Universal Healthcare. Good Idea or Commie Plot?

[griff61]

Actually, unless they're stupid - and most wouldn't be....they are millionaires.  Average annual salary for a family medicine doctor is close to $200k.  Specialists make almost twice that on average.  Of course that doesn't include perks, bonuses, investment income, or tax minimalization techniques...

or overhead, or malpractice insurance etc, etc. Most doctors are more like a small business.
I wouldn't say that they're not comfortable, just not millionaires.
an example would be pediatricians http://wiki.answers.com/Q/How_much_money_does_a_pediatrician_earn the actual annual salary is closer to $100k

The other point I would make is that the AMA is pretty much in favor of Universal Healthcare, so I don't think the doctors would mind a vote on the issue. Big pharma and insurance, on the other hand, would spend until the end of time to prevent it.

[Duckbutta]

Let me see if I have this correct. You want the same type of government bureaucrats that brought you the I.R.S. (federal) and the D.M.V. (state) to provide your health care?

The Senate can't even run it's own cafeteria efficiently. I strongly urge you to read this link to see how truly inept these people are.

_{http://startthinkingright.wordpress.com/2008/06/11/senate-cafeteria-democrat-incompetence-in-microcosm/}

These are the people you entrust to formulate a well run health care system? Puleeze!

[_Adam_]

For those of you advocating socialized health care, how would you prevent the problem of the commons.   Specifically, how would you handle free riders?

[jimmyc]

Let me see if I have this correct. You want the same type of government bureaucrats that brought you the I.R.S. (federal) and the D.M.V. (state) to provide your health care?

The Senate can't even run it's own cafeteria efficiently. I strongly urge you to read this link to see how truly inept these people are.

_{http://startthinkingright.wordpress.com/2008/06/11/senate-cafeteria-democrat-incompetence-in-microcosm/}

These are the people you entrust to formulate a well run health care system? Puleeze!

says the guy who has professed to "eating at the Gov trough til death"

[griff61]

For those of you advocating socialized health care, how would you prevent the problem of the commons.   Specifically, how would you handle free riders?

I think you'll need to give a little more explanation of what you mean.
In the present system there are more people costing us poor slobs who pay premiums millions. In a single payer system those same people could go to a regular PCP type doctor and get preventative treatment or get their sniffles taken care of instead of clogging up emergency wards.

[_Adam_]

For those of you advocating socialized health care, how would you prevent the problem of the commons.    Specifically, how would you handle free riders?

I think you'll need to give a little more explanation of what you mean. 
In the present system there are more people costing us poor slobs who pay premiums millions.  In a single payer system those same people could go to a regular PCP type doctor and get preventative treatment or get their sniffles taken care of instead of clogging up emergency wards.

the problem of the commons is a classic example when goods, services, or privileges are offered at zero price.   (remember that zero price is different that zero cost).   For instance, If a field held in common (government land available to the public) can support the grazing of 100 sheep.   Assume 10 farmers each have ten sheep and a properly grazed sheep can yield $100 at the market.   Each farmer is given free and unfettered access to the field so that they can graze the sheep at will.   If everyone behaves as they should, each farmer will have 10 well grazed sheep that fetch $100 each for a grand total of $1000 for each farmer.   This would be a perfect system, one that we would all want as it provides the best end for everyone.

Now imaging that one of the farmers of a less than ethical nature decides to graze eleven sheep instead of 10 but the field can only support 100, not 101 so the quality of each sheep is degraded due to less than optimal grazing to support that 101st sheep.  Since each sheep is now receiving 99% of what it should and as a result, the sheep only fetches $99.   Now the honest farmer receives $990 for his ten sheep while the less than ethical farmer receives $1089 for his eleven sheep.   He wins while the other nine honest folk lose.

We've seen this phenomenon throughout history and we witness it today in the form of welfare scams, social security scams, and any other construct that offers a good or service for zero price despite its large cost.   It happens most often when finite goods and services are offered at free or little price to almost an infinite consumer.

So my question remains, how do we keep people who intentionally want to cheat or abuse the system from degrading a socialized medical system?

[griff61]

So my question remains, how do we keep people who intentionally want to cheat or abuse the system from degrading a socialized medical system?

Again, what system are you talking about?
The Canadian single payer system replaces the insurance providers, not the service providers. In it's present form there is no reason to game the system any more than there is anywhere else. The cow example, while entertaining, is not appropriate when applied to medical care. Unless you're talking about physician or provider fraud, which occurs in all systems in virtually every business, service and country on the planet. Controls are fairly simple to implement and penalties are very severe for fraud.

Medical care isn't free under the single payer system any more than Medicare or Medicaid is free under ours. Just a lot cheaper to the consumer. The single payer system is funded by replacing the premium system with something more along the lines of tax. Until the recent recession, the Canadian system has not bankrupted the country, more often  there is a budget surplus.

That there might be scams  is simply not a valid reason to do nothing, otherwise we should simply stop everything, particularly the internet. It's like scam central.
It is simply an excuse to stand still.

[Bryan]

Universal Goverment Health Care will be the end of liberty.
The payer will dictate the behaviour  of the subjects by threatening to withhold payment for people that don't tow the line living within the guidelines they prescribe.  Things that will cause problems, smoking, drinking, eating meat, owning guns. 
Other behaviour that is risky such as some activities associated with homosexuality on the other hand will be celebrated. 
Then the pendulem swings back and it reverses.
Living your life based on other people paying for it is a sure way to serfdom.

[griff61]

Universal Goverment Health Care will be the end of liberty.
The payer will dictate the behaviour  of the subjects by threatening to withhold payment for people that don't tow the line living within the guidelines they prescribe.  Things that will cause problems, smoking, drinking, eating meat, owning guns. 
Other behaviour that is risky such as some activities associated with homosexuality on the other hand will be celebrated. 
Then the pendulem swings back and it reverses.
Living your life based on other people paying for it is a sure way to serfdom.

What do you base that on besides a hunch? Canada has had single payer for decades and no such thing has occurred.
It has happened in the United States on a fairly large scale though, try getting private insurance with a pre-existing condition. Or is that ok, because it's just business?

As far as gun ownership goes, there's that 2nd amendment Constitution thing, so I'm not too worried about that.

Absolute Monarchies/Oligarchies are the way to serfdom.

[_Adam_]

Again, what system are you talking about? 

I am talking about your proposed system of socialized health care.   How do you propose keeping free riders from using the system that they are not paying for?

Again, what system are you talking about? The Canadian single payer system replaces the insurance providers, not the service providers.   

Which, on paper is FANTASTIC!  The problem remains that you have a horde of users obtaining a service that is very finite.  And the more people that use that system, the less of it remains for when you actually need it.   You can see evidence of this in the wait times that Canadians experience when awaiting hip replacements. 

The cow example, while entertaining, is not appropriate when applied to medical care.   

The Sheep example is quite applicable.   According to wikipedia, a problem of the commons exists when free access and unrestricted demand for a finite resource ultimately dooms the resource through over-exploitation.

If free loaders are clogging and abusing the system (the farmer with 11 sheep), then less of that finite and expensive resource is available to the people who have actually paid for it.

As reported in December 2003 by Kerri Houston in her story titled Access Denied: Canada's Healthcare System Turns Patients into Victims, "...in some instances, patients die on the waiting list because they become too sick to tolerate a procedure. "

According to the Fraser Institute, US patients have greater access to advanced medical technology than do canadians.   They site that per 1 million people: the US has 3. 7 open heart surgery centers while Canada as 1. 6.   The US has 6. 1 MRI units while Canada has 1. 8.   The US has 15. 3 CT scanning centers while Canada has 8.

This alone should be evidence that the free and unfettered access impacts everyone's ability to access the resource (health care).

Controls are fairly simple to implement and penalties are very severe for fraud.   

If controls are fairly simple to implement and penalties are very severe for fraud, why is medicare defrauded of over 20 BILLION DOLLARS annually?

I offer this as proof that EFFECTIVE controls are not fairly simple to implement as you have suggested.   I do agree that the penalties for fraud are high.

Medical care isn't free under the single payer system any more than Medicare or Medicaid is free under ours.  Just a lot cheaper to the consumer.  The single payer system is funded by replacing the premium system with something more along the lines of tax.  Until the recent recession, the Canadian system has not bankrupted the country, more often  there is a budget surplus. 

I am not using cost and price interchangeably and neither should you.   Cost refers to how much something cost to produce the service, while price is the fee charged to purchase a good or service.   Many people assume that cost and price are one and the same and when presented with something that is of zero price assume that it is of zero cost when nothing could be further from the truth.

If I have a headache, I go to the store and buy some ibuprofen - because I am normal like that.   There are those that choose to go to the emergency room to get ibuprofen and those are the people who will continue to abuse the system because the "price" is free.   Since they do not directly see the "cost" they think it is free.  The problem is that people think that having the government pay for it will make it cost nothing to the individual which is flat out wrong.   This is why insurance premiums continue to rise - people continue to use their coverage until it is no longer to provide that service and the insurance providers have to raise the premiums.

I have a deductable on my insurance and I avoid seeing the doctor until absolutely necessary because I don't want to pay the deductable.   Once that deductable is paid, I am going to see the doctor for everything that I feel I need to since the out of pocket per visit is negligible.   How do you think that is going to change once I no longer have to pay the deductable first?

That there might be scams  is simply not a valid reason to do nothing, otherwise we should simply stop everything, particularly the internet.  It's like scam central.
It is simply an excuse to stand still.

Who said we were doing nothing.   Change is not necessarily a good thing.   I have fantastic medical coverage available to me, as does everyone else in the US, and some of our visitors from the south.  There are people that would argue that we have the best health care in the world.   Lets not confuse health care with health care insurance, they are NOT one and the same. . .


I have even included some sources just for your reading pleasure.

Houston, Kerri.  Access Denied: Canada's Healthcare System Turns Patients into Victims.  Frontiers of Freedom Institute.  December, 2003. 
http://www.capmag.com/article.asp?ID=4271

Opensecrets. org.  Pharmaceuticals/Health Products:Long-Term Contribution Trends.  5 Dec 2006. 
http://www.opensecrets.org/industries/indus.asp?Ind=H04

"Tragedy of the commons. " Wikipedia, The Free Encyclopedia.  2 Dec 2006, 22:48 UTC.  Wikimedia Foundation, Inc.  5 Dec 2006
http://en.wikipedia.org/w/index.php?title=Tragedy_of_the_commons&oldid=91671044

Williams, Walter.  Why Canadians Purchase Private Health Insurance.  Capitalism Magazine.  June 20, 2005. 
http://www.capmag.com/article.asp?ID=4271

[Winterfire2008]

Dang Griff you beat me to it. 

"In 2008, the U. S. Supreme Court, in District of Columbia vs. Heller, struck down a Washington, D.C. ban on individuals having handguns in their homes.  Writing for a 5 to 4 majority, Justice Scalia found the right to bear arms to be an individual right consistent with the overriding purpose of the 2nd Amendment, to maintain strong state militias.  Scalia wrote that it was essential that the operative clause be consistent with the prefatory clause, but that the prefatory clause did not limit the operative clause.  The Court easily found the D. C. law to violate the 2nd Amendment's command, but refused to announce a standard of review to apply in future challenges to gun regulations.  The Court did say that its decision should not "cast doubt" on laws restricting gun ownership of felons or the mentally ill, and that bands on especially dangerous or unusual weapons would most likely also be upheld.  In the 2008 presidential campaign, both major candidates said that they approved of the Court's decision."

Is it an infringement to allow a felon to keep and bear arms?  Is it an infringement to allow the mentally ill to keep and bear arms?  Is an infringement to ban the ownership of grenade launchers to the civilian population? I would hope we all know the answer to that.  Since the Supreme Court has refused to announce a standard of review this for this particular amendment it will continue to come before the Supreme Court for clarification.  Meantime those states that allow concealed weapons will continue to do so.  So if you are in Texas and exhibit road rage beware of the person in the next car.  He/She just might pull their weapon in self defense!!!!!

As to health care.  Be glad that there are doctors out there that will treat people regardless of  situation.

[griff61]

etc etc

There is not free or unfettered access to health care in Canada.

Health care and population are both limited quantities, no matter what system you use. I invite you to provide evidence of a fraud free, abuse free system in place anywhere in the United States as comparison.
Given that your examples are usually cases of patients being turned away, or on waiting lists or dying from waiting to long for a hip replacement, I don't see how that lines up with your argument that there would be overuse and abuse of the system.
Which is it? They would use up the health system for fun or they can't get service because it's to tightly controlled?

Canadians are free to purchase additional insurance above & beyond what the government system provides, the Canadian Supreme Courst said so. Just like Medicare users can, and do in the US.

What Medicare fraud has to do with the Canadian system I'm not sure, but I'll play
$3.5 billion costs to private US insurers for pharmacy fraud http://www.aishealth.com/Bnow/hbd040809.html
$3 million from a single doctor http://articles.lancasteronline.com/local/4/235785

Could you find a couple like that in Canada for me?

As for confusing health care with health care insurance, I'm thinking you might be doing that. The fact is, if we eliminated the health insurance middle-men we could put a lot of money back into regular people's pockets and cover everyone for less than we do now.
The Canadian system isn't about nationalizing the providers. That's why your analogy doesn't work. Other than the fact that Canada has made it work for the majority for decades, there's the other thing that providers still control the distribution. The reason people go to the emergency room here is because they don't have insurance. So it is, in fact, free to them, the insurance companies simply pass the cost along to the rest of us.

I pretty much grew up in Montreal and I never had a problem getting care. Nor did my family or my thousands of loony french Canadian relatives. Do people fall though the cracks, certainly, just as they do here. It would be interesting if you could find a single bit of evidence of a failure that ACTUALLY occurs in the Canadian system that never happens in the present, commercial US insurance system .

[_Adam_]

Canadians are free to purchase additional insurance above & beyond what the government system provides, the Canadian Supreme Courst said so.  Just like Medicare users can, and do in the US.

If the Canadian system was superior to the privatized approach here in the US as you are portraying it to be, why would any Canadian waste money purchasing additional service.   Why would additional insurance be needed in the first place?  And why would Canadians be flocking to the US to get medical services that they were deemed to old, too sick, or otherwise ineligible to receive in Canada?

In reality, the only difference between the US an Canada is that the US discriminates on price and Canada discriminates on a host of other factors.

[griff61]

Canadians are free to purchase additional insurance above & beyond what the government system provides, the Canadian Supreme Courst said so.  Just like Medicare users can, and do in the US.

If the Canadian system was superior to the privatized approach here in the US as you are portraying it to be, why would any Canadian waste money purchasing additional service.   Why would additional insurance be needed in the first place?  And why would Canadians be flocking to the US to get medical services that they were deemed to old, too sick, or otherwise ineligible to receive in Canada?

In reality, the only difference between the US an Canada is that the US discriminates on price and Canada discriminates on a host of other factors.

Again, you are confusing insurance with service. Many of the Canadians who come stateside are doing so on the Canadian system's dime and as a percentage of the total, they are a minute percentage. Unlike people who die in the US because they can't get treatment of any kind because there's no profit in it.
http://www.lasvegasnow.com/Global/story.asp?S=10138898

Private insurance, in most cases, covers things like prescription drugs and/or dental.

Also, as I've repeated, over and over, Canada spends $3400 per capita to cover everyone with excellent health care while the US spends $6700 to cover 70% of the people.
You can get the greatest health care in the world in the US, but only if you have very, very deep pockets.
It's a lovely thing, on paper, to say we have 'the best' health care, until you see who can actually afford it.

Please define the factors that Canada discriminates on? Is price really the superior choice?

[Winterfire2008]

Well if Canadian citizens are coming to the US for medical treatment, why are US citizens going to Canada to fill drug prescriptions?  Seems to me no one is perfect.