The biggest problem with a nationalized healthcare system

[soccerballtux]

just posted this in my thread in Off Topic about things America does better, but then figured it might make for a good thread on its own in P&N.

The short of the matter is it doesn't encourage/reward research. If the US's healthcare system functioned like GB's NHS, then much less money would be spent on research. The money goes to treating known problems, and nothing more.

I was talking to a guy on Britrail the other day who was telling me how about now they're beginning to see a compromise in treatment, where EVERYONE is getting what is cheapest and best for the PEOPLE as a whole for the problem at hand; but people are not getting the individual treatment that they specifically need, because there are not enough of those people to justify paying research in that area to treat them in the special way they need care.

For example, a cure for AIDS might never be developed under the GB heathcare system, because not enough people have it to justify the government spending money on a cure. America's system, however, would basically pay for the treatment if it were available, no matter the cost. So with a cure on the horizon, SOMEONE would pony up the venture capital for the cure to be developed, because our privatized healthcare could and would pay for that AIDS cure, almost no matter what the cost; this entices the venture capitalist because he know if the cure can be developed, then he will get his money back for sure. So GB's populace's health in general, as far as advancement goes, is at the mercy and ability of our own industry. In the long run, theirs, and ours, will suffer stagnation in development of new cures if we move to a nationalized healthcare system.

So basically if it weren't for our healthcare system, where money can be made hand over fist for cures for even a small portion of the population (like AIDS), GB wouldn't have any technology to buy to help treat their citizens, because they wouldn't have developed it in the first place. That fate awaits us, too, if we move to a NHS under Obama; and we would have to resign to trusting medical developments to some other nation. Rest assured that other nation would not have the resources we have to throw at the problem.

Thoughts?

 

[StageLeft]

There are probably numbers support/refuting your stance either way. I think that the socialized system in England is awful. Apparently it's better than Canada's, but my preference is to keep things closer to how they are in the US now than going to either of those inferior systems. All they are, essentially, is further forced redistribution of wealth since a vast number of those currently uninsured could, in fact, be insured if they had their priorities properly setup.

 

[soccerballtux]

Another interesting point this guy on Britrail made was that England was very lucky to institute it when they did, right after WWII. At the time, there was a lot of concern about the country getting back on it's feet after the war, and the struggles some families would face in the process. Struggles that might cause a sizable section of the populace to forgo healthcare insurance (did they have that back then?), which, if something then happened to them, would have devastated them. So the time and situation was ripe for change.

But to try to change from our current system, to an NHS, would not only be ridiculously difficult, it would create needless inefficiency.

 

[sandorski]

Medical Research is going on everywhere. Latest Medical breakthrough news

 

[soccerballtux]

Originally posted by: sandorski
Medical Research is going on everywhere. Latest Medical breakthrough news

Ugh. Not saying it isn't. I'm saying initial funding is thanks to our system.

 

[GTKeeper]

I dont think national health care is an either or proposition. I don't think flipping the system on its head is a good idea either. But to answer your competition/innovation question, we should look at Switzerland.


Switzerland is the only country who recently went from a US like system to a partially nationalized one. What they found out in terms of innovation and competion is this:

Companies compete more than ever, they compete for market share and to not go out of business.

They spend a lot of money on new products/innovative procedures to increase their market share of treated patients, to increase revenues, to make more money.

The idea that any government involvement will kill all competition is dumb. I think total govt involvement is bad. I think in the coming years we will have a few choices. Either a) give people basic preventative care (somehow) b) keep things the same. Since overall health in America is deteriorating in terms of obesity, heart desease, diabetes I don't know if society would be willing to let fat people die because they are fat. I personnally think its a fast person's fault that they are fat and they have no argument whats so ever of why they are short of breath, their chest hurts, or they have to take insulin because all they eat is fast food and 10 liters of cola every day. Sadly though expenses are only going to go up for all of us, we either have to find out how to prevent this, or be ready to pay a lot more.

 

[DealMonkey]

We already have a nationalized healthcare system. It's called Medicare.

Here's a thought - what if we simply expanded Medicare to cover the uninsured? While I have no idea of the expense involved in expanding Medicare this way, perhaps it could be offset by allowing Medicare to collectively bargain for reduced pharmacutical prices? Obviously Medicare isn't going to be the best coverage, however it's more of a safety net than anything. Anyone who can afford to self-insure or who receives coverage at work, would still do so. I can't see how such a plan would impinge on medical research.

 

[sandorski]

Originally posted by: soccerballtux

Originally posted by: sandorski
Medical Research is going on everywhere. Latest Medical breakthrough news

Ugh. Not saying it isn't. I'm saying initial funding is thanks to our system.

Got any hard data that backs that up?

 

[rudder]

Originally posted by: DealMonkey
We already have a nationalized healthcare system. It's called Medicare.

Here's a thought - what if we simply expanded Medicare to cover the uninsured? While I have no idea of the expense involved in expanding Medicare this way, perhaps it could be offset by allowing Medicare to collectively bargain for reduced pharmacutical prices? Obviously Medicare isn't going to be the best coverage, however it's more of a safety net than anything. Anyone who can afford to self-insure or who receives coverage at work, would still do so. I can't see how such a plan would impinge on medical research.

Some state have tried this. In Tennessee where I live we have Tenncare. It is supposed to be for people who are denied insurance or could not afford it. Turns out quite a few people who could get insurance through their work were getting Tenncare, as well as people living in neighboring state. The ones who could get it legitimately for financial reasons were using the system to avoid buying over the counter medicines themselves by visiting emergency rooms at great cost. So what if that $3 bottle of Tylenol cost the taxpayers $150... it was FREE!!! The average Tenncare user had 2-3X the number of prescriptions as the average person with regular insurance.

Eventually it was set to consume a large portion of the State budget so things like patient copays where considered along with other cost saving measures. Of course with entitlements when you try to reduce them you get flack. The State had to fight many a lawsuit before eventually getting a large number of people kicked off Tenncare to save money without making any other changes.

I would rather the U.S. Government not offer something like that to everyone. They tend to be a bit slow in responding to fraud... even with the medicare system they have now.

 

[thegpfury]

Originally posted by: Skoorb
There are probably numbers support/refuting your stance either way. I think that the socialized system in England is awful. Apparently it's better than Canada's, but my preference is to keep things closer to how they are in the US now than going to either of those inferior systems. All they are, essentially, is further forced redistribution of wealth since a vast number of those currently uninsured could, in fact, be insured if they had their priorities properly setup.

Yeah, you're right about that. I have a few friends who are "uninsured" and talk about how much they "hate" it, but they turned down the offer to get basic insurance through their jobs because they didn't want to lose $15-20 off their paycheck each week. Instead, they use that money to get games for their xbox. Go figure...

 

[zephyrprime]

soccerballtux, I thought along the same lines as you a long time ago. We in the US basically carry a greater burden of the share of R&D for other countries because we're willing to spend so much more on health care. We also don't get very good results overall though because of our spotty coverage.

 

[soccerballtux]

Originally posted by: zephyrprime
soccerballtux, I thought along the same lines as you a long time ago. We in the US basically carry a greater burden of the share of R&D for other countries because we're willing to spend so much more on health care. We also don't get very good results overall though because of our spotty coverage.

Hm, a long time ago...do you mean that you have moved on?

 

[bamacre]

Originally posted by: DealMonkey
Here's a thought - what if we simply expanded Medicare to cover the uninsured?

Want to rethink that?

 

[WHAMPOM]

Originally posted by: soccerballtux
just posted this in my thread in Off Topic about things America does better, but then figured it might make for a good thread on its own in P&N.

The short of the matter is it doesn't encourage/reward research. If the US's healthcare system functioned like GB's NHS, then much less money would be spent on research. The money goes to treating known problems, and nothing more.

I was talking to a guy on Britrail the other day who was telling me how about now they're beginning to see a compromise in treatment, where EVERYONE is getting what is cheapest and best for the PEOPLE as a whole for the problem at hand; but people are not getting the individual treatment that they specifically need, because there are not enough of those people to justify paying research in that area to treat them in the special way they need care.

For example, a cure for AIDS might never be developed under the GB heathcare system, because not enough people have it to justify the government spending money on a cure. America's system, however, would basically pay for the treatment if it were available, no matter the cost. So with a cure on the horizon, SOMEONE would pony up the venture capital for the cure to be developed, because our privatized healthcare could and would pay for that AIDS cure, almost no matter what the cost; this entices the venture capitalist because he know if the cure can be developed, then he will get his money back for sure. So GB's populace's health in general, as far as advancement goes, is at the mercy and ability of our own industry. In the long run, theirs, and ours, will suffer stagnation in development of new cures if we move to a nationalized healthcare system.

So basically if it weren't for our healthcare system, where money can be made hand over fist for cures for even a small portion of the population (like AIDS), GB wouldn't have any technology to buy to help treat their citizens, because they wouldn't have developed it in the first place. That fate awaits us, too, if we move to a NHS under Obama; and we would have to resign to trusting medical developments to some other nation. Rest assured that other nation would not have the resources we have to throw at the problem.

Thoughts?

With Federal funding almost 50% of all medical research and non-profit/public another +30%, just what the hell are you talking about? Besides the made up deseases of reflux, restless legs, or limp dick that have an advertising 100 times the drug research. Just what would we lose?

 

[emfiend]

Originally posted by: soccerballtux
just posted this in my thread in Off Topic about things America does better, but then figured it might make for a good thread on its own in P&N.

The short of the matter is it doesn't encourage/reward research. If the US's healthcare system functioned like GB's NHS, then much less money would be spent on research. The money goes to treating known problems, and nothing more.

I was talking to a guy on Britrail the other day who was telling me how about now they're beginning to see a compromise in treatment, where EVERYONE is getting what is cheapest and best for the PEOPLE as a whole for the problem at hand; but people are not getting the individual treatment that they specifically need, because there are not enough of those people to justify paying research in that area to treat them in the special way they need care.

For example, a cure for AIDS might never be developed under the GB heathcare system, because not enough people have it to justify the government spending money on a cure. America's system, however, would basically pay for the treatment if it were available, no matter the cost. So with a cure on the horizon, SOMEONE would pony up the venture capital for the cure to be developed, because our privatized healthcare could and would pay for that AIDS cure, almost no matter what the cost; this entices the venture capitalist because he know if the cure can be developed, then he will get his money back for sure. So GB's populace's health in general, as far as advancement goes, is at the mercy and ability of our own industry. In the long run, theirs, and ours, will suffer stagnation in development of new cures if we move to a nationalized healthcare system.

So basically if it weren't for our healthcare system, where money can be made hand over fist for cures for even a small portion of the population (like AIDS), GB wouldn't have any technology to buy to help treat their citizens, because they wouldn't have developed it in the first place. That fate awaits us, too, if we move to a NHS under Obama; and we would have to resign to trusting medical developments to some other nation. Rest assured that other nation would not have the resources we have to throw at the problem.

Thoughts?

So I think you're saying that average Joe pays for medical care, gets treatment, that money goes to R&D and the whole system continually improves. In effect, I think you're attempting to connect the "healthcare system" to "medical R&D".

This is incorrect. Privatized healthcare does not mean better or worse R&D. There's no explicit relationship.

Most medical R&D is covered by Federal programs and have nothing to do with our modern healthcare system. The money spent on healthcare goes straight into the pockets of clinical practitioners (minus taxes paid by them, malpractice insurance, etc... but this would be the focus of an entirely different debate).

I think you're trying to talk about Intellectual Property and the rights of private drug firms to patent drug designs and have exclusive production/sales rights by which they can charge what they want to who they want.

The term "healthcare system" doesnt appear to belong...

 

[frostedflakes]

Originally posted by: rudder

Originally posted by: DealMonkey
We already have a nationalized healthcare system. It's called Medicare.

Here's a thought - what if we simply expanded Medicare to cover the uninsured? While I have no idea of the expense involved in expanding Medicare this way, perhaps it could be offset by allowing Medicare to collectively bargain for reduced pharmacutical prices? Obviously Medicare isn't going to be the best coverage, however it's more of a safety net than anything. Anyone who can afford to self-insure or who receives coverage at work, would still do so. I can't see how such a plan would impinge on medical research.

Some state have tried this. In Tennessee where I live we have Tenncare. It is supposed to be for people who are denied insurance or could not afford it. Turns out quite a few people who could get insurance through their work were getting Tenncare, as well as people living in neighboring state. The ones who could get it legitimately for financial reasons were using the system to avoid buying over the counter medicines themselves by visiting emergency rooms at great cost. So what if that $3 bottle of Tylenol cost the taxpayers $150... it was FREE!!! The average Tenncare user had 2-3X the number of prescriptions as the average person with regular insurance.

Eventually it was set to consume a large portion of the State budget so things like patient copays where considered along with other cost saving measures. Of course with entitlements when you try to reduce them you get flack. The State had to fight many a lawsuit before eventually getting a large number of people kicked off Tenncare to save money without making any other changes.

I would rather the U.S. Government not offer something like that to everyone. They tend to be a bit slow in responding to fraud... even with the medicare system they have now.

What we need is to patch all the loopholes. I see no reason why Medicaid shouldn't be able to cover low (and to some extent, maybe even medium) income families if we streamline the system. The first step would be to increase physician compensation so they are actually willing to take on Medicare/Medicaid patients and these people don't have to go to the ER just to get care. Would reduce burdens on the ER, and would probably end up saving money considering how expensive ER visits are.

 

[soccerballtux]

Originally posted by: frostedflakes

Originally posted by: rudder

Originally posted by: DealMonkey
We already have a nationalized healthcare system. It's called Medicare.

Here's a thought - what if we simply expanded Medicare to cover the uninsured? While I have no idea of the expense involved in expanding Medicare this way, perhaps it could be offset by allowing Medicare to collectively bargain for reduced pharmacutical prices? Obviously Medicare isn't going to be the best coverage, however it's more of a safety net than anything. Anyone who can afford to self-insure or who receives coverage at work, would still do so. I can't see how such a plan would impinge on medical research.

Some state have tried this. In Tennessee where I live we have Tenncare. It is supposed to be for people who are denied insurance or could not afford it. Turns out quite a few people who could get insurance through their work were getting Tenncare, as well as people living in neighboring state. The ones who could get it legitimately for financial reasons were using the system to avoid buying over the counter medicines themselves by visiting emergency rooms at great cost. So what if that $3 bottle of Tylenol cost the taxpayers $150... it was FREE!!! The average Tenncare user had 2-3X the number of prescriptions as the average person with regular insurance.

Eventually it was set to consume a large portion of the State budget so things like patient copays where considered along with other cost saving measures. Of course with entitlements when you try to reduce them you get flack. The State had to fight many a lawsuit before eventually getting a large number of people kicked off Tenncare to save money without making any other changes.

I would rather the U.S. Government not offer something like that to everyone. They tend to be a bit slow in responding to fraud... even with the medicare system they have now.

What we need is to patch all the loopholes. I see no reason why Medicaid shouldn't be able to cover low (and to some extent, maybe even medium) income families if we streamline the system. The first step would be to increase physician compensation so they are actually willing to take on Medicare/Medicaid patients and these people don't have to go to the ER just to get care. Would reduce burdens on the ER, and would probably end up saving money considering how expensive ER visits are.

if you take care of all the needs of a low income family, what incentive do they have to stop being low income? Some people need a kick in the ass to get going, and a wad of $100's down the road isn't enough for them.
For these people, we have
a). Starvation
b). The fear of death because you can't afford healthcare

Why would you take away their drive to survive by providing them healthcare?

 

[fskimospy]

Originally posted by: soccerballtux

if you take care of all the needs of a low income family, what incentive do they have to stop being low income? Some people need a kick in the ass to get going, and a wad of $100's down the road isn't enough for them.
For these people, we have
a). Starvation
b). The fear of death because you can't afford healthcare

Why would you take away their drive to survive by providing them healthcare?

First of all poverty isn't based around people being lazy. (at least not to a significant extent) There are zillions of reasons why people are poor. That is unless you think that all of Africa is lazy or something.

Your idea of what would motivate people not to be poor anymore strikes me as a ridiculous caricature. You sound to me as if you are very young. Why do middle class people try and earn more money? They aren't at risk of starvation or fearing death because they can't afford healthcare. There would still be plenty of incentives for people to 'get going'.

We are going to pay for people's healthcare one way or the other because we are human beings. We're not going to adopt a nationwide policy that leaves people to die in the street as a matter of course, because that would make us animals. So the question becomes what the best way is to provide this care to everyone... and our current system is atrocious at it. It is probably the least efficient system on the entire planet.

 

[GroundedSailor]

Originally posted by: rudder

Originally posted by: DealMonkey
We already have a nationalized healthcare system. It's called Medicare.

Here's a thought - what if we simply expanded Medicare to cover the uninsured? While I have no idea of the expense involved in expanding Medicare this way, perhaps it could be offset by allowing Medicare to collectively bargain for reduced pharmacutical prices? Obviously Medicare isn't going to be the best coverage, however it's more of a safety net than anything. Anyone who can afford to self-insure or who receives coverage at work, would still do so. I can't see how such a plan would impinge on medical research.

Some state have tried this. In Tennessee where I live we have Tenncare. It is supposed to be for people who are denied insurance or could not afford it. Turns out quite a few people who could get insurance through their work were getting Tenncare, as well as people living in neighboring state. The ones who could get it legitimately for financial reasons were using the system to avoid buying over the counter medicines themselves by visiting emergency rooms at great cost. So what if that $3 bottle of Tylenol cost the taxpayers $150... it was FREE!!! The average Tenncare user had 2-3X the number of prescriptions as the average person with regular insurance.

Eventually it was set to consume a large portion of the State budget so things like patient copays where considered along with other cost saving measures. Of course with entitlements when you try to reduce them you get flack. The State had to fight many a lawsuit before eventually getting a large number of people kicked off Tenncare to save money without making any other changes.

I would rather the U.S. Government not offer something like that to everyone. They tend to be a bit slow in responding to fraud... even with the medicare system they have now.

The problem with plans like Tenncare is that it is selective, so there is incentive to game the system as your examples point out. If it covered everyone then everyone has to pay his/her share of the premiums and it would eliminate the downside that states like Tennessee face when they try to increase health care coverage.