User Panel
Posted: 12/5/2007 1:09:54 PM EDT
Professor is using these articles to back up his claims about how our system is the worst;
|
||
|
Our system does suck.
But name one thing the government has gotten involved in and made it better?????????? Exactly, it's going to be a long wait. |
|
Can the system correct itself, or will it just continue to get worse? |
|
|
Have your prof take the class on a field trip to your local DVM. From there go to the local medicaid clinic.
I don't think you will have to work hard to draw any parallels after that. If he still has doubts after all of that, take him to most any VA hospital. Get there early because the parking lots are completely full by 6am in most places. Bring a book too, because you are going to be waiting a while. |
|
CANADA.
That is the good example of how socialized medicine does not work. High taxes with terrible customer service. You are pretty likely to not "make it" waiting on socialized healthcare. |
|
Remember how all the USPS removed all the clocks at Post Offices due to the high volume of complaints about long wait times. It'll be like that.
|
|
DVM? |
|
|
He used Canada as an example because even if the Canadian service does not have the service the person needs (ie, care) they will pay for them to be treated in another country if possible. |
|
|
Well, frankly we are so over taxed and guys like me (employed caucasion) receive nothing from the system compared to what I pay in.
Fuck it, give me Federalized health care. |
|
Imagine a healthcare system that combines the efficiency of the DMV with the compassion of the IRS.
|
|
Good catch...my digital dyslexia is acting up. DMV (Dept. of Motor Vehicles) is what I meant. |
||
|
No. |
|
|
I cannot undertake to lay my finger upon an article of the Constitution which granted a right to Congress of expending, on the objects of benevolence, the money of their constituents. – James Madison
Congress has not unlimited powers to provide for the general welfare, but only those specifically enumerated. – Thomas Jefferson When a man spends his own money to buy something for himself, he is very careful about how much he spends and how he spends it. When a man spends his own money to buy something for someone else, he is still very careful about how much he spends, but somewhat less what he spends it on. When a man spends someone else's money to buy something for himself, he is very careful about what he buys, but doesn't care at all how much he spends. And when a man spends someone else's money on someone else, he doesn’t care how much he spends or what he spends it on. And that's government for you. – Milton Friedman In general, the art of government consists in taking as much money as possible from one party of the citizens to give to the other. – Voltaire (1764) There is no virtue in compulsory government charity, and there is no virtue in advocating it. A politician who portrays himself as caring and sensitive because he wants to expand the government's charitable programs is merely saying that he's willing to try to do good with other people's money. Well, who isn't? And a voter who takes pride in supporting such programs is telling us that he'll do good with his own money – if a gun is held to his head. – P.J. O'Rourke If you have been voting for politicians who promise to give you goodies at someone else's expense, then you have no right to complain when they take your money and give it to someone else, including themselves. – Thomas Sowell (1992) The national budget must be balanced. The public debt must be reduced; the arrogance of the authorities must be moderated and controlled. Payments to foreign governments must be reduced. If the nation doesn't want to go bankrupt, people must again learn to work, instead of living on public assistance. – Marcus Tullius Cicero, 55 BC When you subsidize poverty and failure, you get more of both. – James Dale Davidson, National Taxpayers Union The welfare state reduces a citizen to a client, subordinates them to a bureaucrat, and subjects them to rules that are anti-work, anti-family, anti-opportunity and anti-property … Humans forced to suffer under such anti-human rules naturally develop pathologies. The evening news is the natural result of the welfare state. – Unknown What's *just* has been debated for centuries but let me offer you my definition of social justice: I keep what I earn and you keep what you earn. Do you disagree? Well then tell me how much of what I earn *belongs* to you – and why? – Walter Williams The New Deal began, like the Salvation Army, by promising to save humanity. It ended, again like the Salvation Army, by running flop-houses and disturbing the peace. – H. L. Mencken There are people who think that plunder loses all its immorality as soon as it becomes legal. Personally, I cannot imagine a more alarming situation. – Frédéric Bastiat Everyone wants to live at the expense of the State. They forget that the State lives at the expense of everyone. – Frédéric Bastiat We are living in a sick society filled with people who would not directly steal from their neighbor but who are willing to demand that the government do it for them. – William L. Comer Public works are not accomplished by the miraculous power of a magic wand. They are paid for by funds taken away from the citizens. – Ludwig von Mises The one with the primary responsibility to the individual's future is that individual. – Dorcas Hardy, Director, Social Security System If you would not confront your neighbor and demand his money at the point of a gun to solve every new problem that may appear in your life, you should not allow the government to do it for you. – William E. Simon We have rights, as individuals, to give as much of our own money as we please to charity; but as members of Congress we have no right so to appropriate a dollar of public money. – David Crockett, Congressman 1827-35 You can't get rid of poverty by giving people money. – P.J. O'Rourke The welfare state is the oldest con game in the world. First you take people's money away quietly, and then you give some of it back to them flamboyantly. – Thomas Sowell Somehow, the fact that more poor people are on welfare, receiving more generous payments, does not seem to have made this country a nice place to live – not even for the poor on welfare, whose condition seems not noticeably better than when they were poor and off welfare. Something appears to have gone wrong; a liberal and compassionate social policy has bred all sorts of unanticipated and perverse consequences. – Irving Kristol Don't go around saying the world owes you a living. The world owes you nothing. It was here first. – Mark Twain Asking liberals where wages and prices come from is like asking six-year-olds where babies come from. – Thomas Sowell It's illegal to say to a voter "Here's $100, vote for me." So what do the politicians do? They offer the $100 in the form of Health Care, Social Security, Unemployment Insurance, Food Stamps, tobacco subsidies, grain payments, NEA payments, and jobs programs. – Don Farrar I feel obliged to withhold my approval of the plan to indulge in benevolent and charitable sentiment through the appropriation of public funds … I find no warrant for such an appropriation in the Constitution. – Grover Cleveland, 22nd and 24th US President The power to tax, once conceded, has no limits. – Anonymous We cannot restore traditional American freedom unless we limit the government's power to tax. No tinkering with this, that, or the other law will stop the trend toward socialism. We must repeal the Sixteenth Amendment. – Frank Chodorov |
|
I was thinking of something like; "Doctor of Veterinary Medicine". I wasn't sure what you were talking about.. |
|||
|
Here is the Federal Government's granted powers:
Show me medical welfare in there. Oh, that's not important, you say? I disagree. I am in good company, too, it seems:
|
||
|
Fuck that. I paid for it! |
||
|
Thats a nice quote. |
|
|
You are deathly ill.
Do you want efficient, immediate care that you must agree to repay at the market rate? -or- Shitty care months or years from now that is six times the cost, purely because you personally are no longer responsible individually for the bill? I don't know about you, but I'm willing to work out a payment plan. |
|
americanrevival.org/quotes |
||
|
The same group of people in charge of securing our borders will
be in charge of your healthcare system. |
|
Problem is that for all the overtaxing going on, the public coffers are in the red. |
|
|
No. |
|||
|
The Europeeps (France, Germany, England) all operate in the red. |
||
|
Simple economics. When the marketplace is not allowed to place a value on a good or service, it will either be oversubscribed (and under supplied) or those responsible for that good or service will lower the quality of the product to match their compensation.
That and Krugman is a socialist idiot. Our system is neither broken nor bad. I am 52 years old. I have always been able to attain whatever health care I needed assuming I was willing to pay for it. I have no right nor guarantee to health care. It is a limited resource just like any consumer good. |
|
I have a couple of questions about this:
#1 Will every low life scum sucking asshole that works for an insurance company become a govt employee or will they get fired. #2 Will the rich be able to buy care outside of the system. #3 When the govt begins to ration health care will productive members of society ( people like me who pay shitloads of taxes ) have priority or will that be given based on race? #4 Will govt employees and govt officials be saddled with the same shitty care system? #5 What if I die waiting for 'service'? |
|
When I lived in england, to get any help on the free medical care, you had to get on a waiting list. My mother in law had to wait 6 weeks to get her jaw fixed. It was misaligned and she was having all knid of toruble eating and what not. All because the jobs there dont typically offer health insurance and to get immediate care you have to have your own insurance.
on top of that, the care is not as good as what we get here. Free health insurance is great for people that really cant afford it, but if you have a stable job and pay for health insurance I think we're better off the way we do it. |
|
|
|
|
And fine models they are! |
|||
|
I will put up retirement as case in point. Before Social Security, 95% of people worked untill they died, no retirement. Now 92% actually get to retire and do not have to live on dog food to survive. Is it perfect, no far from it. |
|
|
socialist insecurity is a good solution for a problem?????? WTF are you smoking??? ss is the worst solution of all. I get the shit taxed out of me so someone else can retire. In all probability I will get nothing back from ss. How is that a good solution? If I get anything at all I will have to beg some lying leftist asshole in congress. How is that a good solution? Great fucking solution. Come to think of it it will be like socialist medicine -- I'll get the shit taxed out of me to pay for someone else's medical care. socialism sucks O.K.? |
||
|
Oh, I agree. But.. I don't know how governments can operate in the red at such a high % of their GDP. And no one has given me an answer. |
||||
|
It is a better-than-horible solution because, you actually do get to retire. Without SS; the average person, in all likelyhood, will not get to retire. Do you want to be working when you are 77? When I was 24, I did, I thought I would want to work until I dropped over, simply because work was fun. Now in my mid-50s, it is not so much fun, and I look forward to not working (for someone else to generate income). Even after retirement, I have oodles of things to do--for me and my family--not for him because he pays. I suggest as you get within a decade of retirement age (65-ish) you may also moderate your tone. But remember, these old codgers vote and in much larger numbers than any other class of citizens. There is a reason they vote, because the youngsters (like yourself) do not want to pay, yet if the system was shut down, they would be the ones suffering. So, they are simply voting for their own well being. You cannot blame them for that. Nor can you blame the senators and congresscritters, they are simply listening to their constituents. |
|||
|
|
||||
|
Yes, and imagine how broke they'd be if they had to actually carry the cost of securing western Europe against the Soviet Union for 40 years. Every "success" story involving socialized medicine generally involves a small country with a homogeneous population. (Read "common culture") Watch European socialized medicine break as their population demographics continue to shift. |
|||
|
Ie; more immigration from Eastern/ME areas? When do you estimate this will occur? |
||||
|
We should do first things first. People always say we need food, clothing and shelter.
National Food Program....no fatties allowed. National Clothing Program.....yes, black does make your ass look bigger.. National Shelter Program....expand the GHETTO...we're movin' on up...you too Warren Buffett. ETA and no whining about not having a choice you beggars. |
|
Sweden is a good example of that as well. Everyone has the right to healthcare here but no-one gets it in time. People die waiting for the right treatment and the hospital staff is underpaid and flees the country. Socialised healthcare sucks. |
|
|
Is it solvent? Where is the lockbox? Printing money is one fine program, I'll have to agree. So no one gets confused, the idea of saving money via SS was OK. Just as long as what you got back somehow related to what you put in and a fair interest on it's interim use. |
||
|
http://www.freerepublic.com/focus/f-news/1741315/posts
How to Cure Health Care (Milton Friedman Plan) Hoover Digest ^ | Milton Friedman Posted on 11/19/2006 4:24:42 PM PST by John Lenin Since the end of World War II, the provision of medical care in the United States and other advanced countries has displayed three major features: first, rapid advances in the science of medicine; second, large increases in spending, both in terms of inflation-adjusted dollars per person and the fraction of national income spent on medical care; and third, rising dissatisfaction with the delivery of medical care, on the part of both consumers of medical care and physicians and other suppliers of medical care. Ilustration by Taylor Jones for the Hoover Digest. Rapid technological advances have occurred repeatedly since the Industrial Revolution—in agriculture, steam engines, railroads, telephones, electricity, automobiles, radio, television, and, most recently, computers and telecommunication. The other two features seem unique to medicine. It is true that spending initially increased after nonmedical technical advances, but the fraction of national income spent did not increase dramatically after the initial phase of widespread acceptance. On the contrary, technological development lowered cost, so that the fraction of national income spent on food, transportation, communication, and much more has gone down, releasing resources to produce new products or services. Similarly, there seems no counterpart in these other areas to the rising dissatisfaction with the delivery of medical care. International Comparison These developments in medicine have been worldwide. By their very nature, scientific advances know no geographic boundaries. Data on spending are readily available for 29 Organization for Economic Cooperation and Development (OECD) countries. In every one, medical spending has gone up significantly both in inflation-adjusted dollars per person and as a fraction of national income. In 1997, the United States spent 14 percent of gross domestic product on medical care, the highest of any OECD country. Germany was a distant second at 11 percent; Turkey was the lowest at 4 percent. A key difference between medical care and the other technological revolutions is the role of government. In other technological revolutions, the initiative, financing, production, and distribution were primarily private, though government sometimes played a supporting or regulatory role. In medical care, government has come to play a leading role in financing, producing, and delivering medical service. Direct government spending on health care exceeds 75 percent of total health spending for 15 OECD countries. The United States is next to the lowest of the 29 countries, at 46 percent. In addition, some governments indirectly subsidize medical care through favorable tax treatment. For the United States, such subsidization raises the fraction of health spending financed directly or indirectly by government to more than 50 percent. What are countries getting for the money they are spending on medical care? What is the relation between input and output? Spending on medical care provides a reasonably good measure of input, but, unfortunately, there is no remotely satisfactory objective measure of output. Ultimately, the purpose of this article is to examine the situation in the United States. I have mentioned the data on the OECD countries primarily to document the two (related?) respects in which the United States is exceptional: we spend a higher percentage of national income on medical care (and more per capita) than any other OECD country, and our government finances a smaller fraction of that spending than all countries except Korea. Why Third-Party Payment? Two simple observations are key to explaining both the high level of spending on medical care and the dissatisfaction with that spending. The first is that most payments to physicians or hospitals or other caregivers for medical care are made not by the patient but by a third party—an insurance company or employer or governmental body. The second is that nobody spends somebody else’s money as wisely or as frugally as he spends his own. These statements apply equally to other OECD countries. They do not by themselves explain why the United States spends so much more than other countries. No third party is involved when we shop at a supermarket. We pay the supermarket clerk directly: the same for gasoline for our car, clothes for our back, and so on down the line. Why, by contrast, are most medical payments made by third parties? The answer for the United States begins with the fact that medical care expenditures are exempt from the income tax if, and only if, medical care is provided by the employer. If an employee pays directly for medical care, the expenditure comes out of the employee’s after-tax income. If the employer pays for the employee’s medical care, the expenditure is treated as a tax-deductible expense for the employer and is not included as part of the employee’s income subject to income tax. That strong incentive explains why most consumers get their medical care through their employers or their spouses’ or their parents’ employer. In the next place, the enactment of Medicare and Medicaid in 1965 made the government a third-party payer for persons and medical care covered by those measures. We are headed toward completely socialized medicine—and, if we take indirect tax subsidies into account, we’re already halfway there. We have become so accustomed to employer-provided medical care that we regard it as part of the natural order. Yet it is thoroughly illogical. Why single out medical care? Food is more essential to life than medical care. Why not exempt the cost of food from taxes if provided by the employer? Why not return to the much-reviled company store when workers were in effect paid in kind rather than in cash? The revival of the company store for medicine has less to do with logic than pure chance. It is a wonderful example of how one bad government policy leads to another. During World War II, the government financed much wartime spending by printing money while, at the same time, imposing wage and price controls. The resulting repressed inflation produced shortages of many goods and services, including labor. Firms competing to acquire labor at government-controlled wages started to offer medical care as a fringe benefit. That benefit proved particularly attractive to workers and spread rapidly. Initially, employers did not report the value of the fringe benefit to the Internal Revenue Service as part of their workers’ wages. It took some time before the IRS realized what was going on. When it did, it issued regulations requiring employers to include the value of medical care as part of reported employees’ wages. By this time, workers had become accustomed to the tax exemption of that particular fringe benefit and made a big fuss. Congress responded by legislating that medical care provided by employers should be tax-exempt. Effect of Third-Party Payment on Medical Costs The tax exemption of employer-provided medical care has two different effects, both of which raise health costs. First, it leads employees to rely on their employer, rather than themselves, to make arrangements for medical care. Yet employees are likely to do a better job of monitoring medical care providers—because it is in their own interest—than is the employer or the insurance company or companies designated by the employer. Second, it leads employees to take a larger fraction of their total remuneration in the form of medical care than they would if spending on medical care had the same tax status as other expenditures. If the tax exemption were removed, employees could bargain with their employers for higher take-home pay in lieu of medical care and provide for their own medical care either by dealing directly with medical care providers or by purchasing medical insurance. Removal of the tax exemption would enable governments to reduce the tax rate on income while raising the same total revenue. This hidden subsidy for medical care, currently more than $100 billion a year, is not included in reported figures on government health spending. Extending the tax exemption to all medical care—as in the current limited provision for medical savings accounts and the proposals to make such accounts more widely available—would reduce reliance on third-party payment. But, by extending the hidden subsidy to all medical care expenditures, it would increase the tendency of employees to take a larger portion of their remuneration in the form of medical care. (I discuss medical savings accounts more fully in the conclusion.) Expressed as a fraction of national income, Americans spent a mind-boggling 17 percent of the national income on medical care in 1997. No other country in the world approaches that level of spending as a fraction of national income, no matter how its medical care is organized. Enactment of Medicare and Medicaid provided a direct subsidy for medical care. The cost grew much more rapidly than originally estimated—as the cost of any handout invariably does. Legislation cannot repeal the nonlegislated law of demand and supply: the lower the price, the greater the quantity demanded; at a zero price, the quantity demanded becomes infinite. Some method of rationing must be substituted for price, which invariably means administrative rationing. A look at the data is instructive. The effect of tax exemption and the enactment of Medicare and Medicaid on rising medical costs from 1946 to now is clear. According to my estimates, the two together accounted for nearly 60 percent of the total increase in cost. Tax exemption alone accounted for one-third of the increase in cost; Medicare and Medicaid, one-quarter. Now consider a different breakdown of the cost of medical care: between the part paid directly by the government and the part paid privately. Government’s share went from an eighth of the total in 1919 to a quarter in 1965 to nearly half in 1997. The rise in the government’s share has been accompanied by centralization of spending—away from state and local governments to the federal government. We are headed toward completely socialized medicine and are already halfway there, if, in addition to direct costs, we include indirect tax subsidies. Expressed as a fraction of national income, spending on medical care went from 3 percent of the national income in 1919 to 4.5 percent in 1946 to 7 percent in 1965 to a mind-boggling 17 percent in 1997. No other country in the world approaches that level of spending as a fraction of national income no matter how its medical care is organized. The changing role of medical care in the U.S. economy is truly breathtaking. To illustrate, in 1946, seven times as much was spent on food, beverages, and tobacco as on medical care; in 1996, 50 years later, more was spent on medical care than on food, beverages, and tobacco. The Changing Meaning of Insurance Employer financing of medical care has caused the term insurance to acquire a rather different meaning in medicine than in most other contexts. We generally rely on insurance to protect us against events that are highly unlikely to occur but that involve large losses if they do occur—major catastrophes, not minor, regularly recurring expenses. We insure our houses against loss from fire, not against the cost of having to cut the lawn. We insure our cars against liability to others or major damage, not against having to pay for gasoline. Yet in medicine, it has become common to rely on insurance to pay for regular medical examinations and often for prescriptions. This is partly a question of the size of the deductible and the copayment, but it goes beyond that. "Without medical insurance" and "without access to medical care" have come to be treated as nearly synonymous. Moreover, the states and the federal government have increasingly specified the coverage of insurance for medical care to a detail not common in other areas. The effect has been to raise the cost of insurance and to limit the options open to individuals. Many, if not most, of the "medically uninsured" are persons who for one reason or another do not have access to employer-provided medical care and are unable or unwilling to pay the cost of the only kinds of insurance contracts available to them. If the tax exemption for employer-provided medical care and Medicare and Medicaid had never been enacted, the insurance market for medical care would probably have developed as other insurance markets have. The typical form of medical insurance would have been catastrophic insurance (i.e., insurance with a very high deductible). The Black Hole of Bureaucratization Third-party payment has required the bureaucratization of medical care and, in the process, has changed the character of the relation between physicians (or other caregivers) and patients. A medical transaction is not simply between a caregiver and a patient; it has to be approved as "covered" by a bureaucrat and the appropriate payment authorized. The patient—the recipient of the medical care—has little or no incentive to be concerned about the cost since it’s somebody else’s money. The caregiver has become, in effect, an employee of the insurance company or, in the case of Medicare and Medicaid, of the government. The patient is no longer the one, and the only one, the caregiver has to serve. An inescapable result is that the interest of the patient is often in direct conflict with the interest of the caregiver’s ultimate employer. That has been manifest in public dissatisfaction with the increasingly impersonal character of medical care. Some years ago, the British physician Max Gammon, after an extensive study of the British system of socialized medicine, formulated what he called "the theory of bureaucratic displacement." He observed that in "a bureaucratic system . . . increase in expenditure will be matched by fall in production. . . . Such systems will act rather like ‘black holes,’ in the economic universe, simultaneously sucking in resources, and shrinking in terms of ‘emitted production.’" Gammon’s observations for the British system have their exact parallel in the partly socialized U.S. medical system. Here, too, input has been going up sharply relative to output. This tendency can be documented particularly clearly for hospitals, thanks to the availability of high-quality data for a long period. The data document a drastic decline in output over the past half century. From 1946 to 1996, the number of beds per 1,000 population fell by more than 60 percent; the fraction of beds occupied, by more than 20 percent. In sharp contrast, input skyrocketed. Hospital personnel per occupied bed multiplied ninefold, and cost per patient day, adjusted for inflation, an astounding fortyfold, from $30 in 1946 to $1,200 in 1996. A major engine of these changes was the enactment of Medicare and Medicaid in 1965. A mild rise in input was turned into a meteoric rise; a mild fall in output, into a rapid decline. Hospital days per person per year were cut by two-thirds, from three days in 1946 to an average of less than a day by 1996. Taken by itself, the decline in hospital days is evidence of progress in medical science. A healthy population needs less hospitalization, and advances in science and medical technology have reduced the length of hospital stays and increased outpatient surgery. Progress in medical science may well explain most of the decline in output; it does not explain much, if any, of the rise in input per unit of output. True, medical machines have become more complex. However, in other areas where there has been great technical progress—whether it be agriculture or telephones or steel or automobiles or aviation or, most recently,computers and the Internet—progress has led to a reduc- tion, not an increase, in cost per unit of output. Why is medicine an exception? Gammon’s law, not medical miracles, was clearly at work. The provision of medical care as an untaxed fringe benefit by employers, and then the federal government’s assumption of responsibility for hospital and medical care of the elderly and the poor, provided a fresh pool of money. And there was no shortage of takers. Growing costs, in turn, led to more regulation of hospitals and medical care, further increasing administrative costs and leading to the bureaucratization that is so prominent a feature of medical care today. So much for input. What about output? What have we gotten in return for quadrupling the share of the nation’s income spent on medical care? I have already referred to one component of output—days of hospital care per person per year. That has gone down from three days in 1946 to less than one in 1996. Insofar as the reduction reflects the improvements in medicine, it clearly is a good thing. However, it also reflects the pressure to keep hospital stays short in order to keep down cost. That this is not a good thing is clear from protests by patients, widespread enough to have led Congress to mandate minimum stays for some medical procedures. The output of the medical care industry that we are interested in is its contribution to better health. How can we measure better health in a reasonably objective way that is not greatly influenced by other factors? The least bad measure that I have been able to come up with is length of life, though that too is seriously contaminated by other factors—improvements in diet, housing, clothing, and so on generated by greater affluence, better garbage collection and disposal, the provision of purer water, and other governmental public health measures. Expected longevity went from 47 years in 1900 to 68 years in 1950, a truly remarkable rise. From 1950 on, expected longevity continued to increase but at a much slower rate, reaching 76 years in 1997. For our purposes, it is of fundamental importance that, whatever its source, the increase in longevity did not have any systematic relation to spending on medical care as a fraction of income. On the evidence to date, it is hard to see that we have gotten much for quadrupling the share of the nation’s income spent on medical care other than bureaucratization and widespread dissatisfaction with the economic organization of medical care. The United States versus Other Countries Our steady movement toward reliance on third-party payment no doubt explains the extraordinary rise in spending on medical care in the United States. However, other advanced countries also rely on third-party payment, many or most of them to an even greater extent than we do. What explains our higher level of spending? I must confess that despite much thought and scouring of the literature, I have no satisfactory answer. One clue is my estimate that if the pre–World War II system had continued—that is, if tax exemption and Medicare and Medicaid had never been enacted—expenditures on medical care would have amounted to less than half the current level, which would have put us near the bottom of the OECD list rather than at the top. In terms of holding down cost, one-payer directly administered government systems, such as exist in Canada and Great Britain, have a real advantage over our mixed system. As the direct purchaser of all or nearly all medical services, they are in a monopoly position in hiring physicians and can hold down their remuneration, so that physicians earn much less in those countries than in the United States. In addition, they can ration care more directly—at the cost of long waiting lists and much dissatisfaction. In addition, once the whole population is covered, there is little political incentive to increase spending on medical care. Once the bulk of costs have been taken over by government, as they have in most of the other OECD countries, the politician does not have the carrot of increased services with which to attract new voters, so attention turns to holding down costs. An additional factor is the tax treatment of private expenditures on medical care. In most countries, any private expenditure comes out of after-tax income. It does in the United States also, unless the medical care is provided by the employer. For this reason, the bulk of medical care is provided through employers, and private expenditures on medical care are decidedly higher than they would be if medical care, like food, clothing, and other consumer goods, had to be financed out of posttax income. It is consistent with this view that Germany, the country second to the United States in the fraction of income spent on medical care, has a system in which the employer plays a central role in the provision of medical care and in which, so far as I have been able to determine, half of the cost comes out of pretax income and half out of posttax income. Our mixed system has many advantages in accessibility and quality of medical care, but it has produced a higher level of cost than would result from either wholly individual choice or wholly collective choice. Conclusion: Medical Savings Accounts and Beyond The high cost and inequitable character of our medical care system are the direct result of our steady movement toward reliance on third-party payment. A cure requires reversing course, reprivatizing medical care by eliminating most third-party payment, and restoring the role of insurance to providing protection against major medical catastrophes. The ideal way to do that would be to reverse past actions: repeal the tax exemption of employer-provided medical care; terminate Medicare and Medicaid; deregulate most insurance; and restrict the role of the government, preferably state and local rather than federal, to financing care for the hard cases. However, the vested interests that have grown up around the existing system, and the tyranny of the status quo, clearly make that solution not feasible politically. Yet it is worth stating the ideal as a guide to judging whether proposed incremental changes are in the right direction. Most changes made in the final decade of the twentieth century were in the wrong direction. Despite rejection of the sweeping socialization of medicine proposed by Hillary Clinton, subsequent incremental changes have expanded the role of government, increased regulation of medical practice, and further constrained the terms of medical insurance, thereby raising its cost and increasing the fraction of individuals who choose or are forced to go without insurance. There is one exception, which, though minor in current scope, is pregnant of future possibilities. The Kassebaum-Kennedy Bill, passed in 1996 after lengthy and acrimonious debate, included a narrowly limited four-year pilot program authorizing medical savings accounts. A medical savings account enables individuals to deposit tax-free funds in an account usable only for medical expense, provided they have a high-deductible insurance policy that limits the maximum out-of-pocket expense. As noted earlier, it eliminates third-party payment except for major medical expenses and is thus a movement very much in the right direction. By extending tax exemption to all medical expenses whether paid by the employer or not, it eliminates the present bias in favor of employer-provided medical care. That too is a move in the right direction. However, the extension of tax exemption increases the bias in favor of medical care compared to other household expenditures. This effect would tend to increase the implicit government subsidy for medical care, which would be a step in the wrong direction. Before this pilot project, a number of large companies (e.g., Quaker Oats, Forbes, Golden Rule Insurance Company) had offered their employees the choice of a medical savings account instead of the usual low-deductible employer-provided insurance policy. In each case, the employer purchased a high-deductible major medical insurance policy for the employee and deposited a stated sum, generally about half of the deductible, in a medical savings account for the employee. That sum could be used by the employee for medical care. Any part not used during the year was the property of the employee and had to be included in taxable income. Despite the loss of the tax exemption, this alternative has generally been very popular with both employers and employees. It has reduced costs for the employer and empowered the employee, eliminating much third-party payment. Medical savings accounts offer one way to resolve the growing financial and administrative problems of Medicare and Medicaid. It seems clear from private experience that a program along these lines would be less expensive and bureaucratic than the current system and more satisfactory to the participants. In effect, it would be a way to voucherize Medicare and Medicaid. It would enable participants to spend their own money on themselves for routine medical care and medical problems, rather than having to go through HMOs and insurance companies, while at the same time providing protection against medical catastrophes. A more radical reform would, first, end both Medicare and Medicaid, at least for new entrants, and replace them by providing every family in the United States with catastrophic insurance (i.e., a major medical policy with a high deductible). Second, it would end tax exemption of employer-provided medical care. And, third, it would remove the restrictive regulations that are now imposed on medical insurance—hard to justify with universal catastrophic insurance. This reform would solve the problem of the currently medically uninsured, eliminate most of the bureaucratic structure, free medical practitioners from an increasingly heavy burden of paperwork and regulation, and lead many employers and employees to convert employer-provided medical care into a higher cash wage. The taxpayer would save money because total government costs would plummet. The family would be relieved of one of its major concerns—the possibility of being impoverished by a major medical catastrophe—and most could readily finance the remaining medical costs. Families would once again have an incentive to monitor the providers of medical care and to establish the kind of personal relations with them that were once customary. The demonstrated efficiency of private enterprise would have a chance to improve the quality and lower the cost of medical care. The first question asked of a patient entering a hospital might once again become "What’s wrong?" not "What’s your insurance?" |
|
Look at how the VA hospitals are run. Look at how Walter Reed Army Medical Hospital ended up...
This is what is known as a "clue". |
|
+1. Ever stood in line at your local driver's license office? Or at the county tax assessor-collector? Or tried to get a straight answer from the IRS on a tax question? Why would anyone think that those are good models for health care? |
|
|
As a ex memer of the UK...just mention the British NHS to him...they have waiting lists of years for some of the poor saps over there for transplants...they make the USSR look effecient
Why do Brits have bad teef?...NHS dentists... they might see you once a year if you are very very lucky |
|
The Brit press reported earlier this fall that Brits are resorting to pulling their own teeth because getting timely dental care in the UK is next to impossible. |
|
|
Everybody knows the government can do it better than private industry can...
TSA, Social Security, FDA greenlights followed by lawsuits... Socialized meds will just be a window to enable shitheads to buy more votes by giving ouf tax money away to poeple who don't take responsibility for themselves... |
|
You guys ever see what happens when a Baskin Robins has a free ice cream cone day? People pile their whole family in their gas hog SUV and drive 50 miles to get an ice cream cone, just cause Baskin Robins is giving one away if you walk thru the door. That's for some stupid shit like an ice cream cone. Imagine how bad it would be if idiots of that caliber were giving something really important, like free medical care? They'd go to the hospital for a paper cut or demand an x ray for a stupmed toe. If you've got a serious problem, like an MI, you're just gonna have to wait until that papercut is patched up because we're all busy at the moment.
Anybody who thinks socialized medicine is a good idea needs to be taken behing the woodshed like ole Yeller and shot in the face. On the other hand, fuck it. Let socialized medicine happen. This country has needed to crash for a long time. If that doesn't make it happen, nothing will. |
|
Don't believe everything you read It's not brilliant but I see my dentist twice a year. The biggest problem with the NHS is the mis-management (speaking from experience as my wife is a midwife). There are more non-medical staff working in the NHS than medical. Bunch of halfwits couldn't organise a piss up in a brewery. Also the strain from immigrants coming here for free healthcare doesn't help. My wifes delivered an Africans twins who travelled from Angola illegally just to have her babys. She can now stay here because her kids were born here |
||
|
Does the NHS have long waiting lists for surgeries? Transplants? Etc. ? |
|
|
From my classmates on our class discussion board..
|
||||||
|
Sign up for the ARFCOM weekly newsletter and be entered to win a free ARFCOM membership. One new winner* is announced every week!
You will receive an email every Friday morning featuring the latest chatter from the hottest topics, breaking news surrounding legislation, as well as exclusive deals only available to ARFCOM email subscribers.
AR15.COM is the world's largest firearm community and is a gathering place for firearm enthusiasts of all types.
From hunters and military members, to competition shooters and general firearm enthusiasts, we welcome anyone who values and respects the way of the firearm.
Subscribe to our monthly Newsletter to receive firearm news, product discounts from your favorite Industry Partners, and more.
Copyright © 1996-2024 AR15.COM LLC. All Rights Reserved.
Any use of this content without express written consent is prohibited.
AR15.Com reserves the right to overwrite or replace any affiliate, commercial, or monetizable links, posted by users, with our own.