Factors In Healthcare Outcomes

[Ethereal]

Proponents of "single payer" and/or "universal healthcare" often make comparisons between healthcare outcomes in the USA versus other industrialized countries like Canada, Japan, Denmark, etc.

However, these comparisons almost always neglect to examine important variables like diet, lifestyle, and genetics, among other things.

Just as one example of why the USA may be experiencing higher healthcare costs than it's industrialized counterparts, the US government has been heavily subsidizing corn for decades, which has resulted in massive amounts of corn sugars like "high fructose corn syrup" being put into the food supply.


(Scientific American) For a Healthier Country, Overhaul Farm Subsidies (https://www.scientificamerican.com/article/fresh-fruit-hold-the-insulin/)

Indeed, the US government's role in promoting excess consumption of sugars in American diets is not just limited to subsidizing corn, but can be directly attributed to their pseudo-scientific dietary guidelines and recommendations, guidelines and recommendations that were shaped largely by big agribusinesses lobbying and bribing the government.



(The New York Times) How the Sugar Industry Shifted Blame to Fat (https://www.nytimes.com/2016/09/13/well/eat/how-the-sugar-industry-shifted-blame-to-fat.html?_r=0)


(Slate) The FDA’s phony nutrition science: How Big Food and Agriculture trumps real science — and why the government allows it (http://www.salon.com/2015/04/12/the_fdas_phony_nutrition_science_how_big_food_and_ agriculture_trumps_real_science_and_why_the_govern ment_allows_it/)

Naturally, proponents of increased government control over America's healthcare system are remiss to talk about this, since it shows their solution, more government, is actually a big reason why our healthcare costs are so out of control, and why we experience poor healthcare outcomes relative to other industrialized nations.

But wouldn't it make more sense to simply stop subsidizing and promoting the corn and sugar industries before we let the corrupt and incompetent politicians in Washington DC take over our healthcare? How many billions of dollars could this country save on healthcare costs if Americans just ate healthier and exercised more?

[Ethereal]

(The Guardian) Sugar, not fat, exposed as deadly villain in obesity epidemic (https://www.theguardian.com/society/2013/mar/20/sugar-deadly-obesity-epidemic)

How much death and disease has the US government caused in America with its subsidization and enabling of sugar-laden diets? How much has it increased our healthcare costs? One has to wonder.

[Docthehun]

When I get a chance, I'll dig up the list of countries who've adopted universal health and the year they implemented their plan. It's actually pretty impressive and leads me to wonder if it's such a disastrous idea, why haven't they abandoned this medical socialism. Perhaps we should at least take a hard look at having the world's best medical program and not worry how it gets labeled.

[Ethereal]

When I get a chance, I'll dig up the list of countries who've adopted universal health and the year they implemented their plan. It's actually pretty impressive and leads me to wonder if it's such a disastrous idea, why haven't they abandoned this medical socialism. Perhaps we should at least take a hard look at having the world's best medical program and not worry how it gets labeled.

Forgive me, but I don't see what this has to do with my argument. There are so many other variables to consider when examining healthcare outcomes besides "universal healthcare" or a lack thereof. And in considering those variables, we see there are any number of ways to improve healthcare outcomes in the USA without transferring more power and money to the US government.

[Common]

When I get a chance, I'll dig up the list of countries who've adopted universal health and the year they implemented their plan. It's actually pretty impressive and leads me to wonder if it's such a disastrous idea, why haven't they abandoned this medical socialism. Perhaps we should at least take a hard look at having the world's best medical program and not worry how it gets labeled.
You have to look at if those countries had the same system as we do before they changed first.
How do you take millions and I mean literally millions of private workers and make them govt workers overnight. How do you exchange all the private medical testing facilities, care facilities, nursing homes and and hospitals and make them govt run. How do you just tell the medical insurers and all the INVESTORS for all those things to suck eggs over night.

Look at obamacare how much more expensive its made healthcare while it fails.
I honestly do not see how it could ever be done in an organized reasonable manner and make it work

[Captain Obvious]

When I get a chance, I'll dig up the list of countries who've adopted universal health and the year they implemented their plan. It's actually pretty impressive and leads me to wonder if it's such a disastrous idea, why haven't they abandoned this medical socialism. Perhaps we should at least take a hard look at having the world's best medical program and not worry how it gets labeled.

We exist in a materialistic, capitalistic politically polarized society.

The government doesn't give a fuck about our continuum of care, it's bough-and-paid-for by special interests.

How could a single-payer system possibly work here?

[Ethereal]

We exist in a materialistic, capitalistic politically polarized society.

The government doesn't give a $#@! about our continuum of care, it's bough-and-paid-for by special interests.

How could a single-payer system possibly work here?
When the US government is arguably one of the biggest reasons why Americans are so unhealthy, what makes anyone think they would be any better at managing our healthcare? It boggles the mind.

[Captain Obvious]

When the US government is arguably one of the biggest reasons why Americans are so unhealthy, what makes anyone think they would be any better at managing our healthcare? It boggles the mind.

Right, and big pharma - those who profit the most off of actual and manufactured illness isn't letting anyone shit on their dinner plate.

[Ethereal]

Another factor that is often overlooked by proponents of "single payer" and/or "universal healthcare" in the USA is the scale at which these systems tend to operate.

The most populous modernized country with such a system is probably Germany, with around 80 million people.

The USA, by comparison, has around 320 million people.

To ignore the massive differences in scale is simply irrational.

[William]

Actually a universal health care system does not need to change anything except the insurance companies (and even they can have a place in systems like the Australian one). The Dept of Public Health, or a similar body, is the insurer, and the funds come from general taxation and a 2.5% levy on taxable income. The Australian rate of taxation is not higher overall than the American rates, but the marginal rates for the top earners might be higher.

The main health providers and researchers are private practitioners and corporations, who agree to certain set rates for various procedures, and are paid by the government department concerned. Australia's health care system is rated higher than the US one by the WHO.

Here's what happens -

You get sick and you go to the doctor of your choice.

He treats you or refers you to a specialist, who treats you or refers you to a hospital. Which he, not the government, recommends.

You get better, and the doctor or hospital sends the bill to the govt department, who pays it. You do not pay anything at the point of treatment.

Other countries do, but Australia doesn't include dental or optical care for anyone except veterans of the armed forces, or pensioners.

So, I can see no reason why the USA shouldn't keep its excellent physicians, hospitals and research labs, and just do away with private insurance companies. Have a single payer system financed by taxation, like every other developed nation does. It shouldn't be a matter of ideology - it's not socialism to make sure everyone has health care - and a healthy society is a happier and more productive society. :smiley:

[Chris]

The US government is also the biggest poluter in the US if not the world.

[Chris]

Actually a universal health care system does not need to change anything except the insurance companies (and even they can have a place in systems like the Australian one). The Dept of Public Health, or a similar body, is the insurer, and the funds come from general taxation and a 2.5% levy on taxable income. The Australian rate of taxation is not higher overall than the American rates, but the marginal rates for the top earners might be higher.

The main health providers and researchers are private practitioners and corporations, who agree to certain set rates for various procedures, and are paid by the government department concerned. Australia's health care system is rated higher than the US one by the WHO.

Here's what happens -

You get sick and you go to the doctor of your choice.

He treats you or refers you to a specialist, who treats you or refers you to a hospital. Which he, not the government, recommends.

You get better, and the doctor or hospital sends the bill to the govt department, who pays it. You do not pay anything at the point of treatment.

Other countries do, but Australia doesn't include dental or optical care for anyone except veterans of the armed forces, or pensioners.

So, I can see no reason why the USA shouldn't keep its excellent physicians, hospitals and research labs, and just do away with private insurance companies. Have a single payer system financed by taxation, like every other developed nation does. It shouldn't be a matter of ideology - it's not socialism to make sure everyone has health care - and a healthy society is a happier and more productive society. :smiley:


Since what you pay is taken little by little and hardly noticed, and you don't pay at the pump, why does this not lead to overuse and abuse, sending costs skyrocketing? --Basically the same argument as the OP, government policies have lead to unhealthy people who need and demand more health care, sending costs skyrocketing.

[MisterVeritis]

Actually a universal health care system does not need to change anything except the insurance companies (and even they can have a place in systems like the Australian one). The Dept of Public Health, or a similar body, is the insurer, and the funds come from general taxation and a 2.5% levy on taxable income. The Australian rate of taxation is not higher overall than the American rates, but the marginal rates for the top earners might be higher.

The main health providers and researchers are private practitioners and corporations, who agree to certain set rates for various procedures, and are paid by the government department concerned. Australia's health care system is rated higher than the US one by the WHO.

Here's what happens -

You get sick and you go to the doctor of your choice.

He treats you or refers you to a specialist, who treats you or refers you to a hospital. Which he, not the government, recommends.

You get better, and the doctor or hospital sends the bill to the govt department, who pays it. You do not pay anything at the point of treatment.

Other countries do, but Australia doesn't include dental or optical care for anyone except veterans of the armed forces, or pensioners.

So, I can see no reason why the USA shouldn't keep its excellent physicians, hospitals and research labs, and just do away with private insurance companies. Have a single payer system financed by taxation, like every other developed nation does. It shouldn't be a matter of ideology - it's not socialism to make sure everyone has health care - and a healthy society is a happier and more productive society. :smiley:
Eventually, you run out of other people's wealth. Then rationing care becomes the control mechanism.

[DGUtley]

When I get a chance, I'll dig up the list of countries who've adopted universal health and the year they implemented their plan. It's actually pretty impressive and leads me to wonder if it's such a disastrous idea, why haven't they abandoned this medical socialism. Perhaps we should at least take a hard look at having the world's best medical program and not worry how it gets labeled.

Doc, my old friend, where's the constitutional basis for it? There's many good (or bad) things that we could or might do that sound good but fall outside of the constitution. If the people want it, let's amend the constitution and guarantee the right to accessible healthcare.

[Ethereal]

Actually a universal health care system does not need to change anything except the insurance companies (and even they can have a place in systems like the Australian one). The Dept of Public Health, or a similar body, is the insurer, and the funds come from general taxation and a 2.5% levy on taxable income. The Australian rate of taxation is not higher overall than the American rates, but the marginal rates for the top earners might be higher.

The main health providers and researchers are private practitioners and corporations, who agree to certain set rates for various procedures, and are paid by the government department concerned. Australia's health care system is rated higher than the US one by the WHO.

Here's what happens -

You get sick and you go to the doctor of your choice.

He treats you or refers you to a specialist, who treats you or refers you to a hospital. Which he, not the government, recommends.

You get better, and the doctor or hospital sends the bill to the govt department, who pays it. You do not pay anything at the point of treatment.

Other countries do, but Australia doesn't include dental or optical care for anyone except veterans of the armed forces, or pensioners.

So, I can see no reason why the USA shouldn't keep its excellent physicians, hospitals and research labs, and just do away with private insurance companies. Have a single payer system financed by taxation, like every other developed nation does. It shouldn't be a matter of ideology - it's not socialism to make sure everyone has health care - and a healthy society is a happier and more productive society. :smiley:
Here's one reason why: Lots of Americans like their private health insurance.

http://media.gallup.com/POLL/Releases/pr021209i.gif

Another reason why: The US government is corrupt and heavily influenced by corporate lobbying, as evidenced by their promotion of excess sugar consumption. To entrust them with financing America's healthcare is kind of like asking a fox to guard your hen-house.

Yet another reason why: The USA's population is several times larger than countries with "universal healthcare", making issues of scale and efficiency unavoidable. Put another way, financing the healthcare of 24 million people is much different than financing the healthcare of 320 million people.

Lastly, there are other important variables that contribute to America's relatively high healthcare costs, as I've already demonstrated. Addressing these problems would be much easier and far more effective than trying to push through a universal healthcare system. Simply improving the average American diet and encouraging more exercise would likely decrease our healthcare costs by many billions of dollars every year. Why not try that first before we attempt a major and controversial overhaul of our entire healthcare system?

[Docthehun]

Doc, my old friend, where's the constitutional basis for it? There's many good (or bad) things that we could or might do that sound good but fall outside of the constitution. If the people want it, let's amend the constitution and guarantee the right to accessible healthcare.

There would be no constitutional basis, I concur. The same could be said about much of our benefits, strictly speaking. I would go back to and old saying; "An army runs on it's stomach." In a sense, that applies to all of us and stretches beyond the notion of food. The Army tries it's best to provide food, shelter, clothing, tools and education. All those things in tandem are what maintains our World standing.

Worry most about the least among us. I believe that's exactly how you and I were raised. Was it not?

[DGUtley]

There would be no constitutional basis, I concur. The same could be said about much of our benefits, strictly speaking. I would go back to and old saying; "An army runs on it's stomach." In a sense, that applies to all of us and stretches beyond the notion of food. The Army tries it's best to provide food, shelter, clothing, tools and education. All those things in tandem are what maintains our World standing.

You are correct but we have to maintain our status of being a society of laws. The constitution protects the individual from the centralized government. Hence, the defined powers etc. The debate over whether other benefits are constitutional has been lost doesn't justify adding other additional unconstitutional structures. If we want to guarantee this as a right (and maybe we do), then we should put it in our structural document, IMHO.


Worry most about the least among us. I believe that's exactly how you and I were raised. Was it not?

It truly is and I have tried to live my life that way. Isn't that the age old debate of compassion versus compulsion? Should my compassion lead to someone else's compulsion, absent a constitutional structural requirement? I don't know.

[William]

Since what you pay is taken little by little and hardly noticed, and you don't pay at the pump, why does this not lead to overuse and abuse, sending costs skyrocketing? --Basically the same argument as the OP, government policies have lead to unhealthy people who need and demand more health care, sending costs skyrocketing.

Maybe, but the proof of the pudding is in the eating. Australia has had this system for at least the past 50 years - costs have not skyrocketed, the standard of healthcare has been judged by the WHO as better than yours, and the country has not gone broke. Perhaps because the system allows medical practitioners to make a good living, and the system also allows for collective bargaining with people like the big drug companies. Like if you are buying for a whole nation, it gives you pretty good price leverage. No system is perfect, and I'm not saying the Aussie system is, but it is better than any system which requires you to have money before you receive health care.

[William]

Here's one reason why: Lots of Americans like their private health insurance.

http://media.gallup.com/POLL/Releases/pr021209i.gif

Another reason why: The US government is corrupt and heavily influenced by corporate lobbying, as evidenced by their promotion of excess sugar consumption. To entrust them with financing America's healthcare is kind of like asking a fox to guard your hen-house.

Yet another reason why: The USA's population is several times larger than countries with "universal healthcare", making issues of scale and efficiency unavoidable. Put another way, financing the healthcare of 24 million people is much different than financing the healthcare of 320 million people.

Lastly, there are other important variables that contribute to America's relatively high healthcare costs, as I've already demonstrated. Addressing these problems would be much easier and far more effective than trying to push through a universal healthcare system. Simply improving the average American diet and encouraging more exercise would likely decrease our healthcare costs by many billions of dollars every year. Why not try that first before we attempt a major and controversial overhaul of our entire healthcare system?

I'm sorry, but you are missing the point. Nothing need change in your health care system, except the way the doctors and hospitals are paid. The system stays the same - just the leeches in the insurance companies get the boot. Have a look at the tallest buildings in any major city - they are the insurance companies. Where do you think all that money comes from? A single payer system does away with all that profiteering.

[Docthehun]

You are correct but we have to maintain our status of being a society of laws. The constitution protects the individual from the centralized government. Hence, the defined powers etc. The debate over whether other benefits are constitutional has been lost doesn't justify adding other additional unconstitutional structures. If we want to guarantee this as a right (and maybe we do), then we should put it in our structural document, IMHO.



It truly is and I have tried to live my life that way. Isn't that the age old debate of compassion versus compulsion? Should my compassion lead to someone else's compulsion, absent a constitutional structural requirement? I don't know.

I suspect you and I would agree, that at the end of our journey neither of us would pull out a copy of our Constitution as justification for any of our actions or inactions. In the end, it was either right, or not.

[Ethereal]

I'm sorry, but you are missing the point. Nothing need change in your health care system, except the way the doctors and hospitals are paid. The system stays the same - just the leeches in the insurance companies get the boot. Have a look at the tallest buildings in any major city - they are the insurance companies. Where do you think all that money comes from? A single payer system does away with all that profiteering.
Actually, you're missing the point. You haven't even addressed the basic premise of my argument, which is that government policies are contributing greatly to America's relatively poor health outcomes in terms of their cost and effectiveness. Changing the financial model of our healthcare system isn't going to stop Americans from eating too much sugar, nor is it going to encourage them to lead healthier lifestyles in general. It will simply shift the costs to taxpayers with no assurance of improved outcomes or decreased costs. And saying that nothing need change except the way healthcare providers are paid is like saying nothing need change in your car except the kind of fuel it uses. Changing the financial model of healthcare is a major overhaul with significant implications for how healthcare is provided in general, especially in a country with 320 million people, many of whom like their private health insurance.

[Chris]

Maybe, but the proof of the pudding is in the eating. Australia has had this system for at least the past 50 years - costs have not skyrocketed, the standard of healthcare has been judged by the WHO as better than yours, and the country has not gone broke. Perhaps because the system allows medical practitioners to make a good living, and the system also allows for collective bargaining with people like the big drug companies. Like if you are buying for a whole nation, it gives you pretty good price leverage. No system is perfect, and I'm not saying the Aussie system is, but it is better than any system which requires you to have money before you receive health care.

Health care costs are skyrocketing everywhere:

https://i.snag.gy/HxCLyM.jpg


The probelm with the government making these decisions and negotiations is they have no good idea what individual people value.

[ripmeister]

Another factor that is often overlooked by proponents of "single payer" and/or "universal healthcare" in the USA is the scale at which these systems tend to operate.

The most populous modernized country with such a system is probably Germany, with around 80 million people.

The USA, by comparison, has around 320 million people.

To ignore the massive differences in scale is simply irrational.
But what about economies of scale

[William]

Actually, you're missing the point. You haven't even addressed the basic premise of my argument, which is that government policies are contributing greatly to America's relatively poor health outcomes in terms of their cost and effectiveness. Changing the financial model of our healthcare system isn't going to stop Americans from eating too much sugar, nor is it going to encourage them to lead healthier lifestyles in general. It will simply shift the costs to taxpayers with no assurance of improved outcomes or decreased costs. And saying that nothing need change except the way healthcare providers are paid is like saying nothing need change in your car except the kind of fuel it uses. Changing the financial model of healthcare is a major overhaul with significant implications for how healthcare is provided in general, especially in a country with 320 million people, many of whom like their private health insurance.

Your argument is a valid one with regard to the health problems of obesity and too much sugar suffered by your country (and many others,) but that isn't what I am talking about.

I am simply telling you how Australia's health care system is funded and works, and many European systems operate along those lines.

With respect, your further arguments about 'shifting the costs to taxpayers' make no sense. The costs of health care are met by the taxpayer anyway - either directly or by insurance. Those who are uninsured can go to the ER and be treated (and if they are cannot pay, there is no way of getting the cost back from them,) so those costs are also met by the taxpayer.

The equation is something like -

Health care costs the nation X

The profit motive of private insurance adds Y

So in a system of private insurance health care costs the nation X+Y

In a single payer UHC system where the profit motive is eliminated, health care costs the nation X - X being less than the sum of X plus Y.

Plus the purchasing power of a single payer, such as a government department, can reduce X, specially in the case of pharmaceuticals.

Your closing argument that most Americans like their private health insurance, is basically an ideological one (only the Commies have UHC, and I'm not paying for some other lazy bum's health), and probably means the USA will never have a system whereby everyone, whether rich or poor, is entitled to health care.

That's fine with me - who am I to tell Americans how to run their country? All I'm doing is telling you how things work elsewhere, yer pays yer money and yer makes yer choice. :smiley:

[DGUtley]

But what about economies of scale

Mordor on the Potomac eats that part?

[Dr. Who]

You have to look at if those countries had the same system as we do before they changed first.
How do you take millions and I mean literally millions of private workers and make them govt workers overnight. How do you exchange all the private medical testing facilities, care facilities, nursing homes and and hospitals and make them govt run. How do you just tell the medical insurers and all the INVESTORS for all those things to suck eggs over night.

Look at obamacare how much more expensive its made healthcare while it fails.
I honestly do not see how it could ever be done in an organized reasonable manner and make it work

You don't. You substitute Federal government or State governments (preferable) for the insurance companies and gradually make enough of the private hospitals public to serve the public adequately and network them regionally to reduce administrative costs. You don't eliminate private hospitals - there will be people who want to have choice, but you offer the best level of care to all people, who then would have the choice to buy up the luxury aspect like private rooms etcetera with insurance or give them the option to go to a private hospital where the government pays X rate for X services and insurance pays the rest. Insurance moves from being the primary source of funding to a secondary source of funding. Then they will not face the death panel decisions (except where experimental drugs are concerned) and no one ends up being unable to insure themselves. Unlike an insurance company, a State or Federal Government gets all of the premiums from the least likely to need health care to offset the cost of care for those who need the most health care - primarily the elderly. A government does not have to deal with opportunistic buyers who come and go because their rates are increased because of claims. They have a captive market. Whether you claim or not would not change your premiums. Premiums would reflect the cost of the overall program.

Governments are then in the position to create clinics near hospitals and encourage people to use clinics for non-emergency care rather than clutter up the ERs with cold and flu sufferers who think that they are dying. The cost of operating clinics is far less than that of hospitals and if they are located nearby hospitals, those individuals who should be attending the ER can be moved there easily to immediate attention because the paperwork is already done.

As with private hospitals, there would have to be boards of directors whose responsibility is to ensure that public hospitals run efficiently and effectively. There is also no reason why public hospitals cannot fundraise for extras in terms of equipment or research. Lotteries are a popular form of fundraising. (volunatary taxation).

[Common]

Your argument is a valid one with regard to the health problems of obesity and too much sugar suffered by your country (and many others,) but that isn't what I am talking about.

I am simply telling you how Australia's health care system is funded and works, and many European systems operate along those lines.

With respect, your further arguments about 'shifting the costs to taxpayers' make no sense. The costs of health care are met by the taxpayer anyway - either directly or by insurance. Those who are uninsured can go to the ER and be treated (and if they are cannot pay, there is no way of getting the cost back from them,) so those costs are also met by the taxpayer.

The equation is something like -

Health care costs the nation X

The profit motive of private insurance adds Y

So in a system of private insurance health care costs the nation X+Y

In a single payer UHC system where the profit motive is eliminated, health care costs the nation X - X being less than the sum of X plus Y.

Plus the purchasing power of a single payer, such as a government department, can reduce X, specially in the case of pharmaceuticals.

Your closing argument that most Americans like their private health insurance, is basically an ideological one (only the Commies have UHC, and I'm not paying for some other lazy bum's health), and probably means the USA will never have a system whereby everyone, whether rich or poor, is entitled to health care.

That's fine with me - who am I to tell Americans how to run their country? All I'm doing is telling you how things work elsewhere, yer pays yer money and yer makes yer choice. :smiley:

William you have to understand that this is not australia and im not saying that negatively. Clearly our politics are different.

You just cant take the behemoth industry of healthcare in the USA with all its ancillary business' and just slap them under the umbrella of the govt. There are millions employed by the private health industry. There are billions invested in health care companies. Hospitals in the USA are private owned, so are testing facilities like MRI and Catscans etc. Laboratories for blood samples are all private owned.

The health care that is owned and run by the US Govt is and has been a total failure for decades and thats our VA for our veterans. If the govt cant run the Veterans Adminstrations health care and provide good care how in the hell are the going to do it for the entire country.

William this is an entirely different thing here than australia or europe.
I would like to say lastly that I am for all americans having healthcare. I just dont have a clue how to do that.

[Common]

You don't. You substitute Federal government or State governments (preferable) for the insurance companies and gradually make enough of the private hospitals public to serve the public adequately and network them regionally to reduce administrative costs. You don't eliminate private hospitals - there will be people who want to have choice, but you offer the best level of care to all people, who then would have the choice to buy up the luxury aspect like private rooms etcetera with insurance or give them the option to go to a private hospital where the government pays X rate for X services and insurance pays the rest. Insurance moves from being the primary source of funding to a secondary source of funding. Then they will not face the death panel decisions (except where experimental drugs are concerned) and no one ends up being unable to insure themselves. Unlike an insurance company, a State or Federal Government gets all of the premiums from the least likely to need health care to offset the cost of care for those who need the most health care - primarily the elderly. A government does not have to deal with opportunistic buyers who come and go because their rates are increased because of claims. They have a captive market. Whether you claim or not would not change your premiums. Premiums would reflect the cost of the overall program.

Governments are then in the position to create clinics near hospitals and encourage people to use clinics for non-emergency care rather than clutter up the ERs with cold and flu sufferers who think that they are dying. The cost of operating clinics is far less than that of hospitals and if they are located nearby hospitals, those individuals who should be attending the ER can be moved there easily to immediate attention because the paperwork is already done.

As with private hospitals, there would have to be boards of directors whose responsibility is to ensure that public hospitals run efficiently and effectively. There is also no reason why public hospitals cannot fundraise for extras in terms of equipment or research. Lotteries are a popular form of fundraising. (volunatary taxation).
The system you proposed is just a hybrid health system not single payer and the bulk of it is still borne by taxpayers, plus it sounds like middle class with insurance would have less health care.

Theres one thing everyone just doesnt mention. When you take the incentive from Drs to make as much money as they can just like everyone else quality goes down there is nothing to strive for. WIth a controlled govt system we cant allow drs and hospitals to keep making whatever they freight will bear. Theres so many variables that no one includes in the discussion of healthcare.

Europe has had single payer for many Decades. We have had ALWAYS had a private system

[Dr. Who]

Actually, you're missing the point. You haven't even addressed the basic premise of my argument, which is that government policies are contributing greatly to America's relatively poor health outcomes in terms of their cost and effectiveness. Changing the financial model of our healthcare system isn't going to stop Americans from eating too much sugar, nor is it going to encourage them to lead healthier lifestyles in general. It will simply shift the costs to taxpayers with no assurance of improved outcomes or decreased costs. And saying that nothing need change except the way healthcare providers are paid is like saying nothing need change in your car except the kind of fuel it uses. Changing the financial model of healthcare is a major overhaul with significant implications for how healthcare is provided in general, especially in a country with 320 million people, many of whom like their private health insurance.
America also exports all of that nasty junk food around the world. The difference is that different countries have different food cultures. The American food culture derives primarily from the British and Germanic and later Mexican food cultures, which were historically oriented to meat and carbohydrates or in the case of Mexico, corn. Not everyone in America eats bad food, but those who never learned to like vegetables or were ever really introduced to them fare the worst and are most likely to indulge in junk food and diets high in unnecessary carbs and sugars. Additionally, obesity is not ignored as normal in other countries. Obesity is highly abnormal in Continental Europe. Obesity in children is generally unheard of and certainly addressed as a health concern. Europeans actually walk a great deal or ride bicycles. They are not enslaved to cars.

This is far more complex than just pandering to the corn industry. European cities are human-scaled - they are not dedicated to cars, so people have to walk or take public transit. They deliberately dedicate vast amounts of space, including retail space to walking - no cars. This means that the average Euro gets far more exercise than the average American. Drive-throughs are a rarity in Europe, are associated with American franchises and found only in the outermost suburbs.

In Europe and really the rest of the world, no restaurant serves you a portion size that would feed several people. That is uniquely American. So, whether or not the government indulges the corn industry is not the source of the problem, it may be a part of it, but the bigger issue is both the affinity for excess, ignorance and advantage.

[William]

William you have to understand that this is not australia and im not saying that negatively. Clearly our politics are different.

You just cant take the behemoth industry of healthcare in the USA with all its ancillary business' and just slap them under the umbrella of the govt. There are millions employed by the private health industry. There are billions invested in health care companies. Hospitals in the USA are private owned, so are testing facilities like MRI and Catscans etc. Laboratories for blood samples are all private owned.

The health care that is owned and run by the US Govt is and has been a total failure for decades and thats our VA for our veterans. If the govt cant run the Veterans Adminstrations health care and provide good care how in the hell are the going to do it for the entire country.

William this is an entirely different thing here than australia or europe.
I would like to say lastly that I am for all americans having healthcare. I just dont have a clue how to do that.

Thank you for that informative and thought-provoking post, and I am sure, like you, most Americans want what is best for all Americans. :smiley:

What I found even more informative, and honest, was something you wrote in reply to Dr Who, it was -


Theres one thing everyone just doesnt mention. When you take the incentive from Drs to make as much money as they can just like everyone else quality goes down there is nothing to strive for. WIth a controlled govt system we cant allow drs and hospitals to keep making whatever they freight will bear.

This is why I think the problem in the USA is mainly ideological. The opinion that doctors should be able to make as much money as they can, and that doctors and hospitals should be allowed to charge whatever the public will bear, seems to be a very American attitude. I don't say that as a criticism - each society has its different values - but to accept that as a valid basis for any system would be unthinkable in Europe. And of course there are people in Europe who think that way, and would love to operate on that basis, but the right to make as much money as you can at the expense of the rest of society, is not a generally accepted European value.

[Dr. Who]

The system you proposed is just a hybrid health system not single payer and the bulk of it is still borne by taxpayers, plus it sounds like middle class with insurance would have less health care.

Theres one thing everyone just doesnt mention. When you take the incentive from Drs to make as much money as they can just like everyone else quality goes down there is nothing to strive for. WIth a controlled govt system we cant allow drs and hospitals to keep making whatever they freight will bear. Theres so many variables that no one includes in the discussion of healthcare.

Europe has had single payer for many Decades. We have had ALWAYS had a private system

There are two kinds of people who become doctors - those who want to help people and those who want to make money. Which one would you rather have as your doctor?

[Peter1469]

We exist in a materialistic, capitalistic politically polarized society.

The government doesn't give a fuck about our continuum of care, it's bough-and-paid-for by special interests.

How could a single-payer system possibly work here?

Remote Area Medical model. (https://ramusa.org/virginia/)

Then let the free market work for those who can pay for better. This model will provide more than adequate care on the cheap.

[donttread]

Proponents of "single payer" and/or "universal healthcare" often make comparisons between healthcare outcomes in the USA versus other industrialized countries like Canada, Japan, Denmark, etc.

However, these comparisons almost always neglect to examine important variables like diet, lifestyle, and genetics, among other things.

Just as one example of why the USA may be experiencing higher healthcare costs than it's industrialized counterparts, the US government has been heavily subsidizing corn for decades, which has resulted in massive amounts of corn sugars like "high fructose corn syrup" being put into the food supply.



Indeed, the US government's role in promoting excess consumption of sugars in American diets is not just limited to subsidizing corn, but can be directly attributed to their pseudo-scientific dietary guidelines and recommendations, guidelines and recommendations that were shaped largely by big agribusinesses lobbying and bribing the government.



Naturally, proponents of increased government control over America's healthcare system are remiss to talk about this, since it shows their solution, more government, is actually a big reason why our healthcare costs are so out of control, and why we experience poor healthcare outcomes relative to other industrialized nations.

But wouldn't it make more sense to simply stop subsidizing and promoting the corn and sugar industries before we let the corrupt and incompetent politicians in Washington DC take over our healthcare? How many billions of dollars could this country save on healthcare costs if Americans just ate healthier and exercised more?


Yes, Monsanto's patented mono culture is part of it, has are our own actions . We don't just have a healthcare problem in America, we have a HEALTH problem as well.

[Ethereal]

Your argument is a valid one with regard to the health problems of obesity and too much sugar suffered by your country (and many others,) but that isn't what I am talking about.

Then you're not actually discussing the thread topic, which are the variables that effect healthcare outcomes OTHER THAN financing models.


I am simply telling you how Australia's health care system is funded and works, and many European systems operate along those lines.

I already know how it works, William. The point of this thread was not to discuss how single payer and/or universal healthcare systems work. It was intended to discuss other important variables that contribute to healthcare outcomes, including costs. Specifically, the US government's promotion of unhealthy diets that contribute to obesity and a wide range of deadly diseases.


With respect, your further arguments about 'shifting the costs to taxpayers' make no sense. The costs of health care are met by the taxpayer anyway - either directly or by insurance. Those who are uninsured can go to the ER and be treated (and if they are cannot pay, there is no way of getting the cost back from them,) so those costs are also met by the taxpayer.

Private insurance is paid for by consumers in the market, not taxpayers.


The equation is something like -

Health care costs the nation X

The profit motive of private insurance adds Y

So in a system of private insurance health care costs the nation X+Y

In a single payer UHC system where the profit motive is eliminated, health care costs the nation X - X being less than the sum of X plus Y.

Plus the purchasing power of a single payer, such as a government department, can reduce X, specially in the case of pharmaceuticals.

Your closing argument that most Americans like their private health insurance, is basically an ideological one (only the Commies have UHC, and I'm not paying for some other lazy bum's health), and probably means the USA will never have a system whereby everyone, whether rich or poor, is entitled to health care.

That's fine with me - who am I to tell Americans how to run their country? All I'm doing is telling you how things work elsewhere, yer pays yer money and yer makes yer choice. :smiley:

It's not an argument, it's just a fact. Most Americans who have private insurance (well over one-hundred million people) like their health insurance. There is nothing "ideological" about it. It's just reality.

[Ethereal]

But what about economies of scale
Economies of scale apply only in the limited context of a firm producing goods. We're not talking about changing how healthcare is produced by a single firm, but how it is financed by an entire economy. Additionally, economies of scale only work up until a certain point and then they start to experience diminishing returns. Perhaps there is some way to shoehorn that concept into the debate over financing healthcare at the scale of an entire nation, but I'm not aware of it.

[Ethereal]

America also exports all of that nasty junk food around the world. The difference is that different countries have different food cultures. The American food culture derives primarily from the British and Germanic and later Mexican food cultures, which were historically oriented to meat and carbohydrates or in the case of Mexico, corn. Not everyone in America eats bad food, but those who never learned to like vegetables or were ever really introduced to them fare the worst and are most likely to indulge in junk food and diets high in unnecessary carbs and sugars. Additionally, obesity is not ignored as normal in other countries. Obesity is highly abnormal in Continental Europe. Obesity in children is generally unheard of and certainly addressed as a health concern. Europeans actually walk a great deal or ride bicycles. They are not enslaved to cars.

This is far more complex than just pandering to the corn industry. European cities are human-scaled - they are not dedicated to cars, so people have to walk or take public transit. They deliberately dedicate vast amounts of space, including retail space to walking - no cars. This means that the average Euro gets far more exercise than the average American. Drive-throughs are a rarity in Europe, are associated with American franchises and found only in the outermost suburbs.

In Europe and really the rest of the world, no restaurant serves you a portion size that would feed several people. That is uniquely American. So, whether or not the government indulges the corn industry is not the source of the problem, it may be a part of it, but the bigger issue is both the affinity for excess, ignorance and advantage.
Foods that contain high levels of corn syrup are generally cheaper due to the subsidies. Consumers are hyper-sensitive to price. So, yes, subsidizing corn has a huge impact on eating habits in America. It's basic economics. Combine this with the government's dissemination of dietary guidelines that are based on junk science and you have a recipe for disaster. Granted, culture plays a significant part in health outcomes in America, and that is another variable that can and should be addressed, but I definitely do not agree with your attempt to downplay the significance of government subsidies.

[Ethereal]

There are two kinds of people who become doctors - those who want to help people and those who want to make money. Which one would you rather have as your doctor?
Whichever one is more skilled, obviously.

[Common Sense]

Foods that contain high levels of corn syrup are generally cheaper due to the subsidies. Consumers are hyper-sensitive to price. So, yes, subsidizing corn has a huge impact on eating habits in America. It's basic economics. Combine this with the government's dissemination of dietary guidelines that are based on junk science and you have a recipe for disaster. Granted, culture plays a significant part in health outcomes in America, and that is another variable that can and should be addressed, but I definitely do not agree with your attempt to downplay the significance of government subsidies.

Canada also offers farm subsidies and subsidizes the Canadian corn industry. Not to mention the exact same foods are available here in Canada that are available in the US. Except we don't have In n' Out Burger...

[Dr. Who]

Whichever one is more skilled, obviously.
Since medical malpractice is something that I am familiar with, those who are most interested in the welfare of their patients rarely end up getting sued. Those who are in it for the money, not so much.

[Ethereal]

Canada also offers farm subsidies and subsidizes the Canadian corn industry. Not to mention the exact same foods are available here in Canada that are available in the US. Except we don't have In n' Out Burger...
And Canada also has a problem with obesity. According to the CIA fact book (https://www.cia.gov/library/publications/the-world-factbook/rankorder/2228rank.html), adult obesity rates in the USA are 33% as compared to 26% in Canada. Not a huge difference.

[Ethereal]

Since medical malpractice is something that I am familiar with, those who are most interested in the welfare of their patients rarely end up getting sued. Those who are in it for the money, not so much.
I can't really respond to an anecdote.

[Common Sense]

And Canada also has a problem with obesity. According to the CIA fact book (https://www.cia.gov/library/publications/the-world-factbook/rankorder/2228rank.html), adult obesity rates in the USA are 33% as compared to 26% in Canada. Not a huge difference.

It's really not. The reality is every Canadian city and town is basically the same as the US equivalents. There are the same McDonalds, Burger King and the like. The supermarkets stock the same items.

The argument that the US culture and habits are vastly different, ergo the same systems wont work, is not a valid argument.

[Dr. Who]

Foods that contain high levels of corn syrup are generally cheaper due to the subsidies. Consumers are hyper-sensitive to price. So, yes, subsidizing corn has a huge impact on eating habits in America. It's basic economics. Combine this with the government's dissemination of dietary guidelines that are based on junk science and you have a recipe for disaster. Granted, culture plays a significant part in health outcomes in America, and that is another variable that can and should be addressed, but I definitely do not agree with your attempt to downplay the significance of government subsidies.

Consumers who are that hypersensitive to price could eat far more cheaply if they knew how to cook and had eaten more than deep fried foods, hot dogs and Kraft Dinner their whole lives.

[Dr. Who]

I can't really respond to an anecdote.

Med Mal case law is available on the internet if you are really interested.

[kilgram]

Forgive me, but I don't see what this has to do with my argument. There are so many other variables to consider when examining healthcare outcomes besides "universal healthcare" or a lack thereof. And in considering those variables, we see there are any number of ways to improve healthcare outcomes in the USA without transferring more power and money to the US government.
First, there is no more power or control to government.

Second, what is goal with healthcare?

Do you want a healthcare reachable by all citizens or not? You have to study your goals what is what you want, then you choose your ideal system.

I have already given my opinion about this in the other two threads about this topic.

And yes, it is true that USA lacks of prevention. It is, a very bad diet and high in sugars it makes them to suffer worse healthcare. But it is not the only factor.

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[Common]

You don't. You substitute Federal government or State governments (preferable) for the insurance companies and gradually make enough of the private hospitals public to serve the public adequately and network them regionally to reduce administrative costs. You don't eliminate private hospitals - there will be people who want to have choice, but you offer the best level of care to all people, who then would have the choice to buy up the luxury aspect like private rooms etcetera with insurance or give them the option to go to a private hospital where the government pays X rate for X services and insurance pays the rest. Insurance moves from being the primary source of funding to a secondary source of funding. Then they will not face the death panel decisions (except where experimental drugs are concerned) and no one ends up being unable to insure themselves. Unlike an insurance company, a State or Federal Government gets all of the premiums from the least likely to need health care to offset the cost of care for those who need the most health care - primarily the elderly. A government does not have to deal with opportunistic buyers who come and go because their rates are increased because of claims. They have a captive market. Whether you claim or not would not change your premiums. Premiums would reflect the cost of the overall program.

Governments are then in the position to create clinics near hospitals and encourage people to use clinics for non-emergency care rather than clutter up the ERs with cold and flu sufferers who think that they are dying. The cost of operating clinics is far less than that of hospitals and if they are located nearby hospitals, those individuals who should be attending the ER can be moved there easily to immediate attention because the paperwork is already done.

As with private hospitals, there would have to be boards of directors whose responsibility is to ensure that public hospitals run efficiently and effectively. There is also no reason why public hospitals cannot fundraise for extras in terms of equipment or research. Lotteries are a popular form of fundraising. (volunatary taxation).
Ironically your idea just crashed in fla. Floridas public hospitals that were failing were bought by private health care companies.

Which hospitals go public ? are they forced to go public ? what about the investors in those private hospitals ? what happens to their investments.

Clinics can work but there still has to be hospitals to take the indigent. Your plan is pretty much like what we already have.

[DGUtley]

If we are going to have the central government determine what doctors make that provide that right of healthcare, should we also have the central government decide what contractors or grocers make that provide those rights of shelter and food? I'm sure that will encourage the best and brightest to enter those fields -- it certainly did that in the USSR.

[Peter1469]

Since medical malpractice is something that I am familiar with, those who are most interested in the welfare of their patients rarely end up getting sued. Those who are in it for the money, not so much.

The ones in it for the money are interested in keeping money and making more, correct?

If the answer is yes, then why would they potentially commit malpractice and risk losing money and even being priced out of the ability to practice medicine?

[Peter1469]

When Canadian doctors can't come to the US to make loads of money you may see the more talented people go into something other than medicine.

[Ethereal]

It's really not. The reality is every Canadian city and town is basically the same as the US equivalents. There are the same McDonalds, Burger King and the like. The supermarkets stock the same items.

The argument that the US culture and habits are vastly different, ergo the same systems wont work, is not a valid argument.

The point I just made, which you clearly did not understand, is that Canada ALSO has a problem with obesity, one that is roughly comparable to the one we have in the USA. So your earlier attempt to cite Canada's subsidies as some kind of evidence that subsidies are not a major contributor to obesity is fallacious. Clearly, the subsidies are having such an effect not only in the USA, but in Canada as well. Furthermore, I'm not necessarily arguing such systems won't "work", however you're defining that, I'm arguing that there are OTHER factors that can help explain healthcare outcomes that proponents of such systems routinely ignore. In this case, diet. But that is only one such variable. There are others like genetics, lifestyle, and environment to consider as well.

[Ethereal]

Consumers who are that hypersensitive to price could eat far more cheaply if they knew how to cook and had eaten more than deep fried foods, hot dogs and Kraft Dinner their whole lives.

Yes, well, when the US government is filling their heads with pseudo-scientific dietary guidelines that were created largely by Big Agribusiness, it's hardly surprising they're eating that way.

[Ethereal]

First, there is no more power or control to government.

This is a silly statement. I don't see how I can have a reasonable discussion with you when you cannot even get basic facts right.


Second, what is goal with healthcare?

Do you want a healthcare reachable by all citizens or not? You have to study your goals what is what you want, then you choose your ideal system.

I have already given my opinion about this in the other two threads about this topic.

And yes, it is true that USA lacks of prevention. It is, a very bad diet and high in sugars it makes them to suffer worse healthcare. But it is not the only factor.

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I didn't say it was the only factor. I said it was one of several factors that advocates of "single payer" and/or "universal healthcare" tend to ignore when discussing healthcare outcomes. The only thing they seem to care about it is who finances healthcare, markets or governments. They think that by removing profit incentive, that this somehow magically reduces the cost of healthcare. But this demonstrates a profound ignorance of how markets work. Profit incentive actually causes prices to go down in markets that are functioning properly. The problem is not profit incentive in healthcare, but the lack of a functional healthcare market, and this can be easily explained by the myriad of bad government policies that stifle competition, constrain supply, and cripple innovation.

[Peter1469]

Yes, well, when the US government is filling their heads with pseudo-scientific dietary guidelines that were created largely by Big Agribusiness, it's hardly surprising they're eating that way.Our old food pyramid was based off what what big-agri said cows needed.

[Ethereal]

I'm also perplexed by this idea that the USA is the only modern nation without "universal healthcare". Not only because the concept of "universal healthcare" is fundamentally erroneous, but because the US government has been heavily subsidizing America's healthcare for decades. If the inability of everyone in America to get all the healthcare they want or desire is proof that we do not have so-called "universal healthcare", then nobody in the world has it either because every country has to ration healthcare by economic definition. Healthcare is limited, just like every other resource. Getting the government to finance healthcare does not transform it from a limited resource to an unlimited resource. All it does is take the power to ration healthcare away from the market and gives it to the government.

[Ethereal]

Our old food pyramid was based off what what big-agri said cows needed.
The US government has probably caused the deaths of millions of people based on their dietary guidelines and farm subsidies, to say nothing of their unethical and unconstitutional war on drugs.

[kilgram]

This is a silly statement. I don't see how I can have a reasonable discussion with you when you cannot even get basic facts right.



I didn't say it was the only factor. I said it was one of several factors that advocates of "single payer" and/or "universal healthcare" tend to ignore when discussing healthcare outcomes. The only thing they seem to care about it is who finances healthcare, markets or governments. They think that by removing profit incentive, that this somehow magically reduces the cost of healthcare. But this demonstrates a profound ignorance of how markets work. Profit incentive actually causes prices to go down in markets that are functioning properly. The problem is not profit incentive in healthcare, but the lack of a functional healthcare market, and this can be easily explained by the myriad of bad government policies that stifle competition, constrain supply, and cripple innovation.
Wrong. Spain has public healthcare and private healthcare. Private is even cheap compared to USA basically because it needs to compete with a system that is affordable and very good and they don't have profit goal. While a private business always is profit based and always will be more expensive than the public healthcare. Always.





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[Peter1469]

Wrong. Spain has public healthcare and private healthcare. Private is even cheap compared to USA basically because it needs to compete with a system that is affordable and very good and they don't have profit goal. While a private business always is profit based and always will be more expensive than the public healthcare. Always.





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private business has a reason to make the customer happy

public business doesn't. They could care less if you are happy.

[Ethereal]

Wrong. Spain has public healthcare and private healthcare. Private is even cheap compared to USA basically because it needs to compete with a system that is affordable and very good and they don't have profit goal. While a private business always is profit based and always will be more expensive than the public healthcare. Always.

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There is really no sense is arguing with someone who doesn't understand how markets work.

[William]

There is really no sense is arguing with someone who doesn't understand how markets work.

Maybe how conservative Americans think markets work, and how most Europeans think markets work are just different. :wink:

[Peter1469]

Maybe how conservative Americans think markets work, and how most Europeans think markets work are just different. :wink:

Markets micromanaged by the State.

[Ethereal]

Maybe how conservative Americans think markets work, and how most Europeans think markets work are just different. :wink:
Well, I'm not a conservative, and markets work the same regardless. Adam Smith described and explained their functioning in Wealth of Nations.