Republicans are fond of saying that "The US has the best health care in the world," which is true. What they fail to add is, "...if you can afford it."
Many people have poor health care or none at all. And many of those who have none at all are NOT unemployed. They simply can't afford the premiums or they have what are called pre-existing conditions.
Ten percent of the population account for 60% of health care costs, and many of those people who go to the ER for their health care once their condition has gotten totally out of control. Not only are millions of people left with the ER as their health coverage, which is incredibly expensive, but the current system isn't designed to lower costs. Quite the opposite. In most states, one or two companies have 80% of the business and are not under much pressure to keep costs low, because most people don't really shop for their health care. And with only one or two real choices, most companies don't, either, especially now that more and more companies are asking their employees to pick up more of the tab.
Obamacare makes several important changes designed to reduce costs. First, it moves to make payouts based on outcomes rather than pay-per-procedure. Secondly, it brings many of those left-out people into Medicare, which is costly. However, it's based on the well-established idea that catching health issues early and treating them relatively cheaply saves a lot of money later on.
Here's an example: someone has type II diabetes in his mid-sixties and takes two forms of insulin (one quick-acting taken at mealtime and one slow-acting and constantly in the background). The quick-acting insulin costs $500/mo and the other one $600/mo in round terms). The patient, who is already struggling to live on Social Security by living without many things and by making a lot of compromises when it comes to healthy food has Medicare Part B and pays only about 1% of those costs.
Suppose, though, that his condition had been diagnosed early enough to prevent it, when he was in his 30's or 40's. Even if he did get diabetes but it was treatable with some daily pills costing $20-$50/mo, I think you can see the wisdom of this approach.
There's a glimpse at the upside. What's the downside?
I guess it would be that someone has to pay for it in order for it be "affordable". Which would be a typical anti ACA response but in the sake of an argument, that would be one of the downside
There is seldom any purpose to entering a debate regarding health care as opinions tend to be fixed and, combined with almost zero understanding of costs and issues, no useful conclusions result. We have government funded health care in Canada which covers basics, however these vary somewhat from province to province. Some sectors receive greater benefits because of their status or economic circumstances so that some people paying for the system receive poorer levels of care than those who are on social assistance. Opinions are polarized as to who is responsible to pay and what levels are reasonable.
Cost of funding health care is the single largest budget item for most provinces and is expected to be the majority expenditure for all provincial budgets soon. This begs the question as to what we can afford however there seems to be no appreciation of the need to pay. Given rising federal and provincial debt, it appears obvious that some hard decisions are required but typically these will be deferred as things grow worse.
The balance between the cost of funding and provision of services will increase in importance as our population ages, however since I seem to be the only person in the country who is not certain as to how to solve all the problems I may only voice concern as to the outcome.
How do you define "affordable"?
I has some loopholes for the insurance companies they can drive a freight train through.
The act requires this procedure to be fully covered if it is performed as a preventative screening for colon cancer. The catch here is that if the doctor finds a polyp and then takes a biopsy sample, the insurance company reclassifies the colonoscopy as a diagnostic procedure which is not fully covered. This leaves the patient with thousands in medical debt the insurance doesn't pay due to deductibles, and co-insurance.
Unlike the patients, insurance companies are fully aware that polyps (usually benign) are found in over one third of colonoscopies and are using this loophole to punish patients who have the procedure as well as the medical providers performing the procedure.
2 administrative costs:
Another part pf the act that is in effect requires insurance companies to spend 80% of their revenues on health care. The insurance companies are working out ways to redefine various administrative costs as health care expenses.
The main flaw in the act is that is still leaves the foxes in charge of the hen house
Well, if you want Revlimid, Bosulif, Xalkori or another high-priced cancer drug here in Norway you can forget about it. The government won't offer them and it is illegal to buy as a private citizen, so if conventional treatment can't treat your cancer then you die.
Another downside is that supply is restricted by queuing, as opposed to the price mechanism, so it doesn't matter if you are a criminal or scientist, your place in the queue is your place in the queue. Nor do you have a choice of health practitioner or hospital, you get what you get, and if you are not happy there is nowhere to turn. And if you get maltreated you have to sue the government, which usually leads nowhere.
Also, the system has a tendency to be hijacked by special interests. When healthcare becomes politicized the ailment with the strongest lobby group will get the resources.
There are a number of other drawbacks as well, for instance there are no incentives for doctors to perform, hospitals to operate more efficiently, limit bureaucracy, or to innovate.
Shit will always happen, Taking an extreme example, suppose there's a baby suffering from a disease and the cure would cost the entire annual national product of the country to produce enough for a cure. Plus, the cure is merely a possibility, not a certaiinty.
Obviously, hard hard choices need to be made under any system and money is always an issue.
The difference is, if you can afford the drug and you are willing to pay, you can't in a fully socialized schema.
If your daughter was dying of cancer and could be saved by a $75.000 drug which you could afford, but it was being denied to her due to solidarity towards those who cannot afford it, how would that make you feel?
Some people who can't get treatments or can't afford them in the US go to hospitals in places like India or Thailand where the treatments are available or are at a more affordable cost.
It's not a solution in every case, of course, but some people do it.
That's an interesting free-market type approach that I think will become more common.
And someday, I wonder if a foreign country could offer insurance at lower rates for people in their home country who can prove how good their DNA is. But I don't want to take this too far of topic.
Arcus, I have to call bullshit on this argument against socialized medicine.
This is the typical astroturf sock-puppet argument.It is easily recognized formulaic response
>> "Well, if you want [expensive, unproven drug or treatment ] here in [country with socialized medicine ] you can forget about it. The government won't offer them and it is illegal to buy as a private citizen, so if conventional treatment can't treat your [terminal medical condition} then you die.
"Another downside is that supply is restricted by queuing, as opposed to the price mechanism, so it doesn't matter if you are a criminal or scientist, your place in the queue is your place in the queue. Nor do you have a choice of health practitioner or hospital, you get what you get, and if you are not happy there is nowhere to turn. And if you get maltreated you have to sue the government, which usually leads nowhere."
In the US, access to medication and treatment are restricted by corporate profitability, unless you are wealthy enough to self insure. A queuing ( first come, first served) system would be infinitely better. Most Americans have had no choice in their insurance policy, as the insurance contracts are negotiated between employers and insurance companies.Some employers offer a choice between two insurance options which can be generally described as bad and worse. In general, the incentive for employers is to take the contract offer that costs them the least, or that transfers most of the cost to the employees.
The insured then is confronted with a bewildering array of co-payments, , coinsurance, deductibles, forrmularies, and uncovered treatments.. Depending on the policy provided by your employer, you may be required to use doctors from a list of insurance company approved 'in network' physicians. You may even have to cede your eights to make health care choices to the insurance companies/
if the insurance company denies treatment, for the patient its tough tiddy, as most policies now include forced arbitration clauses requiring disputes to be settled by a corporate sponsored arbitration panel.
"Also, the system has a tendency to be hijacked by special interests. When healthcare becomes, politicized the ailment with the strongest lobby group will get the resources."
Our current for profit health insurance system was hijacked long ago by special interests of the financial sector. 'nuff sed
"There are a number of other drawbacks as well, for instance there are no incentives for doctors to perform,"
My observation is that most doctors are find compassion and not greed as their incentive
"hospitals to operate more efficiently,"
efficiency doe not translate to better health care. it does translate to more profit.
studies have indicated that corporate bureaucracy often far exceeds the complexity and inefficiency of government bureaucracy, yet the wingers always bring up this argument
"or to innovate. "
competition is the only incentive to innovate in a tree market, but we don't have a free market in the health insurance sector, What we have is a managed supple market.
In a free market, buyers have direct access to the sellers, and price and quality are determined by demand
On a managed supply market, however, a small group of middlemen control the supply, increasing price by restricting access and acting as gate-keepers
I specifically mentioned those medicines because they are proven effective and unavailable, something which caused quite a bit of consternation a few months back here when a patient was denied the drug ipilimumab. I have no dog in this fight, so accusing me of astro-turfing falls on its own unreasonableness.
The rest of your tirade I have no interest in arguing against point by point as my argument was not that privatized medicine is perfect, but rather that socialized medicine is far from a panacea.
I have to agree with Arcus that socialized medicine is not a panacea. Our health care costs in Canada continue to rise, such that medical is now the largest single budget item for provincial governments. In most cases the medical costs are equal to or close to equalling the remainder of the budget. This is obviously an unsustainable trend.
We have queuing which prevents someone from moving ahead of their turn and one cannot pay for own treatment in many cases. There are some battles taking place in which private facilities are offering for payment services but our laws seem to be intended to prevent that. Why it should be an issue if someone wishes to step out of the line and to bear the entire cost of treatment, it is difficult to rationalize excepting through the lens of compulsion to the herd. Paying for one's own treatment does not remove the obligation to continue to fund the public system so it would seem that stepping out should reduce cost to the public and open earlier treatment through the public system.
IMO, the problem is that of all of public discourse: presupposition, irrational thinking, demonization of anyone offering question or opposing views. We will not improve our condition by these means.
As Unseen pointed out,
anyone who can afford to pay out of pocket for an expensive unapproved medication or treatment can just as easily afford o travel outside the country to a place where the treatment or medicine is available.
Also, my point by point critique of your claims is entirely fair as you made these assertions as part of your comment.
And let's get something straight."Obama Care: is patterned after the Swiss system ehich id anything but sociolized