[Epaphras]

A search for a thread on this film turned up nothing, so here we are.

I watched this documentary for the second time last night, and it was the first time my wife saw it.

In the film, Michael Moore explores the malfunctions of managed healthcare (HMOs) and profiles the national health systems of Canada, England, France, and Cuba (yes, Cuba). He points out the tendency of HMOs to deny treatment because of "pre-existing conditions" or "experimental treatment" in order to save money. He claims that many HMO doctors are actually rewarded for saving money, not people. He even goes as far as accusing the pharmaceutical companies, managed health care industry, and even the government of collusion in setting prices and having profit be the bottom line, not quality health care.

He then shifts gears and goes to London, Ontario and interviews people in the waiting rooms there. They all say, "We have been waiting about 15 minutes. I've never waited more than an hour to see a doctor. We don't pay anything." One interesting comparison was a man who almost lost his four main fingers in a skating accident and had them fixed at no cost time him, to a man in the U.S. who cut the tips off two fingers and had to choose which finger he could afford to have re-attached ($12,000 for the ring, $60,000 for the index). He interviews another man and asks, "Why should you pay for my medical bills through your taxes? Why don't you just look after yourself?" The man said, "Some people aren't in a position to help themselves. I gladly pay for others' care because I know they are doing the same for me." The basic philosophy is: Payment according to means, treatment according to need.

In London, he interviews patients at a NHS (National Health Service) hospital, asking them what they have to pay to get their care. They all laugh at him. A pregnant woman explains how she gets six months paid maternity leave, and another six month unpaid. Moore finds the Cashier, only find out he is the one who actually reimburses people if they had to take a cab to the hospital. Moore thought it was where you go to pay your bills. He also interviews a doctor to see if he earns little more than a liveable wage, but turns out the NHS doctor makes the equivalent of $200,000 a year and owns a $500,000 three-story home in Greenwich, London and drives an Audi. The doctor also said they get bonuses if they can get a majority of their patients to stop smoking or other healthy preventative habits. In other words, the more he promotes patients' health, the more he gets paid.

In France, he meets a doctor who makes house-calls, much like a 24-hour plumber, at no cost to the patient. He has dinner with several Americans who have expatriated to France for health or other reasons. One man gets free treatment for life for his Type 1 diabetes, another woman gets free childcare and maid service. All of them explain how it is mandatory for every employer to offer employees five weeks of paid vacation. If they work more than 35 hours per week, the overtime is counted toward additional paid time off. There are an unlimited number of paid sick days. He claimed that even while the French drink and smoke more, their life-expectancy is four years longer than Americans.

Finally, he interviews several ailing 9/11 rescue workers who are dealing with serious respiratory illnesses with little or no public assistance. Moore finds out that detainees at Guantanamo Bay, Cuba receive top-of-the-line health care, so he decides have an experiment. He loads up a few boats worth of people who want free health care in Miami, and sailed down to Cuba. They float into the Gitmo harbor, and Moore blares on a megaphone, "We just want the same medical treatment as the evildoers - no more, no less. We want the same medical care you give to Al Qaeda". No response.

Next, they load up on $0.05 prescription inhalers that cost the 9/11 rescue workers $150 each back home, and head to Havana Hospital, which is apparently world-renowned for its medical expertise and third-world relief efforts. They all receive free medical treatment and are even embraced by a local Cuban fire department as brothers for their service on 9/11. All this between supposed enemies.

I have a couple of questions about the points raised in the film that I hope some of you can answer. To anyone living in England, France, Canada, or any other country with socialized medicine: Is it as great as this film makes it out to be? What is the real story? If it's so great, why isn't it implemented here? What are the main barriers to overcome in establishing universal health care in America? What would it take, economically, to pull it off?

[JerryLove]

I have a couple of questions about the points raised in the film that I hope some of you can answer. To anyone living in England, France, Canada, or any other country with socialized medicine: Is it as great as this film makes it out to be? What is the real story?

No. Moore's claims are exaggerated. The standard of healthcare, particularly in countries like Germany is higher than in the US. Doctors do make house calls, there is universal coverage, and the per-capita costs are half. However, Moore does give a one-sided view, and often misleads (such as implying that in-home-care nurses typically do dishes).

In some of the countries there are larger problems glossed over. Canada has had an on-again-off-again problem with wait times (OTOH, socialized Japan has twice the equipment we do, and their people spend three times as much time under care).

While Cuba rates very well on life expectancy, it does so/so at best on infant mortality (though considering the fact that it's most powerful and closest naighbor has embargoed it for 50 years, there's likely more to that story than social-vs-capital.)

If it's so great, why isn't it implemented here?

There's no single answer to that. Certainly a right-wing that believes that universal healthcare = communism and communism = bad has a lot to do with it. Not to mention the *tremendous* lobbying by medical companies.

Every HCP (Health-Care Provider) worth its salt has a long list of congressmen in their pocket. They contribute heavily to campaigns. They have numerous lobbyist. They send internal emails encouraging every employee to write their representatives (the really didn't like the most recent piece of legislation lowering what they get paid), and they engage in ad campaigns.

In short: there's a big-business interest in keeping healthcare expensive and making profit off it.

What are the main barriers to overcome in establishing universal health care in America? What would it take, economically, to pull it off?

Changing the view of much of the American public. Getting congress to back it. Getting the government free enough of the corruption of the HCP industry to write good legislation.

[Skeeter]

While "Sicko" is certainly one of Moore's more balanced and thoughtful films, the picture isn't quite as rosy as Moore paints it. In Canada, at least, there is a fairly significant issue of waiting times, especially for major surgeries and operations. At the same time, I have had to go into the Emergency room only a couple of times in my life and have always been served immediately and received help right away. I definitely prefer it to the alternative of private healthcare, however.

[danlong]

I wouldn't even consider it good stewardship on my part to give any time to Micheal Moore or his antics.

My wife could share, as a provider, how difficult it is to provide health care in Ontario, Canada ( She lived in Stouffvile (sp) and worked out of Toronto and New Market). She wouldn't give up what we have here to go back.

Currently we pay $145/mth full coverage tax exempt fee. For a total of $1740/yr , again as a write off, with both of us covered fully.

What the state of Wisconsin democrats are trying to push through is a 15.1 % universal health care income tax ( to mirror the feds FICA and medicare tax) so my wife at $40,000 a year would pay $3020 (1/2 the tax and employer the other half). For my part, making $30,000 self employed I would pay $4530 a year, the full tax). So our health bill would be $7550, not tax exempt.

$1740 vs $7550, I fail to see the benefit, especially since I live healthy and rarely see a doctor.

Nothing is free, not even free health care.

[JerryLove]

Originally Posted by danlong

Currently we pay $145/mth full coverage tax exempt fee. For a total of $1740/yr , again as a write off, with both of us covered fully.

The average American costs $5,000 per year in medical bills.

Therefore, there is no way for average medical costs (divided between what one pays to insurance and what one pays out of pocket) to go below $5,000 per year (the real costs).

There are three possible ways for you to pay $870 per year per person.

1) Someone else is paying the remaining $4130 per year.
2) You are, essentially, under insured and betting that you will be lucky enough to not get very ill.
3) You are in an insurance that is only willing to cover a slim portion of the population.

In the first case, your "cost of health care" is untrue.
In the second case, you are essentially saying "insurance is bad", and not making a social-vs-capital case.
In the third case, you are saying that only some people should be able to get health coverage.

What the state of Wisconsin democrats are trying to push through is a 15.1 % universal health care income tax ( to mirror the feds FICA and Medicare tax) so my wife at $40,000 a year would pay $3020 (1/2 the tax and employer the other half). For my part, making $30,000 self employed I would pay $4530 a year, the full tax). So our health bill would be $7550, not tax exempt.

You are using faulty math.

You seem to think that the portion paid by your wife's insurance is "free", which you advocate against later.

Let's look at me and my last employer (IBM paid 100% of my premiums when I started there). By the math you appear to be using (the one where you discount the portion your employer), my health care was completely free: obviously superior to any health care that costs anything at all. Therefore we should just make the employers pay it all.

Of course you know that there is no free lunch (you even say so later). So let's get back to my earlier number.

It costs $5,000 per person in actual medical bills. We have two choices:
1) we can divide the costs among everyone.
2) we can leave everyone only able to get the care they can afford.

There is no magic way of organizing health-insurance that will change that $5,000 figure. That has to be done through changes in the health care system, or American lifestyle, itself.

$1740 vs $7550, I fail to see the benefit, especially since I live healthy and rarely see a doctor.

So why do you even bother with health-insurance?

Obviously most of the population pays more into health insurance than they get out: otherwise where would the money come from. We must conclude, therefore, that most Americans have health insurance in case something bad happens (the point of "insurance").

You seem to be asserting that, since nothing bad has happened yet, you shouldn't have to pay the average cost of the bad things. OK. Then why should you be covered when something bad does happen?

BTW, considering you are self-employed: How do you plan on paying for your medical coverage if you get a prolonged illness and cannot work? Do you think your medical coverage will let you renew at $145/mo when you are undergoing continuing cancer treatment? If so, it's your wife's group coverage, which is payed to a good extent by her employer, not yours.

Nothing is free, not even free health care.

Very true The question here is "will everyone eat?"

[danlong]

Originally Posted by JerryLove

The average American costs $5,000 per year in medical bills.

Therefore, there is no way for average medical costs (divided between what one pays to insurance and what one pays out of pocket) to go below $5,000 per year (the real costs).

There are three possible ways for you to pay $870 per year per person.

1) Someone else is paying the remaining $4130 per year.
2) You are, essentially, under insured and betting that you will be lucky enough to not get very ill.
3) You are in an insurance that is only willing to cover a slim portion of the population.

In the first case, your "cost of health care" is untrue.
In the second case, you are essentially saying "insurance is bad", and not making a social-vs-capital case.
In the third case, you are saying that only some people should be able to get health coverage.

You are using faulty math.

You seem to think that the portion paid by your wife's insurance is "free", which you advocate against later.

Let's look at me and my last employer (IBM paid 100% of my premiums when I started there). By the math you appear to be using (the one where you discount the portion your employer), my health care was completely free: obviously superior to any health care that costs anything at all. Therefore we should just make the employers pay it all.

Of course you know that there is no free lunch (you even say so later). So let's get back to my earlier number.

It costs $5,000 per person in actual medical bills. We have two choices:
1) we can divide the costs among everyone.
2) we can leave everyone only able to get the care they can afford.

There is no magic way of organizing health-insurance that will change that $5,000 figure. That has to be done through changes in the health care system, or American lifestyle, itself.

So why do you even bother with health-insurance?

Obviously most of the population pays more into health insurance than they get out: otherwise where would the money come from. We must conclude, therefore, that most Americans have health insurance in case something bad happens (the point of "insurance").

You seem to be asserting that, since nothing bad has happened yet, you shouldn't have to pay the average cost of the bad things. OK. Then why should you be covered when something bad does happen?

BTW, considering you are self-employed: How do you plan on paying for your medical coverage if you get a prolonged illness and cannot work? Do you think your medical coverage will let you renew at $145/mo when you are undergoing continuing cancer treatment? If so, it's your wife's group coverage, which is payed to a good extent by her employer, not yours.

Very true The question here is "will everyone eat?"

Eat what?

The question really is, why can you not accept a given statement as a given statement??? I make no mention, point or otherwise involve the average American. Everything you brought up is superlative to the posting, more or less uninvited or should I say you're wrong, no faulty math, no errant numbers. Your assumption is faulty. There are none of the included fallacies you interject. The given statement is my wife and I pay x amount out of pocket, why would we favor paying almost 4 1/2 times more to subsidize someone else. My charity goes through my church, not the government, thank you.

As for my income and possible LTC , yes I am covered for cancer, though I wouldn't use much of it. I don't believe in protracting the inevitable and prefer quality of life to the end. I'm secure in Christ, and have no fear of dying.

After state and federal income taxes, 15.1 % FICA and medicare, I have less than 60% remaining, throw $6000 into IRA and the rest is not a part of our budgeted income. I fear tax burden much more than illness, its taxes that are killing me. Why do I stay in business? It's a question that leaves many of us self employed or very small business owners scratching our heads right now.

If you want to present the costs to the average American, you have to remove MA recipient's needless trips to medical facilities( they go because it's free, not necessary, and that can only increase), placebos, needless treatments given freely to placate the hypochondriac or do you feel that my wife and I should subsidize those also? And studies already show that these numbers are inflated by free health services.

Also, since we have an HMO, we get a "billing" of the actual cost of a visit or treatment, and you're quite wrong, as in 3 years we have never approached $5000 in a year for both of us, let alone each.

As for your IBM employer, did you pay anything for your insurance? No? Than for you, it is free. Simply because you have a social agenda(choosing #1) doesn't infer I have flawed math. I simply don't share your government as the parent mentality or the everyone must be covered ( or at least pay) mindset.

[JerryLove]

Originally Posted by danlong

The question really is, why can you not accept a given statement as a given statement??? I make no mention, point or otherwise involve the average American. Everything you brought up is superlative to the posting, more or less uninvited or should I say you're wrong, no faulty math, no errant numbers. Your assumption is faulty. There are none of the included fallacies you interject. The given statement is my wife and I pay x amount out of pocket, why would we favor paying almost 4 1/2 times more to subsidize someone else. My charity goes through my church, not the government, thank you.

So you are arguing that you get a free lunch, which you've said don't exist.

Of course, it is your latter comment that is correct. There are no free lunches. Someone is paying $5000 per person. If you somehow feel an employer giving you $5000 in health-insurance rather than $5,000 more in salary isn't "out of pocket", then I would say that you are rationalizing.

As for my income and possible LTC , yes I am covered for cancer, though I wouldn't use much of it. I don't believe in protracting the inevitable and prefer quality of life to the end. I'm secure in Christ, and have no fear of dying.

There is no unsubsidized (whether by the government or an employer) insurance with comprehensive coverage, that will insure anyone (such as someone with a need for LTC) and a price in the range you suggest. The math simply doesn't support it.

After state and federal income taxes, 15.1 % FICA and Medicare, I have less than 60% remaining, throw $6000 into IRA and the rest is not a part of our budgeted income. I fear tax burden much more than illness, its taxes that are killing me. Why do I stay in business? It's a question that leaves many of us self employed or very small business owners scratching our heads right now.

This would carry more weight if you had decided to not carry health-insurance (though then I could argue about your burden on other tax-payers). You have chosen to. By it's very nature, health-insurance is "everyone pays in, some get more out than others".

You don't want to pay part of the coverage for the poor. Well, I have some goof news and some bad news. The bad news is that you already do (how do you think hospitals recoup indigent care?), the good news is, being so poor you wonder why you even work (I presume that it's so you can eat regularly and sleep indoors. You obviously can afford luxuries like a computer and internet connection as well), you wouldn't really be paying much of someone else's.

If you want to present the costs to the average American, you have to remove MA recipient's needless trips to medical facilities( they go because it's free, not necessary, and that can only increase), placebos, needless treatments given freely to placate the hypochondriac or do you feel that my wife and I should subsidize those also? And studies already show that these numbers are inflated by free health services.

The number is accurate even when looking solely at private health-insurance recipients. Between my deductible, my contribution, and my employer's contribution, my costs are around $6,000 per year. They were the same at the last employer.

Also, since we have an HMO, we get a "billing" of the actual cost of a visit or treatment, and you're quite wrong, as in 3 years we have never approached $5000 in a year for both of us, let alone each.

You are hacking a straw-man. I never said you did. I said the average was.

As for your IBM employer, did you pay anything for your insurance? No? Than for you, it is free. Simply because you have a social agenda(choosing #1) doesn't infer I have flawed math. I simply don't share your government as the parent mentality or the everyone must be covered ( or at least pay) mindset.

So then as long as the taxes are taken out at the employer, rather than after being given to you, social health insurance is free?

Of course not. That's another example of the flawed math I was discussing. The money always comes from somewhere, and in the end that somewhere is always the people. The only thing that can change is how the burden is distributed, and how many are covered.

I'd also appreciate it if you avoided the ad homonyms.

[danlong]

Originally Posted by JerryLove

So you are arguing that you get a free lunch, which you've said don't exist.

Of course, it is your latter comment that is correct. There are no free lunches. Someone is paying $5000 per person. If you somehow feel an employer giving you $5000 in health-insurance rather than $5,000 more in salary isn't "out of pocket", then I would say that you are rationalizing.

I'll take the $5000, in fact that's what healthcare savings accounts are about.

I understand, you are a prolific googler but stick with the facts and the essence of the post. Simply because you hold a religious belief that all taxpayers (some more than others) should cover all people ( including non-taxpayers), I don't desire you to jump my post to preach, I don't hold your premise. As pointed out, that ministry is between myself and my church.

There is no unsubsidized (whether by the government or an employer) insurance with comprehensive coverage, that will insure anyone (such as someone with a need for LTC) and a price in the range you suggest. The math simply doesn't support it.

Again, your math, is unappraised and wrong. Throw in employer contribution and the insurance cost is $5795 for the year, for two people @ 2898/person and even less if we still had children living at home.

This would carry more weight if you had decided to not carry health-insurance (though then I could argue about your burden on other tax-payers). You have chosen to. By it's very nature, health-insurance is "everyone pays in, some get more out than others".

this makes no sense, though I have no need to impress you.

You don't want to pay part of the coverage for the poor. Well, I have some goof news and some bad news. The bad news is that you already do (how do you think hospitals recoup indigent care?), the good news is, being so poor you wonder why you even work (I presume that it's so you can eat regularly and sleep indoors. You obviously can afford luxuries like a computer and internet connection as well), you wouldn't really be paying much of someone else's.

ad hominem

So you are admitting that urgent care is available for all.

since my self employment is web hosting and I work out of the home an Internet connection is hardly a luxury. The reason for the business was to be at home raising the kids, they are gone and now it is more of a government cash cow.

The number is accurate even when looking solely at private health-insurance recipients. Between my deductible, my contribution, and my employer's contribution, my costs are around $6,000 per year. They were the same at the last employer.

Good for you, but that doesn't reflect accuracy.

You are hacking a straw-man. I never said you did. I said the average was.

actually you did. Medical bills are medical bills, insurance is not a medical bill.

The average American costs $5,000 per year in medical bills.

Therefore, there is no way for average medical costs (divided between what one pays to insurance and what one pays out of pocket) to go below $5,000 per year (the real costs).

So then as long as the taxes are taken out at the employer, rather than after being given to you, social health insurance is free?

Of course not. That's another example of the flawed math I was discussing. The money always comes from somewhere, and in the end that somewhere is always the people. The only thing that can change is how the burden is distributed, and how many are covered.

This might have some merit if everyone ( and I mean everyone, thank you) payed the same flat dollar fee, not percentage, but that's not what was posted. And as I pointed out 15.1% would be taken from me personally.

I'd also appreciate it if you avoided the ad homonyms.

synonyms, acronyms, what ever...

Might happen if you would.

[bread man]

Originally Posted by Skeeter

While "Sicko" is certainly one of Moore's more balanced and thoughtful films, the picture isn't quite as rosy as Moore paints it. In Canada, at least, there is a fairly significant issue of waiting times, especially for major surgeries and operations. At the same time, I have had to go into the Emergency room only a couple of times in my life and have always been served immediately and received help right away. I definitely prefer it to the alternative of private healthcare, however.

The situation is very similar in Australia from what I know.

[JerryLove]

Originally Posted by danlong

I'll take the $5000, in fact that's what healthcare savings accounts are about.

HSAs are not insurance. In advocating HSAs as a solution, you are arguing against health insurance at all.

This is not only disingenuous coming from someone who has health insurance, it's not in scope.

I understand, you are a prolific googler but stick with the facts and the essence of the post. Simply because you hold a religious belief that all taxpayers (some more than others) should cover all people ( including non-taxpayers), I don't desire you to jump my post to preach, I don't hold your premise. As pointed out, that ministry is between myself and my church.

I'm trying to be nice, but you continue to be belligerent and harassing.

Let's see if I can enumerate.
- The use of Google, prolific or otherwise, is pretty irrelevant.
- As "prolific" here seems intended to infer something negative about me as a person, the fact that it is unquantifiable is a problem.
- An assertion that I am not sticking to the essence of the post is simply hostile: to be constructive, it should enumerate how I am failing to stick to the essence of said post: perhaps including what the essence of the post was and why I should stick to it.
- The use of the word "religious" here is obviously intended to flame-bait
- The use of the word "religious" is an ad hominem (my position, being something I am supposedly religious about, is not based in fact and should be ignored)
- The assertion that I am asserting that all taxpayers should cover all people is false: and therefore a straw-man.
- The assertion is also misleading... in fact what you are saying and your position are at odds. Under the current system, a minority of taxpayers pay for everyone.
- You accuse me of "jumping your post", as though having a discussion on a discussion forum was a break in decorum.
- You accuse me of preaching. Again a personal judgment rather than an argumentative one... again attempting to insert bias (it's part of the religious ad hominem)

At this point you fall back into your relationship with Jesus, and might actually have a valid (if already a given) point about charity; but you don't really tie it in.

Again, your math, is unappraised and wrong. Throw in employer contribution and the insurance cost is $5795 for the year, for two people @ 2898/person and even less if we still had children living at home.

the cost for an average American is 5000 per person. The fact is unchanging. For insurance to cover that they must charge at least that.

Of.course, many insurances do not cover that. First they put in a deductible (add that to your premium), then there are copays (next to impossible to factor in here) and then there is a cap on total pay-out (again moving part of the burden). I suspect your coverage has all three.

Ad Hominem

Really? How so? You brought up your income and the effect you presume that social healthcare would have on it. I discussed your topic. If I made a comment about you that isn't in rebuttal to your comment about you please point it out and I will clear it up or remove it.

So you are admitting that urgent care is available for all.

there are certainly some major caveats there, but "yes"; despite your odd verbiage.

since my self employment is web hosting and I work out of the home an Internet connection is hardly a luxury. The reason for the business was to be at home raising the kids, they are gone and now it is more of a government cash cow.

are you saying that you have zero discretionary income?

Good for you, but that doesn't reflect accuracy.

the assertion seems useless without support so I suppose I should just respond in kind: "yes it.does"

actually you did. Medical bills are medical bills, insurance is not a medical bill.

the average American spends $5000 per year in health care (medical bills).

This might have some merit if everyone ( and I mean everyone, thank you) payed the same flat dollar fee, not percentage, but that's not what was posted. And as I pointed out 15.1% would be taken from me personally.

so you've asserted one proposal would do. As I have mentioned repeatedly, no moving of the burden changes the average cost.

You seem to keep coming back to your costs which are dependent on you being healthy (or are being misrepresented)

If you want to assert "every man for himself" then go ahead; but that's not a capital-vs-social health insurance statement (though I suppose it dost address universal health insurance)

synonyms, acronyms, what ever...

Again this is just harassment. It certainly serves no useful purpose from the perspective of a discussion. It is, at best, a taunt; and at worst an attempt to paint me as a person in some negative light.

[adamwagg]

Living in Australia - where we have universal health care it seems to be heaps better than in the US.

In general it works like this:
For seeing a doctor for a checkup etc. - you can either go to a bulk billing place (where they only take what the Government provides - so free to you) or you can go to a private GP where you pay a bit extra over the top of what the Government provides. (You book for the private ones, the public ones you just go and line up and wait from 1 hour to 3 hours)

For emergencies you go to the closest hospital where you go through triage - if you have a heart complaint or asthma etc you would normally get admitted righrt away - down to just wanting to see a doctor which depending on how busy it is can take 1 - 4 hours. Someone dying waiting to be admitted is very rare - at the national news sort of level and is normally because a triage assesment was stuffed up. As always if there happens to be lots of emergencies you wait longer. You don't pay for this - you may have to pay some extras if you are admitted to hospital but nothing that will break the bank.

For elective surgery - this is where having private health cover starts to make a difference - in the public system that wait times are up to 2 years (but often quicker if you push into a cancellation). However these wait times have become a major political issue so hopefully should be being reduced soon. If you are a private patient (i pay about 50 a month) you can pick your doctor (not get one assigned to you), get your own room (not a ward) and get in sooner (not sure how long). Either way you will still probably have to pay some extras as per being admitted in emergencies. (Though a quick note - nothing to the extent of not getting medical treatment - just might mean having less entertainment money for a little while).

For prescriptions we have a system where drugs listed are about $30 (or $7 for low income/pensioners etc.). The only issue with this is it sometimes takes a little while for a new drug to make it on the list - so if you're the first on a new drug you sometimes have to pay full price for a while. (Again if this goes on very long it makes the news/current affairs shows).

For other health providers - like dentists there is both private and public, but the wait is pretty long public. You can just pay for a private one (couple of hundred for a check up etc.). If you have private health insurance you will get some money back for these.

One thing to note is that my private health insurance is a members benefit fund - i.e. not a private company trying to make a profit - all profit goes back into the members benefits. (There is a tax rebate to be in a private health insurance if your income is over $150000.

[JerryLove]

So the row over waits is specific to "elective surgery for people who want it free"?

[Chrysostom]

Originally Posted by JerryLove

2) You are, essentially, under insured and betting that you will be lucky enough to not get very ill.

Or, 2a, you're not the average person. E.g., in my case, I've been to a doctor once in the last decade; because I'm young and in good health I pay much below the average. But even when I get to be 60 I'm much less interested in prolonging my life than the average American so I'll continue to incur less in healthcare costs than others in my age bracket. Once everybody's healthcare gets standardized there is much less incentive to avoid what is really elective medical treatment, even though today it is called standard and routine.

(I'm not at all criticizing you for choosing cancer treatment. I would almost certainly make the same decision.)

Originally Posted by adamwagg

Living in Australia - where we have universal health care it seems to be heaps better than in the US.

In general it works like this:
For seeing a doctor for a checkup etc. - you can either go to a bulk billing place (where they only take what the Government provides - so free to you) or you can go to a private GP where you pay a bit extra over the top of what the Government provides. (You book for the private ones, the public ones you just go and line up and wait from 1 hour to 3 hours)

For emergencies you go to the closest hospital where you go through triage - if you have a heart complaint or asthma etc you would normally get admitted righrt away - down to just wanting to see a doctor which depending on how busy it is can take 1 - 4 hours. Someone dying waiting to be admitted is very rare - at the national news sort of level and is normally because a triage assesment was stuffed up. As always if there happens to be lots of emergencies you wait longer. You don't pay for this - you may have to pay some extras if you are admitted to hospital but nothing that will break the bank.

For elective surgery - this is where having private health cover starts to make a difference - in the public system that wait times are up to 2 years (but often quicker if you push into a cancellation). However these wait times have become a major political issue so hopefully should be being reduced soon. If you are a private patient (i pay about 50 a month) you can pick your doctor (not get one assigned to you), get your own room (not a ward) and get in sooner (not sure how long). Either way you will still probably have to pay some extras as per being admitted in emergencies. (Though a quick note - nothing to the extent of not getting medical treatment - just might mean having less entertainment money for a little while).

For prescriptions we have a system where drugs listed are about $30 (or $7 for low income/pensioners etc.). The only issue with this is it sometimes takes a little while for a new drug to make it on the list - so if you're the first on a new drug you sometimes have to pay full price for a while. (Again if this goes on very long it makes the news/current affairs shows).

For other health providers - like dentists there is both private and public, but the wait is pretty long public. You can just pay for a private one (couple of hundred for a check up etc.). If you have private health insurance you will get some money back for these.

One thing to note is that my private health insurance is a members benefit fund - i.e. not a private company trying to make a profit - all profit goes back into the members benefits. (There is a tax rebate to be in a private health insurance if your income is over $150000.

I don't know if that's heaps better. IIRC the Australian and US dollars are worth roughly the same, and my prices are lower for dentists and prescription drugs. It sounds like your waits are much longer than mine, too. Now, that might just be because I've gotten lucky with the right doctors; I don't know the averages for the US. But what in particular are you thinking is better? Is it mostly just that instead of paying a premium it's taken in taxes?

[JerryLove]

Originally Posted by Chrysostom

Or, 2a, you're not the average person. E.g., in my case, I've been to a doctor once in the last decade; because I'm young and in good health I pay much below the average.

I have a different perspective, but it is covered ground. The next part is far more interesting so I'll skip ahead

But even when I get to be 60 I'm much less interested in prolonging my life than the average American so I'll continue to incur less in healthcare costs than others in my age bracket. Once everybody's healthcare gets standardized there is much less incentive to avoid what is really elective medical treatment, even though today it is called standard and routine.

Dan has hinted around this topic a couple of times as well, and it's an interesting one. Tell me if my paraphrase is correct.

I think that "X" care is appropriate.
Many other people think that "Y" care is appropriate.

Y > X (life support for old people, saving crack babies, treating low-survivability disease, whatever (I'm not trying to pin you into any particular difference, just set an idea of what those might be))

Since I want X, I wouldn't choose insurance that covers Y and my insurance costs would be lower than those who would choose Y. I don't want to pay for Y since I don't want it, and so shouldn't subsidize those that do want Y.

Is that about right?

[thelitguy]

Being a Diabetic with a number of other chronic health issues, I have to say I am favor of univeral health care. On top of the insurance costs I pay, I would not feel stretched to say that I spend, on average, $400 a month on visits, bloodwork, and treatments alone (that is not including any sort of medication or other Diabetic supplies).

Of course, I can see where a healthy person wouldn't be interested in, mainly due to the fact that they wouldn't use it much. It does come down, essentially, to a tax issue. Being the crazy liberal I am, I have no problem with higher taxes to support such causes.

Then again, I am one of the people who would really benefit from this.