Healthcare

How do you think healthcare should be run/accommodated in society?

Should it be entirely subsidised with taxes going towards funding it, or should those who need treatment pay for only themselves?

Or something inbetween?

I personally prefer socialised healthcare, with money collected through taxation. I am biased as I grew up with the NHS not the best, but still universal coverage. However if private companies want to provide alternate cover they can, as long as everyone still pays the taxes.

edited 18th Apr '11 2:52:19 PM by IanExMachina

At a certain level, it is better for all of us if people are healthy and so it is a public need. Why? Well, sick people can be infectious. That's a problem. Sick people also don't work too well. That's an issue if you want other people to be working, not dying.

Then there's the issue of the people who need the most help being those LEAST able to do anything regarding their care. Most expensive health care? Babies and elderly, with the occasional coma or other critical injury patient out in the cold.

Also, I think I saw somewhere that you'd wind up paying less in taxes for government provided healthcare than you do with insurance premiums as it is now.

In the US, at least, I know that the rate on insurance went through the roof after the mangled healthcare bill went through. I literally don't make enough money to get a basic health plan through my employer, since they want $280-something a month, and I make maybe $200 if I'm lucky.

That sucks :(

Quick question regarding US healthcare it costs for you to be taken by ambulance for emergency to a hospital right?

Yeah, but insurance usually covers that. Without insurance, it's between $700 and $800 where I live.

European-style, state-run healthcare, universal, high quality, lots of preventative treatment and check-ups and as little cost to the patient as possible.

It's not even hard to do this.

I get basically everything through provincial healthcare, in terms of basic needs. Employer health insurance (I do not have to pay for it) covers dental, optometry, pharmacy and so on.

I believe last calculation was that around 2200 per capita goes into healthcare costs for Canada. It's worse than European healthcare but it is better than American healthcare. I think much of the cost arises out of our mentality that we go with "cure first" instead of "prevent first". A person not getting cancer, or getting a much less severe form of cancer saves hundreds of thousands in tax dollars in the long run.

When you've got a national healthcare program (or a provincial one like Canada) it does push the government to seek cost efficiency in a lot of ways. For instance, seniors here get pharmacare and as part of the drive to lower costs, they buy generic labels instead of brand name drugs. The cost of litigation is limited. Ambulance rides here are around $100, but you're only charged if you didn't have an emergency. Healthcare professionals have their salaries limited.

If there were some nutrition education or doctor-visiting-patient rather than the other way around, we could save a lot of money. Though, Canada needs more doctors.

We need more doctors down here too. I got insurance through my family at the beginning of the year, and it took me several months to get an appointment, and because my insurance doesn't cover the doctor in town, I have to commute to the next city. It's a major PITA.

@DG

Fuck that is expensive, what happens if the person cannot pay and doesn't have insurance?

The more people you have on your healthcare base, the more distributed the costs are.

The more people you have on your healthcare base, the more negotiating power you have with hospitals. (Look up what they charge people w/out insurance vs. what they charge those who have insurance. Often it's 5-10x as much.)

And finally, the more control you have over your insurance company, the less likely they are to unnecessarily gouge you to pad their own profit margins, while providing unbelievably shitty service.

Most people have 0 control over their health coverage, if they have private coverage.

Hence, govt. healthcare.

They go to the emergency room when it gets really bad, and the hospital eats the cost. That cost is later passed on to you.

edited 18th Apr '11 3:51:44 PM by deathjavu

The ambulance service eats the cost, basically. They can't bill in advance, they take you, get your ID, and send it later. Eventually a collection service may get the note, but they probably won't bother with it for long.

If you're lucky, you get on Medicaid and they get compensated, if not...yeah, they bill the rest of us.

I like the NHS and feel relieved that this sort of thing isn't left up to chance or in the hands of private businesses. The private option is there and thats fine, but if people fall ill, some means of treating them should be provided for. I'd say I put public healthcare even before public education (second biggest priority) on the list of "things for the state to provide".

Looking for the other old threads on this subject.

Unfortunately I think they're gone.

Or at least the one I remember participating in is gone. It was a few hundred pages, too. Had a bunch of arguments and sources I wouldn't mind finding again.

Even if their deaths costs us money?

edited 18th Apr '11 9:23:49 PM by deathjavu

I am against anything that saves potential Darwin Award winners from dying.

I think a move to universal health care in America at least, would necessarily have to go through some "growing pains" as the private health providers jack up premiums in defiance of the passing, as DG mentioned, then dodging the lobbying that will ensure they have a monopoly. Once health care goes through people will opt into the public system more and more until private health providers simply have no choice but to adjust and lower premiums to compete with the national system. With that power over the system finally taken away they'll settle into the quiet but ineffectual whining that any industry that faces government regulation goes through, slowly a generation gets used to universal health care and before you know it we'll wonder how we did without it just like we wonder how we did without Social Security or unemployment benefits.

Neither hospitals nor ambulance services are legally permitted to deny somebody based on ability to pay.

Meaning if you can't pay and they deny you, you have an unloseable case and can sue the ambulance service for literally every dime they're worth and then some.

Well every country has had their "growing pains" with the system.

For Canada, it began with the socialists in Saskatchewan back in the 1960s. It took twenty years before it became so obvious that their healthcare was a million times better that the rest of Canada simply adopted it. So we've a provincially controlled and funded system. However, due to global rise of healthcare costs, the Federal government has started to dump money into it. Healthcare is basically the single most expensive item in the Canadian budget.

So really, I think we should be gravitating towards preventative medicine to help lower costs. From the estimates I've seen, if we brought in pharmacare, home care and preventative practices for healthcare practices and then nutrition/cafeteria changes at schools and homes, we could basically flat line healthcare costs for the next decade while everything improves (child mortality, life expectancy, general health).

As for America there's a long list of things that would have to be tackled:

• You can leave healthcare in the control of state agencies who then sell a public option for insurance
• Federal government should ensure that Federal money is split "evenly" per capita, and per local cost of living, per state
• Limit litigation and malpractice lawsuits in America, I think it's time to end the era of "how did this even get to court?"
• Begin expanding out public hospitals and slowly buy-out private-hospitals (As public healthcare becomes more prominent, private businesses will suffer and become cheaper to purchase)
• Some public models have user fees, Canada's does not but I've not seen empirical evidence to suggest one is better than the other (however, there is indication that user fees cause people to wait until serious problems crop up before seeing a doctor)
• Bulk purchase of drugs and services

I remember when I was little and was told that in the US they didn't have public healthcare, I was horrified. "Do they just leave people to die in the streets?" were my thoughts. Now, I know that reality is a little more complex than that and that emergency care is not denied people in most (first-world) countries without a universal healthcare system, you just have to pay later, if you can.

Anyway, I still find the prospect of not having a universal healthcare system to be a petty bad one. After all, the idea of just letting people die because they can't afford to pay their medical bills is something that I find highly unethical. Mind you, I might be biased by growing up with a universal healthcare system.

Now, I'm not saying that this system is perfect, it is far from perfect. Wait-lists, lack of enough personnel etc. often plagues public healthcare systems and the more urgent your problem, the sooner you will be taken care of (thinking about big stuff, like operations), meaning that if it isn't urgent, but still an inconvenience, you might have to wait for a while. Also, digressing into Danish politics, if you have a government that doesn't give a fuck about public healthcare and is trying to boost private hospitals over the public ones, not directing enough funds towards it, the system is somewhat vulnerable. yes, I don't like the current Danish government, why did you ask? :p

Still, regardless of it's problems, universal healthcare is by far a net-gain for the population and helps a lot of people survive every year. Also, I honestly find the idea of just letting people die, because they can't pay for treatments, to be morally reprehensible.

Doesn't happen in the US barring the occasional malpractice incidents. Hospitals are forbidden by law from turning away people owing to inability to pay. (Doubly so for life-threatening diseases and injuries)

Why nobody seems to know that is beyond me.

So if the hospitals are by law required to treat anyway, why not have it run by the sate rather than private insurance?

Edit:

You could almost be talking about the current Uk government. Also on the subject there is mean to be some healthcare 'reform' coming, however the Royal College of Nurses came back with a 99% vote of no confidence in Andrew Lansley's (Health Secretary) reforms.

So he apologised... kind of...

So now the govt is having a pause for thought about it's reforms.

edited 19th Apr '11 8:56:19 AM by IanExMachina

Because the hospitals are private entities regardless of whether or not the insurers are private.

That and the state here has a horrible record of running things. Seriously, take any two things the state can do alongside the private sector. The state usually has a reputation for being over-budget, behind schedule, and poor quality. This happens on roads and infrastructure all too commonly. The state workers do such a shoddy job that the job should never have been done in the first place then the private workers have to be called in to fix the state workers' mess.

Health care is no different, remember the big scandal about Walter Reed Army Medical Center?

LOL. You think the private workers have a better reputation? Not in healthcare. You can find scandals at ANY hospital. It's just the government doesn't do such a good job of hiding it. Something about being responsible to the public keeps them from burying things. Heck, much road work IS contracted out to private companies, who are more than happy to cheat the taxpayers.

I feel that is in contrast to over here (about how state run things are run), although I'm not sure the govt would agree on that line, especially due to all the shitty ridiculous PFI deals we've got going on.

edited 19th Apr '11 9:00:29 AM by IanExMachina

@Tom: I'd be happy if I didn't have to pay for my healthcare twice. There's the monthly premium, the copay, then I have to hit my out-of-pocket maximum before they pick up the full tab. On my last set of labs (I have a repressed immune system due to a thyroid disorder), I had to fork over an additional $80, because the insurance company only paid for half of it. I have insurance, and I'm still barely able to afford healthcare, not to mention that I have to commute to the next city (about twenty miles) to get a checkup because the insurance refuses to work with my local doctor, and I have to drive even farther (sixty miles south) if I wind up having to go to an endocrinologist for my thyroid disorder. Which essentially translates into "Drunkscriblerian has to take a day off work to drive me, because the bus doesn't go that far." At this point, the government can't do much worse.