Sorry to all the Giuliani fans on SF.

[lamberts-lost-tooth]

Five Myths to Socialized Medicine


MYTH: ?A RIGHT TO HEALTH CARE?
People who believe in socialized medicine have come to believe many myths. One is that socialized medicine gives you a right to health care. If you ask the head of Parkland Hospital and his counterpart in Toronto or London what the difference is in these systems, I think all three would say that in Toronto and London people have a ?right? to health care, whereas in Dallas they do not. That is just not true. If you?re a citizen of Canada, you don?t really have a right to any particular health care service. You don?t have a right to heart surgery. You don?t even have a right to a place in the waiting line. If you?re the hundredth person waiting for heart surgery, you?re not entitled to the hundredth surgery. Other people can and do get in ahead of you. From time to time, even Americans go to Canada and jump the queue, because Americans can do something that Canadians cannot - Americans can pay for care. Canadian hospitals love to admit American patients, because that means cash into their budgets. The British government says that, at any one time, there are about a million people waiting to get into hospitals. According to the Fraser Institute, almost 900,000 Canadian patients are on the waiting list at any point in time. And, according to the New Zealand government, 90,000 people are on the waiting lists there. Those people constitute only about 1 to 2 percent of the population in those countries, but keep in mind that only about 15 percent of the population actually enters a hospital each year. Many of the people waiting are waiting in pain. Many are risking their lives by waiting. And there is no market mechanism in these countries to get care first to people who need it first.

MYTH: ?HIGHER QUALITY?
Another myth has to do with the quality of care that patients receive. British ministers of health have told British citizens for years that their health system is the envy of the world. Canadian ministers of health say much the same thing. In fact, Canadian and British doctors see 50 percent more patients than American doctors do, and, as a consequence, they have less time to spend with each patient. In Britain, the typical general practitioner barely has time to take your temperature and write a prescription. And even if they discover something wrong with you, they may not have the technology to solve your problem. Among people with chronic renal failure, only half as many Canadians as Americans get dialysis, and only a third as many Britons on a per capita basis. The American rate of coronary bypass surgeries is three or four times what it is in Canada, and five times what it is in Britain. Britain is the country that invented the CAT scanner, back in the 1970s. For awhile it exported more than half the CAT scanners used in the world. Yet they bought very few for their own citizens. Today, Britain has half the number of CAT scanners per capita as we do in the United States. A similar problem exists in Canada.

MYTH: ?MORE BANG FOR THE BUCK?
Yet another myth is that although the United States spends more on health care, we don?t get more. That argument is often supported by pointing to life expectancy, which is not that much different among developed countries, and infant mortality, which is actually higher in the United States than it is in most other developed countries. What do we get for our money? The first thing we need to do is separate those phenomena that have little to do with health care from those that do. In the United States, life expectancy at birth for African American men is 68 years, while for Asian American men it?s 81 years. We find wide differences in life expectancy among women, too. Nobody thinks that those differences are due to the health care system. What, then, would we want to look at if we really wanted to compare the efficacy of health care systems? We would look at those conditions for which we know medical services can make a real difference. Among women who are diagnosed with breast cancer, only one fifth die in the United States, compared to one third in France and Germany, and almost half in the United Kingdom and New Zealand. Among men who are diagnosed with prostate cancer, fewer than one fifth die in the United States, compared to one fourth in Canada, almost half in France, and more than half in the United Kingdom.

MYTH: ?EQUAL ACCESS? Perhaps no notion is more closely tied to national health insurance than the idea of equal access to health care. Every prime minister of health in Britain, from the day the National Health Service started, has said that is the primary goal of the NHS. Similar things are said in Canada and in other countries. The British government - unlike most other governments - studies the problem from time to time to see what kind of progress they?re making. In 1980, they had a major report that said, essentially: ?We really haven?t made very much progress in achieving equality of access to health care in our country. In fact, it looks like things are worse today, in 1980, than they were 30 years ago when the British National Health Service was started." Everybody deplored the results of that report, and they all promised to do better. There were a lot of articles written, a lot of conferences, and a lot of discussions. Another 10 years passed and they pondered another report, which said that things had deteriorated further. Today we are long overdue for a third report, but no one expects the situation to have improved. It?s true that racial and ethnic minorities are underserved in the United States. But we are hardly alone. In Canada, the indigenous groups are the Cree and the Inuits. In New Zealand, they are Maoris. In Australia, the Aborigines. Those populations have more health care problems, shorter life expectancies, higher infant mortality, more health care needs, and they get less health care. When health care is rationed, racial and ethnic minorities do not usually do well in the rationing scheme. A Canadian study showed vast inequalities among the health regions of British Columbia. In some cases, there were spending differences of 10 to 1 in services provided in one area compared to another. That probably would not surprise most health policy analysts; you just don?t usually get this kind of data. But if we had the data, we would probably find similar inequalities in access to health care all over the developed world. I?m especially interested in the elderly, because I find that - not only in Britain and Canada, but also in the United States - when people have to make decisions about who is going to get care and who is not, they frequently choose the younger patient. Surveys of the elderly show that senior citizens in the United States say it?s much easier to get surgery, see doctors, see specialists, and enter hospitals, than say seniors in other countries.

MYTH: ?LESS RED TAPE?
Then we have the myth that national health insurance is an efficient way to deliver health care. I hear this frequently repeated by advocates in the United States. Probably the most telling statistic for hospitals is average length of stay. In general, efficient hospitals get people in and out more quickly. By that standard, the U.S. hospital sector is the most efficient in the world. And I think by many other standards it would not be much in dispute that the U.S. hospital sector is far more efficient than the hospital sectors of other countries. In Britain, where at any one time there are a million people waiting to get into British hospitals, 15 percent of the beds are empty, and another 15 percent are filled with chronic patients who really don?t need the services of hospital; they?re simply using the hospital as an expensive nursing home. So, effectively, almost one-third of the beds are closed off to acute care patients. A study compared Kaiser in California with the NHS and concluded that, after you make all of the appropriate adjustments, Kaiser spends about the same per capita on its enrollees as Britain spends on its population. But the Kaiser enrollees were getting more care, more access to specialists, and other services. We often hear that Medicare and Medicaid are efficient. The government says Medicaid only spends about 2 percent of its budget on administration. But that ignores all the costs that are shifted to doctors and hospitals. When you incorporate all those costs, it turns out that actually Medicare is not very efficient at all.

[Stlrs4Life]

You would get the same care you get today. Only change would be it would be cheaper for you. Doctors would make a little less. Regardless, the healthcare system we have now is not working.

[SteelCityMan786]

Originally Posted by Stlrs4Life

Not the Scared Socialized Medicine view. Damn shame the Reps don't want every American to havehealthcare. (Free) I spent 2 years in Germany, and the Germans loved it. Never copmplained about it either.

And your feelings about Obama? I feel the same about Rudy and Mitt, (Other than being a Republican) that they are mistrusting.

I want Americans to have healthcare, just those of us who are legal citizens should be getting our healthcare. The Illegal Immigrants should be getting in line with the rest of them and waiting to get theirs. I don't want to be eventually paying taxes higher then my parents do/did at their age. Free Healthcare is what you may think is coming, but in reality it's not as 76 said. No healthcare is free. They make it up in tax increases for all Americans. I don't want a mass tax increase with the current state of our economy and where it could end up going.

[Preacher]

Originally Posted by Stlrs4Life

You would get the same care you get today. Only change would be it would be cheaper for you. Doctors would make a little less. Regardless, the healthcare system we have now is not working.

Sorry, but you are very wrong. My family lives in Canada. Do you really want to hear about the year plus wait my aunt is dealing with in agony waiting to get surgery on her liver? Then, when the surgery is available to she will have to fly hundred of miles away, because BC provincial healthcare only does those surgeries in a couple places.

Or do you want to discuss how long my uncle had to wait for knee replacement surgery?

In the US, both operations would have been done within a couple WEEKS.

Those prolonged surgeries are costing Canada BILLIONS of dollars in EXTRA health care costs (see link in quoted portion) because other problems are being caused by the original issue that is not yet taken care of.

Instead of me going on, let me quote from a post I wrote in another forum

3. On the general state of health care. I read that we are ranked 37th, and how bad is that. I say, what a crock. We are ranked 37th (World Health Organization) because the system used to rank us is tilted towards free healthcare and so-called "availability." Matter of fact, here are the five points which these rankings are dependent,

quote:
WHO’s assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system’s financial burden within the population (who pays the costs).

Look at each of these. All but the first one IS BASED ON FINANCES. So we are number 37, out of 180 plus health care systems in people being able to get decent health care. Furthermore, 2 or these are PURELY SUBJECTIVE. SO if you have been TOLD that your system sucks (as we have for years), then you reflect that in a survey. I have been to doctors in the states, I have been to doctors in Canada, I have been to doctors in Turkey, and I gotta say, of all three, my best experience, is IN THE USA. Is it affordable for all? No. But spinning it towards socialized medicine is simply wrong. Why? Thanks for asking....

4. Socialized medicine produces second rate health care for the masses. Right now in our country, ANYONE can get a job, and if they have health benefits, they can go to any number of excellent hospitals and doctors. However, if we moved to a socialized medicine, that all goes away. You are now assigned to a doctor/hospital. You have no ability to go outside that, and if you can, you still have to pay (via taxes) the wages for the doctor in the social system.

What is worse, is what has happened in Canada. In B.C., almost all major surgeries are now done in Vancouver. That means if you want a major surgery, you get put on a waiting list to be flown down there. I have an aunt that has been waiting for over a year for surgery to repair her liver(?) It is a necessary surgery as she is in major pain. However, because people from all over the province keep having problems (heart attacks, etc.) that are greater, she gets moved back further and further. Socialized medicine creates massive backlogs of patients (See Canada's discussion of its costs via backlog here) of its costs because of this backlog here. Someone here is going to pull out a small nation in Europe.. to which I will respond.. 300 MILLION people in this country. There simply is no comparison to small European countries.

The result, is that the top 1 or 3 percent of people fly to the US to get those surgeries. This is surprising like the old U.S.S.R., where everyone went to the average hospital, but the "Special" ones got "Special" treatment in top of the line hospitals.

Speaking of coming to America... socialized medicine also creates what is called the "Brain Drain." Canada is losing a number of its doctors, and now many other professionals, because the taxes continually increase, making it not feasible for professionals to live in Canada.

This is NOT what we want here. What we need to do in this country is NOT SOCIALIZE the medicine, rather, we need to bring the costs back under control. That is done in a number of ways, including limiting lawsuits and insurance premiums (please tell me you all do realize that doctors are paying upwards of HALF A MILLION A YEAR in insurance ALONE... and that is before they pay for their office, their staff, etc. etc. That includes lawsuits against drug companies. Turn on the TV during the day, and see how many adds there are by lawyers who are trying to get class action suits against drug companies. If just ONE of those wins, just how much money gets paid out.. most to the lawyers?

Also... Medicare needs to be complete revamped, as it is driving the ENTIRE HEALTH CARE COST SKYWARD. Here is what happens. Medicare pays a base rate for a visit. If the doctors don't take medicare, then they get cut out of a number of other things. SO most doctors take medicare. Now, when they see patients, they only get the medicare (MC) allowable rate, which is often times 70, 80, 90 percent below what is charged... and is set by the feds. The doctors and hospitals (having to cover their enormous insurance premiums) have to make up that money. So what they do, is they double their rates, knowing that the insurance companies will only pay contract anyways. that does three things. 1. It prices a visit out of reach for a non-insurance person. 2. It gives a better bargaining tool for the doctors to deal with the insurance companies next contract, and 3, and this is the biggest, it drives up the MC allowable for the next year, as MC fixes their rate based on percentage of charge (either a real number for many of the providers, or percentages for hospitals). SO the doctors will raise their rate from 50 dollars a visit to 150 a visit, so that medicare will pay 30 a visit instead of 20 a visit. Meanwhile, the uninsured are left in the cold.

The way to fix it is to drive medicare SOLELY through the health insurance companies, and allow the companies to make their own contracts with the providers and hospitals, within a set limit... much like, as is kinda funny, NFL teams do with salary caps.

that is just a first couple of steps.

[HometownGal]

Originally Posted by Stlrs4Life

You would get the same care you get today. Only change would be it would be cheaper for you. Doctors would make a little less. Regardless, the healthcare system we have now is not working.

Why would I want cheaper health care if I have to wait months on end to receive it? I'd rather pay a little more and have access to my doctors and hospitals whenever I choose as I do now. That's a no-brainer for me.

Instead of giving billions of dollars to Global AIDS foundations, why doesn't our government start taking care of their own, damn it??? In his State of the Union address earlier this week, GW proposed allocating $30 BILLION dollars over the next 5 years for HIV/AIDS treatment/research. How about putting a fraction of that money towards getting the word out there that the best weapon against HIV/AIDS is practicing safe sex???? It's really not rocket science. Take the large balance of those billions and come up with a health insurance plan that would make insurance affordable to the 47+ million Americans who simply can't afford it. There should be NO American without health insurance. Not one.

[fansince'76]

Originally Posted by Stlrs4Life

You would get the same care you get today. Only change would be it would be cheaper for you. Doctors would make a little less. Regardless, the healthcare system we have now is not working.

Doctors would make less? OK, what about the astronomical cost of malpractice insurance? That has a LOT more to do with the (non) affordability of healthcare in this country than doctors' salaries do. I agree, the healthcare system in this country as it currently stands is broken and needs fixing drastically, but I don't think handing the reins over to the government is the answer. I think it should be approached with the mindset of controlling and then gradually reducing costs, without compromising the quality of care, and I don't think the socialization of healthcare will fill that bill - look at how many billions of dollars a year Medicare is defrauded out of, as an example. When it comes to controlling/reducing costs in any industry, the federal government should be the last party involved.

[HometownGal]

Originally Posted by Stlrs4Life

Not the Scared Socialized Medicine view. Damn shame the Reps don't want every American to havehealthcare. (Free) I spent 2 years in Germany, and the Germans loved it. Never copmplained about it either.

And your feelings about Obama? I feel the same about Rudy and Mitt, (Other than being a Republican) that they are mistrusting.

Dom - how long ago were you in Germany? Times have changed. As I said - ask any Brit or Canadian how they feel about socialized medicine. You'll get a much more negative response, I'm sure of it.

You seem to tow the party line, Dom, and that is fine. I don't vote that way normally and I took a good hard look at each candidate's (even Bitchary and Obama) platform. Truthfully, as I've said before, I'm not overly impressed with any of the candidates, not even the GOP'ers, but a vote for McCain or whoever gets the GOP nom is a vote taken away from Bitchary or Obama.

P.S. If John Edwards had stayed in the race and had secured the nom, he would definitely have had my vote.

[fansince'76]

Originally Posted by HometownGal

In his State of the Union address earlier this week, GW proposed allocating $30 BILLION dollars over the next 5 years for HIV/AIDS treatment/research. How about putting a fraction of that money towards getting the word out there that the best weapon against HIV/AIDS is practicing safe sex???? It's really not rocket science. Take the large balance of those billions and come up with a health insurance plan that would make insurance affordable to the 47+ million Americans who simply can't afford it. There should be NO American without health insurance. Not one.

Good point, Marianne - a government-subsidized health insurance plan should be the extent of "socialization" of healthcare in this country, IMO.

Private employers can also do things to reduce the cost of healthcare in this country. For example, my company, through its "employee wellness" program, is offering to cover the entire health insurance premium in 2009 (both employer and employee share) for 50 employees that are picked in a drawing. To be eligible for the drawing, you have to earn 30 "wellness points" by the end of 2008. To do this, you must actively participate in at least two company-sponsored programs that promote a healthier lifestyle (a weight loss program, exercise program, nutritional program, among others). In so doing, the employees that participate in these programs themselves become healthier and presumably less of a burden to the healthcare system which translates to reduced overall healthcare costs. BTW, I am participating - a chance at a year of free health benefits is a little too good to pass up. Initiatives like these by private employers en masse could really make a huge difference in the amount spent on healthcare in this country in the long run.

[revefsreleets]

No offense, and I mean that sincerely when I say it, but the reason I am a moderate and not a liberal is that I live in the real World. Many liberal views are nice, and I actually share many of the same end goals, but living in Utopia is a dream, and not at all realistic.

I'd love for everyone to have affordable health care. I want everyone to have a job. I believe the environment needs to be cleaned up. I think cars should be more efficient. I think overpaid CEO's who rape companies then float down on golden parachutes while the rank and file get f*cked are filthy pigs that should be taken out in the street and shot. I want all people of varying ethnicities/religions to live together in harmony. Etc, etc, etc...

But that ain't how the World works.

[Godfather]

The best solution is to take the shackles off HSAs. Instead of $12K a year (avg cost last I saw) going into the insurance company's pocket, it goes into your account, tax-free. When you need to use the health care system, you pay out of your account.

You can use the funds for any service from a licensed provider or any drug either already FDA-approved or going through clinical trials. You can donate funds to another person if you wish. It's your money, and you and your doctor know how to spend it better than government or insurance companies.

No more claims adjustors deciding what is and isn't medically necessary. No more lenghty delays in paying doctors. No more patients dying because they were defrauded by the HMO on an expensive procedure.