US Universal Healthcare

I often see this issue come up in social media. I think we can all agree here that we want people to be able to have access to healthcare. The issue revolves around how to best do that to ensure efficacy, efficiency and sustainability.

So, how do we begin to fix US healthcare?

In Australia we have both public hospitals and private hospitals, anyone can turn up and get treatment at the public hospital anytime for free. But its slower because its busier..... and so if you have health insurance coverage you can instead use a private hospital which might be faster or more comfortable. What does it cost for the public system.... 2% taxation on income.

It extends to other medical services as well, like GP's and specialists but in the form of a rebate to reduce the cost by various amounts.

https://en.wikipedia.org/wiki/Medicare_(Australia)

We have a much smaller population though, and no land borders with other nations... but also a smaller economy, so the question I wonder is can the US afford such a system!?

In terms of U.S. healthcare, I doubt any single person has the definitive answer, but I hope this is a helpful contribution.

I recall reading years ago that when an Asian country - Vietnam, if memory serves - wanted to implement a system of universal health care, they studied the public health care systems of various nations to determine which system did the best overall job of caring for its clients, preventing fraud, and being financially viable. They then set out to model their own system after the optimal choice.

They picked America's Medicare as their benchmark. To me, that speaks well to the idea now frequently promoted in the U.S., "Medicare for all", since the system does only apply to senior citizens and some people with disabilities today.

If we go that way, the big question to me is how to make the shift from our current, for-profit healthcare system to an exclusively taxpayer-funded system without causing economic chaos as insurance agents, claims adjusters, accountants, actuaries, and the like are fired. I am sure we can work this out, but as far as I know it hasn't been addressed yet.

Affordability, which is often raised as an objection, isn't an issue. The Koch brothers, in attempt to prove Medicare for All isn't viable, commissioned a study to prove the point. Their own study showed that over a decade, Medicare for All would cost around $2 trillion less than our current system.

We can do this.

Controversial opinion: insurance is only expensive because the price of healthcare is too high. Getting a treatment in the US can cost much higher than getting the same treatment in another country. I've looked into the cost of some hospital supplies; some hospitals charge over 1000x the actual cost of an item (such as an IV bag) in the US. If hospitals and doctors did not charge ridiculously high fees, insurance companies would have to pay them less. If insurance companies didn't have to pay as much, people buying the insurance wouldn't have to pay as much. An affordable and reasonable healthcare system which doesn't require compulsory membership (and thereby respects the autonomy of individuals in the state) is totally achievable, it just requires doctors to take seriously their duty to heal the sick.

Dude your completely uninformed as to the machinations of health care. There are 3 major factors in health care, only two of which can be priority at any time. Those factors are high quality, affordability, and universality. So the question becomes, which one of these three do you want to sacrifice to maximize the others?

Kyrin Wyldstar wrote: Dude your completely uninformed as to the machinations of health care. There are 3 major factors in health care, only two of which can be priority at any time. Those factors are high quality, affordability, and universality. So the question becomes, which one of these three do you want to sacrifice to maximize the others?

I, in the past month, went from being misdiagnosed to having an official diagnosis from a specialist, pre op appointments, to having the surgery, and now am quickly recovering... all without a dime spent.

If the US decided some of its insanely over-inflated defence budget was to go to defend the health and well-being of its citizens, perhaps then you'd have excellent universal healthcare without having to sacrifice any of those three...

And that is coming from someone who has lived in two countries with universal healthcare. So yeah, I understand it quite well.

Arisaig wrote: I, in the past month, went from being misdiagnosed to having an official diagnosis from a specialist, pre op appointments, to having the surgery, and now am quickly recovering... all without a dime spent.

If the US decided some of its insanely over-inflated defence budget was to go to defend the health and well-being of its citizens, perhaps then you'd have excellent universal healthcare without having to sacrifice any of those three...

And that is coming from someone who has lived in two countries with universal healthcare. So yeah, I understand it quite well.

I did not say you didnt understand it. However just because you use it does not automatically mean you do. Also I didn't say the US system was not in need of some sort of reform. My comments above were a commonly used triad when addressing health care concerns however. The problem in the US is that health care is neither a free market system nor is it fully regulated. It is half and half, making it subsidized and and partially govt regulated, leading to increased costs. That combined with the fact that the US population is just generally less healthy than a lot of other countries with universal health care systems make it one of the least effective systems around for general health care even though we have some of the greatest medical technology available. For example the US actually ranks number one in 5 year cancer survival rates but it is expensive. So the question then becomes how can we bring the cost down.

If we go for universal health care with high quality it becomes quite expensive. If it is a single payer system the Govt foots the bill for this expense and that comes out of taxes. In the case of Canada and Brittan those systems are extraordinarily expensive making tax rates on middle and lower classes extremely high. What I think we should be looking for is to make health care not universal but affordable and high quality and these things would be provided if our health care system was moved to a free market system. This leaves the majority of the population with the ability to get good health care and then at that point the small portion that cant afford it can be picked up and covered with relatively small governmental investment.

Kyrin Wyldstar wrote:

Arisaig wrote: I, in the past month, went from being misdiagnosed to having an official diagnosis from a specialist, pre op appointments, to having the surgery, and now am quickly recovering... all without a dime spent.

If the US decided some of its insanely over-inflated defence budget was to go to defend the health and well-being of its citizens, perhaps then you'd have excellent universal healthcare without having to sacrifice any of those three...

And that is coming from someone who has lived in two countries with universal healthcare. So yeah, I understand it quite well.

I did not say you didnt understand it. However just because you use it does not automatically mean you do. Also I didn't say the US system was not in need of some sort of reform. My comments above were a commonly used triad when addressing health care concerns however. The problem in the US is that health care is neither a free market system nor is it fully regulated. It is half and half, making it subsidized and and partially govt regulated, leading to increased costs. That combined with the fact that the US population is just generally less healthy than a lot of other countries with universal health care systems make it one of the least effective systems around for general health care even though we have some of the greatest medical technology available. For example the US actually ranks number one in 5 year cancer survival rates but it is expensive. So the question then becomes how can we bring the cost down.

If we go for universal health care with high quality it becomes quite expensive. If it is a single payer system the Govt foots the bill for this expense and that comes out of taxes. In the case of Canada and Brittan those systems are extraordinarily expensive making tax rates on middle and lower classes extremely high. What I think we should be looking for is to make health care not universal but affordable and high quality and these things would be provided if our health care system was moved to a free market system. This leaves the majority of the population with the ability to get good health care and then at that point the small portion that cant afford it can be picked up and covered with relatively small governmental investment.

Its easily affordable. As I said, the military is massively over-funded. You don't need to increase taxes, just redirect the ones from filling a desert with the newest tanks that were bought just to justify spending increases and instead spend that on the average joe just trying to get medical help. Its common sense, but that's something American politics has been void of for a while now...

and no, I didn't say you said I didn't understand it, your comment in the quoted text wasn't to me. I said that because then no one can say I don't without a reason...

Arisaig wrote:
Its easily affordable. As I said, the military is massively over-funded. You don't need to increase taxes, just redirect the ones from filling a desert with the newest tanks that were bought just to justify spending increases and instead spend that on the average joe just trying to get medical help. Its common sense, but that's something American politics has been void of for a while now...

and no, I didn't say you said I didn't understand it, your comment in the quoted text wasn't to me. I said that because then no one can say I don't without a reason...

No its not massively over funded. Its just not that simple as "dont buy a few tanks" and your good! In fact the US provides the major portion of NATO funds to support national defense budges of most European countries. We are also the primary protectors of Japan in conjunction with their national defense force. We are the primary deterrent to military aggression from countries like North Korea and Russia. The US military was forced onto the world stage in WWII and put down a global aggression which left us a world leader in defense and that has never changed. In fact one of the things Trump is trying to do is get other NATO nations to step up and spend more on their national defense so we can reduce costs. However that is not the case today and if we were to pull those budgets and weaken our stance, aggressive nations and organizations would be on our door step and they would be on yours as well. This is what happened during 911 under the democratic military reductions and weak stances like what happened in Somalia. This idea that if we just put our weapons down that everyone will just play nice is a naive thought.

Kyrin Wyldstar wrote:

Arisaig wrote:
Its easily affordable. As I said, the military is massively over-funded. You don't need to increase taxes, just redirect the ones from filling a desert with the newest tanks that were bought just to justify spending increases and instead spend that on the average joe just trying to get medical help. Its common sense, but that's something American politics has been void of for a while now...

and no, I didn't say you said I didn't understand it, your comment in the quoted text wasn't to me. I said that because then no one can say I don't without a reason...

No its not massively over funded. Its just not that simple as "dont buy a few tanks" and your good! In fact the US provides the major portion of NATO funds to support national defense budges of most European countries. We are also the primary protectors of Japan in conjunction with their national defense force. We are the primary deterrent to military aggression from countries like North Korea and Russia. The US military was forced onto the world stage in WWII and put down a global aggression which left us a world leader in defense and that has never changed. In fact one of the things Trump is trying to do is get other NATO nations to step up and spend more on their national defense so we can reduce costs. However that is not the case today and if we were to pull those budgets and weaken our stance, aggressive nations and organizations would be on our door step and they would be on yours as well. This is what happened during 911 under the democratic military reductions and weak stances like what happened in Somalia. This idea that if we just put our weapons down that everyone will just play nice is a naive thought.

It sorta is, and of course its more complex than the example I gave it. Your country loves war and profit of the rich over the lives and mental and physical well-being of the hard working American.

but, of course, more complex than that. More funded than the next twenty counties militaries combined, while many of those following it also fund a full military, pay their soldiers better, and have healthcare. But whadda I know, eh?

Arisaig wrote:
It sorta is, and of course its more complex than the example I gave it. Your country loves war and profit of the rich over the lives and mental and physical well-being of the hard working American.

but, of course, more complex than that. More funded than the next twenty counties militaries combined, while many of those following it also fund a full military, pay their soldiers better, and have healthcare. But whadda I know, eh?

Guess why those countries can do that. yes you guessed it, The United States. Are you suggesting we just pull all those budgets and direct that money inward leaving all those foreign militaries having to actually spend their due on their defense or be invaded and in the process have their internal wealth collapse?

I dont think this discussion was supposed to be about US military defense anyway. :pinch:

Kyrin Wyldstar wrote:

Arisaig wrote:
It sorta is, and of course its more complex than the example I gave it. Your country loves war and profit of the rich over the lives and mental and physical well-being of the hard working American.

but, of course, more complex than that. More funded than the next twenty counties militaries combined, while many of those following it also fund a full military, pay their soldiers better, and have healthcare. But whadda I know, eh?

Guess why those countries can do that. yes you guessed it, The United States. Are you suggesting we just pull all those budgets and direct that money inward leaving all those foreign militaries having to actually spend their due on their defense or be invaded and in the process have their internal wealth collapse?

I dont think this discussion was supposed to be about US military defense anyway. :pinch:

No, it wasn't supposed to be about it. Thanks.

And yes, the States should get their nose outta other countries and fix themselves first. Log outta your own eye before you remove the splinter from your neighbour...

Arisaig wrote:
And yes, the States should get their nose outta other countries and fix themselves first. Log outta your own eye before you remove the splinter from your neighbour...[/color]

Bold words from one who has inhabited not one but two countries that greatly benefit from the United States protections. Everyone begs the US to help them and save them and when we do its complained about. We don't help we get accused of indifference, we do help we get accused of interference. Well take your medicine world and get over it.

TheDude wrote: I've looked into the cost of some hospital supplies; some hospitals charge over 1000x the actual cost of an item (such as an IV bag) in the US. If hospitals and doctors did not charge ridiculously high fees, insurance companies would have to pay them less. If insurance companies didn't have to pay as much, people buying the insurance wouldn't have to pay as much. An affordable and reasonable healthcare system which doesn't require compulsory membership (and thereby respects the autonomy of individuals in the state) is totally achievable, it just requires doctors to take seriously their duty to heal the sick.

This is something I have seen reported by many American friends. The example of hospital supplies, or ambulance rides, for example. Why exactly are they so ridiculously high?

I am sure quality alone does not account for the high price. Also, what stops new and potentially smaller capitalists from wanting to invest? (If I were a capitalist, I would offer more affordable care, getting a huge chunk of the market and still making an interesting margin despite offering low cost).

Manu wrote:

TheDude wrote: I've looked into the cost of some hospital supplies; some hospitals charge over 1000x the actual cost of an item (such as an IV bag) in the US. If hospitals and doctors did not charge ridiculously high fees, insurance companies would have to pay them less. If insurance companies didn't have to pay as much, people buying the insurance wouldn't have to pay as much. An affordable and reasonable healthcare system which doesn't require compulsory membership (and thereby respects the autonomy of individuals in the state) is totally achievable, it just requires doctors to take seriously their duty to heal the sick.

This is something I have seen reported by many American friends. The example of hospital supplies, or ambulance rides, for example. Why exactly are they so ridiculously high?

I am sure quality alone does not account for the high price. Also, what stops new and potentially smaller capitalists from wanting to invest? (If I were a capitalist, I would offer more affordable care, getting a huge chunk of the market and still making an interesting margin despite offering low cost).

It's high because of the number of people who don't pay and/or don't have insurance. Or worse they have government insurance programs such as medicare/medicaid.

For example, We HAVE to as an ambulance service anywhere servicing a 911 area, pick up and treat you, whether you have insurance or not. So if your overdosed as a homeless person in the park, we treat all of that, and we collect no money for it, because they can't pay. So when you do 2-3 of those inbetween a call with someone who has legit insurance and so forth on the regular basis, in order to cover the costs of those other calls you have to raise the costs of your supplies and interventions for billing across the board evenly. Same thing for hospitals. Then you have wonderful programs like state medicaid and medicare programs, who are so underfunded you don't get your costs covered from that either. I can take a transport to a specialist facility 2 hours away, Advanced life support, several meds and interventions going etc, and if they have medicare the cost of that ambulance ride "might" depending on your area be somewhere around $2500-$5000 easily, but medicare will only cover maybe $1500 of it and thats only because of the mileage, a 10 minute transport or down the street, doing all the interventions necessairy for say a possible heart attack, $1500, medicare will maybe pay $200...And we have to accept that because of government laws. So Those who have insurance or can self pay are essentially paying higher costs because of all the people who don't, or can't afford it.

You can possibly correlate the cost of healthcare to two problems, one being the amount of people who can't financially afford it, and thus a spinning circle that will only get worse, but also pharmaceutical companies who are not only charging out rages prices because they can, but they intentionally come up with and put out more expensive treatments, more expensive devices for "advanced care" and "scientific breakthroughs" and any other catch phrases to get you on board as well.

The whole thing is annoying, but unless the government is going to throw a budget equal to the US military at universal health care I highly doubt it will ever be a thing. They can't even fund medicare now...

What tella is saying is exactly what I said. Highly regulated requires services to be provided regardless of ability to pay and lack of free competitive market leaves no competition for companies or even doctors or hospitals so they can charge whatever they want and there is nothing to force them to drive down prices or increase quality.

Kyrin Wyldstar wrote:

Arisaig wrote:
And yes, the States should get their nose outta other countries and fix themselves first. Log outta your own eye before you remove the splinter from your neighbour...[/color]

Bold words from one who has inhabited not one but two countries that greatly benefit from the United States protections. Everyone begs the US to help them and save them and when we do its complained about. We don't help we get accused of indifference, we do help we get accused of interference. Well take your medicine world and get over it.

Sweet sassafras, just what tabloids is yer nose stuck in?!:pinch:

To be straight and short, our government even if it "is" founding a major part of NATO, "can" redirect founding to proper healthcare for all. How? the Aussie gave a good example but it's not so much in tanks as it is aircraft. Congress is buying a jet called the joint strike fighter, and even tho statistics show it to be "massively" inefficient for the role's it's meant to takeover, there still going to pay the "$6 million per unit".

The F35 kicks arse! Lockheed Martin should hire me I could sing its praises so loud

Defense spending is one of those things.... the US (and 'the West') needs a technological advantage to counter for the numerical disadvantage it has against the pool of other players both individually (in China alone) or as pacts (like the Shanghai Cooperation Organisation). And R&D costs a fortune.... and must be ongoing. Then add to that the higher standards of living required by developed countries in 'the West' and the military is going to be expensive, really expensive. But history tends to tell a story of preparation prevents poor performance, and so when it comes to security its of the highest need. No need for healthcare if your being invaded :silly: And no-one can magic up an innovation advantage to large capability overnight, especially in the time that a large low tech threat can develop increases in its capabilities - the mismatch affords them an advantage, as its just easier to make lots of simple stuff if you have the boots to wield it. Not only that, but having the technological advantage is the same as having the advantage of surprise, which for a good intentioned nation is a good thing (affords fast and effective reaction to surprise), but for a bad intentioned nation its a really bad thing (see Hitler).

Then of course add to that all the other security demands placed on it to support globalization and continued expansion of human rights. It's great to see the finish line but sprinting too soon might put one out the race entirely. It's a long game, something China seems quite good at.

PS: the F35 is going to cost closer to $100 million per unit, but there are various ways to measure cost of course; per flying hour, per jet, per jet plus share of whole fleet program supports etc etc.

Eugene wrote: Sweet sassafras, just what tabloids is yer nose stuck in?!:pinch:

To be straight and short, our government even if it "is" founding a major part of NATO, "can" redirect founding to proper healthcare for all. How? the Aussie gave a good example but it's not so much in tanks as it is aircraft. Congress is buying a jet called the joint strike fighter, and even tho statistics show it to be "massively" inefficient for the role's it's meant to takeover, there still going to pay the "$6 million per unit".

Not buying aircraft is the single worst thing the military could do! Air power and wartime air superiority is the single most important deciding factor in any modern day war. Not keeping a strong air power would be the stupidest thing the US could do. A more effective route would be to actually cut that big govt budget you love so much that is slowly bleeding us dry and instead deregulate and privatize health care.

I am not saying that we should "ditch" the air force, nor am I saying that we "shouldn't" develop batter defensive system's in which to defend our nation; what I'm saying, is that we can not field an aircraft to take on multiple "specific" roles which it can not handle.

To define what I mean let us look to nature. The peregrine falcon evolved to "dive" at there target clocking in at over 200 mph, the harpy eagle evolved to "dodge" between tree's on it's hunt in the amazon; and then the penguin, evolved to torpedo thru the ocean at over 20 mph.

Each evolved for max efficiency in a specific "way" of hunting, and that is what we should emulate. the F 35/joint strike fighter is thus inefficient for what it's worth, and we can put that money else where.