Because The United Kingdom?

[rmgill]

4 hours ago, Ssnake said:

Getting care in time, and not bankrupting yourself in the process. As mind-bending as it may appear, these are not mutually exclusive!

By pretty much any metric, the US system is terrible unless you're several times above the median income so you can afford to pay whatever bill the hospitals are throwing at you.

I will note that in the US if you pay cash, you can shop around for procedures you may need and the prices will not be the quite nearly as high. I' have seen as much as a 1/3rd discount for a procedure where cash was going to be the method of payment from a medium sized practice. 

Part of the problem is that people have stopped shopping around for various medical procedures and they just hand over the insurance card/plan card and go with it. 

And the Big cost factor, Hospitals in the US ARE regulated and the federal government keeps those costs hight in order to milk the system. Its like the US airlines and rail systems before deregulation. 

Oh, on the life expectancy, there's some demographic differences there. And lifestyle that affect that. 

Edited January 4, 2024 by rmgill

[Ivanhoe]

2 hours ago, rmgill said:

Oh, on the life expectancy, there's some demographic differences there. And lifestyle that affect that. 

I can't take anyone seriously who uses life expectancy as a measure of health care effectiveness.

 

[Ssnake]

Fine, which metrics should we use if we want to have a serious conversation?

I've mentioned others, like infant and maternity mortality (the US system doesn't look so good here either).

 

Also, you could search for the lowest bidder in Europe and pay cash for your procedure. Few do it because when health insurance is mandatory, you'd trade a minor savings in co-payment for a potentially bigger uncertainty of the quality of the doctor and the way he might perform the procedure - but it's definitely not forbidden.

The argument that only in the US system there's no rationing of medical treatment is also demonstrably false. If the insurance company has a say in whether or not a certain procedure is "necessary", that alone is a measure of rationing. The countless number of Gofundmes for medical treatment in the US is another indication that there's strong rationing for those that can't afford to pay for it. So, rather than rationing for everybody, it's "none for the rich, and tough luck for the rest". But surely you have a convincing argument why that is a Good Thing (TM).

[rmgill]

22 minutes ago, Ssnake said:

Fine, which metrics should we use if we want to have a serious conversation?

Procedural outcomes.
Diagnosis of cancers and the life extension of the treatments. 
Rates of negative outcomes on the operating table and with regards to mis-diagnosis. 

 

22 minutes ago, Ssnake said:

I've mentioned others, like infant and maternity mortality (the US system doesn't look so good here either).

Yes. that's a good metric but you can't be univariate there. You have to take into account cultural aspects. In the US we have a very large country with a great variety of variables across that nation. Simply put the racial make up is a factor as there are differences of incidence of disease in certain racial groups that are dependent upon culture AND genetics. Those cultural differences are going to have factors on behavior and diet. 

Europe doesn't have the same demographics. 

CDC data on the subject. Note Black Americans have an infant mortality at 10.6 deaths per 1,000 births and Asians have a 3.7 deaths per 1,000 births.  
https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm

Pre-natal care is going to affect that. So too is drug use. My mother used to work at a lab for Emory in Downtown Atlanta just across from Grady Hospital (the large urban hospital for Atlanta). They were working out how to diagnose HIV/AIDS in babies (the normal blood tests looks for Antibodies which a baby will have as those cross the placental barrier from the mother).  One of the sources of blood samples they had for the testing regimen was babies who's mothers were drug users and HIV positive. Which was to say that the babies were both at risk for HIV/AIDS And were, at birth addicted to crack or other illegal drugs (alcohol being another issue). They had the lab there because it was a useful place for getting ready samples for the testing regimen. 

22 minutes ago, Ssnake said:

Also, you could search for the lowest bidder in Europe and pay cash for your procedure. Few do it because when health insurance is mandatory, you'd trade a minor savings in co-payment for a potentially bigger uncertainty of the quality of the doctor and the way he might perform the procedure - but it's definitely not forbidden.

The US system as proposed was a total Monopoly. So that is part of our objection here. 

 

22 minutes ago, Ssnake said:

The argument that only in the US system there's no rationing of medical treatment is also demonstrably false.

I have very clearly stated that there IS a rationing of Hospitals. These are termed Certificate of Need. This is part of the National Health Planning and Resources Development Act. So there is quite clearly already a hybrid system of rationing care and keeping costs at a certain point. 

22 minutes ago, Ssnake said:

If the insurance company has a say in whether or not a certain procedure is "necessary", that alone is a measure of rationing.

Yes. They cover certain things. But you can go and get those procedures done elsewhere. And again, if you pay for something out of pocket it's often times substantially cheaper because the provider doesn't have to pay for the red tape baked into that cake. I have HAD this discussion first hand with the doctor providing the care to my then girlfriend who needed a certain procedure that was not covered by insurance. 

Likewise corrective eye surgery in the US is both lucrative, quick, safe and reasonable in price. 


As for Go fund Mes in the US, people do the same for PET vet emergencies. The big tell there is that Americans aren't saving enough and aren't planning for emergencies enough.  There are health care plans that cover a great deal of things as part of a voluntary network. 

And as for government provided care. At this point California has announced it's going to fund health insurance for illegal aliens. We don't even provide across the board insurance for vets. 

https://www.instagram.com/p/C1pQTxUOpLA/?utm_source=ig_embed&utm_campaign=loading

I never thought I'd be citing 50Cent on a point of conservative politics. *Eyeroll*

Edited January 4, 2024 by rmgill

[Tim Sielbeck]

17 minutes ago, Ssnake said:

The countless number of Gofundmes for medical treatment in the US is another indication that there's strong rationing for those that can't afford to pay for it. So, rather than rationing for everybody, it's "none for the rich, and tough luck for the rest". But surely you have a convincing argument why that is a Good Thing (TM).

Are the "Gofundmes" to get in the door for the procedure or to pay for it after it's done?  I only know one person, my sister, who had to get major surgery and didn't have insurance.  It didn't stop her from getting the procedure she needed.

[Ssnake]

Having to pay considerable sums for every visit to the doctor is also a deterrent to get treatment in a timely fashion when minor treatment is still an option. Instead, people go sick to work and spread their infections to co-workers, or refuse to take the ambulance even when it'd be better if they did. Over-use of antibiotics with the resulting cultivation of multi-resistant germs is another side-effect of that.

A friend of mine with multifibrosis/chronic fatigue syndrome moved from the US to Germany because she could't afford proper treatment. She'd collapse in the ER, receive treatment there (but only there), so she could deteriorate until she ended up in the ER again.

In Germany, she's received proper preventive treatment with medication and other measures and is able to lead a somewhat normal life. Still "not great", but much, much better.

[DB]

It's funny how many people from the US who have encountered any of the European health care systems seem to have opinions at variance with those whose opinion is based only on theory.

[Tim Sielbeck]

2 hours ago, Ssnake said:

Having to pay considerable sums for every visit to the doctor is also a deterrent to get treatment in a timely fashion when minor treatment is still an option. Instead, people go sick to work and spread their infections to co-workers, or refuse to take the ambulance even when it'd be better if they did. Over-use of antibiotics with the resulting cultivation of multi-resistant germs is another side-effect of that.

A friend of mine with multifibrosis/chronic fatigue syndrome moved from the US to Germany because she could't afford proper treatment. She'd collapse in the ER, receive treatment there (but only there), so she could deteriorate until she ended up in the ER again.

In Germany, she's received proper preventive treatment with medication and other measures and is able to lead a somewhat normal life. Still "not great", but much, much better.

If your friend had lived in Dallas county and went to Parkland hospital she would have received the same treatment as she did in Germany.  They would have sent her bills but they wouldn't have denied her treatment.

[rmgill]

47 minutes ago, DB said:

It's funny how many people from the US who have encountered any of the European health care systems seem to have opinions at variance with those whose opinion is based only on theory.

How much experience do you have with the US's form of government health care? OR private health care? Or Insured health care? 

I've seen how they handled a friend who had a broken hip. You might want to go to Grady in Atlanta for a GSW, but for quality care on anything else...good luck. Or you can expand upon how the US VA system is all milk and honey. 

Seriously, a more realistic appraisal of how a system might function would be useful. But for a US based system it's going to be infested with all of the same manner of folks in the US who infest other US government agencies like the VA or the US Postal system with all of the variances of people who are great to entire offices of staff who are basically punching in to get a paycheck and have next to ZERO incentive to do useful work product. There are entire Post Offices in the US system where the staff are all zeros who have retired on the job. AND they don't get fired because federal workers have a RIGHT their jobs due to a twist of how due process works and applies to federal employment. 

Edited January 5, 2024 by rmgill

[Stuart Galbraith]

20 hours ago, rmgill said:

So you get care, but you're bankrupt from the cost. Or you don't get care because you're on a waiting list and die. Which is better? 

As to refused treatment. When you're told to wait and you die of your condition, how is that not refused treatment. Here, sit in this corner while we ignore you for hours. Does that count as refused treatment? 

It's a closed system with controlled by a coterie of bureaucrats. It's by default going to have problems and monopolies are not a good thing. 

Funny thing is that I've seen very clear examples of how the NHS fails in the UK from someone who works for them. Several very clear citations in fact. The US has an analog of the NHS with US government workers. It's the VA Medical System. I'm sure that the members here can tell you how swimmingly that system is. 

I personally don't want that writ large and mandated as a monopoly as Hillary proposed it would when she was First Lady. 

Hahah. What's the proper level of taxation for a 21st Century European Economy? How's that going to encourage your economic growth? 

Just raise taxes. that's the answer? Not Hire better staff, implement better rules? Get rid of the idiots? 

Well gee Ryan, we spent the past 13 years continually lowering taxes. We have broken roads, broken defence, broken police, broken judiciary. What the fuck else are they supposed to do, launch a gofundme appeal?

I can never reconcile you guys. You believe in having a big military, keeping your military industrial capacity strong. And then when it comes to paying taxes to pay for it all, you all suddenly become small statists.

 

Edited January 5, 2024 by Stuart Galbraith

[Rick]

From an ultra-left U.S. site several years ago.

"How would Medicare for All work from a financial aspect?

At present, 100% of contributions made to Medicare by everyone who has a job in this country cover the healthcare costs for the current program. Those tax dollars are barely enough to cover seniors on Medicare, who account for roughly 19% of the population.  So the question is: how much would payroll taxes need to increase to cover 100% of the population as opposed to the current 19%? The current tax rate is 1.45% for the employee and 1.45% for the employer, or a 2.9% total. 19% divides into 100% 5 times, so one assumes that one would need to raise the payroll tax five-fold to cover 100% of the population. That would mean that the employee would pay a tax of 7.25% as would the employer, equaling a tax of 14.5%.  Add into this the fact that current Medicare recipients pay monthly premiums of $109 on average, or $1308 a year.  So do the math: if you earn $50,000 a year, your Medicare tax would be $3625 at 7.25%. Add in your premiums of $1308, and you're paying just under $5,000 a year per person for Medicare for All. Sounds good.

But what if you are a family with a spouse who doesn't work and two young children who don't work? How are they covered in the Medicare for All scenario? Surely, there would be additional premium cost involved. They can't be covered free of charge. That $5000 per year mentioned above covers ONE working person, not their family members. Even if you waive the payroll tax deduction and charge only the average monthly premium per person (as Medicare currently does), you are looking at an additional $3900 per year to cover a non-working spouse and two children. That makes your cost around $9000 per year, and that is equal to 18% of that $50,000 income you are earning.

And, to cover all bases, let's not forget that you are currently paying 6.2% of your income in Social Security taxes. Add that into the mix, and your combined Medicare for All and SS expenses for that family of 4 with one bread winner described above would be over 25% of your income.

That's still a bargain when compared to the taxes paid in European nations, and it's the true cost of having a truly socialistic approach to things. It is what it is. Let's not downplay the realities involved.

I don't have the answers. I do know that while Medicare for All might well be the best and fairest approach we could take toward universal healthcare, it comes with real expenses and real costs to real people."

[seahawk]

A government regulated health Care Service is just a first step towards Socialism. The US citizens need to fight this and push back Medicare as much as possible. Medical services are a service like any other and should be a private problem.

[Ssnake]

It's not as if healthcare is free anywhere. Even in Cuba you pay for it, if indirectly. 5..6 grand per year per person sounds credible; this would be offset against payments already made into existing insurances.

The main reason for a manfatory and general healthcare is to avoid the far greater costs to society and the individual in cases of medical bill that would bankrupt the individual. This is a quite real danger that threatens everybody, at every moment.

[EchoFiveMike]

The 900lb gorilla in the room is that you can't compare what they have in mono-ethnic nations to what we have in diversity shithole clown world empire.  America's problem is overwhelming parasite load.  Anything you give away from free will instantly attract subhuman parasites.  To the point of motherfuckers coming into a business demanding their "free wee fee."  S/F....Ken M

[Strannik]

4 hours ago, seahawk said:

A government regulated health Care Service is just a first step towards Socialism. The US citizens need to fight this and push back Medicare as much as possible. Medical services are a service like any other and should be a private problem.

Folx can always sell one their kidneys to finance the needed services.

[seahawk]

2 hours ago, Ssnake said:

It's not as if healthcare is free anywhere. Even in Cuba you pay for it, if indirectly. 5..6 grand per year per person sounds credible; this would be offset against payments already made into existing insurances.

The main reason for a manfatory and general healthcare is to avoid the far greater costs to society and the individual in cases of medical bill that would bankrupt the individual. This is a quite real danger that threatens everybody, at every moment.

But that means those who work and contribute to society pay for those that do not and this attracts lazy and useless people who do not pay and suck up the money of the working people like parasites. 

[Stuart Galbraith]

21 minutes ago, seahawk said:

But that means those who work and contribute to society pay for those that do not and this attracts lazy and useless people who do not pay and suck up the money of the working people like parasites. 

Tough. Go live in Fascistia if you dont like it.

At heart, its an easily disproved argument. 'But I pay for roads that are used by the poor and the non working class! Thats not fair!'

Or,

'But I pay for the police, so they can help people whom suffer crimes. Ive never been burgled, why should I pay?'

Well gee, go watch Robocop, and learn. 

 

 

Edited January 5, 2024 by Stuart Galbraith

[seahawk]

21 minutes ago, Stuart Galbraith said:

Tough. Go live in Fascistia if you dont like it.

At heart, its an easily disproved argument. 'But I pay for roads that are used by the poor and the non working class! Thats not fair!'

Or,

'But I pay for the police, so they can help people whom suffer crimes. Ive never been burgled, why should I pay?'

Well gee, go watch Robocop, and learn. 

 

 

But America was not made great by handing out "Freebies" and slacking.

[Stuart Galbraith]

Sure it was. It was made great by tax dodgers, look at Boston Harbour.

 

[Tim Sielbeck]

1 hour ago, Stuart Galbraith said:

Sure it was. It was made great by tax dodgers, look at Boston Harbour.

 

Protesting an unfair, and unjust, tax is not tax dodging.  Grow up.

[Colin]

On 1/4/2024 at 4:06 AM, rmgill said:

 

It's a closed system with controlled by a coterie of bureaucrats. It's by default going to have problems and monopolies are not a good thing. 

 

Here in Canada, it's the large businesses that create monopolies and do their best to strangle any competition. 

[rmgill]

23 hours ago, Stuart Galbraith said:

Well gee Ryan, we spent the past 13 years continually lowering taxes. We have broken roads, broken defence, broken police, broken judiciary. What the fuck else are they supposed to do, launch a gofundme appeal?

You have to also spend the money you DO tax wisely. Is your nationally and locally taxed money spent wisely? 
|

23 hours ago, Stuart Galbraith said:

I can never reconcile you guys. You believe in having a big military, keeping your military industrial capacity strong. And then when it comes to paying taxes to pay for it all, you all suddenly become small statists.

If you spend some time studying history and civics, you might grok that there are other portions of the federal budget that don't include the military. 

If you look at the US federal budget before the advent of the FDR administration, most of the federal agencies managed to fit into the offices on the mall and proximate to the mall in DC and their budets were tiny bumps on the federal pie chart. 

This is what it looks like now. 

 

There's also this issue. The spending needs to be in line with the income. It's not. Biden has blown it out. 

[rmgill]

12 hours ago, Colin said:

Here in Canada, it's the large businesses that create monopolies and do their best to strangle any competition. 

Your PM wants a complete monopoly on the use of deadly force too. 😉

 

[Stuart Galbraith]

13 hours ago, Tim Sielbeck said:

Protesting an unfair, and unjust, tax is not tax dodging.  Grow up.

Not paying tax and they get eulogised for it. And you wonder how you ended up with a 3 trillion dollar debt? You had a president, the first in something like 100 years, whom refuses to release his tax details. And he is adored for it.

All tax is unfair. Its also necessary, and if you make people whom dont pay it into sometime hero's, you cant wonder that so many try to dodge it.

 

Edited January 6, 2024 by Stuart Galbraith

[Stuart Galbraith]

18 minutes ago, rmgill said:

You have to also spend the money you DO tax wisely. Is your nationally and locally taxed money spent wisely? 
|

If you spend some time studying history and civics, you might grok that there are other portions of the federal budget that don't include the military. 

If you look at the US federal budget before the advent of the FDR administration, most of the federal agencies managed to fit into the offices on the mall and proximate to the mall in DC and their budets were tiny bumps on the federal pie chart. 

This is what it looks like now. 

 

There's also this issue. The spending needs to be in line with the income. It's not. Biden has blown it out. 

Oh, wisely. So tell me, when the Conservatives were in between 1979 and 1997, what were they doing precisely? cutting expenditure, and letting the roads turn into rubble. And when they were in between 2010 and today, were they not doing the same thing, cutting expenditure and balancing the books? And turning the roads into rubble. And shutting the library's. And cutting the bus services. And foreign aid. And the Army. And the Police. And they STILL cant seem to make the economy grow, for 13 years!

The faults facing this nation are not due just to spending money unwisely. The Conservatives, which are essentially unrepentant Reaganites, have had 13 years to cut everything they could cut. And they have. Give them credit, they have been absolutely ruthless in that regard. They sell off the channel tunnel, Bentley priory and Admiralty arch to property developers. They have been wholly effective at trimming money, on anything that isnt nailed down.

In large part the problem we have now are not wanting to spend anything at all, and the nations infrastructure is falling to bits. How do I know this? I was in a hospital yesterday helping my mother get a scan, and do you know what they said? 'We keep losing people and they are never replaced'. Do you think perhaps, that might have something to do for the vast majority of the past 13 years they havent had a pay rise? And the Army, the Navy and the RAF, cannot get personnel. Do you think that might also have something do with the fact that we put a freeze on pay? As well as overdeploying them because we dont have a large enough armed forces for everything we want to do.

Or the railways. For the past 10 years ive been driving past a railway viaduct in stroud, with a small tree growing out of it. But they dont remove it, because Network rail have reverted to the British rail practice of not spending money on infrastructure till the last minute, and anyone that remembrs the history of Britains railways will tell you how that worked out. It took about 20 years of solid investment to fix.

Tax money is a lubricant. You might not like forking out for it, but try forking out for a new engine when it seizes up for want of it. The engine is seizing up, and everyone can see it. The only people who wont see it are Americans obsessed with right wing podcasts that pretend the problems are identical to your own country, and you know what, they just arent.

Edited January 6, 2024 by Stuart Galbraith