Universal Health Care - Still Not Possible in US

[Epi]

Hillary would have done a lot more for single-payer universal healthcare. That WAS what she was campaigning for and has been for years. Paul Krugman was the only one pointing that out for months while everyone was enamored with Obama.

Obama's a great guy, but he was never one who advocated for a single-payer system, thus it's not going to happen.

 

[kEiThZ]

Without a cultural shift, I doubt universal health care is very feasible in the US. Even many liberal Americans I come across think Canadian health care is some horrendous beast where a government bureaucrat in Ottawa determines how and when you get treated. As long as they fail to understand our system (both its successes and failures) they will have a tough time selling single payer health care (or even one with more private involvement like France for example) to the American public.

It's quite similar to how Canadians react to any notion of private sector involvement in our health care system even in cases when it makes sense (diagnostic services for example). The only way the situation would change on the either side of the border is for economic or financial reasons. For the US not having universal publicly funded health care is quickly becoming an issue of economic competitiveness. For Canada, we are fast reaching the point where we will need some private sector involvement to deliver the care we want....both societies need to start debating where the line should be drawn between public and private contributions to health services.

 

[afransen]

Starting? We already have a sizable amount of private medicine in Canada. I think the important thing is single-payer. If the private sector can perform procedures for less than the public sector while meeting service standards, I see no harm in private delivery. I see single payer as the critical part of the equation, it terms of ensuring equity of access.

 

[kEiThZ]

^ I was referring to those who freak out at an combination of the words 'private' and health care. I don't dispute the value of our single-payer system.

 

[Brandon716]

Canada really doesn't need to start down the slippery slope of allowing massive private health systems to accrue, gain power, and eventually start buying off politicians.

If there were any type of increase in private medical services, I'd be okay with limited health facilities for 3rd party services that aren't primary care. Getting some tests done, like you said for imaging or whatever, is one thing. But allowing actual care or hospitals to become financed privately is a mistake.

Canadians are right to be anti-private care. Its saved the system many times and will continue to do so.

Most Americans actually don't realize how bad the American system is, and its such a foreign idea to average Americans to not pay for medical services. Beyond that, what Americans tend to do is cling to the ideas they are told rather than the realities of the system. We look at our well-off systems like the Mayo Clinic and John's Hopkins, or the Cleveland Clinic.. And Americans look at those few examples as why we have the "greatest health system" as many Americans believe. But when it comes to reality, most medical systems are horrendous here.

My mother worked in health care for over 35 years before retiring, I've studied health systems for nearly 10 years now. The American system is nothing like what our best represents it.

Most US patients with insurance face longer waiting lists and outright rejections that Canadians never have to deal with. HMO's and PPO's denying hip replacements or cancer surgeries for years, doctors afraid to treat patients because they don't think they will be reimbursed.

Americans are actually delusional about health care, because they think of private free-enterprise ideology above rational thinking. It doesn't matter if its a corporation that denies your care or tells you to die, because its not government involvement! LOL

Its literaly delusional, ideological based thinking rather than rational, health and helping people oriented thinking. And health care is supposed to be about the betterment of all, not about private, for profit enterprise.

Americans have to change on that in large numbers before help will arrive, otherwise we'll keep getting these half-baked Democratic and Republican 'health' plans that are government giveaways to private health insruance and will never be universal care.

 

[Long Island Mike]

Brandon: Universal Health Care: The Great American Dilemma...

Brandon: I agree with you concerning Universal Health Care in the USA!

I feel that doing something to assist the upwards of 50 million US residents with no insurance should be a high priority!

It makes me angry when Republicans in particular argue against health care and mention the Government bureaucrat that would stand between you and your Doctor - but you have a for-profit Insurance Company in between today!

I remember seeing a show on how other Industrialized societies provide health care-I believe if you want to keep private insurance or care you should be able to opt out if you choose-Like The Netherlands allows I believe.

Those same anti single-payer types complain about people waiting for care in Canada but at least they are getting the care - the Uninsured in the US may NEVER get it because they CAN NOT AFFORD IT!!!

This is why I feel that it is the Great American Dilemma!

- Opinion and insight from Long Island Mike -

 

[afransen]

What I think is interesting is a point that was raised by Paul Wells and Andrew Coyne in their most recent podcast (which are great, btw). Canada now has, as a result of economic growth and fiscal responsibility, managed to return to levels of taxation that we have not seen since the 1950s, yet we've managed to do that while maintaining our generous welfare state. Moreover, it goes to show that we certainly have more room to put money into health care. My main concern is that we have not done a great job of making a comprehensive health care system. There is a whole spectrum of treatment options between your family physician and your local emergency room that is underdeveloped. Given that doctors are less and less interested in working 70h weeks, I see multi-physician practices working in conjunction with nutritionists, nurse practitioners and other specialists being the way forward. Progress on that front has been agonizingly slow, but it does seem to be happening. Once we set up a system that is much more geared toward health rather than treatment and that uses appropriate levels of resources (rather than tying up ER space to treat minor cuts and scrapes), then I would wholeheartedly support a substantial increase in funding for health. As it is, we spend much less than other countries on our health care system, and barely half what the US spends.

 

[kEiThZ]

I'd like to see more prevention. For starters I think a minimum fitness standard for a high school diploma would go along way towards reducing health care costs in the long run.

 

[jade_lee]

A huge problem with healthcare and who pays for it in the states is directly linked to the business model of their system, which is placed in the hands of doctors who are not business men yet they control the way business is conducted at all levels. Their power over our notions of healthcare is extraordinary. For example, hospital care being the most expensive of any form of healthcare delivery is very convenient for a doctor yet not always best for the patient. Doctors currently are virtually uncontrolled and uncontrollable. The main decision makers are independent, private, entrepreneurs, accountable to virtually no one for decisions they make in their use of resources. Futhermore, few doctors are trained to have any consciousness of the economic power which they exert collectively. Doctors control hospital admissions, access to prescription drugs, and access to certain theraputic procedures. A very powerful monopoly position indeed.
Victor Fuchs decribes in his book "who shall die" how the health care industry does not fit a market economy where consumers are free to buy or not to buy. In health care, both the doctor and patient assume that it is necessarily proper for the provider and not the consumer to decide which product to buy, how much of the product should be purchased, what the cost of that product should be, and when the product is needed. In addition there exists social taboos against the customer asking the price or details of the service they are receiving. especially if the state, insurance or other is covering the cost. Unlike Canada if you throw the private insurance industry into the loop a complete nightmare evolves and that is what I see happening down there. Big business controls healthcare completely and continues to position itself that way despite the numbers of individuals faced with financial ruin due to healthcare costs. It's a strong lobby indeed which is supported overwhelmingly by the demigods we all commonly know as physicians.
It's not shocking at all that the previous president of our CMA is shooting off his mouth down south about the failure of our Universal health care model, this individual is a strong advocate for private health care delivery and payment as well as government payment. He wants to suck and blow at the same time and I doubt that it's the good health of every Canadian he has in mind. Yes just another case of how power corrupts. There is no political will in the United states for universal health care because the power is clearly not in the hands of the consumer. It's not much better here where government tweeking is often based on the dictates of the health care
industry.

 

[kEiThZ]

BTW I read somewhere in this forum that you thought kids in Highschool here should not get their diplomas if they are over weight.......tell me do you think that shit up by yourself?

Care to explain why this is a bad idea? We live in a society where health care is fully funded by the taxpayer. Surely, it is incumbent upon all citizens then to attempt to live a healthy lifestyle to ensure that scarce health care dollars can be used effectively and efficiently.

There may not be a way to enforce that principle with adults but we should at least try to set up our kids to have healthy lifestyles....and it's especially in a world where we live increasing sedentary lifestyles. Obesity and particlarly teen obesity is rising. We need to combat it. I have met 18 years olds lads who could not do a single push-up or run a mile without running out of breath. There is zero excuse for that kind of physical condition. Nobody is saying they have to be all-star athletes. But if you can't stay in shape, you will be a burden on society. We encourage kids to get an education so they are not a burden on society. Why should it not be the same with the health care system?

I am all for a stricter phys ed component. And indeed, if you did something like the IB or any other school system which has higher standards than the OSSD, my requirement would seem like a joke.

I would consider for example the minimum used for enrollment by the CF...for males that's 19 push-ups, 19 sit-ups, 2.4 km in 12 mins, 6 chin-ups. I was in high school a decade ago and virtually every guy in my class could do that, most without breaking a sweat. Today, there's fewer and fewer teen males who can meet those standards without xbox breaks. I don't know what standard we could adopt (there's professional who could figure that out) but setting a standard would be a good first step.

You make think it's shit, but I am sure many folks on here would not think it's such a bad idea....especially if you want the health care system to be sustainable.

 

[jade_lee]

I have no problem with promoting good health and in this age of information kids are bigger and stronger than ever before. Poverty and obesity is a huge problem because healthy food is expensive and that can no longer be denied, enforcing physical strength and fitness requirements on teens in order to receive their diplomas might put some at a disadvantage, good parents who can provide the best are always stiff competition. Your idea is draconian don't ya think? You call yourself a Centrist?

BTW my 16 year old regularly lifts 245 lbs no problem.

We live longer, that is going to cost Canada large in our near future and we have not prepared for it either. That is why maintaining Universal Health Care in Canada is a top priority of Baby Boomers who continue to have a huge voice politically.

 

[kEiThZ]

Your idea is draconian don't ya think? You call yourself a Centrist?

It's no more draconian than any other standards we set for kids. Is it draconian to require x amount of credits for a high school diploma? Is it draconian to force them to go to school by law (or they are charged with truancy) when there are few that don't want to? Is it draconian when parents sign their kids up for soccer or hockey just to get them moving?

When raising kids we accept a certain level of authority. Parents discipline kids because it's good for them. And governments enforce school standards because it's good for the kids. That might be a tad draconian but we accept it because it is good for the kids and good for society in the long run. Having a physical fitness standard to save health care bucks in the long run is no different than requiring all teens to attend high school till the age of 18 in the hopes that we'll have fewer welfare cases.

I don't see any conflict with me being a centrist and advocating for regulation once in a while. That's the beauty of being a centrist; I don't have to be dogmatic. I can advocate for or against various issues as I see fit. I actually use my own principles to advocate on issues instead of towing the party line on everything.

If we didn't have public health care then I don't think it would be a big deal. If you want to kill yourself and it costs the taxpayer nothing, I don't see why the government should stop you. But since we have a publicly funded health care system, I would expect that any good citizen would do his best to minimize health care costs to the taxpayers. Indeed, my argument was used in a recent court ruling against a Sikh who wanted to wear a turban instead of his helmet. The judge ruled that the citizen had a responsibility to society to exercise a reasonable level of care over himself to ensure that he didn't become a burden on the health care system by ending up a paraplegic.

 

[kEiThZ]

Poverty and obesity is a huge problem because healthy food is expensive and that can no longer be denied, enforcing physical strength and fitness requirements on teens in order to receive their diplomas might put some at a disadvantage...

The same could be said for any issue on parenting from school to other extra-curricular activities (piano lessons for example). I don't think it's an acceptable excuse. It costs nothing to run outdoors. And it costs nothing to do push-ups and situps on the floor. It may not be as fun as going to a gym to work out but it is effective. And hell if they aren't eating enough then aren't likely to be overweight anyway.... However, when it comes to stuff like this, I'd also support a universal breakfast and lunch programs so that kids can be fed right as well. But we'll save that for another discussion.....

Have a look at the standards for the IB. Aside from the academic standards there are significant components of community service, creative development (music, art, etc) and of course physical activity. That's a well rounded education. Requiring one credit in PE in grade 9 is not. If you don't want a test, then we could require kids to play x amount of hours in vigorous sports. That would probably achieve the same result. I'd rather set a standard and then let kids get there on their own (personal training, sports, group training, etc.). Perhaps give them tests every year just so they know where they are (does not account towards anything).

Back on topic....I am surprised that prevention is not discussed when it comes to the US. Obesity rates there are exploding too. And I am sure all this stuff is probably starting to impact their economic competitiveness.

 

[afransen]

The same could be said for any issue on parenting from school to other extra-curricular activities (piano lessons for example). I don't think it's an acceptable excuse. It costs nothing to run outdoors. And it costs nothing to do push-ups and situps on the floor. It may not be as fun as going to a gym to work out but it is effective. And hell if they aren't eating enough then aren't likely to be overweight anyway.... However, when it comes to stuff like this, I'd also support a universal breakfast and lunch programs so that kids can be fed right as well. But we'll save that for another discussion.....

Have a look at the standards for the IB. Aside from the academic standards there are significant components of community service, creative development (music, art, etc) and of course physical activity. That's a well rounded education. Requiring one credit in PE in grade 9 is not. If you don't want a test, then we could require kids to play x amount of hours in vigorous sports. That would probably achieve the same result. I'd rather set a standard and then let kids get there on their own (personal training, sports, group training, etc.). Perhaps give them tests every year just so they know where they are (does not account towards anything).

Back on topic....I am surprised that prevention is not discussed when it comes to the US. Obesity rates there are exploding too. And I am sure all this stuff is probably starting to impact their economic competitiveness.

There is a wrinkle in that at least some people will need exemptions due to disability--unless you expect people with cerebral palsy to run or do chin ups. So once there are some exemptions, where you draw the line becomes sticky.

I would also be in favour of a substantial tax credit for people who maintain a good level of physical fitness.

 

[kEiThZ]

There is a wrinkle in that at least some people will need exemptions due to disability--unless you expect people with cerebral palsy to run or do chin ups. So once there are some exemptions, where you draw the line becomes sticky.

I would also be in favour of a substantial tax credit for people who maintain a good level of physical fitness.

There's always exceptions. That does not make it a bad policy. We don't expect kids with cerebral palsy to do calculus to get out of high school today, so why would we expect them to do push-ups to graduate if there was fitness standard in place? Just cause there might a few challenges with implementing the policy does not necessarily make it bad. The impact on quality of life, health care costs and life expectancy would be massive if this plan was implemented.

Tax credits for fitness could well be more difficult to achieve. How do you test people and give credit for good behaviour? We can tax goods that are bad for you (cigarettes, alcohol, UK sugar tax) but it's kinda hard to implement a tax break for the fit. And while I am sure we could find some way to implement it, I am skeptical that any tax break given to them would be enough of an incentive to get others more fit. That's like the argument for the transit tax break. It just rewards those who use transit anyway. The impact on ridership has been minimal. I fear that we'd have to have a substantial tax cut to motivate people on fitness. And that seems off to me. We shouldn't have to pay people to take care of themselves.