Edwards’ Socialism and Funny Numbers

Yikes!  Edwards wants a plan to force people to see a doctor on his schedule.

Democratic presidential hopeful John Edwards said on Sunday that his universal health care proposal would require that Americans go to the doctor for preventive care.
“It requires that everybody be covered. It requires that everybody get preventive care,” he told a crowd sitting in lawn chairs in front of the Cedar County Courthouse. “If you are going to be in the system, you can’t choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK.”

He noted, for example, that women would be required to have regular mammograms in an effort to find and treat “the first trace of problem.” Edwards and his wife, Elizabeth, announced earlier this year that her breast cancer had returned and spread.

Edwards said his mandatory health care plan would cover preventive, chronic and long-term health care. The plan would include mental health care as well as dental and vision coverage for all Americans.

“The whole idea is a continuum of care, basically from birth to death,” he said.

So much for freedom.  This is what I mean when I say that when the government controls your health care, they control everything about you. 

But I also found this interesting…

Edwards said his plan would cost up to $120 billion a year,

Really?  Healthy Wisconsin, the government-run health care program proposed by the Democrats, is projected to cost $15.2 billion per year. 

Wisconsin’s population is about 5.5 million people.  At $15.2 billion, Healthy Wisconsin comes out to $2763.64 per person.

The U.S. has a population of about 300 million people.  At $120 billion, Edwards’ plan comes out to about $400 per person. 

What gives? 

1. Right, $2764 per person.  My guess it will be more like about $6000 per person per year.  In WI. that comes to about $33 billion dollars.
   With 303 million people in the U.S., the cost is almost 2 trillion dollars a year.
   Edwards is just a fraud and hypocrite.  It seems that he thinks is losing to Hillary and Obama and he will say anything to get into the news.
   The only way he would get the figure to $400 is that no one will get salary in the medical field and the suplies will be free.
   The question is, will the main stream media call him on it?  If they do, then it will also put pressure on Hillary to come up with a cost on her plans.

   Posted by (JavaScript must be enabled to view this email address) on September 03, 2007 at 1756 hrs




2. Uh, $6000 per person is what we’re paying already for health care.  In case you didn’t know. 

   Edwards is talking right out of his ass on this one.  Everyone has a fundamental right to refuse medical care.  Period.  Apparently none of his staffers informed him of this.  You can bet they have now.  Heh.  I’ll bet you $5 he never says this again. 

   Posted by scott on September 03, 2007 at 1849 hrs




3. He may not say that again, but I bet you he will say something as stupid.
   I stand by my $6000 a year for two reasons.  First, if single payer health does come, more people are going to access they system for the very minor things like cold, fever and flu, when they normally wouldn’t go to the doctor.  And second, whiel many people won’t use the $6000 a year, there are many that do and many of those guys have huge doctor bills.  Look at nursing home care, mental institution costs, burn and trauma victims routinely have bills inthe hundreds of thousands of dollars a year.  What figure, scott, do think it would be close to?
   I am glad you don’t agree with Edwards on this one.

   Posted by (JavaScript must be enabled to view this email address) on September 03, 2007 at 1932 hrs




4. I don’t think it’s in your interest to start a “stupid contest” between Rs and Ds.  Seriously. 

   You guys just don’t get single payer.  The problem with American health care isn’t that people are consuming too much, it’s that they aren’t consuming enough.  At least that’s one of the problems.  If more people went to the doctor for regular care they wouldn’t be as sick later on.  “Cold, fever and flu” aren’t the cost drivers of our runaway system. 

   Furthermore, I’m unimpressed with your explanations as to why we’re paying $6000 per year per person on health care.  While your list is impressive sounding, don’t other countries have burn victims and mentally ill?  Look elsewhere for the explanation.

   Posted by scott on September 03, 2007 at 2016 hrs




5. You guys just don’t get single payer.  The problem with American health care isn’t that people are consuming too much, it’s that they aren’t consuming enough.

   You just don’t get America.  Well, the way America was supposed to be anyway.

   If I don’t go to the doctor for 20 years and then I get sick down the road, who should pay the price for that?  Me.  Not you.  Me.

   If you want to go to the doctor 4 times a year for preventative care, you should get to do that… but it should cost you.  YOU.  Not me.  According to your thinking, you’ll save money down the road.  Good for you.

   If we go universal, one of the best ways to keep costs down WOULD be to require everyone to go to the doctor.  Too much government intrusion?  Why is that such a big leap from the intrusions that universal health care inherently brings?  For example, government telling doctors what they can charge for their services, which is another thing the government will have to do? 

   The day anyone can point to health care as a right in the US Constitution, I may change my mind on this.

   Posted by Deibert on September 03, 2007 at 2118 hrs




6. who should pay the price for that?  Me.  Not you.  Me. [...] it should cost you.  YOU.  Not me.

   So basically you’re an every man for himself kind of guy.  That’s not America. 

   
   too much government intrusion?  Why is that such a big leap from the intrusions that universal health care inherently brings?

   you’d have an interesting case there… if there were a rash of single-payer countries doing this.  As far as I know, there are none. 

   You don’t like having an increased role for government in health care?  Fine.  Come up with a private way to get everyone insured and bring costs down to a point where we’re not number 1 in price.

   Posted by scott on September 03, 2007 at 2133 hrs




7. One of the big problems is that these companies won’t cover pre existing conditions which cost big and it really seems unfair to push on these people. We have 45 million uninsured. We need to bring that down to zero. Everyone deserves health. (I think)

   Posted by (JavaScript must be enabled to view this email address) on September 03, 2007 at 2151 hrs




8. 47 million.

   Posted by scott on September 03, 2007 at 2217 hrs




9. 21-31 million

   Posted by (JavaScript must be enabled to view this email address) on September 03, 2007 at 2246 hrs




10. What on earth are y’all talking about??  I don’t get the doctor of my choice when I want him NOW… and I have famously good health insurance.

    Of course, if Belgium can have universal health insurance, or Luxembourg, or Holland, or the Scandinavian countries, there’s no way we could ever do that.  It’s just too complicated. 

    Obviously.

    Dan, when people access the system for little stuff, there’s a net gain in savings.  Something like 80% of ALL the money spent on health care is spent in the last few months of life on catastrophic illness.  When people can go to the doctor when they feel sick, the big stuff gets picked off early and doesn’t cost the system as much. 

    Anyway, it works in all those dinky countries where the people are measurably healthier and happier.  But if you’d rather wait to go to the doctor until you’re dying, then you force the rest of us to pay for your privilege.

    hiho
    Mp

    —
    ps. definitely not voting for Edwards.

    Posted by Mpeterson on September 03, 2007 at 2332 hrs




11. The day anyone can point to health care as a right in the US Constitution, I may change my mind on this.

    Funny you should mention this, as it came up at nickschweitzer.net the other day.  You’re right that no ink is spent on the matter, but it surely was on the minds of the founders.  The “pursuit of happiness” concept from the Declaration is a culmination of thought   derived from Adam Smith, who in turn borrowed from John Locke, for whom inalienable rights included not only life and liberty but health and property.  So if we’re allowed to consider framers’ intent…

    Posted by spice on September 04, 2007 at 0306 hrs




12. Slight correction. We’re talking about the Constitution, not the Declaration of Independence.

    But while we’re at it, I love the notion that there is an element of choice currently with our health care system. this bellowing about protecting my “freeedom” as Ted Nugent says.

    In this country, choice comes down to money. If you have no money, you have no choice and certainly no access. And the character of this country comes down to if many people have very limited access to health care, where’s the morality.

    In this country we have a consumer economy. And the current rate of increases in our health care means we will eventually run out of consumers pretty soon. Now let’s have the learned lectures about how this economy works.

    By the way, the socialism label adds nothing to the discussion and only indicates little thought has gone into the topic.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 0723 hrs




13. Every time I comment on this topic I say the same thing.  If we do nothing and allow insurance to continue to go the direction it is currently going it will overtake our economy in the not to distant future.  opponents of universal health care seem to be satisfied with the idea the staus quo is good enough.  This will work for them as long as thier employers provide some sort of medical insurance or they can buy it for themselves.  When those days are gone they will come to a rude realization that they should have been more open to alternatives and discusstion sooner.  rather than throwing out the socialist accusation and walking away from the discussion.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 0800 hrs




14. Of course, if your employer changed your health care package a few years after you joined the company, and they required two checkups a year, it would be praised as keeping costs down, and heralded as free choice.

    Posted by John Foust on September 04, 2007 at 0813 hrs




15. Slight correction. We’re talking about the Constitution, not the Declaration of Independence.

    Though the 14th amendment does state:

    ...nor shall any State deprive any person of life, liberty, or property, without due process of law;...

    So this line of thinking runs from at least 1689 (Locke’s 2nd Treatise) through 1868.

    Spice

    Posted by spice on September 04, 2007 at 0832 hrs




16. 47 million.

    Posted by scott on September 04, 2007 at 0838 hrs




17. Good catch spice and something I can use.

    47 million

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 0935 hrs




18. When those days are gone they will come to a rude realization that they should have been more open to alternatives

    No they won’t.  They’ll just find a way to blame liberals or poor people.  Or both.

    Posted by scott on September 04, 2007 at 0946 hrs




19. That is the easy way of doing things. Why hold corporations accountable?

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1046 hrs




20. Scott, regarding the link in #16… that’s a very interesting article, and with a little math, one can make a lot of conclusions, or judgements on it.

    For example.  80% of the 47 million are US citizens.  That means we have almost 10 million uninsured that are not US Citizens. 

    Of the 8.7 million uninsured children,  almost 6.5 million of them are eligible for government care.

    9.3 million make over $75,000 per year in income, and another 8.5 make between $50,000 and $74,999 per year.  That’s almost 18 million that could afford healthcare, and choose not to.  That right there is over 1/3 of the uninsured…  The number of uninsured drops to 29.2 with that fact alone.

    Trying to combine a couple of the stats together is almost impossible…  Say taking out Non-US Citizens with incomes over 50K isn’t in the facts of the article, but it will fall within a range…
    The number of remaining uninsured changes from 19.8 million ((47-20%) - 17.8) to 23.36 million ((47-17.8) - 20%).

    If you take the statement that only 18,000 die each year from lack of health care, you get 3.8% of the uninsured die.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1047 hrs




21. yes, the government says 47 million… BUT.. and it’s a big BUT… those numbers include anyone that was without health insurance for even a day.  So, if you had insurance for 350 days in a year, you are included in that 47 million number.  Kind of a shady way to count it if you ask me.

    you’d have an interesting case there… if there were a rash of single-payer countries doing this.  As far as I know, there are none. 

    Uhm… EVERY country that has a single payer system is doing this.  For a good example of the intrusions I was talking about, give this article a look:
    http://www.thisislondon.co.uk/news/article-23410977-det ails/‘NHS+should+not+treat+those+with+unhealthy+lifest yles’+say+Tories/article.do

    Every country that has single payer has to ration it’s services and control costs by telling doctors what they can charge for their services. 

    The Constitution is NOT a living document.  You can’t “infer” what the framers meant to say.  They were very specific in giving government it’s powers.  The 14th amendment does say ...“nor shall any State deprive any person of life, liberty, or property, without due process of law;…” as quoted above.  How you can get from that the government is supposed to provide those things is beyond me.  All it’s saying is the state can’t kill you, jail you, or take your property without a trial.  Notice it doesn’t say it can’t do those things… it says it can’t do it without a trial.  This has to do with single payer health care… how?

    Again, I’ll ask it… where does it say you have a right to health care?  I’ll save you some time… it doesn’t.

    I’ve been in the situation before where both my wife and I had jobs that offered insurance that didn’t meet our needs.  We paid for our own.  You are all aware that you have that option, right? 

    We have a health care system that serves 85% of the people in this country just fine and you want to blow it up and destroy it for the other 15%, to grant them another government service that should not be the business of the government.  This just doesn’t make sense to me.

    Posted by Deibert on September 04, 2007 at 1136 hrs




22. The Constitution is NOT a living document.

    Female, black, and 18-year-old voters would beg to disagree.  So would the ghosts of a few seriously jonesin’ drunken flappers.

    Posted by spice on September 04, 2007 at 1155 hrs




23. Uhm… EVERY country that has a single payer system is doing this.

    Which ones are forcing people to go to the doctor or get medical treatment they do not want?

    Every country that has single payer has to ration it’s services

    We do too.  Didn’t you realize?

    We have a health care system that serves 85% of the people in this country just fine

    I beg to differ.  We’re paying far, far too much for our health care.  Even those with insurance can easily become bankrupt and destitute if they suffer a major illness or injury.  And even if you’re lucky and stay healthy, you’re still limited in your choice of employment because of the tie-in with health insurance.  We won’t even get into some of the dirty and unethical things that insurance companies do to their customers.

    Posted by scott on September 04, 2007 at 1157 hrs




24. You keep saying “we” are paying too much, Scott.  I pay for my healthcare, not “we”.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1211 hrs




25. We here in America pay a hell of a lot more for health care than folks in other countries do.  That’s a fact.  Playing games with pronouns won’t change it.

    Posted by scott on September 04, 2007 at 1212 hrs




26. You pay nothing for my healthcare, Scott.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1217 hrs




27. O Rly?  Do explain.

    Posted by scott on September 04, 2007 at 1222 hrs




28. My healthcare is private.  If I choose to spend $10,000 a year on it, that’s my choice.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1224 hrs




29. You do or don’t have insurance?

    Posted by scott on September 04, 2007 at 1225 hrs




30. Who pays for your health care is not the point,

    The problem is we all are paying too much for health care in the US. I’d wager you wail when you get jacked up a few bucks by the government and smile and take it when your health insurance leaps by double digit percentages.

    Help us figure that one out.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1230 hrs




31. I am insured for some things, uninsured on others.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1231 hrs




32. Who pays for healthcare is exactly the point.    when the government jacks up my bill, I can’t go elsewhere.  When insurers jack up my bill I can easily go elsewhere.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1234 hrs




33. When insurers jack up my bill I can easily go elsewhere.

    So where’d you go?

    Posted by scott on September 04, 2007 at 1307 hrs




34. Most of us have employer funded plans. The idea that most people can go shopping for health insurance is not only a fantasy based on how much people make, but the fact that insurance companies got you by the balls is no incentive for them to find ways to cut costs—executive salaries would be a good place to start—or to deliver what they promise without looking for loopholes.

    And when the government does run health care as it does in many cases, the professionals keep a close eye on costs. That is the problem when you get into the private sector everyone has their hand out. Other countries prove they curb that with their systems.

    Some day you’ll just have to be an adult and share—for your own good.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1307 hrs




35. The Constitution is not a living document
    Female, black, and 18-year-old voters would beg to disagree.  So would the ghosts of a few seriously jonesin’ drunken flappers.

    jonesin’ drunken flappers…. now that’s funny! 

    With amazing foresight, the creators of the US Constitution gave us the ability to change it.  Surely you must see the difference in changing the Constitution vs inferring from it.

    Again, like I said, the day you can point to a spot in the US Constitution that says specifically health care is a right, I’d have to refocus my argument.  If you can convince 2/3 of Americans that the government should guarantee health care for its citizens, then you are well on your way to changing the Constitution.

    Posted by Deibert on September 04, 2007 at 1313 hrs




36. Some day you’ll just have to be an adult and share—for your own good.

    From each according to his ability, to each according to his need, right kr?

    Posted by Deibert on September 04, 2007 at 1317 hrs




37. Insurance companies don’t have any company by the balls.    Companies routinely shop insurance.  It’s easy to do.  I have never worked for a company that did not change plans at least once.    Additionally, companies have become very good about allowing their employees to determine what their insurance will cover, with the corresponding increase or decrease in premiums.

    Health care professionals have no incentive whatsoever to control costs, and they don’t.  Costs are controlled best when the end user has some idea of how much they are paying, what they are paying for, and how that affects their pocketbook.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1322 hrs




38. Yeah that has worked really well for keeping costs down in this country.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1327 hrs




39. the day you can point to a spot in the US Constitution that says specifically health care is a right

    Who cares if it doesn’t?  Is it required that it be specifically enumerated in the Constitution for the government to do it?  If that’s your argument, you’re looking at dismantling modern government and going back to 1823 or something.  And I guess some libertarians among us are going to say “yes, that’s exactly what we want!”  But you should be reminded of this: pretty much nobody else shares that view.  Good luck selling it.  This is why you guys can’t get anyone elected dog catcher in this country.  Or any other.

    You guys want a non-government solution to our health care problems?  Fine.  I’m willing to have such a solution.  First you have to acknowledge that we do have problems and we need some agreement on what they are.  I say this because lots of you spend a lot of time denying them or minimizing them.  Then having done that, you’ll have to explain your plan for having market forces a) cover everyone and b) reduce cost drastically.  So far nothing you guys have said inspires a lot of confidence that you can do it.

    Meanwhile, we on the other side have a lot of examples and evidence that the kind of solutions we’re looking at do in fact solve the problems we have.  You don’t like those solutions?  Fine.  But throw me a bone here and at least acknowledge that it’s not at all ridiculous for us to be looking at these solutions.  Your perpetual “OMG how can you even think that!” tone is severely divorced from the reality of our situation and damages your credibility.  instead try “I can see why you think these might be good solutions, but here’s my concerns and here’s why I think our plan will work better.”

    Posted by scott on September 04, 2007 at 1331 hrs




40. I don’t need credibility Scott, I’m not trying to impose the biggest government program in history upon the country.    The burden is on you.

    kr:  I don’t have a problem with my costs.  You appear to have a problem with my costs. 

    “Is it specifically required to be enumerated in the constitution for the government to do it?”.  Yes.  That’s called an assumption of liberty, and it’s the only thing that keeps you free.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1342 hrs




41. If you don’t care about your costs I don’t care about your costs. I care about our costs, which include impaired competitiveness.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1346 hrs




42. I don’t need credibility Scott,

    Well it’s a good thing, too!  But seriously, I think you do need it.  You’re claiming that you have a better solution to these problems (or are you now in denial mode that we have problems?).

    I’m really becoming ill with all the every man for himself mentality here with regard to health care.  I mean, hell, that flies in the face of insurance itself, let alone who you get the insurance from.  According to this philosophy it would be the most desirable outcome if people who had money in their pocket went to the doctor and people with no money didn’t.  People with $100k on hand to pay for heart surgery would get it, people without such means would not.  I guess it wouldn’t bother you that a lot of people got little or no care, just so long as it meets your grade-schoolish idea of fairness.

    Posted by scott on September 04, 2007 at 1353 hrs




43. We can’t afford for you to become ill, Scott.  You’ll have to keep it together. 

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1428 hrs




44. Scott:

    In your world, how much should people in the health care profession get paid?  How much should primary care physicians make, how about specialists?  Should we limit nurses salaries also.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1428 hrs




45. This is a question that should be asked. Doctors do work for less in other parts of the world and they are very well paid, very happy with what they make.

    It comes down to power. In GB, France, Germany elsewhere the people have the power. Here, we choose to give it away to those with a lot of money. No wonder Sykes puts out a book where the central thesis is everyone must feel like crap about themselves. The movie Sicko was sure right on that point.

    The other question is how much of our economy do you want to see going for health care? 20%. 30% 40%.

    Afterall, we can’t make our doctors, for profit insurance companies, health system executives unhappy now can we?

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1437 hrs




46. I believe physicians should be paid per procedure.  I further think it’s okay for an insurer to set limits on what they will compensate for that procedure.  Sort of like what happens today.  Doctors can do as much work as they like, and they can take cash from people who have it if they want - at any price they can get.  Fine by me.  Not that different from what goes on today, really. 

    Now it’s my turn.  Do you think it’s okay for insurance companies to give doctors bonuses for not referring patients to specialists and for not giving patients diagnostic tests?

    Posted by scott on September 04, 2007 at 1438 hrs




47. People with $100k on hand (A) to pay for heart surgery would get it, people without such means would not (B).

    emphasis mine
    
    In the free market, A might be willing to pay for B’s procedure if B was employed by A, and it cost more to retrain a replacement for B than the surgery would cost.  And you could bet A would only spring for the cheapest shunt which has a shelf life of approximately B’s retirement date.

    Seriously, don’t we, as a society, aspire to more than simple cost/benefit ratio analysis?  Can’t we put the beneficence back in benefits?

    Posted by spice on September 04, 2007 at 1446 hrs




48. Scott:

    Of course I do not think that is right.  Any doctor that does that should have their license revoked.  If a patient truly needs a procedure or a test done then it should be done.  But, I test should not be done just because a patient thinks it should. 

    I do not think one should compare doctor compensation in the US to doctors in other countries.  I would venture to say that accountant, teachers, lawyers, auto workers, engineers also make less in other countries also.  In addition, in other countries, college and medical school in paid for by the Government.  It is subsidized here to an extent, but not to the extent it is in other countries. 

    For the amount of time and money that individuals put into being a doctor and the scafices that are made the payoff is not that great.  Doctors do not go into the medicine for the money, at least the ones I know.  In addition, most of the them that I know are looking to get out, especially the ones in primary care, since you have to see 20-25 patients a day to make any money.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1454 hrs




49. Of course I do not think that is right.  Any doctor that does that should have their license revoked.

    Then start revoking the licenses of all doctors who work for HMOs, because they all do it.  In some cases these bonuses comprise 30% of their compensation.

    Frankly, I don’t worry that physicians might not make enough money under a single-payer system.  Other countries usually have more doctors per capita than we do.  If it was so horrible they wouldn’t have so many people itching to become doctors.  Meanwhile, in the USA we have a shortage of primary care physicians because being a specialist is so gosh darned lucrative.

    Posted by scott on September 04, 2007 at 1505 hrs




50. Physician fees account for 22% of total health care costs in the United States $500 billion compared to the $2.2 trillion spent annually.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1512 hrs




51. Who would be the most against full government payment of medical tuition? Why it’s the AMA.

    The artificial suppression of doctors doesn’t quite fit in with those free market fantasies now does it?

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1514 hrs




52. Scott:

    You are wrong.  My friend is a doctor who works for any HMO and he receives no bonuses or incentives to withhold treatment from a patient that needs it.  I am not saying that no doctors do this, but to say all is an outright lie

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1515 hrs




53. KR

    Please provide proof of that.  To my knowledge the AMA has nothing to do with medical schools.  There are new DO schools opening up also.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1518 hrs




54. It’s what I’ve heard from people in the medical profession. Want proof? Has the AMA ever pushed for it?

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1519 hrs




55. KR:

    Yes I want proof.  You are the one the made the assertion.  By the way, did you know that the AMA endorses Medicare for all.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1523 hrs




56. Scott:

    Which countries in particular have a surplus of doctors?  Canada does not not does England.  Each are projecting a shortage.  So which counties have a surplus?

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1531 hrs




57. he receives no bonuses or incentives to withhold treatment from a patient that needs it.

    O Rly?  Ask him if he can earn bonuses for keeping his referrals and diagnostic tests low.  My understanding is that HMOs do this regularly: at the end of the year the insurance company runs the numbers and the folks that keep this stuff low are given large bonuses.  Ask him if he’s aware of this.  There’s even a name for it, but it escapes me at the moment.

    Posted by scott on September 04, 2007 at 1535 hrs




58. Yes, there are incentives to not overutilize medical procedures or tests.  Healthy Wisconsin will do the same thing.  The issue is if a doctor will withhold treatment to someone who needs it just for their own personal gain.  That is wrong.  I think you mixing apples and oranges their my friend

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1540 hrs




59. Sweden, Germany and France all have more physicians per capita than we do.

    Posted by scott on September 04, 2007 at 1542 hrs




60. Scott:

    Please provide proof of that?  Also provide proof that those countries will not expect a shortage within the next 10-20 years

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1551 hrs




61. Scott:

    You were right regarding the # of Physicians being higher in France and Germany.  Is training the same in those countries, meaning does one have to go 4 year of college, 4 years of medical school, 3 years of residence to become a primary care physician?

    I am not sure how happy German doctors are, since their was talk of them going on strike, and many of them were contemplating closing their doors

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1613 hrs




62. Please provide proof of that

    Actually I got it from this page at wikipedia.  But you can find all kinds of data on this by googling for OECD physicians per 1000 people and similar. 

    Also provide proof that those countries will not expect a shortage within the next 10-20 years

    Why on earth should I have to provide this?  I guess I need to remind you that we currently have a nurse shortage right here, right now.  Likewise general practitioners.  Projections about shortages that may or may not happen in other countries in 20 years aren’t nearly as relevant.

    Listen, at what point do you guys stop challenging me on every. single. thing I say and start admitting that some of the stuff I say is right?  Gimme a break here.

    Posted by scott on September 04, 2007 at 1624 hrs




63. Listen, at what point do you guys stop challenging me on every. single. thing I say and start admitting that some of the stuff I say is right?  Gimme a break here.

    When you start admiting that some of the stuff you say is wrong.  You only tell half of the story, not the whole truth.  But that is okay, most people in the left do that.  When I am wrong I admit it.  I was wrong about the # of doctors per capita in France and Germany.  Even though that point is meaningless.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1634 hrs




64. You only tell half of the story, not the whole truth.

    Yeah?  Where?

    Hey, I’m not the one that brought up this “meaningless” issue.

    I was wrong about the # of doctors per capita in France and Germany.  Even though that point is meaningless.

    Posted by scott on September 04, 2007 at 1641 hrs




65. Scott:

    Do you think it’s okay for insurance companies to give doctors bonuses for not referring patients to specialists and for not giving patients diagnostic tests?

    You said that ALL HMO doctors receive these bonus, which is not true.  First of all my friend, who works within an HMO does not receive a bonus based upon how many procedures or test are not performed.  He receives a bonus based on the quality of care given based on patient outcomes.

    Second of all, you make it sound like doctors who receive bonuses for not referring pateints to specialists or for not giving dianostic tests is always bad, it is not.  It is only bad if a patient actually needs the test or the referral and the doctor will not give it.  That is what is wrong.  I would be willing to bet that 95% of doctors would never do that.  They did take an oath to do no harm, remember. 

    You make it sound like doctors have it great in places that have single-pay health care, well in Germany, Canada and England, doctors are complaining and are threatening to go on strike. 

    
    Yes, health care costs are a major problem, are their doctors getting paid too much, probably.  But as I said in a previous post, Physician fees only make up 22% of the total health care pie. 

    Maybe Barrak Obama’s wife should take a pay cut from her $300,000 hospital administrator job.  This is where a large problem lies, administrative costs.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 1716 hrs




66. When people routinely depart the USA to obtain healthcare because they can’t get it here, then we will have a health care problem.   

    You’re going to set physicians fees but let them take private money?  Any physician worth his salt will do exclusively private work.  You essentially condemn all but the wealthy to having second rate care.    Good thinking.

    Kr, “we” don’t compete with other countries except in sporting events and wars.  Individuals and individual companies compete.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 2131 hrs




67. you make it sound like doctors who receive bonuses for not referring pateints to specialists or for not giving dianostic tests is always bad, it is not

    Yes it damned well is.  Incentives against delivering care are inherently not good for patients.

    well in Germany, Canada and England, doctors are complaining and are threatening to go on strike.

    Fascinating.  And doctors here are on my side in this.  What should we make of it? 

    Any physician worth his salt will do exclusively private work.

    There aren’t enough people who can - and would choose to - pay their medical expensses out of their own pocket to achieve that effect.

    When people routinely depart the USA to obtain healthcare because they can’t get it here, then we will have a health care problem.

    Do the Americans who buy drugs from Canada and Mexico count?  And besides, one can’t just jump over the border to get cancer treatment if you’re not a citizen.  Such tactics only work here and only work for the wealthy.  Joe Sixpack who gets his heart surgery denied cant’ just go to Canada and get it.  Sheikh Mahmoud Ali Zimbabwa can, however, come here to get the expert care they don’t have in Bahrain because he’s filthy rich.  I don’t really see your point.

    Posted by scott on September 04, 2007 at 2157 hrs




68. “There aren’t enough people who can…”.  I’ll ignore your lack of evidence to that effect, but even your beloved workers paradises see private health care expenditures that would easily support private only physicians, which is precisely why Canada had to outlaw private insurance for most procedures.

    Where do the rich go for health care, Scott?  They come here.  That should tell you where the world’s best health care is.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 2231 hrs




69. Yeah, it’s fabulous health care - if you’re rich.

    Posted by scott on September 04, 2007 at 2240 hrs




70. It’s fabulous healthcare if you’re average, or even if you’re way below average.  At least we can finally get past the nonsense of other countries providing equal quality care.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 2247 hrs




71. I know this long ago deteriorated into a I hate you-you hate me fest, but someone should point out that the underlying premises of Owen’s post are just plain wrong.

    Posted by folkbum on September 04, 2007 at 2259 hrs




72. Folkbum, I don’t think the premise is wrong, although the $400 figure appears wrong.  The original post was comprised of statements Edwards himself made.    Per your link, we can assume that employers will not be providing insurance to those they don’t employ, and thus there will be a significant public expenditure which may be the 120 billion to which Edwards referred.  The per capita expenditure would be the 120 billion divided by the number of unemployed people, a figure much lower than 300 million.

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 2318 hrs




73. scott and kr, since Edwards plan is not single payer, but allows employer insurance, do you support it?

    Posted by (JavaScript must be enabled to view this email address) on September 04, 2007 at 2342 hrs




74. BVBigBro, no, the premise is wrong.  No one will be “forced” to go to the doctor.  There are no punishments, only un-gotten incentives for not going.

    And, yes, the math is wrong, too.

    Owen quotes a whole bunch of a press report without bothering to do a lick of googling on his own to get his facts right, and he blows both points he tries to make.  He’s just plain wrong.  Period.  End of story.

    Posted by folkbum on September 04, 2007 at 2352 hrs




75. So can I choose not to go to the doctor for 20 years or is Edwards wrong about his own plan?

    Posted by (JavaScript must be enabled to view this email address) on September 05, 2007 at 0026 hrs




76. You can choose not to go, and the MediCops aren’t going to show up and haul you to MediJail or anything like that.

    You just don’t get the incentives and bonuses for going.  You pay a price being lax, which, as I read conservative complaints upthread, is exactly what you all want.

    Posted by folkbum on September 05, 2007 at 0522 hrs




77. You’re right, folkbum.  I shouldn’t have actually assumed that Edwards himself knew anything about his own plan or relied on direct quotes from him.  I won’t make that mistake again.

    Posted by Owen on September 05, 2007 at 0610 hrs




78. Owen, there is a monumental difference between “required” (his word) and “forced” (your word).  If you’d bothered to do even a cursory check, you’d have seen what it meant to be required and what the consequences may have been for not going.  You didn’t research, and now you look foolish.

    And your $400 mistake doesn’t help, either.

    Posted by folkbum on September 05, 2007 at 0624 hrs




79. If something is required, then doesn’t that “force” you to do it?  No, there may not be government thugs dragging you out of your house to go get your cholesterol checked, but there are serious punishments if you don’t do it.  You’re hanging a lot on that one word. 

    As for the $400, “Edwards said his plan would cost up to $120 billion a year…”  He seems to think that’s what it will cost.  Or maybe he’s talking about a different plan.  He does have a tendency to “speak in the moment,” as they say.

    Posted by Owen on September 05, 2007 at 0639 hrs




80. $120b is what his plan will cost taxpayers, not what it will cost to cover every American.  This is not hard to understand.  Only someone willfully ignorant would keep believing it.

    “Forced” would be somebody throwing a pillowcase over your head and dragging you to your GP.  The Edwards plan costs people who don’t get preventive care more money.  This is a hallmark of every freaking conservative health care plan ever proposed!  It’s a very conservative notion that if you make bad decisions, you should pay for it yourself!  I know this, because every conservative in this thread posed that very same argument to scott!  And it’s a fundamental plank of the Edwards plan!

    Aggggggggg!  My head is exploding!  The stupid burns my eyes!!!!

    Posted by folkbum on September 05, 2007 at 0749 hrs




81. “Forced” would be somebody throwing a pillowcase over your head and dragging you to your GP.

    Really?  That seems like a convenient interpretation to support your hyperbole.  Let me give you some examples:

    Teachers that take challanging classess that force them to collaborate and be inventive in the classroom arena, do become more effective.

    I don’t see any pillow cases or beatings going on there. 

    Ho about this one:

    If the MTEA is smart, it will devote a large amount of it’s time and energy to promoting this cause, and if they were successful, they’d find an interesting financial benefit for its members, more money in their pockets, because they’d no longer be forced to spend so much of their own money to create a decent classroom.

    Was someone “throwing a pillowcase over [teacher’s] head[s] and dragging” them into the classroom to pay for supplies.  I don’t think so.

    I seems that the word “force” doesn’t have to connote physical force.

    BTW, those examples are from your blog.

    http://folkbum.blogspot.com/2005/12/winning-back-pub lic-mind.html

    Posted by Owen on September 05, 2007 at 0905 hrs




82. Scott:

    You are a typical liberal, who spouts off about things you know nothing about except what you read.  When you work in a hospital or in a doctors office and experience first hand what happens then come talk to me.  Do you know how many patients that come in and what all of these tests done because they think they have a problem.  If doctors did not put their foot down some of the time, health costs would be even greater.  I think you should stick with taking pictures instead of blabbing on about things you know nothing about.

    Posted by (JavaScript must be enabled to view this email address) on September 05, 2007 at 0948 hrs




83. Mike, I’m not complaining about tests and referrals, per se.  I’m complaining that the incentives are working the wrong way.  They are encouraging doctors not to make referrals and not to do tests or other procedures which might incur a cost for the HMO.  Doctors should not be compensated based on how much medicine they don’t practice.  Period.

    One more thing.  In invite you to re-read your comment numbered 82 and ask yourself whether you shouldn’t be toning it down some.  Thanks.

    Posted by scott on September 05, 2007 at 1008 hrs




84. True or false, Owen:  You believe people who do not take care of themselves should be (forced/required—take your pick) to bear a greater share of the cost for their care.

    (Anyone else is also welcome to answer.)

    Posted by folkbum on September 05, 2007 at 1703 hrs




85. Interesting question.  If you are a bad driver, your auto insurance rates go up.  If you live in a bad neighborhood or make too many claims, your homeowner insurance goes up.  But can you translate into health insurance?
    In car insurance, if you are young, your rate is high no matter what.  So, if you have a chronic condition, should you have a higher rate because you have the potential to cost the pool a lot of money.  Is it fair, probably not, but tell that to a 16 yar old driver who is very careful.
    Do you want the insurance company or government to also dictate your life style?  Should you have a higher rate if you eat at McDonalds 2 times a week, smoke, drink 6 beers in a week, work at a dangerous job like a firefighter.  I doubt it.  Maybe blogging is unhealthy because you are sitting at your computer a few hours a day instead of going out for walks.  Should you be penalized?  I don’t think so.

    Posted by (JavaScript must be enabled to view this email address) on September 05, 2007 at 1848 hrs




86. lol Deibert #36.  You knew kr wasn’t citing Marx, but the New Testament, right?

    Acts 4:34-37… or if you’d rather, Ex. 16:16-18.

    And I won’t even mention the book of Amos. 

    hiho
    Mp

    Posted by Mpeterson on September 05, 2007 at 2237 hrs




87. I find it interesting that we complain about the high cost of healthcare while at the same time demanding that we provide the best, most expensive healthcare that the world can offer.  It comes off like complaining that our silver spoon is not golden.

    America provides the best healthcare in the world.  Anyone who needs the best care and can afford it comes here.  Additionally, and this is one of the biggest reasons it costs so much for the rest of us, those who can not afford it come here and get it for free.

    At the same time, anyone who is even slightly satisfied with the outcome of his/her care can sue for millions of dollars in the “healthcare lottery” that also helped build the Edwards’ fortune.  The cost doctors must bear for insuring themselves against this “lottery” adds thousands of dollars in cost to each and every doctor we see (my friend pays over $70,000 per year in premiums for malpractice insurance as a surgeon, and that’s a pretty good rate).

    We should take away free health care for illegals by billing Mexico (and other countries of origin) for the expenses that their citizens incur if they cannot or will not pay.  We should also cap law suits to cover actual costs and a limited amount of damages.  Lawyers would have to live on a little less too, sorry.

    Posted by Tracy on September 25, 2007 at 1518 hrs




88. “anyone who is even slightly satisfied” should have read “dissatisfied.”

    Posted by Tracy on September 25, 2007 at 1520 hrs




89. America provides the best healthcare in the world.  Anyone who needs the best care and can afford it comes here.

    Let’s say that’s true.  America does have the best health care in the world.  I would like to point out that this is vastly different than having the best health care system in the world.  You know why billionaire sheiks come here for cancer treatment?  Because they’re billionaires, that’s why.  And we have the best health care for wealthy people, foreign or domestic, as long as you’re loaded.  The rest of us?  We get screwed by drug companies and want to buy pharmaceuticals from Mexico and Canada.  We get shafted by our insurance companies and want to get Canadian citizenship so we can get our cancer treatment covered. 

    this is one of the biggest reasons it costs so much for the rest of us, those who can not afford it come here and get it for free.

    Who comes here to get care for free?  And can you really demonstrate that this is “one of the biggest reasons it costs so much”?  I rather doubt that’s true. 

    The cost doctors must bear for insuring themselves

    Is not a major driver of health care costs.  I’ve posted links to academic studies that show this before.  Do I need to do it again?  When will it stick?

    Posted by scott on September 25, 2007 at 1525 hrs




90. Los Angeles County alone spends over $350,000,000 per year to provide healthcare for “undocumented immigrants.”  That’s one county’s cost for people coming here for free healthcare (that does not count what LA County spends for US citizens who cannot afford or refuse to pay for care).

    Over 70 hospitals in California have closed in the past 15 years because they cannot continue operating in the red indefinitely (as 58% of California hospitals now do).  Adding extra squeeze on the health care industry is Medicare’s (Big Brother’s single-payer plan for retirees and disabled) price structure for reimbursing hospitals (a forshadow of national health care programs for the rest of us).

    Medicare’s set price schedules do not provide enough income for hospitals to recoop expensive care charges.  That is precisely what single-payer plans have to do to keep costs down (HMOs are the private version of single-payer systems); limit the amount that doctors and hospitals can charge.

    Since hospitals are required to accept Medicare assignment and to treat all those who request care, they are forced to hike prices way up for those who can pay.  Thus, we are currently forced to pay much higher premiums and costs because government is already running a single-payer plan for those over 65 and requires hospitals to provide care to everyone.

    By the way, Mexican hospitals require payment prior to discharge for any non-citizen; like I said, send Mexico the bill instead of me.

    Posted by Tracy on September 25, 2007 at 1712 hrs




91. Los Angeles County alone spends over $350,000,000 per year

    That’s an awfully big number, but it’s really not showing what I asked.  I’m interested in knowing why we pay so gosh darned much more for our health care and health insurance than everyone else does.  And I’m saying I’m pretty darned skeptical of people who want to lay the blame on illegal immigrants.  Show me some believable data which says illegal immigration is one of the primary causes of this cost disparity.  I bet you don’t find it.  I’ve been reading everything I can get my hands on about the American health care system and I haven’t seen anything that seriously contends illegal immigration is the culprit.

    Adding extra squeeze on the health care industry is Medicare’s (Big Brother’s single-payer plan for retirees and disabled) price structure

    Actually, if everyone had medicare prices would drop.  The negotiating power of a group of 300 million can’t be ignored.  Doctors make more money here than just about anywhere.  Medical procedures here cost more than just about anywhere.  This is precisely because we don’t have that negotiating power.  And insurance companies make their money by providing less and less coverage and charging more and more premiums for it - after shaving off administrative costs triple what medicare needs.  All this and you want me to blame illegal immigrants?  By the way, they don’t come here for the health care.  They come here for work.

    Typical conservative.  See a problem, find the most powerless person around to blame for it.

    Posted by scott on September 25, 2007 at 1723 hrs




92. See a problem, find the most powerless person around to blame for it.

    Hilarious oversimplification by yourself.

    Are you saying that the extra $350 million per year for LA County just gets magically absorbed into the economy?  Who pays for it if it doesn’t?

    Actually, if everyone had medicare prices would drop.

    True, but health care would also be rationed to accomidate the net loss of physicians, hospitals ala the Canadian system.  Who wants to wait 18 months for a knee replacement (if you’re young enough to qualify for one under the government standards) when you can get one in a couple weeks under the current, unrationed system?

    It costs more because of so many factors that I mentioned, because we demand the best care, and because doctors must protect themselves against law suits by ordering extra tests and procedures we probably don’t need.

    Obviously, you don’t know much about Medicare assignment schedules either from your comments.  On average, hospitals and doctors get less than 1/2 of what they bill from Medicare patients while they get the full amount from insured people and nothing from many of your illegal friends.

    A recent bill from my mother is a great example:

    $1,184.00 Total Charges
    -  789.48 Medicare Adjustment
    $  394.52 Actual Charges

    $  394.52 Paid by “Evil Insurance Company”
        0.00 Member Responsibility

    Medicare Adjustments are not paid to the hospital or doctor.  They are simply the amount that the bill is reduced for people who have Medicare benefits.  On this bill, the clinic received 33.32% of what you or I would have had to pay for the same procedure.

    Without Medicare in the picture, the price would be somewhere in between.  Hospitals lose money at the Medicare rates, so care could not be provided at that rate that liberals think could be negotiated with 300 million buyers.  The rate would be much higher for those currently covered by Medicare and lower for many of the rest of us (in the short term).

    In the long term, like the Canadian model, services would be forced to ration and patients would be placed on waiting lists for even major surgeries.  Costs would again climb as services became shorter in supply.  Expensive equipment such as portable MRI machines would be in much shorter supply because government would eliminate the competition between hospitals and clinics by mandating pricing.

    So much more to this, but hard to convince someone who’s already made up their mind despite any additional facts and figures.

    Posted by Tracy on September 25, 2007 at 1814 hrs




93. Are you saying that the extra $350 million per year for LA County just gets magically absorbed into the economy?

    No.  I’m simply saying it’s not one of the major cost drivers.  It’s not one of the major reasons we’re paying double what everyone else pays.  It’s not one of the major reasons our insurance premiums have gone up over 50% since 2001. It’s just not.  Is it a problem?  Sure.  But it’s not what we’re talking about.  You’re just rearranging deck chairs on the Titanic.

    True, but health care would also be rationed

    Health care is already rationed.

    to accomidate the net loss of physicians, hospitals ala the Canadian system.

    Actually most other countries have more doctors than we do.

    Who wants to wait 18 months for a knee replacement

    I’m betting quite a few people would, if they could have half of that $6k a year back “like the Canadians do.”

    if you’re young enough to qualify for one under the government standards

    if you qualify for it under your private insurance company’s rules.  Yadda, yadda, yadda.

    when you can get one in a couple weeks under the current, unrationed system?

    I don’t believe you really have data on the average wait time for a knee replacement in the United States.

    because doctors must protect themselves against law suits by ordering extra tests and procedures we probably don’t need.

    Actually, you’ll find me willing to listen on this one.  It definitely is not lawsuit payouts, or lawsuits themselves, which contribute much to the cost delta between us and the rest of the world.  But the fear of those suits and the “defensive medicine” that may follow?  You might have a case there.  So I propose a solution.  You give me single-payer coverage, I’ll give you caps on damages.  Deal?

    n the long term, like the Canadian model, services would be forced to ration and ...

    A scary and frighteningly detailed scenario!  Can you point to such disasters?  The way I see it we have the worst health care delivery system in the civilized world.  The disaster I see is right here, right now.

    Posted by scott on September 25, 2007 at 1925 hrs




94. Health care premiums have many driving factors that are making them skyrocket.  Again, we treat everyone (many for free) regardless of ability (or intention) of paying.  California alone spends $5,100,000,000 annually to cover “uncompensated care” at its hospitals.

    We make up the difference in higher costs and thus higher premiums.  Companies have also been unable to fund Cadillac benefit plans like the ones breaking Ford’s and GM’s backs due to rising rates and increased demands of services.

    To state that other countries have more doctors than the US is immaterial.  Countries like China, India and Russia all have populations much larger than we.  However, we have inarguably the best doctors in the world with the best facilities money can buy.

    Ask any veteran how they like their single-payer government coverage and the hospitals they are afforded for their care.  Can you honestly surmise that a system like that is what we all need?

    And finally, the cost.  Look at the income tax rates in England, Canada and other countries with nationalized health care.  Are you completely insane by suggesting it comes without a huge cost?

    And no one can answer where we’re going to get our drugs when we tell the pharmaceutical companies what their prices are and they tell us to make the stuff ourselves.  Canada already does that to our drug companies and, in essence, tells them to make up the difference on the backs of Americans (we’re made out of money, after all according to liberals who want to soak us with bigger and bigger government bills).

    Posted by Tracy on September 25, 2007 at 2216 hrs




95. Again, we treat everyone (many for free) regardless of ability (or intention) of paying.

    Whoa!  I thought you lived here in the United States!  What country are you from?  Your english is terrific.

    To state that other countries have more doctors than the US is immaterial

    You brought it up, not me.  It was “material” when you thought it was workin’ for ya, but now it’s not.  I see how it is.

    Countries like China, India and Russia all have populations much larger than we. 

    First of all, who’s talking about China, India and Russia?  I’m talking about the OECD countries about whom we have reliable data.  And second, I meant more doctors per capita, not just “more doctors.” 

    Ask any veteran how they like their single-payer government coverage and the hospitals they are afforded for their care.

    Yes, let’s do that.

    Look at the income tax rates in England, Canada and other countries with nationalized health care.  Are you completely insane by suggesting it comes without a huge cost?

    Let’s look at that, too.  Money does count, after all.  And I’d like to keep as much of mine as I reasonably can.  Taxes as a percent of GDP breaks down thus:

    US:  26.8%

    Can: 33.5%

    UK:  37.2%

    So, yeah, there’s a meaningful difference there. But maybe not earth-shattering.  And besides, the tax rates in the UK and Canada are determined by a lot of things besides health care.  I’m willing to bet that the UK has lots of social spending safety-net stuff that we might not want here - things that have nothing to do with health care. 

    But here’s the real point.  We pay a lot more for our health care than they do.  A lot more.  The accounts I’ve seen have us paying double what the average OECD country pays.  That includes insurance premiums, out of pocket expenses, drugs, everything.  Add it all up and average it, we pay way more than they do. 

    A simple illustration.  Country A pays $1 in taxes and $2 for health care per person.  Country B pays $2 in taxes, but that includes health care.

    Whatcha gonna go with?  Financially, speaking, I mean?  See how that works, when you start looking at these numbers?

    You may have ideological reasons for objecting to single-payer health insurance.  Or maybe you have concerns about the quality of care.  But please don’t bother with the financial argument.  That battle is way over.

    Posted by scott on September 25, 2007 at 2328 hrs




96. Since taxes as a percentage of GDP is what you like to use, let’s use the example of Argentina where the tax rate (as a percentage of GDP) is 3.5%.

    Argentina provides generous public wellfare programs and social security as well as “free” healthcare.  Certainly, this looks like a great bargain; low costs based on the overall economy and great benefits (at least on paper).

    Before you pack your bags and move there, you might want to be aware of the fact that although the taxes are low (based on GDP), the marginal rate (the percentage of workers’ wages that are collected as tax revenue) was 95% in 1989!!  It has gone down slightly since then, but the social security portion of income tax is still 46% on top of regular income taxes.

    Mean income tax rates in Europe are far higher than here (rounded):
    55% Belgium
    52% Germany
    48% Sweden
    38% Netherlands

    Canada (36.1%) and the UK are roughly were you placed them as a percentage of income as well as a percentage of GDP.  However, that does NOT include other taxes (such as the European value-added taxes) that add up to another 17.5% in the UK and around 10% in Canada (including national and provincial taxes).

    Half your income (or more) for “free” healthcare is not free.  And when you add the inconvenience of long waiting lists and lack of available care, I’ll take my current health plan over anything Europe or Canada can offer (In fact, our costs would go down if Canada would privatize their system).

    Sorry to “bother you with the financial argument,” but it’s so not over.

    Posted by Tracy on September 27, 2007 at 1347 hrs




97. There are a few things I could choose to respond to in your comment, but let me just get right to the point:

    Less is not more<i>.

    It’s really that simple.  They pay less for health care, we pay more for it.  We pay more than every single OECD nation.  Way more.  The fact that they’re paying one way (taxes) and we’re paying it another (insurance premiums, copays, out of pockets, etc.) doesn’t change the fact that we pay <i>more not less.

    As I said before, you may have all kinds of legitimate concerns about going single-payer for health insurance, but cost simply cannot be one of them.  Next time you find yourself about to say “but how can we afford it!” or “think of all those extra taxes!” please repeat to yourself: less is not more.

    Posted by scott on September 27, 2007 at 1354 hrs




98. They pay less, no doubt there.  They get less, which is precisely why Canadians continue to come here for health care when they get tired of waiting for it or simply cannot get it in Canada.

    No country has more critical care units and expensive advanced imaging machines (MRI, PET, CAT, etc…) than the US.  No country comes close to the availability of the best services to even the very “poor” (our poor enjoying a living standard far above the average citizen in, say, Argentina, Cuba, Mexico or even most European countries).

    It costs more to get more.  If you want to drastically cut costs, we, as Americans, will have to accept the fact that we will get less.  You tend to get what you pay for.

    We could cut costs significantly by using the measures I suggested without cutting services.  Nationalization will inevitably give us Canadian health care with rationed care, waiting lists, and fewer high-tech services that we currently enjoy.

    I know you’re going to say we already ration care, but that is liberal B, as in “B,” S, as in “S.”  Everyone who walks, crawls or rolls through an emergency department door gets care.  We only ration it in the sense that we (individually) limit certain visits if we know our insurance company won’t pay for an emergency room visit to treat a sniffle.

    Posted by Tracy on September 27, 2007 at 1505 hrs




99. Canadians continue to come here for health care when

    Canadians with cold hard cash, do, yes.  Under certain circumstances. And so do billionaire sheiks from Saudi Arabia.  What I really wish you could see, though, is that millions of Americans would gladly go to Canada for the care they cannot get here.  Alas, they cannot do so. 

    No country comes close to the availability of the best services to even the very “poor”

    I think you don’t know what you’re talking about.

    our poor enjoying a living standard far above the average citizen in [...] most European countries

    Here, too.  I think you have no clue what you’re talking about.

    We only ration it in the sense that we (individually) limit certain visits if we know our insurance company won’t pay

    Or if our insurance company only pays for X number of days in a hospital.  Or caps our drug expenditures at X dollars a month.  Or won’t pay for our “pre-existing condition.”  Or won’t cover our only treatment option because it’s “experimental.”  No, I’m sorry.  Care here is quite rationed.  Don’t kid yourself.  The only sense in which it isn’t is that you can pay for anything you want yourself.  But the same is true everywhere else, too.

    Posted by scott on September 27, 2007 at 1548 hrs