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Pick One.
As many of you know, I am a member of the American healthcare system. Lately, I have been privelaged enough to hear several health care "futurists" and philosophers talk on world and American healthcare. That being said I will pose a question to you all.
In healthcare, or any service field for that matter, you can have low cost, accessibility and quality. However, you can only have two of these things at the same, and this is especially true in medicine. For example, in the U.S. high quality and easy accessibility have been "picked" at the price of higher costs. Canada and "socialized" European countries have decided on high quality and low costs at the price of more difficult accessibility. China and Russia have chosen easy accessibility and low costs at the price of quality. My question to you all is what two of the three would you pick for your health care system, and how would you justify the loss of one of the three?
(And if you're going to somehow give me an example of how you could in fact have all three, I'd like for you to give me an example of where this is the case and an economic model of how you could possibly support it.)
i didn't understand the poll the way i should understand it.
after editing.
ammm israeli healthcare system is good quality amm then i guess just lower the price.
Very interesting.
I'd have to go with "Quality and Accessibility," because there really is no excuse, in a nation as wealthy as the United States, to not have healthcare that is accessible (and affordable) to every citizen with a reasonable degree of quality.
If the US were a poorer nation, then you�d also have to factor in the costs more in your analysis.
Now, we don't have to go completely "socialized," but some combination of government involvement, regulation, and private enterprise like we have now would still meet the goal.
The HMO industry at this time I would classify as predatory in nature, but it can be regulated in a way that ends this.
I would also argue that the HMO industry operates in a manner that reduces its costs at the expense of both quality and accessibility (but most notably quality).
It�s ok if you get an ear infection or something, but if you get truly sick you�re often simply fucked.
To pay for covering all citizens with healthcare, you'd simply need to cut back on corporate welfare and some of the bloated pentagon budget to pay for it without raising taxes.
This would be quite a feat though considering the grip large corporations and the military industrial complex currently have on Washington.
i would say Quality and Accessibility but not the US way, more the EU way, accessable to everyone.
If that is too much to take for a country (which it is not) i would rather see Quality and Low cost.
err, don't you mean "Pick two." ?
quality and low cost.
People should have to overcome their lazyness to gain access to it. im assiming that by accessability you mean people have to go through more paper work and beauracracy.
What exactly do you mean by low cost? Do you mean low cost for individuals or for the government?
I am for the highest quality and accessibility. Despite what John Kerry may want you to believe, I do not believe that healthcare is an implicit "right", and I don't think there is a very pursuasive argument to prove otherwise. If you want to lower the cost, that's fine, but the result is a cheap clinic or HMO. However, if you don't have the funds to go to a more costly/higher quality facility, you're not exactly in a position to complain. Like Neophono said, you can have 2 out of 3. Don't try to rationalize the 3rd into the package, as that's what creates the problem.
Interesting/good points, Neophono.
Okay, better definitions:
Low cost - Low cost to primarily the patient, but also reduced costs to the health care insurance provider, be it the government or HMO.
Accessibility - Ease of seeing a health care provider. For instance, an appointment to see a family practice doctor in the states can *usually* be made days after a call is made. In other countries this wait can be weeks to months for non-critical visits.
Quality - Kind of obvious, I'd guess. The quality of the healthcare you are being given in terms of both technology and scope.
I personally believe that part of the answer in the American health care system is higher copays. Americans, per person, demand four times the amount of health care dollars as the nearest country (Japan). If you look at just emergency room visits, only 7% are actual emergencies, and over half of the people suffering from these non-emergencies know they do not have an emergent reason for visiting the ER. The difference is that an ER visit costs hundreds to thousands of dollars, whereas waiting to see a family practice doc costs a fraction of that. To add insult to injury, 1/3 of ER vistors do not pay a dime and 1/3 pay a reduced amount. (Who says there's no free health care in the US? 
) So you only have 1/3 of people actually paying for their visits. My solution would be to drive up copays to keep people without emergencies from abusing the system. This would lower costs for everyone and also keep non-emergencies from clogging the system.
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| Originally posted by NeoPhono Okay, better definitions: Low cost - Low cost to primarily the patient, but also reduced costs to the health care insurance provider, be it the government or HMO. Accessibility - Ease of seeing a health care provider. For instance, an appointment to see a family practice doctor in the states can *usually* be made days after a call is made. In other countries this wait can be weeks to months for non-critical visits. Quality - Kind of obvious, I'd guess. The quality of the healthcare you are being given in terms of both technology and scope. I personally believe that part of the answer in the American health care system is higher copays. Americans, per person, demand four times the amount of health care dollars as the nearest country (Japan). If you look at just emergency room visits, only 7% are actual emergencies, and over half of the people suffering from these non-emergencies know they do not have an emergent reason for visiting the ER. The difference is that an ER visit costs hundreds to thousands of dollars, whereas waiting to see a family practice doc costs a fraction of that. To add insult to injury, 1/3 of ER vistors do not pay a dime and 1/3 pay a reduced amount. (Who says there's no free health care in the US? ) So you only have 1/3 of people actually paying for their visits. My solution would be to drive up copays to keep people without emergencies from abusing the system. This would lower costs for everyone and also keep non-emergencies from clogging the system. |
I'm a bit intrigued by this one..
I think that us Australian's are quite lucky with our health care system. Neophono mentions that theres an opportunity cost in only chosing 2 of the 3 options in assessing healthcare.. For some reason, i dont agree.. not in australia anyway.
Let me explain.
Accessibility - Our public hospitals, although having waiting lists for elective surgery, are virtually queue free. I have walked into the emergency ward several times and recieved treatment without waiting more than 20 minutes.
Quality - I think that the quality of treatment in this country is second to none (not literally, but it's pretty damn good). I mean, our royal childrens hospital here in melbourne greets patients from all over the globe (including the US), and in this sense is the best in the world. So quality isnt a problem.
Low cost - Our health care is virtually free to the consumer (thankyou medicare). Bulk billing at our General Practitioners is readily available (some may like to disagree tho), and our prescription drugs are dirt cheap. (top-line, ground-breaking medicines go for as little $5 a pop here)
At the moment we enjoy the best of everything, but I can understand that there needs to be a tradeoff, and i think that our health care system is turning more and more into an american system. Talks of increasing prescription costs, and an imminent collapse of our medicare, suggests that our dirt cheap system is not viable. Looks like the consumer is enjoying low cost, but the government is getting slammed with the high costs.
I dont know... which one, of the three, would you want to give up though?? too hard to answer.
On a personal aside, I think the idea of health care being expensive is an interesting one. In the US, people will go out and buy $6000 flat screen TVs, homes that are tens of thousands of dollars above their income range and cars that guzzle both gas and maintenance fees. Then, when they have to pay a several hundred a month in health insurance, it is too expensive. If I had to choose (as I've had to) between paying for a fancy car or expensive TV, or paying for insurance, so that if I get sick I WON'T DIE, the choice seems pretty obvious. All of those other material possessions are pretty insignificant if you're dead. I just can't understand why paying several hundred dollars a month for a TV or car is fine, but when health insurance gets to that range, it's outrageous.
(One reason I say this is because the majority of individuals without health insurance could afford it, but choose not to buy it.)
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| Originally posted by NeoPhono On a personal aside, I think the idea of health care being expensive is an interesting one. In the US, people will go out and buy $6000 flat screen TVs, homes that are tens of thousands of dollars above their income range and cars that guzzle both gas and maintenance fees. Then, when they have to pay a several hundred a month in health insurance, it is too expensive. If I had to choose (as I've had to) between paying for a fancy car or expensive TV, or paying for insurance, so that if I get sick I WON'T DIE, the choice seems pretty obvious. All of those other material possessions are pretty insignificant if you're dead. I just can't understand why paying several hundred dollars a month for a TV or car is fine, but when health insurance gets to that range, it's outrageous. (One reason I say this is because the majority of individuals without health insurance could afford it, but choose not to buy it.) |
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| Originally posted by St_Andrew You basically just said that in america (one of the richest countries in the world), if you don't have enough money, you can die due to bad healthcare. that is sick imo. |
Someone please explain to me why healthcare is a "right". Seriously, I'd love to hear a compelling argument that doesn't rely on emotional pursuasion, but rather an argument that is objective and explains why a person should be entitled to receive something for free at the cost of another. Don't feed me some shit like "Doctors are rich and therefore should be required to perform services for free."
If you can convince me of that, I will be hiring you to also make sure my car and homeowners insurance are free as well.
I pick the libertarian solution:
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[June 19] America has a health care problem that has developed into a full-fledged epidemic. Over 40 million Americans currently lack health insurance. Skyrocketing healthcare costs eat up about 15% of the nation's total productivity. Thousands of businesses have dropped their employee health care benefits. How did the American health care system become so diseased? Prior to the 1960s, America had a health care system that many considered the best in the world. Most Americans could afford to pay for health insurance; hospital procedures didn't cost a week's pay; charity hospitals were available for the poor and indigent; and doctors even made house calls. Then the federal government stepped in with programs and regulations that would allegedly make health care more accessible. Since then, prices have gone up at a feverish pace, and increasing numbers of people are unable to afford coverage. The ballooning cost of health care has been met by cries for even more government intervention. In the past year, politicians have proposed a Medicare prescription drug benefit, a "mental health parity" bill to force insurers to cover mental illnesses, and a "Patients' Bill of Rights" to give individuals more power to deal with health maintenance organizations (HMOs). But further government intrusion into the health care market would be a cure worse than the disease. For a case in point, just look to America's northern neighbor. Under Canada's "free" health care system, tax revenues fund all health care. There are no user fees. No insurance companies. No health care management organizations. At first blush, it sounds like the perfect patient paradise. The reality is quite different. Canadian politicians may have been able to dispense with the for-profit system, but they have been unable to repeal the laws of supply and demand. According to the Canadian Fraser Institute, hospital waiting times have increased a dramatic 51% since 1993, when the median wait for Canadian patients to receive treatment was already 9.3 weeks. Why? Because with government paying health care bills, there is no reason for individuals to economize. As a result, every minor ache or pain is viewed as a legitimate reason for a medical visit. So Canadian physicians suffer from case overload, while Canadian patients wait. And wait. And wait. As Guy King, former chief actuary for the Health Care Financing Administration, noted, "When people, either patients or doctors, are spending other people's money, they do not worry about the cost or number of services consumed." That's the problem in a nutshell. Today, almost half of all American health care dollars are spent by governments -- not by private individuals or companies. In addition, reams of regulations further burden health care providers. Rather than further enmeshing the government in medicine, we should dramatically reduce its role -- and, by doing so, make health care more affordable. To that end, politicians should: * Replace the FDA. According to the Food and Drug Administration (FDA), getting a new drug approved costs a pharmaceutical company $300 million on average, and can take as long as 10 years. This regulatory hoopla not only boosts the price of drugs, but it keeps potentially life-saving medicines off the market. As a result, patients suffer and die. Take the case of Propanalol. In 1968, the FDA approved this drug, but, for almost a decade, refused to allow it to be used for angina or hypertension. A study by Arthur D. Little, Inc. estimated that roughly 10,000 Americans died for lack of the drug each year the FDA prevented doctors from prescribing it. Not only does the FDA keep prices high and waiting periods long, but as Robert Goldberg of Brandeis University said, "The FDA has sat on or rejected drugs for depression, schizophrenia, kidney cancer, and epilepsy -- not because they were unsafe, but because in the final analysis the agency didn't think the drug was so important or effective." If we disposed with the FDA, patients and their doctors would be able to decide whether a particular drug is "important or effective" -- not health care bureaucrats. Moreover, private certification associations could fill that niche, similar to how Underwriters Laboratories (UL) currently certifies electrical appliances. UL is an independent, not-for-profit organization that develops standards and rates electrical products, giving them a non-governmental seal of approval if they are safe. * End Medicare and Medicaid. Passed in 1965, Medicare is a compulsory medical welfare program for the elderly, while Medicaid is a medical welfare program for the poor. According to former LP presidential candidate Harry Browne, the average senior citizen now pays more than twice as much from their own pocket for health care as they did before Medicare -- even after allowing for inflation. In addition, there are over 100,000 pages of Medicare regulations in the Federal Register. Meanwhile, the payroll tax to fund the programs continues to rise. In 1965, the tax was just 0.9%, divided between employer and employee. Today the total tax is 2.9%, taking over $1,200 from the average worker's income. According to Browne, "Because these programs impose so many requirements, the health-care system now has far more administrators per patient and far fewer doctors and nurses per patient. Those big medical bills aren't paying your doctor's country club dues -- they're financing a bigger and bigger health-care bureaucracy." If the government ended these programs, the government-mandated administrative costs would disappear, and the price of care would drop dramatically. * Institute a universal medical tax credit. About 90% of workers with health insurance are covered through their employers, who are permitted to write off health care coverage from their taxable business revenue. As a result of this tax code enticement, many American workers consider health insurance to be "free." A medical tax credit would, by contrast, encourage consumers to pay closer attention to how their health care dollars are spent. Under such a system, each taxpayer would personally pay for health insurance and medical costs -- and then deduct those payments, dollar for dollar, from his or her tax bill. According to the actuarial firm Milliman USA and the Council for Affordable Health Insurance, an $800 per-person tax credit could cover 90% of a typical health insurance premium. As for the "universal" component, individual taxpayers could choose to write off an additional amount and donate it to hospitals or low-income individuals. Merill E. Mathews, Jr., director of the Council of Affordable Health Insurance, said, "A tax credit would be the most efficient way to assist uninsured Americans who do not get health insurance through an employer." * Deregulate insurance companies. Currently, the government forces insurance companies and HMOs to cover certain maladies and services -- regardless of whether you need them or not. One example is gynecological services, which must be offered even in a plan bought by a man. Politicians also force insurance companies to cover pre-existing medical conditions -- such as glaucoma or cancer -- under their policies. A study by the American Society of Actuaries found that claim costs rise by an average of 38% wherever a guaranteed-issue rule is imposed. Instead of further driving up costs, Congress should focus on deregulating the health care companies, and allow consumers to choose a less inclusive plan tailored to their individual needs. Considering the current trend toward a nationalized health care program, the prognosis for the ailing American system looks bleak. However, the situation is still curable if we enact a healthy dose of free-market initiatives -- not additional centralized controls. As the debate rages over how to fix America's health care system, many falsely claim the debate is about who should get more power: The government, or big health care companies. But Michael Tanner of the Cato Institute said there's another way. "It doesn't have to be more power to the government or more power to the HMOs," he said. "It could be power to the people." He's right. Only by expanding consumer choice, freeing people to spend their own money, and unshackling the free market can America save its ailing health care system. |
Amen, Shakka.
I don't think anything that comes at someone else's expense, like health care, should be a "right".
"Rights" are things like being able to: (1)say what you want, own (2)property, (3)go where you want provided it doesnt violate 2, and so on.
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| Originally posted by tupsox Amen, Shakka. I don't think anything that comes at someone else's expense, like health care, should be a "right". "Rights" are things like being able to: (1)say what you want, own (2)property, (3)go where you want provided it doesnt violate 2, and so on. |
I do agree with both Shakka and the Libertarian party's ideas. There is one problem I see however with their reasoning, and that is the current increasing cost of medicine. No matter how you want to look at it, medicine is more expensive now, procedurally, than it was in the 60's. Medicine is very technology based, but the catch is, whereas in most fields, advances in technology make things cheaper (computer chips, tv's, etc.), advances in medical technology make things more expensive. An MRI is more expensive than a CT is more expensive than an X-ray, etc. So, if a doctor desides more expensive technology is required, things are going to be more costly than before that technology was available. And on top of that, patients demand "cutting edge" technology in their treatment. I hope that makes sense.
As far as Shakka is saying...I see medical care as a technology, and as long as we aren't "entitled" to cars or tv's, I don't see why we are entitled to medical care.
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| Originally posted by MisterOpus1 I see. So you and Shakka believe the quality of life is not equal amongst everyone? Those who cannot afford the same quality of life as the affluent should not ever be given that opportunity? What's that Animal Farm saying go? "All animals are created equal, but some more than others." |
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| Originally posted by MisterOpus1 I see. So you and Shakka believe the quality of life is not equal amongst everyone? Those who cannot afford the same quality of life as the affluent should not ever be given that opportunity? What's that Animal Farm saying go? "All animals are created equal, but some more than others." |
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| Originally posted by tupsox I'm generally hesitant to dignify such idiocy with a response, |
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| but....where did I say anything about denying opportunity? I'm just saying, as Neo Phono and Shakka have said, that merely being born doesn't entitle you to the highest-tech expensive health care. It does, however, entitle you to speak, to own property, and so forth. |
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| Nice Orwell quote, I assume you're probably the one between us that supports Affirmative Action? |
To me the right for healthcare, the right to education and right to own property etc is equally worth.
Shakka:
To motivate your right is not the easiest, it will finally come down to basic view of life. You will argue about that everyone should had the right own what he earn, meanwhile i will argue that everyone should have a right to life, and an equal opportunity to go on in life.
But if you are up for it, sure i will too 
I don't think the debate should be whether health care is a right.
It isn't.
Neither is social security, but we have that. And neither is paying taxes, but we have those too.
The debate should really be focused on how this government choses to provide a minimum net for its society.
Although healthcare is not a right, it most defintely is a positive thing for most people in society to have. Just like social security. And although I might despise that 15% of my paycheck is going to a fund I will never see, I enjoy that thought much better than the though of having to witness a great depression during my lifetime.
In this regard, it is just as important to have a health 'net' for our poor, elderly, etc, so we don't have anyone dying in the streets. The USA does has achieved this net (so we aren't even debating this point) - no one is dying in the streets of America because they can't afford healthcare.
The real question is how do we go about doing it? Right now this net has been cast so large that it has forced the government, and the private citizen (either via insurance or his own pocket) a huge amount of money. More than in history.
The issue with the healthcare system in the USA is not about the poor. The poor have excellent healthcare and it is affordable. The issue is about the American class - the middle class.
The middle class always had health care, it had superb health care. And it never payed for it out of pocket - well not directly anyhow. They would pay health insurance, and health insurance would cover almost all of the tab.
The only thing that has changed over the past 10 years is that the middle class is still paying health insurance, now though at back-breaking rates, and these insurance companies are covering less and less of your expensives. So while paying the companies 100% more than you would have ten years ago, they are covering only 50% of your expensive, instead of almost all as they used to.
This isn't effecting the middle class either. No one is dying. But medical cost are driving many into debt, and many into bankruptcy (medical costs is the 2nd highest caust of bankruptcy in the USA). To most of us it is a nusiane, we have been used to getting good health car for cheap, and now were forced to pay for it. Many of us can, we just don't want to. And its fine, I understand that.
The question than is, since everyone basically needs health care anyone (whether they will do it via insurance, via government, or via their own funds) they'll need it.
So if everyone in the nation needs it, and is paying for it one way or the other. I am tempted to start thinking it simply will be a good idea for the government instead of the insurance company to take 5-15% of your paycheck, and cover all of us.
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| Originally posted by St_Andrew To me the right for healthcare, the right to education and right to own property etc is equally worth. Shakka: To motivate your right is not the easiest, it will finally come down to basic view of life. You will argue about that everyone should had the right own what he earn, meanwhile i will argue that everyone should have a right to life, and an equal opportunity to go on in life. But if you are up for it, sure i will too |
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