I agree 110% with Joe!

[98cwitr]

there are many who can't take social security

get a gov't job or:

8 Types of Americans Who Won't Get Social Security

None of those apply for me, and I would be foolish to leave where I am now as I am vested.

 

[Kentonio]

And there are millions that see NHS's shortcomings, failures, and overreach into individual rights of UK citizens. All opinions are noted.

"universal healthcare coverage" = forcing your neighbor to pay for your healthcare and you being forced to pay for your neighbors'. Does that sound right?

Despite the fact I'm used to the selfishness after all these years, I won't lie it still astounds me when I hear other human beings showing such total disregard for the health of their fellow citizens.

The NHS is outstandingly popular in the UK. In a recent poll 88% of people put ‘the NHS/health care’ as a main area of public spending that should be protected. That's not just 88% who approve of it, thats 88% who things its protection is more important than any other area of national life. So please don't project your own bizarre misunderstandings of this wonderful national treasure onto UK citizens. You might find a few that have been sucked into some American/Randian vision of everyone for themselves, but that certainly is not a significant number of the people who actually live under and are grateful for the NHS.

As for 'being forced' to pay for other people's healthcare, most decent people consider that grouping societies resources to ensure that everyones health is protected is not some undue burden. If you can sit and smugly watch your neighbour die of a treatable condition because they weren't lucky enough to have the financial resources that you do, then you're certainly not someone I'd want as a neighbour.

 

[Always in His Presence]

There's no such thing as a free lunch, but some ways of paying for a social good can definitely be better for individuals and for society than others.

Currently you can pay off your student debt in 10-15 years at the high end - under the socialist form we are speaking of, you pay student debt (part of your taxes) for 40 plus years.

 

[Always in His Presence]

If that is allowed as a definition of "socialism" then obviously it isn't "failed".

Would completely agree that state communism failed.

So I only agree 100%. And disagree 10%.

it is one of THREE definitions I posted. Sorry you missed that

 

[durangodawood]

it is one of THREE definitions I posted. Sorry you missed that

Ok. Then by one of those definitions socialism is doing fine.

 

[Arcangl86]

"Communism is a failed system, universally failed system," Biden admitted. "I don't see socialism as a very useful substitute, but that's another story," he continued without elaborating.

100% in agreement on both items.

Communism is a failed system and Socialism is not a very useful substitute.

Maybe now we'll have the end of all the people claiming that Biden is a radical leftist who is trying to usher in socialism.

 

[RDKirk]

And there are millions that see NHS's shortcomings, failures, and overreach into individual rights of UK citizens. All opinions are noted.

The NHS is well-known to be one of the worst examples of universal health care--and there are many better examples--yet not many Brits are anxious to get rid of it to go on the "American plan."

"universal healthcare coverage" = forcing your neighbor to pay for your healthcare and you being forced to pay for your neighbors'. Does that sound right?

If they voted for it, it's not "force" any more than any other democratically voted tax. Many people don't like being "forced" to pay for such an outsized military force or corn subsidies or space exploration. At this point, we're just haggling over details.

And as far as total outlay, Americans are paying more money for poorer healthcare than Europeans.

 

[RDKirk]

Currently you can pay off your student debt in 10-15 years at the high end

Some will. I know many others who have paid and paid and still owe two or three times what they originally borrowed. It depends on what kind of employment they are able to get.

But how healthcare is managed and paid for and how higher education would be managed and paid for are two separate issues. In both cases, though, Americans are paying far more than necessary...mostly because of the middle-men.

 

[returntosender]

His spending is tale tale. A precursor.

 

[98cwitr]

The NHS is well-known to be one of the worst examples of universal health care--and there are many better examples--yet not many Brits are anxious to get rid of it to go on the "American plan."

I can understand why too. The "American plan" is the worst of both worlds. Medicare/aid drives costs through the roof, private insurance makes up for it through high premiums for both employer and their employees, then you slap the "certificate of need" icing on top to lock down the market and stifle market competition. It's horrible.

If they voted for it, it's not "force" any more than any other democratically voted tax. Many people don't like being "forced" to pay for such an outsized military force or corn subsidies or space exploration. At this point, we're just haggling over details.

And as far as total outlay, Americans are paying more money for poorer healthcare than Europeans.

And if they didn't vote for it, is it then simply "tyranny of the majority?" Maybe getting the government out of the healthcare business would be the better plan. By all means, keep the regulations that keep the industry safe and clean, but stop doling out money that has been taken by force for something as subpar as what we have.

 

[Always in His Presence]

But how healthcare is managed and paid for and how higher education would be managed and paid for are two separate issues. In both cases, though, Americans are paying far more than necessary...mostly because of the middle-men.

Trading the current 'middle men' for the the Federal Government that has never run a business without massive cost over runs and incredible amounts of red tape and regulations. Is not a viable option IMHO

 

[RDKirk]

I can understand why too. The "American plan" is the worst of both worlds. Medicare/aid drives costs through the roof, private insurance makes up for it through high premiums for both employer and their employees, then you slap the "certificate of need" icing on top to lock down the market and stifle market competition. It's horrible.

Someone need to explain to me how Medicare drives costs through the roof.

Just a couple of weeks ago, I had an outpatient prostate procedure done. The doctor and hospital charged $19,000. Medicare paid one tenth of that, $1,900, and since they allowed only that much, my secondary insurance, Tricare (military) didn't pay any more.

The doctor specializes in that procedure...he does four or five a day. This was an "old man's procedure" that practically no man younger than 65 would ever have. I expect Medicare doesn't pay any more for any of them than they paid for mine, so $1,900 is pretty much all he ever gets.

And for that matter, my previous employee insurance never paid the full amount charged, either. And neither of them will pay for a whole lot of tests, examinations, and procedures doctors say are advisable.

So how are they driving up costs? The price we pay for insurance is more than the costs they pay for medical services--which is how health insurance companies and the medical billing industry make their money. It's not the doctors, it's the middlemen.

 

[RDKirk]

Trading the current 'middle men' for the the Federal Government that has never run a business without massive cost over runs and incredible amounts of red tape and regulations. Is not a viable option IMHO

The examples of other countries says otherwise.

 

[mark46]

Someone need to explain to me how Medicare drives costs through the roof.

Just a couple of weeks ago, I had an outpatient prostate procedure done. The doctor and hospital charged $19,000. Medicare paid one tenth of that, $1,900, and since they allowed only that much, my secondary insurance, Tricare (military) didn't pay any more.

The doctor specializes in that procedure...he does four or five a day. This was an "old man's procedure" that practically no man younger than 65 would ever have. I expect Medicare doesn't pay any more for any of them than they paid for mine, so $1,900 is pretty much all he ever gets.

And for that matter, my previous employee insurance never paid the full amount charged, either. And neither of them will pay for a whole lot of tests, examinations, and procedures doctors say are advisable.

So how are they driving up costs? The price we pay for insurance is more than the costs they pay for medical services--which is how health insurance companies and the medical billing industry make their money. It's not the doctors, it's the middlemen.

The costs to the consumer would be higher without Medicare or Blue Cross negotiating a set of charges for thousands of customers at once.

 

[RDKirk]

The costs to the consumer would be higher without Medicare or Blue Cross negotiating a set of charges for thousands of customers at once.

That sounds like they're keeping down the cost, not the other way around. I don't think it's the cost of what is actually being paid to healthcare givers that's the problem (just as the wages paid to college instructors is not really the problem). It's the insurance companies, the billing industry, bankers, and all other profit-takers in between.

 

[Always in His Presence]

The examples of other countries says otherwise.

This isn’t other countries.

I can’t judge how well the Cleveland Browns will perform based on how well the Yankees played last year.

 

[durangodawood]

This isn’t other countries.

I can’t judge how well the Cleveland Browns will perform based on how well the Yankees played last year.

Of course we can compare to other countries. We're talking about providing health care to human beings, not some alien life forms. Whats so off the charts special about the USA needs?

 

[mark46]

That sounds like they're keeping down the cost, not the other way around. I don't think it's the cost of what is actually being paid to healthcare givers that's the problem (just as the wages paid to college instructors is not really the problem). It's the insurance companies, the billing industry, bankers, and all other profit-takers in between.

The open question is who should set the prices of doctors, other health professionals, and hospitals (for the use of their equipment and facilities.

One option is for the state to take over the means of production, set the prices and own the facilities and set the wage rates. Here competition for services is gone. Monetary incentives for medical professionals is no longer relevant. Do we dream that the administrative cost has gone away, or is lessened, because the government is in charge.

Another option is for doctors and others to organize in groups and buy the hospitals (the HMO model). Here individuals would be free to chose their HMO. Each HMO might have different plans.

We could have insurance companies gather tens of thousands of members, and then set rates for any set of doctors who will accept those rates. Is it worth nothing for one entity to negotiate rates. Do we believe that individuals would do better negotiating on their own.

The government could become the insurance company (Medicare instead of the HMO, or the BCBS).
============
SOME OPEN QUESTIONS
1) How do we best minimize administrative costs?
2) How do we reduce the overall cost of highest quality service?
3) How do we incentivize doctors and hospitals for developing improved methods, and processes?

It is NOT at all clear to me that taking the PROFIT OUT is the answer. Is the administrative costs of an HMO really lower than that of a government owned and operated system? Give me Kaiser thank you.

Personally, I think that a single-payer system like Medicare works fine. Do we think that Medicare is a failed system merely because it could be a better administrator, or because there are many improvements that could be made?

I believe that supplementary insurance plans are a good idea. At very least, there should many choices of plan. Again, is it really wrong to pay insurance companies to the administration? Are they really so much worse at than the government? Standardization of forms is a great need.

BOTTOM LINE FOR ME
It is not all clear which system provides the best care for the lowest long-term cost. And it is certainly not clear that a government owned system for doctors and hospitals is a very good idea at all. It may be better than the US, but that is a very low bar indeed.

And just BTW, how would eliminating supplemental insurance work? The government wouldn't cover everything in the way that everyone once. Some would be willing to pay for more service. Are we to disallow this, or forbid people to form groups to negotiate?

 

[mark46]

This isn’t other countries.

I can’t judge how well the Cleveland Browns will perform based on how well the Yankees played last year.

I understand American exceptionalism, but health care can indeed be compared from country to country, as can so many things.

We can CHOOSE not to guarantee medical services as a right of citizenship, exceptional compared to every other developed country on earth. We limit governmental responsibilities in many ways compared to other countries. We often say that we don't have to pay for someone else's health care, or schooling, or security or water for that matter. Surely everyone should pay his or her own way. IMO, that is not the best model of society.

IMO, there should be a guaranteed set of service that is indeed the right of citizenship. I used to think that clean air and water were part of this guarantee.
And yes, taxes are required to pay for these services. Our taxes are much too low.
The issue is that the government is so inefficient. (Consider the cost of building a bridge or a power plant).

As an aside, what were the marginal tax rates in the Republican dream era (the era of Ozzie and Harriet)? Consider the taxes rates from the 1955 to 1965.

 

[RDKirk]

The open question is who should set the prices of doctors, other health professionals, and hospitals (for the use of their equipment and facilities.

One option is for the state to take over the means of production, set the prices and own the facilities and set the wage rates. Here competition for services is gone. Monetary incentives for medical professionals is no longer relevant. Do we dream that the administrative cost has gone away, or is lessened, because the government is in charge.

Another option is for doctors and others to organize in groups and buy the hospitals (the HMO model). Here individuals would be free to chose their HMO. Each HMO might have different plans.

We could have insurance companies gather tens of thousands of members, and then set rates for any set of doctors who will accept those rates. Is it worth nothing for one entity to negotiate rates. Do we believe that individuals would do better negotiating on their own.

The government could become the insurance company (Medicare instead of the HMO, or the BCBS).
============
SOME OPEN QUESTIONS
1) How do we best minimize administrative costs?
2) How do we reduce the overall cost of highest quality service?
3) How do we incentivize doctors and hospitals for developing improved methods, and processes?

It is NOT at all clear to me that taking the PROFIT OUT is the answer. Is the administrative costs of an HMO really lower than that of a government owned and operated system? Give me Kaiser thank you.

Personally, I think that a single-payer system like Medicare works fine. Do we think that Medicare is a failed system merely because it could be a better administrator, or because there are many improvements that could be made?

I believe that supplementary insurance plans are a good idea. At very least, there should many choices of plan. Again, is it really wrong to pay insurance companies to the administration? Are they really so much worse at than the government? Standardization of forms is a great need.

BOTTOM LINE FOR ME
It is not all clear which system provides the best care for the lowest long-term cost. And it is certainly not clear that a government owned system for doctors and hospitals is a very good idea at all. It may be better than the US, but that is a very low bar indeed.

And just BTW, how would eliminating supplemental insurance work? The government wouldn't cover everything in the way that everyone once. Some would be willing to pay for more service. Are we to disallow this, or forbid people to form groups to negotiate?

I would point out that practically nobody is proposing fully government owned healthcare system, and not many people are talking about doing away with supplemental insurance plans. Single payer is really the only government system being seriously discussed in the US.