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Healthcare Reform in the US - Page 63

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funk100
Profile Joined May 2010
United Kingdom172 Posts
December 12 2010 12:49 GMT
#1241
ahh, the healthcare debate.
what i say is (as a resident of the UK) is that fundamentally national health systems are alot fairer; the REAL question is is if the US public will acept it as a policy.
and honestly, i really hope they do
after every post "oh god I hope i've made sence"
{CC}StealthBlue
Profile Blog Joined January 2003
United States41117 Posts
December 12 2010 20:33 GMT
#1242
On December 12 2010 21:49 funk100 wrote:
ahh, the healthcare debate.
what i say is (as a resident of the UK) is that fundamentally national health systems are alot fairer; the REAL question is is if the US public will acept it as a policy.
and honestly, i really hope they do


Public opinion supported a Public Option it was the powerful Lobby industry that really runs this country that killed it, I think it was United Healthcare that spent over 10 million a day for motnhs that killed Healthcare Reform.
"Smokey, this is not 'Nam, this is bowling. There are rules."
KwarK
Profile Blog Joined July 2006
United States44231 Posts
December 12 2010 20:42 GMT
#1243
If I may quote a post I made a year ago in this topic I think it still pretty much sums up my opinion.
On August 17 2009 19:23 KwarK wrote:
I believe a key advantage of nationalised healthcare over a private system is that public health challenges can be met with a co-ordinated, universal approach in a public system. From pandemics to obesity, public can invest in the good health of the people which pay for themselves and more in lower healthcare costs. For example, we can get nicotene gum subsidised on the NHS as well as other help to stop smoking. While this does cost tax money whereas in a private system the cost of dealing with their lung cancer would fall firmly on the smokers (in his insurance premiums) it still costs less money. Prevention is far cheaper than cure. So while I acknowledge the argument "why should the healthy man pay for another mans vice?" I don't agree with it because by doing so the overall costs of healthcare are decreased. And when society is wasting less money treating preventable illnesses everyone benefits. That money gets spent or invested and returns back into the cycle. Wasting money makes society as a whole poorer, not just the individual wasting it.
This example of low cost prevention is even more extreme when you look at vaccination programs or free checkups for early treatment of cancer. In the UK women at risk of cervical cancer are notified and recommended to see their doctor for a checkup because it is far cheaper to only find it in 1% of the people you screen but find it when it is easily treatable than wait until the symptoms force them to you but require far more trained staff spending far more hours dealing with it.

Secondly, the costs of curing someone are less than the costs of treating the symptoms of a condition for years on end. Lower class people without insurance will have trouble paying for the treatment they need immediately and will instead spend far more money with worse results managing the symptoms over a long period of time. Again, this is money being wasted. I get that you believe people should be allowed to waste their money as they see fit but ultimately, unless you believe in it so strongly you'll allow them to die on the street, eventually you pick up the tab. If you accept the responsibility of providing critical care to a patient regardless of insurance, and I hope you do, then ultimately you're agreeing to pick up the tab on his healthcare. Once you accept the state has a vested interest it makes sense to act pre-emptively to lower that. A state system does that. An insurance system doesn't because they only pay indirectly, through higher hospital costs. Either way the people end up paying for it, through premiums or taxation. But in one system they pay less.

Thirdly. medicine has a diminishing return on investment, the improvement in healthcare is not proportionate to the increase in cost. To put that in context. Public takes X money and treats everyone with Y quality of health care. Private will take X money, treat half the people with only 1.5Y quality. Better for the people being treated but far less cost efficient.
This is where we get moralising versus free market. I accept that the guy who has saved all his life will want to spend his fortune on some expensive treatment by the most expensive doctors to try and buy himself another 6 months of breathing. However that same money could buy people who don't need such talented doctors or such expensive equipment many times his 6 months. Why should he get to waste his money on buying himself a few more days when the same money could buy some poorer people years. Of course here we're moving into socialism and there is no right answer. After all, you could take it to the extreme and point out that if I really believed in that then I'd do away with the NHS and spend all the money on curing tb and malaria in Africa for the few dollars it takes to save a life.
I believe a mixed system of public and private along with rationing in the public sector is the best answer to this question. You may disagree and I won't begrudge you for it because this is an entirely subjective issue. However, in my opinion rationing provides by far the most effective healthcare with the money provided. We have an institute called NICE (National Institute for Clinical Excellence) which weighs the costs of treatments against the gains in patient welfare and judges where the money should be spent. By dealing with all the cheaply cured patients first and moving up the scale you get the maximum bang for your buck. This system is more efficient than a private system but it also takes away individual choice. However you must remember that there is always the private option. By opting to go private you are essentially forfeiting the tax you paid towards the nationalised health service but ultimately that is not all that much money. The procedures which will be out of reach of the middle class in a public system will still be out of their reach in a private system. The rich will get the same quality of care in both systems. It is only a very small segment of society on the cusp who could just about scrape the money together in a private system but could not in a public who will be adversely effected. Whereas the number of people positively effected is far greater.
However as I've already said, I will understand if you don't agree with my third point about the morality of rationing (although not if you disagree with the greater efficiency from rationing).

Fourthly, sick people are bad for society in general. Poor people who are ill with a contagious virus ignore it and infect those around them, perpetuating the problem. While that may not bother you, eventually one of those people getting paid so little he can't afford to take a sick day will be the guy coughing over your food. To use a crude analogy, you may not like your toilet on a personal level, you may not think it deserves your investment, but you still buy products to keep it hygenic because if you don't it'll be worse for you.

ModeratorThe angels have the phone box
KillyKyll
Profile Blog Joined July 2010
United States267 Posts
December 12 2010 22:49 GMT
#1244
On December 13 2010 05:42 KwarK wrote:
If I may quote a post I made a year ago in this topic I think it still pretty much sums up my opinion.
Show nested quote +
On August 17 2009 19:23 KwarK wrote:
I believe a key advantage of nationalised healthcare over a private system is that public health challenges can be met with a co-ordinated, universal approach in a public system. From pandemics to obesity, public can invest in the good health of the people which pay for themselves and more in lower healthcare costs. For example, we can get nicotene gum subsidised on the NHS as well as other help to stop smoking. While this does cost tax money whereas in a private system the cost of dealing with their lung cancer would fall firmly on the smokers (in his insurance premiums) it still costs less money. Prevention is far cheaper than cure. So while I acknowledge the argument "why should the healthy man pay for another mans vice?" I don't agree with it because by doing so the overall costs of healthcare are decreased. And when society is wasting less money treating preventable illnesses everyone benefits. That money gets spent or invested and returns back into the cycle. Wasting money makes society as a whole poorer, not just the individual wasting it.
This example of low cost prevention is even more extreme when you look at vaccination programs or free checkups for early treatment of cancer. In the UK women at risk of cervical cancer are notified and recommended to see their doctor for a checkup because it is far cheaper to only find it in 1% of the people you screen but find it when it is easily treatable than wait until the symptoms force them to you but require far more trained staff spending far more hours dealing with it.

Secondly, the costs of curing someone are less than the costs of treating the symptoms of a condition for years on end. Lower class people without insurance will have trouble paying for the treatment they need immediately and will instead spend far more money with worse results managing the symptoms over a long period of time. Again, this is money being wasted. I get that you believe people should be allowed to waste their money as they see fit but ultimately, unless you believe in it so strongly you'll allow them to die on the street, eventually you pick up the tab. If you accept the responsibility of providing critical care to a patient regardless of insurance, and I hope you do, then ultimately you're agreeing to pick up the tab on his healthcare. Once you accept the state has a vested interest it makes sense to act pre-emptively to lower that. A state system does that. An insurance system doesn't because they only pay indirectly, through higher hospital costs. Either way the people end up paying for it, through premiums or taxation. But in one system they pay less.

Thirdly. medicine has a diminishing return on investment, the improvement in healthcare is not proportionate to the increase in cost. To put that in context. Public takes X money and treats everyone with Y quality of health care. Private will take X money, treat half the people with only 1.5Y quality. Better for the people being treated but far less cost efficient.
This is where we get moralising versus free market. I accept that the guy who has saved all his life will want to spend his fortune on some expensive treatment by the most expensive doctors to try and buy himself another 6 months of breathing. However that same money could buy people who don't need such talented doctors or such expensive equipment many times his 6 months. Why should he get to waste his money on buying himself a few more days when the same money could buy some poorer people years. Of course here we're moving into socialism and there is no right answer. After all, you could take it to the extreme and point out that if I really believed in that then I'd do away with the NHS and spend all the money on curing tb and malaria in Africa for the few dollars it takes to save a life.
I believe a mixed system of public and private along with rationing in the public sector is the best answer to this question. You may disagree and I won't begrudge you for it because this is an entirely subjective issue. However, in my opinion rationing provides by far the most effective healthcare with the money provided. We have an institute called NICE (National Institute for Clinical Excellence) which weighs the costs of treatments against the gains in patient welfare and judges where the money should be spent. By dealing with all the cheaply cured patients first and moving up the scale you get the maximum bang for your buck. This system is more efficient than a private system but it also takes away individual choice. However you must remember that there is always the private option. By opting to go private you are essentially forfeiting the tax you paid towards the nationalised health service but ultimately that is not all that much money. The procedures which will be out of reach of the middle class in a public system will still be out of their reach in a private system. The rich will get the same quality of care in both systems. It is only a very small segment of society on the cusp who could just about scrape the money together in a private system but could not in a public who will be adversely effected. Whereas the number of people positively effected is far greater.
However as I've already said, I will understand if you don't agree with my third point about the morality of rationing (although not if you disagree with the greater efficiency from rationing).

Fourthly, sick people are bad for society in general. Poor people who are ill with a contagious virus ignore it and infect those around them, perpetuating the problem. While that may not bother you, eventually one of those people getting paid so little he can't afford to take a sick day will be the guy coughing over your food. To use a crude analogy, you may not like your toilet on a personal level, you may not think it deserves your investment, but you still buy products to keep it hygenic because if you don't it'll be worse for you.



Thanks for saving me the time to look through to this whole thread for me to say this:

I agree. This sums up why nationalized healthcare isn't just the private one we have now +10 times cost. People need to realize that, because on the surface, it looks like that which leads to an obvious "that's a horrible country destroying idea!" response. But in reality, it is very, very different.
Seriously?
SweetNJoshSauce
Profile Joined July 2010
United States468 Posts
December 12 2010 23:02 GMT
#1245
On December 13 2010 05:42 KwarK wrote:
If I may quote a post I made a year ago in this topic I think it still pretty much sums up my opinion.
Show nested quote +
On August 17 2009 19:23 KwarK wrote:
I believe a key advantage of nationalised healthcare over a private system is that public health challenges can be met with a co-ordinated, universal approach in a public system. From pandemics to obesity, public can invest in the good health of the people which pay for themselves and more in lower healthcare costs. For example, we can get nicotene gum subsidised on the NHS as well as other help to stop smoking. While this does cost tax money whereas in a private system the cost of dealing with their lung cancer would fall firmly on the smokers (in his insurance premiums) it still costs less money. Prevention is far cheaper than cure. So while I acknowledge the argument "why should the healthy man pay for another mans vice?" I don't agree with it because by doing so the overall costs of healthcare are decreased. And when society is wasting less money treating preventable illnesses everyone benefits. That money gets spent or invested and returns back into the cycle. Wasting money makes society as a whole poorer, not just the individual wasting it.
This example of low cost prevention is even more extreme when you look at vaccination programs or free checkups for early treatment of cancer. In the UK women at risk of cervical cancer are notified and recommended to see their doctor for a checkup because it is far cheaper to only find it in 1% of the people you screen but find it when it is easily treatable than wait until the symptoms force them to you but require far more trained staff spending far more hours dealing with it.

Secondly, the costs of curing someone are less than the costs of treating the symptoms of a condition for years on end. Lower class people without insurance will have trouble paying for the treatment they need immediately and will instead spend far more money with worse results managing the symptoms over a long period of time. Again, this is money being wasted. I get that you believe people should be allowed to waste their money as they see fit but ultimately, unless you believe in it so strongly you'll allow them to die on the street, eventually you pick up the tab. If you accept the responsibility of providing critical care to a patient regardless of insurance, and I hope you do, then ultimately you're agreeing to pick up the tab on his healthcare. Once you accept the state has a vested interest it makes sense to act pre-emptively to lower that. A state system does that. An insurance system doesn't because they only pay indirectly, through higher hospital costs. Either way the people end up paying for it, through premiums or taxation. But in one system they pay less.

Thirdly. medicine has a diminishing return on investment, the improvement in healthcare is not proportionate to the increase in cost. To put that in context. Public takes X money and treats everyone with Y quality of health care. Private will take X money, treat half the people with only 1.5Y quality. Better for the people being treated but far less cost efficient.
This is where we get moralising versus free market. I accept that the guy who has saved all his life will want to spend his fortune on some expensive treatment by the most expensive doctors to try and buy himself another 6 months of breathing. However that same money could buy people who don't need such talented doctors or such expensive equipment many times his 6 months. Why should he get to waste his money on buying himself a few more days when the same money could buy some poorer people years. Of course here we're moving into socialism and there is no right answer. After all, you could take it to the extreme and point out that if I really believed in that then I'd do away with the NHS and spend all the money on curing tb and malaria in Africa for the few dollars it takes to save a life.
I believe a mixed system of public and private along with rationing in the public sector is the best answer to this question. You may disagree and I won't begrudge you for it because this is an entirely subjective issue. However, in my opinion rationing provides by far the most effective healthcare with the money provided. We have an institute called NICE (National Institute for Clinical Excellence) which weighs the costs of treatments against the gains in patient welfare and judges where the money should be spent. By dealing with all the cheaply cured patients first and moving up the scale you get the maximum bang for your buck. This system is more efficient than a private system but it also takes away individual choice. However you must remember that there is always the private option. By opting to go private you are essentially forfeiting the tax you paid towards the nationalised health service but ultimately that is not all that much money. The procedures which will be out of reach of the middle class in a public system will still be out of their reach in a private system. The rich will get the same quality of care in both systems. It is only a very small segment of society on the cusp who could just about scrape the money together in a private system but could not in a public who will be adversely effected. Whereas the number of people positively effected is far greater.
However as I've already said, I will understand if you don't agree with my third point about the morality of rationing (although not if you disagree with the greater efficiency from rationing).

Fourthly, sick people are bad for society in general. Poor people who are ill with a contagious virus ignore it and infect those around them, perpetuating the problem. While that may not bother you, eventually one of those people getting paid so little he can't afford to take a sick day will be the guy coughing over your food. To use a crude analogy, you may not like your toilet on a personal level, you may not think it deserves your investment, but you still buy products to keep it hygenic because if you don't it'll be worse for you.



This is pretty well written argument, but it all comes down to your faith in the American public. You feel that Americans will pick up their act if they have the medical options, but It's perfectly reasonable to assume the opposite.

The average American has plenty of options to stay healthy but consistently chooses to try and eat themselves into a heart attack as quickly as they can. Maybe there's some medium between our faith in the people because I'm sure many would take the opportunity to better themselves. But I'm also sure some will use this free ticket to healthcare to continue their disgusting habits with a bit more confidence in their lifestyle decision.
oZii
Profile Blog Joined May 2010
United States1198 Posts
December 12 2010 23:45 GMT
#1246
On December 13 2010 05:42 KwarK wrote:
If I may quote a post I made a year ago in this topic I think it still pretty much sums up my opinion.+ Show Spoiler +
On August 17 2009 19:23 KwarK wrote:
I believe a key advantage of nationalised healthcare over a private system is that public health challenges can be met with a co-ordinated, universal approach in a public system. From pandemics to obesity, public can invest in the good health of the people which pay for themselves and more in lower healthcare costs. For example, we can get nicotene gum subsidised on the NHS as well as other help to stop smoking. While this does cost tax money whereas in a private system the cost of dealing with their lung cancer would fall firmly on the smokers (in his insurance premiums) it still costs less money. Prevention is far cheaper than cure. So while I acknowledge the argument "why should the healthy man pay for another mans vice?" I don't agree with it because by doing so the overall costs of healthcare are decreased. And when society is wasting less money treating preventable illnesses everyone benefits. That money gets spent or invested and returns back into the cycle. Wasting money makes society as a whole poorer, not just the individual wasting it.
This example of low cost prevention is even more extreme when you look at vaccination programs or free checkups for early treatment of cancer. In the UK women at risk of cervical cancer are notified and recommended to see their doctor for a checkup because it is far cheaper to only find it in 1% of the people you screen but find it when it is easily treatable than wait until the symptoms force them to you but require far more trained staff spending far more hours dealing with it.

Secondly, the costs of curing someone are less than the costs of treating the symptoms of a condition for years on end. Lower class people without insurance will have trouble paying for the treatment they need immediately and will instead spend far more money with worse results managing the symptoms over a long period of time. Again, this is money being wasted. I get that you believe people should be allowed to waste their money as they see fit but ultimately, unless you believe in it so strongly you'll allow them to die on the street, eventually you pick up the tab. If you accept the responsibility of providing critical care to a patient regardless of insurance, and I hope you do, then ultimately you're agreeing to pick up the tab on his healthcare. Once you accept the state has a vested interest it makes sense to act pre-emptively to lower that. A state system does that. An insurance system doesn't because they only pay indirectly, through higher hospital costs. Either way the people end up paying for it, through premiums or taxation. But in one system they pay less.

Thirdly. medicine has a diminishing return on investment, the improvement in healthcare is not proportionate to the increase in cost. To put that in context. Public takes X money and treats everyone with Y quality of health care. Private will take X money, treat half the people with only 1.5Y quality. Better for the people being treated but far less cost efficient.
This is where we get moralising versus free market. I accept that the guy who has saved all his life will want to spend his fortune on some expensive treatment by the most expensive doctors to try and buy himself another 6 months of breathing. However that same money could buy people who don't need such talented doctors or such expensive equipment many times his 6 months. Why should he get to waste his money on buying himself a few more days when the same money could buy some poorer people years. Of course here we're moving into socialism and there is no right answer. After all, you could take it to the extreme and point out that if I really believed in that then I'd do away with the NHS and spend all the money on curing tb and malaria in Africa for the few dollars it takes to save a life.
I believe a mixed system of public and private along with rationing in the public sector is the best answer to this question. You may disagree and I won't begrudge you for it because this is an entirely subjective issue. However, in my opinion rationing provides by far the most effective healthcare with the money provided. We have an institute called NICE (National Institute for Clinical Excellence) which weighs the costs of treatments against the gains in patient welfare and judges where the money should be spent. By dealing with all the cheaply cured patients first and moving up the scale you get the maximum bang for your buck. This system is more efficient than a private system but it also takes away individual choice. However you must remember that there is always the private option. By opting to go private you are essentially forfeiting the tax you paid towards the nationalised health service but ultimately that is not all that much money. The procedures which will be out of reach of the middle class in a public system will still be out of their reach in a private system. The rich will get the same quality of care in both systems. It is only a very small segment of society on the cusp who could just about scrape the money together in a private system but could not in a public who will be adversely effected. Whereas the number of people positively effected is far greater.
However as I've already said, I will understand if you don't agree with my third point about the morality of rationing (although not if you disagree with the greater efficiency from rationing).

Fourthly, sick people are bad for society in general. Poor people who are ill with a contagious virus ignore it and infect those around them, perpetuating the problem. While that may not bother you, eventually one of those people getting paid so little he can't afford to take a sick day will be the guy coughing over your food. To use a crude analogy, you may not like your toilet on a personal level, you may not think it deserves your investment, but you still buy products to keep it hygenic because if you don't it'll be worse for you.




Agree with this I myself have recently moved back to the states I was stationed in Germany for 7 years(I am in the military) I think NHS is a very good idea for the people as a whole. As the OP said a healthy country is a efficient country.
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