Is Universal Health Care Just a Pipe Dream?

[Alhena]

All of our major candidates are for universal health care, but anyone who saw 60 Minutes tonight would have a hard time disputing the fact that there's no earthly way we can pay for it. The report tonight basically explained how just about no one, either conservative or liberal, disputes the fact that in coming decades we won't even come close to being able to pay for the Medicare benefits that we've already promised. According to the report, unless we make major Medicare cuts, in 40 years we won't have the money to do anything but pay interest on the national debt- no military spending and almost no entitlements.

Universal Health Care is clearly a noble goal, but I worry that it's going to hurt our candidate in the general election and there's no earthly way it's going to be passed into law regardless- you need 60 votes to pass anything in the Senate. There's a reason why this issue only get dragged out during every presidential election- Congress could pass Universal Health Care tomorrow, but no one is even considering doing it. It went absolutely no where when Hillary tried to pass it years ago and - thanks to Bush's idiotic tax cuts and warmongering, along with the aging of our population, our fiscal situation is infinitely worse.

So the bottom line AFAIC is that this whole issue is basically a fraud upon the American people because it is completley unaffordable and will never get passed into law, and so what's the point of costing ourselves votes in the general election? Most Americans have health care and they won't have any desire to pay for the benefits of those who don't. I'd rather our candidates just play it straight with the American people instead of making promises that anyone with half a brain knows will never be kept.

[BayCityProgressive]

1. if it is so unattainable

why does the rest of the industrialized world and even socialist countries like Cuba have it?

[Alhena]

4. I'm not an expert but I gather they ration care ...

you always hear about Canadians having to wait 9 months for a CAT scan and things like that. Also, I lived in Germany for a while and doctors there earned FAR less than they do here in the US. It's not like it's politically feasible to cut the salary of every doctor in the US.

[Solon]

26. The waiting list thing is an exaggeration, at the very least...

Generally, no matter where you live, the U.S., Canada, anywhere, if you need to see a specialist for a non-life threatening condition, you are put on a waiting list. It could be quick, within a few weeks, or long, depending on the availability. My Grandmother, as an example, had to wait for knee replacement surgery, for damned near a year, and she was in pain while waiting for it.

As far as CAT scans and stuff, I don't believe you, simply put, that sounds foolish, and I never heard of people having to wait THAT long to get something like a CAT scan. Besides, you must ask yourself, if these UHC systems in other countries are so bad, why do they always get high marks from their citizens?

[Adelante]

35. I never heard of waiting lists in the US

For a specialist or a CAT scan - that's very bad if it's what's happening now.

[colinmom71]

58. Of course it happens here in the US...

We just call it "waiting for an open appointment".

We have very good insurance coverage for our family (dual ins. and Medicaid coverage for our son), and we had to wait about a month between each of the initial diagnoses, diagnostic tests, and the eye surgeries our son had to have over a year ago. And it was an urgent situation (not life threatening, but urgent in order to try to preserve his sight). But much of the delay was being able to schedule the needed surgical and diagnostic equipment at the first available appointment.

Of course, appointment availability depends on the specialty and how largely populated the area you live. When we lived in a smaller city, it was usually easier to get quicker open appointments since there were fewer people vying for appointments than there are here in the Atlanta area... And when you have to see a well regarded pediatric specialist, there is even more "competition" for appointments... That's just how it goes.

[Joe Bacon]

6. We ALREADY ration care based on the money you have!

I'm tired of hearing this crock that medical care is rationed everywhere but America. We already ration it by the amount of cash one has! Ask Barry Morse why he never became a US Citizen and he will tell you it is because of health care. His wife was in a nursing home for years suffering from Parkinsons. If he had lived here, he would have gone bankrupt.

Ask Canadians if their care is rationed the way liars like Andrew Sullivan say it is. They will look at you as if you are out of your mind!

The Republic Party has made sure that there will be no major expansion of any government service because of all the red ink they have spilled since Reagan opened the spigot.

The other factor that will stop any form of national health insurance is the inherent selfishness of Americans. Truman ran into accusations of "Socialized Medicine" from the Baxter lobby. Johnson had to water down Medicare by letting private insurance companies which opposed it run it.

Any proposal for expanding national health insurance will bring Harry and Louise out of retirement. They torpedoed Hillary's plan and they will do it again and again and again. And you'll also have liars like Andrew Sullivan ready to torpedo any proposal. Sullivan said the best thing he ever did was torpedo Hillary's plan in THE SCREW REPUBLIC. Thanks to Sullivan, millions have no chance for help with their medical bills and bankruptcy is their only recourse.

The only help might come from Adam Smith's "invisible hand" of charity, which will wither away with the elimination of estate taxes. Well, that will leave only the churches, so get ready to give $1,000 to Pat, jerry, Paul Crouch, James Robison or Dobson to pray for divine intervention for you.

[Massacure]

7. Cuba doesn't have a 8 trillion dollar debt to pay off.

The U.S. is over 8 trillion dollars in debt and has to pay nearly 350 billion dollars in interest to finance it yearly. Not to mention Mr. Spend-and-Borrow has been adding to the debt at a rate of about 300-400 billion dollars a year.

[John Q. Citizen]

2. I didn't see "60 Min." tonight, but I do know for a fact that Universal Health Care IS affordable,

but only if we get a single payer fee for service system.

We need to self insure as a country and get the bloodsucking private insurence companies out of the business.

Other countries do it and do it well. We can't? Why not?

[malikstein]

32. Well also need to tax the rich.

That's how every other industrial country can afford social services. The rich pay, just like the rest of us, on a progressive scale.

[John Q. Citizen]

41. Except that single payer universal health insurance isn't a social service,

anymore than a public highway is perceived to be a social service.

Everyone with income pays into the kitty, and everyone gets to drive down the road, or their milk gets delivered to their local market on that road.

[SOS]

44. Exactly

In Sweden the cost per person per year on health is $2,000.
In the US it is $7,000.

Sweden covers everyone, has excellent medical facilities and covers everyone.
They even pay for a stay at a spa if your doctor says you're suffering from job stress.
They also have unlimited nursing home care.

We could have that too, but only if the Wall Street vampires are kicked out.
Health care should not be an exchange traded commodity.

[SharonAnn]

45. It's affordable and it doesn't have to be a dream.

[frankenforpres]

3. we already pay more

than other countries with UHC


there will be tradeoffs though, it isnt a utopia.

[BayCityProgressive]

5. I also support

socializing house, life and car insurance. In my state car insurance is mandatory, and anything mandatory should be nonprofit in my opinion. Especially with the huge job cuts and lost wages we are suffering from.

[John Q. Citizen]

10. I support a pay at the pump state run basic auto liability insurance pool. It would save

a lot of money. Everyone with gas in their tank would be insured. (no more uninsured drivers) No more police and court costs, because everyone on the road would be insured.

If someone wants comprehensive then they can go buy it from a private company.

I don't support socializing house or life insurance. Since auto is mandatory in all states I know of, then it should be not for profit to comply with the basic requirements of state auto liability laws.

[enough already]

39. The private insurance companies need to be put out of business

They are nothing but blood-sucking leeches.

[John Q. Citizen]

40. I agree, when it come to nessecities such as health care and basic auto liability.

which is required by law.

[Greyhound]

50. California voters have passed this twice and each time the insurance industry

just buys a few politicians and kills it. This country would be far better off, both socially and economically, if we would just seize their assets and outlaw the whole insurance industry. Include the banking and finance industries and we could easily afford the "liberal utopia" that the corporatists are constantly telling us is "just a pipe dream".

[John Q. Citizen]

53. Was it passed by the voters or was it an initiative that lost? If it passed I don't see

they could stop it unless they got court relief or something, based on the wording. The leg in CA doesn't like to mess with initiatives, at least once they are passed.

I doubt seizing their assets would work as well as just politely informing them that health care is too important to leave up to magic, and we need a not for profit funding system system so bug out.

There would be a period of financial reconciliation in terms of premiums received/on going claims/ and then a system.

Everyone would be relieved, from patients to doctors, to politicians, to nurses. Even low level health insurance sales people. It's the only way to go. You always self insure when it's feasible. We owe it to ourselves for being such good patriotic SOBs the last six years. Why not now more than ever?

[Greyhound]

57. After I posted, I remembered more about it, and it was both.

It was passed through a referendum in the early 90's and the insurance industry challenged it in court and tied it up in court until the state couldn't afford to keep fighting the case. It cost the insurers about 200 million.

The second time, the insurers were better prepared and spent ~$140 million on false advertising to kill it during the campaign. The advertising campaign was the usual collections of lies combined with a subtle implication that it would end California's unique "lawsuit lottery" system and it worked.

[AnOhioan]

8. The 60 minutes report is BS

Single payer health care IS affordable.

From the website of Congressman Kucinich;

"FACT: We already spend enough to have universal health care. "The truth is, we cannot afford to not reform the health system." We spend about 50% more than the next most expensive nation and nearly twice per person what the Canadians do. On May 1, 2006 Paul Krugman explained in Death by Insurance how incredibly wasteful the current system is. The doctor he referenced has two full-time staff members for billing, and two secretaries spend half their time collecting insurance information on the 301 different private plans they deal with. This type of waste is easily 20%. Also consider that 98% of Medicare funds are spent on medical care."

http://kucinich.us/issues/universalhealth.php

We take out the insurance comapnies and their bloated overhead and we have what we want, and need.

And I also must correct your statement "All of our major candidates are for universal health care".

Wrong, the majority of candidates are espousing band-ad fixes for a aping wound. Only Congressman Kucinich is proposed single payer, the only "universal" plan worth considering.

[davekriss]

9. You and 60 minutes are just wrong on the facts

I suggest you acquaint yourself with this site, http://www.pnhp.org/ From its intro page (with emphasis added)...

The U.S. spends twice as much as other industrialized nations on health care, $7,129 per capita. Yet our system performs poorly in comparison and still leaves 46 million without health coverage and millions more inadequately covered.

This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment though a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.

[Alhena]

11. What about the millions of Americans who work for insurance companies

and other private entities that service our health care system? For better or worse, the private medical system is the way our medical economy is structured and you don't just switch horses overnight by going to a single-payer system. Do you have any idea how many politically connected interest groups would scream bloody murder (and write fat checks to politicians) if that system were threatened?

We can debate about what might happen in some Utopian world, but in the real world anything we pass is going to need 60 votes in the Senate. I doubt Universal Health Care could even get 30 votes. And - to his credit - John Edwards is upfront that his program will cost a lot of money and will require new taxes. Thanks to Bush, we'll need new taxes just to pay for the promises we've already made. The political will for Universal Health Care isn't there, and even if it were, the money isn't there.

So why waste everyone's time by talking about it? It reminds me of one of those late night bull sessions I used to have in college.

[AnOhioan]

12. Sorry, but you are wrong on this one.

The money is already there, the political will is not, yet, but that too is changing.

[Solo_in_MD]

13. Or those for whom it would represent a loss in benefits

My wife is a teacher and her medical benefits are incredible. Certainly better than those I have had in Federal Civil Service, the military, or in industry.

The other question is where do the savings to the employers go? Employees? Lower prices? Shareholders?

[John Q. Citizen]

16. Why would anyone need to take a loss in benefits by moving to a single payer

fee for service system?

What about your wife's benefits are superior to active duty military, or to FCS, or to industry?

[Solon]

25. How incredible are they?

Really, what is it, no co-pays or something? Why would a public, universal system, be any different?

[Solo_in_MD]

27. Glasses are minimal cost, great dental including cleanings, minimal copay for visits or perscription

Rate is quite reasonable and it continues after retirement. Better than anything I have seen anywhere else. It has enabled me to take on my current high risk/high reward/no benefits job.

[Solon]

28. And how would a UHC system affect that, in a negative way?

That's what I'm puzzling over here, as far as I can tell, you could have all that, and more, with REDUCED co-pays and REDUCED premiums, instead having the premiums rolled up into taxes, but at an overall reduced cost for your wife. I don't see a negative here.

[Solo_in_MD]

29. WIll it cover as much for the current cost...

Many unions over the years have put tremendous empahisis on benefits over salary. If the Universal plan is a fixed system with lesser benefits, it could be perceived as a step back.

I am not as up on UHC as I am on other issues. However, this is something I have heard discussed as a concern.

[Solon]

31. Generally, most UHC systems cover all health related issues that...

are necessary for a person to function. In other words, they aren't going to pay for face lifts and enlarged breasts, but will pay for re constructive surgery and breast reductions to reduce back pain. Most UHC systems focus on PREVENTATIVE care, hence doctor visits are encouraged. This is one way that UHC systems reduces costs.

The thing is that they aren't "fixed", but can be even more flexible than private systems, as I said in other posts, private insurance companies are, in general, much less efficient than public insurance systems in delivering money where it is actually needed, in medical care. Because of less overhead costs, a public system would be much more flexible in how the money is used, and could increase benefits substantially for many people, even reducing or eliminating co-pays and out of pocket costs.

Generally speaking, such a system would require increased or decreased funding as needed, or even better, simply have it run at a surplus, to keep up with medical demands. Basically the system would involve eliminating your current premium, and increasing your taxes to less than half the cost of the premium you had to pay in the past, that's a net gain for you in money on each paycheck.

Also, having everything under a Government run system, rather than dealing with dozens, or even hundreds, of billing plans, reduces the bureaucracy substantially, further reducing costs.

Would such a system be perfect? No, it wouldn't, however, it would be loads better than the "pay as you go" system we have right now.

[many a good man]

15. Single Payer is the ONLY real world solution

It may take 50-10-20 years but one day we'll get it. It's the ONLY viable solution.

Incremental fixes like expanding MediCare will only postpone the day of reckoning. People will fume to see their taxes go up to "cover" poor people all the while continuing the downward slide in quality of care and skyrocketing in prices.

Costs will decrease as you expand the coverage pool and cut out the middle men (who add no value) and redundant paper work. Business will benefit immensely when health care costs are contained, as well.

The single payer will be in a strong position to negotiate fair prices with health providers. Rationing? What you call rationing will be determined by DEMOCRACY. The people will decide, through their elected representatives, how much health care they want to pay for. You want to reduce the wait for that elective surgery from six weeks to four weeks? $x billion. Doctor's office wait from two hours to one? $y billion. At least we get to decide and have some control.

The spiraling costs of health care are THE GREATEST threat to the American economy. Its past time for a REAL WORLD solution. The longer we wait the worse off we'll be.

[Guaranteed]

22. Those are the people that the ridiculous amounts of money are going to.

You can't complain that healthcare is costing too much money, and then turn around and say that we can't let go of the people doing the "services."

[area51]

30. "What about the millions of Americans who work for insurance companies"

Well, if that's so important, let's stop NAFTA, CAFTA, WTO, etc. Far too few give a rat's ass about all the people whose careers have been destroyed by traitorous republinazis shipping their jobs offshore.

Also, probably most of the people pushing paperwork at the insurance cos. now could get jobs w/the govt. doing the same thing.

Straw man.

[Adelante]

37. Of course, there needs to be a transition period

to single payer. I don't think anyone is talking about "switching horses" overnight - but we have to move and keep moving.

[Solo_in_MD]

14. Why are so many convinced that single payer/non profit/Gov managed will be cheaper?

Ive worked in and around the various parts of the Gov my entire career. Never seen a serious drive for efficieny or cost effectiveness. What would stop it from becoming a medical version of Pentagon aquisition?

Most Americans have a healthy skepticism about Governement run anything. How it will be better and more efficient will have to be clear and obvious, and its not to me, not now.

[Joe Bacon]

18. Really?

I work for Social Security, where our administrative costs are only 1¢ out of every dollar collected in taxes.

You want inefficiency, go work for Haliburton and their cost-plus contracts that cause such things as the mess at Walter Reed.

[John Q. Citizen]

19. Medicare runs at a 2% overhead. It costs 2% of all the money taken into

the system to administer the system. 98% of the money collected for medicare goes to health care.

Private health insurance companies run between 15% to 25% overhead. They need to advertise, name sports arenas, pay very well compensated upper management, and turn a profit for their stock holders.

What do you imagine the pay differential is for say, the Secretary of Health and the pay for a CEO in a private insurance company? And there are a lot of them.

Also, the larger the insurance pool the cheaper cost per individual. We would self insure as a country, save lots of money, get more people paying in something (instead of nothing, like at present) and actually have a system as opposed to a hodge podge mess like we do now.

Do you feel the military would be cheaper for taxpayers if we just outsourced the entire deal? I don't. I think privatization = rip-off in the vast majority of cases, from Halliburton in the military to the privatization of electrical energy generation, to the privatization of prisons. It's a scam, and I'm tired of being scammed.

[Solon]

24. You do realize that our private system is more inefficient than the government...

On average, right?

Just because something is private doesn't make it efficient, and given what our Social Security system and Medicare have, as far as funds, their efficiency is beyond question, and can't be reached by any private entity.

No insurance company can reduce individual costs and spread the risk pool to as many people as the Federal Government can. There are hundreds of insurance companies, nationwide, most rely on the stock market to gain a substantial profit, and dip into premiums when the market stagnates. This means they have entire teams of people who don't even deal with potential patients, but instead they deal with, or are, stockbrokers, sometimes these people constitute up to 70% of the employment at these companies. Not to mention administrative costs, the CEOs of these companies, HMOs, etc. are paid large salaries, something that a public system wouldn't have to deal with.

Not to mention that, once the profit motive is eliminated, you save money right there. Not only would the government be more efficient, but also more effective as well, no more screening patients for pre-existing conditions, or refusing to cover certain expenses because they didn't pay for the "Gold" package in medical insurance. That's another level of bureaucracy that would be eliminated in a public system.

[ProudDad]

54. Medicare has already proved it

Admin costs under 3%.

HR676 just extends Medicare to all including folks like me...

I'm on a fixed income, Social Security but I'm too young for Medicare and not broken enough for Workman's Comp or Disability.

So under the current "system", I'm one of th 47 MILLION uninsured Americans...

[meldroc]

17. The money situation can be solved, if we can get the sociopaths out of power.

This is an unpleasant truth, but I'll go ahead and say it. We need to raise taxes. Especially on the filthy rich. Just from the proposed tax cuts for the Walton family in Bush's budget, we can pay for all the Medicare benefits he's proposing to cut. If we raised the cap on the FICA tax, we can easily save Social Security. We all know where the GOP's loyalties lie - to the Waltons and other rich billionaires, not to the American people.

Until we get those bastards out of power, that's how things will be. The sociopaths will continue to steal from us while telling us the money isn't there for things we need. The money is there. They're just stealing it.

If we do get them out of power and bring in someone who actually works in our interests, we can certainly raise enough money through taxes to save Social Security, Medicare, Medicaid, and implement universal health care

[madrchsod]

20. illinois is planning for some form of universal healthcare

for adults in the state. details are kind`a sketchy at this point and where the money is coming from is a tax on business. the last i read it was about three years out before anything is concrete...but it is a step

[Guaranteed]

21. You need to look into the ideas behind single-payer healthcare.

The whole point of it is to control costs by reducing administrative overhead, using the state's buying power and cutting out middlemen.

A study was done recently that showed that California would actually SAVE $8 BILLION per year if they switched to a single-payer program, while at the same time be able to cover everyone in the state.

[manic expression]

23. Of course not

It's easy:

ABOLISH CAPITALISM. That solves the problem without a single issue.

[Vinca]

33. Single-payer health care is the most efficient way to deliver

health services to Americans, but first we have to pull the politicians away from the insurance companies. After we do that, we have to make the "T" word acceptable - taxes will need to be raised (why would anyone complain about paying a $1,000 extra tax dollars instead of a $10,000 premium??). Then the health care providers need to be slapped up side the head. Rising health care costs have happened because of them. Health care providers work out deals with insurance companies. The insurance companies agree to pay 50% of the provider's going rate for their insured. What does the provider do? Increase the going rate. What's the insurance company do? Increase the insurance premium. It's like hamsters on a wheel. The government needs to step in, negotiate prices and pony up only the agreed upon fees. Insurance companies can go where they've told tens of millions of us to go - to hell.

[NDP]

38. You all are too facts based and not real enough. The facts may be that it is the most efficient

way to deliver health care services, but reality is that single-payer does not just spontaneously generate. It has to be legislated, and you don't have enough Democrats in the Senate to have a chance at going straight into a single-payer system. You need more than 20 more Democrats to even have a chance, because many who are already there would not support the legislation. There are not enough progressive Democrats in the Senate to have a prayer at that.

[John Q. Citizen]

42. That sounds the same for most legislation. Most bills passed were preposed

long (many times years)before they made it into law.

[Vinca]

43. Chances are very good we'll have a super majority and

the White House a couple of years from now. It can happen. It has to happen. When little kids die from brain infections from untreated toothaches, we're morally obligated to make it happen. Failure is not an option.

[Gryphons Eyre]

46. the real facts are...

Until we raise enough awareness of what is possible there won't be support for universal health care. Perhaps not until the misery index gets severe enough; business is compromised to the point that they can no longer be a substantial vehicle for providing health care; and those in what use to be the middle class find they can no longer afford health care or have retirement security because of it. You ask anyone who is about to retire or even thinking about, one of their biggest concerns is going to be health care.

[NDP]

47. I'm not talking about "awareness." I'm talking about the ridiculous people here who lose their mind

when a Presidential candidate like John Edwards proposes a health care plan that's not "single-payer." Those people are out of their minds if they think this country is just going to leapfrog from the crap that we have now all of the way to single-payer in one step.

It's not going to happen, and it's not going to happen because not even the Democrats in the Senate are going to give it to you. You better get what you can right now. What John Edwards proposed can evolve into single-payer if most Americans opt for that plan.

Awareness is fine, but save the ridiculous, and unrealistic boo hooing whenever someone doesn't "propose" single-payer, right now.

[ProudDad]

60. "Somebody" already has proposed

single-payer:

California: SB840
http://www.health-access.org/
http://www.healthcareforall.org/

Federal: John Conyers' HR676 --
http://www.dailykos.com/story/2007/1/31/221225/992

We just need to kick ass and take some names until the CongressCritters pass these!!!

[ProudDad]

55. If we keep booting them out of office

everytime they vote against single-payer, we'll soon end up with a majority -- probably in time to have a Dem president sign it into law...

[Bridget Burke]

34. The average DU'er has more than half a brain

And he or she won't heed your call to shut up about Health Care.

[ClassWarrior]

36. Thank you for your concern.

Please have some respect, by the way, and call her Senator Clinton.

NGU.

[thoughtcrime1984]

48. I think, in the end, it would come down to...

some would be sacrificing their "great" benefits, and I may even fall into that category, for something that is somewhat less, to ensure that the tens of millions that go without health careshould have some decent benefits. That seems like a very Democratic thing to do, unlike the Republican survival of the fittest crap.

[Greyhound]

49. Using the so-called "reporting" of 60 minutes to say "It just can't be done"

is like taking the word of the tobacco lobby that cigarettes are good for you.

They conveniently leave out little factors such as the hundreds of billions of dollars that are currently going into the coffers of the insurance industry that will be freed up when they are no longer the only game in town.

They use straight line projections of the costs associated with health care, which assumes the hyper-inflation we've seen will continue indefinitely (and has been entirely driven by corporate manipulation of fees and resources), and is both a logical and mathematical fallacy.

The lie that "no one is even considering doing it" simply ignores the half dozen or so plans that are currently in various states of congressional limbo.

These are just a few of the reasons that we must either ignore the amerikan M$M, or at least assume that they are lying to you, before you give up. Remember that 60 minutes is owned by CBS, which is owned by Viacom, which also owns... is the very same show that spiked the tobacco story that eventually lead to the lawsuit because several of their executives were liable to lose out on multi-million dollar bonuses if the story aired (see http://imdb.com/title/tt0140352">The Insider, for a relatively truthful account of the type shenanigans these whores regularly engage in).

[Snellius]

51. Sooner or later corporations will realize it's in their self-interest

The manufacturing industry, especially steel and automobiles, has already faced the fact, weighed down with huge worker health premiums, that they are at an economic disadvantage with other advanced industrial countries, all of whom have some form of public health program. Sooner or later, and ironically for purely economic reasons, business as a whole must realize that only "socialized medicine" will cure the what's wrong with American capitalism. Isn't it odd that the most competitive country in the world is a Communist state?

[WhaTHellsgoingonhere]

52. Single-Payer Health Care System

Below is a compilation of articles written by NYT OP-ED columnist Paul Krugman in 2006

American health care is unique among advanced countries in its heavy reliance on the private sector. It’s also uniquely inefficient,” argues Paul Krugman, professor of Economics and International Affairs at Princeton University.

Why is this the case? Special interests and privatization ideology have long colluded to quash reform. Special interests – the American Medical Association, the Health Insurance Association of America, insurance companies – form a powerful lobby that spends millions of dollars to block legislation aimed at providing insurance to the uninsured. Meanwhile, privatization ideologues, whose faith in free markets and continuous demonize of government intervention persists even when evidence points to the contrary.

Myth 1. Americans are lead to believe that we have the best health care system in the world.

Advanced countries, including Germany, France and Canada, spend far less per person for health care than the US. In 2002, the latest year for which comparable data are available, the US spent $5,267 on health care per person, while Canada spent $2,931 and France spent $2,736. Yet, a 2003 study published in Health Affairs found that, while the US scores high on high-tech services, such as MRI’s, on more ordinary measures, like the number of doctors’ visits and number of days spent in hospitals, the US is only average, or below average; identical procedures cost far more in the US than in other advanced countries. And most notably, Americans have lower-life expectancy and higher infant-mortality figures. This administration’s favorite whipping-boy, France, consistently ranks much better on most measures of health care quality than the US.

Waiting lists, which vary in length from country to country, are often offset by one’s inability to find adequate on-demand care in the States.

Taiwan, which has a population and economy similar to ours, moved from a US-style health care system to a Canadian-style single-payer system a decade ago. In 1995, less than 60 percent of Taiwan’s residents had health insurance; by 2001 the number was 97 percent. A careful study published in Health Affairs concluded that this huge expansion in coverage came virtually free due to rising population and incomes.

Finally, Health Affairs found that the medical experience of sicker adults in six countries, including Canada, Britain, Germany and the US, don’t support claims about superior service from the US system. Most notable here, Americans are far more likely than others to forgo treatment because they can’t afford it. Forty percent of Americans surveyed failed to fill a prescription because of cost. A third were deterred by cost from seeing a doctor when sick or from getting recommended tests or follow-ups. As a result, many Americans end up disabled or dead.

Myth 2. The unimpeded competition of free markets will produce the best outcome.

Currently, 46 million Americans are uninsured. The Commonwealth Fund, a nonpartisan organization that studies health care, found that 41 percent of nonelderly American adults with incomes between $20,000 and $40,000 were without health insurance for all or part of 2005. How can this be? Employment-based health insurance is the only serious source of coverage for Americans too young to receive Medicare and insufficiently destitute to receive Medicaid. But good insurance is hard to come by, because private markets are driven by adverse selection, in which bad risks drive out good. Consequently, insurance companies devote a lot of effort and money screening applicants, selling insurance only to those considered unlikely to have high costs, while rejecting those with pre-existing conditions or other indicators of high future expenses. In fact, due to administrative costs associated with the screening process and advertising, insurers spend less than 80 cents of each dollar on health insurance.

Of the $5,267 the US spends per person, $2,364, or 45 percent is spent by the government, not private insurers (compare that to $2,048 per person spent by the Canadian government; and $2,080 per person spent by the French government).

Needless to say, American health care is desperately in need of reform. Ironically, there exists a single-payer success story in the US. The Veterans Health Administration is one of the best-kept secrets in the health care debate. Overcoming years of a tarnished reputation of bureaucracy, inefficiency and mediocre care, reforms beginning in the mid-1990’s transformed the system, and the VA’s success in improving quality, safety and value has allowed it to emerge as a leader in health care.

Last year, customer satisfaction with VA health care as measured by an annual survey conducted by the National Quality Research Center, exceeded that for private health care for the sixth year in a row. The secret of its success is the fact that it’s a universal, integrated system. Because it covers all veterans, the system doesn’t need to employ legions of administrative staff to check patients’ coverage. Nor is it burdened with advertising costs incurred by private insurers. And because it covers all aspects of medical care, it has been able to take the lead in electronic record-keeping and other cost reducing innovations. The VA avoids dealing with insurance companies and is in a better position to bargain hard with medical suppliers, and pays far less for drugs than most private insurers. In short, cost saving practices employed by single-payer providers, like the VA or Medicare, can allow them to spend as much as 98 cents of each dollar on medical care.

[Ninja Jordan]

56. No

[colinmom71]

59. I really do believe that the French health care system would be the best...

One to adapt here in the US. Essentially, the French system is a heavily subsidized and regulated insurance program that has evolved into a part of the French Social Security benefits. http://www.ess-europe.de/en/france.htm

I read a very good history on how the French system came into place about a year ago and I can't seem to find that article again. But from what I remember, the French system came about when private insurance companies were caught price fixing and denying coverage during the aftermath and economic recovery after WW2. Costs were rising swiftly for insurance, far exceeding the per capita inflation rate (IIRC) and even middle class workers were getting squeezed out of the market for health insurance.... Hmm, sounds kinda familiar to me....

The French government responded by passing sweeping regulations over how health insurance was to be provided. One of it's first steps was to require that all employers provide some form of insurance with a regulation on what types of services were to be offered and established a public subsidy to help reduce premiums for poor and working class French citizens to affordable levels. Essentially, it became a heavily regulated private enterprise with an emphasis on cooperative responsibility between public and private health systems. French citizens can also elect to purchase extra insurance to cover those costs not provided by their primary insurance coverage, which apparently a lot of French do. There is also a newer compulsory health insurance program that does not tie eligibility for subsidized health insurance to employment for those temporarily out of work.

To b fair, even this system has had to battle rising costs for advanced medical care in the last two decades and premiums have had to be adjusted upwards for some workers. But it's origins are pretty darn similar to our own system here in the US. And the fact that the French system still respects a private and public enterprise dynamic, albeit heavily regulated, is likely the best compromise for Universal Health Coverage to which our own system could be adapted.

[ProudDad]

61. Uh, that would be passing HR676

and getting it signed into law.

We already have all of the infrastructure for Single-Payer in place -- it's called Medicare and with a few minor fixes would work quite well.

Either that, or we could save a half-trillion dollars a year by outsourcing health care to the French... :evilgrin:



ON EDIT:

Sorry, but allowing private health "insurance" companies in on the deal WON'T WORK HERE!!! They (and Big Pharma) ARE THE PROBLEM!

What makes it work in France is a VERY STRONG working class. They won't allow the French Govt. to screw them the way we get screwed here. We haven't got a strong working class and in fact, the deck is stacked so heavily against working people in the U.S. that we ain't likely to see a strengthened working class as a bulwark against the greedy rich in this country...


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From your link, I guess nothing's perfect. Looks like they should do more to rein in big pharma:

"The expenses regarding health services are also growing too high in France. A reason for it can be the rising of the ageing population. That is why the costs are increasing by approx. 1.5% of the GDP. What are/were the measures concerning this deficit:
· First of all a strict price control. Therefore the prices for medication are fairly low on the European market.
· Stricter measures for the prevention and promotion of health
· Creation of a company for health services with extended competences (further nationalisation)
· Transfer of the administration of hospitals to a regional level
· Further development of the out-patient surgery to lower the costs of stationary treatments
· Creation of a net to better coordinate different suppliers of health services
Setting up of rates for pathological treatments for hospitals
Finally generic drugs should be mentioned. It is a medicine, made from a tested active substance, as soon as the patent right has expired. Generic products have the same effect and the same quality as original products, sometimes even a better form of use. Since 1996 the use of generic drugs in the sector of medicine is promoted. At the moment especially medicine with non-provable medical benefits became the centre of attention. The prices of such drugs are going to decline and certain refund rates are planned to be introduced. Pharmacists are able to replace a prescriptive medicine from a doctor with a generic drug. The margin was brought into line with the products of reference. But it turns out that the share of generic drugs is relatively low.
Figures (from 2001)
France has approx. 59.196.600 inhabitants. The life expectancy is 75.9 years for men and 83.0 years for women. The infant mortality (per 1000 life-births) amounts to 1.9. There is one doctor for 302 inhabitants, one dentist for 1464 inhabitants. In 2000 public expenses for health services amounted to 9.5% of the GDP."