Name:	copperline -	Reply
Subject:	A national healthcare system
Date:	4/1/2012 9:03:02 PM

              This is a really interesting article that i’ll use to make a pro-universal healthcare argument to the forum.    BTW, i just bought a new asbestos monitor just to prepare for the flaming i expect to get…  i must be in the mood to be abused….

http://www.foreignaffairs.com/articles/137358/sonia-shah/when-superbugs-attack?page=show

              Case in point:  the recent discovery of naturally occurring super-nasty infection that has the potential to become a world-wide killer as it mutates & becomes more infectious.   Right now, it’s primarily in india.  However, the indian national medical health care system is so fragmented into areas of vastly underserved (poor) people, and vastly over-treated (rich) people.   Because it came into existence in this society, the bug stands a much better chance of developing and spreading, well beyond the boundaries of the indian border.

              For those interested, check out the article for more details while i jump to my point:  i believe having a fragmented & uncoordinated Health Care system(or should i make that systems) like we currently is not going to protect the state of our nation’s health over time, in fact, it’s going to make it worse.   As the healthcare demand grows and healthcare expenses rise, the population stratifies into groups of haves and have-nots.   Certainly, those people who don’t get adequate health care suffer terribly.   But the article points to a larger problem:   antibiotic resistant bugs are actually promoted by the lack of uniform healthcare… more easily allowing them to mutate into a more transmissible incarnation… becoming more damaging and less stoppable.

              What we have in the US  is a patchwork system primarily designed around profit-seeking medical corporations,  insurance corporations battling each other for market share while spending huge sums on that administrative portion of your healthcare dollar,  consumers who frequently can’t make sense of their insurance options, mazes of regulations to comply with, hungry lawyers…..   A country where pharmaceutical companies buy TV time to convince me that depression hurts and tell me that Cialis will really jazz up my life.

              it seems to me that only a highly centralized and uniform healthcare system, with the ability to reach the largest possible number of the US population is the only answer.  That, i think, fairly well points me toward favoring a single-payer system… like a nationwide Medicare program might look.   The article describes what an unplanned system looks like (as currently in india).   Chaotic, ineffective, unfair and unable to respond to national healthcare needs because it developed around market  forces.  This ineffective, fragmented national health care system can then actually promote bugs that have potential to become epidemic, leading to some pretty horrifying scenes i had hoped to only see in a movie….   i don’t base my argument simply on some apocalyptic scenario of mass devastation, but this article describes a really frightening nation-wide health crisis for india that’s on the verge of being exported into the developed world.     i think that if universal healthcare isn’t going to be available anytime in the future of the US, then we won’t be prepared for treating problems like bird flu, and now NDM-1 as they arrive.      

              Maybe not now, but sometime in the near future, i don’t think we will have any choice except to have a Universal Healthcare System, with all it’s very likely flaws and shortcomings…   Not a cure for everything, but better than where we are headed now.    Everybody should hope it won’t take another Spanish Flu-type calamity to prompt the changes we need, but i’ll readily admit it’s going to be a hard pill to swallow.   ;)

    Your thoughts?

Name:	copperline -	Reply
Subject:	distilling down the question
Date:	4/2/2012 8:41:53 AM

Distilling the question is a good idea, the topic is way big.  So here goes:    Would you support or oppose  the idea that everyone should have equal access to healthcare in the US?   Would universal healthcare improve & protect the health of the US population as a whole?  Or is this not important enough to try to do?

is the reason for opposing universal coverage based on a bias against all government programs in general because they are seen as inefficient ....while private corporations are regarded as not wasteful as we are confident that competition will eliminate the "poor" performers?    Can we trust that private corporations will make the best choices about such a large (and potentially profitable) issue?   And are they be guided by what's best for the country, or by their balance sheets?

Name:	comrade -	Reply
Subject:	comrade
Date:	4/2/2012 10:33:53 PM

In an ER, there is no private insurance company to pay for non-payers. It is a hospital obligation (courtesy of the government) for any hospital that accepts Medicare/Medicaid. The very few hospitals that are entirely private and do not accept Medicare are still obligated to treat, and that money comes from hospital capital entirely. It is true that insurance companies and hospitals have lots of back-room and under the table dealings over re-imbursement/charges  (to "square up" at the end of the year) and there may be some passed on rate increases as a result, but the majority is essentially government subsidization for the opportunity to treat the giant volume of Medicare/Medicaid

Name:	copperline -	Reply
Subject:	A national healthcare system
Date:	4/3/2012 7:57:16 PM

              This thread is about to run out of steam but since i started it, let me make a few more observations.  it’s a terribly complex issue with lots of POV’s, but no one here argued that it is good for us to have lot of people going without healthcare coverage.   Disagreement with Universal Coverage comes from questions of how we would pay for it, whether the government caused the inflation of healthcare in the first place (and could fix it by ‘undoing’ this), and whether the government could deliver a system more efficiently than a multitude of private companies… but no one said it would be bad if everyone had basic care.    Everyone seems to agree that the costs of caring for uninsured people results in higher prices passed along and ultimately paid by all of us.   There was some suggestion that we might not actually have a national healthcare problem because free care is available in any ER, still….most people agree that rising costs are threatening the system and ER care is not really “free”.   Wix offered some specific ideas, but i think he might agree his ideas would only plug a few holes in a very leaky ship.

              Here are some numbers to ponder:   16.3% (50 million) of us don’t have healthcare insurance.   9.9 million of these are non-citizens, but 40 million are citizens.      31/% of people in the US relied on government programs for healthcare in 2010, and this number is on the increase…. it was 24.2% in 1999.

              And the World Health Organization ranked US Healthcare highest in costs…. but 37^th in overall performance, and 72^nd in overall level of health in 2000. 

              65% of Americans have commercial insurance policies thru their jobs or by direct purchase, and 31% rely on public programs.    14.5% (45 million) are on Medicare, 15.9% Medicaid (48 million), and 4.2% (13 million) have military health insurance.   With this public-private system, the U.S. spends more on healthcare than any other nation in the world, but is the only wealthy industrialized country in the world that lacks some form of universal health care.  We also spend more money per person than any other nation, and a greater percentage of total income in the US is spent on health care than in any UN member state.  

              But if government programs only account for 35% of the market,  how can we say that the government alone has caused the inflationary spiral?    65% of our healthcare was administered by for-profit corporations.   Everybody focuses on the need to reduce the government’s presumed role in the problem,  and shies away from  the need to change the impact of profit-driven strategies even though these occupy the majority of the market.  i don't understand how we can have faith that if the government "just got out of the way" and let those corporations create our national healthcare policy... that we would all be better off.

              So why don’t more people just buy commercial health care policies?    What would happen if we pared back government programs and told all those people to start looking for private medical insurance?    The average commercial premium for family coverage is now $13,770 per year now…and that cost has doubled in the past 10 yrs.   This means 1 in 4 working adults are already uninsured & 9.8% of kids under 18 have no coverage in spite of government programs targeting them.

              in Canada, the only country easily comparable to the US in size and culture, they have a single-payer healthcare system.   in 2006, per-capita spending for health care in Canada was (converted to US dollars) $3,678; in the U.S., $6,714.   Here we spent 15.3% of our GDP on health care in that year; Canada spent only 10.0%.   Studies do have different opinions when comparing the details of the two systems, but not the fundamentals.      But a 2007 review of all studies comparing health outcomes in Canada and the US in a Canadian peer-reviewed medical journal found that "health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent."    Canada appears to have found a way to constrain the growth of their healthcare costs.  We haven't.      

    Whether the differences were consistent or not, Canadians spent much less, had more of their citizenry covered by health insurance, and had at least the same health outcomes we did.         To me, that's pretty strong evidence that our way isn't the only way of doing things.