The Great Universal Health Care Debate w/Poll (note: it just passed both houses)

[Harrier Dude]

Spekkio.......please, for the love of GOD......get an economics book and read it. You seem like an otherwise intelligent guy, but this basic supply/demand relationship is just kicking your ass. You might start with the ones suggested in the other thread.

Seriously.

 

[Random8145]

I think a few things yank up the cost of healthcare in the United States, one I believe being the drug companies and the Food and Drug Administration. I believe the FDA essentially allows the drug industry to, for the most part, be controlled by an oligopoly of big drug companies, which stifles drug creation and also allows these companies to charge higher prices for their products than would normally be permitted by the laws of supply and demand.

For example, to put a new drug out, one has to first invest the time, money, research, etc...just to create the drug, then that drug must go through about 10 - 15 years of FDA testing. This pretty much kills all incentive to start up any new drug companies for any aspiring entrepreneurs.

Then there's health insurance. I believe again regulations play a part, driving up the cost artificially, by requiring by law health insurance to cover certain things universally; health insurance should be more like car insurance when you buy it from what I understand.

Some health insurance companies have essentially a monopoly over their states, which I would think is likely from excessive regulations in the industry again killing off incentives for entrepreneurs to create competing organizations.

I could be dead wrong on that though, haven't researched it enough.

There is licensing with doctors, which artifically limits the amount of new doctors entering the field, which artificially yanks up the price for them.

And then also there's a lot more government intrusion on doctors and their practices these days then there used to be I believe.

There are also the hospitals who will treat anybody, even if they have no health insurance, which is noble but unfortunately creates huge cost overruns, for example all the illegals who have babies and have no health insurance but the hospitals treat them anyhow.

All this stuff added up I believe is what has driven up the cost of healthcare so much.

But "universal healthcare" doesn't work. It can't work, and it infringes on people's rights because it infringes on the rights of the medical professionals to charge prices for their skills.

ANYTHING that depends on the skills of someone else cannot be a right, not housing, food medical care, etc...

The European nations are having a hard enough time trying to fund their systems, in the United Kingdom right now, there are battles going on about what portions of healthcare to fund b/c the State is having to cut people's care, in Canada, they have considered bringing back private care and some Canadian bureaucrats have even been caught getting private care, etc...

As even further proof of this, CALIFORNIA, the biggest state in the U.S., and the 5th largest economy in the world, just put an axe to its universal healthcare plan, because the liberal democrats in the state concluded it would bankrupt the state.

I also think the universal healthcare program implemented by Mitt Romney in Massachusettes, is also facing cost overruns now.

So how in heaven the current Democratic Presidential candidates are claiming they can somehow provide all 320 million Americans with "quality," "affordable" healthcare is beyond me.

 

[mrkoje]

We don't have socialized medicine for a bloody reason! UHC is just another step toward a socialized/communist government. Russia, China, Korea, Vietnam, and many other countries that have UHC are (or on the road to being) communist. Does communism/socialism work? No! Look at the Pilgrims they had a socialized government at first and within two years they had to scratch it, because it didn't work. No one wanted to work hard when they knew that their labor was just as much for a lazy bum as it was for them. Russia: Joseph Stalin's plans for communism worked great(NOT); the great Soviet Union is now a pile of rotting crap (trust me I have had to live with 2 people from Russia for 2 months :icon_rage). Red China: what more do I need to say. Germany: how many millions have died from Hitler's brand of communism, Nazism? Venezuela: would you really want some like Hugo Chavez (i.e. Hilary Clinton) to run this country. Communism and Socialism don't work; they never have and never will. If you don't believe me then read history. Why on earth would you want to use a system that has caused/is causing the down fall of many nations?

I guess we better watch out for Canada, United Kingdom and France! Pst... Pst.. for the clueless: All three have some sort of UHC.

 

[Random8145]

France is very socialist, and if that Sergolene Royale had won, she'd have nationalized more industries, given people 90% unemployment benefits (that'll motivate 'em to work!), etc...

United Kingdom is very capitalist but led by a rather socialist party right now I believe.

And Canada, that's that evil foreign dictatorship to the North right...

 

[milky-f18]

And Canada, that's that evil foreign dictatorship to the North right...

If Canada weren't there, our border hospitals and doctors would lose half their business. Hmmm... why do they come across the border for medical services? It's free on the other side.

 

[Cobra Commander]

EXCEPT...

Not all specialties require the same training. The work required through residency and fellowships generally drives doctors away from "hard" specialties like neurology. The people left going for them are the ones who either really like the subject, or really like money.

And there are many specialists who also choose to practice general medicine at the same time. What I'm getting at is that supply/patient demand doesn't play into what a doctor is going to pick for a specialty all that much.

I sort of agree with you. My old man is a physician so I've met many a doctor in my day and I have to say that I don't think money is a motivating factor for 99% of them. Despite what you see on TV, doctors are straight up nerds and they do what they do because they're really interested in it, not just because you can make a good living doing it. There are a lot of professions where you can do much less work and get paid a lot more. It's not the cushy job most people think it is (it's no coal mine either). Their on call a lot, and spend a ton of time at the office and I just don't think it's the money or the workload that motivates them in what they do.

Having said that, I do think that doctors in specialities expect to be financially compensated for it. Aren't Britian and Canada facing a doctor shortage because the pay physicians recieve there is really low compared to the US?

 

[Flash]

Canada has excellent healthcare? Then why do they have to wait 6 months for an MRI and 6 month to have it read? Why is there a shortage of neurologists that can't be remedied until the government decides to hire more? Why are they sending people across the border for treatments? I wouldn't call it "excellent."

+1, To add, good luck seeing any kind of specialist or getting any kind of surgery. There is a reason cancer survival rates are higher in the US.

If Canada weren't there, our border hospitals and doctors would lose half their business. Hmmm... why do they come across the border for medical services? It's free on the other side.

I find it mildly amusing…….no, make that a bit pathetic…….that many here are making broad and sweeping judgments on a system they have no experience with. Other than taking in a few evening news reports and the occasional article, how many here know much about the Canadian health care system at all? Or have any first hand experience? My in-laws have generally had excellent care in Canada, and I have plenty of them since they are from good Irish stock.

As I noted earlier in this thread: The Canadian Health care system actually works quite well. A case in point: my Mother-in-law (Vancouver, BC) got faster and better care than my mother (New York) for a bad foot injury. There was no waiting in line or a 5 month wait for surgery for the mother–in-law, it happened the next day. My mother had to get transferred and wait 5 days for very similar surgery. The father-in-law waited less than a month for a hip replacement, no more than the wait in the states, and so on and so on.

Almost every other experience my in-laws have had with the health care system in Canada has been a good one, much better than what my wife has had down here, with the military and civilian health care systems. Yes, they do pay more in taxes but with what I pay in insurance every month, co-pays, etc, it comes pretty close to what they pay in Canada.

And one more thing to point out, Canada's health care system is not run by the federal government, each province or territory is responsible for administering it and paying a large part of it. As a result, richer provinces like Alberta (oil) and British Columbia (timber/trade) have better systems than poorer provinces like the Maritimes on the east coast. The federal government still has a hand in setting policy and doling out some money, but it is largely up to the provinces and some do a very good job, some not as good. It is not at all perfect, I know of one bad experience from a friend of my wife's (I also know plenty of bad experiences from my mother's work here in the US), but don't knock if you don't know it.

So before you all start making claims about how their system sucks, ask yourself how you can really make a judgment like that when you have no first-hand experience with it? It’s kind of like an airline pilot saying Naval Aviators suck because he read about Tailhook and ran into Masterbates one night in a bar, and he was bitchin about HSL. Sound stupid to you?

Oh yeah, just in case anyone was wondering, Canada has an average longer life expectancy and a lower infant mortality rate than the United States. Those are the two measures of health including in the CIA Factbook for every country. Here are the facts:

Canada:

Infant mortality rate:
total: 4.63 deaths/1,000 live births
male: 5.08 deaths/1,000 live births
female: 4.17 deaths/1,000 live births (2007 est.)

Life expectancy at birth:
total population: 80.34 years
male: 76.98 years
female: 83.86 years (2007 est.)

https://www.cia.gov/library/publications/the-world-factbook/geos/ca.html#People

United States:

Infant mortality rate:
total: 6.37 deaths/1,000 live births
male: 7.02 deaths/1,000 live births
female: 5.68 deaths/1,000 live births (2007 est.)

Life expectancy at birth:
total population: 78 years
male: 75.15 years
female: 80.97 years (2007 est.)

https://www.cia.gov/library/publications/the-world-factbook/geos/us.html#People

P.S. Why the heck was this thread resurrected?

 

[Spekkio]

To be clear: I wasn't saying that supply/demand doesn't drive the price for neurologists or other "rare" specialists; rather, I was countering the notion that doctors aren't entering the specialties due to lack of demand. Pretty much any specialty is in demand, so it doesn't really factor into the average doc's decision when he puts in for various residency programs.

For example, to put a new drug out, one has to first invest the time, money, research, etc...just to create the drug, then that drug must go through about 10 - 15 years of FDA testing. This pretty much kills all incentive to start up any new drug companies for any aspiring entrepreneurs.

I said this before, but this thread is long: drug costs aren't high because of all this research; they're expensive because of those prescription drug commercials you see on TV during prime time hours. They're expensive because people make six figures to do door-to-door sales for new drugs, and get a budget to take docs out to lunch and coddle them in order to get the docs to prescribe their product over the competition. R&D makes up the minority of a pharmacy company's budget.

Then there's health insurance. I believe again regulations play a part, driving up the cost artificially, by requiring by law health insurance to cover certain things universally; health insurance should be more like car insurance when you buy it from what I understand.

Car insurance coverage is mandated by law. I don't get what you're getting at here...

There is licensing with doctors, which artifically limits the amount of new doctors entering the field, which artificially yanks up the price for them.

This is a good point, but you're off in one respect: it's not licensing that's limiting doctors, it's medical school spots. When I applied in 2005/06, there were the same amount of spots open in US medical schools as there were in 1986. However, it's quite obvious to see how the healthcare business has expanded over the years.

That's not to say that we should take any yucko off the street and allow him to get an MD or DO, but an increase of the "supply" here could help reduce healthcare costs.

Once a doc has graduated, they usually pass their licensing exams. As a matter of fact, the licensing exam is given in 3 "steps," and the first one is taken during the 2nd year of med school.

 

[Brett327]

I was countering the notion that doctors aren't entering the specialties due to lack of demand. Pretty much any specialty is in demand.

Now you're talking out of your own ass. I work with a number of docs that would disagree with you. There are definitely certain specialties that docs gravitate towards because there is demand, thus increased potential for compensation.

Drug costs aren't high because of all this research; they're expensive because of those prescription drug commercials you see on TV during prime time hours. They're expensive because people make six figures to do door-to-door sales for new drugs, and get a budget to take docs out to lunch and coddle them in order to get the docs to prescribe their product over the competition. R&D makes up the minority of a pharmacy company's budget.

Do you have a reference for your assertion? I think you're engaging in wishful thinking again. Many pharmaceuticals take 10-20 years to develop & approve. I encourage you to examine the costs of R&D vs. sales & promotion for your average pharmaceutical firm and I think you'll surprise yourself.

Brett

 

[Spekkio]

First paragraph: docs have various reasons for entering their specialties, and some might be seeing the dollar signs at the end of the road. However, using money as the sole motivator is overly simplistic here. Not all specialties are created equal; some take as many as 7 years of training to obtain a license. That's a lot to swallow after 8 years of schooling. Besides, it's not like the lowest-paid physician "specialist" - pediatricians - are claiming poverty. Last I checked, we aren't short of pediatricians, and the demand for them is pretty damn high.

Second paragraph: What you quoted is a summary from an earlier post in the thread. I posted the links a while back in this thread, and don't feel like looking it up atm. Pharmacy companies want you to think that they're charging $100 a pill because of all this fancy R&D, but really $50-60 of that pill is from advertising cost. Mind you, I'm not claiming that R&D doesn't cost anything, but it pales in comparison to what these companies pay to push their drugs on people.

 

[Brett327]

First paragraph: docs have various reasons for entering their specialties, and some might be seeing the dollar signs at the end of the road. However, using money as the sole motivator is overly simplistic here. Not all specialties are created equal; some take as many as 7 years of training to obtain a license. That's a lot to swallow after 8 years of schooling. Besides, it's not like the lowest-paid physician - pediatricians - are claiming poverty.

Second paragraph: What you quoted is a summary from an earlier post in the thread. I posted the links a while back in this thread, and don't feel like looking it up atm. Pharmacy companies want you to think that they're charging $100 a pill because of all this fancy R&D, but really $50-60 of that pill is from advertising cost.

Post it, or you'll be dismissed.

Brett

 

[Spekkio]

Aye, sir:

http://www.amsa.org/hp/RandD.cfm
http://www.amsa.org/hp/pharmstructure.cfm

Looks like I was mistaken: $35 of the $100 is marketing -- but only $13 of it is R&D.

 

[Brett327]

Aye, sir:

http://www.amsa.org/hp/RandD.cfm
http://www.amsa.org/hp/pharmstructure.cfm

Looks like I was mistaken: $35 of the $100 is marketing -- but only $13 of it is R&D.

Your own statistics prove my point. What exactly is your beef with how the pharmaceutical companies do business & what remedy do you propose? Ultimately, these firms shoulder the costs (however you choose to count them) of bringing these valuable products to the public and are entitled to charge whatever the market may bear. These products save countless lives and increase the quality of life for millions of people. The vast majority of people who can benefit from these drugs do so within the established system. While some may slip through the cracks, to impugn the entire system because of that seems ridiculous to me.

Brett

 

[scoober78]

Canada:

Infant mortality rate:
total: 4.63 deaths/1,000 live births
male: 5.08 deaths/1,000 live births
female: 4.17 deaths/1,000 live births (2007 est.)

Life expectancy at birth:
total population: 80.34 years
male: 76.98 years
female: 83.86 years (2007 est.)

https://www.cia.gov/library/publicat...ca.html#People

United States:

Infant mortality rate:
total: 6.37 deaths/1,000 live births
male: 7.02 deaths/1,000 live births
female: 5.68 deaths/1,000 live births (2007 est.)

Life expectancy at birth:
total population: 78 years
male: 75.15 years
female: 80.97 years (2007 est.)

https://www.cia.gov/library/publicat...us.html#People

P.S. Why the heck was this thread resurrected?

Why indeed...

Something else I would point out is that while our Cannuck bretheren to the north may live longer...they are in Canada...which begs the question, do they ever really live at all?

Seriously though...Infant mortality I'll grant you...but average life expectancy? It's always touted as a stick to beat those who don't favor UHC...but honestly, who cares? I mean if we were talking the difference between 60 year avg. lifespans and 80....that might be significant...but the fact that country x lives 1.1 year longer on average seems ultimately insignificant. What is our goal, to live longer or be healthy, active, etc...while we are alive? I think to argue based on average life expectancy misses the forest for the trees.

On top of all that...what is a "statistically significant" difference?? What part of the difference is attributable to health care itself and what is attributable to lifestyle differences in culture, climate etc...

In short...what's the chi squared on that?

 

[HH-60H]

Actually, you can't compare infant mortality rates between countries. There is no international standard and different countries count it different ways. In fact, the U.S. has a stricter standard which results in a higher infant mortality rate.

I will post a reference later this afternoon.