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PoliticalGround >> Arnold: Universal health coverage


1/9/07 11:36 AM
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kung_pow
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Edited: 09-Jan-07
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If UH is so good in England, why has there been a huge push over there to allow privately owned healthcare companies and to give people a choice on healthcare systems? The issue with healtcare in Canada or Australia is that if you have a toothache or a broken arm, it can get fixed no problem. But when you need heart surgery or cancer treatment you have to get in line and wait. People in those situations go to America where price is used to determine who gets treatment immediately.
1/9/07 12:20 PM
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007
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Edited: 09-Jan-07
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There is nothing more expensive than free healthcare. Why people feel that healthcare is a right is beyond me. But I guess it's what people want, so this is what they'll get. The cost will be astronomical and we'll recall another governor in 10 years.

1/9/07 12:33 PM
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populist
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Edited: 09-Jan-07
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"""The biggest factor pushing up healthcare costs is frivolous malpractice claims." No way that is true. Have any data to back that up?" Read the rest of the post. The statement was sarcasm to highlight one of the idiocies in the healthcare costs debate. And you're right. It's between 98% and 99% wrong.
1/9/07 12:34 PM
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DangerMouse
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Edited: 09-Jan-07
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Health care is a basic human right but i do think that it should come with guidelines, for example if there is UHC then there should be a certain responsibility on the citizens. If you are fat, smoke etc then quite simply you should have to take out further insurance to cover illnesses that result from these conditions. If you are blind drunk and end up injured then you should be forced to pony up a certain percentage of the cost.
1/9/07 1:06 PM
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Jbraswell
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Edited: 09-Jan-07
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"Health care is a basic human right " That's fine and dandy to say that, but it doesn't make money magically appear to pay for it. How much of it is a basic human right? Does each human have a "right" to brain surgery? An MRI to look for cancer? An MRI to diagnose a knee injury? An MRI every year to test for possible, asymptomatic knee injuries?
1/9/07 1:10 PM
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SirPrize
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"The biggest factor pushing up healthcare costs is frivolous malpractice claims." What about frivolous claims and treatment? Since much of health care is "free", I think a lot of people go to the doctor when they don't need to, and they have tests that they don't really need. After all, they can get all the tests they want for "free" after they pay their co-pay. Those costs get passed from the insurance company to the consumers. "LOL @ people still thinking that the fed should not provide health care to its citizens...." What about the fed providing other necessities of life? What about universal housing? What about universal food? What about universal gasoline?
1/9/07 1:18 PM
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jellyman
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Edited: 09-Jan-07
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"But when you need heart surgery or cancer treatment you have to get in line and wait. People in those situations go to America where price is used to determine who gets treatment immediately." In the US it's prioritized by how much money you have, in Canada it's how much your heath is under threat. If you're a plutocrat you like the former, if you're more egalitarian you like the latter. JBraswell brings up a point that private industry funds a lot of research in the US, which then is sold to the rest of the world. I don't see why UHC will stop privae medical research, it's not like the company execs are doctors themselves.
1/9/07 1:19 PM
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SirPrize
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"If you are fat, smoke etc then quite simply you should have to take out further insurance to cover illnesses that result from these conditions. If you are blind drunk and end up injured then you should be forced to pony up a certain percentage of the cost." I would support that. :)
1/9/07 1:22 PM
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Jbraswell
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Edited: 09-Jan-07
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"I think a lot of people go to the doctor when they don't need to, and they have tests that they don't really need. After all, they can get all the tests they want for "free" after they pay their co-pay." This rings of Arnold Kling's position, adumbrated at the above link. A big part of his position is that the federal gov't should stay out things, with the exception that a gov't entity, say, the NIH, should handle large-scale cost-benefit analysis studies, as currently, nobody, neither doctors or insurance companies, know the marginal benefit of any given bit of "premium" medicine.
1/9/07 1:28 PM
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killer rabbit
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Edited: 09-Jan-07
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I personally like the fact that I am able to get healthcare for my family that is excellent, and it is definitely a factor in my wife and I keeping our jobs. With Universal Healthcare, healthcare will universally suck. Rates paid to doctors will be set by the government, and the incentive to go through 8 years of school, followed by a few years of residency will be greatly reduced. Care will also be reduced - if the only method available to increase revenues is to increase volume, then each patient is getting 15 minutes. Period. Doctors will be pressured to reduce patient time in order to maintain business viability. Removing the consumer even further from the price they pay is hardly going to reduce health care costs.
1/9/07 1:31 PM
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jellyman
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SO killer rabbit, how do you explain the US' higher health care costs?
1/9/07 1:58 PM
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George Bush Fancier
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Edited: 09-Jan-07
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"Rates paid to doctors will be set by the government" Are price ceilings actually enumerated in the California proposal? Or are you just making that up?
1/9/07 2:00 PM
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killer rabbit
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Supply and demand, as well as effective lobbying and marketing. Also, if you don't think the current insurance programs remove the consumer from the cost, you are nuts. A personal example: I have chronic sinus problems. So, I got a referral to a specialist. That specialist ordered imagery - X-rays and Cat scan (I think, might have been something else). After examining the imagery, they said that the surgically correctable issues I had weren't worth correcting. SO basically, a few thousand dollars were probably spent to determine that the problem wasn't really a problem. They then precribed me some antihistamine, both oral and spray, to see if that might help. More money spent. All at the same hospital, because it makes it very simple for both me and my docs. Now, do I have legit sinus problems? Yep, constant congestion, infections, and a deviated septum that I just don't care to get fixed right now. Would I have been willing to spend the money out of pocket? If I had it, maybe. Would I have comparison shopped for both specialists and imagery (X-rays, etc.) if it was going to change how much money came out of my pocket? You bet your ass I would have! Now the prescriptions they gave me: I pay nothing for prescriptions whatsoever. So, I fill them at the closest pharmacy, since I am completely insulated from the cost. Would I comparison shop if I was paying for them? Hell yes, that shit is expensive! But I am not, and the way the system is set up, I really would have trouble even finding out how much they really cost my insurance company, since many pharmacies charge different providers different prices based on various deals worked out. And in the end, I am not sure how much the oral antihistamine helps, but it is free so why not use it? True Universal Healthcare involves the government setting the reimbursement rates. Try getting a swanky Beverly Hills doctor to accept medicare reimbursement rates - they won't unless they have to. And you get what you pay for, just like anything else. I am also restricted to certain providers who accept my insurance reimbursement rate. Many employers offer different plans, with different systems of copayment vs coverage for prescription vs providers, etc. The plan is frequently part of a negotiated settlement where cost is a part of the deal - better/worse insurance for less/more pay.
1/9/07 2:03 PM
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jellyman
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Edited: 09-Jan-07
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So if the health care is worse, why is the general health not better?
1/9/07 2:03 PM
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Jbraswell
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Edited: 09-Jan-07
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"SO killer rabbit, how do you explain the US' higher health care costs?" A number of people have suggested good reasons on this thread. Are you saying simply because we spend a lot on healthcare, we should immediately give it all over to government, analysis be damned?
1/9/07 2:05 PM
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killer rabbit
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Edited: 09-Jan-07
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"Are price ceilings actually enumerated in the California proposal? Or are you just making that up?" I am talking about a true federal healthcare system, like Medicare for every single person, not the California proposal, which is essentially an expansion of the current Medicare to include more people. As long as there are private providers, then some market pressures do exist. If someone in a socialized medicine country can let us know how the prices are set that would be great.
1/9/07 2:07 PM
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Jbraswell
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"So if the health care is worse, why is the general health not better?" Again, several possibilities have been suggested on this thread, and a tiny bit of digging on your part would reveal the ones most favored by mainstream economists.
1/9/07 2:15 PM
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Nick6742
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Edited: 09-Jan-07
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the real cost in malpractice is defensive medicine. No one arguing for tort reform in this area bases their argument on the absolute cost. 1. When one state enacts malpractice reform and another doesn't doctors are drawn to the state that is protective of them and repelled from the state that does not. This makes health providers rarer and more expensive in the state without reform. 2. When doctors are afraid of being sued, they will eliminate everything, even if it is incredibly unlikely and the test is expensive. Why? Because if they don't, and this person does have a rare disease then they will get sued and life will be miserable. Not because they don't have the money (insurance will pay) but because of the horrible stress going through a court case and worrying about your license inflicts on you. These are the true costs of our malpractice system. Add to that, doctors' fates being decided by essentially ignorant juries on topics that haven't been well described by researchers and you have a recipe for disaster in which physicians hate and fear the legal system and will spend a lot of effort on reforming that, rather than on reforming how they treat patients, which is the most rewarding part of their job.
1/9/07 2:17 PM
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Ted Bennett
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Edited: 09-Jan-07
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Care will also be reduced - if the only method available to increase revenues is to increase volume, then each patient is getting 15 minutes.

Try 5.

I know psychiatrists who cover s/t like 600 (yes, six hundred) patients a week. Granted, they were residents who were stuck doing the 100 hour work week and thus not comparable to the average private practice folks, but that's still *insane* (no pun intended).

1/9/07 2:19 PM
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Jbraswell
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Edited: 09-Jan-07
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That's true, Nick. It blows me away, for example, that women who sued Dow Corning get to keep their money after the FDA approves silicone implants again.
1/9/07 2:25 PM
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George Bush Fancier
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Edited: 09-Jan-07
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"I am talking about a true federal healthcare system, like Medicare for every single person, not the California proposal, which is essentially an expansion of the current Medicare to include more people. As long as there are private providers, then some market pressures do exist." Gotcha. Sorry to come off so snidely in my question, BTW.
1/9/07 2:27 PM
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armbarcrashdummy
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Edited: 09-Jan-07
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I live in Australia which has Universal Health Care and it's not the disaster everyone claims it is. We have some problems with recruiting doctors & nurses but otherwise, the system works pretty well. Example, one night I took myself to the hospital ER with arrythmia (irregular heart beat) walked up to the Triage nurse and said "my heart's not beating right". I'm then taken to the ER, checked out for an hour, given some meds and a referal for my GP. Turns out it was an overtraining thing, but I paid nothing, got treated immediately and everything was top notch. I once took my wife in for a really bad case of nausea and they treated her within 1 hour. My wife had our baby in a public hospital, the whole thing was free and the care was top notch. She had a few appointments, some classes and then just showed up at 3am and had the bub. Zero cost, zero dramas. I still go to a private GP who sees all his patients within 45 mins of appointment time and who's charge is quite reasonable. The advantages of private GP's are convenience of booking and you can pick who you want. The downside to UHC? Tax. In Australia we pay one of the highest rates of personal income tax in the world (including a 1.5% UHC levy). My last years earnings was taxed (aggregate) about 35%.
1/9/07 2:40 PM
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jellyman
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"A number of people have suggested good reasons on this thread. Are you saying simply because we spend a lot on healthcare, we should immediately give it all over to government, analysis be damned? " Hardly, I make no recommendations, not really my problem, whatever works for you, great. But having said that, I'm pretty happy with the health care me and my famly have gotten, and we've gotten a fair bit. I probably pay more in taxes than I used up, but if I paid private insurance, what would that cost me, and would they be so quick to honour life-threateneing conditions that surface after the policy is signed for? My uncle has a disease, very rare, that requires he get a pile of new blood weekly. He doesn;t have to wait in a big line to do so. He doesn't have to sue anyone to get this benefit. Having worked for insurance companies, albeit not health insurance, I know there are batallions of very ruthles people looking for any loophole they can find to avoid paying a claim. Maybe I'm just used to things the way they are here, but that said, I'm pretty attached to it and so am very skeptical when people tell me I'm living in some kind of emergency and should privatize pronto. I think health is bad in the US partly because a lot of people are simply not covered. They may get emergency care, but that's not the same as preventative care. If I have a carcinoma that is deemed not immediately life threateneing, do I get cancer treatment anyway? I'm not selling you guys anything, it's your life. But I'm trying to hear the pitch for the other side, and thus far am not very convinced.
1/9/07 3:40 PM
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SirPrize
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"I'm then taken to the ER... I paid nothing "My wife had our baby in a public hospital, the whole thing was free... Zero cost, zero dramas." "The downside to UHC? Tax. In Australia we pay one of the highest rates of personal income tax in the world (including a 1.5% UHC levy). My last years earnings was taxed (aggregate) about 35%." Your health care was not really free. You paid for it in taxes. How much of that 35% went to health care? FYI, in the USA, I pay over 32-34% in taxes before taking any deductions. "I know there are batallions of very ruthles people looking for any loophole they can find to avoid paying a claim." Yeah. Now, that is a good point. I used to work for a health insurance company. It was on the IT side, but I still overheard some conversations. I heard several stories about the company paying a claim and then either jacking up the rates or dropping the user. WTF? That's what insurance is FOR!
1/9/07 3:57 PM
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Au Jus
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Edited: 09-Jan-07
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All I know is, if you want something fucked up beyond belief with an absolutely bewildering beuracracy then let the government take over. DSS anyone??

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