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The US Health Care Market
Inherent problems with the US health care model.

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The US Health Care Market
unrealist42
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Posted 10/23/09 - 03:32 PM:
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#11
Pensions and health care for old people and war veterans and limited unemployment benefits had been around for a while in many countries and after the war the socialists had enough political power to extend and expand these policies. There is no question of this.

What you may be missing is that the US entirely financed the recovery of Western Europe after the war and exercised a lot of political power. If US advisors with other views had been sent many of these expanded social policies would have been discouraged and squashed instead of accepted and encouraged.
wuliheron
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Posted 10/23/09 - 03:43 PM:
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#12
Keeping costs down is not the job of the insurance companies. Like any other company their job is to maximize profits and dominate their market sector, all in order to provide the maximum profits for their stock holders. Think about it for a moment, would you claim that it is the job of your auto insurance company to keep down the cost of auto repairs or that every auto insurance company should provide the lowest rates possible? Of course you are welcome to choose the auto insurance company of your choice, but some states have no-fault insurance, while others don't and other laws that either limit or discourage certain auto insurance companies from openning up shop there.

Currently about a quarter of the profits made by hospitals in the US comes from people who are not US citizens. They are wealthy people who come to the US to receive the finest medical care in the world. These people have no incentive to go to countries with nationalized healthcare where their money buys less. As a result, the more expensive hospitals in the US today have a fifty percent lower mortality rate than the rest.

Many have claimed that the last century was dominated by advances in chemistry and physics, and this century will be dominated by advances in medicine. There are a lot of people looking to cash in on that trend who are spending a lot of money buying politicians to insure they can maximize their investiments. Health care is a good investment for investors, even in the current economic down turn it is still pumping out record profits. Like the recent banking scandals and resulting economic collapse these investors are going to ride that pony into the dirt if people let them get away with it.
enkidu
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Posted 10/23/09 - 03:53 PM:
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#13
unrealist42 wrote:
Pensions and health care for old people and war veterans and limited unemployment benefits had been around for a while in many countries and after the war the socialists had enough political power to extend and expand these policies. There is no question of this.

What you may be missing is that the US entirely financed the recovery of Western Europe after the war and exercised a lot of political power. If US advisors with other views had been sent many of these expanded social policies would have been discouraged and squashed instead of accepted and encouraged.


I am not contesting the large financial help that came from USA during the recovery after WW2. What I am contesting is the origin of the ideas of a general heathcare system that did not wait for USA to be implemented in Europe and especially in Germany, and which extended far beyond the coverage of old people and war veterans.
USA could have sent anybody, european people would have never accepted a system that did not grant them basic benefits some of them had had for decades before the war. Gladly, US advisors were intelligent enough to help implementing systems which were in the spirit of the various nations; any other attitude would have resulted in sharp conflicts.
See http://www.pbs.org/wgbh/pages/fron...orld/countries/models.html

Tight toy night, streets were so bright.
The world looked so thin and between my bones and skin
there stood another person who was a little surprised
to be face to face with a world so alive.
I fell.
(Tom Verlaine)
enkidu
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Posted 10/23/09 - 05:17 PM:
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#14
wuliheron wrote:

Currently about a quarter of the profits made by hospitals in the US comes from people who are not US citizens. They are wealthy people who come to the US to receive the finest medical care in the world. These people have no incentive to go to countries with nationalized healthcare where their money buys less. As a result, the more expensive hospitals in the US today have a fifty percent lower mortality rate than the rest.


This must be one of the most enduring myth in USA, and even though I have heard and read it many times, I have never been provided with the slightest element to believe it is true.
Furthermore, many so-called "nationalized healthcare"(as if it had any descriptive sense, given the variety of systems around the world), money can buy as much as anywhere in US, since doctors'fee are not limited, rather it is the portion reimbursed by the state or the insurance that is limited.

Anyway, I find the argument itself quite insulting for doctors that somehow would deliver an healthcare service commensurate to the money they are paid for, which, incidentally, is in direct conflict with the Hyppocratic Oath.

Tight toy night, streets were so bright.
The world looked so thin and between my bones and skin
there stood another person who was a little surprised
to be face to face with a world so alive.
I fell.
(Tom Verlaine)
wuliheron
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Posted 10/23/09 - 06:32 PM:
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#15
To quote Kurt Vonnegut Jr., "What's so special about Harvard men? Nothing."

The idea that doctors are saints has not been endorsed by any church or the AMA. Nor have the people who sell multi-million dollar medical devices, hospitals, and pharmacuticals been cannonized. To insist that because they take an oath doctors are somehow better than everyone else is the real insult, an insult to our intelligence. Next you'll be telling me it is insulting to call a politician crooked because they took an oath of office. Get over it already. Being merely human isn't that bad.

The US is a technological leader and actually restricts the export of many high tech devices in the name of national security. We are also a huge country by the standards of the developed world and have a far larger medical system than average. If you want the latest medical advances you are not going to find them in outer mongolia. You'll find a few here, there, and everywhere but you'll be hard pressed to find a greater concentration than you will in the US. This is in no small part due to the fact that the US also has one of the largest wealthy populations in the world (perhaps the largest) and even those who are not so wealthy are often willing to pay through the nose for the latest health care.

You are, of course, free to summarilly dismiss anything anyone writes and claim a "privilaged" status for doctors, but that isn't an explanation. As the great bard wrote, "It is a tale told by an idiot, full of sound and fury, signifying nothing."

enkidu
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Posted 10/23/09 - 07:02 PM:
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#16
Thanks for your kindness, calling me an idiot is very urbane of you.

Anyway, I did not imply in any way (for an honest reader) that doctors were saint, simply that they had a conscience, as most human beings, and are aware of their responsibility to their fellow human beings, at least for the vast majority of the doctors.

As for the technology, GE Healthcare, Philips Medical Services, Siemens Medical Solutions or Toshiba sell all over the world, not only to US, and hospitals all over the world have the means to buy their products (possibly more so when they are run by the state) so your rantings about some restrictions about high-tech devices that most likely are not even made in US or by US companies, is absurd. I also don't see any demonstrated link between a great concentration of rich people and outstanding healthcare.
What I see however, once more, is that I just have to take your word to believe the great myth saying that USA has the absolute best hospitals in the world, or even that such a hierarchy makes any sense at all (if it does, it certainly isn't measured by the mortality rate anyway as you implied earlier).

My view, supported by my experience, and a few studies easily available on the net (here is one for instance: http://www.rwjf.org/files/research/qualityquickstrikeaug2009.pdf), is that healthcare quality is overall equivalent in most industrialised countries; I would think that US healthcare in pure quality is good (and I practised it for a while) but not any better than healthcare in France or in Singapore, that I also practised.



Edited by enkidu on 10/23/09 - 07:13 PM

Tight toy night, streets were so bright.
The world looked so thin and between my bones and skin
there stood another person who was a little surprised
to be face to face with a world so alive.
I fell.
(Tom Verlaine)
wuliheron
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Posted 10/23/09 - 09:01 PM:
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#17
enkidu wrote:
Thanks for your kindness, calling me an idiot is very urbane of you.

Anyway, I did not imply in any way (for an honest reader) that doctors were saint, simply that they had a conscience, as most human beings, and are aware of their responsibility to their fellow human beings, at least for the vast majority of the doctors.

As for the technology, GE Healthcare, Philips Medical Services, Siemens Medical Solutions or Toshiba sell all over the world, not only to US, and hospitals all over the world have the means to buy their products (possibly more so when they are run by the state) so your rantings about some restrictions about high-tech devices that most likely are not even made in US or by US companies, is absurd. I also don't see any demonstrated link between a great concentration of rich people and outstanding healthcare.
What I see however, once more, is that I just have to take your word to believe the great myth saying that USA has the absolute best hospitals in the world, or even that such a hierarchy makes any sense at all (if it does, it certainly isn't measured by the mortality rate anyway as you implied earlier).

My view, supported by my experience, and a few studies easily available on the net (here is one for instance: http://www.rwjf.org/files/research/qualityquickstrikeaug2009.pdf), is that healthcare quality is overall equivalent in most industrialised countries; I would think that US healthcare in pure quality is good (and I practised it for a while) but not any better than healthcare in France or in Singapore, that I also practised.




Virtually every human being on the planet has a conscience and some sense of social responsibility so, again, the statement is just so much meaningless rhetoric. Next you'll be telling me they cry over babies starving in Africa and debate what to do about it at their country clubs. Nor was I talking about the "overall" quality of the US healthcare system, I was pointedly talking about a system that is increasingly two tiered and gouging the average person for profit. You can only hide behind words and obscure research for so long when the pharmacutical companies and other involved parties are making record profits during the worst economic downturn since the great depression.
Caldwell
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Posted 10/23/09 - 11:56 PM:
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#18
unrealist42 wrote:


The government pays over %40 of the money paid to health care providers now while providing care for the %50 of the population that is in most need of medical services, the elderly, the poor, the disabled.
This is less than %20 of overall health care dollars in the US. In other words the private sector pay for less than %60 of health care services wile receiving over %80 of the money. Overhead costs in the government sector are less than %5 compared to %8-20 for the private sector.

Can you tell me where you got these figures? I'd like to see a pie chart, or something like that. Because I don't understand the way you explained these figures. So, it would really help if you could give more explanations for this.

I do not believe that the US health care mess is possible to fix without an overwhelming government presence in the market, either by regulation or by entering the market itself, or both. It is the only thing that can possibly bring ever rising prices under control. Private insurers are the Achilles heel of health care. They simply do not have enough power in the market to control prices.

Not necessarily. The Annals of Internal Medicine (link is provided below) has this to say:

"In seeking an explanation for high and rising health expenditures, the economics and health policy literature offers several perspectives. The aging of the population is not an adequate explanation, nor is the post-1950s' spread of health insurance, which reduced patients' responsibility for the costs of care. The lack of well-developed competitive markets in health care may be partially responsible for high health expenditures. The next article in this series will explore a more plausible explanation for high and rising health expenditures: technological innovation."

Note: I did not get the next article which discusses "technological innovation" as an explanation for rising health expenditures. Maybe you could find it.

So, what is your proposal to bring health care prices under control before they bankrupt the nation which will happen within the next 15 years if nothing is done?
You do have one don't you?

Ah, I'm not that brilliant. First, let us read this piece and educate ourselves on why health care costs are rising High and Rising Health Care Costs. Part 1: Seeking an Explanation, from the Annals of Internal Medicine. The public, in general, needs to learn from studies, not from politicians, no?
enkidu
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Posted 10/24/09 - 05:39 AM:
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#19
wuliheron wrote:

Virtually every human being on the planet has a conscience and some sense of social responsibility so, again, the statement is just so much meaningless rhetoric. Next you'll be telling me they cry over babies starving in Africa and debate what to do about it at their country clubs. Nor was I talking about the "overall" quality of the US healthcare system, I was pointedly talking about a system that is increasingly two tiered and gouging the average person for profit. You can only hide behind words and obscure research for so long when the pharmacutical companies and other involved parties are making record profits during the worst economic downturn since the great depression.


You again failed to provide any element to support the claim that there exists a higher top quality healthcare in US than in the rest of the world. Maybe are you confusing medical research and patients treatment; well, while it is undisputable that US medical research is very good and certainly the first in the world (for a demographic reason, but also because it attracts a lot of foreign researchers), this research, once done, is made available to the world by peer-reviewed papers and the internet, and as soon as they can lead to progress in healthcare, these are implemented all over the world simultaneously.

Furthermore, there is no reason to think that more money can buy better healthcare because healthcare technology is provided by multinationals that are led to sell their products all over the world, besides, there is no link (except in some exceptional cases) between "nationalised healthcare" and lack of equipment or low fees for doctors.

I guess you remark may apply to cosmetic surgery, but this is usually not included into healthcare (except for some exceptional procedures).

Tight toy night, streets were so bright.
The world looked so thin and between my bones and skin
there stood another person who was a little surprised
to be face to face with a world so alive.
I fell.
(Tom Verlaine)
wuliheron
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Posted 10/24/09 - 09:45 AM:
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enkidu wrote:


You again failed to provide any element to support the claim that there exists a higher top quality healthcare in US than in the rest of the world. Maybe are you confusing medical research and patients treatment; well, while it is undisputable that US medical research is very good and certainly the first in the world (for a demographic reason, but also because it attracts a lot of foreign researchers), this research, once done, is made available to the world by peer-reviewed papers and the internet, and as soon as they can lead to progress in healthcare, these are implemented all over the world simultaneously.



There is no reason to provide such evidence since it is not central to my argument. What is are the facts that healthcare providers are gouging the public and making record profits. These fly in the face of your argument that healthcare costs are merely the result of a system that does not encourage efficiency.


enkidu wrote:
Furthermore, there is no reason to think that more money can buy better healthcare because healthcare technology is provided by multinationals that are led to sell their products all over the world, besides, there is no link (except in some exceptional cases) between "nationalised healthcare" and lack of equipment or low fees for doctors.

I guess you remark may apply to cosmetic surgery, but this is usually not included into healthcare (except for some exceptional procedures).



Again, you are straying from the central argument and nit-picking at petty details.
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