Healthcare with an occupy tie in

[Pete Nice]

I wanted to post this blog post from a lower middle class Pittsburgh resident the same age as me.

It is more about healthcare, as it was written in September of 2007. But OH MY GOD look at the foreshadowing that basically is ripping Occupy 4 years before it happened.

"Wide-eyed and terrified I watch the democrat primary "debates", which are actually just like joint press conferences, all the slack jawed lefties salivating for Hilary to announce Obama as her running mate. Cold sweat leaks out of me, white knuckles grips the remote. I see them all jabbering about a nationalized health care system, all of them saying the same thing like some warped dilapidated cassette tape that was sitting out in the sun too long, perhaps locked inside a car like a dog, or a neglected toddler.

Empty suits or skirts, whatever, yammering about our health care system and how bad it is. I frantically look around for the faintest sign of laughing, or disbelief from the audience; instead they draw cheers and applause. "What the fuck has happened to this nation?" I think out loud, only my cat is in the room to hear me. When did we need other people to pay our bills? I spend a little time online doing research about the Canadian health care system and England's nationalized health care system and suddenly ours doesn't look too shabby. In fact, when I analyze it, I recognize that we have the best health care system in the world.

When rich foreigners need surgery they come here, even Castro; despite what that tubby bastard Michael Moore told you. I have all the perspective in the word in this department; I went for a long time without a good job, or medical insurance, at a time in my life when I was being dropped on my neck and thrown into barbed wire for a living. When you get sick, you go to the doctor, and you pay for it when you can. To me, that's the key, YOU pay for it, yourself. Not me, I don't want to pay for you. And I am sure you wouldn't want to pay for me. We will be living in a nanny state, where the taxes will be astronomical just so we can pay for our neighbor's sickness.

When my lungs succumb to the black mentholated cancer, or my spotted, abused liver finally gives out under the heavy weight of beer and whiskey, I do not expect any of you to pay for my medical treatment, like a beggar on the corner of 6th and pen with a misspelled sign and stained old coffee cup. The taxes that are going to mount on us as citizens are going to more than double in the light of this health care crisis. I heard that some Canadians are up to 30%. Staggering, I can't imagine 30% of my money redistributed to other people.

I am not an economist; in truth I cannot balance my checkbook properly. However, I do know that the government can lower a price on something through laws and rules and tariffs, but it cannot lower the cost or value of something. In that fragile equation somewhere leaves a large gap of slack. That slack needs pulled by someone, that slack encompasses research, technology, and education of our medical professionals. We have the best doctors in the world, and I hate to tell you this it is because of the free market. Money is like blood in the water, but not just for doctors, for everyone. I am thinking about jumping to another job, because I got a pay cut in a "work force reduction" Everyone aspires to a better paying job. Medical professionals are the same. This country gives you the opportunity to increase your quality of life, through freedom. That is the answer to the question of the human condition; freedom to succeed and fail. That is how the generations before us built the best country that has ever been on the face of the Earth.

On the philosophical front, I take a somewhat callous point of view. I already pay enough taxes to pay for schooling of children that aren't mine; enough of my money is already transferred to people who can't afford their own groceries. It doesn't take a village it takes a responsible adult. I am tired of being taxed. And it chills me to my bones to think that some Americans harbor the idea that it's right for us to be paying for each other's medical treatment. Where is the American spirit and national identity in begging for the government to take care of us? Like we were all children? Where is the squared jaw can-do attitude of our grandfathers? Where are the tough ones saying "We are here to do the job, and we do not rattle easily"? When did we become a nation of people shaking in our boots? When did we become a people begging big brother to take care of our every needs? When did we start checking our personal responsibility at the door?"

[Hondo]

Unfortunately those of us that DO get it are quickly becoming outnumbered by those who don't. It's a whole lot easier for these lazy fucks to wait for or get someone else to do things for them than to nut up and do the heavy lifting themselves.

On the plus side...when it all does collapse they'll be the first to go. In the big sorting out afterwards only the people who know how to work and take care of themselves will survive the culling of the herd. Once the dead weight is out of the way maybe we can do a better job of keeping the Republic the next time around.

[i bleed green]

Sure our health care system has it's flaws, but I would take it over yours any day of the week.

[Hondo]

What's your nominal tax rate in Canada?

How long do you have to wait for non-critical medical services?

Oh...and how come so many Canadians come here for medical treatment?

We've got some serious issues with health care in the US. But socialized medicine like in Canada isn't the answer. You guys can't make it work with 34 million people. Why do you think it would be better with 310 million?

[Rydrum]

I have a number of thoughts-
the first of which, is Pete you can't really agree with everything that guy said- its just asinine to whine about paying for children's education.

2nd I personally don't have an opinion on socialized vs non-socialized health care, when a consensus is reached using research in related & relevant fields than I will side with it.

Recently, it was shown that giving socialized care to those who normally can't afford it did a surprising number of things,
1) increased personal spending on health services by 25%
2) 25% decrease in unpaid bills sent to collection agency
3) and an increase in preventative spending (which is where huge money can be saved)

but this study isn't enough to sway me by itself
My two main concerns (at least discussible are)
1) They only gave the care to the poor which is different than giving it to all income levels for variety of reasons (a) poor are typically in worst health so increasing their preventative medicine could overestimate the long term savings (b) there could be a decrease in out of pocket spending by higher income earners as optional things taken now could no longer be partially covered © the coverage was given to those who wanted it not all people
2) decrease in bills sent to collection agency isn't exactly the same as a decrease in debt accrued by govn't.

There are some technical points that I disagree one, nothing as major as those 2 above but way beyond the level of discussion here.

Link to study: <!-- m --><a class="postlink" href="http://www.nber.org/papers/w17190.pdf">http://www.nber.org/papers/w17190.pdf</a><!-- m -->

[Pete Nice]

I have a number of thoughts-
the first of which, is Pete you can't really agree with everything that guy said- its just asinine to whine about paying for children's education.

2nd I personally don't have an opinion on socialized vs non-socialized health care, when a consensus is reached using research in related & relevant fields than I will side with it.

Recently, it was shown that giving socialized care to those who normally can't afford it did a surprising number of things,
1) increased personal spending on health services by 25%
2) 25% decrease in unpaid bills sent to collection agency
3) and an increase in preventative spending (which is where huge money can be saved)

but this study isn't enough to sway me by itself
My two main concerns (at least discussible are)
1) They only gave the care to the poor which is different than giving it to all income levels for variety of reasons (a) poor are typically in worst health so increasing their preventative medicine could overestimate the long term savings (b) there could be a decrease in out of pocket spending by higher income earners as optional things taken now could no longer be partially covered © the coverage was given to those who wanted it not all people
2) decrease in bills sent to collection agency isn't exactly the same as a decrease in debt accrued by govn't.

There are some technical points that I disagree one, nothing as major as those 2 above but way beyond the level of discussion here.

Link to study: <!-- m --><a class="postlink" href="http://www.nber.org/papers/w17190.pdf">http://www.nber.org/papers/w17190.pdf</a><!-- m -->

Actually, I do disagree that I have had to pay school district tax in Pittsburgh for about 16 years with no children. But that is a different argument, so I digress.

I have a few questions b/c I want to understand what you are saying, not b/c I disagree.

For the first three points:
1) increase personal spending on health services by 25%. I am not sure EXACTLY what this means. Increase by who? The patient? The government? the insurance company? Who is spending 25% more and why is spending more money good in relation to health care? Is the point of universal health care not to spend LESS money?
2) 25% decrease in unpaid bills sent to collection agencies. Should it not be a 100% decrease b/c there are no more bills to send? What good is universal health care if you are still paying for the services?
3) an increase in preventive spending. I am assuming that means preventive medicine, trying to keep people healthy BEFORE they get sick right? If so, that is a good thing BUT will NEVER work. Why? B/c I have to wait at least 3 week to see a doctor now, when everyone has free health care, it will be 3 months. I would assume when the ER's and doctors offices are slammed with hypochondriacs, they are not going to be worried about scheduling preventative health care.

I agree completely with the second two things, but could you explain part b of #1. I am not clear on that.

Thanks, looking forward to understanding this a little better.

[Hondo]

You want to fix health care? Let the market drive it. Eliminate restrictions on providers and let them compete across state lines. Enact meaningful tort reform and get the fucking lawyers out of it. They run all kinds of nonsense tests solely to eliminate any possibility of liability for missing something. Want to see something interesting? Go get a quote for a procedure with and without insurance. Those numbers are going to be VERY different. Go figure...

If you allow market forces to shape costs they WILL come down.

[Rydrum]

Sure bro, I'll do my best- this stuff is so much easier to explain in person (guess I do miss teaching...)

1) increase personal spending on health services by 25%. I am not sure EXACTLY what this means. Increase by who? The patient? The government? the insurance company? Who is spending 25% more and why is spending more money good in relation to health care? Is the point of universal health care not to spend LESS money?

It was an increase in spending by individuals who are receiving the free health care (not gov or insurance company). Typically an increase in spending by the person, means they are spending it on preventative or noncritical care, which means better health and mental health (including stress management). For one example, if most of PT is covered after a procedure, instead of neglecting the rehab, people will often do it provided it is cheap which is a huge $ saver since it prevents repeat injuries or complimentary injuries.

2) 25% decrease in unpaid bills sent to collection agencies. Should it not be a 100% decrease b/c there are no more bills to send? What good is universal health care if you are still paying for the services?

Before I answer this I need to comment on study design- conceptually they compared 2 groups of people (those who got the free health care vs those who didn't) after matching them up so the groups were equivalent on a variety of other factors.
What they are saying is that the group that got the free health care had a 25% decrease in unpaid bills compared to the group that didn't get the free health care.

3) an increase in preventive spending. I am assuming that means preventive medicine, trying to keep people healthy BEFORE they get sick right? If so, that is a good thing BUT will NEVER work. Why? B/c I have to wait at least 3 week to see a doctor now, when everyone has free health care, it will be 3 months. I would assume when the ER's and doctors offices are slammed with hypochondriacs, they are not going to be worried about scheduling preventative health care.

The best way to treat people is by not letting them get sick in the first place- this has been pretty much shown to be a fact in terms of physical health & in $ spent.
This is a maybe a minor miss-understanding in what preventative spending means to you vs how its defined technically. For instance preventative medicine is getting your cholesterol or blood pressure checked, having a mammogram & pap smear, or getting vaccinated. These are things that can be done by community care people and not necessarily by MD's (hell CVS can does blood pressure for free and had flu vaccines).
What this does is identify at risk people (for instance overweight young minority adults) so that they are able to make a lifestyle change (now they can afford to see nutritionist to help their diet or get into an exercise routine) to prevent going to see the MD- by that time it might be to late and they have type 2 diabetes.

Also mental health is sometimes included in this area and is vastly underrated in its terms of having a physiological effect. If you are depressed you can go see a psychotherapist who can help which 1. reduces chance of a physical manifestation due to depression (anxiety or stress caused illness) and 2. makes you much more productive at work and in life.

I agree completely with the second two things, but could you explain part b of #1. I am not clear on that.
Thanks, looking forward to understanding this a little better.

[I am inferring that upper middle & upper class will be able to afford upgrades and essentially be at where they are now] But because the study only included people who are too poor to have health insurance it necessarily didn't include those in lower-middle and middle-middle class, who have health care. If it becomes universal it is conceivable (at least to me) that the people in these income brackets will just take the free care and not want to spend $ to upgrade to what they have now. Thus negating some of the spending effect.

[Rydrum]

You want to fix health care? Let the market drive it. Eliminate restrictions on providers and let them compete across state lines. Enact meaningful tort reform and get the fucking lawyers out of it. They run all kinds of nonsense tests solely to eliminate any possibility of liability for missing something. Want to see something interesting? Go get a quote for a procedure with and without insurance. Those numbers are going to be VERY different. Go figure...
If you allow market forces to shape costs they WILL come down.

You make some good points (which is why I am still undecided).

MD's insurance to practice (actually pretty much any health care provider's) is AB-fucking-SURDLY high, due solely to lawyers and the tiny tiny percentage of people who had something go wrong for and want vengeance not just what they should be owed. People need to understand that MDs are people- they will error, no one is perfect. Sorry if it happened to you but there is a human component to these things, same as if when you talk to the dr you don't tell the whole truth or forget something, she/he isn't psychic.

There is a minor problem with the free market approach in that people don't know enough to know what they need & don't need (and this problem does exists now) which is why drug companies shouldn't be allowed to market directly to consumers. I am sure there is some good way of regulating I just don't have an answer on that.
If you have good insurance some failing hospitals will try and take advantage of that by claiming you need lots of tests or to be held overnight- in an uneducated consumer's mind this typically seen as "better" care while in reality it is a money ploy.

[Hondo]

You're spot on about preventative care. It cost SO much less to treat something before it becomes a major problem. As a corollary to this the dietary habits and lack of exercise are huge contributors to the medical issues we face as a population. Mark it...we've already seen peak lifespan and it's a downward arc from here on out. When you couple that with the aging of the baby boom generation who are all about to (or already have) transitioned to Medicare...whoa....this shit is about to spiral completely out of control. I'm honestly not sure there even IS a solution.

[Donginator]

Interesting topic, I have mixed feelings- my paycheck went from $30 to $110 for healthcare since 2003, if I add my girlfriend/spouse, it adds on $200 more out of my paycheck, so someone with a job & healthcare I still have trouble paying everything. Especially when lab work costs hundreds that falls under my deductible.

my solution, government needs to regulate what we eat or do

Americans are lazy & the fattest, they can't handle eating a healthy diet or choose for themselves. I mean there are people who drink a 6 pack or more of soda a DAY!!! these people are the problem, if people could take responsibility then we would all have less health issues

[Rydrum]

Here could be the #1 waster of tax payer money- NCAAM ( national center for complimentary and alternative medicine). If something worked it would not be alternative medicine it would be primary.

<!-- m --><a class="postlink" href="http://www.chicagotribune.com/health/ct-met-nccam-overview-20111211,0,3391775.story?page=1">http://www.chicagotribune.com/health/ct ... ory?page=1</a><!-- m -->


I don't know why this thing was established (under bush sr) or why it is continued... That money could've done an enormous amount of good for people suffering in 1) help their treatment costs & 2) go to research that WORKS.

[i bleed green]

What's your nominal tax rate in Canada?
**Of course our taxes are higher, but well worth it IMO. Also we earn more so it evens out.
______________________________________________________________________________________
How long do you have to wait for non-critical medical services?
**That IS the arguably the #1 issue with our system, but does it really matter whether you wait a year and a half because of wait lists, or because you can't afford it?
____________________________________________________________________________________________
Oh...and how come so many Canadians come here for medical treatment?

When rich foreigners need surgery they come here, even Castro;

**Of course if you can afford to drop 10 or 20 grand on an out of pocket procedure, it would be silly not to do it. There are often wait times of a year to 18 months for procedures sure, which seems like a long time, but if an American can't afford that same procedure, then it's not like they'll be getting it done any faster anyway.
__________________________________________________________________________________________________
We've got some serious issues with health care in the US. But socialized medicine like in Canada isn't the answer. You guys can't make it work with 34 million people.

**By who's definition? Like I said, it has its flaws, but to say it doesn't work is ridiculous and uninformed. Stop listening to the propaganda. Bush HW said back in the day "If you think national health care is a good idea, ask a Canadian what they think of their system" Well I'm Canadian and I fucking love our health care system. Our system has the best interests of the people in mind. Your system is all about the $$$$. ( of course I realize that might be a little too black and white, but I'm sure you can understand what I'm trying to get at)

A few years ago the CBC ran a national contest to see who Canadians considered the greatest Canadian of all time. Care to guess who won? Tommy Douglas, the father of medicare in Canada. A politician running on the platform of privatizing our health care, would stand as much of a chance of getting elected, as an American ruuning on the platform of taking your guns away.


Digression Alert, but it follows the same thread of paying for other people's shit.


Everyone always complains about welfare, EI, etc. and trust me, I don't enjoy working for minimum wage so someone else can sit on their ass and watch their flat screen, and drink beer that they bought with my money, but you know what, some people really do need it, and if it helps them get back on their feet then I'm okay with it. I work 8 hours a night and go to school during the day. I'm pretty much dead on my feet all week, and have almost no social life during the week, because of night shift and how tired I am. I will be going to school for the next few years trying to learn a skilled trade, but I am still willing to have some of my money go to helping my neighbours that need help.
Also the long and the short of it is I would rather, the government give my money to someone that will turn around and immediately spend it, and pump it back into the economy, rather than someone who will put it in a Swiss bank account where no American or Canadian will ever see it again. Maybe that tv was paid for with my money, but maybe it's my next door neighbor or family member that has a job and is putting food on their kids' table with that money from that sale.


***I made Hondo's original points red because it might be confusing differentiate between mine and his

[i bleed green]

"What the fuck has happened to this nation?"

**No one in the US gives a fuck about anyone else is what happened to your nation. I realize it comes down to a difference of opinion, but you'll never convince me that a country where people don't look out for each other is a better place.

When did we need other people to pay our bills?

**That's not the point. It's about helping out your neighbour when they need help, because they would do the same thing for you.


I spend a little time online doing research about the Canadian health care system and England's nationalized health care system and suddenly ours doesn't look too shabby. In fact, when I analyze it, I recognize that we have the best health care system in the world.

**Again, maybe just a difference of opinion, but Bull-fucking-shit.(the red part)

When rich foreigners need surgery they come here,

*** All the rich people on DBN raise their hand.

where the taxes will be astronomical just so we can pay for our neighbor's sickness.
[/color]
**Our taxes are higher, but we earn more, so it balances out


And it chills me to my bones to think that some Americans harbor the idea that it's right for us to be paying for each other's medical treatment.

**Again, it's not about paying for other people's bills. We look out for each other, because the time WILL come when you need help, and when that time comes, I will be happy to help you if I am able.

I put ** beside mine to avoid confusion. Original points in red.

[Hondo]

Economies of scale make any socialized medicine approach non-workable here in the United States. The two largest entitlement programs (Social Security and Medicare) are teetering on the edge of insolvency and WILL crash and burn in the next 20 years when the baby-boom generation fully enters both programs. Where is the money going to come from to fund such a system? In Canada my tax burden would approach 45-50% depending on which province I live in. Sorry, but I'm not about to take a 10% hit to pay for someone else's insurance. That doesn't even begin to deal with how much is going to be necessary to try and salvage Medicare and Social Security. You might be ok with a nominal tax rate of 60-70% but I'm not.

Also...if your 34 million Canadians face 12-18 month waits for services...how do you think that'll translate to 315 million people?

You'll die in line.