While we're in the middle of dealing with my sister's never ending health care problems, I thought it might be a good idea to focus on the system as a whole. The American health care system is failing horribly, as evidenced by Michael Moore's new film 'Sicko'. Universal Health Care is the way to go, and surprise, surprise, some of the candidates have plans! (Though they're not QUITE universal). and before we get into the whole, "a welfare state is a bad thing" debate, let's just discuss the fact that many people who HAVE health insurance and full-time jobs still can't afford proper health care because what they need is not covered on their plan. Kusinich probably has the best ideas, for this as well as most other things, so it's a pity that he'll never be elected (some TV stations are editing him out of the debate completely).
Some other health care stories: Stressed-out moms are at higher risk for mental health problems. It's too bad that psychologist appointments aren't fully covered under most health plans, especially if you need to see someone more than six times a year - and that includes family counseling, individual therapy, and marriage counseling. Military Veterans don't get much more help than the rest of us, so it's a good thing we're supporting our troops.
These people no longer need health care: 3,494 US Soldiers killed in Iraq
These people will need health care for the rest of their lives: 25,549 US Soldiers wounded in Iraq.
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34 comments:
Your sister's health problems obviously has sensitized you to the problems and woes of the American health care system. I work in the health care system myself, and can attest to how the high costs have driven up deductibles to the point of lunacy.
HMO's make it difficult to for healthcare providers to give the treatment the patient needs, for fear of not getting paid. I also see it first hand and have concerns.
However, what you propose as an answer to these woes seems a bit utipian. I too am looking for solutions, but I am unconvinced that the government can do a better job than the private sector. Didn't you have a post on the terrible conditions of Walter-Reed Medical Center in Washington? That is the type of health care I fear.
It may be worth our while to hear from friends who live in countries who have universal health care to let us know the good AND the bad so that we can correctly compare the two modes of health care. Assuming that universal health care is the way to go seems to be 'jumping the gun.'
Just a thought...
People die in countries with universal heath care too.
I'm very sorry to hear about your sister's health problems. We're dealing with stuff we'd rather not as well.
I'm quite confident we'll have some type of socialized heath care system in the near future, so the Micheal Moore's of America will have their way. Reason doesn't stand much of a chance against such passionate emotional arguments.
I only wonder if anyone is listening to this man.
United, I agree. Among the world leading economies, the US has the most expensive and least effective health care system. I posted an article on it yesterday. I think the reason is that what they spend for health care goes to people's health care. Much of what we spend for health care goes to huge profits for Big Insurance and Big Pharma. While single-provider health care may not be a perfect solution, the numbers don't lie, and for the 46 million of us with no health care, anything would be an improvement.
The private sector can do no better than the government can. The private sector has the "profit motive" to "increase efficiency", but that increase in efficiency only serves the profit, not the consumer. Yes, the government has problems with inefficiency and waste, but, guess what, those can be corrected through oversight, and theoretically oversight by anyone. Ever checked the level of transparency in a contracted provider? Even your own?
Dont worry, though (this applies to UL and Scott; UWL can keep on worrying), because whatever "reforms" get passed in the next wave will be, at best, lip-service. As long as there is a middle-man taking a (big) cut of the money "administering" our health care, as long as Drug Companies spend as much money on marketting as they do on research, as long as doctors have to put themselves through medical school and then go where the money is to pay for that education, the system will not make any significant changes.
Actually, all of the above have nothing to do with it: As long as most of the money in races for elective office come from corporate donors, nothing is going to change.
I'm skeptical of fully-socialized health care at this point as well. However, I think we need to start slowly transitioning our system toward it. We can work out bugs along the way. It cannot be a simple transition like flipping a switch. We certainly need a system that listens to what the doctors say is best for their patients rather than to the HMO accountants and Pharm Lobbyists.
People's health should not be subject to the discretion of a pencil pusher focused on the bottom line.
Mental health care is abysmal in this country. I knew someone with severe anorexia whose family was forced to put admit her to an in-patient substance abuse program because that's all their insurance would cover. Needless to say she got no help whatsoever. Her outpatient plan by our employer several years later was little better.
We need a system that provides WELLNESS care, real health care, not just, "sick care." Most people cannot afford preventative medical attention - that alone would drive down the costs of the system tremendously.
The private sector can do no better than the government can. The private sector has the "profit motive" to "increase efficiency", but that increase in efficiency only serves the profit, not the consumer.
sigh.
Our country is educated by rhetoric rather than economic science. This reminds me of what Mike Moore said on the Bill Maher show the other day. Something to the effect that private insurance companies only seek to serve their share holders through profit and the only way they can do that is by screwing customers.
Yeah.
If the private sector can do no better at providing services than the government, why don't we have the government provide hot dogs, haircuts, or computers? People need those just as much as they do aspirin.
Those business are regulated by the two things:
1) Massive competition. We got computer and hot dog companies out the wazoo. You know what's expensive? Operating systems. How many choices do you have there?
2) More importantly, you dont have to buy hot dogs or haircuts or even computers. Anytime that you have no choice but to buy something, that's when you're most likely to be screwed. Insurance is a prime example; got homeowners insurance? Has it gone up lately? How about auto insurance, which most states require (not that I think this is necessarily a bad thing). And who can get health care anymore without health insurance?
Do you live someplace where electricity was deregulated? I do, and it doubled in cost. Why, when "competition" was supposed to lower prices? Because the most cost-lowering choice that you can make is to say "no". When that choice is not an option, then all that's left to lower costs is the benevolence of the Market, which does not exist, or government intervention.
The market ultimately answers to stockholders, not consumers. As long as the stock provides a "good" return, nothing will change. A loss of return, as caused by lagging sales, is often combatted with a lowering of the price to bring in more customers, hopefully in numbers enough to regain profits (price-lowering is also often accompanied by cost-cutting, usually resulting in a lower quality, if cheaper, product).
If there is no loss of customers though, prices will not be lowered because that would cut into profits (the profit motive, however, does not stop cost-cutting measures, in fact it encourages them).
Government, on the other hand, is (in theory) beholden to the People (or, in our case, K-street), so it responds to the people's needs regardless of whether or not it is profitable.
Daveaway:
No doubt pharmaceudical costs are atrocious, but have you considered why? Is it because they are mean capitalists looking to make big bucks off of sick people? Not entirely.
Look at the amount of money a company like Merck has to invest in research and development of a drug, and then pay the fees, and do the testing for drugs to be authorized by the FDA to be sold to the public. This doesn't take months, it takes years, up to 10 years.
In addition to these costs, say a drug causes some guy named Uncle Fester's hemorroids to bleed and he sues Merck for damages, pain and suffering. He wins big, and anti-Capitalists cheer Yahoo! cuz Big Pharmaceudical Merck got screwed in court. Merck then alters the pricing to offset its losses from the lawsuit and the consumer takes it on the chin. Can anyone say TORT Reform?
I think the situation is much more complex than what you had described. I think it requires a more careful look.
Here's a question...Is health care a right? If so, how so and why?
Health care is absolutely a human right. If we value the ability of each individual to exercise his/her voice in our political/economic system then we must value everything that makes that participation possible. A liberal democracy works best when everyone participates right? Ideally, if everyone has an equal opportunity to participate. So if people are unable to fully participate because their health prohibits them (physically, mentally or financially) from full participation, then we do not have an equal starting point for all as we claim to have. The poor share several things in common across racial/ethnic and national boundaries: Their poor health and their limited political participation. People have far less time and energy to ponder the inner workings of a system that requires their participation if they're worried about more immediate concerns like their physical well-being.
I also think that full dependency on the free market is also a utopian solution because it requires individuals to pick up the slack for their fellow citizens in need. Someone who cannot afford health insurance has got to get health care from somewhwere, and I doubt the philanthropy of self-interested individuals to willingly give up some of "their" earnings to help those in need. A free market system would require either A) we let them eat cake or B) a safety net that comes from willing participation from the masses, since there is no obligitory government system to pay into.
UL: I prefer to look at the money a company like Merck spends on marketing, rather than research, since the two are roughly the same. You know marketing, that's those glad-handing fellows who drop by doctors offices with coffee mugs and free samples and take everyone to lunch, or those obnoxious commercials which try to convince you to "ask your doctor". Is it necessary for the medical profession? No, but it is "necessary" for profit-making, especially when those reps are recommending the drug be used for something it wasnt developed or tested to do.
As for tort reform, it's a good idea that is being skewed, twisted from getting rid of nuisance suits (good) to getting rid of liability for companies (bad). I'd love to see some sort of reform to limit stupid and obnoxious lawsuits. Unfortunately, the way it seems to always work out is that stupid lawsuits continue, but nobody (including truly worthy cases) gets any big money anymore.
Also, you cant complain about the time and cost involved in testing, and then call for tort reform also. If you'd like to beef up testing, along with tort reform, that'd be great, but otherwise, how do you ensure the public safety (as opposed to the safety of corporate profits - which is more important, do you think?)
Yes, the situation is more complex, but only in the fringe details. Basically this is how it works, and while I can look as carefully as you like, I'll only find exceptions.
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@ Laura: "If we value the ability of each individual to exercise his/her voice in our political/economic system then we must value everything that makes that participation possible."
You're making a big assumption there. I'm not sure that a large part of the American public does believe this.
A much better arguement is the economic one: that a healthy populace is more productive than a sick one. That a preventative (wellness-based) health-care system is more cost-effective than an emergency-based one. Even slave owners knew that, even if they didnt always practice it.
Unfortunately, that arguement works better when one is talking to fiscal conservatives, rather than the cold-war raised social conservatives running the Republican Party now. This batch appears to believe that poor and sick people deserve to be poor and sick, just as rich people deserve to be rich and healthy.
UL,
Hmmm... do you really think that someone like me who has to plan everything and get as much information as possible HASN'T asked my friends who live in (or are from) the UK, Ireland, Canada, Germany, Argentina, and Colombia. I know the good AND bad points. I also know that the wealthiest nation in the world should be able to IMPROVE upon the system in other countries and do it better. Why does everyone assume that because there are problems with other systems that they are wrong? Problems are solutions waiting to happen. And you people think I'm pessimistic.
Scott,
Thanks. I hope your situation improves as well. I think the most frustrating thing is having drugs available that will help greatly, but not being able to actually USE them. That, and the astronomical cost of health care - that's WITH insurance, by the way. I checked out that video and I need to watch it again. It's true, people do die in countries with Universal Health Care, but not because a hospital turned them away for emergency care. No system is perfect, but again, isn't it better to look at the problems with a system and improve it rather than ignore the need comepletely? What if we just refused to improve the education system because those countries who are doing it better have problems, too? Do no one else see the HUGE FLAW in this argument?
UL - I do believe the founding fathers said something about LIFE, liberty, and thepursuit of happiness. It's difficult to have the right to life if you don't have health care.
Dave: The economic argument does hold up better. It just leaves a bad taste in my mouth. I try to resist, as much as possible, thinking of people as human capital resources rather than human beings.
UWL:
You wear your comments too closely to your heart. Can anyone honestly disagree with you without you taking it personally?
As to the question about us having the right to health care, I am posing the question to see what people think. You read into my question and assume the worst. Please stop this. It skews the discussion and creates more heat, less light.
Having good health, I believe is a human need. Any health care that supports this need is necessary and therefore needs to be developed. Is this something that must be available for free? No, I don't think so. Do the rich have to be forced to pay for the health care for the poor? This is where it gets sticky and where some want the government to re-allocate income from the rich to the poor for healthcare. Talk about Fascism and Marxism!
Government controls that deplete the rich for the sake of the poor sounds wonderful and utopian (and certainly feeds our lust for revenge), but as governments go, will inevitably corrupt the system. It is here that I have by druthers. I do not trust governments to do what can be done by the people. Power and money corrupts, and to suffer corruption in health care will create a human toll much worse than what we are seeing today in our own system.
I do not trust big government to solve our ills; certainly not in health care. This calls for a populace that cares for its own, which requires a moral and charitable populace. A self-centered greedy and hedonistic populace is not inspired to take care of poor and therefore must be controled by government. At this point, the alternatives to big government controls are a populace that is motivated to care for their own.
This leads to the question: "What will motivate us and how can we solve this problem without having the imposition of government controls?"
It's true, people do die in countries with Universal Health Care, but not because a hospital turned them away for emergency care.
No, but life or death decisions are still made by the heartless bureaucracy. If people are deemed terminal by the State they don’t receive the most aggressive or experimental treatments possible, because it’s not cost effective to the whole of society. So someone always makes those decisions. I am of the belief that individuals are best fit to make decisions about their own health care.
No system is perfect, but again, isn't it better to look at the problems with a system and improve it rather than ignore the need comepletely? What if we just refused to improve the education system because those countries who are doing it better have problems, too? Do no one else see the HUGE FLAW in this argument?
I guess I’ll respond to this on the new post that you made that seems to be directed at me. :)
Lest anyone doubt my cynicism for the free market to act commonly decent ways without oversight...
I bring you Booze2Go...
Is there any reason for this product other than pure profit? Let's face it, any system that relies solely either on government OR the free market will be flawed.
"Do the rich have to be forced to pay for the health care for the poor?"
Did the rich become the rich without the help of the poor? There's a lot of wealth created in this country by a lot of hard-working people, but only a very few reap the (large) benefits. So yes, since the rich dont feel like sharing "their" wealth with the people who helped make it, they do have "to be forced to pay for the health care for the poor".
Wealth is made in this country because of its people, not in spite of them.
Scott,
Not just you. I hear this from a lot of people.
Daveaway:
Don't get me wrong. I'm not against controls, but how you implement them. Taxation for the redistribution of wealth penalizes the wage earner across the board. It is ineffectual in preventing injustices to the poor.
This is why I'm still in favor of guilds, etc. that insure a just wage and price. Industrial capitalism creates injustices as well as Marxist/Maoist "reforms." The rich already pay a lion share of the tax burden, which may or may not engender pity. Be that as it may, the middle class gets squashed in the battle, which is precisely the target of Marxism: eliminate the middle class. This is certainly unjust.
"Guild"? You mean a Union?
I believe that the middle class is shrinking in this country, is it not? Certainly if you call the middle class those who own things free and clear, it is. Is all this debt just financial fashion, or stupidity?
The middle class is not hated only by Marxists. Feudalists hate it too, because it has less control over it.
It always fascinates me, the individual first attitude of the majority of the US to public services; why not pull together to provide care for all?
Scott: "heartless bureaucracy"? Sounds like you've been reading too many Kafka novels...
Daveaway:
No. I mean guild. Such as a merchants guild, shipping guilds, etc. that actually keep the commerce in an industry or trade honest and fair. It implies a populace exists that will only work with companies who are a part of guilds. This requires a strong moral conscience in the population, something I don't think we enjoy universally.
Unions, however, deal labor vs. management in individual companies and does not police the practices within the industry. Unions are good as union people are good, but it doesn't go far enough to bring a check to the industry.
Unbridled capitalism does not foster justice...AND, I might add, neither does socialism.
Unbridled anything is bad UL.
Scott: "heartless bureaucracy"? Sounds like you've been reading too many Kafka novels...
Never read him.
Pardon me whilst I give a hearty guffaw!
UL, guilds were not set up to "keep the commerce in an industry or trade honest and fair". They were set up as a way of controlling prices, just as a union is set up to control wages. Both work the same way, collective bargaining power and control of supply.
"Unbridled capitalism does not foster justice...AND, I might add, neither does socialism. "
Agreed. Which is why you should have a mix. Goods and "unnecessary" services should be free market. Necessary services and infrastructure should be regulated.
As a caveat though, I would add that it should not be regulation like we have today. Much of the regulation we see today is made (via lobbyists and campaign-contribution access) by the industries that are supposed to be reined in by that regulation, but are instead given cover for their less than ethical behavior (how familiar is this phrase anymore: "We/I have done nothing illegal"?)
@ Scott: I just reread this comment, and have to respond:
"People die in countries with universal heath care too."
response: Yes, but do they die for profit?
No, they die for the common good.
It always fascinates me, the individual first attitude of the majority of the US to public services; why not pull together to provide care for all?
The question is not whether or not we should pull together; no one is suggesting your argument that we partake in an every man for himself society. The question is whether care can be provided for all (that is a diverse multitude of individuals present AND future) better through services provided by a multitude of unique individuals at a local level with several different options for taste, style, need, and appetite, or services provided by a monopolistic State run by a handful of bureaucrats that necessarily cater to the lowest common denominator so as to provide for the most possible.
Daniel:
Yes! You and I agree. How does it feel? LOL.
HOW DO WE BRIDLE? IS THE QUESTION. It requires the knowledge of standards by which to judge either personal or collective action. Otherwise, whoever has the guns has the standards.
"with several different options for taste, style, need, and appetite"
???!!!
Are we talking about restaurants or medical care here? Like schools, it should be a public service, not an opportunity to make profit at the expense of the whole society. Libraries, fire departments, and the police seem to do just fine as government monopolies. Or would you rather see that farmed out, also?
If you think health care is a one size fits all service.... well, okay.
At any rate, everything the government provides is merely a service. Something we all pay for, and pay for every day. NONE of it's free, and the fact is we get much less in return for what we put into the system because so much is wasted in typical State bureaucratic inefficiencies.
The police are merely a agency of protection. There are plenty of people who get protection from private agencies. I see no reason protection can't be provided outside of the coercive, parasitic State.
The more Scott writes the less seriously I can take him, first off he's read no Kafka, then he states that people die for the common good which is all a little bit 'Reds under the beds' for me.
I have a deep mistrust for people who fear collective services in key areas.
As I've said endlessly, public funded healthcare works marvellously in the forward thinking nations that use it but hey, what do they know...
I'm aware that none of it is free, but then, I'm not a tax hater, either. Not that I like taxes, but I understand their necessity, just as I understand the necessity of transparency, (citizen) oversight and review in the spending of those tax dollars.
And yes, until aliens land on the planet, one size of health care will fit all, seeing how we're all human beings.
We pay the lowest taxes of the industrialized world. Our cost of living is lower for some things, but not what's important. What we pay for prescriptions, gas, and milk is really high compared to what it costs to make.
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