let’s have a NQ town hall on health care!

I just heard an astounding statistic: those who are employed by the health care industry in the UK are part of the third largest employer in the world, behind the Chinese army and the railroad employees in India. China and India have well over 1 billion people each…the UK only 61 million, by comparison.

What about administrative costs/fees for a public program? How do the employees/staff costs figure in?

That’s a pretty staggering figure.

A Gravitational Pull
Joseph Ashby
The Dominion Post, a New Zealand newspaper, has a story that may prove prophetic for the future of American medical care.

New Zealand’s vaunted public health care system is in dire financial straits after a decade of high health care inflation. In response, a freshly published government report recommends giving new powers to a new National Health Board and increasing the powers of an already existing board which currently controls pharmaceutical purchases:

[The report] recommends putting the National Health Committee in charge of determining what new treatments should be eligible for public funding “and the conditions under which they should be applied”.

“For example, as well as defining the patient group most likely to benefit, a new treatment might only be suitable for trial, or use in tertiary hospitals, or where everything has failed an individual patient.

“As part of its reprioritization process, the National Health Committee should also be asked to identify and assess a number of existing interventions annually that … appear to be low priority.”

The New Zealand government has already attempted rationing by temporarily denying the breast cancer drug Herceptin.

Country after country, all over the world, continues to tell the same story. Under the pretense of compassion, the government begins meddling in the health care industry by partial or complete socialization. The programs then become too expensive. Government’s solution is to bestow rationing power on unelected bureaucracies. As result care become less humane, less effective and reduces a nation’s health and quality of life.

This health care pattern seems to have a gravitational pull.

Gravity pulls in America too. We’ve seen the creation Medicare and Medicaid in the 1960s and their subsequent expansions, the SCHIP creation and expansion and countless state mandates on care. Now that government cannot keep up with the costs, it has created a bureaucratic board to analyze the “effectiveness” of care. If Obama gets his way, can this board’s power to enact draconian rationing be far behind?

The law of gravity would suggest otherwise

http://www.americanthinker.com/blog/2009/08/a_gravitational_pull.html

WE, the people, employ the members of Congress.
WE, the people, pay their salaries and provide them with excellent medicial coverage.
Shouldn’t WE, the people, equally share the same benefits that WE, the people, offer to our employees on Capital Hill? When our employees share the same benefits as we,their employers, I’ll vote for the boy blunder’s health care reform.
Where does the line form?

I’m too tired at the moment to be of much use discussing this. But I would like to note my appreciation to you for looking at this so comprehensively. First rate work.

Likely the whack jobs that attacked you were left-wing nutcases that know nothing other than Love Dear Leader Obama. Hate Everyone and Everything Else.

You asked, “Where to start? How to pay for it! To implement universal health care all wage earners must pay taxes to fund the universal HC system. Taxes will go up but how much?”

Where to start is to realize that Americans are already paying almost twice more, per capita, then Western countries that have universal coverage. Read the sentence again and think about it. Even though America has millions of people who have no coverage, Americans are paying more ‘per capita’ (per person) than countries with universal coverage that have better health statistics than America. Get it? You are already spending more than enough money to pay for universal, single payer health insurance. More than enough.

Where to start is to insist that your government bargains with the drug industry, just like all other Western democracies do, for better prices. Investigate and eliminate that various patent schemes the drug companies use to keep generic drugs off the market many years after the original patents have expired.

Where to start is to get the insurance companies out of the primary healthcare industry altogether. They are sucking at least thirty cents out of every healthcare dollar they generate in administrative costs, including obscenely huge executive compensation.

Where to start is to tell your friends and family that all their talk about government ‘rationing’ of healthcare is a misplaced fear. Americans with insurance are already experiencing rationing by their insurance companies. Most Americans cannot even choose their own doctor, but have to use whoever their HMO dictates. Canadians and Brits can choose their own doctors, their own clinics, their own hospitals.

In the province of Quebec, Canada, for example, employers contribute a payroll tax starting at 2.7% for payrolls under a million dollars and going to a high of 4.26% of payroll for multimillion dollar payrolls. There is no employee contribution, but individuals can by private drug insurance or join the government program that costs a maximum of $595 dollars per YEAR per adult family member, and has a maximum deductible up to about $70 per month for upper income brackets. Most doctors’ offices are private and the doctors see patients and get paid by Medicare. Doctors are free to have completely private clinics outside of Medicare, but it is illegal to get paid by Medicare and also extra-bill. Hospitals are a mix of private and public, and many have foundations active for years that get money for various projects. The government also gives all the hospitals an annual sum based on needs for equipment, medicine and building maintenance.

Where will your drug companies get money for research and development?? Don’t you realize that the government and private universities are already providing massive subsidies to the drug companies? For only a part of the total cost, drug companies are able to contribute towards research projects done in universities, and in the past the drug companies have been keeping the patents and the profit from the patents all to themselves. In the past while, some institutions have insisted on sharing in the ownership and profits from their research, but the universities are left holding the bag for all the research that doesn’t result in profitable patents.

Where will the drug companies get money for research? You have to realize that today, drug companies spend much, much more on advertising and lobbying than they do on research. They also make huge profits by skirting laws concerning the expiration of their patents, and another huge swath inventing new conditions for their old drugs.

Americans already have, arguably, the worst healthcare system in the world. Unfortunately, it seems that Obama’s so-called reform will merely add good money to bad, and just expand and fund the existing mess. Americans should start calling and writing and insisting on something better. Perhaps not a single payer system in the Canadian model, but at least a more fair hybrid like the Swiss have.

A view from a Canadian living in Canada. I am 62, very fortunate to have only had one instance of serious illness so far, however have extensive experience of the Canadian Health system through parents, relatives, and friends blessed with less healthy genes and/or less lucky life circumstances.

Canada has 10 provinces and 3 territories (I am personally familiar with 7 of the provinces). Health care is the responsibility of the provinces and territories — financially, legislatively, and procedurally. The federal government has mandated that all provinces and territories must provide health care to ‘visitors’ from other provinces and territories and that the home province/territory must pay the bill to the servicing province/territory.

Originally, single payer health care was instituted to prevent catastrophic illness from bankrupting a person or family — only hospital care was covered, and it was covered completely. Over the years this has evolved to include nearly all medical procedures and consultations. The government does not hire doctors or nurses, nor does it own or manage medical laboratories. It does provide all funding to hospitals (bulk funding) and pays independent health care providers (doctors, labs, physiotherapists, etc.) on a fee for service basis. There are a few exceptions to this in some provinces where different models are being experimented with.

Medicare in Canada DOES NOT cover dental, vision correction, drugs (although many provinces now have some drug coverage especially for seniors — partially covering a specific list of drugs and very slow to incorporate ‘new’ drugs), or alternative medical care.

Many, perhaps most, Canadians purchase private medical insurance which covers (depending on the plan) dental, vision care, drug coverage, some alternative medical care, ambulance, and provides extras such as help with walkers, wheelchairs, other appliances, etc. This may be purchased individually or provided by one’s employer. Last year my private insurance cost $350.

Serious, sudden illness in Canada is never a wait list problem. Chronic illness/problems often are. In the late 90s cataract surgery was one of the worst with as much as a 2 year waiting list. One of my aunts was on such a list — the family pooled funds and paid for her to attend a private clinic for immediate care ($1,100). She was also on a wait list (up to a year) for hip replacement (at age 80), however during a 6 week period her hip deteriorated rapidly and she was moved to the head of the list — a wait of 4 days. She made a remarkable recovery and lived a productive life for another 5 years.

Much time, energy and money has been put into reducing wait lists in the past decade — some areas have improved remarkably, others have not. There is a serious Canada-wide shortage of nurses that contributes to the wait list problem. Generally speaking funds, doctors, ORs, etc. are available to reduce/eliminate the wait lists — often surgeries are cancelled because there is a shortage of hospital beds for the after care — frequently the bed is there, but there are insufficient nurses to staff the ward(s).

Hospitals in Canada are mostly in good condition. Smaller hospitals (particularly in more rural areas) often lack the most modern equipment (patients are ferried to larger centers for MRIs, CTScans, etc. Such transfers are covered for the patient, but not for family). Large and expensive equipment is often purchased through fund raising in a community — the cost of installation and on-going use of the equipment then becomes a problem for the particular hospital or health care organization.

All but two of my personal interactions with the Canadian health care system have been positive. One of the negative experiences was indirectly related to single-payer health care — my mother had a heart attack during a strike by hospital workers (nurses, cleaners, technicians). She was in intensive care being monitored by a pharmacy student, who had a phone number for a physician if he noticed any change in her condition. Fotunately all went well for my mother, but others in the intensive care ward during the strike were less fortunate.

The other was a case of medical malpractice that could have occurred anywhere in the world. However, this being Canada means that it is difficult to get a lawyer to take the case because the courts here do not award large amounts in such cases — if I remember correctly the largest award in Canada was just over $3 million.

Hope this contributes a little to the debate.

I am not that old- mid 40′s- but even I remember when no one needed to take out their insurance card unless they were at the hospital for tests, procedures or being admitted. Office vists and prescriptions were all out of pocket, set by the free-market, and reasonable. Hospitalization policies were affordable which is why so many employers offerred it as a benefit.

It seems to me that 2 things happened at the same time to make costs skyrocket:
1.) The goverment got heavily involved with micromanaging services in a backwards-ass attempt to address fraud in Medicare and Medicaid. Insurance followed suit to maximize their profits.
2.)Insurance companies changed. Remember the good old days when Insurance Companies were in the business of providing insurance? Premimums are now just a means to an end. Premimums are how they fund their other business ventures.

http://www.usatoday.com/news/washington/2009-08-17-aarp-health-overhaul_N.htm

people are speaking out with their pocket books. When an organization no longer represents the best interest of it members, members leave.

WOMEN WITH INTELLIGENCE AND EXPERIENCE,MEN WHO SUPPORT THEM AND COUNTRY BEFORE PARTY ALWAYS

PUMAS,BUBBAS,EQUALISTS AND THOSE PEOPLE RULE

Funny, but, we’ve had a solution and it’s been staring us in the face since the 1960′s – and that to expand Medicare/Medicaid incrementally to cover everyone. Sure, it might need tweaking, but the system is in place and has worked fine for decades. Why do we always have to reinvent the wheel?

The problem with health-care reform is that nobody knows exactly what that is going to mean. Nobody in Congress, or Obama himself, has laid it out in simple terms exactly what is going to happen as a result.

There is going to be a tremendous amount of money spent, but for what? If we aren’t getting at least a public option, then the money is obviously going to benefit the same players it always has…the insurance industry and the pharmaceutical industry. I’ve been working through reading the House bill, but it is very confusing and you need a couple of lawyers with you to decifer it.

Something that we need to be honest about is the role government already plays in our health care and whether that is currently helping or hurting. Then we can decide if we want more government involvement or not.

For example, from an article by Dr. Lawrence Wilson, http://www.campaignforliberty.com/article.php?view=172

The war on cancer

An example of the dismal failure of the government sector in America is the “war on cancer,” which is administered by the National Cancer Institute. It has cost taxpayers some $30 billion over a 35-year period. After adjusting for a longer life span, between 1950 and 1989 the incidence of cancer rose by about 44 percent. Breast cancer and colon cancer in men have risen about 50 percent, while some others have risen 100 percent. A recent article in the Journal of the AMA was entitled “Are Increasing Five-Year Survival Rates Evidence of Success against Cancer?” The answer was “No.”

The news mostly announces new cures and new drugs, but nothing about the waste of money in federal cancer research. A recent news broadcast said some cancer had declined “due to lifestyle changes.” For this the taxpayers paid $30 billion. However, this waste is predictable because national research laboratories are not primarily interested in a cancer cure, no matter what they claim. They are interested foremost in keeping their jobs and second in getting more money next year from Congress. This is the nature of all bureaucracies.

He also says about the FDA:

Anyone who believes the FDA is an impartial or even helpful agency needs to read The History of a Crime; How Could It Happen, by Harvey Wiley, M.D., the first director of the FDA. In the book, he meticulously details how the FDA became infiltrated by food and drug companies and how its mission became completely subverted. As a physician, I believe no other domestic agency has caused more deaths than the FDA. (more in the article)

Here we have two examples of government monopolizing aspects of health care: cancer research and the approval of drugs. Every time you eliminate competition in a sector, you get waste and inefficiency–EVERY E-V-E-R-Y time. We need to keep this in mind. This cannot be stressed enough.

Government Running ANYTHING is a disaster.
Do any of you pay attention to the REAL results in these national health care countries, or do you just have your heads up your asses?

Yeah
Michael Moore is brilliant. And very very RICH.
Hitler would have LOVED to have hired that fat cow.

Elderly: Gov’t should send ‘caring for your aging parents’ info packs to adults when their parents hit 60. (I think Social Security has this data — if not, parents’ year of birth could be requested on tax returns). My father developed chronic pressure sores from drinking/sleeping in his wheelchair. Hospitalization cost to Medicare – $.5 million. Once his ’30-something’ kids got educated on long term care, Medicare, special needs, things improved. We were negligent, yes, but mainly we didn’t know anything about aging. Govt can speed up that ‘learning curve.’

Fragmentation: Fragmented services can lead to cost insanity. Medicaid saves $1000 by denying a home attendant, but drives up Medicare hospitalization by $1 million. Medicaid only cares about its own budget, not Medicare or taxpayers. Patient care should not be fragmented between multiple agencies. Someone should have authority over cross-agency insanity.

Obesity: Healthier food = higher price. Compare whole grain ($3) to white bread ($1). Can govt subsidize healthier foods to equalize price?

The NYC Health Dept requires MacDonalds, etc., to post calorie counts on menus. MacD’s got rid of ‘Supersize Me’ under public ridicule — but they are sneaking back with the ‘Triple Cheeseburger.’ Boo!

Again, I think there’s a window of risk for ’30-somethings’ who don’t realize what’s happening to their metabolism. My neighbor is noticeably spreading — he jogs, he just can’t burn the ’20-something’ pizza diet anymore. I weigh 40 lbs less now than I did in my 30′s — I just didn’t know what was happening to me. Do we have to learn the hard way?

This is the best article on the health care issue I’ve ever read. He lays out the things that contribute to the problem and why what Obama is proposing not only may not make it better, but why it could make things worse! ugh

He is a Democrat who is also a businessman. He recently lost his own 83 year old father. It will appear in the print edition of The Atlantic.

http://www.theatlantic.com/doc/print/200909/health-care

It’s positively brilliant.