On Universal Health Care - Page 2

People still use the post office FAR more than FedEx/UPS to throw another example out.

Now, I don't think the USPS is necessarily MORE efficient than FedEx/UPS, but it is competitive and dominates its niche; if it weren't people would flock to the other businesses. Plus the USPS keeps its costs low because it is only concerned with breaking-even, not with reaping profits - another edge that the public sector has over the private sector.

There are a myriad of good reasons to implement some form of universal healthcare. The argument that the government tends to outperforms the private sector on a dollar for dollar or man hour v. man hour basis is not one of them.

The government is trying to have it both ways. On a federal level, it has done the following:

a. Implemented policies preventing people and businesses from intelligently lowering their tax burden through a rational deduction/credit scheme for health care costs and expenses;
b. Required private entities to provide health care to those who lack insurance and aren't capable of paying;
c. Chosen not to implement some form of universal health care that would provide a basic level of insurance for everyone.

These three policy choices are mutually incompatible, and lead to individual hardships, inefficient economic choices, and a bureaucratic nightmare for hospitals and the uninsured alike.

By the way, ALWAYS NEGOTIATE YOUR MEDICAL BILLS AFTER YOU OR YOUR LOVED ONE RECEIVE TREATMENT. Just about every medical bill is negotiable (particularly if you don't intend on treating with that doctor again). I routinely see medical bills in the tens or hundreds of thousands of dollars reduced by 25-75%.

USPS is a bad example since it's a government supported monopoly.

How can you call it a monopoly when it competes with FedEx, UPS and any number of delivery services?

Also, let's be clear about what I posted. Highways should not be owned and maintained by the private sector. Neither should municipal water systems. Same goes with national parks.

You can't call it "government supported" either - the USPS has been running in the black since Reagan mandated it do so.

Private Express Statues

The monopoly is NOT enforced, however.

In a piece on NPR last year, there was a comparison of the admin costs of running Medicare/Medicaid vs private insurers.

Now, these are my memories, so are ballpark but I think it was c. 4% vs 25% of every dollar was spent on admin.

OK, got to weight in on this one because this is my career...I'm in HR and specifically in Compensation and Benefits (US) for 16 years now. I've worked for an HMO in the past doing provider relations (physician contracting as well), been on the Consulting and Plan design side, been with a major US BPO (Benefits Process Outsourcing), and then to the corporate side. I've seen the health care delivery industry from every side, inside out and upside down. Something fundamental has to change in the way health care is delivered in this country.

We're in the middle of our Medical Plan renewal and I am faced with a 16.5% increase for my company (800 + employees). There isn't much more that can be done to reduce this at this point except jiggering plan design. Deductibles, copays, and out-of-pocket cost will go up along with premiums. It's part of the slippery slope of cost shifting back to employees that has been going on for the last 5 years. At least we have insurance (don't forget the number of uninsured has increased in significantly in the last 8 years), as many smaller companies have dropped coverage all together. Medical costs have been rising so much faster than wages that people are seeing their wage increases eaten up by medical expenses.

Probably the biggest problem with our current system is having medical insurance tied to your job. It's a horrible, arcane system plagued by huge costs for business, administrative hassles (ever deal with COBRA regulations), and tremendous liability. I do not think consumer driven health care is a viable option -- (High Deductible Plans, HSAs, HRAs..) Again, it's just cost-shifting back to the employee with a small tax break. It does nothing to address the millions of uninsured and uninsurable.

Some type of single payer system will need to be created and gradually phased in over a decade. We could always start with covering all kids up to the age of 21 and roll them into a medicare type program. There are no easy answers but we need to start somewhere, but do not fall into the trap of framing the debate into socialized medicine vs. our current "free market" system. There are many variations and many proposals on the table out there ---- I actually think the whole "socialized medicine is a straw man argument anyway since any type of health care delivery system will have some type of rationing of care. Our current system has an extreme form of rationing, almost an all or nothing thing, as compared to the Canadian or European systems where there are waits for certain non-life threating procedures.

Didn't they privatize the USPS a while back?

No, it's still owned/operated/whatever by the federal gov't, but it is RUN like a private company - the USPS MUST operate in the black. As has been mandated since the 80s (if not sooner).

Just checking into this discussion again. There is a cover story in Newsweek from early March that certainly puts the Vet Hospital system in a poor light. They acknowledge several of the strengths of the system, but its overwhelmed with the sheer number of Vets in the system coming back fresh from service.

When a vet comes into a treatment center and declares he's suicidal, they ask him to come back some other time. That's cannot be defended.

Yes, it is disgraceful. At private hospitals, they at least have the decency to ask if he is insured before sending him away.

Re: the tangential discussion about Walter Reed above...The VA doesn't run Walter Reed. The DoD does.

After reading this entire thread I found it to be be extremely enlightening and thought provoking. I only have personal experience to contribute, but still feel compelled to do so.

1. In defense of the VA hospitals, I have a Vet friend who got deplorable attention in Atlanda, GA but is receiving impeccable care in Columbus. Perhaps its wrong to judge them all the same? Atl is extremely overcrowded and I'm not dissing them, but poor health care for our vets is a troubling fact no matter the reason. I would choose a private hospital over another for the same reasons.

2. In defense of private hospitals, I have never been turned away from them for being non-insured or poor. I don't think that a fair arguement. I know its the law and federally mandated (?) and not out of the goodness of their hearts. But in the end someone still has to pay. The insured?

3. USPS vs UPS
USPS employees go postal.

Sorry, witchesbrew, but no - the one who came in seeking medical attention is expected to pay for their care by any means necessary, including out of their pocket. I know this mainly because my local hospital not too long ago instigated litigation against me because I couldn't afford to pay an overdue ER bill (yeah, I represent the other end of the spectrum - lower middle class and unable to afford insurance, even through my job).

My mom, who's been an RN for over twenty years, summed it up the best - health care has no business being managed like a business. They aren't providing you with a random good you can choose to partake of, they're providing an absolute, necessary service. The model it's currently predicated on is all wrong.

Ohmygawd Universal Health Care will implode from all the free riders!!

Bullshit, it's healthcare. They're gonna ride anyway. That, or they won't get any healthcare, and fester and generally slide into an early grave, and that comes back on the economy, and the taxpayer, eventually.

The idea that Universal Health Care cannot work has been effectively disproven in any number of countries. Employer pay healthcare is effectively being shown as dysfunctional right now.

Would I like some health-care? Hell yeah, I would, sign me up. The amount of money relieved from idiotic insurance practices (you got insurance? this aspirin costs $.10. no insurance? $10. Fuck you, I'm not paying $10 for that aspirin, so now the taxpayers have to cover it. Genius) would more than cover the people who can't make the >federal< co-pay.

Denying health care to people who can't afford it is a pretty effective form of class warfare, if you're only concerned about killing poor people (its WAR!). Unfortunately, there's massive blowback from this policy, as seen in the rising number of middle class families who can't afford basic coverage, the increasingly scarce options offered by major employers, and the sky-rocketing cost of per capita medical care.

Know who has a pretty good health care plan? John Edwards. That's a hell of a lot better than freezing millions of children out, so they can't see a doctor. Cause that's pretty fuckin heartless.

Litigation? No kidding? That sucks, and I'm sorry for that.
As I said I only have personal experiences to contribute and did not mean to imply them as the norm. I represent the other end of the spectrum also, and I have visited the emergency room several times because the Doctor's office plainly displays a sign that reads " Compensation is expected when services are rendered". Or something along those lines.
At the ER, I was still attended to but was expected to pay sometime in the future. Like you. I got around being sued by sending a ten dollar check with a note saying that by depositing the check they agreed to $10.00 a month without hounding the piss out of me or taking legal action. I know it sounds too simple but has worked for me. Of course that is not the topic here.

I guess my point was that if I walked in there dying, they would still treat my problem. Not that I wouldn't still be responsible for it as were you.

Another thing that should not be operated as a business-internment. It breaks families too, but is unavoidable..