Actually, Romneycare has increased patient wait times to 1.5 months.

[Bateluer]

Damn those poor people for taking up doctor's appointments. Clearly, something needs to be done or non-urgent medical visits for the rich won't be handled urgently. The horror!

Wow, you're an idiot.

 

[theeedude]

I'm sorry for your loss, but...

Typical rightwinger response on health care.

 

[ShawnD1]

Their system protects the health of their population to generally the same extent as ours does, for about 40% less money. Socialized medicine wins.... again. (and again, and again, and again.) It has nothing to do with ideology, it has to do with reality.

Both systems are horribly broken and people in USA and Canada are retarded.

USA is plagued with insurance companies, lawyers, paperwork, red tape, more forms to fill out, and other crap that adds cost while providing no real care. People who write Free Market with capital letters in the middle of a sentence think this added bullshit is somehow efficient. I can't understand how that could possibly be efficient. Last time I was admitted to a Canadian hospital, they didn't even ask my name. No paperwork, no insurance, no lawyers. I was in trouble, they kept me until I was stable, then I went home. Simple, efficient, no bullshit.

Canada has major problems with funding. Nobody wants to increase the amount of funding going into healthcare (conservatives just won a majority a couple weeks ago), but at the same time people are up in arms against allowing the Free Market to fill the gap because that would mean rich people get preferred treatment. Well wtf? So you don't want the government to pay for it and you don't want to pay for it out of your own pocket. How are we supposed to pay for this? God damn people are fucking retarded. Doctors and nurses actually get paid for their time. I don't know if Canadians know this but it's a fact. I dated a nurse and her apartment was nicer than mine so I'm pretty sure they were paying her money to do her job.



Solution that fixes both private and public healthcare: reduce the number of retards in charge of policy.

 

[Hayabusa Rider]

Typical rightwinger response on health care.

Typical pro Orwellian retort. I do like people who have goals. Your choice of saying six impossibly stupid things before breakfast is a most interesting one.

 

[PokerGuy]

2.: Canada spends approximately 10% of its GDP on health care. The US spends about 15% of its GDP on health care. We spend 150% of what they do, and our outcomes are between equivalent and worse.

I keep seeing that tripe over and over and over, you just keep ignoring the obvious. You can measure the medical outcome of something like a heart attack, but how exactly do you measure the fact that on average someone in Canada has to wait 4 months to get "elective" surgery on their knee, something that might greatly affect their mobility and quality of life? How do you measure the stress you might have not knowing if something serious is going on for months before you can see the specialist, versus the stress of possibly going bankrupt because of medical costs (as is the case in the US)? Lot of factors that are not considered.

The medical outcome might ultimately be the same, but your quality of life and how quickly you got resolution to something that affects you are NOT the same.

Their system protects the health of their population to generally the same extent as ours does, for about 40% less money.

No, it doesn't. You're also making a giant leap of an assumption that "their" system could be applied the same way to another society, which may or may not be true. Taking cost vs medical outcome as the end all be all measure it stupid.

Socialized medicine wins.... again. (and again, and again, and again.)

No, it doesn't, and doesn't and doesn't and doesn't and never will.

 

[matt0611]

While the health care debate is a very complicated one, if you need to break it down into two things it should be this:
1.: http://www.openmedicine.ca/article/view/8/1 This study compared health outcomes in the US and Canada. It generally found the differences in outcomes to be small, with the overall edge to Canada by a small amount. Most of the areas they studied did not have significant differences between the two. (If you don't like this study, there are plenty more that have broadly similar conclusions)

2.: Canada spends approximately 10% of its GDP on health care. The US spends about 15% of its GDP on health care. We spend 150% of what they do, and our outcomes are between equivalent and worse.

Their system protects the health of their population to generally the same extent as ours does, for about 40% less money. Socialized medicine wins.... again. (and again, and again, and again.) It has nothing to do with ideology, it has to do with reality.

Aren't we in the US are lot less healthier and fatter in general then the Canadians? Granted, I'm sure we aren't 50% unhealthier but still, its not a complete apples to apples comparison.

 

[ShawnD1]

Aren't we in the US are lot less healthier and fatter in general then the Canadians? Granted, I'm sure we aren't 50% unhealthier but still, its not a complete apples to apples comparison.

It's not too different. Roughly 1/4 of Canadians are classified as obese.

In terms of percentage, Canada has 10x as many Asian people. Statistical mystery solved

 

[PokerGuy]

its not a complete apples to apples comparison.

Of course it's not an apples to apples comparison because the countries are different in many ways. Demographics, legal system, insurance system, culturally. The comparison of cost to medical outcome (apart from the problems I already identified earlier) is also stupid because it assumes one could achieve the same results if one transplants a "system" from one society to another.

 

[ShawnD1]

is also stupid because it assumes one could achieve the same results if one transplants a "system" from one society to another.

Why not? Lots of the socialist countries have similar healthcare systems and they achieve similar results. For example, almost every one of them has problems with waiting lists. Same system in different country --> same result in different country.

 

[fskimospy]

Aren't we in the US are lot less healthier and fatter in general then the Canadians? Granted, I'm sure we aren't 50% unhealthier but still, its not a complete apples to apples comparison.

These studies specifically try to compare health outcomes after people interact with the health care system in an attempt to mitigate those sorts of concerns. ie: your chances of surviving brain cancer aren't that heavily related to if you're fat or not. (I made that example up, they might be... but you get my point)

Even when you control for lifestyle statistically though, there's really no doubt that these systems are vastly more efficient than ours.

 

[fskimospy]

I keep seeing that tripe over and over and over, you just keep ignoring the obvious. You can measure the medical outcome of something like a heart attack, but how exactly do you measure the fact that on average someone in Canada has to wait 4 months to get "elective" surgery on their knee, something that might greatly affect their mobility and quality of life? How do you measure the stress you might have not knowing if something serious is going on for months before you can see the specialist, versus the stress of possibly going bankrupt because of medical costs (as is the case in the US)? Lot of factors that are not considered.

The medical outcome might ultimately be the same, but your quality of life and how quickly you got resolution to something that affects you are NOT the same.



No, it doesn't. You're also making a giant leap of an assumption that "their" system could be applied the same way to another society, which may or may not be true. Taking cost vs medical outcome as the end all be all measure it stupid.



No, it doesn't, and doesn't and doesn't and doesn't and never will.

A pretty typical appeal for someone who can't actually back up their argument with facts. You're basically saying that because there are certain aspects of health care systems that are difficult to empirically measure that we can't draw any conclusions from the huge parts of the medical system that we CAN empirically measure.

It's nothing more than an act of desperation to cling to ideological mythology. Admit it, if the results were turned around and these numbers applied to a private system you would be singing its praises.

There's a reason why every other industrialized nation on earth has at least some form of a socialized system.

 

[Fern]

Originally Posted by PokerGuy
is also stupid because it assumes one could achieve the same results if one transplants a "system" from one society to another.

Why not? Lots of the socialist countries have similar healthcare systems and they achieve similar results. For example, almost every one of them has problems with waiting lists. Same system in different country --> same result in different country.

Shawn, you just answered your own question.

If you transplant a system from one society to another, and those two societies are similar (socialist countries) THEN you CAN expect similar results.

However, if the transfer is between two dis-similar societies results are unlikely to be similar.

Fern

 

[fskimospy]

Shawn, you just answered your own question.

If you transplant a system from one society to another, and those two societies are similar (socialist countries) THEN you CAN expect similar results.

However, if the transfer is between two dis-similar societies results are unlikely to be the same.

Fern

Can you explain what differences you believe exist between America and say... Germany that will prevent us from implementing a German style health care system here?

 

[Fern]

Can you explain what differences you believe exist between America and say... Germany that will prevent us from implementing a German style health care system here?

Here's an article that touches on the primary difference I'm concerned with:
http://www.tampabay.com/news/article1021977.ece

For neurosurgeons in Miami, the annual cost of medical malpractice insurance is astronomical — $237,000, far more than the median price of a house.

In Toronto, a neurosurgeon pays about $29,200 for coverage. It's even less in Montreal ($20,600) and Vancouver ($10,650).

The costs are strikingly different, largely because of the ways in which Canada insures doctors and protects those who are sued:

Notice this:

But malpractice lawsuits account for less than 1 percent of the U.S. health care tab. The same is true in Canada.

Lets look at the math (a bit of a simplistic calc to demonstrate the principal). If in Canada your insurance is $20K you must charge fees of $2 million for it to be only 1%

If in the USA your insurance is $237K you must charge about $24 million for it to be at 1%

Is it really any wonder that our system is so much more expensive without being any superior? Our physicians are not gonna 'eat' the cost difference; they are gonna jack prices to keep malpractice in line with everybodies elses' at 1%.

IMO, that's a systemic difference that results in substantial cost inflation in the USA.

Thens there's this:

While malpractice litigation accounts for only about 0.6 percent of U.S. health care costs, the fear of being sued causes U.S. doctors to order more tests than their Canadian counterparts.

Everything I've seen about this indicates we have serious problems driving up costs substantially because we have many physicians who, for a number of reasons including defensive medicine, order up any number of extra tests and procedures unlike in other countries with socialized medicine.

Another systemic difference.

The New England Journal of Medicine ran a study comparing treatment of practically identical patients (ages, condition etc) with identical diseases yet the costs of care varied by hundreds of thousands of $'s. There was no medical explanation for difference. We lack standards of care giving our physicians great leeway in care and they may allow/order all kinds of unnecessary care because they wanna keep their patient happy, or they wanna make more money or they want to practice defensive medicine. A systemic difference.

So, I firmly believe if we were to carry over a socialized medicine program, where everyone gets the medical care they seek, and drop it into our system we'd see just more costs increases. We'd just have even more people demanding more tests and procedures and nothing restaining physicians from complying. Why not? The US gov is gonna pay.

----------------------------

Lately I've been wondering if going to socialized medicine wouldn't be a way to force the necessary reforms on the medical industry. For if we go to socialized medicine here we will not be able to bear the costs under our current structure, something's going to have to give.

There's no good reason we can't have those reforms under our current system. I firmly believe if we did our costs would be similar to those of socialized medicine. But our system of government will not allow it.

BTW: Isn't this thread supposed to be about Mass HC?

Fern

 

[ShawnD1]

Lately I've been wondering if going to socialized medicine wouldn't be a way to force the necessary reforms on the medical industry.

I would suspect not since people don't seem to care enough to fix the problems right now even though bad rules or no rules directly affect the cost of health insurance for everyone.

high insurance rates in private system --> people don't care
high tax rates in public system --> people probably won't care

 

[fskimospy]

Here's an article that touches on the primary difference I'm concerned with:
http://www.tampabay.com/news/article1021977.ece



Notice this:



Lets look at the math (a bit of a simplistic calc to demonstrate the principal). If in Canada your insurance is $20K you must charge fees of $2 million for it to be only 1%

If in the USA your insurance is $237K you must charge about $24 million for it to be at 1%

Is it really any wonder that our system is so much more expensive without being any superior? Our physicians are not gonna 'eat' the cost difference; they are gonna jack prices to keep malpractice in line with everybodies elses' at 1%.

IMO, that's a systemic difference that results in substantial cost inflation in the USA.

Thens there's this:



Everything I've seen about this indicates we have serious problems driving up costs substantially because we have many physicians who, for a number of reasons including defensive medicine, order up any number of extra tests and procedures unlike in other countries with socialized medicine.

Another systemic difference.

The New England Journal of Medicine ran a study comparing treatment of practically identical patients (ages, condition etc) with identical diseases yet the costs of care varied by hundreds of thousands of $'s. There was no medical explanation for difference. We lack standards of care giving our physicians great leeway in care and they may allow/order all kinds of unnecessary care because they wanna keep their patient happy, or they wanna make more money or they want to practice defensive medicine. A systemic difference.

So, I firmly believe if we were to carry over a socialized medicine program, where everyone gets the medical care they seek, and drop it into our system we'd see just more costs increases. We'd just have even more people demanding more tests and procedures and nothing restaining physicians from complying. Why not? The US gov is gonna pay.

----------------------------

Lately I've been wondering if going to socialized medicine wouldn't be a way to force the necessary reforms on the medical industry. For if we go to socialized medicine here we will not be able to bear the costs under our current structure, something's going to have to give.

There's no good reason we can't have those reforms under our current system. I firmly believe if we did our costs would be similar to those of socialized medicine. But our system of government will not allow it.

BTW: Isn't this thread supposed to be about Mass HC?

Fern

Oh jesus. Not the tort reform argument again. Did you even read your article? In both the US and Canada tort costs are less than 1% of total health care costs. That means as a component of the health care system, the costs from litigation are roughly equivalent. Even if you take the extremely optimistic (or pessimistic) numbers for defensive medicine cited in the article, it comes nowhere even remotely close to covering the massive disparity in costs between the two countries.

Also, one of the ways in which Canada achieved this lower premium cost is through a socialized insurance program for all doctors, and something tells me that if we tried to implement that here, it would be derided by many people (you included) as a government takeover of insurance. (it's also pretty odd that you recommend a system of socializing insurance to avoid socializing medicine)

If you want a more recent and more comprehensive study on it, the Harvard School of Public Health published a study in Health Affairs that concluded the total cost from malpractice, defensive medicine included, was about 2.4% of our spending. ie: tort reform will do very little to improve our cost/benefit outlay. It's an extreme right wing talking point that's been debunked over and over and over again.

Everyone please repeat after me: Legal costs and defensive medicine cannot come even remotely close to explaining our disparity in health care costs. http://content.healthaffairs.org/content/29/9/1569.abstract

Similarly, it is bizarre that you seem to think that the government would suddenly start paying for every test someone wanted no matter the cost. Medicare doesn't do that now, so why would they start? Simply put, your numbers don't add up. They don't even come close to adding up. In the wildest dreams of those attacking patient's legal rights they don't account for anywhere close to a 50% difference.

 

[GodlessAstronomer]

I know from personal experience with a close family friend from NZ who was in Canada that he ended up having to wait 6 weeks before they could even see him to evaluate the cancer

Bullshit.

 

[Fern]

Oh jesus. Not the tort reform argument again. Did you even read your article?
-snip-

Did you even read my post?

Apparently not given the rest of what you wrote in your post.

Fern

 

[fskimospy]

Did you even read my post?

Apparently not given the rest of what you wrote in your post.

Fern

I most certainly did, your post was just terrible. If your post isn't attempting to say that we have higher costs because of our tort system, (which again, is a hilariously bad argument for the cost disparity) you have failed at communicating in the English language.

 

[werepossum]

Did you even read my post?

Apparently not given the rest of what you wrote in your post.

Fern

He can't help himself. Government health care coupled with retaining our current jury-based malpractice system = easy eternal election funding for Democrats, and all progressives must go aflutter at any hint of reining in the lawyers even if it means gaining socialized medicine. It's a Pavlovian response.

 

[Fern]

I most certainly did, your post was just terrible. If your post isn't attempting to say that we have higher costs because of our tort system, (which again, is a hilariously bad argument for the cost disparity) you have failed at communicating in the English language.

My post, which was in response to your's asking about systenmic difference, discusses several, well, systemic differences.

It obviously hit one of your liberal/progressive 'hot buttons' resulting in you having a major brain spasm and seeing only "tort reform" (a term I never mentioned, btw)

Fern

 

[fskimospy]

My post, which was in response to your's asking about systenmic difference, discusses several, well, systemic differences.

It obviously hit one of your liberal/progressive 'hot buttons' resulting in you having a major brain spasm and seeing only "tort reform" (a term I never mentioned, btw)

Fern

The systemic difference being our malpractice and tort system, and using it to explain higher costs. The excuse that you never said 'tort reform' is pathetic. It's like saying "I'm not calling your mother a whore, I'm just saying she has sex for money". (I actually don't mean it in a way to be offensive, it was just the first example that came to mind). I have a 'brain spasm' when I see transparently stupid arguments parroted by people who should know better.

If you're not advocating tort reform, fine. Allow me to be clearer then. The systemic difference you described accounts for a negligible amount both in overall costs to our system, and as the percentage of our costs as compared to relative costs in the Canadian system. The information you linked is simply not a credible argument for a systemic difference that would prevent the adoption of a socialized system in the US.

So, please try again.

 

[Hayabusa Rider]

My post, which was in response to your's asking about systenmic difference, discusses several, well, systemic differences.

It obviously hit one of your liberal/progressive 'hot buttons' resulting in you having a major brain spasm and seeing only "tort reform" (a term I never mentioned, btw)

Fern

We don't have a systemic and detailed understanding of the state of healthcare in the US, don't know how to best improve things because we haven't defined things properly or asked those who know for ideas. We don't know how best to organize and empower providers. We haven't any notion as to best fund it. We are at the extreme left of the learning curve and apparently will fight to stay there. Stupid.

 

[Mr. Pedantic]

I haven't seen a specific breakdown for MA, but I know from personal experience with a close family friend from NZ who was in Canada that he ended up having to wait 6 weeks before they could even see him to evaluate the cancer. He came here to the US, paid his own way and according to his doctor had he waited 6 weeks he would have had a much smaller chance at successful recovery. He's in remission now.

If he had gone straight to a specialist for this, it is likely. If he had gone to a GP or ED initially, I call shens.

 

[shadow9d9]

You say the shortage is caused by the AMA, it's actually caused by systemic disincentives to becoming a GP. Why would you become a GP when you can make so much more money becoming some sort of specialist?

Simple logic dictates that you MUST address issues such as a supply-side shortage of doctors BEFORE you take actions that will dramatically increase demand, or you'll end up with a situation where demand far outstrips supply, with all the problems associated (bad care, lengthy delays, high costs).

Funny how the lefties rage on, but in this thread have actually admitted what they lied about when they were busy shoving the crappy health care bill down our collective throats: we will all be forced to accept longer delays, less access to doctors, higher overall costs, and a lower level of overall care in order to add coverage for a small group. That's the trade-off.

MA is a little microcosm of what we can expect for the US as a whole, whether anyone will admit it or not. Skyrocketing costs, long delays, less healthcare, crappy access to doctors, even longer ER wait times, that's what everyone is going to get.

"Shoving down our throats" is an almost verbatim talking point. 1 year of congressional debate following 100 years of previous failure is pretty much the longest a debate has ever run in congress.