my thoughts exactly...

and remember folks, you can't win if you don't buy a ticket.

Government controled health care will be run like the veteran’s affairs hospitals, Medicaid, Medicare, FEMA.

Also, look at Canada and England. Their health care system is horrible and they both run on universal health care systems. They also pay like 16% sales tax and horrible income taxes.

what a well run, single party, liberal state we live in. Did you expect anything different?

Ben,

"The Availability of Affordable Healthcare

One-fourth of American respondents are either "very" or "somewhat" satisfied with "the availability of affordable healthcare in the nation," (6% very satisfied and 19% somewhat satisfied). This level of satisfaction is significantly lower than in Canada, where 57% are satisfied with the availability of affordable healthcare, including 16% who are very satisfied. Roughly 4 in 10 Britons are satisfied (43%), but only 7% say they are very satisfied (similar to the percentage very satisfied in the United States).

Looking at the other side of the coin, 44% of Americans are very dissatisfied with the availability of affordable healthcare, and nearly three-fourths (72%) are either somewhat or very dissatisfied. The 44% in the United States who are very dissatisfied with healthcare availability is significantly higher than corresponding figures in either Canada (17%) or Great Britain (25%)."

Source: http://www.gallup.com/poll/8056/Healthcare-System-Ratings-US-Great-Britain-Canada.aspx

The poll may be from 2003, but it's fair to say most Americans are more concerned about the availability of affordable healthcare now.

The USA is #1 in everything. We've got the best healthcare system in the world and the dollar is the strongest currency. We're loved everywhere for our wise and considerate foreign policies and our economy is outstanding. ("The empire is crashing...") Who was that? Arrest him!

Their health care system is horrible

Don't the 45 million uninsured (600,000 in Oregon) make the US health care system horrible? Does your version of "good" include 1 out of every 6 or 7 people lacking coverage? Seriously?

it's odd when people argue that any health care system other than a privately run, exhorbitantly expensive one is a disaster.

despite the existence of abundant, long-term data to the contrary, and the increasing failure of the American system to provide millions of adults and children with *any* health care.

in other words, every other first world government attempts to provide health care for all citizens, and every other first world country does that much better than America.

FACT:
over 46 million Americans, including millions of children, have no health care. most of those adults *work*.

FACT:
millions more Americans have inadequate health care (either very irregular or only covering major medical disasters.)

FACT:
health care in America is the most expensive in the world.

FACT:
America's health care system has the worst preventive care in the world--doctors are incented to prescribe and generate patient rolls, not to minimize the number of patients and prescriptions through preventive care.

FACT:
100% of all first world governments provide free (or nearly free) health care to all citizens, regardless of income or job status--except America.

these are easily verifiable facts, supported by decades of data. any reader with patience and access to Google can do so in about 15 minutes.

Eco, you may be right, but the biggest problem in this country are HMOs and insurance companies. And our government will NEVER be able to make healthcare work until they go away. And that just isnt going to happen. They have too much influence in Washington. There too many congressional pockets to to be lined.
You just cannot mandate universal coverage with institutions whose #1 job is to deny coverage and maximize profit for stockholders.

I mean seriously...people bitch about oil companies, and all they do is power our cars. The health industry makes money denying people medical coverage.
Who is really worse?

And of those 600,000 without coverage in Oregon...I wonder if that includes the illegals?

FACT:
100% of all first world governments provide free (or nearly free) health care to all citizens, regardless of income or job status--except America.

I find this one most interesting, since here in America, we give free health care to non-citizens and raise the rates on citizens to cover it.

Gosh, my government-run single-payer plan worked great for me and several million of my best buds throughout the US military. At least the shortcomings of military medicine are not created by the incentives in the system to deny people care, and nobody's bonus depends on rejecting a claim.

Anyone who supports the current insurance system would logically also support private fire companies who would refuse to put out fires except for subscribers to their plan.

Health care who needs it. I just use the
emergency room, for me and my family.

Ron Mexico.

Ok let me see if I have this correct. The current health care system is "abused" by those who are illegally in this country so that is a good reason to not try to fix it. Is that right?

Or is it that all of the current problems with the current health care system can be fixed by making sure health care is denied to illegals. Is that correct?

Anyone have any actual arguments or data to support either of the above? Or am I misunderstanding and there is another reason why the terms "illegal immigrant" and health care fix belong in the same discussion?

Greg C

George:

Apples to oranges. The health care system you talk about may work fine, but look at the participants - members of the military and their dependents. I don't think the system would work nearly as well when we start including those who really use the bulk of the system's resources - the elderly. How is medicare working? Is anyone (patients or providers) satisfied with it?

The problem with health care in this country is that we already have a universal health care system - it's called the urgent care clinic. Go to one on any night of the week and you'll see what I'm talking about. When those without coverage are billed, many can't pay, so those of us who pay our premiums get the privilege of paying for them each month. A universal system would (hopefully) allocate the costs differently, and save those of us who can hardly afford to pay our premiums a little money. To that end, it would be a benefit.

At the same time, with the struggles that medicaid, medicare, and the VA system have all demonstrated, it's hard for me to have any faith that the dimwits in elected government can run a program any better, especially when it comes to more specialized care. Without private coverage, my wife and I would not be parents, and my father, who had a rare form of cancer, would not be alive today to hug his grandkids. For those of us with family members who have had very specialized medical care, the thought of a government run program which limits our options is not particularly appealing.

And while I am a strong proponent of preventive medicine, good luck at trying to get people to go to the doctor regularly, or change to a healthy diet, or exercise regularly. You can lead a horse to water, but you can't make it drink.

My fear is that this is a problem that will never be solved in a manner that is satisfactory to a large majority of Americans. Once we create a government run system, however, there's no going back, no matter how crappy it turns out to be, as people now have an "entitlement". If it works great, then we made a great choice. I just don't have any faith that it will.

How is medicare working? Is anyone (patients or providers) satisfied with it?

Better, in fact, than the private sector; medicare-eligible people have access to care. Not for want of the Bush administration to try to sink the program with its drug benefit -- a monumental welfare program for pharmaceutical companies. Lots of people are well satisfied with Medicare, and its delivery system is vastly more efficient than the private sector's. All of you who are convinced that government is incompetent to deliver services must be worried sick about national security.

At the same time, with the struggles that medicaid, medicare, and the VA system have all demonstrated, it's hard for me to have any faith that the dimwits in elected government can run a program any better

did you notice that it's working for several hundred million people in the rest of the first world?

The problem with health care in this country is that we already have a universal health care system - it's called the urgent care clinic.

wrong. i've been friends with both trauma surgeons and "urgent care" physicians and nurses, and both agree--most users of urgent care already have insurance.

"did you notice that it's working for several hundred million people in the rest of the first world?"

Did you notice that they pay an exorbitant taxes to get heath care that is several notches below our health care?

Did you notice that many operations that are not necessarily life-threatening (like gallbladder removal) are put on a waiting list? Here, that surgery is done within a day or two (we seem to realize that if the gallbladder erupts the patient is in much worse shape than if it pulled prior to eruption).

Did you notice that many of the better off citizens of Briton go to private hospitals where the care is better and there are no waiting lists? Did you notice that many Canadians come to the US to get surgery and treatment because their system is ... so good???

If you want the government to run healthcare, be prepared to have it run no better than the DMV or the Post Office. And it WILL be more expensive than what we pay now (just one of those added bonuses that you get when the government takes something over).

Did you notice that they pay an exorbitant taxes to get heath care that is several notches below our health care?

i pay about 28% of my pay in taxes. in England, for example, the comparable rate is about 40%.

for that extra 12%, they get an array of services (including health care) that Americans can only dream of. tax rates are comparable to England's in countries like Sweden.

Did you notice that many operations that are not necessarily life-threatening (like gallbladder removal) are put on a waiting list?

sometimes--and that's also true in America (and you can verify it.)

Here, that surgery is done within a day or two
i'd be grateful for *any* proof that that's common in the US.

Did you notice that many of the better off citizens of Briton go to private hospitals where the care is better and there are no waiting lists?

yes, a tiny minority do--but health care for the average Briton is the same or better than that Americans get.

Did you notice that many Canadians come to the US to get surgery and treatment because their system is ... so good???

really? how many? and, how many Americans go to Canada to get both surgery and presciption medicine? more to the point--what the heck does that prove?

If you want the government to run healthcare

i want health care funded by the people, for the people, via taxes. just like Police, Fire, Public Works, Highways, Streets, and a host of other public goods that you and me pay taxes for and are "run" by the government.

And it WILL be more expensive than what we pay now (just one of those added bonuses that you get when the government takes something over).

given that American health care is already more expensive than health care in any other first world country on the planet, why should your argument make me want better health care less?

Ecohuman:

How do you know that it's "working" for the rest of the world? If I live in England or Canada or Sweden or wherever, what are the chances that the people polled are going to have any idea about the type of health care that is available in the United States? For that matter, when asked what they think of American health care, how many Americans are going to be able to provide an answer based on a critical analysis of the health care systems in foreign countries. This is why the "well, it's working everywhere else" argument is specious.

It may be that socialized medicine "works better" than private medicine - it may be that it does not. But to base an argument on the comments made by recipients seems highly questionable.

And what no one answers is what happens to those patients who need specialized treatment. In order to make the system "affordable", rationing will have to occur - look at the Oregon Health Plan for example. What happens to those people who need treatment that is not covered under the system but that is currently available in the private sector - will they be able to get that treatment?

I think what you will find is that people like me are very supportive of health care for all, but also very afraid that in order to provide health care to all, our families, who pay for private insurance, will suffer. If it means that I have to give up a life saving treatment for my spouse or kids or parents or sister in order to cover someone without insurance, then I'm not for it. If we can get universal coverage without sacrificing care standards for those who are currently insured, then I'm for it.

How do you know that it's "working" for the rest of the world?

man, what are you looking for--an Overall Happiness Index? the American system IS NOT WORKING.

while you wonk away on whether or or not every single citizen, without fail, is happy and receiving perfect care 100% of the time, America's got more children without access to health care than all of Europe *combined*.

meanwhile, Europe (for example) has health care for *everyone* (or as close as is possible), and, by god, it ain't bad. the children are generally all covered. the elderly. pregnant women.

and that's good enough for me. while you wait for some certainty about cost, effectiveness, etc., hundreds of millions of others are getting good health care.

'It may be that socialized medicine "works better" than private medicine - it may be that it does not. But to base an argument on the comments made by recipients seems highly questionable.'

Uh, how are you to judge how well a health care system works other than by asking the patients?

Oh wait I get it. I am to judge a health care system by how well it delivers health care to me. And since I have the money to purchase a very good health plan it does a good job. The heck with those people who don't have the money to pay for a very good health care plan. Why should MY taxes go to pay for something that right now I don't need. Of course if somewhere down the road I should need it I will be right along with everyone else screaming at government for "wasting" money on the other guy.

Greg C

You don't need to look at anecdotes for comparisons. It's easy to find overall performance data on the web. For recent years (and earlier ones, too) they show that other developed countries spend vastly less on health care (measured as a percentage of their GDP, as compared with ours) with measurably better outcomes (measured by life expectancy and infant mortality). We spend more than 15% of GDP, compared with 9 or 10% for Canada or France or Germany, all of which have longer life expectancy and lower infant mortality rates, by a significant amount, than we do.

If we can get universal coverage without sacrificing care standards for those who are currently insured, then I'm for it.

sorry--in my haste, i missed that part. i think that's fair, but I believe it's already been addressed (see Allan's comment above.)

When I saw 'England' in the headline, I expected it was going to be this item in The Telegraph:

Fed eyes Nordic-style nationalisation of US banks, By Ambrose Evans-Pritchard, International Business Editor, 01-Apr-2008.

The US Federal Reserve is examining the Nordic bank nationalisations of the 1990s as a possible interim solution to the US financial crisis.

---
"... interim ...?"

Yeah, lets emulate England:

http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=448395&in_page_id=1774

http://www.politics.co.uk/news/opinion-former-index/children-and-family/tories-maternity-units-overburdened-$1214196.htm

http://news.bbc.co.uk/1/hi/england/5284646.stm

http://news.bbc.co.uk/2/hi/uk_news/england/west_midlands/3170497.stm

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/09/12/nhealth112.xml

http://www.e-health-insider.com/news/3130/nhs_failing_on_offering_patients_choice

http://www.timesonline.co.uk/tol/news/uk/article3645853.ece

Ecohuman:

"While you wait for some certainty about cost, effectiveness etc., hundreds of millions of others are getting good health care."

Yes, Ecohuman, I do worry about cost and effectivenss. And guess what - Congress will too. A universal health plan will be expensive. Congress should worry about that, and demand that the program be effective. If that means that Congress doesn't rush in headfirst but instead acts prudently, so be it.

Greg C: If you read my post, what you'd notice is that I'm not asking about how well a health care system delivers services to me. I'm asking about how well it delivers services to those I love. And your damn right Greg - if the coverage for my family declines in order to provide services to others, then I'm not for it. I have an obligation first and foremost to ensure the health and welfare of my family - blood is thicker than water.

And no, Greg, I'm not going to whine about paying taxes to pay for someone else's health care. If you'd taken the time to read my earlier posts, you'd note that higher taxes aren't the reason I would oppose universal health care, if I were to oppose it. But its irresponsible to throw something up on the wall, hoping that it sticks, and not giving a damn about how much it costs or whether it really works, based on models from another country with an entirely different culture, government structure, and business climate.

Allan L.: Thank you for your post. These are the kind of facts that lead to a thoughtful discussion. But I ask you - not Gary or Ecohuman - how do we provide for the specialized coverages that many Americans have come to expect from our current system?

reason why the terms "illegal immigrant" and health care fix belong in the same discussion?

Absolutely. Illegals go to the ER for basic medical care. They cant be turned away. They dont pay, and those of us who have the means to pay (or be billed anyway) get to pay higher costs when we have to use the hospital because the hospital sure isnt going to eat it.

Yeah, lets emulate England:

anecdotes make for good drama, don't they?

like, say, these?

Chris, mining Google for bad examples is easy. why not take a shot at analysis of the actual overall issue?

from Eco's link above:

FACT: Federal spending for health care totaled more than $600 billion in 2005, or roughly one quarter of the federal budget. (U.S. Office of Management and Budget)

Ouch.

And maybe this is why some people dont go to the doctor (even when they have coverage):

FACT: Close to 100,000 Americans die annually from medical errors -- more than double the number of Americans who die annually in car crashes (Institute of Medicine).

"Eco, you may be right, but the biggest problem in this country are HMOs and insurance companies. And our government will NEVER be able to make healthcare work until they go away. And that just isnt going to happen. They have too much influence in Washington. There too many congressional pockets to to be lined.
You just cannot mandate universal coverage with institutions whose #1 job is to deny coverage and maximize profit for stockholders."

Jon hit the nail on the head with this one. I think before going to the extreme of another government entitlement program, we should first work for reform in our current system.

I *have* looked at the issue, Eco. I'm not convinced a national health care program is the correct approach for a country with over 300 million people.

The Commonwealth Fund study that shows the US in 37th place in quality of health care (and other criteria) is full of holes and used questionable methodology in gathering data. But they sure got a lot of publicity out of it, didn't they? You know as well as anybody that 'facts' can be stated (like the Urban Renewal myths), but they aren't always true.

Mortality and birth rates are very subjective depending on the country supplying the data. For instance, the US spends tons of time and money keeping preemies alive whereas other countries label them as stillborn. And do you really think seniors have a better quality of life in Bosnia and Cuba than the US? If so, I have a bridge to sell you.

The overall health of a nation is not a function of healthcare, it's a function of lifestyle. If you haven't noticed, we are the most consumptive and gluttonous society in the world. Plus, many miss the fact we pretty much subsidize medical R & D for the rest of the world.

Sure we have problems, but getting government *out* of our current system is the first step in reform.

PHYSICIANS FOR A NATIONAL HEALTHCARE PROGRAM - Reflecting a shift in thinking over the past five years among U.S. physicians, a new study shows a solid majority of doctors - 59 percent - now supports national health insurance. Such plans typically involve a single, federally administered social insurance fund that that guarantees health care coverage for everyone, much like Medicare currently does for seniors. The plans typically eliminate or substantially reduce the role of private insurance companies in the health care financing system, but still allow patients to go the doctors of their choice.

A study published Annals of Internal Medicine, a leading medical journal, reports that a survey conducted last year of 2,193 physicians across the United States showed 59 percent of them "support government legislation to establish national health insurance," while 32 percent oppose it and 9 percent are neutral.

The findings reflect a leap of 10 percentage points in physician support for national health insurance since 2002, when a similar survey was conducted. At that time, 49 percent of all physician respondents said they supported NHI and 40 percent opposed it.

Support among doctors for NHI has increased across almost all medical specialties, said Dr. Ronald T. Ackermann, associate director of the Center for Health Policy and Professionalism Research at Indiana University 's School of Medicine and co-author of the study. "Across the board, more physicians feel that our fragmented and for-profit insurance system is obstructing good patient care, and a majority now support national insurance as the remedy," he said.

Support for NHI is particularly strong among psychiatrists (83 percent), pediatric sub-specialists (71 percent), emergency medicine physicians (69 percent), general pediatricians (65 percent), general internists (64 percent) and family physicians (60 percent). Fifty-five percent of general surgeons support NHI, roughly doubling their level of support since 2002.

Doctors have often expressed concern about lack of patient access to care due to rising costs and patients' insufficient levels of insurance. An estimated 47 million Americans currently lack health insurance coverage and another 50 million are believed to be underinsured. At the same time, health care costs in the United States are rising at the rate of about 7 percent a year, twice the rate of inflation.

Mortality and birth rates are very subjective depending on the country supplying the data.

do more research on what "mortality rates" are and how the figures are compiled in first world countries. they're directly reported and not abstracted, for starters. they're not "very subjective."

You know as well as anybody that 'facts' can be stated (like the Urban Renewal myths), but they aren't always true.

i agree. but the facts presented here seem well supported and fairly incontrovertable to me. and if they're true, while we spend time critiquing other systems, ours is crap, and failing the vulnerable among us at almost every economic level.

The overall health of a nation is not a function of healthcare, it's a function of lifestyle.

that's simplistic.
i guess what those 46+ million health care-less Americans really need is a new lifestyle, then? Chris, millions of those are children below the age of five, born to working parents.

Plus, many miss the fact we pretty much subsidize medical R & D for the rest of the world.

billions spent on creating drugs is not health care; and those drugs are created in several other places than the US. it's arrogant (and plain false) to assume that medical practices are simply more advanced (or superior) here.

And do you really think seniors have a better quality of life in Bosnia and Cuba than the US?

Cuba's citizens live much longer (with fewer health problems) than Americans. guess they have a better "lifestyle"?

and i should reiterate: i'm arguing for "health care for all, paid for by the people for the people."

public vs. private doesn't matter to me, except for noticing that private (so far) has failed most of us miserably--except for health care providers, who enjoy profits second only to the oil industry.

so, anybody want to tackle why we don't automatically provide *full* health care for all children, all senior citizens, and all other vulnerable citizens? is not the impact on society of that failure fairly clear and far-reaching?

Good grief Eco, talk about simplistic. Are you really suggesting medical data submitted by the government of Cuba is going to be factually correct? Sounds to me like your ideology is showing.

And you think eating/smoking/drinking too much and exercising too little have no effect on health?

I thought you were smarter than that.

Are you really suggesting medical data submitted by the government of Cuba is going to be factually correct?

dang. i always forget: Cuba bad, America good. Cuba lie, America honest. America happy, Cuba sad.

by the way, the WHO and the CIA World Factbook were my sources. i can't vouch for the CIA, but I'm guessing they didn't rely on a phone call from Castro.

"... anybody want to tackle why we don't automatically provide *full* health care for all children, all senior citizens, and all other vulnerable citizens?"

Because Marxism doesn't work. Healthcare is not a right, nor is food, shelter and clothing.

Funny how scads of immigrants are pouring into this uncaring, selfish, capitalist country where we allow children and the elderly to die in the street. I guess they're all gluttons for punishment.

You sound pretty Cassandra-ish there, Eco...

except for health care providers, who enjoy profits second only to the oil industry.

You have a cite for that? Im not disagreeing with you here, I am just curious if thats based on profit margin, or actual $$. Oil companies, while making a ton of profit $$ wise (they sell a LOT of gasoline), on average make something like 8% profit. Far less than most companies, such as banks, big pharma, etc. Even Microsoft has a much higher profit margin than oil companies (like 30% last I checked).

You have a cite for that?

here's a place to start. Google can tell the rest with a quick search.

if you're worried about what "profit" means, others here can head off into that corner with you better than I.

Healthcare is not a right

Emergency health care in America is a right. That's why federal law (EMTALA) requires hospitals to treat everyone who presents with an emergency condition, regardless of their ability to pay. It's also quite clearly a value that Americans hold deeply. I can't imagine anyone, including you, who would suggest that we let someone die rather than give them free medical care.

So the only thing we're arguing about is whether it's better to wait for that to happen, or provide some up front coverage that would make the system more efficient and dramatically improve quality of life for the uninsured.

Healthcare is not a right, nor is food, shelter and clothing.

who's talking about rights? i'm talking about the needs of my fellow humans.

Funny how scads of immigrants are pouring into this uncaring, selfish, capitalist country where we allow children and the elderly to die in the street. I guess they're all gluttons for punishment.

immigrants are pouring into *every* first world country, my friend.

You sound pretty Cassandra-ish there, Eco...

thanks, man. it's not easy being amongst such Socratic giants, but I do my best.

ecohuman, in isolated cases, perhaps a serious concern, (serious sounding bite, anyway), deserves to be given the antisocial estrangement in them.

"... Marxism doesn't work. Healthcare is not a right, nor is food, shelter and clothing."

For the whole of the world, Marxism does 'work' and a healthful planet sustaining 'food, shelter, clothing,' and all necessities of life is a right; though it seems that's not working for disaffected splinter troops.

Aye, and there's the rub that's groomed the grain of griping LIARS.