I was just asking a question, no need to start a hate train on me, just seeing what his opinion is. I guess I can add a followup. Who said an education is a right? To what point of education SHOULD be free? And what happens when we have all of our children marching around with PHDs? I think lines need to be drawn. The last question was just thrown into left field there, choose to ignore but it was more relevant to saturation of the market more than anything else. Sorry to be a shyster but I would like to see what the answers are to those questions, even if they do suck.
I may not be rushing out to get colonoscopies, but I would certainly use far more health care services than I do now. As for colds, I go to class still when it's just a basic cold but I would certainly go get some simple drugs for it if it were free. And there are certainly tests that are not nearly as invasive as something in my ass that I could get (basic X-rays come to mind). Even the doctor's time has a cost and everyone getting basic check-ups would make this quite costly (consider other's posts about the difficulty of finding a basic family doctor in Canada). Some of these things are small but they certainly would add up and obviously there is still moral hazard in health care. I mean, you say I wouldn't get a free open heart surgery because I don't need it but I don't get free car repairs all the time either because my car isn't totaled. Actually I like that analogy. If all car repair was free, tune-ups and oil changes would skyrocket but major repairs would stay about the same because people wouldn't go around crashing their cars on purpose. Similarly, in health care basic procedures would go way up, but catastrophic care would remain about the same because people wouldn't have more catastrophes.
Seeing as my first response was deleted, I will do so in a more constructive manner. MooseKnuckle, I put it to you that you don't understand logic at all. Your statement is highly illogical, in fact. Not one poster has put up anything remotely resembling the position of "paying $20,000 in tax in order to receive abysmal health care is what I love about my country" In this country, the Medicare surcharge is 1.5% for people who earn over $30k or so. I earn a bit over double that, so theoretically I pay the government in the area of $1000 pa for access to a universal health care system. I can walk down the street, make a booking with my local doctor see them that day. When I needed emergency surgery, I received it without any issues at all. Since I can walk, turn my head and don't need a colostomy bag, I'd say the doctors did a good job. Private insurance is an option here and, in the near future when my income increases I will most likely take it up. I'll be entitled to a partial exemption from the medicare levy but still won't cry about paying it. What I hate hearing in discussions like this is the overwhelming "government BAD" mantra that seems to run rampant amongst those who have little productive to add. The reason for it is that: There problems of the US health care system are major problems. Affordability, access, denial of services by insurance companies. The positions of those people who are against any sort of health care reform do absolutely nothing to address these problems.
With respect to education, lines ARE drawn. High school is that line. You get educated for free until the end of high school - then you need to make decisions and, scholarships notwithstanding, you probably will have to pay to be educated further. Part of the my problem with the discussion of health care is that no lines are drawn. It is almost as though people who are anti-reform are saying "well, if you aren't covered by insurance or any pre-existing government program, you can get fucked"
I've been keeping a pretty close eye on this thread and I don't think I've seen a single person say there should not be any reform; the debate has been on what form these changes should take. Obviously there's the government route, which has decent evidence behind it in the way it works for other countries, but there are also legitimate positions to be had saying to take government out of it as this will increase efficiencies and reduce costs. These arguments generally have a pretty decent basis in economics and evidence behind them (although not quite as much as having a similar system in another country) and people who advocate them are not "fucking stupid" as your previous post seemed to imply.
Would you really just get a bunch of x-rays if nothing seemed wrong? Really? I wouldn't. And I have a hard time believing that most people would just get a bunch of x-rays for no reason even if the cost was nothing. And if people didn't skip regular checkups to avoid paying the 200 copay or whatever it is for most people in the US, they'd probably be much healthier in the long run. Preventative care is way better than surgeries, so it's more complicated than how you put it. You wrote that checkups would go up and surgeries/major procedures would stay the same. If checkups were to happen more frequently things would be caught before major surgery was needed. People would be healthier and be able to have advice from their doctors like, "cut out red meat," instead of, "cut out the tumor". Also: would you really just get x-rays because they were free? If so, you're weird. edit: grammar
Deleted. Everyone please note, once you get personal, take it to PM. It's not constructive to fling poo here.
Congratulations. You took an introductory Econ or PoliSci class sometime in your life. This argument is just vacuous. Sure, everybody begrudgingly goes to the doctor. There’s a reason people say they need another Michael Moore documentary like they need a root canal. But that wasn’t the point. If you separate the consumer from their health care purchases, they are going to consume more in general and more expensive items in particular because it is convenient and potentially useful – but most important – because there is no extra cost to them. Take my dad. His ophthalmologist recently recommended him a new prescription for his glasses. His doctor’s price is two to three times that of LensCrafters, but when his doctor told him his insurance policy covers 100% of the cost, what do you think he did? He bought the glasses from his ophthalmologist. Keep up with the plot. I just noted that it added to the costs of health care in general and outright supported the government’s role in this function in a later post. I am actually encouraged by President Obama's initiatives to expand the agency's oversight resources as an FDA limited in staffing and resource capacity has been slow in meeting action deadlines and cautious in approving new drugs. We spend about 17% of GDP on health care. But that’s never been the problem. It’s always how is it spent and who is doing the spending.
I got an A! I think it depends on the situation. For something like glasses purchases, it isn't very difficult under any system to say that insurance will cover market rates (e.g. lenscrafter prices) for lenses and some nominal amount ($50?) for frames and if you want fancy shit you pay the rest. That is roughly how my coverage works. For something like using a newer more effective drug against an older cheaper one, it's more complicated. Since the new one is better its increased cost might be justified. Further, under a universal system, the government can use monopsony power to lower drug prices. The government could make the decision that it will only cover certain drugs and if you want a more expensive drug it will pay up to the cheaper drugs cost with the rest falling on the individual. This is, from what I understand, similar to what pretty much every private health insurance provider does. The government could just return the rents to us through wider coverage or lower taxes instead of paying them out to shareholders. And as for FDA and state regulation. That's neither here nor there. There are lots of reasons that those types of regulation exist (like protecting people from snake oil). And they will be present under ANY health care regime.
I'd love to believe this but are there any hard stats? I mean, have the number of open-heart surgeries gone down in Canada since universal care? Or other countries? I tried finding these myself but my Google-fu is weak. I think it's surely a possibility but I'm just as inclined to believe that someone will keep eating unhealthy (tasty) food because they know they don't have to pay for future surgeries*. I was just using X-rays as an example of a non-invasive procedure that people might get, but yes, personally, I would surely get more non-invasive tests than I do now (which is currently zero, so yeah...) *Yes, most people probably aren't stupid enough to think this but someone out there will.
I've read things in newspaper editorial type stuff that claims stats on the efficacy of preventative care, but I haven't seen any hard stats. It sounds convincing to me. If you currently get no tests or checkups, potentially you are using less health care then you should be using. And name, say, 3 tests that you would just get for the hell of it. I don't think using tests for no reason really happens. At most I would guess you would go to your doctor and ask if there is anything you should be referred to a specialist for and you would probably listen to his advice. You wouldn't ask for x-rays or ultrasounds or MRI's just to check (unless you're a glutton for punishment).
I live in Canada. Alberta specifically, where the care is not as good as some other provinces. When I was in an accident (not my fault) and suffered a concussion, I was taken to the hospital, inspected by a doctor and given instructions on how to recover, and given a CAT scan. While inspecting the CAT scan, the doctor found an undiagnosed sinus condition and called me back, so I went in a week later and he gave me some antibiotics. I paid nothing for all this, but if I were in the States I would have paid many thousands of dollars that I can't afford for it and to me, that is unacceptable. This idea that the poor will steal your valuable health care away from you if the government runs health care instead of giant profit-driven insurance companies is disappointing. What if you get a serious, rare disease that costs thousands to recover from but it is doable if you have the treatment? Oh well, guess you should've had more money.
We can sit here and debate examples until we are both blue in the face. It’s Econ 101. Disconnecting a consumer’s purchases from their own budget increases incentives to consume and spend because those costs are not directly carried by those making the decision. Such a basic principle of economics is not magically annulled at the entrance of a doctor’s waiting room. Drug price controls are a bad idea in theory and an untenable one in practice. Price controls diminish margins and more importantly, R&D productivity and thus incentives for innovative research. It would be shooting ourselves in the foot in the long term. What’s more important is that it isn’t going to happen, at least not with the current bill. Big pharma got behind this thing early and any enacted legislation will most likely grant drug makers approximately 12 years of market exclusivity before the entry of biogenerics, leading to sustained or rising drug prices. This isn’t necessarily a bad thing. If you look at the 2010 regulatory filings for several biotech companies, they have some robust late-stage pipelines for several difficult to treat conditions including lupus and hepatitis C.
I hate to burst your bubble, but price controls most certainly are tenable, and the argument that they'll harm R&D comes straight from the lips of the pharmaceutical companies, and doesn't hold up to analysis. They have plenty of money to throw around, and they put far more of it into advertising than R&D, and lots of R&D is helped out by universities and public sector grants anyways. Simply banning direct-to-consumer advertising would drop drug costs (though not prices) by a considerable margin. I know that drug companies are for-profit companies; they shouldn't apologize for making money and I find a lot of the rhetoric hurled at them overblown and immature. That said, it's an absolute farce to say that their research operations would run out of money if they couldn't charge so much for new drugs. As for price controls, Canada's mechanism of price control is at arm's length from the government and has no legal power to enforce its prices or the fines it levies. But it's very influential, and gets shit done. And yet, the pharmaceutical industry hasn't packed up and left to greener pastures - the generic industry is one of the strongest in the world, and research-based manufacturers still perform plenty of trials and maintain research labs here.
If you're taxing them to pay for health insurance, then they'll have less money to spend on shit like new car leases, expensive cell phone plans, booze, etc. And where are the numbers for this claim of "Vast majority"? Is that kinda like the "vast majority" of welfare recipients who are just lazy fucks who buy Cadillacs and flat-screen TVs? Or the "vast majority" of people who live in the projects because they're just too lazy or greedy to go rent/buy a house somewhere else? Wait, are you making a disctinction between efficiency and quality? Blackwater's probably more efficient than the military, but I don't think it's as good. This isn't some zero-sum game. Giving health care to the poor isn't going to mean that you don't get health care. I already explained my moral reasoning for universal healthcare, and it has nothing to do with coveting your car. What kind of charity work, where, and how many of the people that you helped actually asked you seriously to do that? EDIT: I don't recall who said it first, but it is generally understood in the developed world that children have a right to an education, and widely accepted throughout the rest of the world. Education in the USA is free to everyone until College. if you've done well enough in high school, college is free, and if you haven't colleges are still subsidized by the government. If you do well enough in college, you go to get a PhD for free, and if you don't your PhD program is still subsidized by the government. I can understand you being concerned about cost, but why shouldn't everyone who is talented enough, determined enough, or otherwise qualified for a PhD be able to get a PhD?
I'll throw in shithead comment numero 2, I have heard Americas middle class is the worlds upper class, so why can't we cut back on our spending and live like everyone else's middle class? Its been said American's do not save enough, so maybe this will be a harsh wakeup to us all, and a much needed one. If everyone wants citations I will provide. I'm just tossing the idea out that maybe healthcare will be good, force us to actually cut back. Instead of spend, this is mostly directed to the above comments about cell phones and care leases and etc.
Here's the thing, and I'll bet this will surprise you. It isn't free. Just because YOU aren't paying for it, or aren't seeing the immediate bill, does not mean it's free. Someone, somewhere, is being forced to pay because you can't. To you, this may seem acceptable. But to the competent workers out there, they have no choice but to pay for other people's luxuries.
I believe what you are talking about (taking wealth from the middle class and giving it to the poor, presumably through some sort of a tax) would constitute a transfer payment, and therefore isn't the type of savings economists have in mind when they talk about reversing America's spending glut, but somebody whose economics background isn't as neglected as mine could probably answer more definitively. More to the point, does anyone have any hard numbers related to the influx of patients the healthcare system would have to absorb if some sort of public option/public healthcare plan were passed? Certainly I think there would be a non-trivial amount of people who, now with greater coverage than they've ever had access to, will go to their doctor with myriad conditions, some serious, some not, but all costing money. How do you absorb this in the short run without sacrificing the long term viability of the system as a whole?
Someone from Australian said they pay 32% in taxes. I'm assuming that's federal income tax and I could be wrong. But if that is federal income tax, then there are other taxes that the person is paying as well. I'm not sure how they do it down under, but I'll use some examples from America. On top of that 32% they would also be paying a state income tax. As well as state and local sales tax. As well as gasoline tax. And extra tax on booze/tobacco. And property tax. And taxes to get a driver's license. And taxes to get a hunting/fishing license. And social security tax. A tax to register your vehicle. And on and on it goes. So it's not a stretch to say that that 32% can be closer to 70 or 80% of what you actually earn when it's all said and done. Now granted, that pays for all government services, not just health care (assuming that country doesn't have a deficit.) You say you make about 60k. And let's assume that I'm overestimating a lot and the total taxes are only 50%. Well that's 30,000 in real taxes you're paying for the government to provide services for you*. That's half of your property that you're willing to give up. Are you really surprised that some people might not like that idea as much as you do? *I realize I'm making a lot of assumptions about tax brackets and such, but the point remains. Are you suggesting that the entirety of health care in your country (not sure which one that is) is paid with funds that come from a 1.5% tax? I'm assuming that people who earn a considerable amount more than you have to pay a much higher percentage. But even so, I find it hard to believe that a bunch of rich people (and your 1.5%) can fund a self sustaining health care program and still provide a high level of care consistently across the whole nation. I could be very wrong here, but I'm guessing the government has to dip into a general fund to cover the costs. Sorry if it annoys you, but questioning government's ability to run something this complex isn't a kooky fringe idea. Nor is it a bad thing to do. A responsible citizenry is constantly questioning its government's ability to do what they claim they can do. And I don't know anybody who is "against any sort of health care reform". I haven't seen anyone suggest that on this board or in real life. What you mentioned are most definitely major problems in our current system. But to throw your hands in the air and say "let our government take care of it all" seems foolish to me. Because once we give that much control to government, then we'll never get it back. That decision should not be made without first ruling out any and all other options.
It might be a little hard with such a flimsy needle. It all comes down to property rights. Using someone else’s discovery is cheap, while inventing it is not. On average, it takes more than eight years and costs a risk-adjusted total of $2.2 billion to bring a new drug to market. Companies don’t have the ability to recoup the time and money they invested without secure and exclusive property rights over their discoveries. Price controls significantly erode these protections and threaten the long-term viability of the current business model of branded pharmaceuticals. Just look at Europe. In the early 90s, they spent significantly more on Pharma R&D than the United States and released almost twice as many drugs. A decade of price controls in Europe later and the trends were completely reversed with the United States leading the world in R&D and releasing twice as many drugs as its contemporary. US development spending is predicted to be twice that of Europe by 2012. For some color on this, anyone remember the Swiss pharmaceutical giant, Novartis, relocating its research and development world headquarters to the United States for this exact same reason? The only way branded pharmaceuticals have been able to remain profitable is because the U.S. consumer has been subsidizing artificially lower prices in Europe and Canada. If price controls are enacted in the U.S., there goes the gravy train and profits will be based more on keeping costs down than on innovation. Branded pharmaceuticals will have to achieve cost efficiencies through consolidation and diversifying into generics and consumer products while they still have the capital to do so. The recent tie-ups of Pfizer and Wyeth, Roche and Genentech, and Merck and Schering-Plough all illustrate this trend and were largely a defensive response to the coming legislative changes proposed earlier this year. Your suggestion of banning direct-to-consumer advertising is laughable and communicates an ignorance of the economics underlying the industry. And let’s not make a straw man by taking what I say to extremes. Price controls will not end R&D as we know it, but they will distort markets, undermine patents, shift traditional business models, and ultimately will slow the pace of medical advances. I am not going to speculate on Canada's price control regime, but this debate is ultimately mute for the U.S. right now as it has a snowball's chance in hell of appearing in the current health care bill.