America's Health Care: Paying More for Poorer Outcomes

"What would happen if we devised a health-care system like one of theirs? Why do we think our costs would go up, when theirs are considerably lower than ours?"

Good points! But let's make sure we have a healthcare system "like one of theirs." The current approach would be nothing like a European system. Europeans have rational socialism. They understand that you can't have universal healthcare without cost controls, so the state sets the prices of drugs, hospital care and doctor salaries. That keeps their costs down.

The current bill before Congress is nothing at all like a European system. It will not control costs at all. So costs will explode and premiums will follow. I'm not in favor of socialist medicine, but it is definitely preferable to the messed up system we have in the US.

I have asked these same questions over and over again, but the only response I ever get is "SOCIALISM!"

Those who are opposed to Medicare for everyone do not have an economically valid argument, other than "SOCIALISM!", and an apparently unshakable belief that, despite our phenomenal successes in other areas of endeavor, the United States of America is fundamentally incapable of achieving the health improvements and cost savings all those other countries have.

It's so sad, really - we could have had a system that was simpler, covered everyone, has demonstrably better health outcomes and demonstrably much lower costs for all of us, but because of the irrational fear of "SOCIALISM!" we refuse to adopt it.

We would rather sacrifice tens of thousands of lives, have the unhealthiest population in the developed world, and be left behind in the economic dust of the nations who are not burdened by such outrageous health costs.

Yes, we're blindly marching down the road to becoming a third-world health system, but at least we're not "SOCIALISTS!"

It is simplistic thinking that always associates some form of universal coverage with socialism given the number of capitalist countries that have implemented such health systems for their citizens. These countries also spend only 10-11% of their GDP on health as compared to the 17% spent by the US.

It is also simplistic to associate consumer buying patterns with health care. The vast majority of us won't go to the clinic or the hospital just so we can get more health care than the next guy. Health care is not something that we are eager to receive, but rather it is something we need on occasion with some of the more unfortunate among us needing it more often than others. However, having that security blanket benefits all of us, because we can never predict how sick or injured we might become and just how much that might cost us.

You describe health measures, healthcare expenditures, and paradigms of government provision of health services. If we had a universal system-which of these would change? Where would improvements occur?

If we passed the current proposal--where would improvements occur?

Is it possible we spend so much on healthcare because our health is so bad--versus deciding that it is a dysfunctional system that causes the bad health?

The high cost acute care system we have is the flipside of crappy health and a society that seeks a therapeutic/technological solution to every problem.

Would a universal system alter that equation?

All that said--I don't know why Obama did not put forth a single-payer system and aggressively make the case.

Technology, insurance companies, physicians, hospitals - everyone wants to blame someone for the health care "crisis". The fact is we, as Americans are fat and lazy.

I want health care reform. I believe that the right to life is one of our God-given natural rights.

However, I cannot support single-payer or even a public option. Unfortunately, the American culture and character are not like those in Europe, Canada, or Japan, where they have more-or-less single-payer systems. Instead, in the U.S. we are very obsessed with rooting out "malingers" and "cheaters;" all one has to do is look at our current Veterans Administration and Social Security disability claims. So what happens is that a person will try to get VA or SSA health care and are denied by government bureaucrats on the grounds that they "don't really need it" or "aren't truly disabled" or are "trying to defraud the government."

In the U.S., we have an entire industry of lawyers that specialize solely on appealing denials of SSA/VA health claims. Believe me, if we had a single payer in the U.S., it would be more of the same.

Of course right now, private insurers in the U.S. are doing exactly the same thing. This is because we do not have a true free market. Because the health insurance industry is exempt from anti-trust laws, there is a monopolistic health insurance cartel.

So instead of a single-payer plan or public option, what we need are reforms that break up the monopolistic health insurance cartel and bring back a true free market. That way, if one company denies care, a person can go to another company in a free competition.

"I have asked these same questions over and over again, but the only response I ever get is 'SOCIALISM!'"

You hit the nail on the head. Those people who oppose the current Congressional proposals are offering no alternatives. Instead, the (mostly) Republican politicians are sitting there saying "NO" and "Socialism!"

I'm a free-market supporting libertarian. I would love to see an alternative to what has been offered. I am opposed to a single-payer system as they have in Europe because it wouldn't work in the US. Instead, we'd be seeing scenarios such as what is happening currently within the VA where soldiers are constantly being denied treatment and having to hire lawyers to appeal. This is because, unlike Europe, the US has set up an adversarial system of benefits -- the person has to prove that he/she "really needs" the services being sought. The solider can't walk into the VA and say, "I have strange symptoms of nausea" or "I'm getting nightmares and flashbacks" and expect the people in the system to just take their word for it and give them treatment. Instead, each case is adjudicated and is granted or denied.

But we also have the the "private" health insurance monopoly cartel operating the same adversarial way, denying people care. This isn't a free market, it's a sort of socialism, a single-payer system where people don't even have a say in how it's run because it's supposedly "private." But there is no competition. It's one giant cartel that sets policies and rates.

The Repubs blew it. They could have come up with a free market alternative to the current Congressional plans and pushed hard for it. Instead, they have situated themselves as "the Party of No", just wanting to block all reform and leave things the way they are and scream "socialism!" These tactics set the Repubs up as wanting to support the health insurance monopoly cartel. And this is going to backfire. Most American people might distrust government, but they hate the health insurance monopoly cartel even more.

"The adult mortality rate (the probability of dying between 15 and 60 years per 1000 population) for the other ten countries ranged from 78 (Sweden) to 124 (France). The U.S. came in last, at 137."

Obamacare will make a big difference here since this is due mainly to car accidents and homecieds.

I think that part of the reason the system is so adversarial is because we have so severely limited the resources. The VA has to compete for limited resources because we do not, as a nation, actually believe in providing quality care to our veterans. if we did, we would make darned sure we adequately funded the VA!

Had we not had the Bush tax cuts, and had the Republican congress decided to actually FUND the drug benefit they passed for medicare, the medicare system would be in a lot better shape, too. As it is, medicare has to scrap for limited resources.

I believe we could provide much better funding and still spend less, totally, than we do now, if we went to a Medicare for everyone single pay system.

We disagree about the viability of Medicare for everyone :).

I have an idea. Lets stop using the word "socialist" and come up with something catchy that will be more palatable to those who are so scared of this dreaded disease of "socialism". Most people don't even know what socialism is anyway.

All that said--I don't know why Obama did not put forth a single-payer system and aggressively make the case.
It's just a guess but I think he realized that would be too much change too fast for us. Too many of us are too comfortable with the way things are and we resist change. The enemies of change have spent millions to defeat this thing and have fooled a lot of people. The one good thing about all this discussion and rancor is that people are learning more about insurance systems and politics .

As I see it now, assuming the bill passes on Sunday, we have gotten the rocky boat across the rapids and now we have a lot of repair and rebuilding to do.

Actually, when asked specifically, around 66% of Americans repeatedly say that we WANT Medicare for everyone.

Unfortunately, the President is just as much beholden to corporate health interests as the Congress is, and the President is the one who would not even allow single-pay advocates a seat at the table or a voice in the process.

It was never even considered - not because it would be too much change for Americans, but because the profits of the health insurance industry, and hence the money flowing to the political parties would have been jeopardized.

There's a LOT of repair and rebuilding that needs done once this thing passes!

"Let's stop using the word 'socialist; . . ." How about we call it, "Good health care for all."

Or, call it Medicare for Everyone :)!

Everyone knows medicare, no one who has medicare wants to give it up, most who pay whatever for health care now look forward to the day when they'll be eligible for medicare.

But, also importantly, a lot of senior tea partiers who have and take advantage of medicare are among those screaming the loudest about "socialism".

If we start calling it Medicare for Everyone, we might help them make the connection and begin to become rational, thinking citizens again :).

how about "enhanced free market optional pro-life care"

Patricia, I'm a retired Baptist minister (well, I have become a methodist
since retirement--no Baptist church near me I wanted to be affiliated with)
and of course on Medicare along with my wife who is also Patricia. I love
that socialist program. Without it we would be either bankrupt or dead,
maybe both. I don't know how the health care bill will impact us. Very
little I think. I was hoping we would have universal, single payer
coverage--Medicare
for all if you will. Maybe someday.

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