Universal healthcare and national debt

[RightIsWrong]

I keep reading from posters here and from others everywhere I seem to turn that universal healthcare would be an albatross around the necks of the US taxpayers because of the cost of such a program but, for the life of me can't understand why that is.

Now, I understand the basic tenants that the cost of such a program has to be covered. That isn't what I am referring to. What I am referring to is the cost savings that would be realized should be more than great enough to offset the cost of implementation.

Here's a perfect example....

The United States places last among 19 countries when it comes to deaths that could have been prevented by access to timely and effective health care, according to new research supported by The Commonwealth Fund and published in the January/February issue of Health Affairs. While other nations dramatically improved these rates between 1997?98 and 2002?03, the U.S. improved only slightly.
If the U.S. had performed as well as the top three countries out of the19 industrialized countries in the study there would have been 101,000 fewer deaths in the U.S. per year by the end of the study period. The top performers were France, Japan, and Australia.


..............


?It is startling to see the U.S. falling even farther behind on this crucial indicator of health system performance,? said Commonwealth Fund Senior Vice President Cathy Schoen. ?By focusing on deaths amenable to health care, Nolte and McKee strip out factors such as population and lifestyle differences that are often cited in response to international comparisons showing the U.S. lagging in health outcomes. The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals, and efforts to improve health systems make a difference.?

In 1997?98 the U.S. ranked 15th out of 19 countries on the ?mortality amenable to health care? measure. However, by 2002?03 the U.S. fell to last place, with 109 deaths amenable to health care for every 100,000 people. In contrast, mortality rates per 100,000 people in the leading countries were: France (64), Japan (71), and Australia (71). The other countries included in the study were Austria, Canada, Denmark, Finland, Germany, Greece, Ireland, Italy, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden and the United Kingdom.

How much could be saved on the back end of the spectrum when care is the most costly if we provided everyone the ability to go to a doctor prior to conditions worsening? How much less are antibiotics and an office visit compared to chemo or surgeries to attempt to correct, control or slow down an issue that has already escalated to the point that there are no other options?

I believe that this is the most forgotten aspect in the debate about how much it would cost to implement a universal healthcare option. We, as a country spend more per capita on healthcare and yet have over a 1/4 of the population uninsured and on the brink of bankruptcy or the loss of their home if they get any kind of serious medical condition.

Take into consideration that:

Administrative costs are extraordinarily high and rising. The estimated health care expenditures spent on administration are a staggering 25 percent of hospital spending and are estimated to be over 30 percent of all health care spending.

Source

And you can see a major part of the problem. How much would those costs be reduced if the providers only had to learn a single processing system that was exactly the same for every single person that walked through the door?

I know that the major argument is going to be the implementation cost to put such a system in place and the slippery slope "pervasiveness of socialism" argument will come in a very close second.

But as in most cases in business, you have to spend money to make money. If such a system were implemented the upfront costs would be pretty staggering. However, I believe that the back end savings would be just as staggering. From processing, to end of life treatment costs, to lost time from work due to being able to treat a cold before it becomes pneumonia to the FHA/HUD costs when someone loses their home due to medical expenditures.

Your thoughts? And please, please, please....let's try to be as on topic and flame-free as possible cause I truly would like to find out what points that you believe I am right on and where other solutions might be better so that we can all benefit.

 

[Genx87]

The bottom line is the majority of people in this country have their healthcare paid for by their employers. The employer picks up them majority of the costs. When you move it to the govt the costs are shifted to the working person via income taxation. This means more taxes or running a national deficit to pay for it. The real winners are big business who just got the working man to pay for something these used to cover as a benefit.

And if you look at the true costs, it is generated at old ages. It doesnt matter how much pre emptive care people get. When you turn 80, you are 80, your body is going to fail. The majority of a persons healthcare costs are spent in the last 2 years of their life on avg. This is a symptom of being old. The other major issue is our obesity. Pre emptive care wont stop fatty mcgee from going down to McDonalds for his daily feeding at the fat stand.

Then you have the overall inefficiency of govt. They screw everything up because there is no consequence to their screwup. They simply tax some class to make up for their screwup. If they cant tax anybody they cut benefits. You ready to let granny keel over because the public coffers say no more? The idea the govt wont put restrictions on what is treatable is amusing. Even the govt will have a bound where they can go in terms of treatment. The kid with late stage cancer isnt going to get better treatment by the govt. The govt will probably write him off and send him home.

 

[ProfJohn]

Let me see if I rephrase what you are saying in simple terms?

Right now we spend $2 trillion a year to provide 75% of the nation with healthcare.

Under Universal Healthcare we could spend the same $2 trillion, but instead provide 100% of the nation with healthcare.

I that is right in simplistic terms.

It sounds like a great idea, but I just don?t think it will work that way.
Once we have ?free? healthcare millions of poor and uninsured people will flood doctors and hospitals looking for that ?free? care.

Also, the idea that people will use that ?free? preventive care to catch problems while they are cheaper is naïve at best. We know that smoking is bad for your health, yet millions of people still smoke. We know that being over weight is bad for your health, yet millions of people still over eat. I could continue such a list but let?s just say that wealthy educated people, those most likely to have insurance, spend a great deal of time and money trying to stay healthy. While the poor and uneducated seem to spend little time and effort staying healthy, despite the fact that they are the ones most likely to suffer when they do get ill.

 

[Mxylplyx]

I've always maintained that the U.S. has the best care available in the world...for those that are able to afford it. Our negative numbers are skewed by those who cannot afford healthcare, including illegal aliens. This is not an endorsement of that system, it's just what I believe to be the reality.

With that said, a debate about universal healthcare in this country needs to be based on the premise that we will be trading quality for availability. Any politician that sais that we will be able to extend the quality available to the well insured of this country to everyone else is full of shit. With that said, I would be willing to give up some of the quality that I enjoy so healthcare is universally available. The only problem I have is that the thought of our federal government managing it scares the hell out of me. Will the savings on the administrative side outweigh the bloat that comes with government management? Who knows.

 

[FoBoT]

govt. has never implemented anything with a result of "saving" money

a monopoly has no incentive to save money

 

[alchemize]

You bring up some interesting points. However, I can tell you from experience that the whole "processing system" is a lemon that has been heavily squeezed, there ain't much juice left in it. Claims submission and payments are processed pretty smoothly compared to about 15 years ago. Upwards of 85% of claims are paid "first pass", meaning no human ever touches it, and that number goes much higher when there are comprehensive network agreements. Administrative expenses are staggering because healthcare has become so incredibly complicated from a delivery perspective, not from a cash in/cash out perspective.

Preventative care will save some money also. But not much.

The big fruit is also the forbidden one. People who are chronically sick and dying. That's where the vast majority of healthcare expenses go.

 

[Mxylplyx]

Originally posted by: alchemize
You bring up some interesting points. However, I can tell you from experience that the whole "processing system" is a lemon that has been heavily squeezed, there ain't much juice left in it. Claims submission and payments are processed pretty smoothly compared to about 15 years ago. Upwards of 85% of claims are paid "first pass", meaning no human ever touches it, and that number goes much higher when there are comprehensive network agreements. Administrative expenses are staggering because healthcare has become so incredibly complicated from a delivery perspective, not from a cash in/cash out perspective.

Preventative care will save some money also. But not much.

The big fruit is also the forbidden one. People who are chronically sick and dying. That's where the vast majority of healthcare expenses go.

I agree. We are starting to bankrupt this country so we can allow people to cheat death for a few more months in their old age. Trying to extend the lives of our elderly by miniscule amounts probably kills untold numbers of younger people who cant afford insurance anymore due to those costs. This will never be brought up in the national arena, because anyone that attempts to discuss it will be labeled a monster.

 

[BoberFett]

RightIsWrong

Please list the federal departments and programs that work well in your opinion.

 

[bamacre]

Originally posted by: FoBoT
govt. has never implemented anything with a result of "saving" money

a monopoly has no incentive to save money

:thumbsup:

Originally posted by: BoberFett
RightIsWrong

Please list the federal departments and programs that work well in your opinion.

:thumbsup:

 

[RightIsWrong]

Very good points made so far for the "against".

I have to agree that the majority are paid for by their employer...at least partially paid. Take into consideration that most employers are shifting to an 80/20 type system where the employee is still having to contribute. Then you add into the equation deductibles and other "non-covered" items and you still have the individual paying a fair amount themselves.

Also, you have to take into consideration the rising costs associated with rapidly increasing rates of birth/childhood conditions. Autism (something very important to me having a son diagnosed with Asperger's Syndrome) has shot through the roof with the rate now 1 in 160 having some variation of the condition.

My wife's mother died at the age of 36 because of melanoma that would have been treatable if she had insurance that didn't drop her claiming that it was "pre-existing". Once they did, she couldn't afford to get it treated so that she would have been able to make some minor life adjustments instead of having it spread so rapidly it caused her death.

Just having insurance isn't always an indication that you will be able to get or afford the treatments that you need.

While old age is certainly a major factor in the costs, there are still a lot of lives and money that could have been saved if treatment were available.

As for the quality argument, I think that the rankings show quality in the US is not much dependent on the technological ability of the system but the ability to get that technology/advancements to those that are seeking it:

The World Health Organization has carried out the first ever analysis of the world's health systems. Using five performance indicators to measure health systems in 191 member states, it finds that France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan.

The findings are published today, 21 June, in The World Health Report 2000 ? Health systems: Improving performance*.

*Copies of the Report can be ordered from bookorders@who.ch.

The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18 th . Several small countries ? San Marino, Andorra, Malta and Singapore are rated close behind second- placed Italy.

I think that argument is like comparing a Ferrari to a Ford. Sure, everyone that owns a Ferrari will agree that it is the best....but how many people can actually afford to drive one let alone own one? Is knowing that the US has the most technologically advanced medical care doing a bit of good to the majority of the population?

In response to FoBoT: First off, the government is NOT a monopoly. The government is not out to turn a profit so that is a moot point. They have no incentive to raise the rates to bring in more revenue they only have incentive to keep costs down to save money.

I also find the "government can do no good or nothing right" argument to be specious at best. This country would not have been able to grow at the rate that it did if they government hadn't implemented a highway system. We would not have grown at the rate that we did if not for the PUC controlling costs of necessities until the country was at the point for utilities to go private. As with our health care system, it is the greed of the individual and/or corporation that has ALWAYS escalated costs to the government and NOT the other way around.

As someone once said (I'm paraphrasing): Those that believe that the government can do no good will not do good at governing.

 

[senseamp]

Why look at actual outcomes in countries that have universal healthcare when you can regurgitate the same rightwing talking points about big bad government?

 

[bamacre]

Originally posted by: senseamp
Why look at actual outcomes in countries that have universal healthcare when you can regurgitate the same rightwing talking points about big bad government?

http://forums.anandtech.com/me...=2140534&enterthread=y

You missed this thread. Obviously.

And, I have asked you five times now, why are Canadian drugs not allowed in the USA?

 

[RightIsWrong]

Originally posted by: bamacre

Originally posted by: senseamp
Why look at actual outcomes in countries that have universal healthcare when you can regurgitate the same rightwing talking points about big bad government?

http://forums.anandtech.com/me...=2140534&enterthread=y

You missed this thread. Obviously.

And, I have asked you five times now, why are Canadian drugs not allowed in the USA?

I can answer that question.

My father-in-law was a fellow on Senator Judd Gregg's health policy committee and helped draft the medicaid prescription drug plan.

The reason that Canadian drugs are not allowed in the US is because of the feeling that Canada's equivalent to the FDA does not require the same level of studies that the US FDA does and that they won't enforce US patent laws on big pharm's products so you get a lot of "copycat" type meds that will either not meet US guidelines or will infringe on existing US patents.

Basically...$$$$

 

[BoberFett]

Originally posted by: RightIsWrong
I also find the "government can do no good or nothing right" argument to be specious at best. This country would not have been able to grow at the rate that it did if they government hadn't implemented a highway system. We would not have grown at the rate that we did if not for the PUC controlling costs of necessities until the country was at the point for utilities to go private. As with our health care system, it is the greed of the individual and/or corporation that has ALWAYS escalated costs to the government and NOT the other way around.

PUCs are state run not federal. The federal government is too far removed from the people to be accountable. Just look at our current situation to find all the proof you need of that. Do you really want something as important as health care to be given to people 1000+ miles away who have historically proven they don't give a damn about anything more than their own personal power and profit?

You only look at the good government has done, and ignore the bad that happened to achieve that "good". You cite the interstate system, but have you every really looked at how that affected people? When the interstates were built through urban areas, thousands of people were thrown from their homes. Do you think they built through rich neighborhoods or poor? Who benefited from the interstates more, the rich or the poor? The problem with government programs is that they frequently steamroll right over those who are least able to fight back, and in the case of universal health care, those are the same people you're trying to help.

Finally, do you honestly believe greed is limited to the private sector? People are people, regardless of who they work for. Do you really think CEOs are that much different than members of Congress? The difference is that I have the choice not to do business with private companies. When it comes to government I am forced to do business with them under threat of violence.

 

[bamacre]

Originally posted by: RightIsWrong

Originally posted by: bamacre

Originally posted by: senseamp
Why look at actual outcomes in countries that have universal healthcare when you can regurgitate the same rightwing talking points about big bad government?

http://forums.anandtech.com/me...=2140534&enterthread=y

You missed this thread. Obviously.

And, I have asked you five times now, why are Canadian drugs not allowed in the USA?

I can answer that question.

My father-in-law was a fellow on Senator Judd Gregg's health policy committee and helped draft the medicaid prescription drug plan.

The reason that Canadian drugs are not allowed in the US is because of the feeling that Canada's equivalent to the FDA does not require the same level of studies that the US FDA does and that they won't enforce US patent laws on big pharm's products so you get a lot of "copycat" type meds that will either not meet US guidelines or will infringe on existing US patents.

Basically...$$$$

Sounds like this government policy helps keep USA drug prices high through a lack of competition.

 

[RightIsWrong]

Originally posted by: bamacre

Originally posted by: RightIsWrong

Originally posted by: bamacre

Originally posted by: senseamp
Why look at actual outcomes in countries that have universal healthcare when you can regurgitate the same rightwing talking points about big bad government?

http://forums.anandtech.com/me...=2140534&enterthread=y

You missed this thread. Obviously.

And, I have asked you five times now, why are Canadian drugs not allowed in the USA?

I can answer that question.

My father-in-law was a fellow on Senator Judd Gregg's health policy committee and helped draft the medicaid prescription drug plan.

The reason that Canadian drugs are not allowed in the US is because of the feeling that Canada's equivalent to the FDA does not require the same level of studies that the US FDA does and that they won't enforce US patent laws on big pharm's products so you get a lot of "copycat" type meds that will either not meet US guidelines or will infringe on existing US patents.

Basically...$$$$

Sounds like this government policy helps keep USA drug prices high through a lack of competition.

I'm not sure if you mean in the US or in Canada. If you mean the US, the lack of the similar Canadian policy definitely allows prices to remain high.

If you are referring to the prices of US drugs sold in Canada, you can't be further from the truth. The Canadian government has caps on the price that they will pay for drugs whether they come from the US or not. Those caps still allow the US companies to sell their product in Canada (and they do every single day) they just can't rake in as much of a profit from them.

 

[ProfJohn]

Originally posted by: bamacre

Originally posted by: senseamp
Why look at actual outcomes in countries that have universal healthcare when you can regurgitate the same rightwing talking points about big bad government?

http://forums.anandtech.com/me...=2140534&enterthread=y

You missed this thread. Obviously.

And, I have asked you five times now, why are Canadian drugs not allowed in the USA?

Why is it that people bitch bitch bitch about outsourcing of jobs and then turn around and complain that they can?t get their ?cheap? drugs from Canada?

 

[RightIsWrong]

Originally posted by: ProfJohn

Originally posted by: bamacre

Originally posted by: senseamp
Why look at actual outcomes in countries that have universal healthcare when you can regurgitate the same rightwing talking points about big bad government?

http://forums.anandtech.com/me...=2140534&enterthread=y

You missed this thread. Obviously.

And, I have asked you five times now, why are Canadian drugs not allowed in the USA?

Why is it that people bitch bitch bitch about outsourcing of jobs and then turn around and complain that they can?t get their ?cheap? drugs from Canada?

I understand that you are just replying to senseamp's flame with one of your own...but let's try to stay on topic with more than just jabs. I mean, I could always come back with something like:

Probably for the same reason that people that jump on their pedestal to proclaim from the mountaintops that "Capitalism is KING" get their panties in a bunch when someone wants to undercut a US company.

Maybe if the former (your scenario) didn't provide that causation (jobs outsourced and wages suppressed at home) the latter wouldn't be one of the effects?

But that wouldn't really be constructive to the topic at hand.

You have strong opinions which is fine and actually desired. I want to know what your solution to the problem would be.

What do you believe would be the most effective (cost, treatment quality and availability to the most people) solution to this elephant sitting on the chair behind you?

I think that universal healthcare is the solution for the above stated reasons.

Please feel free to share yours (both you ProfJohn and SenseAmp) in a more productive manner so that we can all benefit from the different viewpoints. Who knows, if we can get enough input here we might be able to come up with a proposed solution that incorporates the best of all worlds with the least cost to us all.

 

[bamacre]

Originally posted by: ProfJohn

Originally posted by: bamacre

Originally posted by: senseamp
Why look at actual outcomes in countries that have universal healthcare when you can regurgitate the same rightwing talking points about big bad government?

http://forums.anandtech.com/me...=2140534&enterthread=y

You missed this thread. Obviously.

And, I have asked you five times now, why are Canadian drugs not allowed in the USA?

Why is it that people bitch bitch bitch about outsourcing of jobs and then turn around and complain that they can?t get their ?cheap? drugs from Canada?

I am just trying to make a point, that government meddling with the free market is one reason why health care is expensive.

 

[Pabster]

Originally posted by: ProfJohn
Let me see if I rephrase what you are saying in simple terms?

Right now we spend $2 trillion a year to provide 75% of the nation with healthcare.

Under Universal Healthcare we could spend the same $2 trillion, but instead provide 100% of the nation with healthcare.

Which brings to light my central argument against a UHC system.

If you're spending the same amount of money, but now having to treat 25% more people, what do you think is gonna happen? Quality of care goes down the crapper right off the bat, and that's just for starters.

I do think some enormous cost savings could be realized by focusing on preventative care and healthy lifestyle doctrine. But the reality is, a UHC system of any flavor will only encourage people to skip both. Who cares, if it's "free"?

It's a terrific idea in theory. But I'm downright scared at the consequences.

 

[RightIsWrong]

That's a valid argument against Pabs,

I would counter with most things technological (with the obvious exception of automotive) becoming dramatically cheaper as they have become more widespread and readily available.

Computers? I bought a 486DX Packard Bell for over $2000 dollars a little over a decade ago. Today, a PC with 10x the CPU power and 10x the memory of that are 1/8th the cost.

TVs? I remember the first plasma that I saw in a Crazy Eddies was "Priced to sell" at $14000+. Today, that same sized plasma with 1080p can be had for less than a grand.

Also add in that those that want to have the best of the best of the best can still go to a private practice to receive treatment if they are willing to pay for that on their own (just as in every other UHC country.

One last thing on this topic (for now anyway)....how would you rate the quality of care for that 25% that don't have access to any care right now? What good is having the best system in the world and making it so that a growing number of people cannot afford to use it? Like the car analogy I posted previously.....we need to have public transportation available. If you believe that you are too good for it and want a Benz or Beamer.....that's your choice. But you have to pay for it.

 

[Pabster]

Originally posted by: RightIsWrong
One last thing on this topic (for now anyway)....how would you rate the quality of care for that 25% that don't have access to any care right now? What good is having the best system in the world and making it so that a growing number of people cannot afford to use it? Like the car analogy I posted previously.....we need to have public transportation available. If you believe that you are too good for it and want a Benz or Beamer.....that's your choice. But you have to pay for it.

There's no question there. The quality of care for 25% isn't much to speak of. But is it acceptable to degrade the quality of care for the majority in favor of something for the minority? I guess that's a fundamental philosophical question each has to answer.

I suspect few would rate their quality of care Benz or Beamer style, even amongst the 75% fortunate enough to be covered. But what if all of a sudden they're down to a Yugo? :laugh:

 

[RightIsWrong]

Originally posted by: Pabster

Originally posted by: RightIsWrong
One last thing on this topic (for now anyway)....how would you rate the quality of care for that 25% that don't have access to any care right now? What good is having the best system in the world and making it so that a growing number of people cannot afford to use it? Like the car analogy I posted previously.....we need to have public transportation available. If you believe that you are too good for it and want a Benz or Beamer.....that's your choice. But you have to pay for it.

There's no question there. The quality of care for 25% isn't much to speak of. But is it acceptable to degrade the quality of care for the majority in favor of something for the minority? I guess that's a fundamental philosophical question each has to answer.

I suspect few would rate their quality of care Benz or Beamer style, even amongst the 75% fortunate enough to be covered. But what if all of a sudden they're down to a Yugo? :laugh:

LOL.....the Yugo was able to get many a people from point A to point B that wouldn't otherwise been able to get there.

As I have posted previously, I'm pretty solidly on the conservative side WRT to fiscal policy and pretty solidly on the liberal side when to comes to social issues. That is why I think that it is imperative morally AND fiscally to implement a UHC system.

I honestly believe that it will benefit everyone to do so. It will give everyone access to quality medical care without the concerns of losing a home to acquire it and keep the population as a whole a lot healthier.

I honestly believe that it will also be cost effective and cheaper in the long run. As has been stated and linked to many times in the past in other threads, the US is spending nearly double what other countries are spending on healthcare per capita and not even covering a significant portion of the population. We are also dying younger on average than other industrialized nations that have some form of UHC. We are now 42nd in the world in lifespan yet #1 in per capita spending on healthcare. Obviously, if something isn't broke you don't fix it. Clearly....this thing is broken.

Source

Americans are living longer than ever, but not as long as people in 41 other countries.

For decades, the United States has been slipping in international rankings of life expectancy, as other countries improve health care, nutrition and lifestyles.

Countries that surpass the U.S. include Japan and most of Europe, as well as Jordan, Guam and the Cayman Islands.

"Something's wrong here when one of the richest countries in the world, the one that spends the most on health care, is not able to keep up with other countries," said Dr. Christopher Murray, head of the Institute for Health Metrics and Evaluation at the University of Washington.

 

[Nebor]

Without even considering how much the cost is, I'd rather see the money gathered up and burned in a big pile than see the government provide "universal health care."

 

[RightIsWrong]

Originally posted by: Nebor
Without even considering how much the cost is, I'd rather see the money gathered up and burned in a big pile than see the government provide "universal health care."

I know that you are pretty militant in regards toward you impression of the government running the country and/or a slushie stand....but can you add more than just your hatred to the thread?

Like.....

What do you think would be a better solution to make sure that everyone is able to see a doctor if needed and lower the current burden on the fed for medical costs occurred via medicare/medicaid?