[Q] US health System - Page 10

On May 19 2009 01:05 Aegraen wrote:

Everything government run is inefficient. Yes, even the military. There are contracts that are absurd, and the government always pays ludicrous amounts for what they get. What makes you think it is suddenly going to stop....You don't think that with the 'full backing' of the government, the medical suppliers aren't going to raise prices? Do you think bureacrocy is a business? They make horrible 'business' decisions, in fact, none of the decisions they make are based on business models, its all politics.

Haven't we all ready seen time and time again the horrendous effects of government run institutions?!

Lastly, the US cannot afford to spend any more. I'm wondering how many people here railed against Boooooosh and his increasing the spending. Doing the same with Obama are you? I have. We need to lower taxes, get government out of the way, and cut spending.

Libertarian and Conservative movements are growing, and for good reason. Politicians are so far out of reality with the populace its border line twilight zone.

I would recommend reading the Federalist and Anti-Federalist papers sometime.

In the end it boils down to this: Do you want to be run by an Oligarchy, or a Republic. It's a philosophical approach, and that is how government should be. There is no more philosophy in politics today, and thats what is causing the downfall. There are no more principles behind politicians anymore. Sad day indeed.

On May 19 2009 01:09 Archerofaiur wrote:
I think this thread is getting too polarized. The overwhelming majority of people here (and in the world) believe that healthcare should be provided to all. However, America is a two party system and ususally the only way we make any progress is through compromise.

So lets try and see what common ground we can establish. Aegraen, can we at least agree that healthcare should be provided to all children?


Also, would you support a mandate that requires all citizens to obtain health insurance? This is a very pro-business option that the private sector has recently embraced.

On May 19 2009 01:31 Aegraen wrote:


Within strict guidelines yes. That means households 200% below poverty level and within the ages of 0-16. The only reason I support this, is because these children are unable to work and support themselves, even then it has to be extremely limited though.

SCHIP covers households up to 75,000$ and until your 32! Absurd.

No I would not. I don't think the government should be mandating to the public much if anything.

On May 19 2009 01:28 aRod wrote:


Cost control is a very legitimate concern. I always advocate cost control. Understand not all government entities and contracts are lucrative due to competition and bidding amongst private entities. Medical suppliers don't simply get the option to "raise prices" after they commit to supply/pricing agreements that they had to bid for. More so, managed care institutions set prices they will pay for drugs. This includes medicare/medicaid whose alotted prices are lower than most managed care organizations. Suppliers can meet these prices or not sell their products.

Frankly your post contributes little to no insight into the health care debate, but simply more governmentphobia where it makes little sense to do so.

I encourage you to look specifically, in each case, if government involvement makes sense. The rest of the industrialized world has chosen a single payer system for a reason.

On May 19 2009 01:34 Archerofaiur wrote:



Ok we can agree that children should be covered. What about the disabled and mentally challenged?

Also should government mandate military service in times of war?

On May 19 2009 01:39 Aegraen wrote:


Yes they should. If you cannot support yourself, or have the means to in some shape or fashion, then yes as last resort government should intervene albeit discreetly. Charity and family should be the main support for these people (Which it was for the betterment of 250 years).

Depends. The only time a draft should be called is in extreme cases such as WWII. There was no need for a draft for vietnam. Even then, the only time a draft should be even called for in extreme cases is when the military is not meeting the demands of recruitment for the war.

I think losing your civilization, and lavishly throwing money out to those who do not produce are completely unrelated.

There have been a lot of debates and discussions recently, both on this forum and in other venues, about the state of healthcare. Looking at the rising costs of health insurance, and at the growing numbers of the uninsured, many are calling for government intervention, and the institution of a system where care is guaranteed to all - usually described as "universal" healthcare. It's a fascinating topic - the issues involved include humanitarian, financial and ideological ones. Unfortunately, debate on the subject is characterised by a startling phenomenon: one side is right, and the other is completely wrong.

Given the importance of medicine, I feel that it would be useful to clarify this issue. I will explain clearly, and with evidence, why it is that universal healthcare of any sort would be better than the current system in every significant way. If you find yourself disagreeing with this assertion, I ask that you read on before replying, as all conceivable objections will be addressed and resolved.

Why The Current Situation Is Bad

At the moment, healthcare in America is provided mostly by private entities, who charge high fees. These fees can be attributed largely due to the difficulty and expense of the medical profession, and although they are significantly higher than those of similar nations this difference is only a small portion of healthcare costs. There then exists the health insurance industry, a loose network of corporations that charge individuals or organisations premiums and will pay for their health costs if any are incurred.

Unfortunately, this system has enormous problems. As of 2006, 44.8 million people in America do not have health insurance. Many are unable to afford it, many are denied coverage by insurers who believe that as customers they will not be economical, and others choose not to purchase it. Without health insurance, the up-front costs of health care are impossible for most people to afford. In fact, 50.35% of all bankruptcies were caused, at least in part, by medical fees. In 2001, this was 2,038,549 bankruptcies.

Furthermore, health insurance does not fully cover medical expenses. Different insurers and different plans have many exemptions, co-pays, threshholds and other expense-minimising devices. As a result, 62% of those two million bankruptcies occurred despite the debtors having health insurance coverage for the duration of their illness.

As well as failing to provide care, and driving individuals into bankruptcy, the existing system is also exorbitantly expensive. Health care spending is now 15% of U.S. GDP - the highest in the world. The costs to businesses, who commonly pay premiums for their employees in lieu of salary, rose by 13.9% in 2003. The annual cost increase has been above inflation since at least 1981. Paying more doesn't result in more value, either - obesity, diabetes, and similar disorders are more common in the United States than anywhere else in the developed world, the U.S. is ranked 72nd in overall health, and life expectancy is below that of 41 other countries.

What Is Universal Health Care?

Universal Health Care, or UHC, refers to a wide range of different systems, the common characteristic of which is that a nation's government guarantees all its citizens access to healthcare. Every developed nation (OECD member) in the world, apart from the United States, has a UHC system. There are three main types:

In a fully public system, there is no or little private healthcare, and the health insurance industry is not a significant one. Medical service providers are government employees, and the education of doctors is also subsidised. The most well known example of a fully public system is the original English NHS, although a private sector is now developing in the U.K. as well.

In an optional public, the government provides the same services, but a private health services industry also exists (generally regulated), and . Sometimes health insurers exist, used by people who prefer private services. This is the most common, and examples include Australia and Sweden.

In a subsidised private system, the government pays for health care, but it is provided by private entities. Either the government acts as a health insurer for the populace, or it pays the fees for private health insurers to do so. This is done in Canada.

For the purposes of discussion, I will be assuming the characteristics of an optional public system, like those used in most of Europe. However, the benefits of UHC apply to all of the above types of organisation.

How UHC Will Improve Things

The single largest problem with healthcare in America is that many people don't have it. It's obvious how UHC solves this: by providing it to all citizens directly (or paying for it to be done). By definition, this is no longer a problem under UHC. All developed nations other than the United States make this guarantee to their citizens, and have so far been able to uphold it. The two reasons which make a person uninsurable - insurer decisions and lack of money - will no longer exist.

The second major problem with the current system is its high cost. This can be divided into two parts: individual cost, and government cost - which to the individual shows up as taxation. UHC is inherently cheaper - far cheaper - due to economies of scale, the bargaining position of monopolies with regard to drugs and salaries, reduced administrative costs, and the lack of a profit motive. When it comes to individual health care costs:

According to the World Health Organisation, average American individual spending on healthcare is $3371 per year. Since this includes the uninsured and those covered by their employers, actual costs are higher. For comparison:

Australia: $1017
Canada: $916
Sweden: $532
United Kingdom: $397

The first of those is the second-highest in the world - meaning that Americans pay, not including taxes, more than three times as much as citizens of any other nation. This would be somewhat justifiable if they received better healthcare, but again - 28% have no care at all, life expectancy is below all other developed nations, and general health rating is below all other developed nations.

It is commonly assumed that this difference in cost is because under UHC systems, higher taxes are required to fund the system. Not so. As mentioned, UHC is a great deal cheaper than private healthcare, and as a result America's health-related taxation is also the highest in the world. According to the OECD, in 2006, American government spending on healthcare was $2887 per person. For comparison:

Australia: $2106
Canada: $2338
Sweden: $2468
United Kingdom: $2372

American healthcare taxes are in fact the highest in the OECD, with France second at $2714. In conclusion, every single UHC system in the world costs less money for individuals, requires lower taxes, and provides better care to more people than the American health care system. By implementing UHC in the U.S., things can only get better.

Frequently Raised Objections

There are many incorrect arguments against the implementation of UHC in the United States. In order to better facilitate discussion, I will explain the errors found in the most common.

"America isn't Europe!", or It Won't Work Here
The argument from American exceptionalism states that what works in Europe will not work in the U.S. It's said that this is because European nations have more people in less space, resulting in less logistical difficulties, and because European government is more competent.

Firstly, not all developed nations are European. The most obvious example that counteracts the logistical argument is Australia, where there are 20 million people in only slightly less space than America's 300 million. This does indeed affect prices, as can be seen by comparing Australia to Sweden or the U.K. - but it doesn't bring them anywhere near the levels currently experienced in America.

The argument that American government is uniquely incompetent, and cannot do things that every other nation in the world can do, is simply nonsense. Not only has America, and American government, achieved many things that other countries have not, America has so many resources and the improvement in care and cost from moving to UHC is so large that even with incredible inefficiencies it would still be a good idea.

"It is immoral to force me to pay for others' healthcare."
You are already paying for others' healthcare. Furthermore, you are paying far more than you would be under UHC. The U.S. government incurs massive costs from paying hospital fees when ER visitors have no money, and from the limited coverage that it provides, which cannot take advantage of economies of scale and which has to subsidise corporate profit.

As demonstrated above, U.S. taxes devoted to healthcare are the highest in the world. Even if you choose not to have health insurance, under the current system, you are still paying more for others' healthcare than you would be paying for theirs plus your own under UHC.

"This is socialism."
It is not socialist to recognise that there is a service the free market is inefficient at providing, and to decide it should better be provided by the government. Even the most staunch libertarian admits that there are some services in this category, such as national defence.

Secondly, it is irrelevant whether this is a "socialist" policy; it's effective. It costs less and provides better care to more people, and as a result is used literally everywhere else in the entire world. Those who want to ensure that society remains ideologically committed to market capitalism need to look for other issues, as if they cling to this one they will only end up providing evidence against their position.

"I don't want more government bureaucracy."
UHC will involve much less bureaucracy than is commonly assumed, as it can replace the existing partial systems like Medicare and also the plethora of state-specific programs. Regardless, the lives and money saved are more important than any potential expansion of the state.

"Why don't we try making the system even more private instead? That might help."
It might. However, there's no evidence to suggest it, and many reasons to presume it wouldn't. By its nature, the less publicly-supported a system, the more people will be unable to purchase health services.

The only potential gain would be reduced costs due to some sort of market mechanism, and in practice this has never occurred; every private healthcare system that has ever existed in world history has proved inefficient and been replaced by public systems, and given the demonstrable gains that have resulted the U.S. must follow.

"Doctors will be paid less."
They probably will. In nations with UHC, doctors often earn less - for example, U.S. doctors earn 30% more than Canadian doctors - but this isn't an inherent problem. It is still one of the highest-paying professions in the world, and there are many other ways of attracting skilled people to medicine - such as subsidising their education.

It is sometimes claimed that doctors paid less in a country with UHC will instead go elsewhere where they can be paid more, but once the U.S. has UHC there will not be an elsewhere to go.

"Medical research is funded by the payments of the rich in the current system, and will be reduced."
It is not true that most medical research is done in the United States. In 2000, U.S. research spending was $46 billion, but European spending was also $43 billion. And although U.S. research spending doubled in the last decade, the funding's efficacy has actually decreased.

Secondarily, if the option for private healthcare still exists - and there is no reason why it should not - there will still be people choosing to pay more for a higher quality of care, faster service, et cetera. Their profits will still be reinvested in the development of new drugs, equipment and understanding of the human body, as they still are in nations with UHC today. Even in the United States, private spending accounts for only 57% of research spending.

"With the option of private healthcare, the rich will 'opt out' and costs will go up."
This isn't necessarily true at all; although private healthcare is usually allowed in UHC nations (for good reasons), it doesn't have to decrease the taxes paid by all to support the public system!

"Other countries fix drug prices, so the US has to pay more for drugs."
This is another common misconception. U.S. healthcare does not include higher pharmaceutical spending than other countries; it's around the average or even slightly lower. From the OECD:

Canada: 17.7%
Germany: 15.2%
Iceland: 13.3%
Australia: 13.3%
US: 12.4%
Sweden: 12%
Ireland: 11.6%

In Conclusion

Thank you for reading. To those who were not previously supporters of UHC, I apologise if anything seemed condescending, but there's no shame in being wrong due to not having all the facts or having been misled. If anyone has questions feel free to ask, and hopefully we can now discuss what sort of UHC system ought to be implemented or how the political will for it can be gathered, rather than being bogged down by misconceptions about its desirability.

On May 19 2009 01:59 SWPIGWANG wrote:

This was originally written by Gul Banana of the Something Awful Forums.



Personally, I don't know If I should agree with his conclusions, but DO KNOW that we should laugh at Americans if they ever bring up anything about health care system To think, they manage to make a private system less efficient than other people's public one. I think Americans have a point, their government is worst than any other in the developed world since it is obvious that if they let their government do it, it can only get worst. American exceptionalism indeed xD They just must fuck everything up.

On May 19 2009 02:11 Aegraen wrote:
United State of America Government intervention is the problem

On May 19 2009 02:25 SWPIGWANG wrote:

Fixed.

The only logical reason why the American distrust the government so much is that the government of USA must suck just that much more than everyone else's.

On May 19 2009 02:32 Aegraen wrote:
Why isn't Canada a world economic superpower? You're just that much more super awesome than us!

People confuse Federal and State governments so much. I don't think even a quarter of the american population understands what Federalism is and how it contributes to society, and then I doubt 3% of the global population even knows what federalism is.

There's a famous Australian joke, which in many variations, has been around since Federation. It is the story of an International Conference held to consider the endangered plight of African & Indian elephants. After a week of "gabfesting" about the matter a group of leading academics from five countries: Great Britain, France, Germany, the United States of America & Australia were engaged to write chapters for a public relations-oriented book on the urgent matter of saving the endangered elephants.

From the British there followed: "ELEPHANTS & EMPIRE - 1000 YEARS of GLORY";

From the French: "THE SENSUAL & EXISTENTIAL IMPLICATIONS of ELEPHANTS";

From the Germans: "THE TRAINING & DISCIPLINE of ELEPHANTS";

From the Americans there followed two chapters…the East Coast academic group came up with: "RAISING ELEPHANTS for FUN & PROFIT" whilst their West Coast counterparts came up with: "THE JOY of ELEPHANTS".

Then, from the Australians there followed: "ELEPHANTS - FEDERAL or STATE RESPONSIBILITY?"!

On May 19 2009 02:11 Aegraen wrote:


Government intervention is the problem, more government doesn't solve the problem that government created.

SCHIP, Medicare, Medicaid, HMO, etc.

You want an example of 'government run' healthcare. Look at the VA. VA is horrible.

Ron Paul wrote:
Additionally, due to the government-enforced monopolies of HMOs (Health Maintenance Organizations) and pharmaceutical companies, many patients will never even hear about some of the most effective and non-invasive treatment methods. These natural and inexpensive ways of regaining one's health are being suppressed by the FDA and the medical establishment not because of safety concerns (they've been around for hundreds of years), but because they cannot be patented and would therefore cut into the pharmaceutical industry's profits.

Forced nationalization is the worst possible answer. To get elected, many politicians promise "free" medical care for everyone. But health care nationalization in European countries resulted in longer waiting periods, severe lack of choice, deterioration of health care quality, prohibition of alternative health treatments, higher taxes, and sadly (for some) permanent illness or death because they could not get the care they needed.

Also, a nationalized system is not "free" at all because someone has to pay for it. And why should anyone be forced to pay for someone else's medical care? Very few decent people would personally assault their neighbors at gunpoint and steal thousands of dollars to pay for their own medical needs. How could any freedom loving person agree to delegate such criminal acts to the government by supporting a nationalized health care system?

There is only one solution that will lead to true health and true freedom: making health care more affordable.

Ron Paul believes that only true free market competition will put pressure on the providers and force them to lower their costs to remain in business. Additionally, Ron Paul wants to change the tax code to allow individual Americans to fully deduct all health care costs from their taxes.

As for the poor and the severely ill who can neither obtain insurance nor pay for the medical care they need, Ron Paul offers the following solution in his book "The Revolution: A Manifesto":

In the days before Medicare and Medicaid, the poor and elderly were admitted to hospitals at the same rate they are now, and received good care. Before those programs came into existence, every physician understood that he or she had a responsibility towards the less fortunate and free medical care was the norm. Hardly anyone is aware of this today, since it doesn't fit into the typical, by the script story of government rescuing us from a predatory private sector.

Illegal aliens already receive de-facto free health care. Why can't poor Americans have the same not as a right, but as a charitable benefit provided by doctors who feel a personal responsibility for their fellow citizens?

Unfortunately, the current medical monopoly corrupts many doctors by rewarding practices that are not in the patients best interest. Pharmaceutical companies have a vested interest in not curing people, but getting them permanently addicted to expensive drugs that have many side effects, thereby requiring additional drugs to suppress those side effects. Many doctors are afraid to speak up and question the system for fear of being ostracized by their peers or even losing their license.

Under a liberated health care system prices would come down and additional options would become available, thereby making health care much more affordable. Moral corruption would give way to true compassion, and many doctors would remember their implicit obligation to provide free medical care to those in need, just like they did in the past.

As a medical doctor, Ron Paul swore the Hippocratic Oath many decades ago. His entire person and career is a monument to the beauty and sanctity of human life. Ron Paul knows that life without health can be very difficult and is not what it was meant to be. He has personally cared for the poor for many years, without asking anything in return.

The government's original role is to protect our freedoms and restrain itself from causing too much harm. Ron Paul is working to prevent greedy bureaucrats, opportunist politicians and corrupt pharmaceutical companies from having any sort of unhealthy influence over our bodies and minds.

Aegraen wrote:
What everyone fails to take into account is the philosophical aspects of the roles of government. Just because something 'may' be more efficient doesn't make it better.

Headbangaaa and myself have all ready pointed out that the government is what created the increasingly exorbinant prices for health insurance. Medicare and Medicaid paying only 60% of the fees, leaving the hospital to recoup the other 40% from those not under Medicare and Medicaid. Secondly, by nationalizing the entirety of the health system, does not drive down costs. In fact, it would put an ever increasing burden on the government who all ready now 'backs your home mortgages, car, and other asinine things the government has no legal/legitimate role in'

The study wrote:
A system with multiple insurers is also intrinsically costlier than a single-payer system. For insurers it means multiple duplicative claims-processing facilities and smaller insured groups, both of which increase overhead. Fragmentation also raises costs for providers who must deal with multiple insurance products — at least 755 in Seattle alone — forcing them to determine applicants’ eligibility and to keep track of the various copayments, referral networks, and approval requirements. Canadian physicians send virtually all bills to a single insurer. A multiplicity of insurers also precludes paying hospitals a lump-sum, global budget. Under a global-budget system, hospitals and government authorities negotiate an annual budget based on past budgets, clinical performance, and projected changes in services and input costs.

The study also states:
Functions essential to private insurance but absent in public programs, such as underwriting and marketing, account for about two thirds of private insurers’ overhead.

Aegraen wrote:
The US Constitution, more than anything is a philosophically inspired document. I would rather live free and poor, than restrained and have money. Freedom is priceless.

You want to only argue stats, which I showed you were used deceitfully, yet you don't account for the philosophical nature of Government and that of human nature.

Once upon a time, Aegraen wrote:
I stand on the side of survival and preservation; realism. You stand on the side of ideology; faerie tales of some intrinsic utopia that is a figment of your imagination.

Aegraen, while perform research at the pulling numbers out of his arse institute
Your healthcare system is so great in Europe and other socialist countries, yet, you are hovering around 1% to under 1% GDP growth a year, and most see no growth. You don't realize the staggering burdens placed on your businesses.

You must read a Wealth of Nations, by Adam Smith. I would also advise you to read Ayn Rands: Atlas Shrugged.

On top of this, economical servitude (slavery), is inherently immoral and unjustified. Why should I have to work to pay for others? Why should I become a slave to the government forfeiting over half my work? Do I not work for myself? Approaching the philosophical nature, with the means to build on the principle foundation to improve the system is what needs to be done.

PS: In before the CIA Worldfact book 1.3% GDP growth in America. Need I remind everyone here, that the US now spends nearly as much as britain accounting for (last I checked) 43% of GDP spending. In every regard, we are all ready socialist.

Put two and two together, with what everyone all ready knew, and socialism does not create wealth, it merely siphons what wealth there is off until everyone becomes poor. Well, at least then everyone is equal right? Thats what it is all about afterall.

You know besides the taxes that pays for it no? Just a question, if you don't pay taxes is your healthcare still free? If so, enjoy stealing from others?

On May 19 2009 04:51 Syntax Lost wrote:
Actually, I'm going to call it a night for now, but I would like to close by pointing out Aegraen expectance that charity will cover people unable to cover their health care costs epitomises his selfishness. He hopes that someone else will cover the costs of those who can't because he knows that he won't.