Sanding our assholes with 150 grit.

National healthcare, or...

...yet another person asks "After seeing the federal government operate in New Orleans after Katrina, why can't those folks run my healthcare?"

http://www.commondreams.org/archive/2007/07/30/2863/
Permalink Send private email Philo 
July 31st, 2007 1:16am
These stumblebees act like our health care is so good we have to protect it all costs. Not even close. It's broken. Especially compared to other health systems.
Permalink son of parnas 
July 31st, 2007 1:24am
So you're voting with the "let's let the folks that brought us FEMA and NCLB run healthcare" crowd?

While it has a lot of problems and there's tons of room for improvement, there's also tons of ways it can get worse.

For one thing - try drafting all our medical professionals into the civil service. I'm sure they'd be welcomed in Canada, the UK, and France with open arms.

I'm not trying to FUD saying that's automatically what could happen - I'm just trying to say it's a hard problem and I don't see "let the Federal Government do it" as the panacea I perceive a lot of folks argue it to be.
Permalink Send private email Philo 
July 31st, 2007 1:38am
> I'm not trying to FUD

It is complete and total FUD. A US system has to reflect US approached. I have a hard time thinking anyone would be nationalized in the process. But that's FUD for ya.
Permalink son of parnas 
July 31st, 2007 1:45am
>>> try drafting all our medical professionals into the civil service.

That's not how it works here in Canada.  Medical professionals aren't employed by the government, that just who they send their bills to.

I'm not sure whether "try drafting" is F or U.  I don't think it'd qualify as D.
Permalink Send private email Ward 
July 31st, 2007 1:48am
Yea, it is a tough one and I am glad that the next leaders in our government have to make the decision (or not that glad).

My gut says that this is yet another program that the government will screw up.  But with almost every country on the planet offering it and it is only human to help others in need. If your arm is falling off and you walk into an office and he says he won't see you because your healthcare plan isn't that good, seems a little less than human.

I think it could work out if there were leaders like Kennedy or FDR or something that stress getting government programs/ initiatives to work.

But something tells me Hillary will go for this and then they will screw it up in the first couple of years.  The privatized healthcare will sky-rocket and then we will all be broke again.
Permalink Bot Berlin 
July 31st, 2007 1:49am
One thing I hate about Moore and some people on this forum. They take one example or one case and then apply it across the board dont do extensive research. Eg, Canada has universal healthcare, that means the US is deficient so the US should have it.

One thing that I haven't thought about, how long does it take to develop such a system, it looks like Canada's program started 60 years.

"It was not until 1946 that the first Canadian province introduced near universal health coverage."

I wonder, in our lifetime will we see a working universal healthcare system in the US.
Permalink Bot Berlin 
July 31st, 2007 1:52am
> how long does it take to develop such a system

So we shouldn't start because it will take time?
Permalink son of parnas 
July 31st, 2007 1:54am
My idea for government-paid health care:

Give people some sort of monopoly money (M$) that they use to pay for medical care.

Doctors, clinics, labs, hospitals all charge whatever they think their services are worth and people pay them with their  M$.

Everyone gets a certain amount of M$ per year based on some lowball average for their age/sex/locale/whatever.  You are always allowed to get more - it's automatic, but you do need to apply for it.

People are encouraged to shop around a bit...  I'm not quite sure how to make this work, I'll come back to it.

The only real check and balance is that any person who's using too much M$ or any doctor or clinic that's collecting too much M$ is subject to an audit to make sure they aren't fucking around.  I think that somehow this audit process could be used to get people to shop around.

That's it.

All the benefits of a free market, but the government pays for it all.  Should be less beaurocracy than the Canadian system.
Permalink Send private email Ward 
July 31st, 2007 1:56am
*crickets*

*sniff*, no one ever likes my ideas.

"Screw you guys, _I'm_ going home."
Permalink Send private email Ward 
July 31st, 2007 2:22am
> ...yet another person asks "After seeing the federal government operate in New Orleans after Katrina, why can't those folks run my healthcare?"

On the other hand...

The USPS has never once lost a single piece of mail that I've ever put in the mailbox.

I'd say it's a wash.
Permalink Michael B 
July 31st, 2007 2:29am
Ward, let me tell you one thing about this place - everyone loves to bitch, but when you try to suggest an actual solution, you'll get squat in response.
Permalink Send private email Philo 
July 31st, 2007 2:52am
I think socialized health care would work pretty well here.  For three reasons:

a) The government already pays less per person than private insurers do for old people (Medicare vs. private insurers).  And this is the unhealthiest segment of the country.  Since younger people aren't as sick as older people, covering them should bring the per person costs down.  e.g. insuring 50M seniors costs D, but insuring the full 300M may only cost 4.5D instead of 6D.  If I multiply my Medicare deduction by 4.5, it costs a bit more than my private health insurance does (since I'm above the curve salary-wise). But still, not a bad price for universal health coverage.

b) Since the government is on the hook for the rest of your life, prevention will take center stage.  A dollar spent on prevention now saves a hundred on critical care in ten years, etc.  Costs should decrease over time.  Would also allow for interesting joint ventures between health service and EPA, FDA, since more data could be coordinated and agencies couldn't externalize their negligence onto the private sector.  Benefits of reduced crime and poverty could be accounted for as well.

c) We're a much wealthier country than all of the others who try this.  If they can afford it surely we can.  Especially if all of the well-to-doers (like most of us) contribute a fair share.

This is so doable, damnit.
Permalink Michael B 
July 31st, 2007 2:53am
>>> Ward, let me tell you one thing about this place

Yeah, I know that's generally the case, but not always.  I got a detailed response from Colm the other day (and didn't have time to do a suitable reply).

You could always go first...
Permalink Send private email Ward 
July 31st, 2007 3:04am
Hate to say I think you have Buckley's chance of introducing any form of socialised welfare into the USA given its governance for and on behalf of rentseekers. Electing the Dems won't change the stakeholders.
Permalink trollop 
July 31st, 2007 4:10am
>....yet another person asks "After seeing the federal
>government operate in New Orleans after Katrina, why can't
>those folks run my healthcare?"

I'm sure the federal government probably could have operated sensibly in New Orleans, it just happens to be run by nepotistic idiots currently.

It's not a fait accompli. The fix for that is to reform the media, so nepotistic idiots don't run your country. You NEED to do it anyway, given everything ELSE they run.
Permalink Send private email Colm 
July 31st, 2007 5:44am
"So you're voting with the "let's let the folks that brought us FEMA and NCLB run healthcare" crowd?"

Or... how about instead giving control to the folks that brought us:

* Rural Electrification
* Securities and Exchange Act and Commission
* The National Forest System and Parks
* The Federal Reserve System
* GI Bill
* National Highway System
* etc. etc. etc.

It may not be fair to cherry pick a few monumental failures while ignoring everything positive...
Permalink Send private email arg! 
July 31st, 2007 6:31am
FEMA was fine under Clinton.  Bush eviscerated it.  So it's not "the government", it's "this government".
Permalink AMerrickanGirl 
July 31st, 2007 7:01am
+1 Michael B, arg!, and AG.
Permalink guess worker 
July 31st, 2007 7:04am
Yes, FEMA has done OK in the past with Florida hurricanes. A big part of the problem was that Arabian Horse Association guy Bush appointed to run the place, who was some stupid spoiled rich kid. Watching their denials during the disaster was like watching that Iraqi press guy who was saying they were defeating the Americans and then the news would cut to the outside of the building where that press conference was and US tanks were rolling through the streets and Iraqis were toppling Saddam statues and shouting 'USA'.
Permalink Practical Economist 
July 31st, 2007 7:15am
>Ward, let me tell you one thing about this place - everyone
>loves to bitch, but when you try to suggest an actual
>solution, you'll get squat in response.

The irony if this statement, considering the context of this thread, is just beautiful.
Permalink Send private email Colm 
July 31st, 2007 8:23am
---"One thing that I haven't thought about, how long does it take to develop such a system"-----

I think in the UK the changeover took about six months.

And it's not just Canada that has universal health care; it's nearly every country in the world.
Permalink Send private email Stephen Jones 
July 31st, 2007 8:45am
>Yes, FEMA has done OK in the past with Florida hurricanes.
The FL hurricanes happened during an election year, in a state where the governor is the brother of the president. As a result, FEMA handed out checks like confetti during a ticker tape parade. Including handing out $25k checks in counties not affected by the hurricane.

Katrina happened in a non-election year in a state where the governor is a Democrat. The bushies spent so much effort lieing and covering things up that we ended up having to let the Mexican Army into the US to help clean it up.

Nepotism: the lifeblood of the republican't party.
Permalink Peter 
July 31st, 2007 9:58am
Every time this comes up (which it has from the earliest days of ?off) I go and get the stats from nationmaster.com which shows the UK spending less on public healthcare per head than the US does *on public healthcare* and a fraction of what the US does on private health. I then get the life expectancy figures which are almost identical.

I can't be arsed doing it again.

*If* your priority is people living longer then a national system is the way to go.  If not - suit yourselves.
Permalink Send private email a cynic writes... 
July 31st, 2007 9:58am
> I think that somehow this audit process could be used to get people to shop around.

How?
Permalink son of parnas 
July 31st, 2007 10:38am
FEMA was run by a Republican hack clearly out of his depth.  Why don't they point to how well Social Security has been run?

I might just as well say "You want the Government OUT of Health-Care?  What, so somebody like ENRON can come in and raise prices and take huge profits out of the system?"
Permalink SaveTheHubble 
July 31st, 2007 10:49am
"I think that somehow this audit process could be used to get people to shop around."

Right now we can't shop around.  Most of us get health care through our employers, which although probitively expensive, is still cheaper than anything we could shop around for.

I'm going for my first physical therapy appointment today (bad shoulder).  Can hardly wait to see how much they gouge me for this.
Permalink AMerrickanGirl 
July 31st, 2007 10:51am
The reason we need the government to run health care is the same reason we don't privatize the police, the firefighters, road maintenance, and the military.

Because some things are too important to be left to profit-seekers.
Permalink AMerrickanGirl 
July 31st, 2007 10:52am
+1 AG.

And "Shop around"?  What, you want TWO or more Health Care Systems competing against each other so you get lower prices? 

Well, first of all, Health Care isn't that profitable for hospitals and doctors, after the Health Insurance companies take their profits out.

Second of all, the only way "Employers" have been able to keep any lid on costs at all is because they DO have thousands of employees to cover, which gives them leverage.  A "single payer" system removes all that leverage.

Thirdly, as Electricity Deregulation demonstrates, you don't GET new suppliers at lower costs, instead you get a new Middle-Man acting as a broker for the existing suppliers, at higher costs.
Permalink SaveTheHubble 
July 31st, 2007 10:58am
>Because some things are too important to be left to
>profit-seekers.

No. It's not because some things are more important than others. Roads are not more important than food, but my dinner was provided by a private company and roads were provided by the state.

It's because some things fundamentally can't be run optimally by the market.

Roads are one of those things because if it were privatized every road owner would hold a local monopoly and could charge as much as they wanted and wouldn't have to maintain them.

Medical services are another, because it's more efficient for the state to run it for numerous reasons as well as fairer.
Permalink Send private email Colm 
July 31st, 2007 11:05am
> Medical services are another, because it's more efficient for the state to run it for numerous reasons

which are?

it seems like there wouldnt be much of a debate if everyone unanimously agreed on the assumptions.
Permalink heartsheep 
July 31st, 2007 11:30am
I mean ... if everyone agreed about the timeless goodness of national healthcare, then even the ancient Egyptians would have had it.
Permalink heartsheep 
July 31st, 2007 11:32am
>>> What, you want TWO or more Health Care Systems competing against each other so you get lower prices?

You didn't read what I wrote.  I meant shop around as in go to different doctors, different specialists, different labs.
Permalink Send private email Ward 
July 31st, 2007 11:47am
>>> after the Health Insurance companies take their profits

In "my system" these guys wouldn't exist.
Permalink Send private email Ward 
July 31st, 2007 11:47am
I think the assumption is that "all men are created equal" which I think the US is meant to at least pay lip service to.
Permalink Send private email a cynic writes... 
July 31st, 2007 11:49am
According to the conservatives "All men are created equal" in the US really means that all men start out with the chance to be successful, but if anyone falls behind, no one is going to help them out.

So there's no equality as far as basic standards below which no one should be able to fall.
Permalink AMerrickanGirl 
July 31st, 2007 11:57am
I suppose you have to thank your Whig ancestors who thought everyone could get on, rather than the horrible reactionary Tories who thought peasants should know their place but felt an obligation to actually feed them.
Permalink Send private email a cynic writes... 
July 31st, 2007 12:05pm
>which are?

* Administrative costs - basically the cost of insurance companies/HMOs.
* Advertising costs - you guys are flooded with "ask your doctor about" adverts. The value to your society of these adverts is either zero or negative.
* Employer administrative costs - when providing healthcare to its employees.

>it seems like there wouldnt be much of a debate if everyone
>unanimously agreed on the assumptions.

You don't really need to. You just have to look at other countries providing similar (or better) levels of care and doing it at half the cost. There's obviously a lot of inefficiency.
Permalink Send private email Colm 
July 31st, 2007 12:11pm
> "all men are created equal"

does that mean all men should get plastic surgery as to have the same cup size?
Permalink heartsheep 
July 31st, 2007 12:11pm
Nope, because they're all "endowed by their Creator".

What you got is what you got.
Permalink SaveTheHubble 
July 31st, 2007 12:12pm
well then, maybe their Creator endowed some kids to die young with cancer untreated.

don't even get started with lung cancer patients.
Permalink heartsheep 
July 31st, 2007 12:18pm
Oh, I thought we were funning about Plastic Surgery.  You didn't need to go all "cancer" on me.

"Endowed by their Creator with certain unalienable rights.  Among these are Life, Liberty, and the Pursuit of Happiness."
Permalink SaveTheHubble 
July 31st, 2007 12:22pm
"you guys are flooded with "ask your doctor about"

Those things drive me crazy.  I want to throw things at the television.

Several trends about this are particularly annoying.

Now they're naming drugs cutesy names to be more marketable.  There's a birth control pill called "Yaz" and a medication for irritable bowel syndrome called "Zelnorm".  Yaz?  What focus group came up with that one?

Also, diseases are being called by their initials to make them seem more common.  Irritable bowel syndrome is IBS.  Rheumatoid arthritis is RA.  Restless leg syndrome (now there's a health crisis!) is RLS.  Erectile dysfunction (no longer good old impotence) is ED.

However did we get along without all this all these years?  I am SO SICK of being bombarded with advertising everywhere I go, all day long.  I'm surprised there aren't video screens embedded in the road pavement so we have to watch ads as we drive around.
Permalink AMerrickanGirl 
July 31st, 2007 12:28pm
>>> I'm surprised there aren't video screens embedded in the road pavement so we have to watch ads as we drive around.

Don't say it too loudly... it's only a matter of time.
Permalink Send private email Ward 
July 31st, 2007 12:35pm
> bombarded with advertising

Imagine how much more alphabet soup there would be if it was all free.

We all need to be treated for Imperfection Disorder. Ask your doctor about it.
Permalink heartsheep 
July 31st, 2007 12:38pm
Nah, we should call it "Perfection Disorder", or PD.

The only problem is, the drugs to treat it are mostly illegal.  I'm sure marijuana would be quite effective.
Permalink SaveTheHubble 
July 31st, 2007 12:44pm
so on the cancer/plastic surgery divide ... STH, you think mastectomy patients should pay for their own reconstructive surgery? God endowed them with whatever it was that made them that way.
Permalink heartsheep 
July 31st, 2007 12:49pm
> God endowed them with whatever it was that made them that way

I am not in right now. You'll have to take care of yourselves.
Permalink God 
July 31st, 2007 1:13pm
Skeeball again!?!
Permalink Send private email JoC 
July 31st, 2007 1:35pm
Hey, a deity needs to unwind now and then.
Permalink Full name 
July 31st, 2007 1:38pm
>> Yes, FEMA has done OK in the past with Florida hurricanes. <<

Maybe in Florida, but not in North Carolina.
Their response during Hurricane Floyd (1999) was widely criticized (and not just by Jesse Jackson)

http://en.wikipedia.org/wiki/Hurricane_Floyd#Criticism_of_FEMA

The town of Princeville was essentially destroyed, yet FEMA took a week to show up.
Permalink xampl 
July 31st, 2007 1:39pm
Aww fuck it.  let natural selection weed out the sickies. Let'em die.  We don't need the drain and I certainly don't want to pay for YOUR geezer parents because you were too lazy to work two or three jobs.
Permalink Send private email sharkfish 
July 31st, 2007 8:34pm

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