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The problem isn't between goverment and Private healthcare..
Switzerland has a also a very expensive (but effective) healthcare system which is mostly run by private insurance companies. BUT, the really big majority of these companies have really low administration costs (4-7%, which is LOW - just compare it with other companies). That means only 4-7% of the amount you pay in Switzerland is for the actual insurance companies, the full rest these companies actually *need* to work. I doubt a state driven insurance company will do this any better.
Result? Our Healthcare cost is expensive and every year rising. Whiteout insurances being able to do anything about it, people just get older and older, demand more and more medicine and (think) they need more and more expensive treatments.
I pay nearly $2400 a year (well I don't because my company is awesome and pays it for me :p) and don't remember when I the last time saw a doctor. Tthe last time I was ill, was in march 2008, for one day. But for these $2400 I'm save, if something does not outright kill me I will get very good healthcare, No matter what sort of illness or accident I have, nearly no matter if I just was a retard or an unfortunate victim, every reasonable and tested practice will be available to me.
The problem is, that health care needs regulations in nearly every aspect and these regulations should make sense.
I think that is where the American system fails compared to many/most of the European ones. Most European system also have big issues, but the USA just seems to have much more and worse ones.
Also all countries have problems with their health care costs. This is not exactly an American problem, America is just way ahead of the curve and at the same time delivering MUCH worse results.
As long people get older health costs will increase. As long as people want to see a doctor for every little cold (and often more than once) the costs will increase. Making healthcare costs lower is every single persons own responsibility, if you run to a doctor every time you have a headache... Well... You pay the price --> Be it directly out of your own pockets, with your taxes or with your insurance bill.
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On July 16 2009 16:30 Arbiter[frolix] wrote:
Personally, I think universal healthcare is a moral imperative for any civilised, developed nation.
Meh, moral imperative? How far does that extend. There can be a system which ostentatiously offer Universal healthcare, then couple it up with limitation of method of treatment used, increases fees on smokers, obese people, AIDS patients...wait. To be honest, I don't believe that 'universal' healthcare can be accomplished under either a perfect market solution or a government based solution. Even in a civilized, developed nation, I don't suppose all of its citizens would wish to shoulder the burden that someone else bears. Or need we attach strings to how universal things are?
On July 16 2009 16:33 Arbiter[frolix] wrote:Show nested quote +On July 16 2009 13:07 gchan wrote:
Actually I think it's interesting that Cuba is in the same life expectancy range as US is considering they are often touted as having the best health care. Not sure on the facts, but I think they have the most physicians per capita. Amusing. You do realise that Cuba is a poor nation, subject to ongoing decades-long sanctions from the global superpower, right? The "interesting" thing is that Cuba is even on the same chart as the wealthiest, most powerful nation on the planet when it comes to healthcare performance.
The Cuban system is a thing of marvels, but we don't see that kind of performance replicated anywhere else. EDIT - Right, Singapore, another weird as hell system, but if there is anything to be emulated, I'd take that. I can't say much about it though, being that I am unfamiliar with it other than hearing the tales of how awesome it is. So in my uneducated opinion, the first thing that comes to mind is like, the KGB. For a nation that we later decided was in shambles for the most part, there were some parts of it that worked amazingly well. As you pointed out yourself, there are other elements that the chart does not take into account which affects the performance that we see.
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United Kingdom2674 Posts
On July 16 2009 16:50 Ecael wrote:Show nested quote +On July 16 2009 16:30 Arbiter[frolix] wrote:
Personally, I think universal healthcare is a moral imperative for any civilised, developed nation. Meh, moral imperative? How far does that extend. There can be a system which ostentatiously offer Universal healthcare, then couple it up with limitation of method of treatment used, increases fees on smokers, obese people, AIDS patients...wait. To be honest, I don't believe that 'universal' healthcare can be accomplished under either a perfect market solution or a government based solution. Even in a civilized, developed nation, I don't suppose all of its citizens would wish to shoulder the burden that someone else bears. Or need we attach strings to how universal things are?
Oh I fully recognise that even some of the more liberal, socially-minded of people here are likely to find my position on such matters to be rather radical. However, I think many of the objections rest on a myopic view of our political, social and moral potentialities.
But I suppose that is a debate for another day and another thread.
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On July 16 2009 16:50 Ecael wrote:Show nested quote +On July 16 2009 16:30 Arbiter[frolix] wrote:
Personally, I think universal healthcare is a moral imperative for any civilised, developed nation. Meh, moral imperative? How far does that extend. There can be a system which ostentatiously offer Universal healthcare, then couple it up with limitation of method of treatment used, increases fees on smokers, obese people, AIDS patients...wait. To be honest, I don't believe that 'universal' healthcare can be accomplished under either a perfect market solution or a government based solution. Even in a civilized, developed nation, I don't suppose all of its citizens would wish to shoulder the burden that someone else bears. Or need we attach strings to how universal things are? Show nested quote +On July 16 2009 16:33 Arbiter[frolix] wrote:On July 16 2009 13:07 gchan wrote:
Actually I think it's interesting that Cuba is in the same life expectancy range as US is considering they are often touted as having the best health care. Not sure on the facts, but I think they have the most physicians per capita. Amusing. You do realise that Cuba is a poor nation, subject to ongoing decades-long sanctions from the global superpower, right? The "interesting" thing is that Cuba is even on the same chart as the wealthiest, most powerful nation on the planet when it comes to healthcare performance. The Cuban system is a thing of marvels, but we don't see that kind of performance replicated anywhere else. EDIT - Right, Singapore, another weird as hell system, but if there is anything to be emulated, I'd take that. I can't say much about it though, being that I am unfamiliar with it other than hearing the tales of how awesome it is. So in my uneducated opinion, the first thing that comes to mind is like, the KGB. For a nation that we later decided was in shambles for the most part, there were some parts of it that worked amazingly well. As you pointed out yourself, there are other elements that the chart does not take into account which affects the performance that we see.
But we "shoulder the burden that someone else bears" all the time. I pay for roads I've never driven on, buses I've never ridden, courts I've never been summoned to, but all of these things are necessary for our economy and our society to function.
I've never called 911 for any reason, but I don't complain when the police save someone's life by stopping a robbery or when the fire department saves someone's life by rescuing them from a building. I recognize the benefit those services have on society and want them to function properly and would hope that if I ever need them, they will be available for me to use as well.
I don't see why that of the three things you call 911 for, 99% of the population has no problem with the first two coming for free, but so many are ok with the third one costing literally thousands of dollars just to use once.
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gchan wrote:
Anyway, I'm done arguing with you because you are obviously on tilt. Try not responding to every message so angrily. Oh, and government programs are _always_ more inefficient because there is no feedback mechanism to manage them.
What do you call voting?
Syntax, look at my other posts about competitive pricing.
Did you actually read the articles I posted on how the private system is less efficient? Please go back and read the actual articles I posted. Claiming that fair market competition is always more efficient is not founded on reality. It can be more efficient under some circumstances, but it isn't necessarily all the time. All of the actual hard evidence posted in this thread shows that this is not the case. Do you have any peer-reviewed studies to refute the claim?
Market conditions in the early 20th century were substantially different than they are now. Also, you outline exactly my point in saying that government is good at developing the theoritical backbone, but not application.
My point just goes flying above your head, doesn't it? You completely ignore the point about universities and the research they perform. You also ignored the example on Japan (profits are heavily regulated but they still make significant progress). Finally you ignored the example of the Sick Kids hospital (which made the discovery that it's possible to donate a heart to a child with the wrong blood type). All of this is done without the incentive for massive profits.
Kwark already responded about the next section, but I'll add a little more to it. I also noticed that you never responded to his points in your next reply. I guess it sucks to be caught making up BS.
Vaccinations--19th-20th century government program, government proliferation because of the need to fight disease during war.
Kwark answered this but here's an article about the matter.
Then there's also the Salk polio vaccine which was bankrolled by the March of Dimes charity. There was actually no war or profit motive behind it. Polio was responsible for untold deaths and cases of paralysis throughout human history. The development of a vaccine was an incredible achievement in the history of medical science.
Antibiotics--early 20th century government research, mass produced by government because, again, of war.
Germ theory--more specific please.
Errr... The entire discovery that a lot of diseases were caused by microorganisms?'
DNA--Initial research done by government, yes, but application mostly used in drugs is done by private industry. Actual direct usage of DNA targetting products is too infant to really say whether it's being picked up by private industry.
Seriously, WTF? You do realise the importance of DNA outside of pharmaceuticals, right? Guess all the research discovery the causes behind cancer doesn't count, does it? Or all the research into innumerable diseases with genetic components or causes.
Ecael wrote:
With the NEJM article, it shows the current system to be inadequate, which we seem to agree on, but actually doesn't show a viable alternative. If the US magically transforms into a Canadian system, then the study shows that a single payer system as opposed to the current system can potentially mean a large sum of savings. As the study admits, it focused on the administrative costs and is unable to take into account many of the other expenses, if we can point solely to administrative cost as the cause of the difference in quality of care and price, then sure.
Are you intentionally trying being thick or does it just come naturally? All the real evidence in this thread shows overwhelmingly that healthcare models implemented in countries with either tightly regulated or entirely socialised systems offer more effective and efficient healthcare. There is no evidence to suggest that any of these models are unviable in the US. Looking at the article I posted on SCHIP you can see evidence that a government programme run by the US represents a reduced cost to US healthcare. I'll admit that no healthcare system is perfect, but that doesn't mean that they aren't a massive improvement to current US healthcare.
About the population density part, that is actually not my point. The primary point was to point to the regional nature of healthcare practices in America, thus a more suitable comparison in these two other countries.
You're lying.
Once upon a time, Ecael wrote:
I don't know, the US suffers from one particular problem that we don't see in European countries in terms of its size. A more suitable comparison would probably be China or Russia, considering they are some of the few countries that can really match US in terms of both population and size. However, those tow differ from the US in too many ways for us to form a proper comparison either. I personally don't think that even with all the resources and potential that the US dumps at the field we should be in the top 3, the culture that has built up until this point as a result of the current system and the legal entanglement that comes with it is going to be difficult to fix. It will take decades before anything shows proper outside of drastic changes on the system.
In short though, "Facts are that the US corporate health system is much worse than some of the worst western government run health care systems.", even if comparisons between the two are really lacking in many ways.
You're basically just trying to appeal to the US being special in terms of its geography without posting any evidence aside from saying its large and stating that comparisons are impossible. This is essentially just a red herring, especially when you consider it's population density that is more of a factor (since providing care to more sparsely populated areas is generally more costlier per capita) and that there are plenty of other countries which are able to contend with this problem and still provide better healthcare than the US.
However, in response to what was said of a government program ensuring coverage in areas with low population density. if a private market solution won't want to settle in an area that is not densely populated, what will draw people to enter government services that work in those areas?
Errr... The fact that they're being paid? You're acting like governments can't incentivise people to work in a specific region which is just nonsense.
As it is, we throw in huge incentives for medical students to work public care and government in forms of the social work program and the army scholarships. That is a hefty sum for a temporary service. As Caller pointed out, there is already a large issue with the amount of people entering the medical field and the price they are forced to pay.
So, in other words, you need the government to provide incentives for people to work in remote areas. Well, colour me surprised...
A government based system will likely not only need to change the insurance system as we know it, but initiate drastic changes in the education field both from students and current practitioners.
You're right about insurance; they won't be able to gouge customers like they're doing now. Your claims about changing the education system are unsubstantiated.
You can't honestly say that academic institutions are not doing it for profit. We have a recent case of Cornell attempting to enforce the patents attached to it, I believe we have yet to see a case of it in terms of biotech and pharmaceutics, but what's stopping them?
You do realise that there's a world outside of the US? A world with universities, many of which are funded primarily through government. What do you think they do? And seriously, do you honestly think that research conducted by universities is driven by the motive for profit? Even if it were made impossible for them to profit on such discoveries, you think their research would dry up?
As it is, I have many issues with the current system myself. However, to point to government control of healthcare as an end-all solution like that is no better than the Bush administration's attempt to paint EHR as an amazing miracle machine that will save lives and cut costs magically.
Strawman. It doesn't have to be perfect to be a massive improvement.
Kwark, does the discovery of a smallpox vaccine via cowpox or the discovery of penicillin via an accident mean that they have discovered the theoretical backbone of the science?
Congratulations on showing that you have no idea what a scientific theory is. The discoveries of both Jenner and Fleming had very real and very tangible direct applications, the results of which you still enjoy today.
Government and academic institutions has always been the ones focused on the basic research to the commercial companies' focus on applications.
Okay, it's clear that you've never participated in real university research so please refrain from talking about it like you actually have an informed opinion. Plenty of university research is devoted to applications. What we don't see are university manufacturing the applications but that's simply because they're not set up to run the production facilities. Private companies step in to actually produce the end product but the vast majority of the research is covered by the universities. This is because private companies will tend to direct their research towards targets that are sure to yield profitable products. In a lot of cases, you will see the university produce the proof-of-concept and then private company leap on the opportunity after that since the product is already known to work. Research into areas which are far more murky, particularly those with very little chance for success (which is most research, since most of it tends to end with failure) does not encourage much investment since the possibility for profit is extremely small. We see this in practice with the corporations since they spend far more on marketing than they do on R&D. Given this information, do you seriously think R&D is such a top priority for them?
Suggesting that either of those were "theoretical backbone" would be just as absurd as to claim that they were related to government programs. Those were the kickers to begin more proper research on the area, which makes up the backbone science, not the theoretical frameworks themselves.
This is just an enormous pile of steaming BS. What the fuck is the "theoretical framework" of vaccination and antibiotics?
While that doesn't preclude government research from being able to turn out practical uses for the basic research, how will such be funded and what impact do they have on our existing market system?
Okay, now you're just getting sidetracked from the actual point. Here's the thing, nobody is against research performed by private corporations or even profit made by those corporations. The points made in the thread is that having enormously healthcare expenditures is not necessary to drive medical R&D. In the framework of a government run healthcare system, like those implemented in so many other countries still allow plenty of medical equipment and pharmaceutical manufacturers to exist and profit.
Well, what does basic science mean to you then? Let's take the cowpox vaccination again, we've found through observation that we can use cowpox to stimulate something which consequently leads to protection against smallpox. What else do we know about it? From how you have put it, we understood the process to be taking something similar in nature to disease in question, become exposed to it, see if it stops the disease. The development of the vaccine itself? Sure, I guess we can test dosages of exposure. Application to patients is self-explanatory. Now what, can we apply this to other things? No. This is empiricism and application based, not basic science.
I posted this link earlier in this post, but I'm going to do it again because the level of ignorance in the paragraph above is astounding. Here's a nice flowchart illustrating how the scientific method works in a nice, easy-for-children-to-understand manner:
![[image loading]](http://www.sciencebuddies.org/science-fair-projects/overview_scientific_method2.gif)
Question: Can we reduce or eliminate the number of smallpox infection?
Background research: Milkmaids, exposed to cowpox, do not contract smallpox.
Hypothesis: Cowpox and smallpox diseases are related and that cowpox is a weaker form. Exposure to cowpox will give immunity to smallpox.
Test: Expose test subject to cowpox and allow recovery. Then expose subject to smallpox and see if subject becomes symptomatic.
Analyze: Subject never become symptomatic to smallpox.
Conclusion: Exposure to cowpox does lead to immunity to smallpox.
Science! It works bitches!
This discovery was further refined particularly by Pasteur who discovered that microorganisms were responsible for a lot of disease, so the science was further refined (without government, war or profit), but the underlying discovery certainly fits in the realm of science.
s_side
What it really boils down to though, is that their will always be "rationing" in health care. It just depends on how you want to ration. In my opinion, it makes more sense to use a regulated free market system in which more productive members of society receive better care. It sounds callous and Darwinian, but compared to the arbitrary and, let's face it, ineffective yoke of a single payer system, it seems the lesser of two evils.
Evidence that a single payer system is ineffective?
And because I feel like putting the nails in the coffin on this issue, here is an interview with Wendell Potter who used to work as the head of corporate communications at CIGNA.
From the interview:
BILL MOYERS: Why is public insurance, a public option, so fiercely opposed by the industry?
WENDELL POTTER: The industry doesn't want to have any competitor. In fact, over the course of the last few years, has been shrinking the number of competitors through a lot of acquisitions and mergers. So first of all, they don't want any more competition period. They certainly don't want it from a government plan that might be operating more efficiently than they are, that they operate. The Medicare program that we have here is a government-run program that has administrative expenses that are like three percent or so.
BILL MOYERS: Compared to the industry's--
WENDELL POTTER: They spend about 20 cents of every premium dollar on overhead, which is administrative expense or profit. So they don't want to compete against a more efficient competitor.
BILL MOYERS: You told Congress that the industry has hijacked our health care system and turned it into a giant ATM for Wall Street. You said, "I saw how they confuse their customers and dump the sick, all so they can satisfy their Wall Street investors." How do they satisfy their Wall Street investors?
WENDELL POTTER: Well, there's a measure of profitability that investors look to, and it's called a medical loss ratio. And it's unique to the health insurance industry. And by medical loss ratio, I mean that it's a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry's been dominated by, or become dominated by for-profit insurance companies. Back in the early '90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.
So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they'll punish them. Investors will start leaving in droves.
I've seen a company stock price fall 20 percent in a single day, when it did not meet Wall Street's expectations with this medical loss ratio.
For example, if one company's medical loss ratio was 77.9 percent, for example, in one quarter, and the next quarter, it was 78.2 percent. It seems like a small movement. But investors will think that's ridiculous. And it's horrible.
BILL MOYERS: That they're spending more money for medical claims.
WENDELL POTTER: Yeah.
BILL MOYERS: And less money on profits?
WENDELL POTTER: Exactly. And they think that this company has not done a good job of managing medical expenses. It has not denied enough claims. It has not kicked enough people off the rolls. And that's what-- that is what happens, what these companies do, to make sure that they satisfy Wall Street's expectations with the medical loss ratio.
Looking at data for personal bankruptcies in the US we see that medical expenses contribute to about half of all bankruptcies occurring in the US. What's most striking about the data--and confirms what Wendell Potter was saying--is that the likelihood of bankruptcy occurring is not mitigated by having insurance!
But don't worry folks. The free market is here to save the day and cover all your medical needs with medical credit cards. I can't possibly see how this could go wrong...
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It's a joy to read your posts 
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On July 16 2009 21:12 Syntax Lost wrote:Hopelessly inefficient. With about 50% turnout, that is definitely not efficient. Show nested quote +
Did you actually read the articles I posted on how the private system is less efficient? Please go back and read the actual articles I posted. Claiming that fair market competition is always more efficient is not founded on reality. It can be more efficient under some circumstances, but it isn't necessarily all the time. All of the actual hard evidence posted in this thread shows that this is not the case. Do you have any peer-reviewed studies to refute the claim?
The private system appears to be less efficient because there is always government interference in the market in some way or another that allows bigger corporations to muscle out smaller competitors. This has been seen in the pharmaceutical industry where Merck and Pfizer have essentailly managed to knock out or absorb many smaller competitors-thus, they own what is essentially an oligopoly. And wtf is fair market competition-fair just means that the special interests have an advantage over everybody else. Show nested quote +
My point just goes flying above your head, doesn't it? You completely ignore the point about universities and the research they perform. You also ignored the example on Japan (profits are heavily regulated but they still make significant progress). Finally you ignored the example of the Sick Kids hospital (which made the discovery that it's possible to donate a heart to a child with the wrong blood type). All of this is done without the incentive for massive profits.
One reason why universities perform research is because by making significant progress on something they provide a bigger name for their school, which in turn draws more prospective students. Because of Japan's regulations, they've effectively been in stagnation for the past 20 years. And one or two non-profit examples doesn't drive the fact that a large number of drugs and methods have been mass produced and converted to general use through private companies. Penicillin was discovered for non-profit, but it required the private field to come up with enough to feed demand.. I'm not addressing anything about the government's discoveries in major fields, because again, I feel they are true. But again, private sector specialization is what has helped to fuel the production and acceleration of these fields. DNA reagents would be even more expensive were it not for private sector dealers to compete with one another. Show nested quote +Are you intentionally trying being thick or does it just come naturally? All the real evidence in this thread shows overwhelmingly that healthcare models implemented in countries with either tightly regulated or entirely socialised systems offer more effective and efficient healthcare. There is no evidence to suggest that any of these models are unviable in the US. Looking at the article I posted on SCHIP you can see evidence that a government programme run by the US represents a reduced cost to US healthcare. I'll admit that no healthcare system is perfect, but that doesn't mean that they aren't a massive improvement to current US healthcare. The models show correlation, not causality. First of all, many of the countries with socialized systems-Japan, for instance-are highly homogeneous. America, by any means, is not homogeneous. Even France is fairly homogenous and is separated quite distinctly-the poor immigrants are in the ghettos and are in some ways excluded-both internally and externally-from the rest of the French. America is very, very diverse, and is not just restricted to its own sphere. What may work in those countries may not work here. Not to mention America has 300 million people, whereas other countries have far less. There are many, many differences between America and other countries, any of which could impact how socialized healthcare works in this country. And finally, basic economics dictates that the addition of "reducing costs" by force (in this case, through government mandate) will always bring about a reduction of supply and an increase in demand. This is elementary high school economics. If one were to quantify healthcare supply and demand increases since SCHIP, I'm fairly certain this would be quantified. Show nested quote +
You're basically just trying to appeal to the US being special in terms of its geography without posting any evidence aside from saying its large and stating that comparisons are impossible. This is essentially just a red herring, especially when you consider it's population density that is more of a factor (since providing care to more sparsely populated areas is generally more costlier per capita) and that there are plenty of other countries which are able to contend with this problem and still provide better healthcare than the US.
While this was addressed to someone else, I find that there are differences and that wishing them away doesn't do anything. Show nested quote +
Errr... The fact that they're being paid? You're acting like governments can't incentivise people to work in a specific region which is just nonsense.
Government incentives backfire very easily if they are not constructed properly, mostly because people are spending other people's money to do so. And like any parent knows, if you give your kid money they will spend it. If they earn the money they won't spend it. Show nested quote +So, in other words, you need the government to provide incentives for people to work in remote areas. Well, colour me surprised... You completely ignore the idea that you're also removing a large amount of the incentive to be doctors. Why the fuck would I want to be saddled with 300k in debt and no pay for 10 years, even if I really want to help people? Show nested quote +You're right about insurance; they won't be able to gouge customers like they're doing now. Your claims about changing the education system are unsubstantiated. Bullshit and bullshit. The education system would have to be radically changed-it is simply just not economical for someone to be a doctor in this country without high compensation because of the education system. As for insurance, that's not what's gouging customers-its the prices on the uninsured that's the primary problem. Show nested quote +You do realise that there's a world outside of the US? A world with universities, many of which are funded primarily through government. What do you think they do? And seriously, do you honestly think that research conducted by universities is driven by the motive for profit? Even if it were made impossible for them to profit on such discoveries, you think their research would dry up? When was the last time you heard of some interesting scientific development from Europe that doesn't involve the LHC? Agreed. Show nested quote +
Congratulations on showing that you have no idea what a scientific theory is. The discoveries of both Jenner and Fleming had very real and very tangible direct applications, the results of which you still enjoy today.
Agreed, but you appear to show that you have no idea how theory is developed either. Show nested quote +Okay, it's clear that you've never participated in real university research so please refrain from talking about it like you actually have an informed opinion. Plenty of university research is devoted to applications. What we don't see are university manufacturing the applications but that's simply because they're not set up to run the production facilities. Private companies step in to actually produce the end product but the vast majority of the research is covered by the universities. This is because private companies will tend to direct their research towards targets that are sure to yield profitable products. In a lot of cases, you will see the university produce the proof-of-concept and then private company leap on the opportunity after that since the product is already known to work. Research into areas which are far more murky, particularly those with very little chance for success (which is most research, since most of it tends to end with failure) does not encourage much investment since the possibility for profit is extremely small. We see this in practice with the corporations since they spend far more on marketing than they do on R&D. Given this information, do you seriously think R&D is such a top priority for them? You ignore that universities and pharmaceutical companies work together or sponsor many, many lines of research. And risky research does take place if the gain is high-see basic statistics on "expected gain." Corporations primarily are encouraged by government regulation and the government sanctioned patent process to focus on long term drugs, rather than cures (i.e. rather coumadin than something that directly targets causes of high blood pressure). Show nested quote +This is just an enormous pile of steaming BS. What the fuck is the "theoretical framework" of vaccination and antibiotics? Germ theory? Antigens? Protein-Protein interactions on the cell membrane? Show nested quote +
Okay, now you're just getting sidetracked from the actual point. Here's the thing, nobody is against research performed by private corporations or even profit made by those corporations. The points made in the thread is that having enormously healthcare expenditures is not necessary to drive medical R&D. In the framework of a government run healthcare system, like those implemented in so many other countries still allow plenty of medical equipment and pharmaceutical manufacturers to exist and profit.
Agreed, but not that many companies that aren't subsidized by the government can survive overseas. Show nested quote +I posted this link earlier in this post, but I'm going to do it again because the level of ignorance in the paragraph above is astounding. Here's a nice flowchart illustrating how the scientific method works in a nice, easy-for-children-to-understand manner: Question: Can we reduce or eliminate the number of smallpox infection? Background research: Milkmaids, exposed to cowpox, do not contract smallpox. Hypothesis: Cowpox and smallpox diseases are related and that cowpox is a weaker form. Exposure to cowpox will give immunity to smallpox. Test: Expose test subject to cowpox and allow recovery. Then expose subject to smallpox and see if subject becomes symptomatic. Analyze: Subject never become symptomatic to smallpox. Conclusion: Exposure to cowpox does lead to immunity to smallpox. Science! It works bitches! This discovery was further refined particularly by Pasteur who discovered that microorganisms were responsible for a lot of disease, so the science was further refined (without government, war or profit), but the underlying discovery certainly fits in the realm of science.
This is nitpicky, but your scientific argument is flawed. There are multiple questions here, and the cowpox incident was not scientifically rigorous at all.
Properly, it would be:
Question: Can we reduce smallpox infections?
Background: Milkmaids, exposed to cowpox, do not contract smallpox.
Hypothesis: Cowpox and smallpox are caused by related viruses
2nd Hypothesis: Cowpox antigen exposure will confer immunity to smallpox.
Test: Expose many test subjects to cowpox and allow recovery. Then, keeping a small group for control, expose subject to smallpox and see if subject becomes symptomatic.
etc.
The continuation of my argument will be in the next post.
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United States42701 Posts
I wish I still had the motivation to make rebuttals like that Syntax. Fortunately I don't have to when you're about.
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Size does not change anything, inhabitants per 10 km² is a better measure (but still not good).
Yes, you might have some backwater places where the nearest doctor/hospital is a few hours away.
What does that mean?
Transport costs for these few people are higher - THE END. They don't make any statistical difference compared to the large majority of the 300 Million people in the USA.
PS: Are you the guy that suggested in an older topic that European and American healthcare (and other) statistics can't be compared because the European countries only have 7-100 Million people? You were proven wrong there and you still are. In fact the bigger sample size of the USA would help it look better, because *abnormalities* have a smaller impact.
If you have a country with 10 people per Km² and compare it to a country with 10 people Km², assuming the overall density is spread over the same area per inhabitant, it does not matter how big the samples are as soon as they deliver a number big enough to outbalance *extremes* (that one person out of thousands that really skyrockets or buries over/under the average).
And it's still about population density, not about total numbers... You seriously don't seem understand how statistics work, not even to a basic level.
Oh and: A public/social health care system works better the more people are part of it... 300 million people is actually an advantage, not a burden.
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On July 16 2009 22:30 Velr wrote:
Oh and: A public/social health care system works better the more people are part of it... 300 million people is actually an advantage, not a burden.
Yeah, it's very dishonest when people look at the costs of Medicare and extrapolate those costs onto the entire country. In reality, the reason Medicare costs so much is because they insure precisely the set of people that insurance companies consider the worst bets. If the system included a sufficiently large number of younger and healthier people the net drain on the budget would decrease.
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Syntax Lost I admire you dedication. Keep up the amazing work!
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The concept of free market cannot be applied to the health care industry. There is a simple reason for this.
Demand is inelastic!! You don't have a demand/supply curve when it's inelastic!! People pay anything for health care because it's life and death! Why don't republicans understand this??
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Sanya12364 Posts
I'm not opposed to public/social health care system because of its costs, but rather over the long-term degradation with respect to quality. One particular factor that I would be really worried about is "time-to-receive-care."
My time is rather valuable so I would prefer a system that could take care of me as quickly as possible - with all the amenities that such quality would require - good transportation access - parking lots if accessed by car, quick scheduling of doctor visits, etc.
It would suck to pay for the public system and then pay again for private care because the public system is so wracked with red tape that I wouldn't ever want to use it. It would suck even more if there wasn't a private system and I'd have to put up with such a public system.
And the idea that promoters of the public system would have the gall to say that private insures are opposed to competition is infuriating. Private insures are opposed to a level playing field. So they have always lobbied for laws that favor their business model. The current health care system is largely tilted towards private insurance.
But a publicly subsidized health system is the furthest from a level playing field. Private insurance companies complaining about publicly subsidized health care system is akin to an athlete complaining about his steroid-aided opponent.
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I'd make a point, but with Caller's post as broken (and incomplete, it seems) as it is right now it is barely possible to see what needs to be responded to and what not. I'll just try to trace back up for now.
Velr, I assume you are talking about me, probably. I have to admit I am bad at stat, tis a shame. I didn't post in older topics about a comparison between European and American healthcare though, so that's someone else. Here is the question I have though, the size, as you said, is not as relevant as population density. But size does contribute to the differences within the population, and consequently, shows us the present day situation of large differences in methods used by practitioners. Stratification of the industry, essentially, as I suggested on an earlier post that seemed to be ignored. An East coast hospital in comparison to the West coast can look for very different things for diagnosis, run different tests, and even different amounts. That is difficult to change because we cannot hope to deliver healthcare across a national scale using prevalence rates and such from the whole country.
A major benefit of government regulated system, far as I can see, lies in the ability to unify care provided and bargain collectively, but without the healthcare professionals learning from the same playbook, we are at a loss. A system is as effective as people adhere to guidelines, but when the guidelines need to be changed by location, how do we begin to start something like that? I feel that it is a difficulty that is understated from the European to American comparison.
BisuBoi, healthcare demand is not inelastic, look at how many people voluntarily forego insurance.
I'll wait on Caller's post for the rest.
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United States22883 Posts
On July 16 2009 21:12 Syntax Lost wrote:Show nested quote +gchan wrote:
Anyway, I'm done arguing with you because you are obviously on tilt. Try not responding to every message so angrily. Oh, and government programs are _always_ more inefficient because there is no feedback mechanism to manage them. What do you call voting?
Not the feedback mechanism most people believe it to be. You don't vote on the specialists that politicans hire, and the process in Washington is so complicated and the laws made are so vague that it's difficult to hold politicians accountable for a policy failure. If something goes right, they take the credit. If something goes wrong, they claim the law is fine (because they wrote it to encompass a huge number of possibilities, some fine and some not fine) and blame the bureaucrats for screwing up the execution. It's easier and faster to cast a wide net and allow bureaucratic discretion, which is basically what the stimulus packages are. One solution is to make detailed execution written into the law (statutory law) but that's dangerous for politicians so they tend not to do it and it causes other problems as well.
The point I assume gchan is trying to make is that bureaucracies always lack a proper mechanism and sometimes necessarily though. Read Max Weber on bureaucracy. The problem is easy to identify, and nowhere since Weber first wrote about it have we found an adequate solution. That doesn't mean it's fatal or that they aren't necessary in the modern world, but that there still is no good way to evaluate them in the real time. Hayek's solution is flawed, Lowi's solution is flawed.
Basically, it's a known problem without a solution, but it's attached to something that's critical for managing any large body of people, so you tread carefully. Claiming it's not a problem is just flat out wrong. It's a matter of costs vs. benefits.
And that's not to say the private realm always does much better. Insurance and banking industries are the perfect example for this. It's possible for the private to meddle with the feedback process as well. I don't know the numbers off hand, but I think when comparing the bureaucratic mess between private insurance companies and Medicare/Medicaid, the government versions actually come out ahead. They don't have the resources to pay like private companies do, and their scope is limited but they're more efficient right now and very reliable.
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United States22883 Posts
On July 16 2009 23:33 BisuBoi wrote:
The concept of free market cannot be applied to the health care industry. There is a simple reason for this.
Demand is inelastic!! You don't have a demand/supply curve when it's inelastic!! People pay anything for health care because it's life and death! Why don't republicans understand this??
Gasoline is inelastic and it seems to have a proper place in the free market. And health care is actually relatively elastic, which is exactly why there are many groups of people who aren't covered or are only covered with government funds. Especially in the product world, people are usually not willing to pay a premium for added safety. People absolutely will not pay anything for their health.
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United States22883 Posts
TL Canadians, what's going on up there recently?
I just talked to a few people from Montreal and they said the care/waiting has gone to shit over the last year or so.
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Sanya12364 Posts
On July 16 2009 23:48 Jibba wrote:
Especially in the product world, people are usually not willing to pay a premium for added safety. People absolutely will not pay anything for their health.
People are definitely willing to pay a premium of added safety provided they can quantify the risks. Investors, heads of households, merchants, etc all prefer lower risk propositions. Humans are generally like this.
The problem with health insurance is not people unwilling to pay for risk, but rather non-uniform risk crammed into uniform risk business model. The presence of the uninsured is because some people figure that they are over paying for their own risk profile, while other people are severely underpaying.
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With regards to willingness to pay, it's all fine and well for non Americans to talk about the wonders of government ran health care but then let it come out of your pockets because I sure as hell do not want to pay more tax dollars for things I don't use. The "911" situation really isn't applicable IMO because in one situation, you are talking about upholding the law while the other also deals with saving property.
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On July 17 2009 01:23 KissBlade wrote:
With regards to willingness to pay, it's all fine and well for non Americans to talk about the wonders of government ran health care but then let it come out of your pockets because I sure as hell do not want to pay more tax dollars for things I don't use. The "911" situation really isn't applicable IMO because in one situation, you are talking about upholding the law while the other also deals with saving property.
Destroyed property is just as much of an opportunity cost as a worker that does not live long or healthy enough to be productive. The example was only to illustrate the fact that I am paying for something other people are benefiting from and I don't have a problem with this (and the vast majority of people who have never called the police or fire department do not have a problem with it either).
Also, I really wish you had read the other posts. Your tax dollars are already paying for uninsured people to get healthcare through the ER. You would actually be spending fewer tax dollars if they got preventative medicine because it would greatly lower the risk of catastrophic illness.
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EPT
