I'm hoping this won't devolve into a discussion of the Affordable Healthcare Act (so-called "Obamacare"). Let's do that under a more specific topic.

Rather let's discuss the current system in America, what's wrong with it and what's right, whether it needs fixing, and how to fix it. Non-Americans are encouraged to chime in.

Here's my take:

1) There is no healthcare system on a national level beyond Medicare and Medicaid. Any other systems are local to some degree or other.

2) Pretty much everyone who doesn't have their head up their hind end can see that the current way of handling healthcare is not sustainable. within a decade or two, assuming costs continue to rise, healthcare will become unaffordable for most Americans.

3) Healthcare isn't a normal market where competition functions to lower cost. Yes, insurance companies exclude certain high-risk, high-cost people in an effort to maximize their profits and keep their rates down. However, that doesn't work because for the excluded people the local ER becomes the primary care provider. Somebody has to pay for this care, so it's passed along to the people who are insured through their insurance company. This is one reason why hospital Tylenol can cost $25. The marketplace actually RAISES costs.

4) Do you think it's ethical to throw 30+ million under the healthcare bus in order to keep rates low for those with insurance, especially considering that it  ends up (as explained in the 3rd point) making costs higher anyway.

5) 30+ million people need affordable healthcare, and indigents need free healthcare. Is it so bad to have socialized healthcare for them, especially if it will function to bring costs down for the rest?

Tags: Act, Affordable, American, Healthcare, healthcare, medicine, national, socialized, system

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i was with u until the last paragraph. open pharmacies, r u kidding, yes u can look up online what drug to take, what about dosage, interactions, side effects (and i don't mean a shit ton of 10 paragraphs that accompany it but the ones that are relevant to ur condition) blood work for certain meds, storage etc. give u an example lets say u get poison ivy the computer tell u to take benadryl and prednisone, u buy it and than look at the side effects of prednisone, try it and find out which ones are relevant to your short term use of the drug. diagnosing based on webmd better than a just Md. lmao. no it is not like a computer, u can buy a new one if this one dies but it doesn't happen with ur body, u can really fuck it up.

Being able to get whatever you want from the pharmacy? Control guns but not drugs? Drugs can be a weapon, too! Anyone who's for gun control should be for drugs only by prescriptions, wouldn't you think?

Also, be realistic: who is more likely to misdiagnose and misprescribe? A doctor or a layman?

My wife with stage 4 breast cancer has a lot of 'warning signs and side effects".  Yes I greatly trust my Doctor with the evaluation and monitoring of them than my own interpretation of what they mean. 

I also trust her Doc more on her recommended treatment than if I were to do a google search and select the chemo drugs myself.

We have done such a terrific job of denigrating education and expertise in this country to our own detriment. 

Nobody know anything better than we do, and if we make the wrong choice on treatment or investment it is our own fault because we didn't take it upon ourselves to learn what we need to make our own decision and screw the 'experts'.

I now next time I need surgery I will do it myself damn it.  Why should I trust some fancy pants book learning Dr.  I'll let Joe the Plumber make my Wife's next diagnosis.

1) This is not true. Anyone who goes to an emergency room cannot be turned away. People currently get free healthcare this way. They just simply do not pay their bill. You point this out in point 3.

Sure, some scam the system, but some simply cannot afford their bill. They may be unable to afford food or a decent place to live, either. Sometimes one has to prioritize, and sometimes part of the prioritizing is deciding which bills can be put off or avoided and which cannot. A single mother who has trouble keeping her head above water, can afford her rent only with assistance, and food only with food stamps, presented with a $200 bill might even intend to pay it, but after a few months of nonpayment and fruitless collection attempts, it will probably be written off.

2) If it is unaffordable to most Americans, the health care industry will loose money. They will be forced to lower their cost to make a profit. It is simple supply and demand. The reason it continues to get so expensive is because there is such a high demand because everyone thinks they need medicine for everything. Health insurance is expensive because they have people that are experts at statistics running numbers on how much it will cost them to provide insurance to you. With a large percentage of the population going to the doctor for every sniffle they get, these numbers get higher. Again, supply and demand. Simple economics.

As time goes by, the industry will begin to cater more and more to those who can pay, charging them more and more and getting by with fewer clients on their rolls. If, on the other hand, they decide to cut expenses, that is hardly likely to improve the availability or quality of care. Right now, a lot of money is spent on advertising and administration, costs which specializing in only the wealthier clients could be brought down. They could be brought down further with one national payer instead of the current patchwork quilt. It isn't sniffles which cause prices to go up so much as cancer and heart disease and other such treatments which go unpaid.

3) It is a normal market. If there were millions of more doctors, a doctor visit would be very cheap. If there were millions of more surgeons, surgery would be very cheap. It is supply and demand. The problem is the rising of demand because we live junk-food lifestyles and rarely work out. As for the part about the ER. No. It is paid for by tax dollars. Or the hospital has to raise there prices to make up the cost. The market place rises cost because these people are STEALING healthcare. If 50% of Apple's IPad's were stolen, they would have to double their price to make up for the loss. The problem is the people stealing healthcare. That needs to be stopped.

Okay, here we have a classic "if only?" solution to healthcare's rising costs. If only people ate better food and if only they got more exercise, then we could get a control on costs. It reminds me of the feminists' "if only men were more like women" solution to sexism. We can't base solutions on pie in the sky and wishful thinking. People go to the ER because they have no alternative, and the go even if they can't pay, often for situations that can't wait for when they have more money. Situations which, in many cases, could have been prevented had they been able to see a doctor earlier on, to have full physical checkups on a regular basis and so on.

It's also not a normal market because one consumes first and finds out the cost on another, later day. Would you want to buy a car if there were no stickers on the window no negotiation? no picking and choosing options in the knowledge of how much they would cost if you took them or save if you removed them? That is how people buy healthcare. No, it's not a normal market. It's a very very weird market.

4) I am not sure what you are getting at.

I'll repeat. It's an ethical issue: Do you think it's ethical to throw 30+ million under the healthcare bus in order to keep rates low for those with insurance, especially considering that it ends up (as explained in the 3rd point) making costs higher anyway.

Maybe you don't see an ethical issue. Okay. I'm sure others will understand what I said and comment on it.

5) It will raise cost. Insurance providers are a business. If they cannot turn people away with preexisting conditions, they must raise prices to everyone. Suddenly everyone is a risk factor and they must drastically raise their prices for everyone to compensate. They cannot operate at a loss or they will go bankrupt and everyone will loose their healthcare. So it will be very expensive. And people will be forced to pay the new outlandish price.

Your reply assumes universal socialized medicine. If we provide socialized medicine for those who have none because they can't afford it, the insurance companies can go on as they have. What is your plan for the uninsured and uninsurable? Besides, you believe that they can economize to keep profits up and rates down. What's stopping them now?


On Obama care, I do not like it. If they wanted to completely socialize medicine and make it universally free, that is fine. But that is not what they did. They made it free for some and more expensive for others. However, I do not consider healthcare a right, I consider it a luxury. If someone makes a pill that will make you live 50 years longer and cure most of your elements for the rest of your life, but it is very very expensive to make, should we make the people that can afford it pay for those who cannot so everyone can take this pill? This is healthcare. Only the pill is doctors working tirelessly every day and it is thousands of pills.

Healthcare is not a right, it's a luxury. That's your plan.

I think the solution is to allow open pharmacies. Allow anyone to go buy any medicine they want. A person researching their symptoms online can probably more accurately diagnose their problem than a doctor. I have experienced this myself on many occasions. Then people who cannot afford to have a professional diagnose them can still do it themselves online. It is just like your computer. Some people can afford to call an IT guy every time it gets "sick". Others cannot. So the ones that cannot are forced to look online to figure out how to fix it for free. I believe healthcare should be this way as well.

And if you determine you need a new kidney, does the pharmacy keep those on hand, and who's going to do the surgery? your cousin Lennie who works behind the grocery market's meat counter?

The last times I went to an emergency room (for myself or for family or friend), I don't remember anyone waiting there for hours just to fix "sniffles".

Wish I had more time to get into more points, and more points to come, here. This picture's not as simple as most people wish it could be.

E.g., health care could be cheaper overall if more people got preventative care instead of having to wait until they have to go to the emergency room to get something fixed.

If our society's family and educational systems worked better, we could teach young people more about health so they could make better decisions before the fix gets much more expensive. The reason there are dozens of the same kinds of medicine on the shelf is because people buy according to brand instead of according to ingredients. They don't don't know crap about the ingredients. When I can, I'll choose the house or generic brand of something because it has the same ingredients as the brand name. The biggest reason there are over-priced brand names filling up the shelves is because of the high number of ignorant people paying the high prices for them.

I.e., at the very least, too many people in America don't know crap about science or medicine, so their minds just accept what the commercials tell them to buy. This kind of "free market" succeeds by making profit on ignorance. Most politicians and a lot of companies love ignorance, because it enhances their bottom line.

So how come it is that most other, civilized countries are getting healthier than the US with their socialized medicine? Maybe one reason is because even our insurance companies, who would supposedly want costs to remain low, have an incentive to keep people ignorant and prices high, so their piece of the pie is more profitable? Meanwhile, the supposedly "corrupt" socialist medical bureaucracies are getting it more right than we are, and the even the people complaining about their socialist system say it's still better than ours.

i will give u a location close to where I live called Marion Ohio where they had to build 2 different er dept one for sniffles and headaches and stupid shit like that and other for real emergencies to decrease the wait time

Perhaps they need to learn a little thing called triage.

Sniffles and headaches are called SYMPTOMS. Sniffles can be a symptom of the swine flu; headaches can be a symptom of a brain tumor. I think we may need to make a distinction between a mere ER and a Trauma Center for victims of serious accidents and falls, gunshots, knife attacks, severe battery, and so on.

most pharmacies generic drug dispensing rate is close to 96 percent for available generics so ur argument of ppl being stupid when generics are available does not hold ....go to any local pharmacy to verify this statement

Are you implying that generic use is per se smart? A recent Supreme Court decision held that generic manufacturers didn't have to comply with the same labeling requirements as brand name drug manufacturers.

In other words, if there is a caution that comes along with the brand name drug, the generic manufacturer is permitted to leave it off. Why? Because generic manufacturers have much less control over how their products are packaged and distributed.

I would guess that even less than 10% of the smartest Rx consumers know this fact.

I implied that.

You're right, I wasn't aware of their lower responsibility on labels. Does that decision apply to both prescriptions, and off-the-shelf drugs?

That I don't know, but of course the more serious (= less safe/more abusable) drugs need a prescription.

"A Supreme Court decision last year, Pliva v. Mensing, barred patients from suing generic drug companies because the court ruled that the companies did not have control over what their labels said and therefore could not be sued for failing to alert patients about the drugs’ risks." (source)

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