No Healthcare for Smokers,Drinkers,Fat,Old..

[joepistole]

The demand for medical care is essentially infinite, and the US is an example of what happens if supply is linked to demand via (distorted) "markets" in a country with great income inequality.

If you want a better idea of what a market would look like in health care, look at veterinary medicine in the US - it's regulated, with regard to drugs etc, licensed and all that other stuff, completely under government control, but:

the customer is normally reasonably well informed and can walk away from the deal (demand can drop, if prices rise)

and insurance companies have little role - no large bureaucracy of service denial has created an arms race of rakeoffs.

So prices are very low, compared with the identical services as supplied by a hospital to a human. And poor people take their sick dogs out back and shoot them. Is that what you are shooting for, in US health care ?

I would argue that your arguement, "The demand for medical care is essentially infinite" is false. There is no evidence of this. If it were true we would see infinate demand for medical services by those already covered by government insurance programs for the poor and for the military. In these instances, the poor and the military, healthcare is completely free in the United States. And we have never seen infinate demand for healthcare in either of these groups. The government picks up 100 percent of the cost of medical care for these people. Most people have better things to do than to seek healthcare services for non existent medical conditions.

There is a finite demand for healthcare services and products, were it not the case insurance companies could never quantify the risk. And not being able to quantify the risk, they could never issue an insurance policy.

The veterinary medicine business is less regulated in the United States, and yes, it is less expensive as a result. But no one is advocating shooting people in the backyard because of an illness. As I said under the plan I proposed, every one has healthcare insurance, and everyone has access to all the healthcare services and products they need.

What is different is that everyone is covered, and everyone pays for it. And costs are kept in check with the free markets (demand and supply). Demand will be grow as the population increases, but supply of goods and services will grow at a higher rate eventually leading to a price equlibrium.

Better and more innovative providers will be rewarded with being able to charge a premium for their services and from their innovations.

 

[joepistole]

Perhaps people do not understand healthcare insurance in the United States as most of the world has socialized medicine. In the United States you purchase a medical insurance policy. They vary in scope and coverage and expense. But most are designed to limit out of pocket medical expenses to a fixed amount within the period of one year. Those out of pocket limits vary from just a few dollars to thousands of dollars. So once you have reached that out of pocket maximum all further expenses are picked up by the insurance company.

 

[joepistole]

Emergency care is not health care. I like how you jump to characterize the people without health care as not frugal. What if they are the working poor, saving everything they can? What if they pay for insurance and the insurance company decides not to cover their particular condition?

The fact is insurance companies are not making it easy or affordable for people, because their goal is profit and denying health care. Republicans don't have the balls to regulate these predatory corporations. We need to go further and take out the profit entirely, it is in the interest of the well-being of the American people.

I don't think you can lay all of the burden with the insurance company SpiderGoat. In many ways they are a key factor in keeping healthcare costs under control as they negotiate wtih providers for lower rates...the only source of price competition in the system. Without insurance companies, prices would be much higher than they are today.
However, that said, denying coverage to individuals is unethical and they spend a lot of money doing it today.
I don't think Sandy is saying that everyone is not frugal. But there are some folks who could be more frugal with their dollars. I have known some who are not in the condition you referenced, and would rather spend their dollars on things other than healthcare insurance. It is not that they cannot afford the policies, they just choose to bear the risk and spend their money on other things.
I think reasonable profits are a good thing. They can encourage better behaviors if markets are free. In corrupted markets they can be obsene.
We have now come to the stage where people just do not have faith in these organizations because of past corruption.

 

[Michael]

I would hope that we could develop a healthcare system that incorporates the best of each. We need a system that is competitive and rewards superior performance...one can get that from a free market. Unfortunately, we do not have a free healthcare market in the United States. It is anything but, the supply of suppliers is strictly regulated by vested interests and law.
Let's apply some good old Ronald Regan supply side economics to this situtation.

We need to have many many many more medical schools. The Gods only know there certainly are a LOT of Ss that want to go. We should open up 5 new schools per state. This will flood the market with Physicians and thus lower the over all amount of money each makes per patient. Let's see market forces work on this problem!

 

[joepistole]

Well we could do with a few more given the increases in population and aging of the population. We have not increased the number of physicans we train in a year since 1980 as the AMA has been predicting a physican surplus for the last twenty seven years...which never materialized.

 

[Asguard]

you know whats interesting. In Australia the regulator sets premiums so that they MUST be able to cover liabilitys and still make a profit (although in Medibank privates case i dont know where the profits go as its members owned). This means that there is no excuse for disalowing conditions because you have enough revinue to fund it and if you DO then the regulator would take you to court. Good regulation helps everyone, if you insist on having private only then you should get better regulation. Although the private system still has usless strategic planing and disases control. Goverments are much better at this than the "free market" will ever be because its not in there own best intrests to surply ABOVE demand. Thats the problem with the ambulance service v the fire service. The fire service is paid by the emergency services levy and therfor has 10% above demand, the ambulance service ISNT (it comes under the health budget) and so DOESNT have the extra resorces because its compeating against the rest of the health services for budget, and few people who dont have cover actually pay there ambulance bills

 

[USS Exeter]

Welfare, foodstamps, free/government housing, government schools, free/cheap medical care/clinics, etc are not exactly used by the rich.

The rich are the minority, the poor and middle class are the majority. Unless you were not just being selfish, I will shut up now.

 

[Michael]

The sad thing in AU is the Medical Schools suck. PBL ..... pffff what a waste of time. or at least USYD where they didn't even teach anatomy! They also sell the degree for top dollar to over seas Ss who couldn't get into a Canadian or USA or English Med School. That's BIG money for the rich kids of those countries.... OH, and of course there is the policy of letting especially dumb rich Aussies take ALL but the few remaing seats - at full tuition of course.

 

[Asguard]

Michael i KNOW you dont like Australian medical schools. I find your reasoning to be wrong because both my sister and I have done classes in A&P, both were more focused than what the med students recive (well i know mine were, not sure about hers) because my classes focus on emergency care (very skills based in some area's) and hers were on muscular conditions (she is training to be a pysio). If i wanted to i could go on to do med post grad at flinders after i finish my degree. Oh and i agree with you about full fee paying courses but HOPEFULLY they will be gone soon anyway (that WAS one of the election promises, i hope he carries it through)

 

[Michael]

All I know is that the USYD med school teaches the Ss (according to them) about 25% of what the USA and Canadian Med Ss get in terms of information. I personally know Ss that have given up trying to pass the examinations to work in the USA and will remain here and work.

Scary huh? And I'm not talking about 1 or 2%....

 

[sandy]

yeah right ok!! your so wrong there, the NHS is shit, and full of no good doctors! (not all of the doctors are bad) but the ones who are bad are very bad!! why are people still suffering after 3 years of having an operation that went so wrong they can't even lift they're child,

You're right LA. I have heard/read this all over the net.

If we want an efficient/affordable health care in this country, we have to turn the private sector loose.

 

[spidergoat]

That's insane. It isn't affordable now, while the private sector is "let loose".

 

[joepistole]

The problem now is that government and the industry are restricting supply:

http://en.wikipedia.org/wiki/American_Medical_Association
Critics of the American Medical Association, including economist Milton Friedman, have asserted that the organization acts as a government-sanctioned guild and has attempted to increase physicians' wages and fees limit by influencing limitations on the supply of physicians and non-physician competition. Friedman said, "The AMA has engaged in extensive litigation charging chiropractors and osteopaths with the unlicensed practice of medicine, in an attempt to restrict them to as narrow an area as possible."[10][11]. Critics who call the AMA a guild assert that these supply limiting actions not only have inflated the cost of healthcare in the United States but also have caused a decline in the quality of healthcare.[11]

Profession and monopoly, a book published in 1975 is critical of the AMA for limiting the supply of physicians and inflating the cost of medical care in the United States. The book claims that physician supply is kept low by the AMA to insure high pay for practicing physicians. It states that in the United States the number, curriculum, and size of medical schools are restricted by state licensing boards controlled by representatives of state medical societies associated with the AMA. The book is also critical of the ethical rules adopted by the AMA which restrict advertisement and other types of competition between professionals, it points out that advertising and bargaining can result in expulsion from the AMA and legal revocation of licenses. The book also states that before 1912 the AMA included uniform fees for specific medical procedures in its official code of ethics. The AMA's influence on hospital regulation was also criticized in the book.[12]

The AMA is also criticized because it derives a significant portion of its income by selling physician prescribing data to pharmaceutical companies.[13] It continues to do this despite physician outcry, claiming approximately 33 million in revenue in 2005 from this practice. However, the AMA does allow physicians to "opt-out" of having their information shared through the Physician Data Restriction Program (PDRP).


And given that the population of the United States has increased more that 33% since the last time seats were added to medical schools, I think it is about time we started training more doctors.

 

[Asguard]

you have that problem there to?

It drives me nuts how much power the AMA (australian medical association) has in Cambera. The Generational Health Review recomended job subsitution as a way of combating the skills shortage. This means that senor Nurses would work as GP's (refering and treating ect), Pysios and Phycologists would work as front line practioners and Paramedics would run A&E's. Insted the goverment imported more doctors from india because the AMA didnt like the idea. Idiocy

 

[Michael]

I have to say - those doctors from India are GREAT. They are probably some of the, if not THE, bets physicians in this country. They are hard working, professional and seem from my point of view to do good work (at least at Uni). One day they will probably be the ones who will make the big changes need to bring medicine in AU back into some sort of semblance of "Health Care" instead of what it is now - money grubbing.

But who really knows?

 

[Asguard]

the only problem i have with indian doctors is there accent makes it hard to understand what they are saying. This is worse with a GP than with a doctor in a hospital (you can always ask the nurse to translate) especially when you are trying to describe mental health problems and you cant understand the person you are expaining them to. Apart from that i agree they are great but we cant keep stealing them from India, they need doctors too. We need a long term solution to the doctor shortage and i agree 100% that job subsitution would work. In country hosptals we already HAVE Paramedics runing A&E's. We already HAVE nurse practioners. Why would you need to waste a doctors time if you can just go to a physio or a shrink.

 

[iceaura]

There is no evidence of this. If it were true we would see infinate demand for medical services by those already covered by government insurance programs for the poor and for the military. In these instances, the poor and the military, healthcare is completely free in the United States.

Health care in the US is rationed, all of it. The poor do not get all they want of every kind they want, and neither do the military.

There is a finite demand for healthcare services and products, were it not the case insurance companies could never quantify the risk.

The insurance companies quantify the risk by limiting their coverage and rationing the delivery.

If you are wealthy enough to pay for it, you can get medical coverage that is essentially limited only by your own inconvenience in accepting the attentions. But very, very few people on this planet can afford that.

The veterinary medicine business is less regulated in the United States, and yes, it is less expensive as a result. But no one is advocating shooting people in the backyard because of an illness. As I said under the plan I proposed, every one has healthcare insurance, and everyone has access to all the healthcare services and products they need.

What is different is that everyone is covered, and everyone pays for it. And costs are kept in check with the free markets (demand and supply).

The vet business is actually pretty tightly regulated. The lower prices are not from lack of regulation, but from market economics - so we have an example of free market health care that lowers prices. And so we can see how a market in health care would work - what the conditions necessary for a free market look like in the health care business. They include, fundamentally, not buying the service.

As far as forcing everyone to buy insurance, without doing anything about the insurance companies' denial of care or rate adjustment options, a better guarantee of continuing the current arms race inflation of insurance premiums and profits of insurance companies is hard to imagine - and the effects on prices easy to imagine.

 

[Tiassa]

If we want an efficient/affordable health care in this country, we have to turn the private sector loose.

The key word in the above is "affordable". The private sector only regards affordability in terms of the desired market. If the desired market is the upper class, affordability is thus defined. If the desired market is the people at large, affordability is thus defined. Should I ask what you mean by affordable, or should we simply presume that, as your other posts around Sciforums indicate, some abstract measure of yourself is the definition of affordability? In other words, as long as you can afford it, all is good, and screw everyone else?

 

[Asguard]

the problem with throwing it to an open market is that the market will move to reduce costs by getting rid of people who overuse the services. For instance people born with a medical condition that will require a lifetime of care would be unisurable. The goverment run systems dont work this way.

 

[Tiassa]

A note to PJdude1219:

... how come when ever i started a universal health care thread i never got this kind of response?

I don't know. Did you start with a disingenuous exaggeration in order to whine and cry and pitch a fit about the concept? To be honest, I don't know. The first one got 119 replies, while the second petered out after 48. At present, this topic is pushing 70 or so replies. Flip a coin? Split the difference? How do you mean?