Jay wrote:
Bertster7 wrote:
A few points.
1. Why does everyone seem to assume that a universal healthcare system would eliminate private healthcare? Most countries with universal healthcare have thriving private healthcare systems. In the UK for example, you can go public and have very limited choice and longer wait times, or you can go private and have as much choice as your insurer permits you to (usually lots) and have very short wait times.
2. If national healthcare systems are less efficient, then why are the costs (to the healthcare system, not the consumer) for drugs far lower for countries such as France and the UK than they are in the US?
Personally, I don't believe that a public healthcare system is more efficient, so I doubt that is the answer. However, there's a lot of evidence to suggest that these prices in the US are artificially inflated by the insurance companies and the pharmaceutical companies to keep profits high. This is the sort of problem with private only systems.
3. If the system is funded by insurance in the US, why does the US taxpayer pay more per capita than the British taxpayer for healthcare? Could it have anything to do with the fact that due to the scale and complexity of the insurance system, 30% of healthcare spending in the US ($2.5 trillion in 2009) goes on administrative costs.
4. If the US system is so great, why is life expectancy there low in comparison to other similar countries?
5. 20000-45000 preventable deaths each year due to lack of health insurance in the US. Doesn't this seem like a bad thing? Or is the overwhelming opinion in the US "fuck 'em"?
To me, it seems like a government run healthcare system is a necessity. The government mandates that healthcare should be available to everyone whether they have insurance or not, surely they need to provide that healthcare, not pass the responsibility to private companies? However, choice and better quality care should not be removed - they should be provided to those who pay for them.
I'd like to see a universal, entirely government funded system in place as the baseline, then a more premium service for those who are insured.
What would happen? Who can say - it's really fucking complicated in the US because of the madly arcane insurance system that has built up and that needs to be thinned off a bit. What isn't complicated looking at a system that is almost twice as expensive as its competitors and yet does not match the average levels of performance from them, is deciding that change is needed - as it stands all your money is being siphoned away by insurers in administrative costs (nearly a trillion dollars a year).
1) Who cares?
2) Because you use generic drugs that we researched for our own market, at cost. You're intellectual leeches.
3) Less than 15% of costs are administrative. Are you saying the government workers would be more efficient and it would require less of them to perform the same job? Because that's the only way you'd cut down on those costs. That, or removing the reamloads of regulation compliance forms that are required to be filled out on every patient by the government.
4) Shitty diet. You ever seen an old fat person? Also, we tend to fight more wars than other nations, so that factors in too. Other than that, shrug, dunno. My grandparents are in their 90s.
5) You do realize that everyone in the US does have a baseline to fall back on, ya? Everyone can go to the hospital and receive treatment whether they have insurance, the ability to pay, or nothing at all. It's the law. But man, those numbers look big, right? What counts as a preventable death? Smoking? Drinking? Driving without a seatbelt? There are lots of preventable deaths and many ways to tweak the stats. Except no death is preventable, we all die. Does your stat count people that have cancer but can't afford the hundreds of thousands of dollars worth of pills that would've extended their life another 3 months? I bet it does. 30,000 people seems like a lot, but if we extrapolated it to the population of the UK it would be about 5,000. Seems like a lot smaller of a problem now doesn't it? Especially since there really isn't one in the first place.
As for the rest, you can't go from a wholly private system to a nationalized system without fucking over millions of people. What happens to the doctors that paid their way through medical school, did their years of drudgery working as a Resident in a hospital, and then took the chance and decided to start their own private practice? "Oh, you now work for the government, here's your much smaller paycheck". You, and people like you, act like it's just a switch you throw one day on a whim. "Let's nationalize the beer distribution industry today, cheaper beer for all" You're completely ignoring the billions of dollars that hospitals invest in themselves every year, the billions the pharma companies invest in research every year. Are you going to compensate them for their loss when you nationalize? Because if not, it's wholesale theft, which I doubt you have a problem with anyway. I do.
1. You apparently, reading your previous posts.
2. Bullshit. Same drugs. Same branding. Different price, due either to economies of scale or price fixing - I don't know which, but it's nothing to do with them being different drugs. Also, British pharmaceutical companies pull their weight in the international market (European drug companies account for 6 of the top 10).
I'll have to dig out some figures, this is from one of Robert Peston's radio programmes (which are about economics).
3. Not according to the study referred to on Wiki:
This system has considerable administrative overhead, far greater than in nationalized, single-payer systems, such as Canada's. An oft-cited study by Harvard Medical School and the Canadian Institute for Health Information determined that some 31% of U.S. health care dollars, or more than $1,000 per person per year, went to health care administrative costs, nearly double the administrative overhead in Canada, on a percentage basis.
31% - not 15%.
I'm saying that 1 set of government workers could be more efficient than thousands of sets of worker for private insurance companies.
4. Life expectancy is a good benchmark of how good a healthcare system is. People in other countries have shitty diets too. Fighting in wars is inconsequential, many more Americans die from lack of health insurance each year than die fighting in wars.
5. I do realise that. Which is why I referenced it in my post, when I mentioned about the government mandating that healthcare must not be withheld.
Yes the number would be far smaller for a population the size of Britain's, but the number for Britain will be exceptionally low (not non-existent, as there will be some treatments available privately that are not deemed cost effective enough to be available under the NHS). I'd be prepared to bet it will be less than 50 per year over here.
As for it not being possible to nationalise overnight - we did it in Britain. You seem to be under the misguided impression that doctors wages would need to go down, I don't know why you seem to think that is the case. Can you provide any evidence to support that assertion?
The US only represents a small proportion of the market for these pharmaceutical companies. Not all of which are American anyway. 6 of the top 10 pharmaceutical companies are European.
I've come to expect this sort of response from you, very firm and authoritative but with very little substance or evidence behind it. Support your points with facts, not opinion. Examples of precedent. Figures. Something meaningful.
Last edited by Bertster7 (2012-07-11 15:38:23)