Socialized National Health Care DOESN'T WORK!*

[Neil D]

Posted by Yollam

Added to homepage Fri Feb 03rd 2006, 09:44 AM ET

That's right. I can tell you from personal experience.

I lived in Japan from 1995 to 2000. I had the Social National Health Insurance.

I paid $70 a month in premiums, which was matched by my employer.

It covered full medical AND dental for me, my wife and two kids.

I could choose any doctor I liked, so we picked the doctor in the neighborhood.

I could go any time, even without an appointment, and still the wait times were less than 30 minutes most of the time.

Office visits were $5.

Prescription drugs were $5.

There was no HMO or other gouging middleman to deal with, and little paperwork involved in being referred to a specialist.

I understand that Japan spends less than HALF per capita of what we do on health care, despite its aging population, and still they manage to cover EVERYONE, while we only cover about 60% of the population.

*Yeah, National Health Care in Japan, and in European countries with similar systems is a dismal failure.

After all, it totally fails to generate huge profits for overpaid CEOs, shell-gaming HMO's and redundant "Health Care Access Administrators".

We'd best never emulate those commie systems. After all, who wants to live in a country where everybody's healthy?

Just wait till one of your lower-paid co-workers comes down with say, kidney disease, and then you and everyone in the office can just have bake sales and car washes to pay for his care. That's the way to do it!

Or if you're really lucky, he just won't mention it for shame of being unable to afford health care, and he'll just die quietly and save you all the trouble,

Oh, thank you George Bush for your wonderful health savings plans. I can't wait until you take away the employer deduction for health care and rid us of those pesky benefits once and for all.

After all, it's not like we can already put money in a tax-deferred account right now, is it?

And EVERYONE has a couple hundred EXTRA bucks lying around at the end of every month to sock away, right?

[Gerr]

I personally would like a two tier plan. 1) coverage for everyone so that all could have access to basic medical care, paid for by taxing everyone, 2) #1 plus additional coverage for those who can afford the extra expense out of their own pocket.

It is unconscionable for someone to have to choose between food & medical care, no prenatal care to pregnant women, etc. etc. Right now there is too much money going to middle men that could otherwise be used to cover the less fortunate.

Gerry

[Nicodema]

I'd always heard the chief arguments against a national health care plan were: (1) not wanting the government to "dictate" to people how or even IF they get their care; (2) not wanting the hefty expense involved in extra taxes; (3) not wanting things to get bogged down with lots of paperwork, middlemen, gatekeepers, and other bureaucratic red tape nonsense.

Well guess what ... now we have HMO corporations running the whole show. THEY dictate to people how or even IF they get their care; THEY cost a small fortune in paycheck deductions equivalent to an extra tax; and THEY bog everything down with lots of paperwork, middlemen, gatekeepers, and other bureaucratic nonsense.

Oh the irony.

[Michelle]

I don't know what would work, but I know that what the US has is a failure. When I look at how much I pay for medical here in HK, I just shake my head in amazement. A doctor visit is usually around HKD $100, which is about $12 USD. $320 ($40 USD) for an eye exam that includes 3 follow up visits (in other words, I don't have to pay each time I walk through their door). And the care is not sub-standard--different maybe, but really decent care. (much better than mainland China, for example--that is a scary place to be sick!) In fact, my eye doctor is doing more advanced contact lens fitting than my US eye doctor (who is excellent, very perfectionist in fitting RGP contacts).

M

[Gregory Matthews]

I am personally eligible for medical care that is paid for by the U.S. Government, and the tax dollars of US citizens, in three different systems. Let us look at these for a moment:

1) I am eligible for medical care through the Department of Veterans Affairs.

In the 19l70s this medical care was objectively very poor. Presently it is being nationally recognized, by objective evaualtions, as some of the best in the nation, and as provided at considerable cost savings. In some areas, it is objectively recognized as better than any other system.

To give you one example: VA Medical care is recognized as being the first, and best in the nation to go to computeried record keeping in a system that has reduced medical errors in the despensing of medications over and above any other system. I have worked in other private hospitals and can personally state that when I worked there they did not have the systems in place to prevent medical errors that we had.

The present quality of our medical care has been nationally recognized as recently as the year 2006.

NOTE: My comments above apply to private profit and non-profit care to include HMOs.

2) My family and I are eligible for medical care under a system that is known as TRICARE. Tricare exists in three different forms, and people have the freedom to chose the form that they use, baed upon the deductables and co-pays that they want to pay. It exists as a HMO, a PPO, and in a form where they have the freedom to decide upon thier provider of medical care.

I do not find this system to be perfect. However, we have chosen a form that we want for our medical care, and we generally feel that it equals, and often is better than what others have who have chosen the same form that we have.

3) I presently have a 4th form of TRICARE which is not available to my family, and from the practical standpoint, I am required to accept, and is only available to certain people eligible for the other forms of TRICARE. So, I am not going to discuss this form. I will simply say that it gives me additional medical benefits that are not available to my family. Although, at a later time they will be available to them.

My comment:

By personal experience, I can tell you that I (we) experience good medical care in a system that might be called socialized medecine. Because I have both VA and TRICARE available to me, I can pick and chose on an individual basis where I get specific care. I.e. When I had my eye-glasses replaced a few weeks ago, I went to the system that provided that benefit, and not the one that did not.

But, I do have some concerns regarding the systems that provide me with medical care. All are funded by your tax dollars. This means that deductables, co-pays, and reimbursement rates are subject to political decisions, and not by market conditions. Periocically those who enact the laws of the United States propose changes in the above which will clearly affect the quality of the medical care that I am my family recieve.

[Dr. Shane]

I am in favor of healthcare reform. I am not even against some form of socialized medicine but strongly believe it would need to be run by the individual states - a federal program would be a monster of inefficiently and corruption.

The US has about 400 million people. So when we compare it to other countries, we need to compare it to those of comparable size. China would be a good comparison - Canada would not be.

I will tell a dirty little business secret here... No one's employer ever matches anything. The employer never pays for health coverage, retirment benefits or even half of one's social security deposits. That is all paid for by the workers' earnings. Instead of paying the worker a higher wage, the employer pays part of their social security, pays unemployment tax, pays into their 401k, pays for their health insurance, pays workers' comp., etc. However, where does the employer get money to pay into these things? He gets the money from the labor of his employees. So if a worker earns $18/hour + benifits, he or she is actually earning $30/hour but the boss is using $10/hour to pay for benefits and keeping $2 for a profit.

HSAs (health savings accounts) have not come into common usage. The idea is to have a high deductable ($10k) insurance to pay for major medical like cancer treatments, major surgery, etc. Presciptions, office visits and minor procedures are paid for by the consumer using tax-free medical savings account. This would allow market forces to set the price of services and if they become in widespread use, we will see prices come under control. The problem we have now is that insurance companies pay the bills and not the consumer.

[Gerr]

Every health plan currently implemented in different countries of the world has its own short-comings. The most common that I have read & heard of is the long wait for a procedure, like cataract surgery, hip or knee replacement, etc. When we were in England, our host friends were in the second tier of what I previously described. This came about as a recognition that the #1 plan was inadequate.

There are many who are touting the Canadian plan. They have their problems too. I have read that many Canadians who can afford to, come to the US when they need certain procedures done which they are unwilling to wait for in Canada. And there are probably more MRI, CT & PET scanners here in Riverside county than all of Canada.

Yes, the HMOs have become the dictators, & much of healthcare dollars are siphoned off by them.

Gerry

[gina i]

I am a socialist, therefore I like our medical system here in Canada. When it works. Basically because I have the best medical, the only thing I have to pay for is.. Nothing.

But if you have cancer or an emergency, good luck. That is why most people go to the states (if they have the money to shell out).

[Gregory Matthews]

Re: " . . . a federal program would be a monster of inefficiently and corruption."

Shane, The Federal plan administered by the Department of Veterans Affairs is recognized for providing excellant medical care at lowered cost. A recent study has placed in Number One in patient satisfactions scores.

[Dr. Shane]

Now compare how many veterns there are to how many Americans there are. Compare how many doctors work for the VA compared to how many work in America.

The bigger the organization is, the more waste there is. A giant health program to provide services to 400 million people would be a nightmare. It would be much more efficient for the program to be federally funded but managed by the individual states - simular to how public education is.

[Neil D]

Quote:

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t would be much more efficient for the program to be federally funded but managed by the individual states - simular to how public education is.

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Ho! Now there's a joke.....

[Dr. Shane]

Public education is a joke? Well, there are many areas of the country that have very good public schools.

The welfare system is another example. These programs are mostly federally funded but are administered by the state and local governments.

I once built a project for Sprint Communications. They are so big that they are quite inefficient. After we built the block walls they paid us $5,000 to move a door opening. After we moved it, they paid us another $5,000 to put it back where it was. That is just a typical example of any giant organization.

If there was social healthcare in the US, if each state administered their own system, it would be smaller and easier to run - less waste. When mistakes were made they wouldn't impact the entire nation and states could learn from other state's problems and successes.

Most federal programs start out as state programs. Look for a state to start its own health program before there is a federal one.

[Gerr]

Quote:

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gina i said:

I am a socialist, therefore I like our medical system here in Canada. When it works. Basically because I have the best medical, the only thing I have to pay for is.. Nothing.

But if you have cancer or an emergency, good luck. That is why most people go to the states (if they have the money to shell out).

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[:"blue"]Costs you nothing? What's your tax rate in Canada? [/]

Gerry

[bevin]

Quote:

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Costs you nothing? What's your tax rate in Canada?

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Gerry has a point, but it is more complex than that.

In each country we pay towards

• the police / justice system
• the welfare system
• the medical system
• the education system
• the military

Each country has a different standard of living - different amounts of leisure time, ammenities, recreational activities, etc.

Each country has a different level of income - for a wide variety of reasons.

It is REALLY difficult to compare two countries, except to note that most citizens of each prefer their own - so there can't be much in it.

Having said that, no-one who understands the USA medical system thinks it makes economic sense. It needs to change, it is changing, and the rate of change will get higher as the baby-boomers retire.

/Bevin

[bevin]

and there are numerous working examples to demonstrate it.

"Working" here is defined as providing a solid basic medicine to everyone. It is NOT defined as wasting millions of dollars on individuals who need cost-ineffective treatments.

For example: It does not make sense to provide

$20,000+/day treatment to a 80 year old COPD/CHF/CABG pt.

/Bevin

[bevin]

Quote:

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It would be much more efficient for the program to be federally funded but managed by the individual states - simular to how public education is.

---

I agree that this would be the right way to fund education.

Unfortunately education is funded by either the town or the state - neither of whom has a strong vested interest in educating children because there is no reason to believe the child will live in that community when they grow up.

/Bevin

[Dr. Shane]

The last figures I saw, the federal government provides about 50% of the funding for our schools in Texas. I think the number was 47%. The remaining is provided by the State and local property taxes.

I believe the States also contribute to the welfare system too.

Such is a good model for any type of socialized medicine too. Although if HSAs become more commonly used, the market forces may bring prices down.

[Neil D]

Quote:

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Public education is a joke? Well, there are many areas of the country that have very good public schools.

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And every single one of them is failing the federal standards that it sets. Yes, it is a joke.

I have posted before what the summery statements that the goverment has reviewed. The "No Child Left Behind" act is an absolute wreck. It micromanages things that it should not even come close to managing and addresses things that should be left at a state level, even county level. It reduces to schools with problem kids, moneys where more money is needed for more teaching on a one on one experience. It causes kids to test to the test, and not for knowledge. It is quite simply a joke.

And when the president says that "we have made improvements to the public school system", he lies thru his teeth. Our kids are not smarter, they are dumber....

Quote:

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I once built a project for Sprint Communications. They are so big that they are quite inefficient. After we built the block walls they paid us $5,000 to move a door opening. After we moved it, they paid us another $5,000 to put it back where it was. That is just a typical example of any giant organization.

---

You call it waste?

I call it "reviewing the plans"...I see that on "This old House" many times when the owner reviews the plans and changes things around. I have done this when I was building a home. And I have paid the penalty for doing so. Apparently, Sprint has the $$$$ to be able to do that....I know if I had the money, I would do it...

Lynndell, are you seeing this? Do you have any input toward this subject?

[Gerr]

Quote:

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bevin said:

and there are numerous working examples to demonstrate it.

"Working" here is defined as providing a solid basic medicine to everyone. It is NOT defined as wasting millions of dollars on individuals who need cost-ineffective treatments.

For example: It does not make sense to provide

$20,000+/day treatment to a 80 year old COPD/CHF/CABG pt.

/Bevin

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[:"blue"]AMEN! AMEN! AMEN!

Nor does it make sense to keep hospitalizing in acute care hospitals bedfast people with advanced Alzheimer's. [/]

Gerry

[Gerr]

I seem to recall reading years ago that Sean Connery of James Bond fame moved his residence to Switzerland to avoid the 90% tax rate he would have had to pay in Britain.

I sure would like to hear from Gina as to what percentage of her income she pays for taxes, especially since Canada does not maintain a huge military that we do.

If the gov't takes a huge chunk of your income to fund these "free" services, then they are not really free.

I personally would not mind paying a little bit higher tax so that the poor among us and those who have some prior existing conditions who presently could not get insurance, could all have basic medical care.

Gerry

[Bravus]

OK, since I really don't mind sharing financial info that many others are shy about, here's the breakdown of my monthly paycheque in terms of taxes. I think this notion that Canadians pay hugely bigger taxes than those in the US is a bit of a furphy... If someone here who is on a similar income to mine is willing to share this kind of info it would make for an interesting comparison. (Also by way of comparison, the income tax rates in Australia are higher, but they include all the pension and employment insurance stuff in the income tax, rather than add it on top as they do in Canada. Australia has a 10% GST, Canada has a 7% one. Some Canadian provinces (like some American states) have a local sales tax too, but Alberta doesn't.)

Reg Salary: 6,566.25

Taxes

Description Amount

CIT 1,401.08

CPP 315.48

EI 122.79

Total: 1,839.35

CIT = Canada Income Tax

CPP = Canada Pension Plan

EI = Employment Insurance

So my total tax is 28%, on an income that is siginificantly above the national average.

As has been pointed out elsewhere, there are all sorts of hidden costs and other things that make these comparisons difficult, but making some sort of comparisons is useful to get rid of myths, I think.

[Gregory Matthews]

Re: "

Nor does it make sense to keep hospitalizing in acute care hospitals bedfast people with advanced Alzheimer's."

I am not aware of this ever being done.

Alzheimer patients are typically moved to dementia wards in Assisted Living Centers, if that is all that they have. IF they have more they go to a nursing home.

But, to stay for years in an acute care hospital, as would be the case if it was ony Alzheimers, I never see it. I do not think that it happens unlessthe family pays for it.

[Gregory Matthews]

Re: "For example: It does not make sense to provide

$20,000+/day treatment to a 80 year old COPD/CHF/CABG pt."

I note that you did not specify any length of time.

So, are you saying that it makes no sense when we can restore that patient to his base line after four days.

I am aware of an actual casse:

Male, 83 years of age.

Baseline: Rides bicycle 6 miles per day, and does 50 sit-ups per day.

After four days, we were able to restore him to a problem free baseline of:

Riding bicycle two miles a day.

Doing 20 situps a day.

Continued independent living.

Was the four days worth it?

[Bravus]

Just for interest I used an online tax calculator to figure out what my US income tax would be. It said I'd pay $1,410 a month, for a rate of 21.5%. So that is lower than than the Canadian tax, though I'd say not dramatically lower. I'm not sure whether there are additional pension and EI deductions in the US. My income tax alone is almost exactly the same, at $1,401 a month.

Then, of course, out of this take-home pay, Americans who want it and can afford it pay for private health insurance... which is the topic of the thread.

Anyway, just chiming in with some data: this topic is one I always avoid with my American friends, because it's one on which they're already completely convinced... and hey, you makes your choices and takes your consequences, and good luck to ya.

[LynnDel]

Warning: This whole post begins slightly off topic and veers completely off, for which I insincerely apologize and point to Neil, saying, "He did it." <img src="/ubbtreads/images/graemlins/smile.gif" alt="" />

I agree with your general premise, Neil, about the degree of success in public education, though I wouldn't have made my statements quite as sweeping. I couldn't say that "every single school is failing" the standards; several schools in my area are meeting them - if the standards to which you refer are the national standardized testing scores. If you are talking about the goal in my previous district, that student scores will be at 50 percentile or higher and will improve each year - that is a statistical impossibility (Is it possible that those who write those goals don't understand what percentile means?)

There are some very good public schools here and there across the nation. NCLB (No Child Left Behind) is a great ideal, but in the zeal to leave no child behind, the end result is to try to have every child achieve the same goals when this is neither pracatical nor desirable. For example, my students who don't read English, and hardly speak it, have to take the national standardized test in English. My students with dyslexia to the point where they cannot tell an f from a t (etc.) from one minute to the next, have to take that same test.

A brief interjection here: US students are often compared, and poorly, to students of other nations. However, I strongly suspect that the high school scores from other countries do not include students who have been passed from grade to grade without having mastered the concepts along the way. I suspect they do not include students who are unable to read the language of the exams. I suspect they do not include students who have learning and emotional disablities. I suspect they do not come from students who have been in classes all along the way with students whose lack of academic skills strongly affect the degree to which the classroom teacher is able to challenge the rest of the class.

It is true that students across the US have made impressive gains in standardized testing scores. This is likely what GB is referring to when he says there are improvements to the public school system. However, I personally don't believe that improved test scores mean students are better able to accomplish higher-level thinking skills.

You are correct in saying that students are taught to the test, and the six weeks before the test is cram time. There is huge pressure on the teachers for their class score to improve from the previous year. The students spend hours practicing filling in bubbles, practicing questions similar to those on the test. When I took my teacher education courses, teaching to the test was considered highly inappropriate, but now it is expected. Granted, a test should test that which a student has studied, but now the cart is leading the horse.

Student potential intelligence has not changed. Students are neither smarter nor dumber. Schools have changed, and though there is an honest effort to make a change for the better, the direction in which public education in the US has headed over the past five years has not been an improvement, in my opinion.

Even more important than public education, when it deals with student potential, is that families have changed and continue to change. Those of us who appreciate and include our children in our daily lives, who talk over decision-making processes and include our children in those processes - thereby educating them far beyond what a school can ever do - those families are rare. I work with students who are raised without meaningful communication with their parents, raised on TV and Play Station games. I strongly believe that early heavy exposure to those media affects mental development negatively, with potential to harm the brain's ability to perceive and process visual and auditory information, not to mention the degree to which it affects the memory and ability to pay attention.

But I digress from the whole point of this thread, so at this point I will stop!

Happy learning,

LynnDel