the initiave to get off my ass and work so my life could be better. Aside from this I feel that this is a very dangerous bill. The idea of affordable healthcare for everyone is great I do not think anyone disagrees with this. However mandating that every citizen is forced to purchase insurance is the wrong way to go about this situation. The federal government is allowed to deal with commerce, if a bill is passed that mandates the purchase of a product/service from someone this would be a Pandora's box which COULD never be shut. Anything would be possible and this bill would set the precedence for it. I am curious as to why the bill mandates such a thing. Why are we not trying to pass a bill which simply gives citizens the option for an affordable health insurance plan? Does it not seem odd that everyone would be required to purchase said plan if they had no other insurance? If the bill did offer a plan which was optional then yes I feel as if it would be constitutional and a great idea. Oh by the way I'm not a conservative  | ||
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Holophonist
United States297 Posts
On March 29 2012 06:36 Falling wrote: Yeah, halfway through I began how much easier it is to deadlock things than to govern in the US. If it was a parliamentary system, it would be much easier. What's the quote? The gears of government grind slowly, but they grind exceedingly fine? Sometimes not being able to get shit done can be a good thing. | ||
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