1) Runaway cost of medical care in this country that is approaching 20% of GNP, by far and away the most costly medical system in the world-with the worse life expectancy outcome.
2) To pay for this largesse, Obamacare forced everyone to buy insurance called the government mandate. A substantial portion of the population considers this gross government overreach.
3) The government subsidizes some portion of the population, but for a variety of reasons including certain mandated coverages such as pre-existing conditions, free yearly checkups, etc., affordable health insurance is becoming more and more difficult to find as younger people are dropping out of the system, forcing some insurers out of states or greatly increasing rates.
4) Costs are rising at an unsustainable rates.
It's a mess, but Google these key ideas and you may find some unbiased discussion but it is unlikely.
WISDOMfromPO-MOAugust 03, 2017 at 02:42#925600 likes
I can't find it again, but an article I read said that the U.S. didn't want to be like its enemies such as WW II Germany and later during the Cold War for ideological reasons did not want anything that was thought of as socialism, therefore the U.S. never adopted a single-payer system like much of Europe did.
Consider the present health care mess in the U.S. to be the legacy of the U.S.'s role in world politics from the early 20th century through the Cold War.
2) To pay for this largesse, Obamacare forced everyone to buy insurance called the government mandate. A substantial portion of the population considers this gross government overreach.
A substantial portion of the population, Democrat and Republican, consider this not enough government involvement and that we need Single Payer to make sure all Americans are covered, as all citizens in a First World country should be.
Reply to Thanatos Sand The overreach is in the form of forcing citizens to purchase a service from private industry. This is unprecedented.
Single payer, such as Social Security and Medicare had been around for some time. However , for good reason, citizens feel that all of this is becoming its own private industry where government keeps growing for its own benefit.
Thanatos SandAugust 03, 2017 at 02:52#925680 likes
Single payer, such as Social Security and Medicare had been around for some time. However , for good reason, citizens feel that all of this is becoming its own private industry where government keeps growing for its own benefit.
No, not for good reason, since most citizens need health care and cant afford it, so they are not going to begrudge the US government paying for it. The fact over 60% of Americans support Single Payer backs that up.
Reply to rickyk95 That's a good request. I don't have a nice succinct resource.
A lot of the reporting on health care is not helpful. There are some questions, however, that can be productively pursued:
1. Health care is provided less and less by small clinics, independent hospitals, and individual physician practices. Most of the care is now provided by a much smaller number of very large clinics and hospital chains. What difference might concentration of capital make?
2. In 1980 there were still many non-profit hospitals and clinics, many operated by religious organizations (like Sisters of St. Joseph Carondolet or large denominations like the Methodists, Lutherans, or baptists). Most of these non-profits either closed or were sold to for-profit companies. What effect on cost might the departure of non-profits from health care had?
3. Doctors quite often buy expensive equipment such as MRI and CT scanners to which they then refer patients for diagnosis. What effect might this practice have on health care?
4. Uninsured individuals generally avoid early proactive visits to a clinic. They tend to wait until their medical problem is very uncomfortable or unbearable, and then they utilize emergency rooms. What effect might this practice have on the complexity of care needed, and cost? What effect does this practice have on emergency room operations?
5. Surgeons, dentists, and orthodontists are among the highest paid professions. How might very high rates of pay affect cost of care?
6. Hospitals consume a vast array of single use disposable material, all purchased from for-profit companies. What effect might this have on cost of health care?
7. Insurance companies do not finance or provide health care. Their only function is to make money by managing premium income and paying claims. This function is a significant part of the overhead cost of medical care. Health care would be cheaper if the government collected premiums (from taxes) and paid all claims at a fixed rate (as they do for Medicare and Medicaid). A single payer health care payment system would eliminate perhaps 10% to 15% of the cost of obtaining health care.
8. Many Americans have unhealthy lifestyles relating to diet, exercise, smoking, and drinking. A significant share of avoidable illness is caused by poor diet, insufficient exercise, smoking, excessive drinking, and so on. We spend very little time, effort, or money in actually promoting good diet, regular exercise, smoking cessation, and moderation in alcohol use.
So, research these angles and you will find out a good deal about why health care costs are so high.
Reply to Thanatos Sand People need to learn to lead healthier lives and how to take care of themselves. Other countries pay half as much per capita with better results. U.S. is absolutely in last place when it comes to life expectancy in developed countries and last year, for the first time in decades, life expectancy actually went down. The U.S. had become a cesspool of drugs, MRIs, and if course prescription opioids that are killing 10's of thousands of people each year. Out medical industry has become a killing machine and some people are reluctant to finance even more of the same.
Thanatos SandAugust 03, 2017 at 03:13#925790 likes
?Thanatos Sand People need to learn to lead healthier lives and how to take care of themselves. Other countries pay half as much per capita with better results. U.S. is absolutely in last place when it comes to life expectancy in developed countries and last year, for the first time in decades, life expectancy actually went down.
And that has nothing to do with the many congenital conditions and unexpected diseases, cancers, or physical ailments from accidents that can cost hundreds of thousands to pay for. You're blaming the victim here, and that's not impressive. Those people suffering from those conditions, and even ones from their own contribution, need medical care for those conditions. And as a First World country, it is our governments position and responsibility to do that.
We spent trillions on the war in Iraq and continue to spend billions on war; we can pay to keep our citizens, including our children, from dying. And this benefits the rest of our country as well, as we don't lose important workers in our society.
And that has nothing to do with the many congenital conditions and unexpected diseases, cancers, or physical ailments from accidents that can cost hundreds of thousands to pay for.
There World Health Organization is attempting to address this "misunderstanding".
MISUNDERSTANDING #4: chronic diseases can't be prevented
Adopting a pessimistic attitude, some people believe that there is nothing that can be done, anyway. In reality, the major causes of chronic diseases are known, and if these risk factors were eliminated, at least 80% of all heart disease, stroke and type 2 diabetes would be prevented; over 40% of cancer would be prevented.
80% of premature heart disease, stroke and diabetes can be prevented
Thanatos SandAugust 03, 2017 at 03:29#925840 likes
?Thanatos Sand People need to learn to lead healthier lives and how to take care of themselves. Other countries pay half as much per capita with better results. U.S. is absolutely in last place when it comes to life expectancy in developed countries and last year, for the first time in decades, life expectancy actually went down.
That's very interesting, but I said congenital conditions and unexpected diseases like Cancer. And even if that is the case, the 20% sure need care too, and many of the 80 % had no idea they were contributing. But you would rather moralize and have people, including children, die of their congenital and/or chronic diseases then have the government pay for their care as they do our military wars and coups.
Congratulations, you've just proven yourself to be as lacking in compassion as Donald Trump.
Not according to WHO. Cancer can be quite predictable: e.g. cigarette smoking, excess drinking, environmental hazards, obesity, food toxins, etc. I wouldn't be surprised if all of those toxic drugs that people are being prescribed are causing all kinds of cancer. We do know that taking prescription opioids is definitely a no-no, but physicians keep prescribing and killing. Go figure.
Thanatos SandAugust 03, 2017 at 03:38#925870 likes
Not according to WHO. Cancer can be quite predictable: e.g. cigarette smoking, excess drinking, environmental hazards, obesity, food toxins, etc.
Sorry, you're reading it wrong, many cancers are not preventable. And people who don't know about food toxins or environmental hazards can't prevent their cancers either. So, they are not to "blame" for those cancers, but you would still rather see them, and the other cancer sufferers dead, then have their government pay for their care. Again, your lack of compassion, and moralizing judgements of cancer sufferers, is disgusting.
We do know that taking prescription opioids is definitely a no-no, but physicians keep prescribing and killing. Go figure.
And this in no way is an argument against Single Payer. Go figure.
Reply to Thanatos Sand The argument against single payer is that government just skims off the c top, as it consumes more and more of the economy. 7 of the 12 richest counties in the U.S. circle Washington D.C. as government gets fatter and fatter off if the hard labor of the working class. People are pretty tired of being slaves for the Bureaucracy. It's really quite out of control.
Sorry, you're reading it wrong, many cancers are not preventable. And people who don't know about food toxins or environmental hazards can't prevent their cancers either.
Looks like WHO has their work cut out for themselves.
Thanatos SandAugust 03, 2017 at 03:47#925900 likes
Reply to Thanatos Sand Wars use to be great money makers for government and the top 1% but nowadays healthcare is much more lucrative. Tens of $trillions and growing. And it's people such as yourself who serve as unpaid marketers for this money-making machine.
Thanatos SandAugust 03, 2017 at 04:01#925940 likes
Thanatos Sand Wars use to be great money makers for government and the top 1% but nowadays healthcare is much more lucrative. Tens of $trillions and growing. And it's people such as yourself who serve as unpaid marketers for this money-making machine.
No, it's people like you who serve as unpaid marketers for the money-making machine called the insurance industry. I want the government to put our taxes to work, do its job, and take care of its citizens. You actually want children to die instead of that...which is sociopathic and offensive.
Reply to Thanatos Sand Actually it is prescription drugs like opioids that are killing 10s of thousands of people each year and hospitals that are killing hundreds of thousands, making hospitals the third-leading cause of death after after cancer and heart disease. So in a sense staying away from hospitals is a good lifestyle practice right after eating veggies and fruits.
?Thanatos Sand Actually it is prescription drugs like opioids that are killing 10s of thousands of people each year and hospitals that are killing hundreds of thousands, making hospitals after cancer and heart disease.
Sorry, prescription drugs doesn't even cause 10 percent (if that) of the illnesses or diseases or physical ailments needing medical treatment. So, you make another pointless non-sequitur.
So in a sense staying away from hospitals is a good lifestyle practice right after eating veggies and fruits.
LOL. Man, you are seriously ignorant and kooky, as well terribly callous. So, we're done; I've wasted too much time on you already.
Reply to Rich The purpose of health care is actually not to prevent death. Everybody is going to die. Roughly a third will die from heart disease, roughly a third from cancer, and roughly a third from strokes. Then there are infections, accidents, gun shot wounds, and so on. Many of the corpses will have been paragons of healthy living.
The purpose of health care, and healthy life styles, is to preserve good health for as long as possible. This is becoming more important as people live longer (but still die). Healthy old people can take care of their personal needs, walk, bike, drive, enjoy life, and so on, but they have to be reasonably healthy BEFORE they get old.
Death from cancer can't yet be prevented, and whether it's heart disease, stroke, infection, a car crash, or whatever -- the specifics of dying are quite often pretty bad, whether it happens when you are 50, 60, 80, or 100.
Reply to Bitter Crank The WHO says that 80% of non-communicable diseases are lifestyle related. Their is a reason that the U.S., which spends 80% more on medical care than than the 35 other developed countries and has the worse life expectancy. A pretty sad situation but not considering considering the lifestyle choices of a large part of our population. The science of medicine actually is different once you leave the U.S.
"This year, more than 1 million Americans and more than 10 million people worldwide are expected to be diagnosed with cancer, a disease commonly believed to be preventable. Only 5–10% of all cancer cases can be attributed to genetic defects, whereas the remaining 90–95% have their roots in the environment and lifestyle. The lifestyle factors include cigarette smoking, diet (fried foods, red meat), alcohol, sun exposure, environmental pollutants, infections, stress, obesity, and physical inactivity."
Actually it is prescription drugs like opioids that are killing 10s of thousands of people each year and hospitals that are killing hundreds of thousands, making hospitals the third-leading cause of death after after cancer and heart disease. So in a sense staying away from hospitals is a good lifestyle practice right after eating veggies and fruits.
2.6 million Americans die every year.
Prescription drugs do, actually, kill quite a few people. Hundreds of thousands people die in hospitals -- but this is a bit misleading.
People aren't dying left and right from taking the common Rx drugs. Quite often very sick people die from very potent drugs which might cure their disease. Drugs for cancer can have devastating consequences. But... it's the certainty of death by cancer or traded off against the possibility of dying from the cure.
As for opiates, most people take narcotic drugs as prescribed and not have the slightest inclination to abuse them. However, maybe 10% of the population run the risk of dependence and addiction. Some people's brains are sitting ducks for drug abuse. Sad, but predictable. So -- give certain histories, some people should avoid narcotics.
Yes, noscosomial infections, surgical errors, treatment failures and so on do kill quite a few people in hospitals. Without excusing poor infection control or surgical mistakes, people who are in hospitals for extended periods of time generally have one foot in the grave already. a very large number of people die in hospitals who could just as well die at home. They are admitted late in life, in poor health, and all sorts of things are done to keep them alive for another month or two, then they die.
Reply to Bitter Crank As all studies on the subject conclude, it is lifestyle choices that are far and away the leading causes of chronic illnesses and healthy people (especially young people who get it) are getting a little tired of paying for the poor lifestyle choices of other Americans. 20% of the GNP is going to medical care. This is astronomical and it is growing.
"This year, more than 1 million Americans and more than 10 million people worldwide are expected to be diagnosed with cancer, a disease commonly believed to be preventable. Only 5–10% of all cancer cases can be attributed to genetic defects, whereas the remaining 90–95% have their roots in the environment and lifestyle. The lifestyle factors include cigarette smoking, diet (fried foods, red meat), alcohol, sun exposure, environmental pollutants, infections, stress, obesity, and physical inactivity."
Well some cancers are preventable. Lung cancer is mostly preventable. People who don't smoke usually don't get lung cancer. Ditto skin cancers: people who stay out of the sun usually don't get melanoma (or even basal cell carcinomas--much less serious). Diet, drinking, and smoking probably have a significant role in colorectal cancer. However, there has recently been an spike in colorectal cancer among people younger than 40, sometimes in people who are only 25 years old. There doesn't seem to be any lifestyle influence there. Hepatitis B and C are probably causative in certain kinds of liver cancer -- but not liver cancers that start somewhere else (like pancreatic cancers that spread to the liver).
?Bitter Crank As all studies on the subject conclude, it is lifestyle choices that are far and v away the leading causes of chronic illnesses and healthy people are getting a little tired of paying for the poor lifestyle choices of other Americans. 20% of the GNP is going to medical care. This is astronomical and it is growing.
It isn't terrible that we spend 20% of GNP on health care -- it's terrible that we spend that much without getting better results.
Look, I agree that lifestyle is a very significant factor in disease. That's an axiom of public health. But bear in mind, all the healthy people in Europe and America, Japan, Australia, China and Mozambique, and everywhere else are still going to die, and they are going to die of very similar causes: Cancer, Heart Disease, and stroke (circulatory failures in the brain).
Like I said, it's very important for an aging population to get healthy before they get old, and that means dealing with excess weight, exercising, stopping bad habits like smoking and drinking, eating a healthy diet, avoiding excessive amounts of preserved, fried, and barbecued food (factors in stomach and gut cancers), and so on.
Disease has deep cultural roots, so it isn't just a matter of irresponsible individuals; it's also irresponsible social practices.
Disease has deep cultural roots, so it isn't just a matter of irresponsible individuals; it's also irresponsible social practices.
And this is part of the debate. Some people would rather see more money going to better food, cleaner water, cleaner air than to more medicine - which is already almost twice as much per capita than other developed nations. More money on medicine doesn't mean better health. In fact, it appears to decrease life expectancy.
Reply to Rich We spend more money on medicine as health declines. But the issue of money needs to be separated from the incidence of disease and treatment. Americans, I suspect, live less healthy lifestyles than Europeans, and this is mostly a matter of culture. Americans, for instance, take much less vacation time than Europeans. American eating habits involve waaaay too much bad fast food (it isn't the fastness, its the badness). I don't know whether European young people binge drink as much Americans do.
European countries generally have more effective public health programs -- like good, practically universal pre-natal care--something that a lot of American women don't get.
You probably know that obesity is a world-wide problem; even in countries with much different cultures than either European or American, are experiencing more obesity (which is most likely caused by cheap fat and cheap sugar).
As for costs, a Rx for XYZ drug is likely to cost much more in the United States than in France or Germany. Why is that? Well, for one thing, the Medicare program was forbidden by Congress from negotiating prices. Crazy? It's flat out insane.
The way we finance health care allows for run ups in costs; the insurance companies raise premiums to match costs, rather than forcing the prices for drugs and procedures down. Single Payer could flatten prices.
This is a personal issue. My copay on eyedrops for glaucoma medication is $24--not a lot, but the amount of medication is only a skimpy 1/2 teaspoon of liquid, if that. It's an old drug, not hot off the lab table. There is no reason for it being that expensive.
2. In 1980 there were still many non-profit hospitals and clinics, many operated by religious organizations (like Sisters of St. Joseph Carondolet or large denominations like the Methodists, Lutherans, or baptists). Most of these non-profits either closed or were sold to for-profit companies. What effect on cost might the departure of non-profits from health care had?
And now for some fact checking:
In 2003, 62% were non-profit, 20% for profit, and 18% government. https://en.wikipedia.org/wiki/Non-profit_hospital
In 2010, 58% were non-profit, 21% government, and 20% for profit. http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=9&ved=0ahUKEwi8_YvRlrvVAhXM1CYKHYwWACUQFghdMAg&url=http%3A%2F%2Fwww.nonprofithealthcare.org%2Fresources%2FBasicFacts-NonprofitHospitals.pdf&usg=AFQjCNEK6qKqi-gwE0__bMHEPL3aJqnYTQ
In 2017, 51% were non-profit, 19% for profit, and 30% government. http://www.aha.org/research/rc/stat-studies/fast-facts.shtml
The 2017 percentages I had to compute because it only gave raw numbers. Assuming it valid, the trend is not toward making nonprofits into profits, but into making profits into government run.
But what is a non-profit these days? Just going on the hospitals in the Minneapolis metropolitan area, the nature of "non-profit" seems to have changed. Many of the hospitals here were formerly denomination affiliated not-for-profit institutions and have since collapsed into several chains of hospitals and clinics which have little resemblance to "not-for-profit". And what is a government-owned hospital but a not-for-profit?
I don't see much difference, these days, between "for-profit" and "not-for-profit".
(Quality or care, based on readmission rankings, is a mixed bag across the board, across the US.)
Reply to Bitter Crank
"What’s the difference between nonprofit and for-profit hospitals?
Hospital officials say there are only two major differences. For-profit hospitals pay property and income taxes while nonprofit hospitals don’t. And for-profit hospitals have avenues for raising capital that nonprofits don’t have. (The ability to access capital is important for hospitals looking to upgrade facilities or buy costly medical equipment or information technology systems.)
But critics of for-profit hospitals — including labor unions, consumer groups and some legislators — say there are other differences, too. They note that unlike nonprofit hospitals, for-profit hospitals have to answer to shareholders, who may not have the same interests as the local communities. Critics also warn that for-profit hospitals are more likely to stop offering money-losing services."
The full article: https://ctmirror.org/2014/04/25/how-different-are-for-profit-and-nonprofit-hospitals/
The overreach is in the form of forcing citizens to purchase a service from private industry. This is unprecedented.
Not entirely. There's compulsory car insurance. It's just that in this case there isn't an analogy to not having a car.
But even then, something being unprecedented doesn't mean it's bad. Seems like a superfluous (and nonsensical) complaint in lieu of the accusation of overreach.
Reply to Michael With cart insurance, one had the choice to buy a car. One does not have a choice about living. That the government can now force citizens to purchase services from private industry brings us one step closer to government totally ruling our lives. Orwell was correct in ascertaining that Totalitarianism will be a product of Leftist thinking. People just don't know when to stop. They literally want a Big Brother. What irony?
No wonder Democrats don't care about losing more and more liberties under Obama. They don't want them and don't understand why others might. Is it now more understandable that Russians like Totalitarianism?
With cart insurance, one had the choice to buy a car. One does not have a choice about living.
Yes, I said that.
That the government can now force citizens to purchase services from private industry brings us one step closer to government totally ruling our lives. Orwell was correct in ascertaining that Totalitarianism will be a product of Leftist thinking. People just don't know when to stop. They literally want a Big Brother. What irony?
Reply to Michael Yep, and we are sliding down that slope into total Government intervention and control of our lives. It is all happening in a very short period of time. The Left wants But Brother, and they got one.
Yep, and we are sliding down that slope into total Government intervention and control of our lives. It is all happening in a very short period of time. The Left wants But Brother, and they got one.
Again, this is just a slippery slope fallacy. You might as well argue that the conservative desire to stop homosexuals from marrying will inevitably lead to banning marriage entirely. It's a ridiculous argument.
No wonder Democrats don't care about losing more and more liberties under Obama. They don't want them and don't understand why others might. Is it now more understandable that Russians like Totalitarianism?
Of course they want them. That's why they push for equality and against discrimination. That's why they're by-and-large pro-choice rather than pro-life.
And I wonder why you're placing all the blame on Democrats and the left. The Republicans and the right want to restrict certain liberties too (e.g. gay marriage).
So what this really comes down to is a disagreement between liberals and conservatives over which liberties are (more) important and over which areas the government has a legitimate reach. Which is fine. But your argument is just a slippery slope, and seemingly also moving the goalposts (unless you want to accuse Republicans and the right of the same totalitarian tendencies).
Of course they want them. That's why they push for equality and against discrimination. That's why they're by-and-large pro-choice rather than pro-life.
Right. And the benevolent Government ruled by the top 1% is going to give it all to them - for free nonetheless. Notice any changes lately or is all empty talk? Let's just say it is very easy to con people, especially those who think they are way too intelligent to be conned.
The largest transfer of wealth, by far, from the middle class to the top 1% occurred under Obama and now he gets $400,000 for a one hour speech from Goldman (which pretty much controls currency in the U.S. Clinton got her $180 million from Wall Street. And the middle class? Totally obliterated. What did the a Left get in return? Oh, some promises of equality-I guess in the poor house and the feeling that they did so much good for those who aren't as smart as them.
Right. And the benevolent Government ruled by the top 1% is going to give it all to them - for free nonetheless. Notice any changes lately or is all empty talk? Let's just say it is very easy to con people, especially those who think they are way too intelligent to be conned.
The largest transfer of wealth, by far, from the middle class to the top 1% occurred under Obama and now he gets $400,000 for a one hour speech from Goldman (which pretty much controls currency in the U.S. Clinton got her $180 million from Wall Street. And the middle class? Totally obliterated. What did the a Left get in return? Oh, some promises of equality-I guess in the poor house and the feeling that they did so much good for those who aren't as smart as them.
The Benevolent Government.
What are you going on about now? Doesn't seem at all related to what we were discussing. So let's add a red herring to your list of fallacies.
Reply to Hanover Scientific American ran an article quite a few years ago about profit vs. non-profit hospitals and outcomes. They showed that for-profit hospitals (Humana would have been the prime example at the time of the article's writing) were more expensive, were less efficient, provided less service to communities, and so on.
Whether non-profits are now much different than for-profits is probably less clear. Many non-profits, for instance, are rated as mediocre in providing excellent care. That's probably true for many for-profits as well. It isn't clear to me why some hospitals are able to deliver much better outcomes than other hospitals. For instance, a handful of states have low rates of readmission for a given problem (that is, the problem is successfully treated the first time around). Other states have much higher rates of readmission (patients were discharged, did poorly, and needed to be readmitted for the same problem). I don't know what all of the factors are, or why entire states seem to have low first-time treatment success.
WISDOMfromPO-MOAugust 04, 2017 at 04:44#929030 likes
Let's not forget that increasingly people are being thought of as--and thinking of themselves as--"customers" rather than as patients. There was an article not too long ago--Harper's Magazine, I believe--about this phenomenon and about a surgeon who refused to be insulted by "customer satisfaction" surveys and chose to retire. A dental practice I went to last year emailed a survey after every visit asking how satisfied I was with the care I received, the wait time, etc. Is this not unprecedented for medical care? Patients being asked for their feedback like customers of retail or fast-food restaurant chains?! Do the hospitals, clinics, etc. now hire, promote and fire doctors based on subjective "customer" satisfaction as indicated in a survey?!
That the government can now force citizens to purchase services from private industry brings us one step closer to government totally ruling our lives.
There's no difference between the government taxing us to pay private companies to insure for health care and it taxing us to to pay private companies to build roads. The argument that Obamacare is an ineffective and destructive government expansion into private enterprise is consistent with conservative thought, but the validity of that argument is ultimately empirical, as opposed to your purely ideological statement. That is, to simply decry Obamacare as an unprecedented step down the slippery slope toward unamerican socialism without offering an empirical basis for its rejection, sounds like an empty rightist rant.
The fact that The Affordable Care Act isn't affordable and doesn't address spiraling health care costs is the reason to reject it. That one side will allow the law to exist as is for the purposes of protecting it and the other will allow it to exist because it can't agree to the best way to detonate it points out that neither side really cares what the law does as much as what it represents.
The government first decides what we should buy (decided by the lobbyists for the medical who bribe to the hilt) and then the government tells us we have to buy it. No wonder they Democratic Party is in shambles. Just a bunch of Wall Street a__ kissers.
WISDOMfromPO-MOAugust 06, 2017 at 01:51#935430 likes
There's no difference between the government taxing us to pay private companies to insure for health care and it taxing us to to pay private companies to build roads.
Very few individuals, if any, can build a network of roads on their own. The overwhelming majority of individuals can purchase an insurance policy on their own. Exploiting the latter in morally and constitutionally questionable ways may be good politics if your goal is to maintain or increase your power by appealing to certain voters, but it is bad politics if your goal is to enact well-vetted reforms that will endure.
Thanatos SandAugust 06, 2017 at 02:33#935450 likes
There's no difference between the government taxing us to pay private companies to insure for health care and it taxing us to to pay private companies to build roads.
— Hanover
Very few individuals, if any, can build a network of roads on their own. The overwhelming majority of individuals can purchase an insurance policy on their own.
You're way off, not only can most citizens not afford health insurance for themselves and their children at their present rates or without a huge deductible, many are either denied insurance for present conditions or are given rates way out of affordability for those conditions.
Exploiting the latter in morally and constitutionally questionable ways may be good politics if your goal is to maintain or increase your power by appealing to certain voters, but it is bad politics if your goal is to enact well-vetted reforms that will endure.
Providing Single Payer health care so all our citizens, including all our children, have sufficient health care isn't exploiting anything; it's being a civilized First World country that doesn't let its citizens die because of lack of money. It's a far better money spent than the trillions we spend on missiles, bombs, drones, and other weapons every year.
You're way off, not only can most citizens not afford health insurance for themselves and their children at their present rates or without a huge deductible, many are either denied insurance for present conditions or are given rates way out of affordability for those conditions.
It's currently illegal to sell a policy that excludes for preexisting conditions. The fact that you admit the Affordable Care Act is unaffordable acknowledges it should be repealed.
Reply to Hanover Well that's silly. Giant national debt. What's affordable?
Thanatos SandAugust 06, 2017 at 19:29#936970 likes
Reply to Hanover It's absolutely not illegal to raise the rates for pre-existing conditions and not to cover those pre-existing conditions in the policy. And it certainly is not illegal to increase the deductible for that pre-existing condition to a ridiculous number, rendering health care unaffordable anyway.
I never said the ACA was unaffordable for all, but it will certainly be better than the GOP plan that just wants to really screw the Poor. But you and I know Single Payer/Medicare-for-All is the best approach anyway, since it will cover everybody and make it affordable for all. I'm glad we can admit that.
It's absolutely not illegal to raise the rates for pre-existing conditions and not to cover those pre-existing conditions in the policy. And it certainly is not illegal to increase the deductible for that pre-existing condition to a ridiculous number, rendering health care unaffordable anyway.
They can't exclude based on preexisting condition nor vary the rates based upon preexisting condition. The rates were to be kept under control in theory by mandating everyone buy insurance, including those with no preexisting condition. The system has failed because many refuse to purchase insurance despite the mandate and because of spiraling health care costs.
Thanatos SandAugust 06, 2017 at 21:20#937360 likes
They can't exclude based on preexisting condition nor vary the rates based upon preexisting condition.
They absolutely can vary the rates, areas of coverage and deductible based on preexisting condition and they do.
The rates were to be kept under control in theory by mandating everyone buy insurance, including those with no preexisting condition.
The rates were not to be kept under control and weren't as the insurance companies never planned to not raise them and they did. And they certainly can and will under the GOP plan.
The system has failed because many refuse to purchase insurance despite the mandate and because of spiraling health care costs.
No, the system has failed because it's a bad, expensive system that still leaves many Americans uncovered. Medicare-for-All will fix that. Since you want all Americans covered, you must want that.
"Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.
These rules went into effect for plan years beginning on or after January 1, 2014."
https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html
This is the crux of the ACA.
Thanatos SandAugust 06, 2017 at 22:25#937770 likes
Sorry, that's just rates. That says nothing about increasing deductible or refusing to cover the pre-existing condition. And that current law will change with the GOP plan. Now address Medicare-For-All or the discussion is pointless.
Reply to Thanatos Sand From the same site: "Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer. They cannot limit benefits for that condition either."
Your understanding of the ACA is completely wrong.
And that current law will change with the GOP plan. Now address Medicare-For-All or the discussion is pointless.
There is no GOP plan. It died in the Senate. The conversation is pointless because you have no idea what the ACA is.
Thanatos SandAugust 07, 2017 at 00:36#937960 likes
No, you didn't address what I said at all. So, it is your understanding of the ACA is completely wrong.
And there is still a GOP plan to fight ACA. So, this conversation is pointless and over since you don't understand what the ACA is and how bad it is, and you failed to address Single Payer, the best option.
So, we're done and I won't be reading any more of your posts.
Comments (59)
1) Runaway cost of medical care in this country that is approaching 20% of GNP, by far and away the most costly medical system in the world-with the worse life expectancy outcome.
2) To pay for this largesse, Obamacare forced everyone to buy insurance called the government mandate. A substantial portion of the population considers this gross government overreach.
3) The government subsidizes some portion of the population, but for a variety of reasons including certain mandated coverages such as pre-existing conditions, free yearly checkups, etc., affordable health insurance is becoming more and more difficult to find as younger people are dropping out of the system, forcing some insurers out of states or greatly increasing rates.
4) Costs are rising at an unsustainable rates.
It's a mess, but Google these key ideas and you may find some unbiased discussion but it is unlikely.
Consider the present health care mess in the U.S. to be the legacy of the U.S.'s role in world politics from the early 20th century through the Cold War.
If I find the article I will provide a link.
https://www.vox.com/cards/obamacare
I also found their explanation-via-cartoon also wonderfully enlightening:
https://www.vox.com/policy-and-politics/2016/11/17/13652466/trump-obamacare-preexisting-cartoon
A substantial portion of the population, Democrat and Republican, consider this not enough government involvement and that we need Single Payer to make sure all Americans are covered, as all citizens in a First World country should be.
Single payer, such as Social Security and Medicare had been around for some time. However , for good reason, citizens feel that all of this is becoming its own private industry where government keeps growing for its own benefit.
No, not for good reason, since most citizens need health care and cant afford it, so they are not going to begrudge the US government paying for it. The fact over 60% of Americans support Single Payer backs that up.
A lot of the reporting on health care is not helpful. There are some questions, however, that can be productively pursued:
1. Health care is provided less and less by small clinics, independent hospitals, and individual physician practices. Most of the care is now provided by a much smaller number of very large clinics and hospital chains. What difference might concentration of capital make?
2. In 1980 there were still many non-profit hospitals and clinics, many operated by religious organizations (like Sisters of St. Joseph Carondolet or large denominations like the Methodists, Lutherans, or baptists). Most of these non-profits either closed or were sold to for-profit companies. What effect on cost might the departure of non-profits from health care had?
3. Doctors quite often buy expensive equipment such as MRI and CT scanners to which they then refer patients for diagnosis. What effect might this practice have on health care?
4. Uninsured individuals generally avoid early proactive visits to a clinic. They tend to wait until their medical problem is very uncomfortable or unbearable, and then they utilize emergency rooms. What effect might this practice have on the complexity of care needed, and cost? What effect does this practice have on emergency room operations?
5. Surgeons, dentists, and orthodontists are among the highest paid professions. How might very high rates of pay affect cost of care?
6. Hospitals consume a vast array of single use disposable material, all purchased from for-profit companies. What effect might this have on cost of health care?
7. Insurance companies do not finance or provide health care. Their only function is to make money by managing premium income and paying claims. This function is a significant part of the overhead cost of medical care. Health care would be cheaper if the government collected premiums (from taxes) and paid all claims at a fixed rate (as they do for Medicare and Medicaid). A single payer health care payment system would eliminate perhaps 10% to 15% of the cost of obtaining health care.
8. Many Americans have unhealthy lifestyles relating to diet, exercise, smoking, and drinking. A significant share of avoidable illness is caused by poor diet, insufficient exercise, smoking, excessive drinking, and so on. We spend very little time, effort, or money in actually promoting good diet, regular exercise, smoking cessation, and moderation in alcohol use.
So, research these angles and you will find out a good deal about why health care costs are so high.
And that has nothing to do with the many congenital conditions and unexpected diseases, cancers, or physical ailments from accidents that can cost hundreds of thousands to pay for. You're blaming the victim here, and that's not impressive. Those people suffering from those conditions, and even ones from their own contribution, need medical care for those conditions. And as a First World country, it is our governments position and responsibility to do that.
We spent trillions on the war in Iraq and continue to spend billions on war; we can pay to keep our citizens, including our children, from dying. And this benefits the rest of our country as well, as we don't lose important workers in our society.
There World Health Organization is attempting to address this "misunderstanding".
http://www.who.int/chp/chronic_disease_report/part1/en/index11.html
MISUNDERSTANDING #4: chronic diseases can't be prevented
Adopting a pessimistic attitude, some people believe that there is nothing that can be done, anyway. In reality, the major causes of chronic diseases are known, and if these risk factors were eliminated, at least 80% of all heart disease, stroke and type 2 diabetes would be prevented; over 40% of cancer would be prevented.
80% of premature heart disease, stroke and diabetes can be prevented
That's very interesting, but I said congenital conditions and unexpected diseases like Cancer. And even if that is the case, the 20% sure need care too, and many of the 80 % had no idea they were contributing. But you would rather moralize and have people, including children, die of their congenital and/or chronic diseases then have the government pay for their care as they do our military wars and coups.
Congratulations, you've just proven yourself to be as lacking in compassion as Donald Trump.
Not according to WHO. Cancer can be quite predictable: e.g. cigarette smoking, excess drinking, environmental hazards, obesity, food toxins, etc. I wouldn't be surprised if all of those toxic drugs that people are being prescribed are causing all kinds of cancer. We do know that taking prescription opioids is definitely a no-no, but physicians keep prescribing and killing. Go figure.
Sorry, you're reading it wrong, many cancers are not preventable. And people who don't know about food toxins or environmental hazards can't prevent their cancers either. So, they are not to "blame" for those cancers, but you would still rather see them, and the other cancer sufferers dead, then have their government pay for their care. Again, your lack of compassion, and moralizing judgements of cancer sufferers, is disgusting.
And this in no way is an argument against Single Payer. Go figure.
Looks like WHO has their work cut out for themselves.
And that argument is wrong and has never even been well-argued, much less proven.
That's completely irrelevant to Single Payer health care, and most of the people who will benefit from Single Payer are the working class.
Sorry, having the government pay for one's health care does not constitute being slaves for the Bureaucracy. It constitutes benefiting from it.
Why aren't you complaining about all our wars and military actions the US Govt takes? They make us slaves to the Bureaucracy.
No, it's people like you who serve as unpaid marketers for the money-making machine called the insurance industry. I want the government to put our taxes to work, do its job, and take care of its citizens. You actually want children to die instead of that...which is sociopathic and offensive.
http://www.npr.org/sections/health-shots/2016/05/03/476636183/death-certificates-undercount-toll-of-medical-errors
Sorry, prescription drugs doesn't even cause 10 percent (if that) of the illnesses or diseases or physical ailments needing medical treatment. So, you make another pointless non-sequitur.
LOL. Man, you are seriously ignorant and kooky, as well terribly callous. So, we're done; I've wasted too much time on you already.
I won't be reading any more of your posts.
The purpose of health care, and healthy life styles, is to preserve good health for as long as possible. This is becoming more important as people live longer (but still die). Healthy old people can take care of their personal needs, walk, bike, drive, enjoy life, and so on, but they have to be reasonably healthy BEFORE they get old.
Death from cancer can't yet be prevented, and whether it's heart disease, stroke, infection, a car crash, or whatever -- the specifics of dying are quite often pretty bad, whether it happens when you are 50, 60, 80, or 100.
https://link.springer.com/article/10.1007/s11095-008-9661-9
"This year, more than 1 million Americans and more than 10 million people worldwide are expected to be diagnosed with cancer, a disease commonly believed to be preventable. Only 5–10% of all cancer cases can be attributed to genetic defects, whereas the remaining 90–95% have their roots in the environment and lifestyle. The lifestyle factors include cigarette smoking, diet (fried foods, red meat), alcohol, sun exposure, environmental pollutants, infections, stress, obesity, and physical inactivity."
2.6 million Americans die every year.
Prescription drugs do, actually, kill quite a few people. Hundreds of thousands people die in hospitals -- but this is a bit misleading.
People aren't dying left and right from taking the common Rx drugs. Quite often very sick people die from very potent drugs which might cure their disease. Drugs for cancer can have devastating consequences. But... it's the certainty of death by cancer or traded off against the possibility of dying from the cure.
As for opiates, most people take narcotic drugs as prescribed and not have the slightest inclination to abuse them. However, maybe 10% of the population run the risk of dependence and addiction. Some people's brains are sitting ducks for drug abuse. Sad, but predictable. So -- give certain histories, some people should avoid narcotics.
Yes, noscosomial infections, surgical errors, treatment failures and so on do kill quite a few people in hospitals. Without excusing poor infection control or surgical mistakes, people who are in hospitals for extended periods of time generally have one foot in the grave already. a very large number of people die in hospitals who could just as well die at home. They are admitted late in life, in poor health, and all sorts of things are done to keep them alive for another month or two, then they die.
Well some cancers are preventable. Lung cancer is mostly preventable. People who don't smoke usually don't get lung cancer. Ditto skin cancers: people who stay out of the sun usually don't get melanoma (or even basal cell carcinomas--much less serious). Diet, drinking, and smoking probably have a significant role in colorectal cancer. However, there has recently been an spike in colorectal cancer among people younger than 40, sometimes in people who are only 25 years old. There doesn't seem to be any lifestyle influence there. Hepatitis B and C are probably causative in certain kinds of liver cancer -- but not liver cancers that start somewhere else (like pancreatic cancers that spread to the liver).
It isn't terrible that we spend 20% of GNP on health care -- it's terrible that we spend that much without getting better results.
Look, I agree that lifestyle is a very significant factor in disease. That's an axiom of public health. But bear in mind, all the healthy people in Europe and America, Japan, Australia, China and Mozambique, and everywhere else are still going to die, and they are going to die of very similar causes: Cancer, Heart Disease, and stroke (circulatory failures in the brain).
Like I said, it's very important for an aging population to get healthy before they get old, and that means dealing with excess weight, exercising, stopping bad habits like smoking and drinking, eating a healthy diet, avoiding excessive amounts of preserved, fried, and barbecued food (factors in stomach and gut cancers), and so on.
Disease has deep cultural roots, so it isn't just a matter of irresponsible individuals; it's also irresponsible social practices.
And this is part of the debate. Some people would rather see more money going to better food, cleaner water, cleaner air than to more medicine - which is already almost twice as much per capita than other developed nations. More money on medicine doesn't mean better health. In fact, it appears to decrease life expectancy.
European countries generally have more effective public health programs -- like good, practically universal pre-natal care--something that a lot of American women don't get.
You probably know that obesity is a world-wide problem; even in countries with much different cultures than either European or American, are experiencing more obesity (which is most likely caused by cheap fat and cheap sugar).
As for costs, a Rx for XYZ drug is likely to cost much more in the United States than in France or Germany. Why is that? Well, for one thing, the Medicare program was forbidden by Congress from negotiating prices. Crazy? It's flat out insane.
The way we finance health care allows for run ups in costs; the insurance companies raise premiums to match costs, rather than forcing the prices for drugs and procedures down. Single Payer could flatten prices.
This is a personal issue. My copay on eyedrops for glaucoma medication is $24--not a lot, but the amount of medication is only a skimpy 1/2 teaspoon of liquid, if that. It's an old drug, not hot off the lab table. There is no reason for it being that expensive.
And now for some fact checking:
In 2003, 62% were non-profit, 20% for profit, and 18% government. https://en.wikipedia.org/wiki/Non-profit_hospital
In 2010, 58% were non-profit, 21% government, and 20% for profit. http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=9&ved=0ahUKEwi8_YvRlrvVAhXM1CYKHYwWACUQFghdMAg&url=http%3A%2F%2Fwww.nonprofithealthcare.org%2Fresources%2FBasicFacts-NonprofitHospitals.pdf&usg=AFQjCNEK6qKqi-gwE0__bMHEPL3aJqnYTQ
In 2017, 51% were non-profit, 19% for profit, and 30% government. http://www.aha.org/research/rc/stat-studies/fast-facts.shtml
The 2017 percentages I had to compute because it only gave raw numbers. Assuming it valid, the trend is not toward making nonprofits into profits, but into making profits into government run.
But what is a non-profit these days? Just going on the hospitals in the Minneapolis metropolitan area, the nature of "non-profit" seems to have changed. Many of the hospitals here were formerly denomination affiliated not-for-profit institutions and have since collapsed into several chains of hospitals and clinics which have little resemblance to "not-for-profit". And what is a government-owned hospital but a not-for-profit?
I don't see much difference, these days, between "for-profit" and "not-for-profit".
(Quality or care, based on readmission rankings, is a mixed bag across the board, across the US.)
"What’s the difference between nonprofit and for-profit hospitals?
Hospital officials say there are only two major differences. For-profit hospitals pay property and income taxes while nonprofit hospitals don’t. And for-profit hospitals have avenues for raising capital that nonprofits don’t have. (The ability to access capital is important for hospitals looking to upgrade facilities or buy costly medical equipment or information technology systems.)
But critics of for-profit hospitals — including labor unions, consumer groups and some legislators — say there are other differences, too. They note that unlike nonprofit hospitals, for-profit hospitals have to answer to shareholders, who may not have the same interests as the local communities. Critics also warn that for-profit hospitals are more likely to stop offering money-losing services."
The full article: https://ctmirror.org/2014/04/25/how-different-are-for-profit-and-nonprofit-hospitals/
Not entirely. There's compulsory car insurance. It's just that in this case there isn't an analogy to not having a car.
But even then, something being unprecedented doesn't mean it's bad. Seems like a superfluous (and nonsensical) complaint in lieu of the accusation of overreach.
No wonder Democrats don't care about losing more and more liberties under Obama. They don't want them and don't understand why others might. Is it now more understandable that Russians like Totalitarianism?
Yes, I said that.
That's one slippery slope.
Again, this is just a slippery slope fallacy. You might as well argue that the conservative desire to stop homosexuals from marrying will inevitably lead to banning marriage entirely. It's a ridiculous argument.
Of course they want them. That's why they push for equality and against discrimination. That's why they're by-and-large pro-choice rather than pro-life.
And I wonder why you're placing all the blame on Democrats and the left. The Republicans and the right want to restrict certain liberties too (e.g. gay marriage).
So what this really comes down to is a disagreement between liberals and conservatives over which liberties are (more) important and over which areas the government has a legitimate reach. Which is fine. But your argument is just a slippery slope, and seemingly also moving the goalposts (unless you want to accuse Republicans and the right of the same totalitarian tendencies).
Right. And the benevolent Government ruled by the top 1% is going to give it all to them - for free nonetheless. Notice any changes lately or is all empty talk? Let's just say it is very easy to con people, especially those who think they are way too intelligent to be conned.
The largest transfer of wealth, by far, from the middle class to the top 1% occurred under Obama and now he gets $400,000 for a one hour speech from Goldman (which pretty much controls currency in the U.S. Clinton got her $180 million from Wall Street. And the middle class? Totally obliterated. What did the a Left get in return? Oh, some promises of equality-I guess in the poor house and the feeling that they did so much good for those who aren't as smart as them.
The Benevolent Government.
What are you going on about now? Doesn't seem at all related to what we were discussing. So let's add a red herring to your list of fallacies.
Whether non-profits are now much different than for-profits is probably less clear. Many non-profits, for instance, are rated as mediocre in providing excellent care. That's probably true for many for-profits as well. It isn't clear to me why some hospitals are able to deliver much better outcomes than other hospitals. For instance, a handful of states have low rates of readmission for a given problem (that is, the problem is successfully treated the first time around). Other states have much higher rates of readmission (patients were discharged, did poorly, and needed to be readmitted for the same problem). I don't know what all of the factors are, or why entire states seem to have low first-time treatment success.
There's no difference between the government taxing us to pay private companies to insure for health care and it taxing us to to pay private companies to build roads. The argument that Obamacare is an ineffective and destructive government expansion into private enterprise is consistent with conservative thought, but the validity of that argument is ultimately empirical, as opposed to your purely ideological statement. That is, to simply decry Obamacare as an unprecedented step down the slippery slope toward unamerican socialism without offering an empirical basis for its rejection, sounds like an empty rightist rant.
The fact that The Affordable Care Act isn't affordable and doesn't address spiraling health care costs is the reason to reject it. That one side will allow the law to exist as is for the purposes of protecting it and the other will allow it to exist because it can't agree to the best way to detonate it points out that neither side really cares what the law does as much as what it represents.
Very few individuals, if any, can build a network of roads on their own. The overwhelming majority of individuals can purchase an insurance policy on their own. Exploiting the latter in morally and constitutionally questionable ways may be good politics if your goal is to maintain or increase your power by appealing to certain voters, but it is bad politics if your goal is to enact well-vetted reforms that will endure.
You're way off, not only can most citizens not afford health insurance for themselves and their children at their present rates or without a huge deductible, many are either denied insurance for present conditions or are given rates way out of affordability for those conditions.
Providing Single Payer health care so all our citizens, including all our children, have sufficient health care isn't exploiting anything; it's being a civilized First World country that doesn't let its citizens die because of lack of money. It's a far better money spent than the trillions we spend on missiles, bombs, drones, and other weapons every year.
It's currently illegal to sell a policy that excludes for preexisting conditions. The fact that you admit the Affordable Care Act is unaffordable acknowledges it should be repealed.
I never said the ACA was unaffordable for all, but it will certainly be better than the GOP plan that just wants to really screw the Poor. But you and I know Single Payer/Medicare-for-All is the best approach anyway, since it will cover everybody and make it affordable for all. I'm glad we can admit that.
They can't exclude based on preexisting condition nor vary the rates based upon preexisting condition. The rates were to be kept under control in theory by mandating everyone buy insurance, including those with no preexisting condition. The system has failed because many refuse to purchase insurance despite the mandate and because of spiraling health care costs.
They absolutely can vary the rates, areas of coverage and deductible based on preexisting condition and they do.
The rates were not to be kept under control and weren't as the insurance companies never planned to not raise them and they did. And they certainly can and will under the GOP plan.
No, the system has failed because it's a bad, expensive system that still leaves many Americans uncovered. Medicare-for-All will fix that. Since you want all Americans covered, you must want that.
From the HHS website:
"Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.
These rules went into effect for plan years beginning on or after January 1, 2014."
https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html
This is the crux of the ACA.
Your understanding of the ACA is completely wrong.
Quoting Thanatos Sand
There is no GOP plan. It died in the Senate. The conversation is pointless because you have no idea what the ACA is.
And there is still a GOP plan to fight ACA. So, this conversation is pointless and over since you don't understand what the ACA is and how bad it is, and you failed to address Single Payer, the best option.
So, we're done and I won't be reading any more of your posts.