Why Private Health Care doesn't work

#626
#626
Just for fun, though, from the NEJM article:

NEJM article said:
On June 9, 2005, the Supreme Court of Canada ruled in a case dating from 1997, in which a patient, along with his physician, sued Quebec after a year-long wait for hip-replacement surgery. In a decision highlighting the persistent problem of waiting lists in Canada ... the Court voted four to three to invalidate the long-standing prohibition on private insurance for services that are available under Quebec's public health care plan.3 Subsequently, the court postponed the effective date until June 2006.

The Court's majority found that “waiting lists for health care services have resulted in deaths, have increased the length of time that patients have to be in pain and have impaired patients' ability to enjoy any real quality of life.
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That last statement is important.
 
#627
#627
fl0at said:
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.
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Okay. Maybe that's why we pay 3x as much for our health care - #1 in responsiveness. It obviously doesn't help the overall health metrics of the society though - or rather, it has limited impact. I've never maintained we didn't score well in certain categories. But we are at the bottom on more than a few.

Your court case is anecdotal, btw. What about the number of deaths here because of no access to care? I can bring up plenty of anecdotes of Americans fleeing to Mexico for treatment.

However, due to the high cost of medical treatment in the USA, many American patients are going abroad for medical treatments. Their purpose is to save 50% to 80% on medical treatment conducted by doctors who are often trained in the United States, at hospitals that maintain the precise standards of patient care and safety.
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In fact it's coined the term "medical tourism."
 
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#628
#628
utgibbs said:
Okay. Maybe that's why we pay 3x as much for our health care.

It obviously doesn't help the overall health metrics of the society though.
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We might pay more, simply because we can get it faster and we can pile up the cost really quickly, if we so desire.

That said, though, if everyone were required to purchase insurance, instead of having to pass off liability and lobby Federal programs for reimbursement, do you think we could reduce costs?
 
#629
#629
utgibbs said:
Your court case is anecdotal, btw. What about the number of deaths here because of no access to care? I can bring up plenty of anecdotes of Americans fleeing to Mexico for treatment.

In fact it's coined the term "medical tourism."
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I highly doubt the Canadian Supreme Court would agree with their finding as "anecdotal." I would assume their justices take great pride in reviewing submitted evidence, rather than just the individual rhetoric of those arguing the case. They probably even cited some, in the rendered opinion. The dissenting opinion would be a worthwhile read, though.

I also don't find 150,000 or 300,000 Americans as "many." From the website you got that quote (health-tourism.com), you will find that the last study done, in 2007, showed approximately 300,000 Americans went South or East.

If, as stated, it is closer to 1 million today, that is less than 1/300th of the population. I highly doubt that qualifies as "many."

That is even 1/50th of the population of the uninsured. Again, probably not "many."

Words like "many," "loads," "tons," etc carry weight. 1/300th does not.
 
#630
#630
utgibbs said:
What about the number of deaths here because of no access to care? I can bring up plenty of anecdotes of Americans fleeing to Mexico for treatment.



In fact it's coined the term "medical tourism."
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Does that offset the opposite?
 
#632
#632
fl0at said:
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.
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Probably. I'm going completely on volinbham's word on Switzerland, but they pay less per capita by making everyone by insurance (probably from an arm of Swiss Re).

However, they are the second most expensive health care system per capita in the world. Their metrics are better than ours, but certainly do not outstrip any of the single payer countries (who pay less).

The UK is fat, AND they smoke. A health service with full access must just help a lot of people (at less cost to boot).

I've got to say though, you're post sounds like someone ready to examine American life and say "Hey, could we do this better?"

That's exactly where utgibbs is.
 
#633
#633
utgibbs said:
Probably. I'm going completely on volinbham's word on Switzerland, but they pay less per capita by making everyone by insurance (probably from an arm of Swiss Re).

However, they are the second most expensive health care system per capita in the world. Their metrics are better than ours, but certainly do not outstrip any of the single payer countries (who pay less).

The UK is fat, AND they smoke. A health service with full access must just help a lot of people (at less cost to boot).

I've got to say though, you're post sounds like someone ready to examine American life and say "Hey, could we do this better?"

That's exactly where utgibbs is.
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Not exactly groundbreaking news. Youd be hard press to find anything that is perfect with no need to try and improve.

Method or ideas on what and to what extent is the issue.
 
#634
#634
utgibbs said:
However, they [Switzerland] are the second most expensive health care system per capita in the world. Their metrics are better than ours, but certainly do not outstrip any of the single payer countries (who pay less).

The UK is fat, AND they smoke. A health service with full access must just help a lot of people (at less cost to boot).
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I haven't looked much into Switzerland, so I'm not sure about insurance competition and all that noise. I found it amusing that when Canada allowed private insurance on top of the public option, the majority opinion was that the private insurance would undercut the care given to the public.

That type of statement can be spun, of course. One could argue that it means the private system is better, and would overshadow the public system. And the other side could argue that it merely meant preferential treatment (faster times) given to private insurance users because the hospitals/docs would be compensated better.

Comparing UK to US would be an interesting side topic, but they still don't have our melting pot culture and the genetic predisposition to disease that comes with such a culture.
 
#635
#635
fl0at said:
Probably would be tough to determine, because they'd actually have to return home for it to be in the same category.
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I see your point about going home, as compared to staying.

But if its a question of access (here), wouldn't it still be relevant to access issues?
 
#636
#636
BeecherVol said:
But if its a question of access (here), wouldn't it still be relevant to access issues?
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I don't think so, but I may be misunderstanding. The point he was making was that high costs have led a small number (0.33% of Americans) to travel elsewhere to get care.

If we were going to try to compare others who come here for care (probably not based on cost, but some other circumstance), we'd be hard pressed because it would require that they return home.

I took your point to mean that we pay out the rear for illegal immigrant care. This is true, but the illegal immigrants typically don't come here just for the care, whereas that small percentage of Americans would be traveling elsewhere solely for the care cost.
 
#637
#637
fl0at said:
I don't think so, but I may be misunderstanding. The point he was making was that high costs have led a small number (0.33% of Americans) to travel elsewhere to get care.

If we were going to try to compare others who come here for care (probably not based on cost, but some other circumstance), we'd be hard pressed because it would require that they return home.

I took your point to mean that we pay out the rear for illegal immigrant care. This is true, but the illegal immigrants typically don't come here just for the care, whereas that small percentage of Americans would be traveling elsewhere solely for the care cost.
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Point taken. :hi:
 
#638
#638
fl0at said:
Comparing UK to US would be an interesting side topic, but they still don't have our melting pot culture and the genetic predisposition to disease that comes with such a culture.
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I have to dismiss the "melting pot culture" right here and right now. I've heard this a lot, and, since I know the US and UK the best, I've shot it down a lot.

First of all, the UK is highly multicultural. They had an empire the sun didn't set on and all.

Second, if you just take our white population, its metrics are still WORSE than the ENTIRE UK population.

Now, if "melting pot culture" wasn't euphamism for "all our non-whites bring the white metrics down," my sincere apologies. :hi:
 
#639
#639
fl0at said:
I don't think so, but I may be misunderstanding. The point he was making was that high costs have led a small number (0.33% of Americans) to travel elsewhere to get care.
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No, I said there were plenty of anecdotes (somewhere between 100,000 and 1M per annum apparently) of Americans going to Mexico for health care.

Access, of course, is a critical component Americans need to address.
 
#640
#640
utgibbs said:
No, I said there were plenty of anecdotes (somewhere between 100,000 and 1M per annum apparently) of Americans going to Mexico for health care.

Access, of course, is a critical component Americans need to address.
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Do you think Americans are going to Mexican hospitals, or are they going to private clinics? My guess is that they are going to private clinics run by highly trained, highly skilled doctors who can charge less because the customers are paying with cash. That's capitalism.

By the way, there are plenty of Canadians and Europeans that engage in medical tourism here in the US.
 
#641
#641
utgibbs said:
No, I said there were plenty of anecdotes (somewhere between 100,000 and 1M per annum apparently) of Americans going to Mexico for health care.

Access, of course, is a critical component Americans need to address.
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100,000 to 1M is a small percentage. Take 1M/300M and turn it into a percentage, you get 0.33%. <1% seems to me to be a rather small number.

As to the melting pot, it was most definitely not meant to mean that non-whites were bringing anything down. It merely means that we have a wide range of varying individuals, all with varying medical needs.

The UK's storied history is quite clear, but today, their kingdom doesn't exactly extend from end to end. How many former, or currently sovereign countries are covered under UK's plan?

The Queen's Crown extends, but not much else does.
 
#643
#643
MG1968 said:
Do you think Americans are going to Mexican hospitals, or are they going to private clinics? My guess is that they are going to private clinics run by highly trained, highly skilled doctors who can charge less because the customers are paying with cash. That's capitalism.

By the way, there are plenty of Canadians and Europeans that engage in medical tourism here in the US.
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It looks like they're going across the border for cheaper medical care.

I'm not sure what the "cash payment" has to do with capitalism. I don't think Lenin got rid of the ruble.

And I think you are missing the forest for the trees.
 
#644
#644
utgibbs said:
It looks like they're going across the border for cheaper medical care.

I'm not sure what the "cash payment" has to do with capitalism. I don't think Lenin got rid of the ruble.

And I think you are missing the forest for the trees.
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cheaper because the private Mexican clinics don't have to serve Medicare patients and lose money based on a government fee schedule. Money that would normally have to be made up elsewhere.

cheaper because the doctors in those clinics don't have to pay upwards of 100 thousand/year for malpractice insurance.

I know that medical care in the US is expensive. That won't change if we go to a single-payer system. You can claim that if the government is paying for it, it's cheaper on the individual. I disagree. Anybody who pays taxes will pay more and to such an extent that any savings that might come from single-payer is offset by loss of income due to increased tax liability.

Your system wrecks the already fragile and dwindling middle class. The poor will continue as they always have, that is being a burden on the system. The rich will continue to engage in medical tourism or use doctor-owned hospitals that don't have to deal with government programs.
 
#645
#645
utgibbs said:
It's classic:

No incentive.

There is no incentive in a private system to keep people from getting sick nor to make them better.

Meanwhile, a single-payer public system focuses on efficiency, prevention, and well-being. It urges individual responsibility and patient education.

Classic.

And the data is comprehensive and unambiguous. Public systems pay less for better care.
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This week, due to the snow, my mail (public) wasn't delivered for three days, but my newspaper(private) was delivered ever day.

Just saying.
 
#646
#646
rockydoc said:
This week, due to the snow, my mail (public) wasn't delivered for three days, but my newspaper(private) was delivered ever day.

Just saying.
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I've had my people hunt down several Fed Ex / UPS deliveries this week that were late (private). I won't even go into airport luggage either (private).

Just saying. :thumbsup:

PS - the Postal Service is one of the most convivial institutions in world history.
 
#649
#649
utgibbs said:
Get real. Besides, I'm talking about the institution.
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The institution that spawned the phrase "going postal"? The one that has its employees carry pepper spray to blast dogs? The one that attends to waiting customers with reluctance and the speed of a sloth?
 
#650
#650
kptvol said:
The institution that spawned the phrase "going postal"? The one that has its employees carry pepper spray to blast dogs? The one that attends to waiting customers with reluctance and the speed of a sloth?
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Weren't they all Republican voters?

The Postal Service is one of the most convivial institutions in world history. It was the internet for most of human history. It's awesome.
 
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