Universal Health Coverage --- Call It Socialized Medicine

[Heracles 417]

Just as a data point, Canada's UHC is federally mandated but provincially managed. Provinces aren't states, but C. paid money to Alberta Health Care. That suffices to give you the sort of flexibility you'd need to deal with smaller problems.

While many of the details would be different, there's no particularly structural or constitutional reason that states couldn't, e.g., receive some federal funding and meet a set of federal guidelines, but be responsible for the administration of the plan.

The taxation system and general system of government in Canada is not like that of the US. Canada, Australia, UK etc have highly centralized government systems, whereas the US is quite the opposite. The introduction of a trillion dollar NHS / UHS would mean that there needs to be an overhaul of the way taxes are collected to pay for it.

Personally I have no problem with centralized governments as it gets rid of the inefficiencies of a system created and scraped overseas many years ago. For me Katrina proved that relying on the states is not the way to go. A nation needs a strong federal government with enough pull to make things happen. But I cannot see it happening as many here strongly believe in the power to the states style system.

Look, Germany is a federal republic of states. We already have a way, even with our constitution to give FEDERAL funds to STATE universities. This 'we're too decentralized' claim is just nonsense. It means the mechanics are different, yes, but to claim the U.S. doesn't have a strong enough federal government ignores, well, pretty much everything about American history since the Civil War.

Actually you missed the point. Those countries do not have as many states as the US does. If the US was made up of 10 'provinces', like Canada, it would be a different story. There are simply too many states to allow them to individually run their own healthcare system. On the other hand schools and the police, which people bring up, are county based. Can you imagine each country trying to run their own healthcare system. That is simply not possible.

I don't know exactly how Canada is run but I can tell you one thing the US system is nowhere near as centralized as the UK or AUS.. The US needs to design a healthcare system that suits the US. Trying to apply healthcare systems of other nations is not possible without changing the foundation of this nation..

PS Yes I can see how well the German HCS is doing. A quick google search on 'healthcare in Germany' shows quite a few unsatisfied users there.

Edited October 9, 2007 by Boo-Yah!

[Heracles 417]

actually Canada has provincial governments too...

how provincial

huh??

Canada has provinces..... and each province has their own government.... so Canada has a provincial governments too ...

Yes 10, which says something considering it is physically larger than the US.. We need to comapre apples with apples. It is silly to try to cherry pick from other nations and think with a little effort it will work in the US.

Edited October 9, 2007 by Boo-Yah!

[Heracles 417]

Why, because you can multiply what the UK spends by five and a bit? Of all the ways to estimate how much an American system would cost, that seems to me to be the most, well, wrong. You wouldn't estimate the cost of your grocery bill in one town versus another that way; why would you do it with a health care system?

Your right. The costs of healthcare is more here so we would probably need to double that figure. Most doctors abroad do not earn anywhere near as much of those in the US..

[Caladan 19]

I didn't miss the point. You're arguing that we can't have federally mandated, state-run health care with federal funding because we don't have a strong enough federal system to do that, even though our federal system already supplies money to the states for various state-run functions. Even though we have 50 states! No one is arguing that we should have exactly the same system as Canada or the UK, so I'm not sure where you're getting that. All I'm saying is that if your main objection to UHC is that you'd be happier if the states ran it, there are ways to do that.

And your argument seems to boil down to 'we can't do it exactly the same as the UK but I can calculate the costs accurately by multiplying by a scalar based on population even though we'd have to do it completely differently meaning that none of the costs would be analogous.' I have to say I think there's some problems with your reasoning.

[Marilyn. 340]

no one is saying that the US needs to do a carbon copy version of another country's medical program etc... but the US system needs some work....

[Anna C. 4]

hmm somebody said it works very well in Germany, and I highly disagree. True, people do not have to wait months for surgeries like in Canada, but you pay so much off your paycheck for health insurance (and you are forced to!) and the service is meager. It's the quick check ups, the least expensive but more invasive procedure, you are in a hospital room with 3 other people, and so on and on. The worst is the two class system: everybody is forced to pay for the government insurance unless you make a certain income monthly. Then you can freely choose to either use the government insurance or the far better and cheaper private insurances. Those private insurances contract with better doctors who have up to date medicine, who really look at you and take good care of you. All bound to your income.... 3.562,50 Euro you have to make at least monthly to choose, which is not that easy as in the USA. Much money goes towards the government, up to 55% of your paycheck. Salaries are meager compared to the USA, e.g. a senior resident in a hospital makes as much as a teacher. The dental is a catastrophe, I had never heard of dental cleanings until 2002 and they are not even covered (as of 2006 when I left my country). Dentists refuse to give you anesthesia for starters! And the whole dentistry to me (who had the meager government health plan) is at least 15 years behind the US American. Of course, if you pay out of your pocket you can go to a private dentist and get the up to date service.

Just an example: my sister went to her doctor 2 years ago because she felt tired all the time. They spent 10 minutes with her, took some blood and claimed she had an under function of her thyroids. Her situation did not improve and she changed doctors (4 doctors over this time) and all of them just looked at her and said she's fine. Then she went to the doctor her husband goes to (he is privately insured and gets top service) and her hubbie insisted that he looks at her (even though he didn't want to spend too much time with the cheap gov health patient) and they finally ran a real blood work, turns out it is Hashimoto's (a thyroid disease).

Doctors are forced to only charge a minimum amount for the health insurance by the government, which causes a big lack of doctors in Germany. They go to other countries where they can actually earn some money, and I don't blame them! Germany now started to import doctors from Eastern Europe. I think this situation proves the failure of the system, and the government knows as they more and more cut services and people can buy private insurance for services not covered by the gov plan.

And in the end, I spend way less money here on health insurance than back in Germany, and I can confidently say I get much better service here. I am listened to and tests I ask for are run. Doctors spent more than 30 minutes with me, a totally new thing. I spent $89 for health insurance a month here before I got it for free through my new work. And I love to be able to choose what I want and need....

Just my two cents....

[Mr. Big Dog 10,747]

Your right. The costs of healthcare is more here so we would probably need to double that figure.

Also keep in mind that the efficiency of the system is nowhere as low as here, either. We sport an overhead like no other thanks to our fragmented and bloated private sector health care system. There are savings to be realized. Huge savings.

Edited October 9, 2007 by Mr. Big Dog

[Heracles 417]

I have to say I think there's some problems with your reasoning.

Or your lack of. Simply jumping on a bandwagon does not equate to reasoning.

Schools, Police etc are controlled by the cities and counties here. Yet are you suggesting the states run the Hospital system. Even so, how would the smaller and poorer states afford to run a UHS? Would they not need twice the federal funding?

UHS is not a walk in the park as many make it out to be. Trying to implement it in the US is probably five times harder without changing the fundamentals of the way tax is collected here.

PS Not to my surprise that some of you are first to use other countries abroad as examples of a fine system. AKA "way of doing things". Yet at the same time disregard my use of those nation's costs associated with the programs you mention.

Edited October 9, 2007 by Boo-Yah!

[Marilyn. 340]

aww geez, no one is saying any one system is perfect, none are perfect...

the US system needs some work and I am sure if it was looked at closely, you would notice that a lot of money is wasted needlessly with this private system.... and that it costs a lot to run this private system....

[Heracles 417]

aww geez, no one is saying any one system is perfect, none are perfect...

the US system needs some work and I am sure if it was looked at closely, you would notice that a lot of money is wasted needlessly with this private system.... and that it costs a lot to run this private system....

The private sector is always much more efficient than a government run system. The key is to use the private system to cover everybody. Hence why I proposed earlier that the government use their buying power and market forces to purchase plans for x providers that covers millions of people. That way they can get a bulk discount. Even if this means each state has a say in which providers they choose.

Totally abandoning the private system for a government run system is absolutely not the way to go. A hybrid system is the key. As well as other measure to regulate the industry. Heavy fines and the threat of jail time against companies abusing their power usually does the trick. As would the risk of them losing large policies, such as the one I proposed.

America needs to use the strengths of the private system to their advantage.

Edited October 9, 2007 by Boo-Yah!

[Marilyn. 340]

that is what is being discussed here, no one said that the private system should be totally ditched... the private system needs more regulation...

I really don't agree with the private system being more efficient

[Heracles 417]

hmm somebody said it works very well in Germany, and I highly disagree. True, people do not have to wait months for surgeries like in Canada, but you pay so much off your paycheck for health insurance (and you are forced to!) and the service is meager. It's the quick check ups, the least expensive but more invasive procedure, you are in a hospital room with 3 other people, and so on and on. The worst is the two class system: everybody is forced to pay for the government insurance unless you make a certain income monthly. Then you can freely choose to either use the government insurance or the far better and cheaper private insurances. Those private insurances contract with better doctors who have up to date medicine, who really look at you and take good care of you. All bound to your income.... 3.562,50 Euro you have to make at least monthly to choose, which is not that easy as in the USA. Much money goes towards the government, up to 55% of your paycheck. Salaries are meager compared to the USA, e.g. a senior resident in a hospital makes as much as a teacher. The dental is a catastrophe, I had never heard of dental cleanings until 2002 and they are not even covered (as of 2006 when I left my country). Dentists refuse to give you anesthesia for starters! And the whole dentistry to me (who had the meager government health plan) is at least 15 years behind the US American. Of course, if you pay out of your pocket you can go to a private dentist and get the up to date service.

Just an example: my sister went to her doctor 2 years ago because she felt tired all the time. They spent 10 minutes with her, took some blood and claimed she had an under function of her thyroids. Her situation did not improve and she changed doctors (4 doctors over this time) and all of them just looked at her and said she's fine. Then she went to the doctor her husband goes to (he is privately insured and gets top service) and her hubbie insisted that he looks at her (even though he didn't want to spend too much time with the cheap gov health patient) and they finally ran a real blood work, turns out it is Hashimoto's (a thyroid disease).

Doctors are forced to only charge a minimum amount for the health insurance by the government, which causes a big lack of doctors in Germany. They go to other countries where they can actually earn some money, and I don't blame them! Germany now started to import doctors from Eastern Europe. I think this situation proves the failure of the system, and the government knows as they more and more cut services and people can buy private insurance for services not covered by the gov plan.

And in the end, I spend way less money here on health insurance than back in Germany, and I can confidently say I get much better service here. I am listened to and tests I ask for are run. Doctors spent more than 30 minutes with me, a totally new thing. I spent $89 for health insurance a month here before I got it for free through my new work. And I love to be able to choose what I want and need....

Just my two cents....

Sounds a lot like Medicare in Australia. The doctors aim is to get as many people in and out as possible. Therefore they do not have the time to thoroughly take care of people. I remember my first visit to a doctor in the US and was shocked at the level of service received. I thought the pre-checks, blood pressure etc let alone a nurse being at the doctors clinic was unbelievable.

My friend works in an emergency ward in one of Australia's largest hospitals and barely makes $45K. Working 60 hours a week might I add. He actually has 2 other jobs which is unheard of by American doctors.

A relaxed doctor means better treatment for all of us. Whereas socialized medicine kind of reminds me of a trip to walmart and the look on so many staff members face earning $5.50 an hour.

Edited October 9, 2007 by Boo-Yah!

[no name 1]

We discussed many of your points earlier, might want to read the other pages first, BooYah.

Edited October 9, 2007 by devilette

[sj5 4]

Universal Health Coverage --- Call It Socialized Medicine

Lawrence R. Huntoon, MD, PhD

One of the biggest myths being propogated today is the absurd notion that "people can't see a doctor without having insurance." The truth is office visits are relatively cheap, well within the means of most people. The problem is most people don't budget anything for their annual medical care. And, then when a problem arises, any expense greater than zero "isn't in the budget."

The other problem is that insurance really isn't insurance anymore. It is pre-paid health care. True insurance is intended to prevent financial disaster in the face of an unlikely event. Most people, however, have come to expect first dollar coverage for everything including very common and likely events like routine doctor office visits. "Covered'' employees don't realize it's their money going to pay for this "wonderful" non-bargain of first dollar coverage. It's not a "free" benefit provided by their employer as most employees believe. These costs are essentially hidden from employees. Money their employer wastes in purchasing first dollar coverage or inferior managed care coverage for the employee is money which would have been the employee's salary to spend as they choose.

The reason most people obtain their health insurance from their employer is because of tax discrimination. During World War II, our government enacted wage and price controls. Employers couldn't attract better workers by offering higher wages, but were allowed to offer health insurance as an untaxed benefit. Although World War II ended 54 years ago, this same tax discrimination policy remains in effect today. This atrocious policy discriminates against the working poor, part-time employees, employees working for small businesses that don't offer health insurance, and the self-employed. Those who obtain their health insurance through their employer, purchase their coverage with pre-tax dollars. On the other hand, those who purchase their health insurance on their own, purchase it with after-tax dollars --- a huge difference. In fact, the uninsured actually end up paying what amounts to a tax penalty for being uninsured.(1) It is estimated that "a family in the bottom fifth of the income distribution pays about $450 more in taxes than insured families at the same income level. For families in the top fifth of the income distribution, the tax penalty is $1,780."(1) The analysis goes on to say that "on the average, uninsured families pay about $1,018 more in federal taxes each year because they do not have employer-provided insurance. Collectively, the uninsured pay about $17.1 billion in extra taxes each year because they do not receive the same tax break as insured people with similar income. If state and local taxes are included, the extra taxes paid by the uninsured exceed $19 billion per year."(1)

Where, we must ask, is the compassion for these overtaxed, hard-working people? This is clearly a government-created problem. What we don't need is more government (nationalized health care) to "fix it." What we need is to get government out of our wallets so people can have their own money needed to purchase and own their own health insurance. The other thing the pro-socialist "crisis mongers" fail to tell people is that only one-third of the uninsured are chronically uninsured.2 For the other two-thirds, it is only a short, temporary condition, "half of all uninsured spells will last less than six-months. Three-fourths of them will be insured within 12 months. Only 18 percent of all last for more than two years."(2)

Those who brandish the "crisis" of the uninsured to promote socialized medicine also often fail to tell people that uninsured doesn't necessarily mean poor. In fact, the National Center for Policy Analysis (NCPA) tells us that "a third of the uninsured households earn more than $30,000 a year and 10 percent earn more than $50,000."(2) That's at least 40 percent of the so-called "uninsured" that could well afford a $45 office visit or health insurance.(2) We need to get away from the concept that "someone else," big government or insurance, needs to take care of our every need.

The other adverse consequence of this tax discrimination is that it led to cost inflation of medical care. Everyone came to believe that we were spending "other peoples' money" (OPM). And, when you're spending OPM, the sky is the limit. Patients have been told that they are getting "free" insurance from their employer and quite naturally came to expect everything they wanted or desired, whether of marginal benefit or not, would be "fully covered." Likewise, the physician who "participated" in insurance and was paid directly by the insurance company for everything with OPM, had no disincentive to hold down costs. The patients came to view these "participating" physicians as "good" and "compassionate" because the physicians would accept their insurance and the patient would have to pay little or nothing out of pocket, not realizing that OPM was actually their money all along.

Both patient and participating physician, therefore, contributed to this disrupted market where both buyer and seller were insulated from costs thus leading to uncontrollable cost inflation. The problem of cost inflation was further compounded by the cost of government regulation. Government mandates increase the costs of health insurance tremendously, and the mandates are often for things that most people don't want or need. Yet, they are forced to pay for the "coverage." "These mandated benefits included wigs for bald-headed women (Minnesota), pastoral marital counseling (Vermont), and community sperm bank services (Massachusetts).(3) In New York state, most health insurance premiums doubled as a result of state-mandated community rating. This has made health insurance especially hard to afford for the young and healthy who are, in effect, punished by the state for being young and healthy and for not engaging in unhealthy behavior. State mandates, which were purportedly instituted to "help" people, have thus had the effect of pricing many people out of the health insurance market. This, however, is predictably what happens when we look to big government to "help" us.

Indeed, "universal coverage," nationalized health care, or socialized medicine, regardless of what you choose to call it, is not the same as medical care. All of the citizens of Canada, for instance, have "universal coverage." What they often don't have, however, is the medical care that they need when they need it. That is why we see Canadians crossing the border into the United States in droves to obtain the health care that they can't get when they need it in their own country. Their government rations access to health care and thus attempts to control costs by making MRI scans, radiation oncology, bypass surgeries and many other health services largely unavailable to their own people. Is this the egalitarian's view of compassion and social justice?

We Get More of What the Government Subsidizes

Government programs also breed highly destructive dependence. How destructive? Well, I once took care of an alcoholic patient who bragged that his government disability checks allowed him to purchase better quality whiskey than he could afford to buy when he wasn't considered disabled because of his alcoholism. The government thus subsidized his alcoholism.

During his hospital stay, I pointed out his government subsidized habit had damaged his liver, his pancreas and his brain. He was slowly but surely killing himself with alcohol, bought and paid for by the government. After much discussion with the patient, I convinced him to give up alcohol, but there was a problem. Although the patient was willing to give up alcohol, he wasn't willing to give up the government checks. You see, if he gave up alcohol, he would lose his disability status, and would have to do something drastic like work to obtain money. But, he reasoned, why work when the government will give him the money to spend doing something that he liked to do? This spontaneous "experiment" in addiction medicine proved one thing beyond a shadow of a doubt. As powerful as addiction to alcohol is, it pales in comparison to the addiction to government money.

Yes, we need health care reform, but it needs to be based upon the principles of individual freedom and individual responsibility. And, there are many options out there. Most people could purchase a high deductible indemnity insurance policy at a lower price than they would pay for monthly managed care premiums. That's right --- a much higher quality of health care at a lower price! Imagine, having the freedom to choose the doctor or hospital you want to go to, being able to go to specialists without denials, delays, and gatekeepers. And, the money saved by purchasing a high-deductible catastrophic policy could be set aside in a special savings account to pay for deductibles. The money saved by purchasing a high-deductible policy could also be used to pay for the insurance premiums.

Medical Savings Accounts (MSAs) allow people to put money aside and take a tax deduction for keeping and controlling their own money. The MSA earns interest year after year tax free and if not spent by retirement age can be converted into a pension fund. Think of all the money you and your employer have turned over to insurance companies since you started working, and how much a young worker would have accumulated after 45 years of investment in a MSA. Those in favor of nationalized health care, of course, don't want to give you control of your own money. Government elites feel that they can better spend your money for you. This is the real message that they don't want you to hear.

And, last but not least, there is charity. No hospital ever turns any patient away because of lack of funds. Hospitals and the physicians on call at those hospitals are required by law to treat all patients presenting to the emergency department irrespective of ability to pay. And we do it all the time. It's a total myth that you can't come to the hospital because you "don't have insurance" or "can't pay." Charity is something that should involve churches, not big government. What big government does, confiscating money from all, including the minimum wage earner, and redistributing it based upon some social engineering scheme, isn't charity. It's legalized plunder. True charity comes from the heart, not from forced "contributions." Most churches and charitable agencies understand the dependency trap of big government programs. They understand that it does no good in the long run to give a man fish for his dinner. This does not help him. To help a man, you must teach him to fish. The goal should be to help a man back to his feet so he can support himself and his family, not to trap them in a cycle of dependency. That is what dignity and self-esteem are all about. That is what true compassion is all about. The Amish don't have "insurance coverage," yet they have existed for centuries via a charitable tradition of voluntarily sharing others' burdens and medical expenses. This same concept has been implemented via other churches and religious organizations in conjunction with MSAs and has been proven by AAPS members like Dr. Alieta Eck and associates to be a much more affordable alternative to traditional health insurance.

I find it very sad in a country where men and women have died fighting to preserve our freedom and have died fighting off socialism and communism that some are now considering socialized medicine as a solution to improving access to health care.

Lenin once said that "medicine is the keystone in the arch of socialism,'' and I believe those who are promoting "universal coverage" via government-run and government-controlled medicine know this. What they hope is that the public won't find out the truth. There is nothing compassionate about socialism. This is why the AAPS gives a high priority to educating other physicians and the public about the truth of socialized medicine. That is why AAPS should be joined and supported by all physicians!

References

1. Are the uninsured freeloaders? National Center for Policy Analysis, Brief Analysis No. 120, August 10, 1994.

2. Goodman JC, Musgrave G. Patient Power. Excerpted from: Problem: The rising number of people who lack health insurance. National Center for Policy Analysis, 1992.

3. Printz D. We need MSAs now! Medical Sentinel 1996;1(2):5.

Lawrence R. Huntoon, MD, PhD is president of AAPS and a practicing neurologist in Jamestown, New York.

Originally published in the Medical Sentinel 2000;5(4):134-136. Copyright ©2000 Association of American Physicians and Surgeons.

http://www.haciendapub.com/article49.html

I can share my story here.. Last Sept 14. 2007.. I had appointment with the dentist..I wanted to have a "BRACE" but they found out I'm having problem with my gums(naked eyes can't see it)No one can tell that I have problem cos its really look so healthy teeth and gums(getting a sign of gum disease).My Dentist in Phils. didn't even told me that I have problems . I'm still under treatment. Anyway, My dental bill came up to $7,400 and my insurance just pay $5,374 and the $2,026 is out of my SO pocket

What do you think about these?

Edited October 9, 2007 by SJ

[Trumplestiltskin 5,791]

I find it very sad in a country where men and women have died fighting to preserve our freedom and have died fighting off socialism and communism that some are now considering socialized medicine as a solution to improving access to health care.

What a load of complete $hit that argument is, not least the puerile grasp of history that is on display.