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Source: (consider it)
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Thread: Purgatory: Health Care
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Crœsos
Shipmate
# 238
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Posted
quote:
Originally posted by New Yorker:
The government screws up a used car program, but we want it to run our health care?
To a large extent it already is "run[ning] our health care". The U.S. spends more public dollars (that's tax money, everyone already knows the U.S. spends more total dollars) on health care per capita than that horrible British NHS that hunted down and killed poor Dr. Hawking.
We've also already got examples of health care that's provided by government insurance (Medicare) or provided directly by the government (the Veteran's Administration). While the cost of both has been increasing, the rate of cost increase in both programs has been significantly less than cost increase of healthcare generally within the U.S. Add in to that the fact that participants in these programs are generally more statisfied with their service than those with private insurance, and I'd say we've got pretty good evidence that the U.S. government can do health care if it puts its collective mind to it.
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Humani nil a me alienum puto
Posts: 10706 | From: Sardis, Lydia | Registered: May 2001
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tclune
Shipmate
# 7959
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Posted
quote:
Originally posted by Jason I. Am:
Tom, I'm feeling extraordinarily thick today. Can you explain (again) why the public option does no good where the single-payer option would? I can tell there's something to what you're saying, but I can't repeat the argument in an understandable way.
Single payer basically turns the medical industry into a governmental service. All medical services are paid for by the government and private insurance is, for all practical purposes, eliminated. There is some room for fudging on that. Medicare is usually seen as a model for single-payer in this country.
If it were extended to everyone, that would be what most folks would think of as a single payer system. However, there is supplimental insurace that is sold to Medicare recipients and the medical industry is not, strictly speaking, nationalized. Physicians can opt out of the system, but their patient base would be very small indeed.
The basic reality is that, if the government were essentially the sole entity that paid for all the core services, then the government could change the way in which services were delivered. We have evolved a very strange medical system because it is completely undirected. Essentially every physican in the US is a specialist. General practicioners and family medicine specialists don't really practice medicine, they provide referrals to the specialist that seems most appropriate for treating your condition.
As a result of this, physicians are massively overpaid for treating routine conditions, tests tht are unnecessary but lucrative to the specialist are routinely ordered, drugs are prescribed to justify doctor's appointments as often as to treat real diseases, etc.
We cannot watch television without being bombarded by ads for pharmaceuticals that only a physician can prescribe. The reason for this is that people ask their physician for the drugs that they see advertized on television, and the physician provides them whether there is a generic that would do the same job or not. A single payer system could eliminate that exhorbitantly expensive practice in one stroke.
Insurance companies have very limited ability to change medical practice -- unless they engaged in unlawful collusion to set prices with other insurance companies, they really couldn't restructure their fees to reorder medical priorities. A single payer system can accomplish those necessary ends.
It would be possible to create some sort of medical oversight board to set those priorities and allow individual private insurance companies to still sell the policies, but that would be a strange and inefficient system. The insurance companies would basically be providing no value and would be retained simply to subsidize the stock holders of the company.
An additional serious concern to my mind is malpractice reform. We have a system where doctors literally perform operations while drunk. If they kill or maim a patient, they are sued by the patient or their surviving spouse for many millions of dollars, and they continue to practice medicine.
This is just crazy. There is no reason why being victimized by a substance abuser with a scalpel should be seen as a winning lottery ticket, and no reason why physicians should not be forbidden from practicing medicine when they are found to be a danger to patients. I think that a single payer system could effrectively police physicians who have demonstrated for years that they are unwilling or unable to police themselves. If there is a real policing of medical practice, then there is an honest environment for allowing tort reform.
If you just add a public option, what you are doing is creating more insurance companies, but some of them are owned by the Federal Government. The stated rationale for creting this new and massive structure is to provide competition to the existing insurance companies "to keep them honest."
Not only does this rationale fail to adddress many of the things that need reforming, but I have seen no evidence that the current companies are particularly dishonest. They may not run their business the way that some people would want them to, but they are not obviously dishonest.
If one's goal is to change the way that care is delivered, simple competition for who provides the insurance is just plain irrelevant. If one's goal is to make sure that everyone can get coverage and will not be cancelled if they get sick or change jobs, a public option is unnecessary.
The real question in my mind is what value a public option has. The only objective thing that has been offered is to suggest that, if insurance companies are price gouging (something that I have yet to see any evidence for), a public option would require the insurance company to either stop that practice or go out of business. Lacking proof that price gouging is happening in the sale of insurance, I remain unmoved.
The other reason for demanding a public option is just perverse. As Rep. Maxine Waters said, she wanted to have a single payer system but was talked out of it on political grounds. She feels that if she doesn't get a public option, she will have "lost" on health care reform. She didn't offer any objective reason why a public option was a good thing, only a political reason that she gave up what she wanted and was unwilling to let the opposition get what they wanted. But polictical face-saving is an incredibly stupid reason to create a bureaucracy. If it doesn't do anything, let Rep Waters lose face -- it isn't that great a face anyway.
--Tom Clune
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Posts: 8013 | From: Western MA | Registered: Jul 2004
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Crœsos
Shipmate
# 238
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Posted
BTW, the commie pinkos at the RAND Corporation indicate that not only does VA care cost less than privately provided care, "VA patients are more likely to receive recommended care than patients in the national sample."
I'm sure the lack of 'death panels' in the VA is purely an oversight. ![[Roll Eyes]](rolleyes.gif)
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Humani nil a me alienum puto
Posts: 10706 | From: Sardis, Lydia | Registered: May 2001
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tclune
Shipmate
# 7959
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Posted
quote:
Originally posted by Crœsos:
BTW, the commie pinkos at the RAND Corporation indicate that not only does VA care cost less than privately provided care, "VA patients are more likely to receive recommended care than patients in the national sample."
Yes, VA medical care went through a major reform fifteen or twenty years ago, and is now generally very good. I meant to call Macx on his suggestion that VA was lousy medical care but never got around to it.
The follow-up care for Iraq War veterans was a genuine problem that resounded to the VA's discredit, but is anomalous in its current form. In the old days, the VA was awful. Now, they may be caught unprepared when there is a huge increase in a kind of care that just wasn't the norm in previous wars.
But we shouldn't over-interpret that slowness of response to an evolving medical situation. It was right to call attention to it, and my understanding is that it has still not been completely dealt with across the country, but the VA is moving in the right direction and will get to a point of addressing the needs in a timeframe that is pretty much the norm for a huge organization.
--Tom Clune
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Posts: 8013 | From: Western MA | Registered: Jul 2004
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Imaginary Friend
Real to you
# 186
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Posted
quote:
Originally posted by tclune:
The basic reality is that, if the government were essentially the sole entity that paid for all the core services, then the government could change the way in which services were delivered.
But surely that logic extends even further if the government actually runs the provision of health services. I mean, if they directly employ the health professionals, manage the hospitals and clinics, and provide all the funding, then they have control over all the costs. From the point of view of cost reduction, that's got to be better than the indirect influence over the pricing set by private companies, even if the government is the sole purchaser.
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"We had a good team on paper. Unfortunately, the game was played on grass."
Brian Clough
Posts: 9455 | From: Left a bit... Right a bit... | Registered: May 2001
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Pretty Butterfly
Shipmate
# 15024
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Posted
quote:
Originally posted by Crœsos:
To a large extent it already is "run[ning] our health care". The U.S. spends more public dollars (that's tax money, everyone already knows the U.S. spends more total dollars) on health care per capita than that horrible British NHS that hunted down and killed poor Dr. Hawking.
Do you have a source for this that you could send me? I've been having a similar discussion on this subject elsewhere, and this is an important point.
[ 20. August 2009, 14:41: Message edited by: tclune ]
Posts: 121 | From: UK | Registered: Aug 2009
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tclune
Shipmate
# 7959
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Posted
quote:
Originally posted by davelarge:
quote:
Originally posted by tclune:
The basic reality is that, if the government were essentially the sole entity that paid for all the core services, then the government could change the way in which services were delivered.
But surely that logic extends even further if the government actually runs the provision of health services. I mean, if they directly employ the health professionals, manage the hospitals and clinics, and provide all the funding, then they have control over all the costs. From the point of view of cost reduction, that's got to be better than the indirect influence over the pricing set by private companies, even if the government is the sole purchaser.
I agree entirely. I am not proposing any particular form of single-payer system, just arguing that anything less is completely incapable of addressing the issues that plague our current system.
--Tom Clune
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Posts: 8013 | From: Western MA | Registered: Jul 2004
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Erin
Meaner than Godzilla
# 2
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Posted
quote:
Originally posted by Crœsos:
We've also already got examples of health care that's provided by government insurance (Medicare) or provided directly by the government (the Veteran's Administration). While the cost of both has been increasing, the rate of cost increase in both programs has been significantly less than cost increase of healthcare generally within the U.S. Add in to that the fact that participants in these programs are generally more statisfied with their service than those with private insurance, and I'd say we've got pretty good evidence that the U.S. government can do health care if it puts its collective mind to it.
NO MEDICARE as the universal plan. The only reason why Medicare recipients are happy is because of the price controls which ultimately result in cost shifts to those of us with insurance or paying out of pocket. A lot of the time the Medicare payment does not even cover the actual cost of the service, much less provide any sort of cushion to pay staff or for the upkeep of the facility at all.
Medicare needs to be off the table as an option as it sucks the hind tit right off a sow.
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Commandment number one: shut the hell up.
Posts: 17140 | From: 330 miles north of paradise | Registered: Mar 2001
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Imaginary Friend
Real to you
# 186
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Posted
OK, so when you say 'public option' you mean a government-run insurance scheme, not government-managed services?
[Edited to add - cross-posted with Erin. My question is aimed at tclune.]
[ 20. August 2009, 14:47: Message edited by: davelarge ]
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"We had a good team on paper. Unfortunately, the game was played on grass."
Brian Clough
Posts: 9455 | From: Left a bit... Right a bit... | Registered: May 2001
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ken
Ship's Roundhead
# 2460
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Posted
quote:
Originally posted by tclune:
... However, there is supplimental insurace that is sold to Medicare recipients and the medical industry is not, strictly speaking, nationalized. Physicians can opt out of the system, but their patient base would be very small indeed.
That's how it is in UK. Although most hospitals are publically owned (though by no means all), most doctors are not employed by the NHS. GPs run their own business affairs. Consultants (i.e. senior hospital doctors & specialists) are in effect private contractors. They do both private and NHS work.
I suppose in the US jargon (we don't really use those words here) the NHS is "single payer" but "mixed provider".
I'm not sure but I think Germany is the exact other way round - most doctors (like university teachers and Lutheran priests) are government employees, civil servants. But there are multiple health insurance schemes.
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Ken
L’amor che move il sole e l’altre stelle.
Posts: 39579 | From: London | Registered: Mar 2002
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la vie en rouge
Parisienne
# 10688
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Posted
quote:
Originally posted by tclune:
If it were extended to everyone, that would be what most folks would think of as a single payer system. However, there is supplimental insurace that is sold to Medicare recipients and the medical industry is not, strictly speaking, nationalized. Physicians can opt out of the system, but their patient base would be very small indeed.
I'm struck that taken in isolation, this sounds a lot like the French system to me. National insurance + other insurance to pay what it doesn't cover. Up to the individual to decide whether they want to see a doctor charging more than the average (and therefore paying more, either in insurance or in upfront fees).
Healthcare in France is more expensive than in the UK, but the care is also better. You pays your money (literally), you takes your choice about which one you prefer.
[code]
[ 20. August 2009, 15:05: Message edited by: lady in red ]
Posts: 3696 | Registered: Nov 2005
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tclune
Shipmate
# 7959
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Posted
quote:
Originally posted by davelarge:
OK, so when you say 'public option' you mean a government-run insurance scheme, not government-managed services?
That's the "public" part of it. The "option" part requires that the government not be the only insurance offered to people.
There has been the suggestion that the "real" agenda of people proposing a "public option" is that they want to create a skewed playing field where the private insurance companies are driven out of business, so it is an end-run to get a single-payer system without having to endure the political flak in the process.
That strikes me as plausible. The arguments offered in favor of a public option make no logical sense as stated, which requires one to either believe the proponents are stupid or dishonest. I suppose it may be seen as more gracious to see them as dishonest.
In addition, it has been widely publicized that Medicare initially was intended to be a public option. It just ended up being subsidized to a point that nothing else could compete, and within a year it became the only game left standing. That was an unintended consequence of Medicare -- we just didn't realize what we were doing at the time. But it is not irrational to imagine that many of the proponents are now aware of the situation and are taking a politically lower-risk strategy for effecting a single payer system. Personally, I find such tactics a despicable misuse of the democratic process. I prefer an honest debate. But that kind of dishonesty is certainly not unheard of in politics.
--Tom Clune
[ 20. August 2009, 15:19: Message edited by: tclune ]
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Posts: 8013 | From: Western MA | Registered: Jul 2004
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Moth
Shipmate
# 2589
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Posted
quote:
Originally posted by prettybutterfly:
quote:
Originally posted by Crœsos:
To a large extent it already is "run[ning] our health care". The U.S. spends more public dollars (that's tax money, everyone already knows the U.S. spends more total dollars) on health care per capita than that horrible British NHS that hunted down and killed poor Dr. Hawking.
Do you have a source for this that you could send me? I've been having a similar discussion on this subject elsewhere, and this is an important point.
You can get all the statistics from
the WHO. For example, you can see that that in 2006 the USA spent 19.1% of total government expenditure on health care, whereas the UK spent 16.5%. Further digging will get you actual figures.
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"There are governments that burn books, and then there are those that sell the libraries and shut the universities to anyone who can't pay for a key." Laurie Penny.
Posts: 3446 | From: England | Registered: Apr 2002
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Imaginary Friend
Real to you
# 186
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Posted
quote:
Originally posted by tclune:
But it is not irrational to imagine that many of the proponents are now aware of the situation and are taking a politically lower-risk strategy for effecting a single payer system. Personally, I find such tactics a despicable misuse of the democratic process. I prefer an honest debate. But that kind of dishonesty is certainly not unheard of in politics.
It might also help explain some of the shrillness of the opponents of a public option, if they fear it is the thin end of the single payer wedge.
Thanks for your explanations: I think I understand what's going on rather better now. ![[Smile]](smile.gif)
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"We had a good team on paper. Unfortunately, the game was played on grass."
Brian Clough
Posts: 9455 | From: Left a bit... Right a bit... | Registered: May 2001
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Crœsos
Shipmate
# 238
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Posted
quote:
Originally posted by Moth:
quote:
Originally posted by prettybutterfly:
quote:
Originally posted by Crœsos:
To a large extent it already is "run[ning] our health care". The U.S. spends more public dollars (that's tax money, everyone already knows the U.S. spends more total dollars) on health care per capita than that horrible British NHS that hunted down and killed poor Dr. Hawking.
Do you have a source for this that you could send me? I've been having a similar discussion on this subject elsewhere, and this is an important point.
You can get all the statistics from
the WHO. For example, you can see that that in 2006 the USA spent 19.1% of total government expenditure on health care, whereas the UK spent 16.5%. Further digging will get you actual figures.
The article most frequently cited is this one from Health Affairs, but it is unfortunately behind a subscription wall.
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Humani nil a me alienum puto
Posts: 10706 | From: Sardis, Lydia | Registered: May 2001
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Dafyd
Shipmate
# 5549
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Posted
quote:
Originally posted by Crœsos:
The U.S. spends more public dollars on health care per capita than that horrible British NHS that hunted down and killed poor Dr. Hawking.
I fully expect you to find yourself cited as an authority attesting that the British government sent elite hit squads after the eminent scientist.
(Does Stephen Hawking really get all his medical treatment privately?)
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we remain, thanks to original sin, much in love with talking about, rather than with, one another. Rowan Williams
Posts: 10567 | From: Edinburgh | Registered: Feb 2004
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Clint Boggis
Shipmate
# 633
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Posted
Hawking said he wouldn't be here (presumably alive) today if it weren't for the NHS. That implies that he relies on it. Honestly -how could someone with his medical history get commercial insurance health cover at ANY price?
I was so pleased to see the ignorance and stupidity of those who think the NHS has death panels and lets us poor Brits die in the streets, revealed for what it is. Sadly those people don't listen to facts. Witness people here STILL citing Obama's "death panels" however slowly and simply they're told: "it's all fairy tales."
Stupidity may not be the sole reason some people are resisting change but (aside from personal financial gain) sure as Hell is the main one!
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[ 20. August 2009, 16:47: Message edited by: Clint Boggis ]
Posts: 1505 | From: south coast | Registered: Jun 2001
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Carys
Ship's Celticist
# 78
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Posted
quote:
Originally posted by Dafyd:
quote:
Originally posted by Crœsos:
The U.S. spends more public dollars on health care per capita than that horrible British NHS that hunted down and killed poor Dr. Hawking.
I fully expect you to find yourself cited as an authority attesting that the British government sent elite hit squads after the eminent scientist.
(Does Stephen Hawking really get all his medical treatment privately?)
I think you'll find that Crœsos was being sarcastic. It was an American editorial last week that suggested that Stephen Hawking would not be alive if it had been left up to the NHS (with the implication he was American). He has since come out to say how much he owes the NHS.
Carys
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O Lord, you have searched me and know me
You know when I sit and when I rise
Posts: 6896 | From: Bryste mwy na thebyg | Registered: May 2001
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Lioba
Shipmate
# 42
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Posted
quote:
Originally posted by ken:
... I'm not sure but I think Germany is the exact other way round - most doctors (like university teachers and Lutheran priests) are government employees, civil servants. But there are multiple health insurance schemes.
Neither Lutheran priest nor doctors are civil servants. The churches pay their clergy's salaries themselves and doctors run independent surgeries.
[ 20. August 2009, 17:22: Message edited by: tclune ]
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Conversion is a life-long process.
Posts: 502 | From: Germany | Registered: May 2001
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Crœsos
Shipmate
# 238
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Posted
quote:
Originally posted by Dafyd:
quote:
Originally posted by Crœsos:
The U.S. spends more public dollars on health care per capita than that horrible British NHS that hunted down and killed poor Dr. Hawking.
I fully expect you to find yourself cited as an authority attesting that the British government sent elite hit squads after the eminent scientist.
Most likely. But for the record, a brilliant scientist with an otherwise incapacitating condition on the run (metaphorically, of course) from his own evil government with nothing but his vast intelligence (and a rag tag team of friends) to keep him alive? That's a movie I'd pay good money to see. If anyone in Hollywood is reading this, I expect 10% of the box office. You're welcome!
quote:
Originally posted by Dafyd:
(Does Stephen Hawking really get all his medical treatment privately?)
“I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived.”
- Stephen Hawking
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Humani nil a me alienum puto
Posts: 10706 | From: Sardis, Lydia | Registered: May 2001
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IconiumBound
Shipmate
# 754
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Posted
Sorry to ring in late on this thread (p 6) but I wonder why the case for "death panels" hasn't been turned back onto the HMO's who regularly deny coverage even it means sentencing the subscriber to death? A relative, suffering from lukemia, was denied a bone marrow transplant by her HMO becuase, at age 70, she was too old to qualify. She died shortly after. Congressional hearings about two years ago heard testimony from a physician who employed by a leading HMO had the job of finding reasons to deny coverage. She resigned on moral grounds.
So.ISTM that we already have death panels and will probably continue to have them till a single payer legislation is enacted.
Posts: 1318 | From: Philadelphia, PA, USA | Registered: Jul 2001
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Crœsos
Shipmate
# 238
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Posted
quote:
Originally posted by IconiumBound:
Sorry to ring in late on this thread (p 6) but I wonder why the case for "death panels" hasn't been turned back onto the HMO's who regularly deny coverage even it means sentencing the subscriber to death? A relative, suffering from lukemia, was denied a bone marrow transplant by her HMO becuase, at age 70, she was too old to qualify. She died shortly after. Congressional hearings about two years ago heard testimony from a physician who employed by a leading HMO had the job of finding reasons to deny coverage. She resigned on moral grounds.
So.ISTM that we already have death panels and will probably continue to have them till a single payer legislation is enacted.
It's been mentioned at least once already in a link to this blog post which makes many of the same points you do. Still, the question of why this isn't more widespread is probably similar in shape to angry seniors who want to makes sure the government keeps its hands off their Medicare.
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Humani nil a me alienum puto
Posts: 10706 | From: Sardis, Lydia | Registered: May 2001
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RuthW
liberal "peace first" hankie squeezer
# 13
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Posted
quote:
Originally posted by CorgiGreta:
Ruth,
The existence of a large number of carriers does not mean that the bulk of us have a wide choice when it comes to our coverage. Lots of companies offer coverage with just one carrier. Even the really large companies may offer only a handful of carriers, albeit with various plans.
Also, I am fairly certain that in most companies, the choice, if any, usually comes down to the same top four or five insurers. The result may not be a cartel or an oligopoly, but it would be fertile soil for one to grow and prosper.
I would guess that in a group as small as yours, the "choice" would be Blue Cross or nothing, but since I assume that you are in a liberal church group, perhaps it's Kaiser. Good on you if it is.
If your employer is trying to save himself or herself some bucks, you could be offered only a skimpy plan.
Greta
I'm well aware of all of this! I said there are a large number of health insurers in California not to say that people here have lots of choice in their health insurance; as you surmise, I have no choice (and dear God I wish it was Kaiser, but no, it's HealthNet). I was posting in response to mjg's assumption that the 4,000 rescissions per year figure was a national figure and took place out of a guesstimated 50 million people insured. Those 4,000 rescissions per year are just in California and just for a few of the many companies that operate here.
So the reality is that we have death panels run by insurance companies. That people like Chuck Grassley and Sarah Palin are getting away with their lies is despicable. If the language in the House bill that they are twisting and mis-reading into talk of death panels is eliminated, what it will really mean is that Medicare will not cover counseling about end of life care, hospice, living wills, etc.
Posts: 24453 | From: La La Land | Registered: Apr 2001
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Crœsos
Shipmate
# 238
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Posted
Here's a polically relevent variation on end of life preparations:
quote:
Senator Edward M. Kennedy, in a poignant acknowledgment of his mortality at a critical time in the national health care debate, has privately asked the governor and legislative leaders to change the succession law to guarantee that Massachusetts will not lack a Senate vote when his seat becomes vacant.
In a personal, sometimes wistful letter sent Tuesday to Governor Deval L. Patrick, Senate President Therese Murray, and House Speaker Robert A. DeLeo, Kennedy asks that Patrick be given authority to appoint someone to the seat temporarily before voters choose a new senator in a special election.
Although Kennedy, who is battling brain cancer, does not specifically mention his illness or the health care debate raging in Washington, the implication of his letter is clear: He is trying to make sure that the leading cause in his life, better health coverage for all, advances in the event of his death.
In his letter, which was obtained by the Globe, Kennedy said that he backs the current succession law, enacted in 2004, which gives voters the power to fill a US Senate vacancy. But he said the state and country need two Massachusetts senators.
"I strongly support that law and the principle that the people should elect their senator," Kennedy wrote. "I also believe it is vital for this Commonwealth to have two voices speaking for the needs of its citizens and two votes in the Senate during the approximately five months between a vacancy and an election."
The law in question was passed in 2004 to prevent the possibility of then-Governor Mitt Romney appointing a successor to John Kerry should Kerry's presidential bid have been successful.
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Humani nil a me alienum puto
Posts: 10706 | From: Sardis, Lydia | Registered: May 2001
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New Yorker
Shipmate
# 9898
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Posted
Watching Bill O'Reilly tonight who had the former President of the Canadian Medical Association, Brian Day. Dr. Day said that, in Canada, if you're having a heart attack the health care system would not pay for the ambulance to take you to the hospital. Is this true? Good God Almighty if it be true and keep that Obamacare far, far away.
Posts: 3193 | From: New York City | Registered: Jul 2005
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Josephine
Orthodox Belle
# 3899
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Posted
quote:
Originally posted by New Yorker:
Watching Bill O'Reilly tonight who had the former President of the Canadian Medical Association, Brian Day. Dr. Day said that, in Canada, if you're having a heart attack the health care system would not pay for the ambulance to take you to the hospital. Is this true? Good God Almighty if it be true and keep that Obamacare far, far away.
Who do you think would pay for the ambulance if you had to go to the hospital in this country? The tooth fairy?
The only time I ever had to have one of my children transported by ambulance (she was having trouble breathing, and the urgent care clinic couldn't handle it, so they sent her to the children's hospital), our private insurance wouldn't pay for the ambulance. They decided it wasn't medically justifiable. (And I lost that appeal, too. Blasted government bureaucrats who care nothing for the life of a child. Oh, wait. They weren't with the government.)
At least on paper, we HAD insurance that covered transport by ambulance. Lots of private insurance companies don't even pretend cover it. Some of them cover a portion of it (often the first $500). Medicare doesn't pay for ambulances at all, nor does Medicaid. Are you absolutely certain that your insurance would pay for it?
And what does Obama have to do with health coverage in Canada anyway?
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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!
Posts: 10273 | From: Pacific Northwest, USA | Registered: Jan 2003
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Leaf
Shipmate
# 14169
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Posted
But since we're on the subject of Canada ![[Big Grin]](biggrin.gif) ... I have some questions for New Yorker et al.
Do you really believe that all the other posters here from countries with universal health care are granny-exterminating death-panel-loving commie nazis (to borrow what appears to be the parlance of the debate)?
Doesn't the possibility exist in your mind that seemingly sane, intelligent, freedom-loving people would choose and support universal health care?
Does the fact that not one single non-American has sighed on this thread, "Gee, I wish we had the American system!" not light one tiny ![[Votive]](graemlins/votive.gif) of doubt in your mind?
Are all us citizens of Canada, Australia, New Zealand, the UK, Europe, and Scandinavia really just that deluded?
Posts: 2786 | From: the electrical field | Registered: Oct 2008
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mousethief
Ship's Thieving Rodent
# 953
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Posted
Leaf, you assume that for the right the debate is about health care. It's not. It's about Defeating Obama At Any Cost.
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This is the last sig I'll ever write for you...
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Clint Boggis
Shipmate
# 633
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Posted
Another difference here. In Britain we have an ambulance service and it's free usually. I have no real idea how it's organised but if you need them they're there and you almost certainly won't get a bill.
I have heard of people being charged but I don't know under what circumstances.
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Posts: 1505 | From: south coast | Registered: Jun 2001
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Dafyd
Shipmate
# 5549
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Posted
quote:
Originally posted by Carys:
I think you'll find that Crœsos was being sarcastic.
So was I. I was commenting on the apparent ability of the US right-wingers to seize on any detail they can twist to support their lies.
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we remain, thanks to original sin, much in love with talking about, rather than with, one another. Rowan Williams
Posts: 10567 | From: Edinburgh | Registered: Feb 2004
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Imaginary Friend
Real to you
# 186
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Posted
quote:
Originally posted by New Yorker:
Watching Bill O'Reilly tonight who had the former President of the Canadian Medical Association, Brian Day. Dr. Day said that, in Canada, if you're having a heart attack the health care system would not pay for the ambulance to take you to the hospital. Is this true? Good God Almighty if it be true and keep that Obamacare far, far away.
What happens in Manitoba is that if you need an ambulance, you dial 911 and you get it.
Once your medical emergency has been taken care of, you are expected to pay $250 (I think). This is partly to help cover the costs, and partly to act as a deterrent from using the ambulance as a taxi service to the hospital. You have quite a long time to pay, and if you will find it difficult to pay, the cost can be reduced or waived.
I (fortunately) have never had to call and ambulance here, so I may have some of the details wrong. It may also be different in other provinces.
I was surprised by the arrangement when I first learned of it, but I can see what they're trying to do and I sympathize with the problem of false and spurious callouts. I don't think the charge is ideal, but at least there is wiggle room for those who cannot pay.
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"We had a good team on paper. Unfortunately, the game was played on grass."
Brian Clough
Posts: 9455 | From: Left a bit... Right a bit... | Registered: May 2001
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Moth
Shipmate
# 2589
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Posted
quote:
Originally posted by Clint Boggis:
Another difference here. In Britain we have an ambulance service and it's free usually. I have no real idea how it's organised but if you need them they're there and you almost certainly won't get a bill.
I have heard of people being charged but I don't know under what circumstances.
.
You are indirectly charged if you get compensation for the injury that required the ambulance service. The most common example is road accidents. The person who caused the accident will have to compensate the victims, but of course, this is usually dealt with by his or her motor vehicle insurance policy. Part of that compensation will be to pay the medical costs of their care to the NHS, on a fixed scale of charges. You can read about it on the DWP web site . The person paying the compensation also has to pay back certain benefit payments, such as statutory sick pay etc. Of course, this reduces the compensation payable to the victim, but the rules are well-known, and taken into account when negotiating compensation.
The ambulance service is always free at point of use, and it is only if compensation is received that any charge is payable, and then it is usually paid by the insurance company directly, so the patient does not see a bill.
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"There are governments that burn books, and then there are those that sell the libraries and shut the universities to anyone who can't pay for a key." Laurie Penny.
Posts: 3446 | From: England | Registered: Apr 2002
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New Yorker
Shipmate
# 9898
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Posted
quote:
Originally posted by Leaf:
Do you really believe that all the other posters here from countries with universal health care are granny-exterminating death-panel-loving commie nazis (to borrow what appears to be the parlance of the debate)?
Well, not all, surely things are not that bad!
quote:
Doesn't the possibility exist in your mind that seemingly sane, intelligent, freedom-loving people would choose and support universal health care?
Sure. There are lots of intelligent people who are wrong on specific issues.
quote:
Does the fact that not one single non-American has sighed on this thread, "Gee, I wish we had the American system!" not light one tiny of doubt in your mind?
Every system has advantages and disadvantages. And, why would they want the American system? I mean the press here and there spend all their time talking about how horrible it is, when it is not really that horrible. It does need some tweaking, but that does not mandate government run or provided healthcare.
quote:
Are all us citizens of Canada, Australia, New Zealand, the UK, Europe, and Scandinavia really just that deluded?
Again, surely not all.
[N.B: I'll be away for a few days without assurance of internet. So your pardon if I am unable to post.]
Posts: 3193 | From: New York City | Registered: Jul 2005
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Imaginary Friend
Real to you
# 186
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Posted
quote:
Originally posted by New Yorker:
I mean the press here and there spend all their time talking about how horrible it is, when it is not really that horrible. It does need some tweaking, but that does not mandate government run or provided healthcare.
If a fundamental overhaul of a system which is based on the wrong priorities and serves the interests of the wrong people counts as 'tweaking' then yes. Personally, I think that's stretching the definition of the word a bit too far.
And I notice you fail to comment on how misleading you talk show buddy was about paramedic services in Canada. But then, that's this debate all over, isn't it? Write a load of rhetoric using horribly distorted facts and playing on the prejudices of the listeners, then when your bluff is called move on to the next pack of lies without mentioning it. It's truly disgraceful.
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"We had a good team on paper. Unfortunately, the game was played on grass."
Brian Clough
Posts: 9455 | From: Left a bit... Right a bit... | Registered: May 2001
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Old Hundredth
Shipmate
# 112
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Posted
quote:
Originally posted by Clint Boggis:
Another difference here. In Britain we have an ambulance service and it's free usually. I have no real idea how it's organised but if you need them they're there and you almost certainly won't get a bill.
I have heard of people being charged but I don't know under what circumstances.
.
I suspect that people are charged for frivolous misuse of the system such as dialling 999 because they have got a minor cough or a splinter in their finger - if you have a genuine emergency that requires attendance of a paramedic and/or urgent hospitalisation, the ambulance comes and you don't pay.
Possibly also some health authorities make a charge for the non-emergency ambulances to transport patients to outpatient clinics or return them home from a hospital stay. I'm just speculating here - however in my experience that has not happened. When I was in hospital for my knee replacement I requested transport home afterwards, and to my physiotherapy sessions, as I couldn't drive and didn't have anyone at home who could drive me, and this was provided at no charge.
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If I'm not in the Chapel, I'll be in the bar (Reno Sweeney, 'Anything Goes')
Posts: 976 | From: The land of the barm cake | Registered: May 2001
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New Yorker
Shipmate
# 9898
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Posted
One other thought before I depart. Here if you call an ambulance it comes to get you and then you or your insurance are billed. The Canadian doctor meant that if you are having a heart attack and ring for the paramedics they won't come!
Sort of like the way it is here when an insurance company denies certain treatment. You are still free to obtain the treatment and pay for it yourself. In socialized systems if you are denied, that's it.
We disagree stronly on this board, but I do wish each of you a great weekend.
Posts: 3193 | From: New York City | Registered: Jul 2005
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Alan Cresswell
Mad Scientist 先生
# 31
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Posted
quote:
Originally posted by New Yorker:
The Canadian doctor meant that if you are having a heart attack and ring for the paramedics they won't come!
Which is, almost certainly complete bollocks!
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Don't cling to a mistake just because you spent a lot of time making it.
Posts: 32413 | From: East Kilbride (Scotland) or 福島 | Registered: May 2001
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Ricardus
Shipmate
# 8757
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Posted
quote:
Originally posted by New Yorker:
One other thought before I depart. Here if you call an ambulance it comes to get you and then you or your insurance are billed. The Canadian doctor meant that if you are having a heart attack and ring for the paramedics they won't come!
Lies.
quote:
Sort of like the way it is here when an insurance company denies certain treatment. You are still free to obtain the treatment and pay for it yourself. In socialized systems if you are denied, that's it.
Lies.
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Then the dog ran before, and coming as if he had brought the news, shewed his joy by his fawning and wagging his tail. -- Tobit 11:9 (Douai-Rheims)
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Sioni Sais
Shipmate
# 5713
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Posted
quote:
Originally posted by Ricardus:
quote:
Originally posted by New Yorker:
One other thought before I depart. Here if you call an ambulance it comes to get you and then you or your insurance are billed. The Canadian doctor meant that if you are having a heart attack and ring for the paramedics they won't come!
Lies.
quote:
Sort of like the way it is here when an insurance company denies certain treatment. You are still free to obtain the treatment and pay for it yourself. In socialized systems if you are denied, that's it.
Lies.
New Yorker must be writing about a proposed American socialized health care system. Under such a system these statements may well be correct, if only because many of those involved in it will be determined to see it fail.
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"He isn't Doctor Who, he's The Doctor"
(Paul Sinha, BBC)
Posts: 24276 | From: Newport, Wales | Registered: Apr 2004
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RadicalWhig
Shipmate
# 13190
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Posted
I'm confused about the Canadian system. Some posters refer to "in Canada". Others say, "in [Province]". Which parts of the Canadian system are federal and which are provincial? To what degree does the level of care and cover (and costs) vary from province to province?
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Radical Whiggery for Beginners: "Trampling on the Common Prayer Book, talking against the Scriptures, commending Commonwealths, justifying the murder of King Charles I, railing against priests in general." (Sir Arthur Charlett on John Toland, 1695)
Posts: 3193 | From: Scotland | Registered: Nov 2007
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Marvin the Martian
Interplanetary
# 4360
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Posted
quote:
Originally posted by New Yorker:
Sort of like the way it is here when an insurance company denies certain treatment. You are still free to obtain the treatment and pay for it yourself.
And how many people can afford to do that? It sounds like a great thing in principle, but in practice it's hideous. It amounts to no more than the poorer members of society being denied care. How any supposedly civilised group of people can sanction such a system is beyond me.
But that's the GOP all over. Their attitude is no more than "I'm all right Jack, and sod the rest of you". How very Christian...
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Hail Gallaxhar
Posts: 30100 | From: Adrift on a sea of surreality | Registered: Apr 2003
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tclune
Shipmate
# 7959
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Posted
quote:
Originally posted by Ricardus:
quote:
Originally posted by New Yorker:
<snip>
Lies.
quote:
<snip>
Lies.
Hostly Hat ON
This post is wildly inappropriate. We do not attack the honesty or integrity of posters in Purgatory. Either take it to Hell or change your comment to the Purgatorial "Bollocks" or equivalent. A point may be full of crap, but the posters in Purgatory are not.
--Tom Clune. Purgatory Host
Hostly Hat OFF
[ 21. August 2009, 12:47: Message edited by: tclune ]
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Posts: 8013 | From: Western MA | Registered: Jul 2004
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lily pad
Shipmate
# 11456
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Posted
In Canada, the Federal Government gives money to the provinces for health care. What is covered or not is different in each province. It makes no sense but that is the reality.
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Sloppiness is not caring. Fussiness is caring about the wrong things. With thanks to Adeodatus!
Posts: 2468 | From: Truly Canadian | Registered: May 2006
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Moth
Shipmate
# 2589
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Posted
quote:
Originally posted by New Yorker:
One other thought before I depart. Here if you call an ambulance it comes to get you and then you or your insurance are billed. The Canadian doctor meant that if you are having a heart attack and ring for the paramedics they won't come!
If you can point to one documented case of this, I'll be very surprised.
quote:
Sort of like the way it is here when an insurance company denies certain treatment. You are still free to obtain the treatment and pay for it yourself. In socialized systems if you are denied, that's it.
You know, if you believe this, you are really crackers. If I don't get the treatment I want, I am perfectly free to pay for it myself. In terms of medical care, I am fortunate enough to be perfectly well, and haven't ever been denied treatment. The closest I've come is that my GP has said he can't prescribe something (nothing life-saving, maybe just a particular brand of skin-cream or antacid) and he writes the name down so that I can buy it myself from the pharmacy if I wish.
I buy my own dental care, as my preferred dentist is non-NHS. I buy my own optical care, as only children and those on benefits get free optical care on the NHS. My younger son is entitled to free spectacles, but I upgrade to buy him designer ones myself.
If I want medical care that I can't get on the NHS, I'll just ask the specialist concerned how much it is to go private, and then I'll check myself in to the nearby private hospital and have the treatment. The fact that I've never needed to do this speaks for itself; I don't even bother with private health insurance because I really don't need it. If I was concerned about costs, I'd check out the eastern European countries and maybe go there - Poland offers some very cheap dental implants at present, for example, and I'm told that the care is excellent.
I would guess I have spent about £500 - £1000 on health care this year on top of taxes, mainly on dental and optical care (I have expensive varifocal specs, and have needed complex dental care this year). In addition, the government pays about $2929 per capita per annum (2006 figures) for the rest of my medical care.
Would you like to give me your medical costs per annum? I can tell you that your government pays $3074 per capita per annum (2006 figures), so I guess I've already won on tax paid for medical care. I get a full emergency and non-emergency medical service for my tax dollars, other than optical and dental. What do you get? In addition, I get completely free care for my son (including dental and optical and all drugs), and can cap any drugs costs at £104 a year for myself. I have a card that entitles me to care in any EU country on the same terms as nationals of that state, which makes travel insurance cheaper except if I go to the USA.
quote:
We disagree stronly on this board, but I do wish each of you a great weekend.
You have a great weekend, too!
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"There are governments that burn books, and then there are those that sell the libraries and shut the universities to anyone who can't pay for a key." Laurie Penny.
Posts: 3446 | From: England | Registered: Apr 2002
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Josephine
Orthodox Belle
# 3899
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Posted
quote:
Originally posted by New Yorker:
One other thought before I depart.
Before you go, New Yorker, I have a question I hope you can help me out with. I have struggled for many years to follow the advice of Martin Luther from the Small Catechism, to interpret the behavior of others in the kindest possible way. And I'm having some real problems finding a kind way to interpret your behavior, and that of those who agree with you, in a way that seems kind.
Here's the deal. When you say something like this:
[quote]Sort of like the way it is here when an insurance company denies certain treatment. You are still free to obtain the treatment and pay for it yourself. In socialized systems if you are denied, that's it.[/quote[/qb]
I wonder whether you actually know anything at all about how our system works or not.
I have a friend with good insurance and a child who is severely mentally ill. The doctors wanted to hospitalize her child. The insurance would not pay for a psychiatric hospitalization. For the hospital to admit her son, she would have to pay for the hospitalization up front.
Maybe you can blithely say, "You are still free to obtain the treatment and pay for it yourself," but I challenge you to look a mother in the eye, when her son is delusional and a real danger to himself and other people (including his siblings), and tell her that. It's like saying to a man who is unemployed, homeless, and hungry, "You are free to buy all the food you want and pay for it yourself."
That may be true. But the Scriptures have something to say about people who look at the poor and say, "Go on your way. Be warmed and fed."
You're a Christian man. You know that. So what am I to think of you?
Do you believe that it's okay for tens of thousands of people in this country to die every year because they couldn't afford medical care?
Or do you not believe that sort of thing really happens?
Do you believe that our system of delivering medical care is affordable and sustainable for the long run?
Do you understand that the various government-supported systems in other countries provides better results than ours does, at much less cost?
Because I'm having trouble figuring out whether, on this issue, you are ignorant (but how could you be? accurate information is not hard to get), or whether you are dishonest, or whether you are so invested in your political party and its platform that you are self-deluded, or whether you lack the mental abilities necessary to understand the issues and evaluate the facts.
As none of those explanations seems particularly kind, I'm hoping there's another option that I've missed. If you could help me find it, I'd be grateful.
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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!
Posts: 10273 | From: Pacific Northwest, USA | Registered: Jan 2003
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Imaginary Friend
Real to you
# 186
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Posted
quote:
Originally posted by lily pad:
In Canada, the Federal Government gives money to the provinces for health care. What is covered or not is different in each province. It makes no sense but that is the reality.
And just to confuse things further, in Winnipeg, the (combined) paramedic and fire services are run by the city.
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"We had a good team on paper. Unfortunately, the game was played on grass."
Brian Clough
Posts: 9455 | From: Left a bit... Right a bit... | Registered: May 2001
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ToujoursDan
Ship's prole
# 10578
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Posted
Exactly. [EDIT: To Lilypad]
The Federal Government provides the finances to the provinces, but the actual healthcare services are administered by the provinces and vary greatly.
In fact, if you live in one province and seek NON-emergency care in another province, you will have to pay out of pocket. It's cheaper than in the states but it isn't free. (This also happens in some cases when you move to another province. There can be a 30 day window before coverage kicks in.)
And while New Yorker may not be intentionally lying, (s)he is passing on complete falsehoods about how the Canadian system works.
One thing that I have been amused about in this debate are all the untruths about the Canadian and British system I keep hearing about, like those repeated above.
It's even more bizarre when some Americans have told me these false claims with great sincerity and authority, when I (as a Canadian who has indeed experienced the Alberta and Quebec medicare system first-hand) have then replied that these claims simply aren't true and would have led to a national scandal and reform of the system if they were true (because, you know, Canada is a democracy and fairly responsive to the needs of the population), and have been told by these same Americans that I have it wrong, or I have been brainwashed.
From a psychological perspective it's fascinating. There is almost a childlike belief that a person's desire for something to be a certain way can triumph over the way things really are. That believing something is true deeply enough magically makes it true. I see so much of this driving the American political debate these days. It's like a piece of a Hollywood fantasy movie is playing a role in real life.
[ 21. August 2009, 13:19: Message edited by: ToujoursDan ]
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"Many people say I embarrass them with my humility" - Archbishop Peter Akinola
Facebook link: http://www.facebook.com/toujoursdan
Posts: 3734 | From: NYC | Registered: Oct 2005
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ken
Ship's Roundhead
# 2460
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Posted
quote:
Originally posted by New Yorker:
One other thought before I depart. Here if you call an ambulance it comes to get you and then you or your insurance are billed.
Here, if you call an ambulance, it just comes.
I have called an amublance recently (a neighbour of mine was collapsed in the street - drunk as it turned out). The ambulance came. The paramedics did their business, said goodnight, and went away.
Whay do you have a problem with that?
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Ken
L’amor che move il sole e l’altre stelle.
Posts: 39579 | From: London | Registered: Mar 2002
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tclune
Shipmate
# 7959
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Posted
quote:
Originally posted by ToujoursDan:
From a psychological perspective it's fascinating. There is almost a childlike belief that a person's desire for something to be a certain way can triumph over the way things really are. That believing something is true deeply enough magically makes it true.
Anyone who believes this obvious was raised inadequately. Everyone should have learned that you need to clap really hard to make your heart's desires come true...
--Tom Clune
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Posts: 8013 | From: Western MA | Registered: Jul 2004
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Clint Boggis
Shipmate
# 633
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Posted
quote:
Originally posted by ToujoursDan:
From a psychological perspective it's fascinating. There is almost a childlike belief that a person's desire for something to be a certain way can triumph over the way things really are. That believing something is true deeply enough magically makes it true. I see so much of this driving the American political debate these days. It's like a piece of a Hollywood fantasy movie is playing a role in real life.
It's amazing how often the truly ignorant are so completely sure of their 'facts'!
quote:
Originally posted by ken:
Here, if you call an ambulance, it just comes.
Why do you have a problem with that?
'cos of damned gummint interference!
[...]
What business is it of theirs to save people's lives indiscriminately, even if they're poor!
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[ 21. August 2009, 14:06: Message edited by: Clint Boggis ]
Posts: 1505 | From: south coast | Registered: Jun 2001
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