Just had to react to a couple of the remarks noted in the discussion above
“But this isnt universal healthcare this is government mandated, taxpayer subsidized, and “forced participation” in the private insurance maket. A big difference!”
Oh dear the “forced participation” thing and affront to free markets everywhere…bottom line is for the demographics and economics to work citizens must fund their health insurance throughout their lives. It is the only way we can leverage the law of big numbers (and mixed demographics) to fund a citizens lifetime health care burden
Just had to react to a couple of the remarks noted in the discussion above
“But this isnt universal healthcare this is government mandated, taxpayer subsidized, and “forced participation” in the private insurance maket. A big difference!”
Oh dear the “forced participation” thing and affront to free markets everywhere…bottom line is for the demographics and economics to work citizens must fund their health insurance throughout their lives. It is the only way we can leverage the law of big numbers (and mixed demographics) to fund a citizens lifetime health care burden
The uniquely US combination of stubborn citizens, wealthy special interests, and incompetent politicians will asssure ACA does not work…
Well sorry but I am afraid the US does not hold a monopoly on these traits at all. Although I am deeply troubled by the influx of big money into our politics!
For all you population size queens suggesting the size and economic “diversity” of the US population precludes a broadly applicable medical care solution
Firstly explain why this matters one iota! And the US GDP/Capita gives the US plenty of flexibility to operate here. This makes no sense.
Also I was intrigued by this point supporting this premise: “Only Brazil among the top 5 population countries has universal health care”. Hmm I am thinking perhaps there is something else at work here. Like maybe universal health care is more ambitious and farther down the priority list for Indonesia, India,…(By the way were in the top 5 and I believe China has a secret socialist solution like keeping family size down at caring for your elders!)
^ So you did, but it still takes almost as long to become a practicing GP in England as it does in the US (10 years vs. 11 years). Perhaps I’m wrong, but it seems the only real difference is that while future MD’s in the US are in medical school, learning and building addtional debt, their European counterparts are getting paid to learn by treating real patients. I will agree that medical school in the US is way too expensive.
Perhaps you can explain why Canada has a separate system for each province/territory or why the UK has separate systems for England, NI, Scotland, and Wales.
“The act does not address the “poor health to bankruptcy” problem”
I think it certainly does:
it does require people to carry health insurance (so the have protection if they get sick or are in an accident)
it establishes certain standards / accountabilities for what plans must provide for (after looking at the broad sweep of human medical needs and conditions and where the spending goes today). Joke policies that take your tiny premiums and lead quickly to bankruptcy when you fall sick are dispensed with.
I also love to hear the high minded complaints from men who wonder why they have to buy maternity health insurance - as if they came into this world via town car LOL! No gender premium differential it all comes out in the wash my friends lets not be so parochial
Canada kind of has a different system for each province, but not really. All provinces are bound to comply by the Canada Health Act, or they lose their Federal transfers. So pretty much the rules and system is a national one. It’s just local delivery of care that’s a provincial responsibility.
Canada should not be a model delivery system for any proposed health care changes. We have one of the worst systems in the developed world, IMO.
Higgmond thanks for reminding me - because I forgot about those folks that had suggested the health insurance solution needed to be applied at the US State Level (generally analogous to question on province).
Don’t have an answer to your question - but I am sure it has nothing to do with the inherent nature of providing health care to the citizenry and everything to do with how governmental jurisdiction, legislation, and treasury is structured. As a general rule bigger is better when establishing the demographic pool for insured.
But with respect to state (or provincial) placement of the insurance solution placing at the state level:
greatly complicates design and implementation and administration and pretty much assures complexity and gaps and incongruence
potentially limits freedom of movement
I happen to think that the US pre-existing health insurance model today was one of the greatest limitations to our freedom today…as people are tethered to their shit jobs/locations just for the health benefits (especially for those with pre-existing conditions)
The so-called affordable policies generally come with deductibles far higher than the insured can afford to pay. If you can’t pay an $8,000 deductible, does it really matter if the bill is $100,000 or more? Bankrupt is bankrupt. This gets back to my main objection though, fix costs first.
I’d hazard a guess that many of the people buying insurance on the exchanges won’t be able to cover the deductables on those plans, since they are rather high. It’s insurance that many people won’t be able to afford to use.
The US employer provided funding for health insurance is a quirk of history - in the US military equipment buildup to the WWII war effort as older men / woman manned the factories it was a challenge to recruit factory workers in a time of strict price controls and so the Yanks, ever resourceful, threw in health insurance as a nice benefit especially appealing to the lady folk!
Well that nice little benefit took root in the heady days following the war and has been with us ever since even as employers actively bail on this as best they can today (employee share, contracting, part time, etc)
The combination of employer funding (yes, while in your youth serving as grist for corporate purposes working for your gold watch they send you away at 45 with perhaps a pre-existing condition or two) and health insurance profit optimization (no need for transparency or cost containment higher cost same mark up/spread % is all good!) is one reason why we are in the state we’re in.
Oh so I gather the big shortcoming you see is that people will be bankrupted because they have no assets? Hmm is there a problem with that? I don’t think so.
No the point is to protect people that have accumulated assets to provide for their needs / retirement
I think one big issue with health care costs is that it isn’t based on supply and demand. If someone wants to charge you $100 for a coke you know should cost $1 you would say no. If someone wanted to charge you $100k for an operation you know should cost $10k you can’t say no if it’s urgent. There is no time to walk around the block and scope out the bodega. Everyone’s important, life is a life, etc. Until there is some mechanism to control price guaging of people in need there can’t be a solution to cost.
Also, we need to stop giving people 6 months to live then giving them 20k/month worth of drugs and medical care. There has to be some balance between controlling price and controlling expectations.
That makes becoming a doctor in the UK cheaper. I would accomplish that in the US by providing government subsidized loans for medical school which will be forgiven completely if the doctor is primary care physician for a certain number of years, effectively making medical school free for those doctors. Medical chools would have to agree to tuition caps for all students if they want to be able to enroll the students who get the government loans.
Enjoyed reading this spirited discussion - talk about Obamacare always is - it is not a beatiful baby but I see it as a first awkward step seeking a more sustainable health care solution. So I would challenge those that slam the acts provisions to:
propose a better plan for assuring that citizens contribute to the funding to their health care over their lifetime
an alternative to the use of emergency rooms as the source of health care for the uninsured
address the dysfunction of cherrypicking by employers (employed term) and insurers