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Question for UHC supporters

XMan

Lifer
The systems as used in Canada, Britain, etc., eventually require rationing of care. Whether it be a 12+ month wait for knee surgery, or a waiting list for the removal of a tumor, turnaround is not nearly as quick as what is currently available to Americans today. There are enough published examples of those sort of things to eliminate any debate otherwise.

In the advent of a single-payer system, what means would be used to ensure that the timeliness of care is at least equal to what it is today? I understand that orthopedic surgeries are not considered "life threatening" and as such are generally subject to a wait - but in our current system there is no such wait. To me it's hard to justify a tax increase for health care (I currently pay ~1300 a year out of pocket for a PPO plan for a famly of three) if the level is not going to be at least consistent with what I can receive today.
 
http://www.prospect.org/csnc/b...me=american_wait_times

American Wait Times

Here's a fun puzzle. Fill in the blanks in the statement below:

In his talk, __________ conceded that "the ___ healthcare system is not timely." He cited "recent statistics from the Institution of Healthcare Improvement? that people are waiting an average of about 70 days to try to see a provider. And in many circumstances people initially diagnosed with cancer are waiting over a month."

If you said "Troy Brennan, CEO of Aetna," and "United States," you'd be right! If you said Canada, or Britain, you'd be wrong. The article goes on:

A Commonwealth Fund study of six highly industrialized countries, the U.S., and five nations with national health systems, Britain, Germany, Australia, New Zealand, and Canada, found waiting times were worse in the U.S. than in all the other countries except Canada. And, most of the Canadian data so widely reported by the U.S. media is out of date, and misleading, according to PNHP and CNA/NNOC.

In Canada, there are no waits for emergency surgeries, and the median time for non-emergency elective surgery has been dropping as a result of public pressure and increased funding so that it is now equal to or better than the U.S. in most areas, the organizations say. Statistics Canada's latest figures show that median wait times for elective surgery in Canada is now three weeks.

"There are significant differences between the U.S. and Canada, too," said Burger. "In Canada, no one is denied care because of cost, because their treatment or test was not 'pre-approved' or because they have a pre-existing condition."

A recent Business Week article arrived at similar conclusion:

Both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. Take Susan M., a 54-year-old human resources executive in New York City. She faithfully makes an appointment for a mammogram every April, knowing the wait will be at least six weeks. She went in for her routine screening at the end of May, then had another because the first wasn't clear. That second X-ray showed an abnormality, and the doctor wanted to perform a needle biopsy, an outpatient procedure. His first available date: mid-August.

The article continues on" "If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston, according to researchers at the University of California at San Francisco who studied the matter. Got a knee injury? A 2004 survey by medical recruitment firm Merritt, Hawkins & Associates found the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days."

One important note on our system's wait times is that, unlike in other countries, we don't collect the data. "There is no systemized collection of data on wait times in the U.S," says Business Week. "That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public." That's a side benefit of the universal systems, which due to their coherence and incentives, are actually quite transparent. That allows not only for an accurate assessment of the problems, but the effective deployment of resources to treat them.

And by the way, want to know which country has the lowest wait times in international comparisons? Hint: It's where sauerkraut comes from.
 
Also, keep in mind countries with socialized/single payer health care spend half as much as we do, so whatever you pay now, you would pay much less (via taxes).

So maybe to make sure there's no rationing, maybe keep the same amount of expenditure on healthcare, but switch over to the much more efficient single payer structure (and save a ton of overhead) and receive more/better/quicker healthcare.
 
Originally posted by: XMan
Ahh, but are they comparing apples to oranges? Wait time in ERs is one thing; I'm talking about critical care.

If my wife finds a lump in her breast, will she have to wait nearly a month to get treatment? Or two? Or three?

http://www.independent.co.uk/n...en-a-year-1084576.html

"And in many circumstances people initially diagnosed with cancer are waiting over a month." <--- from my article. This is the CEO of aetna talking about AMERICAN care
 
Xman: having lived in several countries with universal health care, I can assure you that you WILL experience long waits on anything but the most urgent of care, and you WILL end up paying more for it, and you WILL get lesser service from doctors since they will have less insentive to provide good service to their customers. I've experienced it.

No matter how you turn it, your costs will go up, and your level of service will go down, and you're going to see a whole new level of government bureacracy to run it all. That much is a given. The only people for whom this is going to be a good thing, is those who currently can not get health care. From their perspective, any lousy healthcare system is better than no healtcare. For the rest of the country, it's going to be a step backwards.
 
Originally posted by: Phokus
Also, keep in mind countries with socialized/single payer health care spend half as much as we do, so whatever you pay now, you would pay much less (via taxes).

So maybe to make sure there's no rationing, maybe keep the same amount of expenditure on healthcare, but switch over to the much more efficient single payer structure (and save a ton of overhead) and receive more/better/quicker healthcare.

This is neither Germany nor Switzerland. This is the same US that brought you Iraq and HIPPA. In theory government sponsored health is wonderful. In practice the US government fubars most things. I see no reason that if it can't get the easy things like wars and simple health regulations straight that it could take on health care and do it without dividing it up like some political carcass with the spoils going to the winner. Note that Obama didn't select a health care provider to help run health care. He hired two insurance insiders. Not promising.
 
My UHC solution: The government gives a tax credit which is equal to the lesser of (a) what you actually paid for your private insurance or (b) what it would cost to pay for a high-deductable premium at a private company for someone with your history of health issues. That is the total extent of government involvement. No meddling, no bureacracy.

In that solution, what ensures timely care? The fact that crappy insurance companies can have their customers leave for a better insurance company.
 
http://www.theglobeandmail.com...958-13/TPStory/Comment

Here's a more recent Canadian article, Phokus.

PokerGuy, in your experience, was there an availability of "doc-in-the-box" type operations, IE, PromptMed, in those nations? When I was single and younger PromptMed was a good, cost effective place to go as an alternative to the ER. I think they go unmentioned far too much as they can fill a niche in health care for those who don't have a lot of disposable income or insurance. I'm curious as to what would happen to private health care providers under such a system. Doctors need to make a living as much as anyone else, and if they're limited to Medicare/Medicaid rates by UHC I can see a lot of them retiring or moving on.
 
Originally posted by: PokerGuy
Xman: having lived in several countries with universal health care, I can assure you that you WILL experience long waits on anything but the most urgent of care, and you WILL end up paying more for it, and you WILL get lesser service from doctors since they will have less insentive to provide good service to their customers. I've experienced it.

No matter how you turn it, your costs will go up, and your level of service will go down, and you're going to see a whole new level of government bureacracy to run it all. That much is a given. The only people for whom this is going to be a good thing, is those who currently can not get health care. From their perspective, any lousy healthcare system is better than no healtcare. For the rest of the country, it's going to be a step backwards.

Well that's a whole lot of people.

And that doesn't even count the people that have minimal health care coverage (you have "insurance" but you wind up paying a fortune for it).
 
Originally posted by: PokerGuy
Xman: having lived in several countries with universal health care, I can assure you that you WILL experience long waits on anything but the most urgent of care, and you WILL end up paying more for it, and you WILL get lesser service from doctors since they will have less insentive to provide good service to their customers. I've experienced it.

No matter how you turn it, your costs will go up, and your level of service will go down, and you're going to see a whole new level of government bureacracy to run it all. That much is a given. The only people for whom this is going to be a good thing, is those who currently can not get health care. From their perspective, any lousy healthcare system is better than no healtcare. For the rest of the country, it's going to be a step backwards.

Your post directly contradicts empirical, proven reality. Costs in all UHC countries are vastly lower per capita than in America. As I have said many many times, America already has UHC, it just the worst imaginable kind.
 
Originally posted by: XMan
The systems as used in Canada, Britain, etc., eventually require rationing of care. Whether it be a 12+ month wait for knee surgery, or a waiting list for the removal of a tumor, turnaround is not nearly as quick as what is currently available to Americans today. There are enough published examples of those sort of things to eliminate any debate otherwise.

In the advent of a single-payer system, what means would be used to ensure that the timeliness of care is at least equal to what it is today? I understand that orthopedic surgeries are not considered "life threatening" and as such are generally subject to a wait - but in our current system there is no such wait. To me it's hard to justify a tax increase for health care (I currently pay ~1300 a year out of pocket for a PPO plan for a famly of three) if the level is not going to be at least consistent with what I can receive today.

Do this for us, please. Call your HR and ask them what your Cobra payment would be if you got laid off for that PPO for family of 3.
That way we'll know what the actual cost of your plan is instead of this B.S. $1300 number, and it's probably closer to $10K per year.
Plus if you think people in US never have to wait for insurance approval of procedure, or have insurance reject it, etc, then you got your blinders on nice and tight.
 
Originally posted by: senseamp
Originally posted by: XMan
The systems as used in Canada, Britain, etc., eventually require rationing of care. Whether it be a 12+ month wait for knee surgery, or a waiting list for the removal of a tumor, turnaround is not nearly as quick as what is currently available to Americans today. There are enough published examples of those sort of things to eliminate any debate otherwise.

In the advent of a single-payer system, what means would be used to ensure that the timeliness of care is at least equal to what it is today? I understand that orthopedic surgeries are not considered "life threatening" and as such are generally subject to a wait - but in our current system there is no such wait. To me it's hard to justify a tax increase for health care (I currently pay ~1300 a year out of pocket for a PPO plan for a famly of three) if the level is not going to be at least consistent with what I can receive today.

Do this for us, please. Call your HR and ask them what your Cobra payment would be if you got laid off for that PPO for family of 3.
That way we'll know what the actual cost of your plan is instead of this B.S. $1300 number, and it's probably closer to $10K per year.
Plus if you think people in US never have to wait for insurance approval of procedure, or have insurance reject it, etc, then you got your blinders on nice and tight.

What also interesting is that people claim that they only pay X amount for insurance each year from their employer. They don't seem to realize that the cost to their employer is much higher, and those dollars are coming out of money they could be paying you.
 
Originally posted by: Hayabusa Rider
Originally posted by: Phokus
Also, keep in mind countries with socialized/single payer health care spend half as much as we do, so whatever you pay now, you would pay much less (via taxes).

So maybe to make sure there's no rationing, maybe keep the same amount of expenditure on healthcare, but switch over to the much more efficient single payer structure (and save a ton of overhead) and receive more/better/quicker healthcare.

This is neither Germany nor Switzerland. This is the same US that brought you Iraq and HIPPA. In theory government sponsored health is wonderful. In practice the US government fubars most things. I see no reason that if it can't get the easy things like wars and simple health regulations straight that it could take on health care and do it without dividing it up like some political carcass with the spoils going to the winner. Note that Obama didn't select a health care provider to help run health care. He hired two insurance insiders. Not promising.

Well maybe we can send all republicans to re-education camps like all those glenn beck followers fear so we can get closer to germany or switzerland 😛

 
Originally posted by: senseamp
Originally posted by: XMan
The systems as used in Canada, Britain, etc., eventually require rationing of care. Whether it be a 12+ month wait for knee surgery, or a waiting list for the removal of a tumor, turnaround is not nearly as quick as what is currently available to Americans today. There are enough published examples of those sort of things to eliminate any debate otherwise.

In the advent of a single-payer system, what means would be used to ensure that the timeliness of care is at least equal to what it is today? I understand that orthopedic surgeries are not considered "life threatening" and as such are generally subject to a wait - but in our current system there is no such wait. To me it's hard to justify a tax increase for health care (I currently pay ~1300 a year out of pocket for a PPO plan for a famly of three) if the level is not going to be at least consistent with what I can receive today.

Do this for us, please. Call your HR and ask them what your Cobra payment would be if you got laid off for that PPO for family of 3.
That way we'll know what the actual cost of your plan is instead of this B.S. $1300 number, and it's probably closer to $10K per year.
Plus if you think people in US never have to wait for insurance approval of procedure, or have insurance reject it, etc, then you got your blinders on nice and tight.

He will be surprised. My family plan costs about $13,000 per year with referrals required, $40 co-pays and 15/25/40 drug benefit.


 
All health care systems require rationing of care, so using that as an argument against UHC is just silly. You know how we ration care right now? By not offering any to 50 million people.

As for the cancer thing, it took me about a month to begin receiving treatment after the tumor was discovered. That's fairly typical. Not all cancers require immediate care, it depends on the type. Leukemia for example requires almost an immediate intervention.
 
Originally posted by: GroundedSailor
Originally posted by: senseamp
Originally posted by: XMan
The systems as used in Canada, Britain, etc., eventually require rationing of care. Whether it be a 12+ month wait for knee surgery, or a waiting list for the removal of a tumor, turnaround is not nearly as quick as what is currently available to Americans today. There are enough published examples of those sort of things to eliminate any debate otherwise.

In the advent of a single-payer system, what means would be used to ensure that the timeliness of care is at least equal to what it is today? I understand that orthopedic surgeries are not considered "life threatening" and as such are generally subject to a wait - but in our current system there is no such wait. To me it's hard to justify a tax increase for health care (I currently pay ~1300 a year out of pocket for a PPO plan for a famly of three) if the level is not going to be at least consistent with what I can receive today.

Do this for us, please. Call your HR and ask them what your Cobra payment would be if you got laid off for that PPO for family of 3.
That way we'll know what the actual cost of your plan is instead of this B.S. $1300 number, and it's probably closer to $10K per year.
Plus if you think people in US never have to wait for insurance approval of procedure, or have insurance reject it, etc, then you got your blinders on nice and tight.

He will be surprised. My family plan costs about $13,000 per year with referrals required, $40 co-pays and 15/25/40 drug benefit.

Well, duh. I realize that.

FYI my company contributes about $6,500 a year per my "total compensation" statement. If you think they'd give me that as a raise, or if any company would, if the government took over, I've got a bridge to sell you.
 
Originally posted by: XMan
The systems as used in Canada, Britain, etc., eventually require rationing of care. Whether it be a 12+ month wait for knee surgery, or a waiting list for the removal of a tumor, turnaround is not nearly as quick as what is currently available to Americans today. There are enough published examples of those sort of things to eliminate any debate otherwise.

In the advent of a single-payer system, what means would be used to ensure that the timeliness of care is at least equal to what it is today? I understand that orthopedic surgeries are not considered "life threatening" and as such are generally subject to a wait - but in our current system there is no such wait. To me it's hard to justify a tax increase for health care (I currently pay ~1300 a year out of pocket for a PPO plan for a famly of three) if the level is not going to be at least consistent with what I can receive today.

It's not matter of months, it's a matter of hours if it's acute, if it isn't, you'll have to wait in line.

You can still pay for medical care in ALL of the nations you mentiioned.
 
The fact is that the medical industry, as a percentage of GDP, has to shrink. The well insured get some of the best care in the world, because we pay through the nose for it. I am perfectly willing to deal with some wait times, particularly for non time critical care, if it means that costs are lowered, and access is expanded to everyone. Also, the days of medical specialists raking in millions a year need to end.
 
Originally posted by: XMan
Originally posted by: GroundedSailor
Originally posted by: senseamp
Originally posted by: XMan
The systems as used in Canada, Britain, etc., eventually require rationing of care. Whether it be a 12+ month wait for knee surgery, or a waiting list for the removal of a tumor, turnaround is not nearly as quick as what is currently available to Americans today. There are enough published examples of those sort of things to eliminate any debate otherwise.

In the advent of a single-payer system, what means would be used to ensure that the timeliness of care is at least equal to what it is today? I understand that orthopedic surgeries are not considered "life threatening" and as such are generally subject to a wait - but in our current system there is no such wait. To me it's hard to justify a tax increase for health care (I currently pay ~1300 a year out of pocket for a PPO plan for a famly of three) if the level is not going to be at least consistent with what I can receive today.

Do this for us, please. Call your HR and ask them what your Cobra payment would be if you got laid off for that PPO for family of 3.
That way we'll know what the actual cost of your plan is instead of this B.S. $1300 number, and it's probably closer to $10K per year.
Plus if you think people in US never have to wait for insurance approval of procedure, or have insurance reject it, etc, then you got your blinders on nice and tight.

He will be surprised. My family plan costs about $13,000 per year with referrals required, $40 co-pays and 15/25/40 drug benefit.

Well, duh. I realize that.

FYI my company contributes about $6,500 a year per my "total compensation" statement. If you think they'd give me that as a raise, or if any company would, if the government took over, I've got a bridge to sell you.

They probably wouldn't give you a raise, but I could see them giving a raise to employees they want to retain.
Guess what, their competitors are also going to have more money left to spend chasing top talent, so if they don't get with the program, they will lose good employees to companies who do. Again, it may not apply to you, I don't know. Maybe you are barely pulling your own weight.
 
Originally posted by: senseamp
Originally posted by: XMan
Originally posted by: GroundedSailor
Originally posted by: senseamp
Originally posted by: XMan
The systems as used in Canada, Britain, etc., eventually require rationing of care. Whether it be a 12+ month wait for knee surgery, or a waiting list for the removal of a tumor, turnaround is not nearly as quick as what is currently available to Americans today. There are enough published examples of those sort of things to eliminate any debate otherwise.

In the advent of a single-payer system, what means would be used to ensure that the timeliness of care is at least equal to what it is today? I understand that orthopedic surgeries are not considered "life threatening" and as such are generally subject to a wait - but in our current system there is no such wait. To me it's hard to justify a tax increase for health care (I currently pay ~1300 a year out of pocket for a PPO plan for a famly of three) if the level is not going to be at least consistent with what I can receive today.

Do this for us, please. Call your HR and ask them what your Cobra payment would be if you got laid off for that PPO for family of 3.
That way we'll know what the actual cost of your plan is instead of this B.S. $1300 number, and it's probably closer to $10K per year.
Plus if you think people in US never have to wait for insurance approval of procedure, or have insurance reject it, etc, then you got your blinders on nice and tight.

He will be surprised. My family plan costs about $13,000 per year with referrals required, $40 co-pays and 15/25/40 drug benefit.

Well, duh. I realize that.

FYI my company contributes about $6,500 a year per my "total compensation" statement. If you think they'd give me that as a raise, or if any company would, if the government took over, I've got a bridge to sell you.

They probably wouldn't give you a raise, but I could see them giving a raise to employees they want to retain.
Guess what, their competitors are also going to have more money left to spend chasing top talent, so if they don't get with the program, they will lose good employees to companies who do. Again, it may not apply to you, I don't know. Maybe you are barely pulling your own weight.

Classy.

Thanks for sticking to pertinent facts in this debate.
 
Originally posted by: dullard
My UHC solution: The government gives a tax credit which is equal to the lesser of (a) what you actually paid for your private insurance or (b) what it would cost to pay for a high-deductable premium at a private company for someone with your history of health issues. That is the total extent of government involvement. No meddling, no bureacracy.

In that solution, what ensures timely care? The fact that crappy insurance companies can have their customers leave for a better insurance company.

That seems like a pretty decent plan to me. Retains a competitive, free market, while substantially reducing costs to the tax player in the form of subsidies/tax credits. It also lets the insurance companies and care providers deal with all the overhead. Get rid of all pre-existing condition policies, by law, and I'd call it a winner.

Seems like it would also be the easiest to implement in to our current structure.
 
Originally posted by: Mxylplyx
The fact is that the medical industry, as a percentage of GDP, has to shrink. The well insured get some of the best care in the world, because we pay through the nose for it. I am perfectly willing to deal with some wait times, particularly for non time critical care, if it means that costs are lowered, and access is expanded to everyone. Also, the days of medical specialists raking in millions a year need to end.

I agree in general principle with everything you stated save for the highlighted portion. It's difficult and time consuming to become, say, a neurosurgeon. One's compensation is linked to both the difficulty of the job and the number of people who are capable of doing that job. I see absolutely nothing wrong with a specialist in a given field (whether it be medicine, science, whatever) being paid a salary commensurate with their skills.

If it was easy to do brain surgery then, yeah, they'd only make 100K a year because a large number of doctors would be capable of doing it.

As far as reducing costs, where does personal resonsibility for one's wellness come into play? That's one thing I've not seen discussed in any single payer plan. If I drink a case of beer a day and need a liver transplant at 40, can I reasonably expect that my fellow citizens should have to share the financial burden of that cost? I think if the load on the system could be reduced of the people crowding ER's for the sniffles, costs as a whole would come down.

And while it may be impolitic to say it, the use of the ER by the illegal alien population is a contributing factor to overall medical expenses. Dozens of emergency rooms in California closed simply because they were costing the hospitals too much money in unpaid bills.
 
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