Socialized Medicine - Who has it - What do you think?

Ok, but what they think of us is irrelevant.

And yeah, I don't think a lot is going to get accomplished until other issues are taken care of.

The government will do the same thing. Except instead of high prices, you will get lousy service.

Unfortunately, yes.

Do you know that we are bankrupt? By know, I mean, do you understand how and why?

 

The first post of the linked thread

http://mises.org/Community/forums/t/2605.aspx

Has some excellent information on socialized health care.

I agree with Kaethy, something must be done about health care. I advocate laissez-faire, not more government intervention however. Socializing health care will lower care universally, in order to cover everyone. The free market provides an opportunity to provide everyone, or almost everyone without lowering coverage, but perhaps even increasing it.

 

By most measures, we spend more on healthcare than any modern polity on earth:

(Wiki)

Now, compare it to:

We stand top for how much $$ we drop on medicine, but across many different comparative studies, we're not getting a lot of bang for our buck. Take a look at just one stat, on life expectancies - with many "above us" being under a system of universal healthcare:

(CIA factbook).

I know from my own experience, it is insurance billables that matter, not the quality of care. I would agree that in the U.S., top-notch physicians are doing top notch work. I think the problem is in day to day care.

A bit from my own experience, but really - the misdiagnoses by doctors freaked about turning and burning, literally running in to do a 1 minute appraisal and rendering a flawed diagnosis, well, it gets old. Near my conclusion as what's called an "uchideshi," or literally, an "inside student" living inside a Japanese martial arts dojo/zen temple, I couldn't walk, had to be carried the mat at the end of nightly training; like a knife in my hip.

About two years hunting for a doctor who could tell me something, anything, as to what was happening and why. To a doctor, every one of them literally did a cursory evaluation - (much like a current back situation, with misdiagnoses of what turned out to be a serious L1/L2 herniation) - and said nothing was wrong. It took one doctor actually spending some time digging, ordering deeper diagnostics, to diagnose osteitis pubis, actually, just degradation of the cartilage between my hip bones, right at the seam. Cartilage was destroyed, and during heavy throws/falls, bone was grinding on bone, during the months of uchi life, anbout 1 1/2 years. You know the score. 2 years - and all the destruction during that time. Lousy.

The comparative stats tell the story.

 

I really don't think life expectancy can be used as a true measure of the healthcare system. It may be a factor in our life expectancy, but not a complete measure.

Look at most of the people in this country. They are OBESE. They are not obese because of poor healthcare, but because we are lazy, gluttonous, and have very easy access to LOTS of unhealthy food. That's just one example.....

I've enjoyed reading this debate and think both guerilla and kaethy have made some valid points. Even though you guys don't agree, I think we need more people like you that actually want to find a solution rather than just line their own pockets....

What gets my goat right now with healthcare is that people want to start cracking down on smokers and deny them healthcare or charge them outrageous amounts for it. That's fine and I understand it is a nasty habit. But, if we are going to do that, shouldn't we crack down on all the morbidly obese, drug addicts, etc.? And if we started doing all of that, wouldn't that basically be telling everyone how they should be living their lives? What's next, shoving a camera up my ass so they can make sure I'm not eating too much, drinking, or smoking? Just some of my random thoughts here....

 

I think a mixed version between the two options is the best: free market for hospitals and other healthcare providers but paid by a single payer (a government insurance agency). This way you cut out all the profits of private insurance companies, you cut out all the employees they have a lot of whom only job is to do the best they can to deny you healthcare, you would cut out the employees hospitals have to have to deal with a gazillion insurance companies, you would cut out all the money private insurance companies spend on advertising, you would cut out all the money they spend on having offices and whatever other stuff they need to funcvtion. Basicly removing the private insurance companies you would save a lot of money

 

I don't either - as I said, it is but one stat, as a starting point for discussion. My point is that, comparatively speaking, the astronomical amount of money we spend on healthcare is not reaping concomitant rewards; and many countries with national, managed care, enjoy longer, healthier lives, by the estimation of many different comparative sources. Generally, I believe the paradigm in place now is one of insurance companies pushing billables over incentives for better care. Doctors scream through as many patients as possible during a given work day, offering diagnoses and treatment off of cursory, rushed evaluations. The result is poorer health, and higher costs because of it.

To your point about obesity, personally, from an armchair quarterback's perspective, I think our society is just profoundly screwed up, with everything being about bigger, faster, more valueless, and that extends to food. At best, we prepare food at home from a chemist's toolbox, and at worst, we eat crap prepared unhealthily in central McD's warehouse and then reheated "as you like it." We don't eat for pleasure and health, we cram it down to get it over with in order to rush on to the next useless endeavour. We're running, faster and faster, towards an unknown destination. We do not stop to ask why.

I am intrigued by Iul's notion - I think this is the right area. In this vein, also see Ezra Klein's study, "Health of Nations." (Part 1 below - lengthy, but important; part 2 to follow)

***[NOTE: Firegirl, your point; comparative studies are always difficult, for precisely the reason you mentioned; intervening and conflating variables can cloud issues of causality].

 

(All emphases mine - just things that immediately come to mind as salient, and interesting).

What we are talking about will profoundly piss-off the insurers of our longlasting paradigm. Firegirl, "lining pockets" is exactly what we are talking about, over the pursuit of incentives to reduce costs and improve care.

Sorry for the length of the article. But I think Klein's thoughts are extremely well researched, insightful, and useful to the debate. He can be found at The American Prospect.

At the very least, I wanted to show Klein's article as it shows that creative, pragmatic problem-solving can actually be undertaken, and workable models employed, without resorting to ideologically ossified stances that have nothing to do with reality.

 

The below is the content of the post I linked to above. I see that other views are being directly quoted, and I thought that this research by a libertarian in high school was relevant and useful.

1. The United States had the world’s best health care system.
   1. The World Health Organization ranks the United States number one in the world in responsiveness to patients’ needs in choice of provider, dignity, autonomy, timely care, and confidentiality.
   2. US provides world’s highest quality health care.
   3. The American Enterprise Institute found exogenous factors (like subjective “fairness” and “equality” rankings) effect the USA’s low ranking on the scale.
   4. American cancer, pneumonia, heart disease, and AIDS patients have a greater probability of surviving due to our superior health care system. For example, male American cancer patients have a 62.9% chance of surviving five years while male UK cancer patients have a 44.8% survival rate.
   5. One out of every three Canadian physicians sends a patient to the United States for treatment each year, and those patients along with the Canadian gov’t spend more than $1 bil annually on health care in America.
   6. Foreign heads of state and gov’t (i.e. Italian PM and Canadian MP) come to America for their health needs.
   7. The American system breeds innovation: 18 of the last 25 winners of the Nobel Prize in Medicine are either US citizens or individuals working here.
   8. Advanced medical technology is far more available in the US than in any other country (eg highest per capita MRI units and CT scanners).
   9. US patients are more likely to receive preventative care for chronic or serious diseases than are Canadians.
2. Countries with universal health care face long waiting lists, rationing, restrictions on physician choice, and other obstacles to care.
   1. It has been shown that when people have free access to health care they tend to abuse it. All nations that have adopted universal health care have experienced a problem called “nomadisme medical” in France, but commonly referred to as the “moral hazard” by economists: patients go from one doctor to another (causing waiting lists, rationing, doctor shortages, and high costs) until they find one whose diagnosis they prefer.
   2. Countries with universal health care have inferior access to advanced medical technology, due to central planning. The US has the most per capita CT scanners and MRI units out of any country.
   3. In France: “one study found that nearly 90% of French asthma patients are not receiving drugs that might improve their condition” and “mismanagement and the inability of the system to cope with emergencies were blamed in part for the deaths of 15,000 elderly individuals in the summer of 2003 during the European heat wave; and a shortage of hospital beds occurred in 2004 when a nationwide flue and bronchitis epidemic broke out.”
   4. Waiting lists:
      1. In Italy: average of 70 days for a mammorgram, 74 days for an endoscopy, and 23 days for a sonogram.
      2. In Spain: average of 65 days to see a specialist (Canary Islands 140 days, Galacia 81 days). Average of 71 day wait to see a gynecologist and 81 day wait to see a neurologist. The mean waiting time for a prostectomy is 62 days, for hip replacement surgery it is 123 days. There is no rehabilitation for surgery patients.
      3. Norway: hip replacement surgery - four months prostectomy – three months hysterectomy – two months…. Approx. 23% of all patients referred for hospital admission have to wait longer than three months for admission. Approx. 280,000 Norwegians are waiting for care on any given day out of a population of 4.6 million.
      4. Portugal: at least 25% of emergency room patients do not need immediate treatment. Currently, more than 150,000 Portuguese are on waiting lists for surgery, out of a population of just 10.6 million.
      5. Greece: hospitals suffer from staff shortages, less than half of authorized medical positions are actually filled. Greece needs and estimated 5,000 general practitioners to meet demand while there are only about 600 practicing ones. Six month wait for an outpatient appointment, wait for either the hypertension or neurology departments is 150 days.
      6. Netherlands: three month wait for hip replacement and two month wait for prostectomy and hysterectomy.
      7. UK: 750,000 Britons waiting for admission to hospitals. Cancer patients can wait as long as eight months for treatment. Roughly 40% of cancer patients never get to see an oncology specialist. Only 30 to 50% of patients are treated within 18 weeks. For trauma and orthopedics patients, the figure is only 20%. Overall, more than half of British patients wait more than 18 weeks for care.
      8. Canada: more than 800,000 Canadians waiting for treatment at any given time. Treatment time averaged 17.7 weeks (not including waiting time). At least 50 patients in Ontario alone have died while on a waiting list for cardiac catheterization. “Thirty-three percent of Canadians who say they have an unmet medical need reported being in pain that limits their daily activities.” Canadian Supreme Court Chief Justice: “patients die while on the waiting list.”
3. People in nations with universal health care are dissatisfied.
   1. 65% of French adults believe that reform is “urgent” and another 20% believe that reform is “desirable” (85% total).
   2. 60% of Italians believe that health care reform is “urgent” while another 24% believe it is “desirable” (84% total).
   3. 46% of Spaniards describe the need for reform as “urgent” while another 35% see reform as “desirable” (81% total).
   4. 63% of Britons say that the need for reform is “urgent” while another 24% say it is “desirable” (87% total).
   5. 59% of Canadians want “fundamental changes” to health care while 18% want their health care system to be totally scrapped (77% total).
4. Universal health care will be too expensive.
   1. Health care spending is 4.3 times the amount spent on national defense just because of Medicaid, Medicare, and SCHIP, imagine what it would be with more spending on universal health care!
   2. Health care spending is projected to increase to $4 trillion by 2015. Our gov’t cannot afford that.
   3. Health programs already account for 24% of our federal budget. Anything more would lead us into overtaxation and bankruptcy.
   4. France’s health care system ran the nation into a 10.3 billion deficit. This could top 66 billion euro by 2020.
   5. UK is currently running a 700 pound yearly deficit due to health care.
   6. High payroll, income, and sales taxes are needed to fund health programs. These high taxes often cause unemployment (as entrepreneurs don’t have enough money to hire multiple people) and people to have lower wages (as employers use wage money for payroll taxes). Purchasing power is also reduced due to high sales and income taxes.
5. Cutting regulation will make health care more accessible.
   1. Economists estimate that regulation of health care accounts for about 30% of health care costs in America. By eliminating regulation and taxes on the health care industry, the government could make health care more accessible to everyone.

Here are my sources:
http://www.cato.org/pubs/pas/pa-613.pdf
http://www.angelfire.com/pa/sergeman/issues/healthcare/docshortage2.html
http://www.isil.org/resources/lit/we-can-have-afford-hc.html

 

Great post. Really. I don't know if I'm seeing the world differently, or if there has been this many people on the forum who "get it" all along and I never noticed.

We have to remember, that government theoretically are our peers. But I think, I would rather have dinner with you or Kaethy, than with Hillary Clinton. They may be our "peers" or "betters" but they certainly don't seem much more capable, moral or honest than we are.

If a supercomputer would determine what the health policy should be, without emotion and totally based on logic, that would be one thing. But it's decided by flawed individuals, some of them much more pathetic than the people they rule, deciding based on a lot of factors, many of which are not in the best interest of the people.

And thus, yes, giving up the right to make our own decisions about our bodies and lives is terrifying. It's something out of post-apocalyptic sci-fi.

Nonsense.

That's not a free market. If you remove the physician - patient relationship, it's not a free market. If the government regulates, licenses and decides who can be on the pay schedule for single payer, then it is not a free market.

You have to understand what a free market is. Short version, it's where the consumer makes choices, unlimited choices. When the government gets involved, theoretically, they limit bad choices. But we know that with this power, they also sell opportunities for votes or money, and regulation makes it harder to have more diversity in care, thus resulting in less creativity, less advancement and less care than would be possible under laissez-faire.

Look, profit is incentive. If something is not profitable, people will invest in other opportunities or go broke. The competition for profit, market share and customers, drives down prices and increases quality. This is the notion of capitalism and free market economics.

I want my doctor to be profitable. I want him to get paid well for taking care of me. I want to be able to bribe him to come to my house if I am bedridden, regardless of whether a government sponsored single payer schedule says he cannot.

You want to talk about wasteful employees? What does government produce except more laws (requiring lawyers), and more bureaucracy? Government management of healthcare is the ultimate overhead IMO. Why should the government skim off the top, and pay my Dr. less than if I had paid him direct?

Don't think that by getting rid of private companies, you will get rid of all overheads. The government is notoriously corrupt and wasteful. Wasteful businesses go broke. Government waste just gets more money thrown at it.

We need to rethink the notion of insurance. People need major medical, not insurance for minor treatment like broken bones, upset stomach, regular checkup etc.

Seriously look over Ron Paul's take on this.
http://www.ronpaul2008.com/issues/health-care/

He's a doctor and a free marketer. He understands what medical professionals need to be successful.

Btw, when you go to single payer, and put all services, drugs and operations under government supervision, you are going to see less choices (they will never authorize natural health professionals on the same level as Medical Doctors), you will have a hard time getting prescriptions for natural solutions, and you will see longer waits.

The reason why health care costs are out of control, is government regulation, and subsidization. The two areas the government subsidizes heavily, education and medicine, see poorer returns, and inflating prices. One day, people will put 2+2 together.

 

OK, today I spoke to a woman who had premature twins in October 2007. She had Aetna insurance. Aetna covered only ONE of the twins, and just for for 30 days. Then they cut that off saying they had reevaluated the case. One baby stayed in the hospital at taxpayers expense until January, the other until February.

Now I gotta ask, WTF is wrong with this system ! ! !

 

Northpointaiki - thank you for clarification on your point. I'm at work when I'm on here and sometimes I actually HAVE to work and don't read posts all the way through

And I think it would also be very interesting to have dinner with some of the fine people of this forum. I think we would get a lot farther in solving these major issues over dinner than our government can in a lifetime!

I'm going to read through the last posts more in-depth over the weekend and I'm sure I'll be back with questions for you both! Be ready!

 

Lack of competition, spiraling costs driving insurers to renege on their obligations.

 

Oh, and a more personal story. My daughter has seen a general practitioner, and 2 specialists, none has been able to resolve the condition she has. The specialists wanted tests.

The first one wanted an invasive test that required sedation, I said NO. The "highly regarded" doc told us, "We won't be treating her here then". Didn't bother to discuss other options, or ask me why I was objecting, He said the test was the "Gold Standard" for the condition he suspected. I looked it up online & it is not 100% reliable. So why call it the "Gold Standard"? Besides, a blood test can be done to rule out the condition, so why do an invasive procedure? BECAUSE HE MAKES MORE MONEY THAT WAY.

The second one wanted a glucose test ?, or something, hubby looked it up & said "she doesn't have that, if she did, she'd be dead" So he nixed that test. I said why not if it's not dangerous, he refuses to do a test that he sees as totally unnecessary.

We are next taking her to a holistic Dr, who used to accept BCBS, but got kicked out because he spends too much time with his patients. So despite paying a couple hundred each month for BCBS coverage, I will have to pay cash for the upcoming visit. Now BCBS is nonprofit supposedly, so why do they care how much time he spends with his patients ???

 

I'm really sorry, Kathy. Unfortunately, my experience as well. Most recently, a physician who refused to believe a herniation at L1/L2 was causing extreme pain and radiculopathy in the area of my right leg where it was (despite an MRI and radiologist report confirming the disc herniation, with extrusion into the spinal canal and pressing on my chord), and who injected 3 series of inappropriate spinal injections (non-epidural, and in the wrong place) because of her early conclusion (based on a 5 minute manual eval.) of facet syndrome at L5/S1. Completely misdiagnosed, and mistreated because of it. This is a respected "authority" in her practice, from a respected hospital system here in Chicago. Meanwhile, a few minutes search online yielded what is apparently a well-known symptom profile, with my radiculopathy being entirely consistent with a disc herniation in this part of the spine.

At the heart of much of what I am saying, and much of what Klein argues. We all know it, I would think, if we have lived since the 1960's and have been in need of medical care. The insurance paradigm is on cranking out billables, and this means cursory evaluations and flippant diagnoses. It means poor care. Doctors are rewarded for treating disease, and punished for providing care in the way of the maintenance of good health. The answer is not in giving a big round of applause, and fully taking the restrictions off to say go ahead, fellers! Full steam ahead!

There are many models out there that may address the situation far better than we have now, and the pure market cannot "cure all," though from a market-anarchy perspective, this is the only possible argument to make. Basically, in my opinion,

is putting one's head in the sand, lionizing insurance companies and demonizing any state capacity as categorically evil. From my experience, few things in actual life have this kind of manichean framework.

 

If you adjust for the crap we eat on a daily basis and our lack of exercise we're probably at the top of the life expectancy list. A lot of our health care is focused on giving us antidotes(some call it medicine) to the poisons we put in our body.

/Goes to eat second Hostess cupcake of the day

 

pursuing socialism can disrupt evolution of humans. Marx (bastard) broke down the Russian empire, in other words curropted Russia's evolution, look how far back it send them compared to america.

 

wasn't russia a mostly agrarian country before socialism and it was Stalin who industrialised it?

 

guerilla, are you still covered by your parents health insurance?

was there anyone in the thread who lives in a country where medicine is socialized who doesn't like it?

 

No. I also no longer receive an allowance now that I am in my mid-30s.

@ the clever comments about the market, I have yet to meet one other person on this forum (with perhaps the exception of korr, I cannot confirm) who understands what a free market is, when we have had "mostly free markets" and how what we have today is totally different than a free market.

Here are some failures of a system that (it is supposed) tries to improve health care, and how a free market solves these dilemmas.

I'm terminally ill. There is medication, albeit experimental, that has a 10% chance of saving me, and 90% chance of killing me. I'm going to die anyway.

The FDA hasn't approved this drug, and hence I can't get my Doctor to administer it to me. As there are no other treatments that can save me, I die.

In a free market, I could have made my own choice to take the 10% risk, knowing that the 90% failure outcome was likely whether I took the drug or not.​

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My father has cancer. Chemo is unbelievably painful for him and destroys his appetite. Medicinal marijuana is illegal.

In a free market, medicinal marijuana is easy enough to grow, and if legal, could help ease his pain, and help create appetite so that he doesn't lose weight and put his health in even more significant risk. So not only is it effective, but it is also at a cost of almost zero, given that it can be grown in his garden. It is quite literally, the ultimate home remedy for many things from Migraines to Epileptic seizures.​

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Again, free markets are not about corporate money makers, corruption, scandal etc. Free markets are about having choices. The state run or endorsed systems cannot survive in the wild against competition. They only survive because the state has the power to tax, not because they are the choice of consumers.

The path to better care, more advancements, service improvements, is specifically through profit, competition, and free market choices. And the kicker is, it's the most moral approach as well.

 

The problem with the above argument is basically twofold.

Firstly, precisely what I earlier said: it is a manichean vision that poses pure capitalism, from an anarchist-capitalist perspective, against pure "statism," again, from the same perspective. In fact, Guerilla's presumptive demeanor aside - "no one understands what a free market is" - many do understand an anarchist's unbridled capitalism, but reject it. There are many models that mix different ideas, none of them ideological, to optimize whatever a given society - made up of the people comprising the polity - deems is in its best interest.

Secondly, pretty basic, really: it eludes me how these two things can co-exist in the same logical universe:

In what I would call his religious attention (from a market-anarchist's perspective) on pure "free markets, profit, competition" being the key to a better system of healthcare for the citizenry, the thinking is just flawed, on the face of it. Such a mindset cannot conceive of insurance companies' greed - the heart of the argument - as being a complete hindrance to effective medical care, not boon.

By way of example, my wife and I recently returned from the Upper Peninsula. There, we had over the years befriended an individual who suffered from a certain life-ending illness without imminent, radical intervention in the way of experimental marrow treatments. His insurance company refused treatment, for many months, and only a tortuous litigation process forced them to cough up. He was saved, at the 11th hour, but he might have died. To my knowledge, he's now doing well, though we haven't been in touch for some time.

In Guerilla's example, no one was stopping him from getting the treatment; if he had had the astronomical sums to just pay this out of pocket, he could have gotten them under a "free-market" scenario. But without the insurance company doing what it was obligated to do, he would have died.

At the end of the day, it comes down to priority. In those countries where health is seen as important, a national priority, its citizens agree to put their money into a system of national healthcare. At least thus far, we stand alone among the western industrialized polities in failing to embrace some system of coverage, as a national priority.