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Why do we need healthcare reform? (Page 4)
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 2010-03-09 8:52 AM in reply to: #2715730 |
Pro 4040  |  Subject: RE: Why do we need healthcare reform?scoobysdad - 2010-03-09 7:57 AM That's not the point. The fact is, foreign countries are currently able to provide cheaper healthcare to their own people because the American markets subsidize them. Basically foreign revenue is just "icing on the cake" to big pharma and medical equipment companies. That explains why it looks like foreign countries provide relatively cheaper healthcare. Is that actually true? The US system is rife with inefficiencies and is highly litigious. That has to cost something. Are you suggesting that if the US moved to a single payer system that the healthcare costs in all other countries would increase?
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| 2010-03-09 8:58 AM in reply to: #2715963 |
Champion 6056   Menomonee Falls, WI | Subject: RE: Why do we need healthcare reform? sbreaux - 2010-03-09 8:45 AM scoobysdad - 2010-03-09 5:57 AM bzgl40 - 2010-03-09 6:12 AM That's not the point. The fact is, foreign countries are currently able to provide cheaper healthcare to their own people because the American markets subsidize them. Basically foreign revenue is just "icing on the cake" to big pharma and medical equipment companies. That explains why it looks like foreign countries provide relatively cheaper healthcare.bradword - 2010-03-08 8:56 PM Another thing that is forgotten a lot in these discussions. Right now other countries rely HEAVLY on America's private health companies big research dollars and private sector money to advance medical technique and then trickle down into cheaper forms of healthcare. Lose that, and all the sudden the universal health care in other countries, which some already have problems affording without taxing people to death, will have an even harder time if the US tries the same. That is true, but, that being said, one of those companies got sued for some sort of billion dollar payment and it didn't even put a dent in their budget. They are not suffering cause countries like Canada offer drugs for cheaper. I do not think the big companies will shut their doors if the US offered a single payer system and/or health insurance reform. These components of the system are not what is paying for the research. And a lot of the research dollars actually comes from government grants as well. Absolutely not true. Here is a list of a few h/c companies and revenues from the US. Pfizer - 42% Eli Lilly - 54% Abbott Labs - 49% Bristol Myers - 58% Merck - 56% Celgene - 65% Gilead - 53% Johnson and Johnson - 51% Medtronic - 62% Boston Scientific - 58% Baxter - 41% So to say that foreign revenues are just icing on the cake is just false. And people seem to forget that there are plenty of foreign pharmaceutical companies that also develop drugs including Shire, Novo Nordisk, Novartis, AstraZeneca, Glaxo Smith Kline, just to name a few. The largest generic drug company, Teva, is based in Israel. Um, according to your figures, THE SUM OF THE REVENUE FROM EVERY OTHER COUNTRY IN THE WORLD COMBINED does not equal the revenue generated by America for most of the companies you cited. Sure, collectively it's significant, but on a country-by-country basis, not so much. They make their money in the US. It also doesn't matter where the companies are based, it matters in what countries they sell their products and make the most money. IMO, this excerpt presents logical reasoning and sums it up pretty well: http://www.realclearpolitics.com/articles/2009/07/23/health_care_my... Here's what happens. We have a partially free market in the US where drug companies spend a ton to develop new wonder drugs, much of which is spent to satisfy regulatory requirements. The cost of this development is called a "fixed cost." Once it's developed it does not cost that much to make each pill. That's called a "variable cost." If people only paid the variable cost (or even a bit more) for each pill, the whole thing would not work. The drug company would never get back the massive fixed cost of creating the drug in the first place, and so no company would try to develop one. Thus, manufacturers have to, and do, charge more than the variable cost of making each pill.[3] Some look at this system and say to the drug companies "gee, it doesn't cost you much to make one more pill, so it's unfair that you charge much more than your cost." They are completely wrong and not looking at all the costs. So, let's bring this back to our good natured friends to the North (good natured barring hockey when they'll kill you as soon as look at you[4]). They have socialized medicine and they bargain as the only Canadian buyer for drugs, paying well below normal costs. Drug companies that spent the enormous fixed costs to create new miracles are charging a relatively high cost in the free and still largely competitive world (the US) to recoup their fixed cost and to make a profit. But socialist societies like Canada limit the price they are allowed to charge. The US-based company is then faced with a dilemma. What Canada will pay is not enough to ever have justified creating the miracle pill. But, once created, perhaps Canada is paying more than the variable cost of each pill. Thus, the company can make some money by also selling to Canada at a lower price; as it's still more than it costs them to make that last pill.[5] |
| 2010-03-09 9:03 AM in reply to: #2715956 |
Master 4101 Denver | Subject: RE: Why do we need healthcare reform? Scout7 - 2010-03-09 7:43 AM coredump - 2010-03-09 9:34 AM No. I think it should be each individual's choice as to what he feels is appropriate. Personally, I'd rather we got rid of insurance entirely.Scout7 - 2010-03-09 7:54 AM TriToy - 2010-03-09 8:26 AM Besides that, yes we live in a society - and in a society the stronger help take care of the weaker. But is it right to force the stronger to do so by law?Do you propose the stronger should turn their backs on the weak? We can agree that it's worthwhile to help the weak, right? They become more productive, contribute more to society and the economy, etc... So if we go on that assumption, then won't leaving it to what people feel is appropriate eventually lead to nothing? For example, say you choose to contribute to the weak, but I do not. The entire society benefits from your largresse, it's not confined to just you, the one who made the contribution. I too benefit from the increased productivity, better economy, etc. even though I did nothing. So now you look at me, benefitting from doing nothing and think "why am I the only chump helping the weak, I could do nothing and benefit as well" and pretty soon no one is helping anyone. We ask that everyone in society contribute to helping the weak because the entire society benefits from it, right? |
| 2010-03-09 9:12 AM in reply to: #2716010 |
Champion 6056 Menomonee Falls, WI | Subject: RE: Why do we need healthcare reform? By the way, I'm not arguing Big Medicine isn't gouging us all in the US. They probably are. And insurance is too. But I don't think the best financial answer is to replace private insurance with an inefficient bureaucracy with little incentive to operate efficiently or be responsive to its customers ala the Postal Service (Universal Healthcare). I believe the answer lies in a regulated system that creates the greatest amount of competition, demands transparency of costs and relies on personal responsibility for both saving for one's medical expenses and spending that money wisely. (Also, some sort of plan for catastrophic situations.) The closest model we currently have is an HSA. |
| 2010-03-09 9:41 AM in reply to: #2716023 |
Runner | Subject: RE: Why do we need healthcare reform? drewb8 - 2010-03-09 10:03 AM Scout7 - 2010-03-09 7:43 AM coredump - 2010-03-09 9:34 AM No. I think it should be each individual's choice as to what he feels is appropriate. Personally, I'd rather we got rid of insurance entirely.Scout7 - 2010-03-09 7:54 AM TriToy - 2010-03-09 8:26 AM Besides that, yes we live in a society - and in a society the stronger help take care of the weaker. But is it right to force the stronger to do so by law?Do you propose the stronger should turn their backs on the weak? We can agree that it's worthwhile to help the weak, right? They become more productive, contribute more to society and the economy, etc... So if we go on that assumption, then won't leaving it to what people feel is appropriate eventually lead to nothing? For example, say you choose to contribute to the weak, but I do not. The entire society benefits from your largresse, it's not confined to just you, the one who made the contribution. I too benefit from the increased productivity, better economy, etc. even though I did nothing. So now you look at me, benefitting from doing nothing and think "why am I the only chump helping the weak, I could do nothing and benefit as well" and pretty soon no one is helping anyone. We ask that everyone in society contribute to helping the weak because the entire society benefits from it, right? Despite the rather Hobbesian view, your point is valid, assuming that is what truly happens. But is it? People are not required to donate money, time, and effort, but they still do. I see no laws requiring people to give blood, donate to charities, or volunteer to go to Haiti. But it seems a number of people feel that it is appropriate. However, if I do not feel it appropriate, should I be required to give blood? What if I have a religious belief against it? The argument here is not really about whether people are selfish or not. The argument is about individual rights vs. the needs and wants of the many. Some people believe that the needs of the many outweigh the rights of the individual to choose, i.e. we should be required to pay extra in some fashion to provide health care to everyone regardless of status. Others here believe that it should be solely up to the individual, i.e. we should have the right to choose who and what we support. Personally, I tend towards the rights of states, and the rights of individuals. I think the federal government should stay out of the healthcare issue, and let each state decide for itself. I prefer giving people choices and letting them live with the consequences. |
| 2010-03-09 10:14 AM in reply to: #2716122 |
Master 4101 Denver | Subject: RE: Why do we need healthcare reform? Scout7 - 2010-03-09 8:41 AM Despite the rather Hobbesian view, your point is valid, assuming that is what truly happens. But is it? People are not required to donate money, time, and effort, but they still do. I see no laws requiring people to give blood, donate to charities, or volunteer to go to Haiti. But it seems a number of people feel that it is appropriate. However, if I do not feel it appropriate, should I be required to give blood? What if I have a religious belief against it? The argument here is not really about whether people are selfish or not. The argument is about individual rights vs. the needs and wants of the many. Some people believe that the needs of the many outweigh the rights of the individual to choose, i.e. we should be required to pay extra in some fashion to provide health care to everyone regardless of status. Others here believe that it should be solely up to the individual, i.e. we should have the right to choose who and what we support. Personally, I tend towards the rights of states, and the rights of individuals. I think the federal government should stay out of the healthcare issue, and let each state decide for itself. I prefer giving people choices and letting them live with the consequences. I respect that view and probably agree with it more than you might guess. But I'm not sure it's solely a question of individual rights vs the needs of the many in an absolute sense. After all, there are some things where I think everyone agrees that since we collectively benefit from (such as funding a standing army, paving our streets, etc.) that collectively we should pay for it. It's more a question of how far does that stretch? How much of a benefit do you have to have before you can require it of people? the classic conservative-liberal continuem. Which is basically what you were saying I think. I too prefer giving people choices and letting them live with the consequences. But with the caveat that their choices don't affect me. The problem with the system the way it is now is that if someone chooses to forego insurance it affects me. I don't think I like the idea of the feds running a centralized system but I've kind of come around to the idea of the feds having each state to set up its own exchange like in the current bill, although I have some reservations about how this would actually work in real life. And FWIW, I think there will always be people who are willing to let others freeride on their giving, I don't think my previous hypothetical situation where everyone just looks out for themselves would come to pass. I'm just not sure healthcare is something unimportant enough to leave it to the generosity of a few, especially since it is something that everyone would benefit from. |
| 2010-03-09 11:01 AM in reply to: #2716226 |
Runner | Subject: RE: Why do we need healthcare reform? drewb8 - 2010-03-09 11:14 AM Scout7 - 2010-03-09 8:41 AM Despite the rather Hobbesian view, your point is valid, assuming that is what truly happens. But is it? People are not required to donate money, time, and effort, but they still do. I see no laws requiring people to give blood, donate to charities, or volunteer to go to Haiti. But it seems a number of people feel that it is appropriate. However, if I do not feel it appropriate, should I be required to give blood? What if I have a religious belief against it? The argument here is not really about whether people are selfish or not. The argument is about individual rights vs. the needs and wants of the many. Some people believe that the needs of the many outweigh the rights of the individual to choose, i.e. we should be required to pay extra in some fashion to provide health care to everyone regardless of status. Others here believe that it should be solely up to the individual, i.e. we should have the right to choose who and what we support. Personally, I tend towards the rights of states, and the rights of individuals. I think the federal government should stay out of the healthcare issue, and let each state decide for itself. I prefer giving people choices and letting them live with the consequences. I respect that view and probably agree with it more than you might guess. But I'm not sure it's solely a question of individual rights vs the needs of the many in an absolute sense. After all, there are some things where I think everyone agrees that since we collectively benefit from (such as funding a standing army, paving our streets, etc.) that collectively we should pay for it. It's more a question of how far does that stretch? How much of a benefit do you have to have before you can require it of people? the classic conservative-liberal continuem. Which is basically what you were saying I think. I too prefer giving people choices and letting them live with the consequences. But with the caveat that their choices don't affect me. The problem with the system the way it is now is that if someone chooses to forego insurance it affects me. I don't think I like the idea of the feds running a centralized system but I've kind of come around to the idea of the feds having each state to set up its own exchange like in the current bill, although I have some reservations about how this would actually work in real life. And FWIW, I think there will always be people who are willing to let others freeride on their giving, I don't think my previous hypothetical situation where everyone just looks out for themselves would come to pass. I'm just not sure healthcare is something unimportant enough to leave it to the generosity of a few, especially since it is something that everyone would benefit from. I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. |
| 2010-03-09 11:39 AM in reply to: #2716393 |
Master 4101 Denver | Subject: RE: Why do we need healthcare reform? Scout7 - 2010-03-09 10:01 AM I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. I think you kind of hit the nail on the head - it's a bit of a paradox - in order to make the system more fair you have to remove some choice. I'm not sure there's a good way to eliminate the problem of the freeloaders without either a universal system or some sort of mandate or elimanating insurance althogther. And I'll agree 100% that we really need to question why we have employee sponsered healthcare in the 1st place. It seems to me that it's really inefficient and stifles innovation. If it were up to me the goverment would mandate that every insurer provide some sort of basic plan, set a maximum price for the plan and then give everyone enough money to shop for one of these plans on their own. If you wanted insurance or an HSA over and above this you would be welcome to pay for it on your own (or employers could pay for all or part of it as a benefit or something, but it would not be linked to the employer) and these "extras" would be taxed to pay for everyones basic coverage. There's some reduction of choice, in that everyone would be forced to purchase one of these basic plans and pool risk, but over and above that it's still up to the individual. Also I would mandate that I be provided with mozarella sticks any time I tap my foot 4 times. |
| 2010-03-09 11:47 AM in reply to: #2712366 |
Pro 4909 Hailey, ID | Subject: RE: Why do we need healthcare reform? |
| 2010-03-09 11:53 AM in reply to: #2713459 |
Master 1585 Folsom (Sacramento), CA | Subject: RE: Why do we need healthcare reform? TriToy - 2010-03-08 4:33 AM KeriKadi - 2010-03-07 10:53 AM I've been thinking about this whole heathcare thing and I am sure there are no simple cost effective solutions or we wouldn't be in the boat we are in now. I have a question though which may sound silly but humor me if you will. Did anybody watch the show Northern Exposure in the 90s? The doctor that worked in the small town in Alaska was paying his dues after the state of Alaska paid for his medical school. He was obligated to work in this town for X number of years to pay back his tuition. Otherwise he would not have been able to afford medical school. I haven't researched this myself but have heard that doctors graduate medical school and complete their residency with tens-hundreds of thousands of dollars in student loans. I wonder if there couldn't be some kind of program similiar to Northern Exposure and even the G.I. Bill where doctors would work for the government/state at a set salary to have their education paid for. I wonder if this wouldn't help with the folks who have no insurance. They would be seeing doctors who are paying back their student loans. Obviously this doesn't help with the current insurance issues. I have worked in billing in the medical field and gone most of my childhood without insurance so I know there is much work to be done. However, it seems like these are two separate issues - Those who need some kind of health care without insurance and those who pay a lot of money for insurance getting quality health care. it does exist. for areas that don't have physicians (because people don't want to live there) and the armed services. as for the OP - we need health INSURANCE reform not healthcare reform. This is what I had put in another thread: I think we need to make the insurance companies transparent and accountable. I know for a fact that BCBS wastes MILLIONS of dollars on internal studies that go no where. They label many of the salaries under administrative overhead and right now under the accounting laws can call that 'direct patient care' I call BS. patients are paying a fortune for health insurance, doctors are making less and less - the middle man needs to shift - and no I am not saying we have to have the government run it (they don't seem to do such a great job) I do want to truly see it be not for profit and not for giant bonuses and stock holder earnings. We also need to do something about malpractice - I think it should be handled like worker's compensation. Patients SHOULD be compensated when mistakes happen, but it should not be so punitive nor should it be a lottery ticket. I think those 2 things would do a world of difference, and that does not even address that pharmaceutical companies make more than double on medications here than in europe. I also believe in sin tax - alcohol and cigarettes SHOULD have an extra $5 per item tacked on to go directly to health care. I can understand the rationale behind a sin tax on cigarettes. I don't agree with it, but I can at least understand the reasoning behind it. I'm not sure that I can understand the reasoning behind a sin tax on alcohol though. I'm not aware of any studies linking moderate alcohol consumption to a health risk (although that doesn't mean there aren't any because I am far from an expert). I do know that there are many studies that have linked moderate alcohol consumption to various health benefits. Is the idea to punitively tax something that can have detrimental effects when abused? I would say that if that the case, then we should also put a sin tax on any calorie dense foods. When responsibly used, they pose little health risk but when abuse them they can lead to obesity and the issues related to obesity. Is there something I am missing here? |
| 2010-03-09 11:53 AM in reply to: #2716508 |
Champion 18680 Lost in the Luminiferous Aether | Subject: RE: Why do we need healthcare reform? drewb8 - 2010-03-09 12:39 PM Scout7 - 2010-03-09 10:01 AM I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. I think you kind of hit the nail on the head - it's a bit of a paradox - in order to make the system more fair you have to remove some choice. I'm not sure there's a good way to eliminate the problem of the freeloaders without either a universal system or some sort of mandate or elimanating insurance althogther. And I'll agree 100% that we really need to question why we have employee sponsered healthcare in the 1st place. It seems to me that it's really inefficient and stifles innovation. If it were up to me the goverment would mandate that every insurer provide some sort of basic plan, set a maximum price for the plan and then give everyone enough money to shop for one of these plans on their own. If you wanted insurance or an HSA over and above this you would be welcome to pay for it on your own (or employers could pay for all or part of it as a benefit or something, but it would not be linked to the employer) and these "extras" would be taxed to pay for everyones basic coverage. There's some reduction of choice, in that everyone would be forced to purchase one of these basic plans and pool risk, but over and above that it's still up to the individual. Also I would mandate that I be provided with mozarella sticks any time I tap my foot 4 times. Fair to whom, those who get or those forced to give? |
| 2010-03-09 11:58 AM in reply to: #2716541 |
Master 4101 Denver | Subject: RE: Why do we need healthcare reform? trinnas - 2010-03-09 10:53 AM drewb8 - 2010-03-09 12:39 PM Scout7 - 2010-03-09 10:01 AM I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. I think you kind of hit the nail on the head - it's a bit of a paradox - in order to make the system more fair you have to remove some choice. I'm not sure there's a good way to eliminate the problem of the freeloaders without either a universal system or some sort of mandate or elimanating insurance althogther. And I'll agree 100% that we really need to question why we have employee sponsered healthcare in the 1st place. It seems to me that it's really inefficient and stifles innovation. If it were up to me the goverment would mandate that every insurer provide some sort of basic plan, set a maximum price for the plan and then give everyone enough money to shop for one of these plans on their own. If you wanted insurance or an HSA over and above this you would be welcome to pay for it on your own (or employers could pay for all or part of it as a benefit or something, but it would not be linked to the employer) and these "extras" would be taxed to pay for everyones basic coverage. There's some reduction of choice, in that everyone would be forced to purchase one of these basic plans and pool risk, but over and above that it's still up to the individual. Also I would mandate that I be provided with mozarella sticks any time I tap my foot 4 times. Fair to whom, those who get or those forced to give? Both |
| 2010-03-09 12:12 PM in reply to: #2716540 |
Champion 6046 New York, NY | Subject: RE: Why do we need healthcare reform? uclamatt2007 - 2010-03-09 12:53 PM TriToy - 2010-03-08 4:33 AM KeriKadi - 2010-03-07 10:53 AM I've been thinking about this whole heathcare thing and I am sure there are no simple cost effective solutions or we wouldn't be in the boat we are in now. I have a question though which may sound silly but humor me if you will. Did anybody watch the show Northern Exposure in the 90s? The doctor that worked in the small town in Alaska was paying his dues after the state of Alaska paid for his medical school. He was obligated to work in this town for X number of years to pay back his tuition. Otherwise he would not have been able to afford medical school. I haven't researched this myself but have heard that doctors graduate medical school and complete their residency with tens-hundreds of thousands of dollars in student loans. I wonder if there couldn't be some kind of program similiar to Northern Exposure and even the G.I. Bill where doctors would work for the government/state at a set salary to have their education paid for. I wonder if this wouldn't help with the folks who have no insurance. They would be seeing doctors who are paying back their student loans. Obviously this doesn't help with the current insurance issues. I have worked in billing in the medical field and gone most of my childhood without insurance so I know there is much work to be done. However, it seems like these are two separate issues - Those who need some kind of health care without insurance and those who pay a lot of money for insurance getting quality health care. it does exist. for areas that don't have physicians (because people don't want to live there) and the armed services. as for the OP - we need health INSURANCE reform not healthcare reform. This is what I had put in another thread: I think we need to make the insurance companies transparent and accountable. I know for a fact that BCBS wastes MILLIONS of dollars on internal studies that go no where. They label many of the salaries under administrative overhead and right now under the accounting laws can call that 'direct patient care' I call BS. patients are paying a fortune for health insurance, doctors are making less and less - the middle man needs to shift - and no I am not saying we have to have the government run it (they don't seem to do such a great job) I do want to truly see it be not for profit and not for giant bonuses and stock holder earnings. We also need to do something about malpractice - I think it should be handled like worker's compensation. Patients SHOULD be compensated when mistakes happen, but it should not be so punitive nor should it be a lottery ticket. I think those 2 things would do a world of difference, and that does not even address that pharmaceutical companies make more than double on medications here than in europe. I also believe in sin tax - alcohol and cigarettes SHOULD have an extra $5 per item tacked on to go directly to health care. I can understand the rationale behind a sin tax on cigarettes. I don't agree with it, but I can at least understand the reasoning behind it. I'm not sure that I can understand the reasoning behind a sin tax on alcohol though. I'm not aware of any studies linking moderate alcohol consumption to a health risk (although that doesn't mean there aren't any because I am far from an expert). I do know that there are many studies that have linked moderate alcohol consumption to various health benefits. Is the idea to punitively tax something that can have detrimental effects when abused? I would say that if that the case, then we should also put a sin tax on any calorie dense foods. When responsibly used, they pose little health risk but when abuse them they can lead to obesity and the issues related to obesity. Is there something I am missing here? alcohol abuse and cigarettes lead to the most expensive care from those least able to pay. As someone who drinks I am more than willing to pay a tax on it. As to food - much harder to regulate and draw the line - I think you could make a case for Soda/pop - as no benefits but again much more difficult.... |
| 2010-03-09 12:42 PM in reply to: #2716010 |
| Pro 4040 | Subject: RE: Why do we need healthcare reform? scoobysdad - 2010-03-09 9:58 AMUm, according to your figures, THE SUM OF THE REVENUE FROM EVERY OTHER COUNTRY IN THE WORLD COMBINED does not equal the revenue generated by America for most of the companies you cited. Sure, collectively it's significant, but on a country-by-country basis, not so much. They make their money in the US. It also doesn't matter where the companies are based, it matters in what countries they sell their products and make the most money. IMO, this excerpt presents logical reasoning and sums it up pretty well: http://www.realclearpolitics.com/articles/2009/07/23/health_care_my... Here's what happens. We have a partially free market in the US where drug companies spend a ton to develop new wonder drugs, much of which is spent to satisfy regulatory requirements. The cost of this development is called a "fixed cost." Once it's developed it does not cost that much to make each pill. That's called a "variable cost." If people only paid the variable cost (or even a bit more) for each pill, the whole thing would not work. The drug company would never get back the massive fixed cost of creating the drug in the first place, and so no company would try to develop one. Thus, manufacturers have to, and do, charge more than the variable cost of making each pill.[3] Some look at this system and say to the drug companies "gee, it doesn't cost you much to make one more pill, so it's unfair that you charge much more than your cost." They are completely wrong and not looking at all the costs. So, let's bring this back to our good natured friends to the North (good natured barring hockey when they'll kill you as soon as look at you[4]). They have socialized medicine and they bargain as the only Canadian buyer for drugs, paying well below normal costs. Drug companies that spent the enormous fixed costs to create new miracles are charging a relatively high cost in the free and still largely competitive world (the US) to recoup their fixed cost and to make a profit. But socialist societies like Canada limit the price they are allowed to charge. The US-based company is then faced with a dilemma. What Canada will pay is not enough to ever have justified creating the miracle pill. But, once created, perhaps Canada is paying more than the variable cost of each pill. Thus, the company can make some money by also selling to Canada at a lower price; as it's still more than it costs them to make that last pill.[5] This isn't the whole story. When a company develops a new drug, they own the exclusive rights to it for a number of years (10, I think). This is part of how they recoup their costs. Sure, it costs tens if not hundreds of millions to develop drugs and the companies need to have the opportunity to recoup their costs and make a profit for that effort to be worthwhile. It's a bit of a leap though, to say that Canadian meds are cheaper ONLY because US meds are more expensive. I would say it is due to the fact that there is a single payer system and MAY have something to do with the fact that they can gouge Americans freely though insurance companies. Ultimately though, your freedom to choose insurance coverage also includes the freedom to get screwed over by them and pharma companies - which seems to be a widely exercised freedom, from what I can tell. It's an interesting thing that people would rather trust a for-profit insurance company to administer potentially life-saving health benefits because the spectre of government ineffeciency when it is clear to anybody who has worked for a large corporation that inefficiency is not the exclusive province of government. Corporate efficiency is complex and difficult to implement and the returns are often difficult to quantify. We all know, though, that efficiency, even if it is implemented to the highest possible degree will only lead to the hunt to find other ways to make more money. So then, they usually go for the quick hits in the form of cost cutting. Where is the biggest cost to insurance companies? Hmmmm. But the last paragraph was a big digression, if the issue is that drugs are too expensive in the US as compared to the rest of the world, I would suggest it is your model that is broken, not the rest of the world's. If you insist on holding onto a model that allows drug companies to gouge you for prescription meds, well, don't blame Canada.
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| 2010-03-09 12:43 PM in reply to: #2712366 |
Runner | Subject: RE: Why do we need healthcare reform? I must say, I am quite happy that most of the conversations in this thread, at least the recent ones, have been far less full of demagoguery and political claptrap, and much more open discussion. Kudos to all. |
| 2010-03-09 1:20 PM in reply to: #2716556 |
Champion 18680 Lost in the Luminiferous Aether | Subject: RE: Why do we need healthcare reform? drewb8 - 2010-03-09 12:58 PM trinnas - 2010-03-09 10:53 AM drewb8 - 2010-03-09 12:39 PM Scout7 - 2010-03-09 10:01 AM I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. I think you kind of hit the nail on the head - it's a bit of a paradox - in order to make the system more fair you have to remove some choice. I'm not sure there's a good way to eliminate the problem of the freeloaders without either a universal system or some sort of mandate or elimanating insurance althogther. And I'll agree 100% that we really need to question why we have employee sponsered healthcare in the 1st place. It seems to me that it's really inefficient and stifles innovation. If it were up to me the goverment would mandate that every insurer provide some sort of basic plan, set a maximum price for the plan and then give everyone enough money to shop for one of these plans on their own. If you wanted insurance or an HSA over and above this you would be welcome to pay for it on your own (or employers could pay for all or part of it as a benefit or something, but it would not be linked to the employer) and these "extras" would be taxed to pay for everyones basic coverage. There's some reduction of choice, in that everyone would be forced to purchase one of these basic plans and pool risk, but over and above that it's still up to the individual. Also I would mandate that I be provided with mozarella sticks any time I tap my foot 4 times. Fair to whom, those who get or those forced to give? Both Hmm I wonder when it becomes unfair to the person who is having to pay for others then. Is is unfair when I can no longer afford to send my son to the tutoring he needs because I must pay for my healthcare costs and someone elses? Was it fair that my son took sack lunches to school to save money while my taxes went to give other peoples kids free breakfast and lunch. Where exactly do you draw the fair line and what is the criteria for "fair"? Who decides what I "need" and who decides that I earn more or less than I "need"? |
| 2010-03-09 1:25 PM in reply to: #2716758 |
Pro 3932 Irvine, California | Subject: RE: Why do we need healthcare reform? trinnas - 2010-03-09 11:20 AM drewb8 - 2010-03-09 12:58 PM trinnas - 2010-03-09 10:53 AM drewb8 - 2010-03-09 12:39 PM Scout7 - 2010-03-09 10:01 AM I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. I think you kind of hit the nail on the head - it's a bit of a paradox - in order to make the system more fair you have to remove some choice. I'm not sure there's a good way to eliminate the problem of the freeloaders without either a universal system or some sort of mandate or elimanating insurance althogther. And I'll agree 100% that we really need to question why we have employee sponsered healthcare in the 1st place. It seems to me that it's really inefficient and stifles innovation. If it were up to me the goverment would mandate that every insurer provide some sort of basic plan, set a maximum price for the plan and then give everyone enough money to shop for one of these plans on their own. If you wanted insurance or an HSA over and above this you would be welcome to pay for it on your own (or employers could pay for all or part of it as a benefit or something, but it would not be linked to the employer) and these "extras" would be taxed to pay for everyones basic coverage. There's some reduction of choice, in that everyone would be forced to purchase one of these basic plans and pool risk, but over and above that it's still up to the individual. Also I would mandate that I be provided with mozarella sticks any time I tap my foot 4 times. Fair to whom, those who get or those forced to give? Both Hmm I wonder when it becomes unfair to the person who is having to pay for others then. Is is unfair when I can no longer afford to send my son to the tutoring he needs because I must pay for my healthcare costs and someone elses? Was it fair that my son took sack lunches to school to save money while my taxes went to give other peoples kids free breakfast and lunch. Where exactly do you draw the fair line and what is the criteria for "fair"? Who decides what I "need" and who decides that I earn more or less than I "need"? Who decides? Your elected officials, of course. Don't like the way they've set it up? Then vote them out and get folks elected who will adjust things more to your liking. |
| 2010-03-09 1:27 PM in reply to: #2716775 |
Champion 18680 Lost in the Luminiferous Aether | Subject: RE: Why do we need healthcare reform? Tripolar - 2010-03-09 2:25 PM trinnas - 2010-03-09 11:20 AM drewb8 - 2010-03-09 12:58 PM trinnas - 2010-03-09 10:53 AM drewb8 - 2010-03-09 12:39 PM Scout7 - 2010-03-09 10:01 AM I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. I think you kind of hit the nail on the head - it's a bit of a paradox - in order to make the system more fair you have to remove some choice. I'm not sure there's a good way to eliminate the problem of the freeloaders without either a universal system or some sort of mandate or elimanating insurance althogther. And I'll agree 100% that we really need to question why we have employee sponsered healthcare in the 1st place. It seems to me that it's really inefficient and stifles innovation. If it were up to me the goverment would mandate that every insurer provide some sort of basic plan, set a maximum price for the plan and then give everyone enough money to shop for one of these plans on their own. If you wanted insurance or an HSA over and above this you would be welcome to pay for it on your own (or employers could pay for all or part of it as a benefit or something, but it would not be linked to the employer) and these "extras" would be taxed to pay for everyones basic coverage. There's some reduction of choice, in that everyone would be forced to purchase one of these basic plans and pool risk, but over and above that it's still up to the individual. Also I would mandate that I be provided with mozarella sticks any time I tap my foot 4 times. Fair to whom, those who get or those forced to give? Both Hmm I wonder when it becomes unfair to the person who is having to pay for others then. Is is unfair when I can no longer afford to send my son to the tutoring he needs because I must pay for my healthcare costs and someone elses? Was it fair that my son took sack lunches to school to save money while my taxes went to give other peoples kids free breakfast and lunch. Where exactly do you draw the fair line and what is the criteria for "fair"? Who decides what I "need" and who decides that I earn more or less than I "need"? Who decides? Your elected officials, of course. Don't like the way they've set it up? Then vote them out and get folks elected who will adjust things more to your liking. So 51% of the country can vote to be supported by 49%? That sounds and awful lot like 1) a race to the bottem and 2) a version of the might makes right argument. Edited by trinnas 2010-03-09 1:32 PM |
| 2010-03-09 1:32 PM in reply to: #2716784 |
Pro 3932 Irvine, California | Subject: RE: Why do we need healthcare reform? trinnas - 2010-03-09 11:27 AM Tripolar - 2010-03-09 2:25 PM trinnas - 2010-03-09 11:20 AM drewb8 - 2010-03-09 12:58 PM trinnas - 2010-03-09 10:53 AM drewb8 - 2010-03-09 12:39 PM Scout7 - 2010-03-09 10:01 AM I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. I think you kind of hit the nail on the head - it's a bit of a paradox - in order to make the system more fair you have to remove some choice. I'm not sure there's a good way to eliminate the problem of the freeloaders without either a universal system or some sort of mandate or elimanating insurance althogther. And I'll agree 100% that we really need to question why we have employee sponsered healthcare in the 1st place. It seems to me that it's really inefficient and stifles innovation. If it were up to me the goverment would mandate that every insurer provide some sort of basic plan, set a maximum price for the plan and then give everyone enough money to shop for one of these plans on their own. If you wanted insurance or an HSA over and above this you would be welcome to pay for it on your own (or employers could pay for all or part of it as a benefit or something, but it would not be linked to the employer) and these "extras" would be taxed to pay for everyones basic coverage. There's some reduction of choice, in that everyone would be forced to purchase one of these basic plans and pool risk, but over and above that it's still up to the individual. Also I would mandate that I be provided with mozarella sticks any time I tap my foot 4 times. Fair to whom, those who get or those forced to give? Both Hmm I wonder when it becomes unfair to the person who is having to pay for others then. Is is unfair when I can no longer afford to send my son to the tutoring he needs because I must pay for my healthcare costs and someone elses? Was it fair that my son took sack lunches to school to save money while my taxes went to give other peoples kids free breakfast and lunch. Where exactly do you draw the fair line and what is the criteria for "fair"? Who decides what I "need" and who decides that I earn more or less than I "need"? Who decides? Your elected officials, of course. Don't like the way they've set it up? Then vote them out and get folks elected who will adjust things more to your liking. So 51% of the country can vote to be supported by 49% Well technically, yes, but it would never be sustainable. But let me ask you -- is that what you truly believe is happening right now in the US? |
| 2010-03-09 1:38 PM in reply to: #2716804 |
Champion 18680 Lost in the Luminiferous Aether | Subject: RE: Why do we need healthcare reform? Tripolar - 2010-03-09 2:32 PM trinnas - 2010-03-09 11:27 AM Tripolar - 2010-03-09 2:25 PM trinnas - 2010-03-09 11:20 AM drewb8 - 2010-03-09 12:58 PM trinnas - 2010-03-09 10:53 AM drewb8 - 2010-03-09 12:39 PM Scout7 - 2010-03-09 10:01 AM I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. I think you kind of hit the nail on the head - it's a bit of a paradox - in order to make the system more fair you have to remove some choice. I'm not sure there's a good way to eliminate the problem of the freeloaders without either a universal system or some sort of mandate or elimanating insurance althogther. And I'll agree 100% that we really need to question why we have employee sponsered healthcare in the 1st place. It seems to me that it's really inefficient and stifles innovation. If it were up to me the goverment would mandate that every insurer provide some sort of basic plan, set a maximum price for the plan and then give everyone enough money to shop for one of these plans on their own. If you wanted insurance or an HSA over and above this you would be welcome to pay for it on your own (or employers could pay for all or part of it as a benefit or something, but it would not be linked to the employer) and these "extras" would be taxed to pay for everyones basic coverage. There's some reduction of choice, in that everyone would be forced to purchase one of these basic plans and pool risk, but over and above that it's still up to the individual. Also I would mandate that I be provided with mozarella sticks any time I tap my foot 4 times. Fair to whom, those who get or those forced to give? Both Hmm I wonder when it becomes unfair to the person who is having to pay for others then. Is is unfair when I can no longer afford to send my son to the tutoring he needs because I must pay for my healthcare costs and someone elses? Was it fair that my son took sack lunches to school to save money while my taxes went to give other peoples kids free breakfast and lunch. Where exactly do you draw the fair line and what is the criteria for "fair"? Who decides what I "need" and who decides that I earn more or less than I "need"? Who decides? Your elected officials, of course. Don't like the way they've set it up? Then vote them out and get folks elected who will adjust things more to your liking. So 51% of the country can vote to be supported by 49% Well technically, yes, but it would never be sustainable. But let me ask you -- is that what you truly believe is happening right now in the US? To that extreme no but only slightly more than 50% of filers actualy have any tax liability so many of your fellow americans have voted to have ~50 of the country pay for all the programs they want - through their elected representatives of course. |
| 2010-03-09 1:40 PM in reply to: #2716818 |
Pro 3932 Irvine, California | Subject: RE: Why do we need healthcare reform? trinnas - 2010-03-09 11:38 AM Tripolar - 2010-03-09 2:32 PM trinnas - 2010-03-09 11:27 AM Tripolar - 2010-03-09 2:25 PM trinnas - 2010-03-09 11:20 AM drewb8 - 2010-03-09 12:58 PM trinnas - 2010-03-09 10:53 AM drewb8 - 2010-03-09 12:39 PM Scout7 - 2010-03-09 10:01 AM I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. I think you kind of hit the nail on the head - it's a bit of a paradox - in order to make the system more fair you have to remove some choice. I'm not sure there's a good way to eliminate the problem of the freeloaders without either a universal system or some sort of mandate or elimanating insurance althogther. And I'll agree 100% that we really need to question why we have employee sponsered healthcare in the 1st place. It seems to me that it's really inefficient and stifles innovation. If it were up to me the goverment would mandate that every insurer provide some sort of basic plan, set a maximum price for the plan and then give everyone enough money to shop for one of these plans on their own. If you wanted insurance or an HSA over and above this you would be welcome to pay for it on your own (or employers could pay for all or part of it as a benefit or something, but it would not be linked to the employer) and these "extras" would be taxed to pay for everyones basic coverage. There's some reduction of choice, in that everyone would be forced to purchase one of these basic plans and pool risk, but over and above that it's still up to the individual. Also I would mandate that I be provided with mozarella sticks any time I tap my foot 4 times. Fair to whom, those who get or those forced to give? Both Hmm I wonder when it becomes unfair to the person who is having to pay for others then. Is is unfair when I can no longer afford to send my son to the tutoring he needs because I must pay for my healthcare costs and someone elses? Was it fair that my son took sack lunches to school to save money while my taxes went to give other peoples kids free breakfast and lunch. Where exactly do you draw the fair line and what is the criteria for "fair"? Who decides what I "need" and who decides that I earn more or less than I "need"? Who decides? Your elected officials, of course. Don't like the way they've set it up? Then vote them out and get folks elected who will adjust things more to your liking. So 51% of the country can vote to be supported by 49% Well technically, yes, but it would never be sustainable. But let me ask you -- is that what you truly believe is happening right now in the US? To that extreme no but only slightly more than 50% of filers actualy have any tax liability so many of your fellow americans have voted to have ~50 of the country pay for all the programs they want - through their elected representatives of course. That's not true. As I mentioned (either in this thread of another), that's only regarding federal income tax. If you consider payroll taxes as well (which fund Social Security and Medicare), the number of folks with no tax liability falls to around 24%. |
| 2010-03-09 1:41 PM in reply to: #2716648 |
Champion 6056 Menomonee Falls, WI | Subject: RE: Why do we need healthcare reform? Opus - 2010-03-09 12:42 PM scoobysdad - 2010-03-09 9:58 AMUm, according to your figures, THE SUM OF THE REVENUE FROM EVERY OTHER COUNTRY IN THE WORLD COMBINED does not equal the revenue generated by America for most of the companies you cited. Sure, collectively it's significant, but on a country-by-country basis, not so much. They make their money in the US. It also doesn't matter where the companies are based, it matters in what countries they sell their products and make the most money. IMO, this excerpt presents logical reasoning and sums it up pretty well: http://www.realclearpolitics.com/articles/2009/07/23/health_care_my... Here's what happens. We have a partially free market in the US where drug companies spend a ton to develop new wonder drugs, much of which is spent to satisfy regulatory requirements. The cost of this development is called a "fixed cost." Once it's developed it does not cost that much to make each pill. That's called a "variable cost." If people only paid the variable cost (or even a bit more) for each pill, the whole thing would not work. The drug company would never get back the massive fixed cost of creating the drug in the first place, and so no company would try to develop one. Thus, manufacturers have to, and do, charge more than the variable cost of making each pill.[3] Some look at this system and say to the drug companies "gee, it doesn't cost you much to make one more pill, so it's unfair that you charge much more than your cost." They are completely wrong and not looking at all the costs. So, let's bring this back to our good natured friends to the North (good natured barring hockey when they'll kill you as soon as look at you[4]). They have socialized medicine and they bargain as the only Canadian buyer for drugs, paying well below normal costs. Drug companies that spent the enormous fixed costs to create new miracles are charging a relatively high cost in the free and still largely competitive world (the US) to recoup their fixed cost and to make a profit. But socialist societies like Canada limit the price they are allowed to charge. The US-based company is then faced with a dilemma. What Canada will pay is not enough to ever have justified creating the miracle pill. But, once created, perhaps Canada is paying more than the variable cost of each pill. Thus, the company can make some money by also selling to Canada at a lower price; as it's still more than it costs them to make that last pill.[5] This isn't the whole story. When a company develops a new drug, they own the exclusive rights to it for a number of years (10, I think). This is part of how they recoup their costs. Sure, it costs tens if not hundreds of millions to develop drugs and the companies need to have the opportunity to recoup their costs and make a profit for that effort to be worthwhile. It's a bit of a leap though, to say that Canadian meds are cheaper ONLY because US meds are more expensive. I would say it is due to the fact that there is a single payer system and MAY have something to do with the fact that they can gouge Americans freely though insurance companies. Ultimately though, your freedom to choose insurance coverage also includes the freedom to get screwed over by them and pharma companies - which seems to be a widely exercised freedom, from what I can tell. It's an interesting thing that people would rather trust a for-profit insurance company to administer potentially life-saving health benefits because the spectre of government ineffeciency when it is clear to anybody who has worked for a large corporation that inefficiency is not the exclusive province of government. Corporate efficiency is complex and difficult to implement and the returns are often difficult to quantify. We all know, though, that efficiency, even if it is implemented to the highest possible degree will only lead to the hunt to find other ways to make more money. So then, they usually go for the quick hits in the form of cost cutting. Where is the biggest cost to insurance companies? Hmmmm. But the last paragraph was a big digression, if the issue is that drugs are too expensive in the US as compared to the rest of the world, I would suggest it is your model that is broken, not the rest of the world's. If you insist on holding onto a model that allows drug companies to gouge you for prescription meds, well, don't blame Canada.
I'm not blaming Canada, nor am I defending the current US system. People love to cite statistics saying countries with universal healthcare pay less to deliver comparable care. I'm saying there are many reasons for that beyond that UH countries magically somehow do things more efficiently. It's just that the current American system allows these companies to let the American people subsidize healthcare globally. If the American system weren't as it is, the Canadian system couldn't be as it is. I also agree with you in not trusting enormous for-profit companies anymore than I trust government do behave efficiently and do right by consumers. I trust the free market. I trust individuals being provided with real costs and information on their healthcare to make smart decisions. I trust in providers having to compete for business. And I believe that people, for the most part, should have to save for and spend their own money on healthcare just like they have to budget for food, rent or any other living expenditures. Of course, that's a bit simplistic. There also has to be some sort of coverage for catastrophic conditions. But it's heck of a lot better start than what we have now and what is being proposed. |
| 2010-03-09 1:44 PM in reply to: #2716823 |
Champion 18680 Lost in the Luminiferous Aether | Subject: RE: Why do we need healthcare reform? Tripolar - 2010-03-09 2:40 PM trinnas - 2010-03-09 11:38 AM Tripolar - 2010-03-09 2:32 PM trinnas - 2010-03-09 11:27 AM Tripolar - 2010-03-09 2:25 PM trinnas - 2010-03-09 11:20 AM drewb8 - 2010-03-09 12:58 PM trinnas - 2010-03-09 10:53 AM drewb8 - 2010-03-09 12:39 PM Scout7 - 2010-03-09 10:01 AM I agree that a big part of the problem is the spreading of costs, both within the current system and all the proposed changes. If anything, that is my primary concern, because that does primarily come down to removing choice. So far, all the proposed systems do nothing to address this. And ultimately, the only fair system in that regard is to move towards a single-payer system, or the complete elimination of insurance. There might be others, but it means that you are solely responsible for the costs incurred, not others. The question remains: how do we develop a system that is fair? Obviously we cannot all agree on one system, but whatever system enacted had better at least be fair to everyone. Something I have not seen discussed in all of this is why we have employee-sponsored insurance in the first place. It was not always like that. It came about as part of employee benefits packages because the federal government put salary caps on a lot of industries. So companies had to find new ways to attract quality management and employees, and thus begin offering health insurance as an incentive. Obviously, rising costs in care contributed as well, but we don't think about the role of government intervention. I think you kind of hit the nail on the head - it's a bit of a paradox - in order to make the system more fair you have to remove some choice. I'm not sure there's a good way to eliminate the problem of the freeloaders without either a universal system or some sort of mandate or elimanating insurance althogther. And I'll agree 100% that we really need to question why we have employee sponsered healthcare in the 1st place. It seems to me that it's really inefficient and stifles innovation. If it were up to me the goverment would mandate that every insurer provide some sort of basic plan, set a maximum price for the plan and then give everyone enough money to shop for one of these plans on their own. If you wanted insurance or an HSA over and above this you would be welcome to pay for it on your own (or employers could pay for all or part of it as a benefit or something, but it would not be linked to the employer) and these "extras" would be taxed to pay for everyones basic coverage. There's some reduction of choice, in that everyone would be forced to purchase one of these basic plans and pool risk, but over and above that it's still up to the individual. Also I would mandate that I be provided with mozarella sticks any time I tap my foot 4 times. Fair to whom, those who get or those forced to give? Both Hmm I wonder when it becomes unfair to the person who is having to pay for others then. Is is unfair when I can no longer afford to send my son to the tutoring he needs because I must pay for my healthcare costs and someone elses? Was it fair that my son took sack lunches to school to save money while my taxes went to give other peoples kids free breakfast and lunch. Where exactly do you draw the fair line and what is the criteria for "fair"? Who decides what I "need" and who decides that I earn more or less than I "need"? Who decides? Your elected officials, of course. Don't like the way they've set it up? Then vote them out and get folks elected who will adjust things more to your liking. So 51% of the country can vote to be supported by 49% Well technically, yes, but it would never be sustainable. But let me ask you -- is that what you truly believe is happening right now in the US? To that extreme no but only slightly more than 50% of filers actualy have any tax liability so many of your fellow americans have voted to have ~50 of the country pay for all the programs they want - through their elected representatives of course. That's not true. As I mentioned (either in this thread of another), that's only regarding federal income tax. If you consider payroll taxes as well (which fund Social Security and Medicare), the number of folks with no tax liability falls to around 24%. Sorry I meant to say income tax. However you failed to answer the original queston when does it become unfair to take from one to give to another? |
| 2010-03-09 1:49 PM in reply to: #2712366 |
| New user 900 , | Subject: RE: Why do we need healthcare reform? Just a couple of thoughts on some things mentioned. The idea that we need healthcare reform so that everyone will be a healthier, happier, more productive member of society is wishful thinking. A large majority of people in this nation only care about their health when it goes downhill. The reality is most people don't care about wellness and don't want to put forth any effort to live a healthly lifestyle. |
| 2010-03-09 1:59 PM in reply to: #2716758 |
Master 4101 Denver | Subject: RE: Why do we need healthcare reform? trinnas - 2010-03-09 12:20 PM Hmm I wonder when it becomes unfair to the person who is having to pay for others then. Is is unfair when I can no longer afford to send my son to the tutoring he needs because I must pay for my healthcare costs and someone elses? Was it fair that my son took sack lunches to school to save money while my taxes went to give other peoples kids free breakfast and lunch. Where exactly do you draw the fair line and what is the criteria for "fair"? Who decides what I "need" and who decides that I earn more or less than I "need"? All good and important questions! When is your benefit from giving other kids free breakfast and lunch (since presumably this increases their chance of doing well in school, growing up to be productive members of the economy rather than going to jail and costing us more in the long run) lower than the amount in taxes you pay to support those programs? Honestly, I don't know, I'm sure people can come up with equally valid yet different results. Is it fair that I can't afford a tutor for my kid because they raised my insurance rates to cover the people who chose not to pay for insurance themselves but who still receive care? Like you said, how do you draw the line for 'fair' when everyone has a different definition? |
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