Why Private Health Care doesn't work

[lawgator1]

Wow. It took some time to find actual debate again in this thread.

The US, the richest country in the world, has among the worst health metrics of any developed country. Despite this, we spend almost double per capita on health care on most NHS systems. That is subpar in a big way for the world's largest economy.

"Access to care" is a critical metric. In fact, we already pay too much AND we certainly don't provide equal access. The WHO of course uses this as it is justly a critical metric BUT a host of other metrics are weighted as well. Access IS NOT even close to the only problem, but it is a big one.

Concerning the "if you are insured, there is no better care" I'm wondering where you assume this from. Our cancer survival rates are among the best; for other big diseases, among the worst. It doesn't seem to wash. I'm not sure cancer has overtaken cardiovascular problems, for instance.

If you "get what you pay for" then why are all the other NHS systems paying less and getting more? And moreover, supporting the entire population.

Finally, I don't know an NHS system that doesn't have the choice of private insurance. In fact, I believe in England if you pay for private insurance, you get some tax knocked off. This argument is a red herring.

By the way, I'm considering peppering my monologues with "hobnail boot" as well as "behind the woodshed." Be prepared. :thumbsup:

One word: cheeseburgers.

And also pizza.

 

[Ed12111]

One word: cheeseburgers.

And also pizza.

Fact 1. Cheeseburgers are responsible for all illnesses.

Fact 2. The United States is the only country who doesn't eat healthily.

Fact 3. No other country has any other variable that could possibly influence their health.

I agree.

 

[droski]

That's fantastic on so many levels.

1. The obvious

2. You realize things that go untreated can then end up life threatening

3. Cancer is not the only life threatening illness.

4. I assume you believe life expectancy is the most important metric.

2. i'd argue preventitive care is implied

3. no **** sherlock

4. nope. life expectancy and quality of healthcare are not directly related gibbs.

 

[Lexvol]

One word: cheeseburgers.

And also pizza.

Not the burgers and pizza themselves, mind you. The responsibility ultimately falls on those who sell the burgers and the pizza to unsuspecting patrons.

 

[Ed12111]

2. i'd argue preventitive care is implied

3. no **** sherlock

4. nope. life expectancy and quality of healthcare are not directly related gibbs.

No **** Sherlock? And yet it was you just making a case that cancer survival rate is the only number to be concerned with. I wonder why that number is an important one to you? And life expectancy and healthcare are directly related for God's sake.

 

[MG1968]

Not the burgers and pizza themselves, mind you. The responsibility ultimately falls on those who sell the burgers and the pizza to unsuspecting patrons.

go deeper, the ultimate responsibility rests with the cattle ranchers and pizza farmers

 

[droski]

No **** Sherlock? And yet it was you just making a case that cancer survival rate is the only number to be concerned with. I wonder why that number is an important one to you? And life expectancy and healthcare are directly related for God's sake.

when did i say it was the only number to be concerned with? and yes they are somewhat related, but all the great healthcare in teh world isn't going to make up for americans being 20 pounds fatter on average than your euro utopia buddies.

 

[utgibbs]

2. i'd argue preventitive care is implied

3. no **** sherlock

4. nope. life expectancy and quality of healthcare are not directly related gibbs.

So you are saying a health service doesn't really matter. Therefore, we are still bug-eyed insane for paying what we do for our service.

I can always count on y'all to support my points. And I thought y'all disagreed with me. :hi:

 

[joevol320]

So you are saying a health service doesn't really matter. Therefore, we are still bug-eyed insane for paying what we do for our service.

I can always count on y'all to support my points. And I thought y'all disagreed with me. :hi:

did you see this utgibbs. it's in hussein's healthcare law

Codification of the “economic substance doctrine”(Tax hike of $4.5 billion). This provision allows the IRS to disallow completely-legal tax deductions and other legal tax-minimizing plans just because the IRS deems that the action lacks “substance” and is merely intended to reduce taxes owed.

Read more: http://www.atr.org/comprehensive-lis...#ixzz1B2z1jMWj

 

[utgibbs]

did you see this utgibbs. it's in hussein's healthcare law

Codification of the “economic substance doctrine”(Tax hike of $4.5 billion). This provision allows the IRS to disallow completely-legal tax deductions and other legal tax-minimizing plans just because the IRS deems that the action lacks “substance” and is merely intended to reduce taxes owed.

Read more: http://www.atr.org/comprehensive-lis...#ixzz1B2z1jMWj

Obamacare is bad policy, IMHO. It ignores the 800lbs gorilla in the room.

And all the data from the real world.

Obama has to take care of Bill Frist et al. while trying to improve access. The latter goal is admirable, worthy, and among the best initiatives any politician could support.

The former flies in the face of all the data from the real world. The private system has no incentive for efficiency. That is why we pay.

 

[fl0at]

You do know, with the exception of smoking and nutrition/exercise related deaths, the US has enjoyed decreases in most categories that cause our top 10 causes of death, right?

If by efficiency, you mean cost, we have already been over government payment for residency programs, advances in medical technology, and social programs, not even to mention backing vaccinations to reduce cost to the individual, but also study and trends in global medicine.
Posted via VolNation Mobile

 

[volinbham]

The private system has no incentive for efficiency. That is why we pay.

From what I can tell, it works decently in Switzerland. It is heavily regulated but it is a private insurance system and actually allows more open competition among insurance providers than the U.S. does.

 

[utgibbs]

From what I can tell, it works decently in Switzerland. It is heavily regulated but it is a private insurance system and actually allows more open competition among insurance providers than the U.S. does.

I don't have the data in front of me. I noticed Germany, which also has a substantial private component, spends more as % of GDP relative to the straight single payer systems. My guess - without looking - is Switzerland does too.

I'm not suggesting they are bad models. And I'm guessing Munich Re and Swiss Re are a big reason their systems are geared with private components.

I'm all for redesign to promote access and efficiency - the two things our system desperately needs. As always though, looking at what works is a very good starting point.

 

[utgibbs]

You do know, with the exception of smoking and nutrition/exercise related deaths, the US has enjoyed decreases in most categories that cause our top 10 causes of death, right?

If by efficiency, you mean cost, we have already been over government payment for residency programs, advances in medical technology, and social programs, not even to mention backing vaccinations to reduce cost to the individual, but also study and trends in global medicine.
Posted via VolNation Mobile

You know, you raise a point I didn't think about.

Europe (disgustingly) still smokes.

We'll have to get the data, but I'm willing to be we are among the best rich countries regarding % of the population who smokes.

I now dread to think what our metrics would look like if it weren't for this (pat ourselves on back) excellent public health initiative.

 

[volinbham]

I don't have the data in front of me. I noticed Germany, which also has a substantial private component, spends more as % of GDP relative to the straight single payer systems. My guess - without looking - is Switzerland does too.

I'm not suggesting they are bad models. And I'm guessing Munich Re and Swiss Re are a big reason their systems are geared with private components.

I'm all for redesign to promote access and efficiency - the two things our system desperately needs. As always though, looking at what works is a very good starting point.

The point of the Swiss system is that it is not:

1) single payer
2) government run HC

It's basically a mandate and has substantial patient pay input via premiums, deductibles and co-pays.

Obtaining coverage for all does not require single payer nor government run HC. A private insurance system can do so and does have incentives for efficiency.

 

[utgibbs]

The point of the Swiss system is that it is not:

1) single payer
2) government run HC

It's basically a mandate and has substantial patient pay input via premiums, deductibles and co-pays.

Obtaining coverage for all does not require single payer nor government run HC. A private insurance system can do so and does have incentives for efficiency.

I never said it did, as my post above stated.

What I did say was they pay more than the single payer systems, and I don't think their metrics are substantially better than single payer systems.

There is good triumverate of simplicity, efficiency, and morality with a single payer system.

Just read Swiss are second only to US in terms of health expenditure per capita. Instincts were right. $3847 / person. (US = $5711) Swiss metrics are better than ours. Don't know if the Swiss smoke or not.

More vital data demonstrating the OP - no incentive for efficiency in a private system. The more private, the more money you spend.

Health care is not "widgets."

 

[fl0at]

Here is a good article for ya on wait times that isn't anecdotal:

http://www.nejm.org/doi/full/10.1056/NEJMp068064

WHO also ranks us pretty high. In addition, and more reason to loathe the AMA (who supports the single payer public option):

USATODAY.com - Medical miscalculation creates doctor shortage

Even though the AMA finally backed away from limiting the number of medical students, I can't help but think they did a pretty substantial amount of harm over the near century they advocated such policy.

The United States stopped opening medical schools in the 1980s because of the predicted surplus of doctors. The Association of American Medical Colleges dropped this long-standing view in 2002 with the statement: "It now appears that those predictions may be in error." Last month, it recommended increasing the number of U.S. medical students by 15%.

Yay for the AMA.

 

[Ed12111]

Here is a good article for ya on wait times that isn't anecdotal:

MMS: Error

WHO also ranks us pretty high. In addition, and more reason to loathe the AMA (who supports the single payer public option):

USATODAY.com - Medical miscalculation creates doctor shortage

Even though the AMA finally backed away from limiting the number of medical students, I can't help but think they did a pretty substantial amount of harm over the near century they advocated such policy.



Yay for the AMA.

The AMA is for a single payer? I thought your belief was that doctors would be harmed by a single payer.

 

[MG1968]

The AMA is for a single payer? I thought your belief was that doctors would be harmed by a single payer.

only 18% of US doctors are members of the AMA. You know this, but choose to be deliberately obtuse.

 

[Ed12111]

only 18% of US doctors are members of the AMA. You know this, but choose to be deliberately obtuse.

Yes, that's it. :good!:

 

[fl0at]

The AMA is for a single payer? I thought your belief was that doctors would be harmed by a single payer.

Yea, the AMA is for single payer, or at least their own version of it. The AMA is a very political organization, and one that many physicians butt heads with often. Even the US Task Force and AMA butt heads. The AMA and CDC butt heads, often.

I dislike the AMA, and disagree with many a thing that the AMA advocates.

Like already stated, the AMA represents a very small percentage of physicians. The politics of that organization turn a lot of docs away.

 

[utgibbs]

Here is a good article for ya on wait times that isn't anecdotal:

MMS: Error

WHO also ranks us pretty high. In addition, and more reason to loathe the AMA (who supports the single payer public option):

USATODAY.com - Medical miscalculation creates doctor shortage

Even though the AMA finally backed away from limiting the number of medical students, I can't help but think they did a pretty substantial amount of harm over the near century they advocated such policy.

Yay for the AMA.

We score very well in some WHO categories. I've never said otherwise. But when you look at the overall health metrics for societies, we are near the bottom compared to the single payer services.

The "wait list" argument is therefore, moot. It simply doesn't impact the overall health of the society in any meaningful way. I didn't see any data in the article, but I just skimmed it to be fair. Regardless, it's simply a red herring from the start, IMHO. And I've seen it used far too much as propaganda from the Right.

If the AMA restricted medical students, it was to increase costs by increasing their labor value, and that would be a function of an inefficient private health system.

 

[fl0at]

If the AMA restricted medical students, it was to increase costs by increasing their labor value, and that would be a function of an inefficient private health system.

The AMA stated for years that there were too many doctors, so numbers taught were kept low. This kept compensation high, and costs high. They have now "changed their mind" after they "discovered they were ... maybe wrong."

The AMA was staunchly against Medicare at the start, but now will back it with everything they have; they figured out how it an be useful.

The AMA is nothing more than a trendy political organization that will do whatever it takes to help the AMA.

And they support a single payer system, almost nothing else could give me more pause.

Also, here is your data: MMS: Error

In chart form.

As an Edit: The "overall" metric is flawed, period. We can't compare apples to apples with our melting pot society and demographics. We simply cannot. We are already overweight and don't exercise. Number one cause of death in 2000.

Some clinics have even started working on counseling patients on how to cook... so that we can advert this heart disease crap. Do you think a physicians job should be to mother a patient and teach them out to cook? C'mon.

Therefore, the only thing we can look at is cost.

Yea, it costs less in other places, because everyone pays for it. If everyone were required to pay for insurance, IT WOULD COST LESS.

 

[utgibbs]

The AMA stated for years that there were too many doctors, so numbers taught were kept low. This kept compensation high, and costs high. They have now "changed their mind" after they "discovered they were ... maybe wrong."

The AMA was staunchly against Medicare at the start, but now will back it with everything they have; they figured out how it an be useful.

The AMA is nothing more than a trendy political organization that will do whatever it takes to help the AMA.

And they support a single payer system, almost nothing else could give me more pause.

Also, here is your data: MMS: Error

In chart form.

Okay, where is the comparison to our system? Why does this have almost no impact on health outcomes?

Re: the AMA - so we agree. :thumbsup:

 

[fl0at]

Okay, where is the comparison to our system? Why does this have almost no impact on health outcomes?

Re: the AMA - so we agree. :thumbsup:

WHO consistently ranks us number 1 in responsiveness, this is a look at one system only, which is why it also doesn't include England (has decreased wait time over the past few years), amongst others.