TheSonntag
Topic Author
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A Public Health Insurance In The USA - Necessary?

Sun Mar 05, 2006 11:11 pm

I know many people regard public health insurance systems as a "socialistic" invention from Europe, but was it ever considered in the USA?

I ask, because it seems to me that many companies have huge problems, because they pay for health insurance of their employees in the USA. For example, in Germany every company pays for their employees to a public health insurance company, which makes wages more expensive (that is a problem, of course), but that's it. The company has nothing to do with the health insurance or pension system, so when an employee doesn't work anymore, the company has no financial liability towards the person anymore (unless there are surplus payments which are in addition to the public system, of course).

So the system makes employment more expensive, however there exist no long-term risks.

Why did the US never consider such a system? In the current economy it seems that many companies have huge problems paying all these things.

So could it be that a public health system is actually more economical? Your thoughts?
 
ltbewr
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 12:29 am

We should have a single payer government run health care system in the USA, but because our system is one where part is public and part private control, including religious organizations, too many make money to ever want to change.
Right now in the USA, government assurances of health care is only for the old (over 65 of age with Medicare) and the poor (Medicade). People also very much fear that under government control, they will lose their right of choice of health care providers, especially doctors. Doctors fear losing even more control to government telling them what to do. We could have the Government banning abortion and other medical practices, especially advanced methods. The companies that run the insurance companies don't want to lose their cash and profit cows. The drug companies don't want to lose the income they make with our current system.
It will have to take a real crises to force a wide ranging socialization of medical insurance, such as a massive economic depression, to change our system. In the meantime, unless your poor or old enough or work at a decent level job, health insurance isn't affordable and this cannot continue. The costs of having over 40 million Americans without any health insurance is a deep shame.
The best idea would be to have a government subsidised insurance system, with insurance provided by non-profit or mutual organizations. Everybody would pay for their insurance via a tax on their pay, with rates progressively scaled according to one's pay. Higher income people could pay on their own for more selective coverage insurance.
 
TheSonntag
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 12:56 am

Thanks for your insights... As you might know, the German health care system is far from perfect, it has a lot of problems, as well, so I certainly don't think it is a solution worth copying, but in terms of medical standard, it certainly is one of the best worldwide (somehow based on exploiting the doctors, though, but that is another story).

As in the USA, we have a lot of lobbying groups working against each other, so the system is extremely difficult to modernize, as well, but at least it is universal, so all companies face the same costs, which I think is something good, because it makes predictions easy.
 
deltagator
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 2:12 am

Quoting LTBEWR (Reply 1):
People also very much fear that under government control, they will lose their right of choice of health care providers, especially doctors.

Under Hillary Clinton's proposed plan (luckily destroyed by Congress) in the mid 1990s this fear would have been realized. Her plan called for complete government control of the health system. If you did have the money to see a doctor of your own choosing and willing to pay them for their services it was considered a criminal act under her plan. Scary thought in my opinion.

Quoting LTBEWR (Reply 1):
In the meantime, unless your poor or old enough or work at a decent level job, health insurance isn't affordable and this cannot continue. The costs of having over 40 million Americans without any health insurance is a deep shame.

People without health insurance have made the decisions in their life not to have insurance. It is not a right given to them by the Constitution. I'm sorry but I have no desire to see my tax money (and I pay a hell of a lot in taxes ever year) go towards a system where folks who continue to live in poverty based on their life choices will be rewarded with government handouts. Perhaps it is time for these folks to make a decision...big screen TV, Air Jordans, big mud tires for their truck or healthcare and an education.
"If you can't delight in the misery of others then you don't deserve to be a college football fan."
 
N1120A
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 2:15 am

Quoting DeltaGator (Reply 3):
If you did have the money to see a doctor of your own choosing and willing to pay them for their services it was considered a criminal act under her plan.

Then you obviously haven't read her plan.

Quoting DeltaGator (Reply 3):
It is not a right given to them by the Constitution.

"Life, Liberty and Property" Sounds like it is
Mangeons les French fries, mais surtout pratiquons avec fierte le French kiss
 
deltagator
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 2:21 am

Quoting N1120A (Reply 4):
Then you obviously haven't read her plan.

I did read the plan back in 1993 and was unimpressed and not a big fan of the complete government control and criminalization for going outside of the system.

Quoting N1120A (Reply 4):
"Life, Liberty and Property" Sounds like it is

We'll have to agree to disagree. That doesn't say anything about health insurance. That is not the role of the Federal government.
"If you can't delight in the misery of others then you don't deserve to be a college football fan."
 
N1120A
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 2:30 am

Quoting DeltaGator (Reply 5):
We'll have to agree to disagree. That doesn't say anything about health insurance. That is not the role of the Federal government.

Again, all Americans have constitutional, federal protections for their life, liberty and property. Good health is necessary to both life (obviously) and property. Besides, health insurance is completely within the rhelm of the spending power and would most likely be handled by the states with federal funding..

Quoting DeltaGator (Reply 5):
I did read the plan back in 1993 and was unimpressed and not a big fan of the complete government control and criminalization for going outside of the system.

Try re-reading it
Mangeons les French fries, mais surtout pratiquons avec fierte le French kiss
 
Scorpio
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 2:50 am

Quoting DeltaGator (Reply 3):
Under Hillary Clinton's proposed plan (luckily destroyed by Congress) in the mid 1990s this fear would have been realized.

Government controlled healthcare does not need to jeopardise that freedom of choice. We have government controlled healthcare here in Belgium, yet I can go to any doctor I want, and any hospital I want.

Quoting DeltaGator (Reply 3):
I'm sorry but I have no desire to see my tax money (and I pay a hell of a lot in taxes ever year) go towards a system where folks who continue to live in poverty based on their life choices will be rewarded with government handouts.

Biggest misconception about government healthcare. A government controlled system, when it's set up the right way, will actually cost you less in taxes than what you pay now in taxes and private insurance.

Quoting DeltaGator (Reply 5):
That doesn't say anything about health insurance. That is not the role of the Federal government.

Every other Western country disagrees.
 
aa757first
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RE: A Public Health Insurance In The USA - Necessa

Mon Mar 06, 2006 2:51 am

Quoting TheSonntag (Thread starter):
I know many people regard public health insurance systems as a "socialistic" invention from Europe, but was it ever considered in the USA?

Yes, it was. We already offer insurance to the elderly and to the poor.

Quoting TheSonntag (Thread starter):

So could it be that a public health system is actually more economical? Your thoughts?

Economical at the cost of patient care.

Quoting LTBEWR (Reply 1):
We should have a single payer government run health care system in the USA, but because our system is one where part is public and part private control, including religious organizations, too many make money to ever want to change.

Why is "religious organizations" in there? My mom was an intensive care nurse for many years. She worked at two Catholic hospitals, a Jewish hospital and two community hospitals and she always said the care in a faith based hospital was far better than the community hospitals (and she worked in Lehigh Valley, a highly regarded community hospital).

American healthcare is better. For example, according to one book, Market Driven Healthcare, the UK and Canada owned 1 MRI per million, while we owned 11 per million. We owned 27 CT scanners per million, while Canada had seven per millon and the UK four.

A Journal of the American Medical Association study found that both Canada and New York state had few unnecessary cardiac surgeries. However, the rate we perform cardiac procedures is three times higher. That's because the Canadian system cannot provide for all of its patients properly. 70% of US patients with left main coronary artery disease were operated within seven days. In Canada, 70% of people with the same disease waied thirty-one to sixty days. This caused a 300% increase in death or nonfatal heart attack. But at least it was free.

The median American that has a heart attack returns to work three weeks faster than the median Canadian that suffered a heart attack, and less than 40% of Americans changed their work habits, compared to 57% of Canadians.

Canadian radiation onoclogists suggest waiting time between cancer diagnosis and treatment should be less than two weeks. But the average waiting time for a Canadian was 61 days, which is close to nine weeks.

AAndrew
 
lowrider
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 3:08 am

Quoting Scorpio (Reply 7):
Government controlled healthcare does not need to jeopardise that freedom of choice. We have government controlled healthcare here in Belgium, yet I can go to any doctor I want, and any hospital I want.

If the goverment is the sole provider, what sort of choice is that? Is your only other option not to seek any health care at all?

Quoting Scorpio (Reply 7):
Biggest misconception about government healthcare. A government controlled system, when it's set up the right way, will actually cost you less in taxes than what you pay now in taxes and private insurance.

Maybe in Belgium, but I have yet to see an instance in the US where a government program was cheaper than a privately run one.

Quoting Scorpio (Reply 7):
Every other Western country disagrees.


Disagree all you want and do it your way. That doesn't mean we have to follow. We would probably disagree on the fundemental role of government.

Andrew said it very succinctly and I have heard the same thing through anecdotal evidence. The healthcare system in the US has its flaws, but so does everyone else's. I would like to see a change in the way health insurance is sold and adminstered in the US, and I would like to see more disclosure and rationality in how services are priced. I think that placing this in the hands of the government is the absolute worst way to solve the problem.
Proud OOTSK member
 
N1120A
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 3:25 am

Quoting Scorpio (Reply 7):
Biggest misconception about government healthcare. A government controlled system, when it's set up the right way, will actually cost you less in taxes than what you pay now in taxes and private insurance.

Absolutely. The UK has a massive public health care and pension system and the average Briton pays 1% less in taxes, including both personal income and social security/national insurance, than the average American.
Mangeons les French fries, mais surtout pratiquons avec fierte le French kiss
 
deltagator
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 3:38 am

Quoting N1120A (Reply 10):
Absolutely. The UK has a massive public health care and pension system and the average Briton pays 1% less in taxes, including both personal income and social security/national insurance, than the average American.

And if they want to see a government doctor they have to sit on a waiting list. If they want to pay their own way or have private insurance then the waiting list goes bye bye. Under Clinton's plan there would be no private insurance. That bothers me a whole lot.

Quoting Aa757first (Reply 8):
American healthcare is better. For example, according to one book, Market Driven Healthcare, the UK and Canada owned 1 MRI per million, while we owned 11 per million. We owned 27 CT scanners per million, while Canada had seven per millon and the UK four.

While you and I agree on the market driven model make sure your statistics look at those numbers versus percentage of the population. Since we are many times larger populationwise than the UK or Canada it is expected that we have more of the equipment.

Quoting Lowrider (Reply 9):
Maybe in Belgium, but I have yet to see an instance in the US where a government program was cheaper than a privately run one.

That's my concern. The next thing you know they'll all want to be unionized as if being a civil servant isn't protection enough.

[Edited 2006-03-05 19:39:03]
"If you can't delight in the misery of others then you don't deserve to be a college football fan."
 
Scorpio
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 3:39 am

Quoting Lowrider (Reply 9):
If the goverment is the sole provider, what sort of choice is that? Is your only other option not to seek any health care at all?

I can choose any doctor and any hospital I want, as I said before. The government does not run the hospitals, other independent organisations do this, some faith-based, some linked to universities, etc. They are paid for by the government based on the number of patients and the care they provide, and are allowed to make a profit. Just not by increasing their charges, as those are government controlled. So they compete by providing the best possible care. This increases quality and keeps costs under control at the same time.

Same goes for doctors: they are not paid a monthly wage by the government, they are paid based on how many patients they treat: a doctor who sucks at his job won't have many patients and will go out of business. It's sort of a 'free market', but the bills are paid through the government. This way costs are controlled while keeping the quality at the highest.

And the results show: just ask all the British who check into our hospitals every year because they are so much better than theirs.

And Andrew provided a pretty blinkered picture, comparing the US system to just one or two others, at least of which (the one I know best, the UK) is seriously screwed up, and then using that to come to a wrong conclusion that this is exemplary for all government run systems.

[Edited 2006-03-05 19:42:16]
 
pilotsmoe
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 3:42 am

Quoting DeltaGator (Reply 3):
People without health insurance have made the decisions in their life not to have insurance. It is not a right given to them by the Constitution. I'm sorry but I have no desire to see my tax money (and I pay a hell of a lot in taxes ever year) go towards a system where folks who continue to live in poverty based on their life choices will be rewarded with government handouts. Perhaps it is time for these folks to make a decision...big screen TV, Air Jordans, big mud tires for their truck or healthcare and an education.

Sorry, but most people can't afford it. An idea how much insurance cost per month? About $1200, and that's if you're perfectly healthy
 
cairo
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 3:44 am

Quoting Scorpio (Reply 7):
Biggest misconception about government healthcare. A government controlled system, when it's set up the right way, will actually cost you less in taxes than what you pay now in taxes and private insurance.

I doubt this would be true in America. There is a population of 300 000 000 and several million illegal immigrants and the health care bureaucracy necessary to create a government controlled system would be so massive it would boggle the mind and probably stifle the economy.

It is a lot easier to have "free" healthcare in a place with small geography and smaller population.

I don't think Americans would mind a government health care system if it they were 100% sure it would work as you say - cheaply - the problem is no one believes this.

Also, I have to say that as with all policies, government health care has its drawbacks. People who argue for a European style luxurious social system never acknowledge the drawbacks.

For instance, one of the biggest disincentives to having a baby is AND SHOULD BE that you can't afford it. In Europe, especially in the UK, I see all kinds of couples who have kids almost without a thought because there is no economic cost (to them!) in doing so.

While the ideal of numerous "free services" may be a more humane system, they also produce an economy that is high in taxes, low in new job creation, and consistently 20-25% less wealthier than the American model.*

It is perfectly valid, and just a matter of choice, to want a higher overall average of care/benefits (American model) than to ensure a higher overall minimum of care/benefits (European model).

Europe has a better safety net, but the cost is this also limits the upper level of success and innovation. America has a small safety net and the cost is that many millions live in more or less perpetual poverty and estrangement from a prosperous economy. Both are valid choices and both have their pros and cons.

Cairo

*http://www.timbro.com/euvsusa/

[Edited 2006-03-05 20:15:39]
 
N1120A
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 3:48 am

Quoting DeltaGator (Reply 11):
And if they want to see a government doctor they have to sit on a waiting list.

Wrong.

Quoting DeltaGator (Reply 11):
Under Clinton's plan there would be no private insurance. That bothers me a whole lot.

Try checking again
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777236ER
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 3:52 am

Quoting DeltaGator (Reply 11):
And if they want to see a government doctor they have to sit on a waiting list. If they want to pay their own way or have private insurance then the waiting list goes bye bye. Under Clinton's plan there would be no private insurance. That bothers me a whole lot.

What nonsense is this? I can see a 'government doctor' at any time.
Your bone's got a little machine
 
deltagator
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 3:54 am

Quoting 777236ER (Reply 16):
What nonsense is this? I can see a 'government doctor' at any time.

Sorry if I mispoke. Is there not a waiting list for procedures and such. Preventative care is one thing but actually getting work done via surgery you all have to wait do you not?
"If you can't delight in the misery of others then you don't deserve to be a college football fan."
 
777236ER
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 3:58 am

Quoting DeltaGator (Reply 17):
Is there not a waiting list for procedures and such. Preventative care is one thing but actually getting work done via surgery you all have to wait do you not?

For some proceedures, yes. Although waiting lists tend to be for a few specific operations and are falling.
Your bone's got a little machine
 
deltagator
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 4:01 am

Quoting 777236ER (Reply 18):
For some proceedures, yes. Although waiting lists tend to be for a few specific operations and are falling.

Those waiting lists were one of the big campaign points in the elections last year weren't they? It was interesting to be in the UK last year and talk with folks about the domestic side of things with Blair and the rest of the MPs since we in the US (and I would suppose most of the world) only see the international side of things in the news.
"If you can't delight in the misery of others then you don't deserve to be a college football fan."
 
N1120A
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 4:04 am

Quoting 777236ER (Reply 18):
For some proceedures, yes. Although waiting lists tend to be for a few specific operations and are falling.

Not to mention that "waiting lists" are for non-emergency surgeries.
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TheSonntag
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RE: A Public Health Insurance In The USA - Necessa

Mon Mar 06, 2006 6:55 am

Having a public health system does not mean that you cannot have a private system on top of it. For example, the German public system guarantees you a lot of treatments, but, as said before, treatment of the individual patient leaves something to be desired. Usually, you cannot have a room for yourself in a hospital, for example.

You can easily opt to buy a surplus, private insurance. Besides, Germany has not "one" public health insurance, it has several hundred public insurance companies (I do not think that is very desireable, because more than 45% of the money is used on adminstration, while private insurance companies use much less money on administration). But if the system workes, there is competition between the companies (it leaves a lot to be desired, but nevertheless).

In Germany, you must be insured in a public health insurance company if you a) are employed by a company, b) are a student or retired.

Only if you are working independant, like for example being an artist or lawyer, you do not have to be public insured, in this case you can insure yourself private. When you are employed as a serviceman by the state, you are insured by the state itself. The system is fragmented because it dates back to the 1890s when Bismarck invented it, as far as I know it was the first state or one of the first states with a public health system.

When you must be insured by a public company, you can still opt for private surplus insurances.

However, the general standard is very high already. The problem in our system is that doctors get more money from private insurances than from the public ones, which leads to a certain tendency that private insured people are treated better, but, as said, there are ways to reduce this problem.

The whole system is due to be reformed, but how it will be changed is not yet discussed, yet chances are very high right now, because we have a grand coalition in the parliament. If they manage to agree on a new system, we might get a new public insurance system.

The problem with the German system is that it is, in principle, paid from the workers and employers, which makes work more expensive. For example, the Danish system is paid entirely from tax, thus taxes are higher. I still prefer the German system, because my impression is that treatments are better than in Denmark, where waiting lists are a more common occurrence.

Nevertheless, I think a public health system is a must for any modern state. It costs a lot of money, but since everybody bears the same burden, it does not affect competition. In Europe, the main problems are not the health systems, but the fact that every country uses a different system so that this can lead to competition between the member states, and I don't want to have a "race to the bottom".
 
B2707SST
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 6:55 am

Quoting DeltaGator (Reply 3):
It is not a right given to them by the Constitution.



Quoting N1120A (Reply 4):
"Life, Liberty and Property" Sounds like it is



The only time the phrase "life, liberty, and property" appears in the Constitution is in the 5th Amendment:

"No person shall... be deprived of life, liberty, or property, without due process of law."

This text clearly does not impose an obligation on the government to provide health care. Moreover, the right to one's life does not obligate someone else to provide life-saving services like health care any more than the right to own property obligates someone else to surrender their property to you or the right to free speech obligates someone to listen to you. This is the crucial difference between negative rights, which can be enjoyed by everyone at the same time, and positive rights, which coercively benefit some at the expense of others and violate their negative rights.

--B2707SST
Keynes is dead and we are living in his long run.
 
deltagator
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 7:09 am

Quoting N1120A (Reply 20):
Quoting 777236ER (Reply 18):
For some proceedures, yes. Although waiting lists tend to be for a few specific operations and are falling.

Not to mention that "waiting lists" are for non-emergency surgeries.

IIRC one of the campaign points against Labor last year was that some people had died while waiting for their surgery and that wasn't a good thing.

Quoting B2707SST (Reply 22):

Well said B2707SST.

Quoting N1120A (Reply 6):
Besides, health insurance is completely within the rhelm of the spending power and would most likely be handled by the states with federal funding..

Just what the states need...another unfunded mandate from the Federal government.
"If you can't delight in the misery of others then you don't deserve to be a college football fan."
 
aa757first
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RE: A Public Health Insurance In The USA - Necessa

Mon Mar 06, 2006 7:58 am

Quoting DeltaGator (Reply 11):

While you and I agree on the market ndriven model make sure your statistics look at those numbers versus npercentage of the population. Since we are many times larger populationwise than the UK or Canada it is expected that we have more of the equipment.

It's on a per million basis. Proportionally, we have more CT scanners and MRIs than the UK and Canada.

Quoting TheSonntag (Reply 21):
Nevertheless, I think a public health system is a must for any modern state. It costsrna lot of money, but since everybody bears the same burden, it does not affect competition.

We do have a public health system. Quite a bit of the healthcare in the United States is paid for by the goverment, through Medicare, Medicaid, state programs, subisidies to hospitals, etc.

AAndrew
 
MD11Engineer
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 8:07 am

Quoting TheSonntag (Reply 21):
In Germany, you must be insured in a public health insurance company if you a) are employed by a company, b) are a student or retir

The drawback is that the public insurances and there especially the AOK's (which have to accept any applicant) are getting stuck with the bad risks (unemployed, elderly, chronically sick, etc.) while the private insurers make sure that they will only get the good risks (wealthy, young and healthy people). Therefore the private insurers can afford to pay more for each single patient (for myself, as a blue collar worker in a relatively high income bracket, I'm just below the income level where I can go for private insurance).

Jan
Je Suis Charlie et je suis Ahmet aussi
 
TheSonntag
Topic Author
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 8:44 am

Quoting MD11Engineer (Reply 25):

If I could change the system, I would make a public system mandatory and allow additional private insurances, however the public system would have to guarantee a good level of insurance.

But getting deeper into this topic would certainly be beyond the scope of this forum, and there are so many people who are more competent in this area than me that I will leave it to them to get a new system.
 
Gilligan
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 8:56 am

As to Hillary Care of 1993, this is one of the best summaries I've ever come across.

http://www.heritage.org/Research/HealthCare/tp00.cfm

Quoting N1120A (Reply 4):
Quoting DeltaGator (Reply 3):
If you did have the money to see a doctor of your own choosing and willing to pay them for their services it was considered a criminal act under her plan.

Then you obviously haven't read her plan.

Yes he has. From the link...

Q. The President emphasizes "choice" as one of the six principles of his reform plan. Do families have the freedom to choose a health care benefits package outside of the regional health alliance?

A. No. The choice available to families is limited by the government, with very few exceptions. As the Manhattan Institute's Elizabeth McCaughey remarks, "Unless you now receive health care through Medicare, military or veterans benefits, or unless your spouse works for a large company, the law will require you to buy basic health coverage from the limited choices offered by your alliance. It will be illegal to buy it elsewhere."53


Quoting N1120A (Reply 4):
"Life, Liberty and Property" Sounds like it is



Quoting B2707SST (Reply 22):
The only time the phrase "life, liberty, and property" appears in the Constitution is in the 5th Amendment:

"No person shall... be deprived of life, liberty, or property, without due process of law."

That is correct. It does not refer to health care anywhere in the Constitution. To say that it does if inventing phrases or interpeting wording that isn't there. In addition if you look at the Clinton health care plan, you are forced to buy into it. You must accept what the government has to offer. To me that is an unacceptable usurption of my personal rights to health care.

Quoting Pilotsmoe (Reply 13):
Sorry, but most people can't afford it. An idea how much insurance cost per month? About $1200, and that's if you're perfectly healthy

When I was a kid I'd ask my Dad for something and he's say, "We can't afford it". My mom wanted a second car and my Dad said, "We can't afford it, I'll ride the bus so you have a car". We always had health insurance though.

Quoting Scorpio (Reply 7):
Every other Western country disagrees.

Virtually every other western country pays far more for gasoline than we do. Should be adjust our price higher just because theirs is?

Quoting N1120A (Reply 15):
Quoting DeltaGator (Reply 11):
Under Clinton's plan there would be no private insurance. That bothers me a whole lot.

Try checking again

Lets'....

Q. Can families buy a plan with more generous delivery of the standard benefits?

A. Not if alliance officials exclude it because the premium exceeds the average premium in the regional alliance by 20 percent. As Elizabeth McCaughey notes, "Plans with added benefits (such as Pap smears every year instead of every third year) and many fee-for-service plans will be excluded by the 20 percent rule."54 4 Ultimately, alliance officials, not the consumer, determine what plans can be bought and sold.

That will be the death knell of private insurance companies. The board would decide what could be bought or sold. Can you spell B-R-I-B-E-S?

The government has no business in the health care industry, none. Look at what medicare and medicaid were projected to cost through the years and then check the actual cost. The Constitution doesn't define it, so by the Constitution's own definition, it is a States or individuals right.

Quoting DeltaGator (Reply 11):
Quoting Aa757first (Reply 8):
American healthcare is better. For example, according to one book, Market Driven Healthcare, the UK and Canada owned 1 MRI per million, while we owned 11 per million. We owned 27 CT scanners per million, while Canada had seven per millon and the UK four.

While you and I agree on the market driven model make sure your statistics look at those numbers versus percentage of the population. Since we are many times larger populationwise than the UK or Canada it is expected that we have more of the equipment.

But those numbers are based on millions of people so the numbers should be the same. In other words for every 1 million people in all three countries, all three countries should have either 1 or 11.
Warm winds blowing, heating blue skies, and a road that goes forever, I'm going to Texas!
 
greasespot
Posts: 2955
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 9:29 am

Lets see.......Where to complain....I needed an MRI on my knee( non-emergency) got it in 3 days.....needed a colonooscopy...2 days....Needed to go to hospital last week in Emergency....admitted in 3 hours......total cost out of pocket......$0.00

Visit doc when ever needed? $0.00

Oh and I can go to ANY doc....Oh and all this for a measly 600 a year (Ontario has a health premium)........I would prefer to take this over private insurance.

I would rather wait for a knee replacemnet and EVERYONE who needs one gets one...as opposed to me getting one because i am working and my neighbour cannot. As said earlier...Most wait times are for non-Emergency prodecures

GS
Sometimes all you can do is look them in the eye and ask " how much did your mom drink when she was pregnant with you?"
 
deltagator
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 9:48 am

Quoting Gilligan (Reply 27):
The Constitution doesn't define it, so by the Constitution's own definition, it is a States or individuals right.

Absolutely. Unfortunately we as a population have let the government slip one past us and the Federal government has overstepped its bounds in so many ways.

Quoting Gilligan (Reply 27):
But those numbers are based on millions of people so the numbers should be the same.

Now that I look at it again I see that. I thought I was reading it a different way where it was say 1 MRI per 7 million versus us having 22 per 2 million.
"If you can't delight in the misery of others then you don't deserve to be a college football fan."
 
MD11Engineer
Posts: 13916
Joined: Sun Oct 26, 2003 5:25 am

RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 10:09 am

Ok, I'm considereda good risk by the health insurance provider I'm with (a public one). My contribution is a percentage of my gross income (50% paid by my boss, 50% by myself as for anyemployed worker in Germany). I'm rarely ill. Still last year I had an accident at work (got hit in the heel by an MD-11 tow bar, which sprained my right foot badly). I have free choice of doctors and hospitals. I got admitted with 30 minutes after I arrived at the emergency ward in the local hospital (thinking that my foot was broken). Ok, there was a life threatening case on which the doctors were working, which had priority over my injured foot. Unlike the private insurance (Debeka) I was with during my student years I didn't have to forward the money, the doctor was sending the bill straight to the public insurer.

If I go to a GP I'll have to pay 10 Euros per quarter, which I think is good (it should be per consultation) to prevent abuse of the system (before we had a lot of people who were too lazy to work, went to their GP to get a cert and stayedat home at full pay, now, since the cert costs a few Euros they are more reluctant to call in fake sick, but on the other hand the amount is not so high as to scare off really sick low income people).
The GP will transfer me to a specialist at no extra costs, though if I go directly to a specialist, he will also charge me these 10 Euros for the current quarter.

With the private insurance I had to foot the bills first myself and would get the money eventually back from the insurer, but as astudent it was quite hard to be able to pay severakl hundred Euros (or Deutschmarks back then).

Jan
Je Suis Charlie et je suis Ahmet aussi
 
bhmbaglock
Posts: 2489
Joined: Thu Jul 14, 2005 7:51 am

RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 10:25 am

Quoting Pilotsmoe (Reply 13):
About $1200, and that's if you're perfectly healthy

Actually, a good family plan is considerably less than this.

Quoting Greasespot (Reply 28):
Most wait times are for non-Emergency prodecures

My brother in law is a Cardiovascular and Thoracic surgeon in central FL. He does quite a few major heart surgeries every year on Canadians who don't think their life is worth 3-6 months of waiting for what the government considers "non-emergency".

Countries with socialized health care also pay a price as far as a talent drain. I know quite a few British and Canadian doctors who decided to either move here or stay here after medical school simply because they can make quite a bit more money.
Where are all of my respected members going?
 
L-188
Posts: 29881
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 10:42 am

Quoting Cairo (Reply 14):
I don't think Americans would mind a government health care system if it they were 100% sure it would work as you say - cheaply - the problem is no one believes this

The problem is that there are two cases existing of US goverment run health care systems-The Indian Health system and the Veterens Hospital system. These systems are not generally known for the efficency.

I would suspect that most people would want the US government to get these two systems right before screwing everybody else's.

Quoting BHMBAGLOCK (Reply 31):
He does quite a few major heart surgeries every year on Canadians who don't think their life is worth 3-6 months of waiting for what the government considers "non-emergency".

I have relatives that have done the same thing.
OBAMA-WORST PRESIDENT EVER....Even SKOORB would be better.
 
N1120A
Posts: 26468
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 11:19 am

Quoting DeltaGator (Reply 23):
Just what the states need...another unfunded mandate from the Federal government.

I said Funded by the Feds, administered by the states

Quoting Gilligan (Reply 27):
As to Hillary Care of 1993, this is one of the best summaries I've ever come across.

Um, try using a little less biased of a resource

Quoting Greasespot (Reply 28):

Excellent summary of the Canadian system.
Mangeons les French fries, mais surtout pratiquons avec fierte le French kiss
 
deltagator
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 11:26 am

Quoting N1120A (Reply 33):
I said Funded by the Feds, administered by the states

That's a failure waiting to happen.

Quoting N1120A (Reply 33):
Um, try using a little less biased of a resource

Well since you keep saying re-read it why don't you provide us something "less biased" (aka more liberal) for us to read then please.
"If you can't delight in the misery of others then you don't deserve to be a college football fan."
 
MD11Engineer
Posts: 13916
Joined: Sun Oct 26, 2003 5:25 am

RE: A Public Health Insurance In The USA - Necessa

Mon Mar 06, 2006 11:49 am

Any insurance is inherently"socialist". The goal is to spread the risk for an individual over a large group, based on the laws of propability. As for e.g. a fire insurance, a possible maximum damage for e.g. a house gets calculated and the chance of this house catching fire. Out of this the insurer calculates the premium. He calculates that many people pay into a pool, but fires happen only to a small number, so the premiums are affordable for everybody, but who has bad luck and has a fire will be compensated out of the pool. The system only works because nothing will happen to the majority of contributors, who regularly pay their premium.

The same applies to health insurances. A large number of people, like me, pays into the system and (knocking wood) doesn't get sick. But in case you get sick, you'll get your medical bills paid out of the jackpot.

The main difference between private and public insurers is that with private companies there is always somebody who wants to reap in a profit at the end of the year.
He is not interested in what he considers "bad risks", people for whom he is likely to pay out. Preferably he would just cash the contributions and not payat all. He is interested in people, who are not likely to get sick, hence the medical checks many private health insurers demand from new customers.
To get the group of customers he likes to have he'll have to offer certain perks, e.g. they will get a single room in hospital, or the doctors can charge the insurance company slightly higher and therefore the patient receives prefered treatment.

On the other hand a public insurance can not deny membership to bad risks, they will have to accept everybody, hence their payouts for medical bills are higher. In Germany the (partial) solution was to make membership of the public insurance mandatory for employees (with the boss paying 50% of the premium additionally to the salary) under a certain (quite high) monthly income, to spread the risk. This system was introduced during the second half of the 19th century because back them most lower and middle class people could not afford medical treatment. On the other hand the rich didn't want to get thrown in with the "plebs" and insisted on their special rules (private insurance). Civil servants receive medical treatment for themselves and their families out of tax money, this is one of their (undeserved) perks.
Since the premiums depend not on the medical and physical condition of the insurance member and the public insurance has to take anybody, young, old, sick, healthy, but on the income of the members, obviously they'll have to spend more money on bills and can't let doctors or hospitals charge them as much as private insurance companies.

One problem with this system is though that many managers and employees of the public insurance organisations have developed a civil servant mentality and are quite inefficient.

IMO, I'd like to have a public insurance with an affordable mandatory membership for every citizen, rich and poor, young and old which provides a basic health care, but if the individual wants e.g. to have extra comfort in hospital (single room instead of a 12 bed room... etc.) he / she should get private supplementary cover.

The administration of the public insurance has to become leaner, they should concentrate on their main job, accute and preventive health care, while I think they should e.g. charge smokers extra.
I also think that a consultation with a GP should cost something between 10 and 20 Euros to be paid in cash by the patient (could be waived for social welfare recepients) to prevent abuse of the system (faking to be sick at work).

Also at the moment the public insurance providers are being held in a stranglehold by pharmaceutical companies and lobby groups (independent doctors, pharmacists) who try to cut a piece as big as possible out of the cake (e.g. the pharmaceutical industry in cooperation with the pharmacists to prevent reimports of medications exported to other European countries where the same medication is being sold cheaper). BTW, hospital doctors, opposed to the independent entrepreneur doctors are earning quite badly and are working very long hours. Hospitals are not allowed to treat outpatients in Germany, so the independent doctors have a monopoly on ambulant treatment, and they are not for nothing , together with the dentists, considered to be one of the richest groups of the population.

I also get annoyed by the monthly coloured advertisement magazine my insurance provider (Technikerkrankenkasse) sends me. They should rather use the money for their services or to reduce the premiums.


Jan
Je Suis Charlie et je suis Ahmet aussi
 
Gilligan
Posts: 1993
Joined: Mon May 02, 2005 12:15 pm

RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 12:24 pm

Quoting N1120A (Reply 33):
Um, try using a little less biased of a resource

Can't argue the facts of the article so you argue the source? What part of the article is not true? What part is not sourced and footnoted? Where is your source to dispute any of the one I provided?
Warm winds blowing, heating blue skies, and a road that goes forever, I'm going to Texas!
 
aa757first
Posts: 3140
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RE: A Public Health Insurance In The USA - Necessa

Mon Mar 06, 2006 12:25 pm

Quoting BHMBAGLOCK (Reply 31):
Countries with socialized health care also pay a price as far as a talent drain. I know quite a few British and Canadian doctors who decided to either move here or stay here after medical school simply because they can make quite a bit more money.

Half, yes half, of Candian doctors leave Canada before even practicing medicine there. They do medical school in Canada and they're out to greener pastures. Additionally, for every one US doctor that goes to Canada, 15 come to the United States, and it's a 1:18 ratio for nurses.

AAndrew
 
andaman
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 1:00 pm

Even though it means higher taxes than in US, I want to keep the "socialistic" system in Finland: public health insurance, free university education for all etc.
But it's hard to compare different countries, the same system doesn't work the same way everywhere.
Chinese cookie in SFO: "You're doomed to a life of forever travelling abroad and to be able to afford it!"
 
bhmbaglock
Posts: 2489
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 2:22 pm

Quoting Aa757first (Reply 37):
Half, yes half, of Candian doctors leave Canada before even practicing medicine there. They do medical school in Canada and they're out to greener pastures. Additionally, for every one US doctor that goes to Canada, 15 come to the United States, and it's a 1:18 ratio for nurses.

Wow! I knew empiracally that there was a large net flow from CA to US but had no idea it was this extreme.
Where are all of my respected members going?
 
centrair
Posts: 2845
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RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 4:01 pm

I am an American living in Japan. My father is a doctor (former head of the Wisconsin Medical Ethics Board) and my mother is a nurse (education and preventive care). I grew up listening to all these discussions.

Every month I pay about $200 into the Japanese national healthcare system. I can go to private or public facilities. That money covers my wife and myself yet we still have to pay a co-pay before leaving the hospital. Now the system is good, but it is still I wanted to have extra "supplementary" insurance just incase my wife and I move back to the states. We currently don't use the the Supplementary system. We have it more for when we are older and on a fixed income. It will cover both of us and any children we have (with problems). The Japanese system will cover us in the U.S. and our supplementarly goes into effect earlier if we move to the U.S.

The National Health Care system, under Japanese law, cover everything from a cold to cancer. Only thing not covered? Child birth...that is a choice and therefore paid from your own pocket (about US$50 per visit and then $1500 at birth) unless the child/mother have problems in which case the national system takes over.

The city provides health education for free to all that need it. Be it prenatal, postnatal, child, teen, adult or eldertly, you are taken care of.

I do have a co-pay of 20% and that is fine with me. The rate paid is relative to the family. More people...more money.

The problem is I don't trust Japanese doctors in some of the public hospitals. They don't have the "human" touch and they change every three years so you can have a different doctor often. They also studied too hard so they think they are the bomb. But if I want good care, I can go to the big private Red Cross hospital about 50 minutes away and get great care all covered by the national system

For the U.S. to have an effective public system, it would have to be tailored to U.S. thinking and attitude. It can't copy Canada, the UK, Germany, Denmark, Japan or anyone else.

1) preventive care and community health education would have to be provided for all from Kingergarten to Adult. (Actually had a system like this post WWII but was dropped as people thought it was too much like the USSR...Communism/Socialism)

2) cost would have to be priced based to cover costs per person. Families pay based on number of dependents. Two income homes would pay

3) CO-PAY at 15-20% so that you don't get everyone coming in or abusing the system.

4) choice of doctors and hospitals public or private: I would prefer the Marshfield Clinc over Cook County anyday.

5) People would be allowed to purchase supplementary insurance. This is needed as the national system nor families could never care 100% for someone with serious long-term medical issues.

6) Streamlined and have little paperwork as Doctors hate this. It takes away from diagnosis (my father bitches and moans about insurance forms all the time. Says he has little time to focus on providing for the patient.)

7) High quality and match or surpass the reputation of the medical system currently in place.

8) The cost of perscription medicines is high and would have to be regulated or generic versions of "brand" name products would have to be made available.

Does the U.S. Consitution say anything about providing healthcare?

Quoting B2707SST (Reply 22):
The only time the phrase "life, liberty, and property" appears in the Constitution is in the 5th Amendment:

"No person shall... be deprived of life, liberty, or property, without due process of law."

This is about law
but...in the preamble of the constitution.

Quote:
We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

Meaning:
Welfare
welfare n. 1. health, happiness, or prosperity; well-being. [wel faren, to fare well] Source: AHD

Welfare in today's context also means organized efforts on the part of public or private organizations to benefit the poor, or simply public assistance. This is not the meaning of the word as used in the Constitution.
U.S. Constitution

Conclusion:
I don't think the U.S. is promoting the general welfare very well. We spend billions on defense of the nation, yet if we needed more to fight, most wouldn't pass their health exams to defend that nation.

Anyone remember why the U.S. made the School lunch program? It was not only to provide at least one healthy meals to all children, but also to have a healthy population in case there was a call to war. Same reason the U.S. Department of education required public schools to have Physical education. Not to torture us, but to have able boddied people ready when the call came.

Having a healthy nation is good for national security. Right now the biggest security threat to the U.S. is the lack of able bodied people who could defend the nation.

Is public Health Insurance in the USA Necessary?
YES for the national defense.
Would Americans accept it? 50/50
Could it be put in place at a resonable cost and in a resonable time, and stil be good for America? In the current political climate...NO, unless made part of the Department of Defense.
Yes...I am not a KIX fan. Let's Japanese Aviation!
 
melpax
Posts: 1728
Joined: Mon Apr 25, 2005 12:13 am

RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 8:33 pm

In Oz, you pay a 'Medicare Levy' which is 1.5% of your taxable income per year - this, in theory gives you access to free medical care, however if you need elective surgery waiting lists can be long in the public system & you may not have a choice of doctor. The system has become overloaded, so the govt gives tax rebates if you chose to have private insurance (I pay around $20 per fortnight) If you are on a high income & you don't have private insurance, you have an additional surcharge of 1% of your taxable income ($50000 p.a. for a single person) - all in all it works well most of the time - if you require urgent treatment you usually get it fairly quickly...

http://www.ato.gov.au/individuals/content.asp?doc=/content/17482.htm
Essendon - Whatever it takes......
 
N1120A
Posts: 26468
Joined: Sun Dec 14, 2003 5:40 pm

RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 8:44 pm

Quoting DeltaGator (Reply 34):
That's a failure waiting to happen.

Um, it has worked quite well in Canada where the provinces administer a federal mandate

Quoting DeltaGator (Reply 34):
Well since you keep saying re-read it why don't you provide us something "less biased" (aka more liberal) for us to read then please.

Um, "more liberal" is relative here. Heritage is a conservative propaganda house

Quoting Gilligan (Reply 36):
Can't argue the facts of the article so you argue the source?

When the source has no credibility, neither does the article. If you had posted something from "The Socialist Worker" I would have said the same thing

Quoting Gilligan (Reply 36):
What part is not sourced and footnoted?

Most of the footnotes are WSJ or Heritage opinion pieces. Again, no credibility.

Quoting Aa757first (Reply 37):
Half, yes half, of Candian doctors leave Canada before even practicing medicine there. They do medical school in Canada and they're out to greener pastures. Additionally, for every one US doctor that goes to Canada, 15 come to the United States, and it's a 1:18 ratio for nurses.

Canada is a smallish country (population wise), yet highly educated with an excellent educational system. The supply of doctors goes above the demand which means they are naturally going to flow out to larger markets, especially when they share a massive border with one.
Mangeons les French fries, mais surtout pratiquons avec fierte le French kiss
 
deltagator
Posts: 6170
Joined: Fri Sep 23, 2005 9:56 am

RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 9:48 pm

Quoting N1120A (Reply 42):
Most of the footnotes are WSJ

Since when is the WSJ considered an unreliable resource? Oh wait, just in your mind because you disagree with their opinion.

You still haven't produced a source to counter anyone's claims contrary to yours that have produced sources. Provide one or go get a big steaming cup of STFU.
"If you can't delight in the misery of others then you don't deserve to be a college football fan."
 
Gilligan
Posts: 1993
Joined: Mon May 02, 2005 12:15 pm

RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 9:56 pm

Quoting N1120A (Reply 42):
When the source has no credibility, neither does the article. If you had posted something from "The Socialist Worker" I would have said the same thing



Quoting N1120A (Reply 42):
Most of the footnotes are WSJ or Heritage opinion pieces. Again, no credibility.

Then that is credibility in your opinion not in fact. The article quotes the plan verbatium which is what you asked Delta to read. If you then say that the facts the article is based on, quoted and sourced from has no credibility then it follows that the plan itself must not have any credibility either. In which case you are right since it was not even brought up for a vote in a Democratically controlled Congress.

Once again, the Constitution makes no specific reference to health care. Articles 9 and 10 in the Bill of Rights make specific reference to an individuals rights and to the fact that items not specifically enumerated in the Constitution are reserved to the States and the people. If you want national health care, gather the support necessary to get 66% of the Congress to pass an ammendment to the Constitution and then get 75% of the States to ratify it(article V). Till then, to say health care is a Constitutional right is just plain wrong.
Warm winds blowing, heating blue skies, and a road that goes forever, I'm going to Texas!
 
scott2187
Posts: 303
Joined: Thu Feb 02, 2006 10:37 pm

RE: A Public Health Insurance In The USA - Necessary?

Mon Mar 06, 2006 10:27 pm

Quoting Scorpio (Reply 12):
I can choose any doctor and any hospital I want, as I said before.

That's Belgium, not America...big difference there. none of us know what kind of plan they would come up with here in America. with people like Hillary around, they probably would prohibit us from seeing the doctor of our choice.

Quoting Pilotsmoe (Reply 13):
Sorry, but most people can't afford it. An idea how much insurance cost per month? About $1200, and that's if you're perfectly healthy

i don't know what insurance you have, but $1200 seems quite high.

Quoting DeltaGator (Reply 3):
I'm sorry but I have no desire to see my tax money (and I pay a hell of a lot in taxes ever year) go towards a system where folks who continue to live in poverty based on their life choices will be rewarded with government handouts. Perhaps it is time for these folks to make a decision...big screen TV, Air Jordans, big mud tires for their truck or healthcare and an education.

i've seen this first hand in the area i grew up. however, people who live in the rich neighborhoods, or places with little or no poverty believe this sort of thing doesn't happen.
“Pleasure in the job puts perfection in the work.”
 
aa757first
Posts: 3140
Joined: Sun Aug 03, 2003 11:40 am

RE: A Public Health Insurance In The USA - Necessary?

Tue Mar 07, 2006 6:26 am

Quoting N1120A (Reply 42):

Canada is a smallish country (population wise), yet highly educated with an excellent educational system. The supply of doctors goes above the demand which means they are naturally going to flow out to larger markets, especially when they share a massive border with one.

Actually, there is a shortage of doctors, not even meeting demands.
http://www.cpso.on.ca/Publications/Dialogue/0504/shortage.htm

There is a nursing shortage too, and by 2011 it will the the worst it has ever been, according to the Canadian Nursing Association. Why? Because of lower payouts, the hospitals can't afford a decent salary. The average nursing pay in Quebec is $36,000 a year, or around $19.00 an hour. In the US the average is $52,000, or around $27.75 an hour. My aunt was the Director of Nursing at a 500 bed suburban Philadelphia hospital. Payrate on the weekends, regardless of experience, is $47.00 an hour. The Democrats wanting nationalized medicine are complaining of falling wages of the middle class. Nursing is a middle class profession with great pay, do they really want to ruin it?

http://www.charlotte.com/mld/charlotte/business/13505387.htm

AAndrew

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