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So it would seem that that old Irish fellow Mr O'Bama has passed this healthcare bill.

As a British person with 100% universal healthcare the US system always baffles me a little but one thing I was curious about was the average american's opinion.

Most news outlets seem to suggest that acceptance of the bill is about 50-50*.
(EDIT Actually the polls seem to be more like 40-50)*
Fox news puts that figure at more like 25-75
but polls also suggest that most Americans (90%) dont understand the bill. So the polls are relatively useless in understanding their actually beliefs on the matter and not just their party's opinion.

So whats your opinion, Americans? are you pro or against?

Having seen universal healthcare work pretty well in the UK for like 60 years and throughout Europe I pretty strongly support universal healthcare as a moral issue but it seems like all the focus in the American media is about the economic issue. They say it's bad from an economic perspective and thus it shouldn't be adopted. I may be wrong there but thats how it seems to me from this side of the pond.

My actual opinion of the healthcare bill from what I understand is that its really a case of wounding the beast.

You've put all these restrictions on the insurance companies which limits the way they operate and will probably affect their long term profits but you didn't limit what they can do with the premiums. As far as I can tell they are free to just hike up the cost of cover as much as they like. There was a provision in the bill to stop that but they were forced to take it out to get it passed.

So although the bill contains a great deal of very positive things I feel that this omission to the bill may be its undoing

Not to mention that it doesn't go fully into play until 2014. At which point Obama's term will be up, so it's quite likely the republicans will try to demolish it when they get into office. Which unfortunately seems rather likely to me, since Obama has only been making subtle changes to the country and therefor nobody notices. There's an overwhelming amount of people who seem to think that Obama hasn't actually done anything, despite the fact that's he's actually done a lot. Just not a lot that's in the public light. So unfortunately it seems to me that the next president being Republican is very likely. And the death of this bill will follow shortly after.

Hmm the problem with entitlements is that they are usually pretty permanent, whether they are good for the country or not.

Once you give a population some form of entitlement that they pay for through tax they are unlikely to be able to take those away again without a riot. Some say this is why the Conservative party in Britain don't campaign against the NHS.. It would be suicide. Not because Britain *likes* the NHS but because the are *dependent* on the NHS.. Although I think thats bollocks myself.

From what I understand the core bill has passed but they are still litigating details of the bill; Issuing amendments and corrections, etc.

I've really only heard two legitimate arguments AGAINST some form of universal health care. The first being that requiring American citizens to participate in a marketplace is unconstitutional. It would be like forcing everyone to buy Ice Cream. It's federally mandated YOU HAVE TO DO IT! You don't have to eat it, it doesn't matter if you're lactose intolerant, you HAVE to buy Ice Cream.

The second argument that I've heard is that regulating and restricting how insurance companies operate we will not only slowly destroy modern Health-care and the insurance companies but we undermine the capitalistic foundation of America and permanently damage the confidence and trust of the private sector.

The other arguments I've heard aren't worth noting, as they are mostly the enraged tears of ill-informed loud mouths, however, those arguments are valid.

Personally, I am for some form of Universal Health-care, however, I'm not really a fan of the current bill. It seems odd to me that the democratic party was able to bypass debate and certify the bill "automatically" yet the bill that they passed was the weakest, most diluted, pussy-footed attempt we've seen yet. Ultimately it will reign in some of the exorbitant waste and inefficiencies in the health-care sector and it will insure millions of more individuals. Ideally it will raise the standard level of care off offered. It doesn't go FAR ENOUGH, however, in regulating inhumane practices, wasteful spending, inefficiencies, nor does it guarantee coverage for all US Citizens, let alone any person present in the country for any reasons.

I wish I could say that it's a solid step in the correct direction but I don't think the foot has landed yet. With mid-term election coming soon it's also a very real possibility that the bill could be repealed. At the end of the day I can't give an honest answer about my opinion yet, due to the fact that the dust is still settling. It will take a few weeks and maybe even months before the bill is finalized and we have a clear picture of how it will change the health-care/insurance landscape.

In my perfect America, we would have an "opt-in" tax for individuals below a certain monthly/annual income. People that opt-in would be eligible for a government overseen or directly operated health-care provider at either no or an extremely low cost. People above the income bracket would be required to pay the tax regardless of if they choose to participate or not in the actual health-care program. Private insurance would always be an option and would ultimately evolve to offer A.) The Highest level of care and B.) The Lowest level of care. Health-care would be mandatory for all Citizens, either public or private. Health-care would also be extended to all non-citizens persons legally present in the U.S.   A possible simplification would be to require ALL citizens to pay a health-care tax and those wanting Health-care beyond what the public system offered could either be re-reimbursed or the government would distribute their health-care funds to the insurance provider of their choice and the citizen could pay the difference. Additionally there would be a government agency similar to the USDA/Health Inspectors/FDA/EPA in order to certify that health-care providers adhered to certain standards. Doctors would be compensated on a salary basis with incentives offered for exceeding quality standards and performing extracurricular care such as home-visitations, over-hours emergency care, etc. Cosmetic surgeries would be outside the scope of public health care, but would be taxed as an additional source of revenue for the public system.

Most likely, none of this will happen withing the next ten years, or so, but that's a pretty vague vision of US Healthcare as I see it.

It strikes me that a small group of people is making a lot of money with the previous system of health care, and would make substantially less with the new system; and that since these people have a lot of money, they can use it to sway the ignorant population with propaganda.

The US currently has the most dysfunctional health system in the developed world (one of the: most expensive, most money wasted, worst population health), and the cost has been going up exponentially for the last forty years at least. It is obviously unsustainable in its current form. Reform is not a choice, it's a necessity.

The bill that got passed is far from perfect. Many better ideas were proposed, but it turned out to be impossible to pass any of them. The Republicans have showed in the clearest way possible that they were not interested in negotiating realistically (with the Democrats controlling the House, Senate and White House, negotiating realistically means realizing that you won't get most of what you want) for the good of the country. That meant cutting out any daring ideas, stuffing it with pork and special interest gi'mmes, and playing ugly political hardball to get it passed.

Is it better than nothing? From what I've heard, yes. The reforms themselves are modest and are not going to solve America's healthcare crisis, but they offer a framework for further reform. Five years from now, with these new systems in place, it's going to be easier to make substantive change that will make an impact. Most importantly, if this effort had failed too, even with the majorities enjoyed by Democrats in Congress, after Hillarycare fell through in the 1990s, no politician would ever dare to try to tackle the problem ever again, and the USA would be utterly fucked.

Good on Obama and Pelosi for showing some backbone and actually standing up for some of what they believe in and got elected to do.

Quite literally every single person I have talked to about this healthcare plan is 100% against it. I don't have all the facts but the idea that anyone who is employed and offered healthcare will be forced to purchase it, regardless of whether they are financially capable of affording it or whether they want the plans their employer offers.

Prior to the bill employed Amerikaans who were offered healthcare through their employer had the option to reject it. Whether they couldn't afford it, they didn't need it, they had a different healthcare plan, or otherwise, the point is it was optional.

With this new bill we will no longer have the choice as to whether or not we want to purchase it. This will likely not improve the average citizen's health. Myself, for example, have rarely ever had a cause to seek medical attention of any kind. This bill is not going to change that. When it has been offered, I have previously taken offered insurance, but it was an option. If I wanted, I could terminate the "benefits". Now, I no longer will have the option (once it goes into law).

As far as I understand it the bill does not actually impose healthcare on those who are unemployed or whose employer does not offer healthcare benefits.

The fact alone that my basic liberty of being able to choose whether or not to accept the offered healthcare is enough that I know I am extremely dissatisfied with the bill. I'm not saying I agree with the entire state of affairs of the present medical system, but forcing the public to purchase healthcare they may not want or even utilize is not going to instantaneously solve any problems.

That's just my take on it though I suppose.

Quote from: monkey_05_06 on Wed 24/03/2010 00:55:16
Prior to the bill employed Amerikaans who were offered healthcare through their employer had the option to reject it. Whether they couldn't afford it, they didn't need it, they had a different healthcare plan, or otherwise, the point is it was optional.

But the trouble with "options" is that one can be pressured into not taking the best one for yourself in all sorts of ways. Before the smoking ban in bars in the UK, it was of course optional for any bar to ban smoking of its own initiative. But hardly any did because some things are financial suicide unless everyone else does it too (or you're catering for a niche).

And people opting out of insurance means that a magical someone has to pick up the bill when sudenyl the person with no previous health problems gets sick. Sometimes this will mean state aid, sometimes this will be bankruptcy... all of these cost "society" money, too. No man is an island.

In the UK, we are forced to  pay National Insurance (its effectly a tax) for the NHS. In my company they offer a subsidized private insurance scheme too, which "tops up" my NHS cover and effectively lets me queue jump. I never signed up for these queue-jump schemes, personally, until I had kids.

Interestingly, the NHS covers some IVF and also abortions. Now that's a can of worms...

Quote from: monkey_05_06 on Wed 24/03/2010 00:55:16
Prior to the bill employed Amerikaans who were offered healthcare through their employer had the option to reject it. Whether they couldn't afford it, they didn't need it, they had a different healthcare plan, or otherwise, the point is it was optional.

With this new bill we will no longer have the choice as to whether or not we want to purchase it. This will likely not improve the average citizen's health. Myself, for example, have rarely ever had a cause to seek medical attention of any kind. This bill is not going to change that. When it has been offered, I have previously taken offered insurance, but it was an option. If I wanted, I could terminate the "benefits". Now, I no longer will have the option (once it goes into law).

As I mentioned earlier this is one of the few legitimate arguments against, however, there is something that needs to be clarified. You are not required to buy into your employers healthcare policy, you are simply required to have healthcare.  Many employers offer healthcare for their employees at a discounted basis or at a fully compensated basis. For instance, where my girlfriend works her company pays for 85% of her healthcare cost and the rest is voluntarily taken from her paycheck. At my previous employer, T-Mobile, I didn't pay a cent for healthcare. Both of us would be considered "legally covered," she would be paying a rate significantly lower than if she had healthcare on her own and I have a $1,100/mo Policy for free! However, the guy that works at the family owned gas (petrol) station probably isn't getting his healthcare covered and Ma & Pa Miller probably don't offer an employer partnership. He would still be required to HAVE healthcare, however. Where he gets it from and how much it costs are still up in the air at this point; IF his employer did offer coverage he could choose to take it or he could seek it on his own. So you're not required to buy from your employer, but if your employer offers healthcare for free or cheaper than normal it would make sense to enlist through them.

There is talk of limiting how much insurance companies can charge based on income and there are talks about having insurance companies setup various tiers of minimum legal coverage up-to premium coverage in order to distribute cost and coverage more effectively. These are tentative, currently, and the logistics of how everything will work has not yet been finalized.

Additionally, currently your employment status (currently) has no effect on whether or not you are required to have some form of healthcare coverage. You are required to have automobile insurance on any cars you own (in most states,) regardless of if you are employed, unemployed, homeless, a teenager, etc. 

I agree that this is a valid argument, however it's an argument that is simple to resolve. If you are going to force everyone to have healthcare you HAVE to offer something that is either low-cost or zero-cost in some way. It's apparent to everyone in the White House that without offering some type of option that low-income individuals can afford, mandating healthcare is only going to have an effect on the middle and upper classes and therefore, be worthless in essence. It would appear as if the next logical step then would be to enact either a government overseen or government run option for these people.  This is the only way to overcome this argument, that or eliminate the coverage mandate, which after all of this work probably is not going to happen.  It seems likely then, that this is a tactic that is being used to force opposition to concede that the only constitutional and effective way to offer the reforms as they exist are to offer a public option or a government regulated option.

State law and federal law are two different beasts and a war has been waged since the inception of the country over which has great control over the rights of the American people. Historically it has been upheld that federal law takes precedent, however there are many cases in which powerful states disregard federal law or supersede it. Auto-makers build cars to meet California environmental and safety standards which exceeds the federals requirement, because California is one of the largest markets. Additional, many states have legalized Marijuana to licensed users, however the federal government still recognizes marijuana as an illegal substance and routine closes down shops/clinics and arrests licensed users. In Hawaii, there is "Universal Healthcare" in a system that is setup similar to NHS. In Wisconsin, the state does not require Healthcare but imposes a small tax on all individuals and offers an extremely low-cost healthcare option provided by the State and funded by tax money and the low cost of being enrolled. Some states are saying that if they pass a law stating that their citizens cannot be mandated to purchase healthcare it over-rules any federal mandates. This is unlikely, however it is unclear how states that DO offer Universal Healthcare or State-run Healthcare (like Hawaii and Wisconsin) will be effected. Similarly unclear is how this will effect people in US Commonwealths who typically have dual citizenship (Puerto Rico, U.S. Virgin Isles, etc.)

AT the end of the day all that we know is that SOMETHING is going to be changed. What and how much is not yet certain.

The long and short of it is this:

The insurance companies have as their primary aim making money. It is in their best interest to give you as little health care as possible for the highest price you will accept.

The government has as their primary aim the welfare of the citizens (or at least in theory). It is in their best interest to give you as much health care as possible for the lowest price they can manage.

Note the obvious conflict of interest here. Traditionally, USA uses the former, and most of Europe uses the latter. According to studies, healthcare in the USA is about thrice as expensive overall while being inferior in quality to that in Europe. I do not think that is a coincidence.

And it makes me cry...

I do think that the problem with American healthcare is the very existence of the insurance companies but the fact of the matter is that American's dont want a socialised medicine system. America is easily the most pure capitalist nation in the world and even poor 'rednecks' seem to oppose any kind of socialism, until they get sick anyway.

We shouldnt look at this as a case of "it those damn corporations keeping the people down!". The people seem to fully support this kind of thing as far as I can tell.

I will express my opinion via the medium of this peculiar image.

(http://i42.tinypic.com/ip4haq.jpg)

Quote from: FSi on Wed 24/03/2010 19:54:43
I will express my opinion via the medium of this peculiar image.

(http://i42.tinypic.com/ip4haq.jpg)

Hmmm, good points FSi, but I think you're forgetting that these corporation haven't had ANY SORT of regulation or accountability AT ALL since the inception of their existence in America.

I'll have to disagree with some things here ...

Quote
The insurance companies have as their primary aim making money. It is in their best interest to give you as little health care as possible for the highest price you will accept.

It is true that insurance companies are in business to make a profit  but is absurd to believe that mistreating customers is the optimal means of maximising profit. Indeed this a a formula for failure and bankruptcy rather than success.  I don't think profit is a bad thing.  It's the incentive that drives an organisation to operate efficiently, eliminate waste,  and to continuously improve it's self.  The tried and true way to success in private business is to provide a superior product or service and/or a better price that the competition.

Quote
The government has as their primary aim the welfare of the citizens (or at least in theory). It is in their best interest to give you as much health care as possible for the lowest price they can manage.

"or at least in theroy" is an admition that this is not the case.  The incentives in a government bureaucracy are all backwards.  Instead of having incentive to eliminate waste and inefficiency government agencies routinely and without exception endeavour to consume ALL funds and resources allocated to them by politicians.  Among government workers it is universally accepted that thgis is an open invitation to politicians to allocate fewer funds and resources in in the future and is to be avoided at all costs.  How can such a system be expected to produce optimal results?

You can take a look at this A 2009  Daily Mail (http://www.dailymail.co.uk/debate/article-1163064/HARRIET-SERGEANT-Why-does-NHS-hate-elderly-much.html) article which states  that "Government NHS policy has placed the emphasis on vote-winning targets such as waiting times, rather than focusing on care".
[/quote]

Quote
... According to studies, healthcare in the USA is about thrice as expensive overall while being inferior in quality to that in Europe. I do not think that is a coincidence.

To which studies are you referring and in what way is the US health care system inferior?   

For example last Monday my 77 year old aunt phoned her doctor  to complain about being tired,  short of breath, and feeling lousy.   Before the end of the day she was booked into the hospital, had blood tests for heart attack and stroke, MRI, and other tests performed, and had seen a cardiac specialist who diagnosed her with cardiac arrhythmia. He told her that she needed a pace maker but wanted to monitor her heart for a couple of days to confirm his diagnosis.  So he booked her into the telemetry unit where they wire you up to a wireless monitor that continuously measures heart and other things 24/7.  The resulting measurements are transmitted to  the nurses station where it is monitored and recorded for doctors' later use.   She had surgery on Wednesday to implant her pacemaker and went home on Friday.   

Now compare this with the UK where my aunt would have had to wait 10-18 weeks before receiving  treatment.  ...
http://www.prnewswire.co.uk/cgi/news/release?id=118403
http://www.drfosterhealth.co.uk/hospital-guide/hospital/nhs/Liverpool-Heart-and-Chest-Hospital-1183.aspx?procedure=CARDPACEMAKER

That is if she recieved treatment at all.  As I understand it NHS does QOL assements to determine what treatments "are worth it"'.  Based on this and other news I hear about NHS from time to time I am not sure my auntie would be deemed  worthy.
http://www.dailymail.co.uk/debate/article-1163064/HARRIET-SERGEANT-Why-does-NHS-hate-elderly-much.html

Quote
America is easily the most pure capitalist nation in the world and even poor 'rednecks' seem to oppose any kind of socialism, until they get sick anyway.

If a private private company screws you over that you many options.  They can be sued in a court, reported to the the state Attorney General, report to Better Business Bureau,  boycotted,  reported to mass media, publish the details on the internet, etc, etc.

You don't have to be very smart to know that when you get fucked by your government your FUCKED! and have no recourse. 

Honestly, I just can't understand why people put so much trust in government.  Have you never dealt with any government agency?  The people there are dumbest fuckers you will ever meet.  Sure they are probably nice folks when they are at home but at work behave like a bunch of escapees from a Monthy Python skit.

For example the first of the year I rented a PO Box for my wife's business.  The idea was to have a secure address where we could receive 2-3 checks each month.   At the end of the month I went to check on the box and found it stuffed to the max with catalogs and other junk mail addressed to some other guy.  I took this huge pile of mail to the clerk and complained the cobversation went soemthing like this:

RickJ:  Someone else's mail was plugging up my little mail box.

Clerk: No! Its your mail all right!

RickJ: But that's not my name.

Clerk: Yeah but right here is says "or Resident".

RickJ: But that's not my name either.

Clerk: No it's not a name, it means who ever is living at that addrress.

RickJ: But I don't live here at the post office do I.

Clerk: I doesn't matter we still have to deliver that mail to you

RickJ: Why it's not my mail.

Clerk: I don't know we just have to do it.

RickJ: But I don't want it

Clerk: I doesn't matter

RickJ: I can't use the box like this, it's useless to me.

Clerk: I don't care but you can talk to the post master but he's not here to day ..

a few days later I return and talk to the postmaster ...

RickJ: I'm having a problem with the PO Box I recently rented.  It's getting plugged up with catalogues and other junk mail making it unusable for my business purposes.

Postmaster: Yeah, probably the previous renter didn't fill out a change of address form so that's why you're still getting his mail.  If he had filled out the proper forms we would just forwaerd his mial and you wouldn't get it.

RickJ: Ok, so I just have to fill out some forms yto get this fixed

Postmaster:  Oh no, you can't fill out the forms.

RickJ: Why not?

Postmaster: Because it's not your mail.

RickJ: That's what I told the clerk but he said that you have to deliver it to me any way.

Postmaster: Yes that's right.

RickJ: Why?

Postmaster:  I don't know why, we just have to.

RickJ: Isn't there anything I can do?

Postmaster:  (yells to an employee in back room) Hey Fred!  What's up with box 147.

Employee: Oh, that was old Herb's box.

Postmaster: Oh! now I understand what happened.  The gentleman who previously rented that box passed away.

RickJ: Ok, so you're not gong to be sending his mail to me anymore?

Postmaster:  Oh no! We have to.

RickJ: Why?

Postmaster:  Because it's addressed to you box  and he hasn't filled out a change of address form ...

RickJ:  ... because he's dead?

Postmaster:  Yes thats right!

---

No kidding this actually happened to me just a couple of months ago. 

The bill is a good start, But we still need the option to buy into Medicare or other government run insurance. Having a public option is just some competition. If the private insurers can't compete with the public option then they are obviously  an inferior product and don't deserve to be in business anyway.

Quote from: RickJ on Wed 24/03/2010 21:48:36
I don't think profit is a bad thing.  It's the incentive that drives an organisation to operate efficiently, eliminate waste,  and to continuously improve it's self.  The tried and true way to success in private business is to provide a superior product or service and/or a better price that the competition.
...
"or at least in theroy" is an admition that this is not the case.  The incentives in a government bureaucracy are all backwards.  Instead of having incentive to eliminate waste and inefficiency government agencies routinely and without exception endeavour to consume ALL funds and resources allocated to them by politicians.  Among government workers it is universally accepted that thgis is an open invitation to politicians to allocate fewer funds and resources in in the future and is to be avoided at all costs.  How can such a system be expected to produce optimal results?

Then how come Medicare, Medicaid and Veterans' care are the most efficient healthcare providers in the US, much more so than the private insurance companies?

Quote

Quote
... According to studies, healthcare in the USA is about thrice as expensive overall while being inferior in quality to that in Europe. I do not think that is a coincidence.

To which studies are you referring and in what way is the US health care system inferior?

This is widely reported and documented. You can start with the Wikipedia (http://en.wikipedia.org/wiki/Health_care_compared#Cross-country_comparisons) articles (http://en.wikipedia.org/wiki/Health_care_reform_in_the_United_States#Quality_of_care) and go from there. ("The United States ranked last across a range of measures of health care in a comparison of 19 industrialized countries, despite spending more than twice as much per person on health as any other of the countries." "although the U.S. system is the most expensive, it consistently underperforms compared to the other countries." "For 2006-2010, the U.S. life expectancy will lag 38th in the world, after most developed nations" "According to the U.S. Census Bureau, people in the U.S. without health insurance coverage at some time during 2007 totaled 15.3% of the population" "The U.S. spends more on health care per capita than any other UN member nation.")

QuoteFor example last Monday my 77 year old aunt phoned her doctor  to complain about being tired,  short of breath, and feeling lousy.   Before the end of the day she was booked into the hospital, had blood tests for heart attack and stroke, MRI, and other tests performed, and had seen a cardiac specialist who diagnosed her with cardiac arrhythmia. He told her that she needed a pace maker but wanted to monitor her heart for a couple of days to confirm his diagnosis.  So he booked her into the telemetry unit where they wire you up to a wireless monitor that continuously measures heart and other things 24/7.  The resulting measurements are transmitted to  the nurses station where it is monitored and recorded for doctors' later use.   She had surgery on Wednesday to implant her pacemaker and went home on Friday.

Hope she's OK. Incidentally, was your aunt's tests and treatments paid for by private insurance, or did she receive government-funded healthcare through Medicare? If she's 77, I'm betting the latter.

QuoteNow compare this with the UK where my aunt would have had to wait 10-18 weeks before receiving  treatment.  ...
http://www.prnewswire.co.uk/cgi/news/release?id=118403
http://www.drfosterhealth.co.uk/hospital-guide/hospital/nhs/Liverpool-Heart-and-Chest-Hospital-1183.aspx?procedure=CARDPACEMAKER

That is if she recieved treatment at all.  As I understand it NHS does QOL assements to determine what treatments "are worth it"'.  Based on this and other news I hear about NHS from time to time I am not sure my auntie would be deemed  worthy.
http://www.dailymail.co.uk/debate/article-1163064/HARRIET-SERGEANT-Why-does-NHS-hate-elderly-much.html

All nations ration healthcare in some way or another. In the US, this is mainly by price and access: if you can't afford insurance, or you exceed your lifetime maximum, or you have a pre-existing condition that means you can't get insurance, you'll receive a low standard of care. The UK takes another approach, which is statistically more efficient (fewer people die from insufficient care), but certainly has its own drawbacks.

But it should be noted that the British system is first of all: quite austere by international standards; secondly: not the only possible template for universal healthcare (e.g. the French system might be more to your liking); and thirdly: nothing at all like even the most radical serious US reform proposal (single payor).

Here in Germany, every citizen has health insurance. If you can't afford it, the state will pay for it.
If you get sick, you receive treatment, no matter how expensive.
The only thing you have to pay extra is dental plans.

The only bad thing about the German system is that rich people can afford private insurance, i.e. they are first in line, get their own rooms in hospitals, etc.

When I heard for the first time that in the U.S. of all countries, poor people can't afford basic treatment because there's no "universal health care", a term I also hadn't heard before, I was sure I was the victim of a very bad joke. Seriously. I couldn't believe it.

I don't know any details about the current bill, but to me, opposing it seems absurd in the highest degree.
It's like opposing the building of homeless shelters, or the distribution of free condoms. Or opposing gay marriage or the teaching of evolution in public schools.
It's as absurd as telling children that sex is evil instead of explaining to them how contraceptives work, causing the STD rates among teens to be four times those of Europe.

It's funny how the most religious western nation also treats their poor the cruelest.

Welcome to America!

Quote from: RickJ on Wed 24/03/2010 21:48:36
It is true that insurance companies are in business to make a profit  but is absurd to believe that mistreating customers is the optimal means of maximising profit. Indeed this a a formula for failure and bankruptcy rather than success.  I don't think profit is a bad thing.  It's the incentive that drives an organisation to operate efficiently, eliminate waste,  and to continuously improve it's self.  The tried and true way to success in private business is to provide a superior product or service and/or a better price that the competition.

McDonalds would like a word with you.

So would Microsoft.

Quote from: RickJ on Wed 24/03/2010 21:48:36
It is true that insurance companies are in business to make a profit  but is absurd to believe that mistreating customers is the optimal means of maximising profit.

That's a good point. In addition to mistreating your customers you can mistreat employees and suppliers too.

Look at the way poor quality meat is produced in a way that is harmful to animals, farmers, and consumers but pretty good for supermarkets.

Yep, companies showed us, what "efficiency" means for two centuries now: Bribes, massive layoffs, complete disregard to hygiene, recycling or anything that could help reducing the destruction of the environment, outsourcing to countries where governments give a shit about civil rights etc. Take a look at all the examples all over the globe where electricity, transit or other key industries got privatized: It all got worse and why shouldn't it? You said it yourself: It's all about profit, but that can't possibly mean anything good. What's the point in having an efficient health insurance for the rich, while the poor become obese eating efficiently made fastfood?

Nah, we all know how bad the American Health care system is and there's no denying it. But it seems that throwing around catchwords like "socialism" keeps the people on the conservative's side in that matter. And many other matters.

Quotethe most religious western nation

This can't be true... can it?? Wait- are we competing with Ireland or are they in a different division?

Quotetreats their poor the cruelest.

The American concept is that with hard-work anyone can prosper, even the poor. For better or worse we are a country founded on the principal of "Surival of the FIttest." Unfortunately, at the sacrifice of self-humanity. The American dream is to have made "something" from nothing but your own applied effort.

Quote
It's funny how the most religious western nation also treats their poor the cruelest.

Agreed.

ADDITIONAL THOUGHTS:
The fact of the matter is that US Healthcare providers do cut corners and they do screw people over. I agree with you that businesses are in business to make money (mostly) and that typically the best way to be a sucessful business is to offer a core product that is superior than your competition. If that we're the case, however, we'd all be flying JetBlue, using Mac's, browsing with Opera and eating at McRamsays. It could be said that these are all successful companies, however they're all considered "niche." Being the best doesn't mean being the most successful and that is the bottom line! EA certain isn't making the best games. Michael Bay certainly isn't making the best films. David Letterman certainly isn't the funniest comedian.

I don't believe that the government needs the added layer of running a healthcare system (I believe that a hybrid of government and private as a public option would probably be most effective) but I think it's the most logical option. Our military is one of the most effective in the world and we certainly fund it with the trillions of dollars that would require! Couldn't we, in a modern world, create an effective healthcare system that keeps EVERYONE healthy instead of most of us healthy and if need be pump it full of cash to make it the best in the world? Priorities in a "post-war era" shouldn't be mainly on military operations. The resource grab is over an we came out pretty good! The Global Political posturing of the last 150 years is mostly settled and we're Top Ten, by all accounts! I think it is time that we focused on the welfare of citizens because when we set our minds to it we tend to do a pretty decent job of thing... the problem is setting ourselves on the task. The battle to focus on healthcare is won, but now the war for the outcome of healthcare reform has really only started.

I agree (with RickJ) that sometimes government agencies can be ineffective but the postal service is an antiquated system. It is largely the same system that it was 100-200 years ago. There is probably room for MASSIVE improvement. The situation you're describing does have a resolution; according to the US Postal Service if you officially notify them that you are receiving mail for a deceased person you can have their mail forwarded to next of kin or an official proxy for the deceased. Additionally you can place their name on the DNC list. You can also have the postal service assign you another P.O. Box with an official complaint in an attempt to have any associated fees with switching be eliminated.

Whether or not the people at the lowest echelon know it or not, there are always ways to get around the red tap and idiocy of the people working at these jobs.

I have a passport, a drivers license, stamps and financial aid. All the government agencies that I need to work for me have worked for me.

Something else to note is that if there was a public option, you wouldn't be dealing with a government agent you would be dealing with a doctor, at a hospital. One you have your drivers license you can drive wherever you want (for four years) without stepping foot in a DMV/BMV.

@Matti
There are three types of conservatives: Conservatives that understand the (original) core value or the movement was that the Federal Government should be a small entity that exists on a basis to keep order and ensure basic human rights... and little else. There is wiggle room here as many conservatives recognize that certain privileges (not rights) are also beneficial to American society: the FDA, Roadways, etc...
These people are known as "sensible conservatives."

People who hate/dislike the government/various government agencies/various government policies/"the other guys." Like the Tea Party, for instance, who in their grand retardation think that it's a good idea to abolish taxes... and then we'll all just continue to exist happily in our modern world! As streets crumble, law enforcement becomes puppets of criminals, the rest of the civilized world abandons us, and ultimately we rape ourselves until a new order is developed which installs taxes! "Right-Wing Conservatives."

People that believe that other people believing in a particular idea must believe in all idea's which they arbitrarily link to that particular idea and also that the people immediately associated with that person must also believe in all of the idea that that person has. Meanwhile, they either have no ideals themselves or are misinformed on the reality of particular schools of thought. These people dissent and oppose these other ideals for mostly no reason, without basis or the ability to offer constructive thought to aid in the process of developing a compromise or a solution. We call these people "Republicans."

It is possible to be more than one, as counter-intuitive as that may seem. John McCain for instance is a "Sensible Republican..." figure that one out. Mitch McConnell is a "Right-Wing Republican." Ron Paul is a "Sensible Conservative." Yay for analogies!

I should interject that I'm a big believer in competition and the private marketplace to hone efficiency and reward innovation. But the "invisible hand" doesn't magically make everything right, individual companies respond to the incentives of their industry. And the US healthcare sector is set up in such a way (involving complex relationships between healthcare providers, insurance companies, employers and, lastly and probably leastly, the people who actually need the healthcare) that many of the most important priorities don't come through as clear signals to those businesses.

Since most people don't choose their own health insurance, but get a package offered them through work, insurance companies have little incentive not to screw their customers. On the flip side, since patients don't pay most of the cost of treatment (and hence have little incentive to limit it), and doctors get paid per procedure (and hence have a strong incentive to maximize it), there's massive over-treatment and over-prescription with little regard for cost-effectiveness.

I think most people agree that if you have health insurance in America, and you're not in danger of losing it (by losing your job or similar), you'll probably get decent treatment. The biggest pain is dealing with the billing and the insurance company. Because of the negotiations between hospitals and insurance companies, this is insanely complex. When I went to the hospital for surgery last year, I ended up getting dozens of statements and bills for months following my stay, each one full of medical and financial gobbledygook. The hospital billings departments and administration eat up something like (IIRC) 30% of each dollar spent on healthcare, and that's not counting the insurance company's costs, or the cost to the economy of the patient's time. That's insanely wasteful! (Also, it is obviously hell for people who are seriously ill to deal with.)

Government intervention and regulation can make the marketplace more efficient as a whole, by reducing externalities and forcing each party to bear the costs of its own actions (similar to forcing polluters to pay for the cost of their destruction).

Quote from: Snarky on Thu 25/03/2010 00:40:49
...the "invisible hand" doesn't magically make everything right...

Agreed.


I should also point out my end of the spectrum. I was just laid off about a week and a half ago. I had fully covered healthcare. Now I can't afford new glasses ($300 WTF?!) nor can I afford even the cheapest quote that I've received for healthcare ($490/mo.) With 3 years experience in management, a year of marketing/business administration and a years worth of Media Arts/Animation/Graphic Design (should've stuck with one major until I got my Associates...) you would think that find a decent job would be easy...

Nope.

For the foreseeable future, I better not run out of contacts, need dental work, get seriously injured, need surgery, get sick, need prescription medication (for new OR previous diagnosis) or require a therapist for any physical/mental/emotional reasons.

If I paid a tax for healthcare (like I did for buying a crateful of grenades/pay a cops salary/inspect some dead cows for disease/fix some potholes in a highway/deliver someones mail) I could get new glasses! I could see a dentist (appointment is in 2 months!) I could let a therapist know that i'm feeling a bit depressed at my whole situation. I could get medicine for my flu (hope there's no pigs in it!) I wouldn't be worried about getting into a car wreck every time I leave my house, and I would feel better knowing that everyone else could do the same stuff.

Is the government telling me to buy healthcare a good thing? No. Is the government telling me to pay for milk and eggs for some single mother with kids from 3 different men a good thing? No. But also, yes and yes. I don't care if the government runs it or if Starbucks runs it, I just care that someone is running something that is keeping all of us healthy. At least I would... if there was.

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Then how come Medicare, Medicaid and Veterans' care are the most efficient healthcare providers in the US, much more so than the private insurance companies?

First of all these [programs are nothing like obamacare.  They function the same as private insurance in that they are not involved in the delivery of services and only make payments on behalf of their beneficiaries.  I have never heard that before but this Washington Post Article (http://voices.washingtonpost.com/ezra-klein/2009/07/administrative_costs_in_health.html) sheds some light on the topic.  It discusses the difficulty in determining what counts as administrative costs and says: 

"...But most seem to think that Medicare's administrative costs are significantly undersold in the public debate. An apples-to-apples comparison would not leave you with the 2 percent of total Medicare spending often bandied about in debate. That doesn't count, for instance, Medicare's premium collection, which is done through the tax code, and thus through the IRS. Nor does it count most of Medicare's billing, which is outsourced -- and this might surprise people -- to private insurers like Blue Cross Blue Shield and listed under vendor services rather than program administration. A more straightforward estimate, according to experts I've spoken to, would be in the range of 5 to 6 percent."

The article asks whether profits should be included in administrative costs or not but doesn't attempt to answer the questions I will opine.  Corporation sell stock certificates to raise money to fund their operation.  Profits are returned to share holders in the form of dividends and/or increased valuation of the stock shares.  Profit is the cost of using other peoples' money.   IMHO if this cost is used in evaluating private insurance than it should also be factored in to government insurance plans as well.  Just because gov agencies get their money from tax payers doesn't mean that there is not cost attached to it's use especially if you are trying to measure who is doing the best job..

If you read further in the article you find that there is a 2:1 variation in private insurers administrative costs depending on group size and other factors.  It would seem that planns with group size of 1000 or more are comparable to what the article guesses are Medicare's actual administrative costs.

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This is widely reported and documented. You can start with the Wikipedia articles ...

I followed the link and read through  a couple of the articles.  First of all according to the linked article the US does not spend 3 times as much as other countries as asserted earlier in this thread but rather only 40% more than France by GDP and 20% more than Norway by per capita expenditures.

The table showing life expectancy and infant mortality is published by the Commonwealth Fund (http://en.wikipedia.org/wiki/Commonwealth_Fund) "a United States private foundation whose stated purpose is to promote a high performing health care system that achieves better access, improved quality, and greater efficiency".   It is currently run by, according to wiki, Karen Davis who worked for Jimmy Carter in the Department of Health and Human Services.   I suspect that "high performing health care system that achieves better access, improved quality, and greater efficiency" is code for single payer government run health care system. I can't say how true  my suspicions are but it is certain that the organisation is promoting a particular point of view. 

In particular there seemed to belittle or  no accounting for other factors affecting life expectancy and infant mortality. The US probably has the most diverse population in the world.  People come from all  parts of the world and bring with them cultural beliefs/habits and genetic pre-disposition for different diseases.  The US also seems to have a disproportionate amount of violent crime as compared to many other countries and it's citizens are infamous for over consuming everything from cigarettes to carbohydrates.   Clearly there are other factors and is confirmed by data in the table under discussion. The Japanese live longer than anybody and spend less per person on medical care; how inconsiderate of them to live so long with out even trying ;).

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Hope she's OK. Incidentally, was your aunt's tests and treatments paid for by private insurance, or did she receive government-funded healthcare through Medicare? If she's 77, I'm betting the latter.

She has private insurance for which she pays premiums.   The insurance company receives some payment from the government for assuming Medicare's obligations.   It is my understanding that her insurance current plan is illegal under obamacare.   

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All nations ration healthcare in some way or another. In the US, this is mainly by price and access: if you can't afford insurance, or you exceed your lifetime maximum, or you have a pre-existing condition that means you can't get insurance, you'll receive a low standard of care.

This not the case.  My wife does language interpretation for medical professionals.  She deals with people in this circumstance  on a daily basis and often complains that they receive better care than our family and friends.

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The UK takes another approach, which is statistically more efficient (fewer people die from        insufficient care), but certainly has its own drawbacks.

Such decisions are inevitably based on political expediency.   Can you not see the immorality of a system where a group group of human beings decide who shall live and who shall die so as to derive the maximum benefit for their benefactors?   In the US system (up til now) the people at least retain their freedom to choose.

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When I heard for the first time that in the U.S. of all countries, poor people can't afford basic treatment because there's no "universal health care", a term I also hadn't heard before, I was sure I was the victim of a very bad joke. Seriously. I couldn't believe it.

Khris, you are mis-informed.  Poor people who can't afford health care are covered by a government program called Medicad.  They receive the same services as anybody else, sometimes even better. My wife deals with such people on a daily basis.    Further it is against the law for hospitals and doctors to deny medical treatment regardless of their ability to pay.

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I don't know any details about the current bill, but to me, opposing it seems absurd in the highest degree.

I think this it's the normal case that people who don't know what's in the bill support it and the people who do know what's in it don't support it.   Maybe if you knew and understood what it says you wouldn't support it either?

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McDonalds would like a word with you.
So would Microsoft.

McDonalds: I often eat at McDonalds.  If I am ever displeased with the product or price I can easily take my patronage elsewhere.   The same cannot be said for universal health care.

MicroSoft:  I have taken my patronage else where.  I now use Linux for everything except AGS which I run from Linux in a virtual XP window (details here) (http://www.adventuregamestudio.co.uk/yabb/index.php?topic=39118.0)

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The American concept is that with hard-work anyone can prosper, even the poor. For better or worse we are a country founded on the principal of "Surival of the FIttest." Unfortunately, at the sacrifice of self-humanity. The American dream is to have made "something" from nothing but your own applied effort.

you are mis-informed.  The US was founded on the principle of personal liberty and freedom from oppressive government and that such freedoms are acquired by virtue of being a human being and not bestowed on anyone by a king or politburo as is the case in all or almost all other countries.

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I agree with you that businesses are in business to make money (mostly) and that typically the best way to be a sucessful business is to offer a core product that is superior than your competition. If that we're the case, however, we'd all be flying JetBlue, using Mac's, browsing with Opera and eating at McRamsays.

JetBlue is a discount no-frills airline that fly a limited number of routes, Apple products look nice but have always been under-powered and over-priced, Opera is a fat black woman with a TV show, and I have no idea what a McRamsays is.  Why do you think everyone would make the same lousy choices? 

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I don't believe that the government needs the added layer of running a healthcare system (I believe that a hybrid of government and private as a public option would probably be most effective) but I think it's the most logical option. ...

I agree to some extent. I wouldn't use the term hybird though.  I think a Medicaid type of system could be extended so that is not an all or nothing deal.  Currently if you earn over a certain amount you don't qualify period.  It could just as easily been setup so that people who have income below a certain amount would have a 100% goverment subsidized health insurance.  Then as an individual's income increases above a certain amount the subsidy decreases and the individual pays the remaining part of the premium.  Of course the problem with this is that it doesn't give any political advantage to the democrat party.

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Something else to note is that if there was a public option, you wouldn't be dealing with a government agent you would be dealing with a doctor, at a hospital. One you have your drivers license you can drive wherever you want (for four years) without stepping foot in a DMV/BMV.

You would be dealing with a doctor, at a hospital who are under the thumb of a government bureaucrat.   

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People who hate/dislike the government/various government agencies/various government policies/"the other guys." Like the Tea Party, for instance, who in their grand retardation think that it's a good idea to abolish taxes... and then we'll all just continue to exist happily in our modern world!

Hmmm, I never heard of any Tea Party folks advocate the abolition of all taxes.   They seem to be in favor of a limited federal government,  a fiscally responsible federal government,  and one that interferes as little as possible in the free market.  More like the first kind of conservative you talk about.

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People that believe that other people believing in a particular idea must believe in all idea's which they arbitrarily link to that particular idea and also that the people immediately associated with that person must also believe in all of the idea that that person has. Meanwhile, they either have no ideals themselves or are misinformed on the reality of particular schools of thought. These people dissent and oppose these other ideals for mostly no reason, without basis or the ability to offer constructive thought to aid in the process of developing a compromise or a solution.

I thought you were describing the far left liberals in the US,  hehe - go figure

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I should interject that I'm a big believer in competition and the private marketplace to hone efficiency and reward innovation. But the "invisible hand" doesn't magically make everything right, individual companies respond to the incentives of their industry. And the US healthcare sector is set up in such a way (involving complex relationships between healthcare providers, insurance companies, employers and, lastly and probably leastly, the people who actually need the healthcare) that many of the most important priorities don't come through as clear signals to those businesses. ...

I agree, Snarky makes some very good points.   It was once said that a free market economy is essential for freedom but not sufficient to guarantee it.   I think it would be fair to say that with regard to health insurance the free market is essential but not sufficient to produce the desired result.    As Snarky suggests government's role ought to be responsible regulation of the industry so that private insurers and their customers (i.e. the people) are incentivized to produce the desired result.

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Since most people don't choose their own health insurance, but get a package offered them through work, insurance companies have little incentive not to screw their customers. On the flip side, since patients don't pay most of the cost of treatment (and hence have little incentive to limit it), and doctors get paid per procedure (and hence have a strong incentive to maximize it), there's massive over-treatment and over-prescription with little regard for cost-effectiveness.

Absolutely agree.   There are a number of things that can be done.   First of all health insurance premiums should be made tax deductible by individuals and not corporations.   If a company provides a health care benefit they should pay the money to their employees and their employees should pay the insurance premiums.  They could still negotiate a group rate for their employees however their employees would be able to spend the money as they see fit.  They would be free to shop for a better or cheaper plan.  They could choose a plan with a high deductible and lower premium.   There would surely be many many options and innovations.

A health savings plan type of thing gives incentive to patients to self-limit their access to the system.  The way it typically works is that a portion of the premiums the insurance company receives  is placed in a savings account setup for the individual and the other portion is used to purchase a high deductible insurance plan.  The individual uses the money in the savings account to pay for doctor visits and prescriptions.   If money is left in the account at the end of the year the individual keeps it tax free.  If all the money is spent then the individual has met his deductible and the insurance benefits kick in.   This was passed into law by the republicans under Bush but has now been eliminated obama and the democrats.

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Government intervention and regulation can make the marketplace more efficient as a whole, by reducing externalities and forcing each party to bear the costs of its own actions (similar to forcing polluters to pay for the cost of their destruction).

Again agreed.  I would characterize it sa little differently as eliminating the possible of gaining  completive advantage in the market place through undesired practices.  If all insurance companies were required to insure a proportionate number of individuals with pre-existing conditions then one company would not be disadvantaged over another by accepting such individuals.  The result would be a slightly higher cost to everyone.

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Now I can't afford new glasses ($300 WTF?!)

Try Eyeglass world or Wallmart.   

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nor can I afford even the cheapest quote that I've received for healthcare ($490/mo.)

Obama and the democrats passed their health car reform bill so now you have coverage right?

On a serious note you should consider getting catastrophic coverage (i.e. high deductible).

Quote from: RickJ on Thu 25/03/2010 08:35:02

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McDonalds would like a word with you.
So would Microsoft.

MicroSoft:  I have taken my patronage else where.  I now use Linux for everything except AGS which I run from Linux in a virtual XP window (details here) (http://www.adventuregamestudio.co.uk/yabb/index.php?topic=39118.0)

Good for you Rick, but surely the laws of market forces dictate that as the most popular OS, Windows must also be the best?

We probably all agree that freedom to choose is invaluable, but the quasi-monopolies of corporations like Microsoft mean that consumer choice is often an illusion. If you want to test this, try choosing to buy affordable clothing made by people who were paid decently using environmentally sustainable materials. Clothing companies could offer that choice, but it's far more profitable not to.

So, given the freedom to choose, I would choose a state healthcare system supported by taxpayers.

Quote from: RickJ on Thu 25/03/2010 08:35:02

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McDonalds would like a word with you.
So would Microsoft.

McDonalds: I often eat at McDonalds.  If I am ever displeased with the product or price I can easily take my patronage elsewhere.   The same cannot be said for universal health care.

MicroSoft:  I have taken my patronage else where.  I now use Linux for everything except AGS which I run from Linux in a virtual XP window (details here) (http://www.adventuregamestudio.co.uk/yabb/index.php?topic=39118.0)

You're missing the point. It's not about whether you personally buy McDonalds or Microsoft products, or whether you have the choice to do so.

The point is that the biggest, most well-known, and most successful companies are precisely the ones with the biggest profit margins, and the ones known to act highly unethically whenever they can get away with it, and precisely not the ones that offer the best products. This directly disproves your points about the free marketplace.

Quote from: RickJ on Thu 25/03/2010 08:35:02
First of all these [programs are nothing like obamacare.  They function the same as private insurance in that they are not involved in the delivery of services and only make payments on behalf of their beneficiaries.

That would make them exactly the same as the now-abandoned "public option (aka "socialism", "government takeover of healthcare" etc.).

Without the public option, Obamacare now amounts mainly to:

-a mandate covering most of the uninsured, obliging them to buy private insurance
-financial support for those who are too poor to afford it, essentially paying for their private insurance for them
-regulations on insurance companies that restrict their ability to deny coverage
-a new system known as an "exchange" where private insurance companies work together to offer insurance plans

In other words, Obamacare, instead of being an alternative to private insurance the way Medicare/Medicaid is, relies on private insurance.

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Something else to note is that if there was a public option, you wouldn't be dealing with a government agent you would be dealing with a doctor, at a hospital. One you have your drivers license you can drive wherever you want (for four years) without stepping foot in a DMV/BMV.

You would be dealing with a doctor, at a hospital who are under the thumb of a government bureaucrat.

Errr... you do realize that the public option would not institute government-run hospitals, just a government-run insurance option, don't you?

QuoteIf you read further in the article you find that there is a 2:1 variation in private insurers administrative costs depending on group size and other factors.  It would seem that planns with group size of 1000 or more are comparable to what the article guesses are Medicare's actual administrative costs.

That would still leave Medicare as efficient as the most efficient private insurance companies, and more efficient than the rest of them.

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I followed the link and read through  a couple of the articles.  First of all according to the linked article the US does not spend 3 times as much as other countries as asserted earlier in this thread but rather only 40% more than France by GDP and 20% more than Norway by per capita expenditures.

A number of different studies were linked from the articles, and they use slightly different numbers, but the most often cited figure is that the US spends twice as much on healthcare (as a proportion of GDP) than the average for developed nations.

QuoteIn particular there seemed to belittle or  no accounting for other factors affecting life expectancy and infant mortality. The US probably has the most diverse population in the world.  People come from all  parts of the world and bring with them cultural beliefs/habits and genetic pre-disposition for different diseases.  The US also seems to have a disproportionate amount of violent crime as compared to many other countries and it's citizens are infamous for over consuming everything from cigarettes to carbohydrates.   Clearly there are other factors and is confirmed by data in the table under discussion. The Japanese live longer than anybody and spend less per person on medical care; how inconsiderate of them to live so long with out even trying ;).

I agree that cultural factors play a big part (I'd add being overworked to the typical American health factors, but the major factor is obviously America's large underclass of poor people), and that it's unlikely that even if the US adopted a French-style or German-style health system its statistics would match those countries', just like adopting European gun-control laws would not by itself reduce crime or gun violence to European levels.

But it also means that preventative care has a greater potential to raise people's wellness and improve the health of the nation; and moving people from critical care through the ER to preventative care that keeps them from getting sick in the first place is one of the main goals of health reform.

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She has private insurance for which she pays premiums.   The insurance company receives some payment from the government for assuming Medicare's obligations.   It is my understanding that her insurance current plan is illegal under obamacare.

I believe you're completely wrong about that. What makes you think so?

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All nations ration healthcare in some way or another. In the US, this is mainly by price and access: if you can't afford insurance, or you exceed your lifetime maximum, or you have a pre-existing condition that means you can't get insurance, you'll receive a low standard of care.

This not the case.  My wife does language interpretation for medical professionals.  She deals with people in this circumstance  on a daily basis and often complains that they receive better care than our family and friends.

So she complains that government-paid healthcare is better than that offered by private insurance, and therefore you think we shouldn't have government-paid healthcare?

It's also the case that the Medicaid system and the quality of care varies enormously from state to state. It's also my understanding that it's focused on critical care, not prevention (for example, it doesn't cover oral screenings, only dental work once a problem has become acute, and it only covers HIV patients once their disease has progressed to full-blown AIDS). That doesn't sound like very good care to me.

Anyway, even it true, it doesn't contradict what I was saying. I was talking about the millions of uninsured, those 60% of poor Americans not covered by Medicaid.

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The UK takes another approach, which is statistically more efficient (fewer people die from        insufficient care), but certainly has its own drawbacks.

Such decisions are inevitably based on political expediency.   Can you not see the immorality of a system where a group group of human beings decide who shall live and who shall die so as to derive the maximum benefit for their benefactors?   In the US system (up til now) the people at least retain their freedom to choose.

Of course, doctors make those decisions every day, in the US like anywhere else. And in the US, insurance companies routinely decide not to cover certain procedures or drugs that are too expensive for too little gain. I don't know why dealing with an insurance company rep is that much preferable to dealing with a government bureaucrat...

Anyway, in countries with a nationalized health system like the UK, rationing mostly doesn't take the form of "we've decided not to treat you, please go home and die", but of waiting lists. You'll get help, but unless it's acute, it might take a few weeks. Are people happy about the wait? Of course not, but they'd rather have guaranteed healthcare with a wait than maybe/maybe-not healthcare that's prompt.

Americans might never be willing to make that tradeoff, which is why none of the proposed reforms looked anything like that.

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Khris, you are mis-informed.  Poor people who can't afford health care are covered by a government program called Medicad.  They receive the same services as anybody else, sometimes even better. My wife deals with such people on a daily basis.    Further it is against the law for hospitals and doctors to deny medical treatment regardless of their ability to pay.

Again, some 60% of poor Americans are not covered by Medicaid. And ERs offer only critical care, causing people to not seek treatment until their illness or injury has become debilitating. (And if you, as an uninsured person, go to the ER with anything less than a life-threatening condition, you'll learn what waiting is!) Treating the uninsured is currently the most expensive part of the healthcare system: it would be cheaper to just give them regular healthcare, except that would create negative incentives and so on. That's what Obamacare tries to get around with the mandates and the financial support and so on.

Quoteyou are mis-informed.  The US was founded on the principle of personal liberty and freedom from oppressive government and that such freedoms are acquired by virtue of being a human being and not bestowed on anyone by a king or politburo as is the case in all or almost all other countries.

You seemed to have missed the last two hundred years of history, buddy. "Almost all other countries"! LOL!  ;D

QuoteOf course the problem with this is that it doesn't give any political advantage to the democrat party.

"Democrat" party instead of "Democratic party"? Have we really descended to that level of discourse?

QuoteFirst of all these programs are nothing like obamacare.  They function the same as private insurance in that they are not involved in the delivery of services and only make payments on behalf of their beneficiaries.

It's unfair to make this assessment as the entirety how how the new healthcare reform bill will function has not been solidified.

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This is widely reported and documented. You can start with the Wikipedia articles ...

http://www.photius.com/rankings/healthranks.html World Health Organization Rankings
http://www.photius.com/rankings/who_world_health_ranks.html Support for the rankings

http://www.nytimes.com/2008/04/27/weekinreview/27sack.html?_r=1
http://www.washingtonpost.com/wp-dyn/content/article/2008/05/13/AR2008051302599.html
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0002181
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=52138
Links referring to the disparity or healthcare in America

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html
Infant Mortality Rate by the CIA

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She has private insurance for which she pays premiums.   The insurance company receives some payment from the government for assuming Medicare's obligations.   It is my understanding that her insurance current plan is illegal under obamacare.

My understanding is that she's set! As long as she is covered by a healthcare provider either privately, through federal means, or a combination of the two she is okay. One of the biggest things that changed in the early iterations of the bill was that existing healthcare coverage will not be invalidated.

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This not the case.  My wife does language interpretation for medical professionals.  She deals with people in this circumstance  on a daily basis and often complains that they receive better care than our family and friends.

Medicare/medicaid are limited service. They're TOO limited. I think that they could play a greater role in providing healthcare for the uninsured but they're not a be-all end all.  Besides, if they're getting better healthcare and paying less: wouldn't you want to be on it?

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Such decisions are inevitably based on political expediency.   Can you not see the immorality of a system where a group group of human beings decide who shall live and who shall die so as to derive the maximum benefit for their benefactors?   In the US system (up til now) the people at least retain their freedom to choose.

Who is deciding who lives or dies? If there's evidence that they've revived Das Herrenvolk, I think we should tell somebody.

People have the right to choose? Like the hundreds that have died A YEAR after Hurricane Katrina, due to related causes because they didn't have healthcare? Or the thousands of people under the age of 25 living on their own (sometimes with kids) who can't break into an industry that pays good enough for them to buy healthcare or offer healthcare? Those people don't really have a choice, do they?

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Khris, you are mis-informed.  Poor people who can't afford health care are covered by a government program called Medicad.  They receive the same services as anybody else, sometimes even better. My wife deals with such people on a daily basis.    Further it is against the law for hospitals and doctors to deny medical treatment regardless of their ability to pay.

Don't be naive. If this were the case do you really think we would be having this debate? People that can't afford healthcare ARE NOT covered by medicaid or medicare. Those that ARE do receive good levels of care. It is NOT against the law for hospitals and doctors to turn you away if you can't pay and even if they DO NOT turn you away you then become personally responsible for the hundreds to thousands of dollars that a typical examination costs.

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I think this it's the normal case that people who don't know what's in the bill support it and the people who do know what's in it don't support it.   Maybe if you knew and understood what it says you wouldn't support it either?

I've said it before and i'll say it again, the litigation is still in effect. How the bill will ultimately respond is still unknowable until that time.

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You are mis-informed.  The US was founded on the principle of personal liberty and freedom from oppressive government and that such freedoms are acquired by virtue of being a human being and not bestowed on anyone by a king or politburo as is the case in all or almost all other countries.

The Declaration of Independence? I am talking about the establishment of the United States as a Capitalist society, not the United States of a Fledgling America.  The REASON we were founded was because we wanted to establish a government that afforded and protected our human liberties and freedoms that were previously repressed. The story of the founding isn't the establishment of modern America. Overtime we have become a different beast entirely and there is no deny that capitalism is our greatest core value, as a nation. That's not misinformed, that's reality.

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I agree with you that businesses are in business to make money (mostly) and that typically the best way to be a sucessful business is to offer a core product that is superior than your competition. If that we're the case, however, we'd all be flying JetBlue, using Mac's, browsing with Opera and eating at McRamsays.

JetBlue is a discount no-frills airline that fly a limited number of routes, Apple products look nice but have always been under-powered and over-priced, Opera is a fat black woman with a TV show, and I have no idea what a McRamsays is.  Why do you think everyone would make the same lousy choices?  

JetBlue is the best airline for the money. You pay less and get more. It runs a limited number of routes because financial it is limiting to exist in all major hubs. It is currently expanding... This is the concept that I was trying get across. JetBlue is more superior than +70% of the commercial domestics flights that I've been on (and I fly alot.) If your concept was true then they would be the largest airline in America as opposed to the CLUSTERFLUCK that is Delta.

Apple products may be over-powered and under priced but are they a superior product (for the average consumer) than a Windows based PC or Linux based PC? Linux is getting close to being ready for primetime but its still not there. I had to jump through hoops to get my scanner to work! And GIMP just isn't photoshop... InkScape just isn't illustrator... and my old windows PC crashed!! OH NO! But My Parents macs are 6 years old and still zippy as hell!

Opera is statistically proven to be the fastest, most secure web browser currently available and it's also available on the broadest array of platforms. IE (the most used web browser in internet land) is a buggy, bloated, hacktastic, crapfest.

Gordon Ramsay is arguably on of the best Chefs in the world and has a reputation for being able to make EXTREMELY delicious food from very cheap ingredients. McDonalds instead contributes to the industrialization of the American agriculture industry which having grown up on a farm in Wisconsin, I can tell you is NOT the way you want your food being raised/grown.

At the end of the day it's all about profits and share holders. Somebody needs to keep companies accountable.

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I agree to some extent. I wouldn't use the term hybird though.  I think a Medicaid type of system could be extended so that is not an all or nothing deal.  Currently if you earn over a certain amount you don't qualify period.  It could just as easily been setup so that people who have income below a certain amount would have a 100% goverment subsidized health insurance.  Then as an individual's income increases above a certain amount the subsidy decreases and the individual pays the remaining part of the premium.  Of course the problem with this is that it doesn't give any political advantage to the democrat party.

I agree, the political posturing is retarded. Medicare/Medicaid could EASILY be expanding to exist on a sliding income scale. Everyone already pays for it, a small hike wouldn't be that big of a deal.  People making under a certain amount get 100% compensation and all the way up to a certain income level means you will get 10% compensation. Then pistol whip the HELL out of the insurance companies, make them get their shit together and then we can all go out to dinner. Problem solved.

With Tea Parties, Coffee Parties, Libertarians... I think we're getting closer and closer everyday to a post-bipartisan Political system and I STRONGLY believe that once (if) that scale tips, we'll be better for it.

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You would be dealing with a doctor, at a hospital who are under the thumb of a government bureaucrat.

We're not talking about the CIA here. Do you really think it would be cost effective for the US government to micromanage doctors like that? Not only would it make zero political sense, it would make zero financial sense and would cause a failure in the healthcare system as the doctors resentment pushed them into rebellion, which would ultimately force the system to be REreformed.

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Hmmm, I never heard of any Tea Party folks advocate the abolition of all taxes.   They seem to be in favor of a limited federal government,  a fiscally responsible federal government,  and one that interferes as little as possible in the free market.  More like the first kind of conservative you talk about.

That would be correct, however the Tea Party isn't a party, doesn't have an official platform and doesn't have any Unity. I've been to three different Rallys here in Ohio and they all talk about almost completely different things. I truly believe that the Tea Party movement at its ROOTS are fundamentally sound, but the message has gotten so convoluted and muddied by people with only the greyest semblance of what the original message was... and that's then you get the shambling muttering masses that take things to extremely that are border line insane. Those are the people that represent the message.

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I thought you were describing the far left liberals in the US,  hehe - go figure

I don't live in New England or California, so I haven't met any...  :P
I suppose that could be said for all "Fundamentalists" "Extremists" or "Wings."

QuoteA health savings plan type of thing gives incentive to patients to self-limit their access to the system.  The way it typically works is that a portion of the premiums the insurance company receives  is placed in a savings account setup for the individual and the other portion is used to purchase a high deductible insurance plan.  The individual uses the money in the savings account to pay for doctor visits and prescriptions.   If money is left in the account at the end of the year the individual keeps it tax free.  If all the money is spent then the individual has met his deductible and the insurance benefits kick in.   This was passed into law by the republicans under Bush but has now been eliminated obama and the democrats.

The bill does not effect previous bills and no laws have been repealed, so I'm not sure how this would STOP being true. Playing along party lines isn't something that you want to instigate, either. Under Bush, our Education system saw it's lowest numbers in relation to the world, our defecit ballooned year after year, we collapsed foreign relationships to almost NIL and we saw increases in illegal immigration. The last 5 years of his presidency were a joke. Regan? I'll give the republics him... HELL, even Bush Sr., was good. Kennedy, Carter and Clinton we also good leaders for the Democrats. However, virtually all of them (maybe with the exception of Carter) we're crooks and liars. There's no question that Bush was the least effective president for the past 30 years. Both parties have their good and bad and I don't think it's fair to ascribe ANY achievements in recent American Political History to either party. I find it amazing that both parties have people with political beliefs that are all over the place... I really think there should be more than two parties, because there aren't only two solutions, or two correct choices.

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Try Eyeglass world or Wallmart.

Exam+Frames+Lenses
My girlfriend accidently broke my last pair and they're a prescription from when I was 17, they hardly worked and I am unable to track down where I got the prescripton from, anyways. Wallymart told me $150 for the exam, frames starting at $20 (really lame frames, but whatever) and lenses typially cost around $70+ It's extra for astigmatism (DAMNIT,) scratch protection (let's be real that is essential,) and a warranty (how is this not included? I didn't ask if it was an extended warranty or not...)

I've got two more pairs of contact lenses so I'm biding my time because money is tight...

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Obama and the democrats passed their health care reform bill so now you have coverage right?

A.) The bill isn't finalized and is going through a process of revisions that are going to take forever
B.) It is most likely that the full rollout of changes won't be completed until 2016
C.) My situation won't get any better until I get a new job but somebody else's might, in the future

My Political Opinions are thusly:
1.) I believe in a strong federal government who's primary interest is the welfare of all citizens and individual present in the country. (This would include making sure they all have healthcare by some measure rather than no measure.)
2.) I believe that the representation system is flawed. State governments rarely listen to their public. The Californian proposition system is an interesting format for guaranteeing that the populace has power, but it is flawed. I think that state governments should seek ways of more actively engaging their public to shape legislature.
3.) Democrat = Wrong
4.) Republicans = Wrong
5.) The welfare of all is more important than the success of some.
6.) Stay off my lawn, out of my house, away from my family or I will kill you... unless you're invited over for a barbecue.
7.) Feed a man a fish, he east for a day. Teach a man to fish and he eats for a life time. Correctional institutions need to focus more on rehabilitation for non violent/sexual offenders and need to have a standardized recommendation for various crimes across all states. No more getting life for weed possession while RapistMcGee is out in 12 Years. Additionally, there should be a rehabilitation center for homeless individuals.
8.) Mitt Romney should NEVER be president... His head is FAR too long.
9.) What is and what isn't taxed is completely fucked up. We need to eliminate the capital gains tax. More heavily tax major corporations. Give tax breaks to smaller comnpanies and more tax breaks to individuals operating businesses. Additionally taxes should be placed on financial entities (default swaps, credit papers, debt obligations, etc...)
10.) Credit companies and Debt collection should be more heavily regulated and observed.
11.) Our education system needs a complete overhaul... actually virtually ALL federal institutions need an overhaul, to be more effective AND save money.
12.) Lobbyists should be outlawed and politicians taking assets from private entities or from those representing private entities should be considered as having revived bribes. Corporations deserve protection under American laws but they do not take precedence over people. American people don't have lobbyists, or thousands of dollars to donate, or ad campaigns we just have tax dollars and if that's not good enough for politicians to eat off of, they're not good enough to be fed by us.
13.) Buying a home for the first time (or the first time in 7 years) should always grant a tax break, which would decline for every house you purchase every 7+ years. This will help get people into homes as opposed to renting which will provide the government with tax money, the banks will mortgage money which the will use to pay back their loans from the federal bank. Additionally, the interest rates for federal loans should be between 60-100% of the interest rate that a bank/credit/corporation charges its loanees.
14.) Small government is good but is flawed. Larger government is small but flawed. We need a medium sized government willing to accept its flaws and correct them where it can and we simply CANNOT get that done with people on the extremes and no-one bringing them together.
15.) Puppies>Kittens

EDIT:

Quote from: Ali on Thu 25/03/2010 11:37:29We probably all agree that freedom to choose is invaluable, but the quasi-monopolies of corporations like Microsoft mean that consumer choice is often an illusion. If you want to test this, try choosing to buy affordable clothing made by people who were paid decently using environmentally sustainable materials. Clothing companies could offer that choice, but it's far more profitable not to.

Good point Ali!

Or try buying a diamond:
You can go to Kay Jewlers, or Jared Jewlers or J.B. RObinson, or LeRoys, or Ostermann, or Belden, or Shaws, or Goodmans, or Westhall, or Rogers, or Friedlanders, or Mark & Morgan, or Adison, or Orange Blossom... except they're all the same company.

Or an Album:
You can buy from Interscope, or Geffen, or A&M, or Octone, or DGC, or Island, or Def Jam, or Mercury, or Motown, or Republic, or MCA, or Mercury, or Nashville, or Lost Highway, or Universal Latino, or Fonovisa, or Disa, or Machete, or Verve, or GRP, or Impulse, or Forecast, or Decca, or V2, or Fontana, or Show-Dog, or Polydor... except they're all the same company.

This idea of 'rationing' in the UK is no where near as widespread as people seem to think.

The figures cited by the conservative media in the US are often ridiculously misleading.

I know that it's considered crass to cite Fox News but it's the most popular news channel in the US so alot of people subscribe to that way of thinking. Fox News ran a section (Hannity i think it was) who described a case in which a baby had been "left to die" despite the mother pleading for doctors to revive the baby.

Hannity put this down to rationing of care without mentioning that the baby was several weeks more premature than the most premature baby ever to have survived but now ofcourse many Americans believe that story to be 100% accurate which fuels the distaste for universal healthcare.

I've had relatively limited experience with the NHS but my girlfriend usually manages to get a doctors appointment within a week, often within 2 days. My mother had surgery under the NHS and had the operation within a few weeks, even though it was non essential.

Yes we do have waiting lists but theres no evidence to suggest that affects the effectiveness of the care.

Also on the subject of the US life expectancy and infant mortality an awful lot of institutions (independent and otherwise) report that America performs terribly when compared to nations with universal healthcare.

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you are mis-informed.  The US was founded on the principle of personal liberty and freedom from oppressive government and that such freedoms are acquired by virtue of being a human being and not bestowed on anyone by a king or politburo as is the case in all or almost all other countries.

I'm....speechless.

QuoteNO Freeman shall be taken or imprisoned, or be disseised of his Freehold, or Liberties, or free Customs, or be outlawed, or exiled, or any other wise destroyed; nor will We not pass upon him, nor condemn him, but by lawful judgment of his Peers, or by the Law of the land. We will sell to no man, we will not deny or defer to any man either Justice or Right.

The Magna Carta - 1215

Quote from: Questionable on Thu 25/03/2010 01:05:45
nor can I afford even the cheapest quote that I've received for healthcare ($490/mo.)

I pay 240 â,¬* a year. As a student that is, but I wasn't, it wouldn't be intolerably more. I'm glad not to live in the US.

* 1â,¬ = 1.3$ or something.

Quote from: RickJ on Thu 25/03/2010 08:35:02
The Japanese live longer than anybody and spend less per person on medical care; how inconsiderate of them to live so long with out even trying ;).

If that was trying to say that the Japanese live really long DESPITE their health care system, I've got to take exception.  Obviously life-style will make a great contribution to life expectancy, but the Japanese health care system's low expenditure per person is not a reflection on the quality or amount of care.

The Japanese government strictly controls costs that providers can charge for every procedure or exam.  This allows them to keep the costs of their universal government-provided health insurance program way down.  The total costs to the government, and by extension, tax payers is so low DESPITE Japanese people having one of the highest average number of doctor visits per person per year in the world.

I was just in japan, and my daughter started having some kind of alergic reaction to something with her eyes getting all puffy and coughing all night, so we took her to the doctor WITHOUT INSURANCE and the total cost of the visit PLUS MEDICINE was $40, which is the same as my copay would have been if I had taken her to a walk-in clinic in the states WITH INSURANCE and NOT INCLUDING MEDICINE. 

If I had taken her with insurance in Japan on the same visit, the cost would have been $4. Plus, I would have been able to get that money refunded in cash to me at the end of the month because all children's medical bills are refundable up to a certain age.  So, it would have cost a net of zero.  (Of course, they could have saved all kinds of administrative money by skipping the parts where I pay and a few days later apply for reimbursement, but that's Japanese bureaucracy for you!)

I'm not saying their health care system is perfect.  It causes some strain on their economy to pay for everyone.  It causes strain on healthcare providers by not allowing them to set their own costs.  But fuck, if there isn't some kind of beneficial middle ground between Japan and America.  No one ever goes bankrupt in Japan due to medical bills.  And I think it would be worth it to try to find a system where we can achieve that too.  I'm tired of balancing the severity of my (or my wife's or kids') illness against my ability to pay for a doctor visit that month.  And that's WITH insurance.


Also, regarding the disapproval numbers reflected in polls, what most people ignore is the fact that a sizeable portion of the people who were disapproving of the bill held that position because they didn't think it was liberal enough.  If you subtract them from the disapproval numbers, every poll is showing significantly less than 50% opposed.

Quote from: Vince Twelve on Thu 25/03/2010 15:26:55
Also, regarding the disapproval numbers reflected in polls, what most people ignore is the fact that a sizeable portion of the people who were disapproving of the bill held that position because they didn't think it was liberal enough.  If you subtract them from the disapproval numbers, every poll is showing significantly less than 50% opposed.

I hadnt thought of that, good point.

Quote from: RickJ on Thu 25/03/2010 08:35:02
The Japanese live longer than anybody and spend less per person on medical care; how inconsiderate of them to live so long with out even trying ;).

See:

QuotePeople from the islands of Okinawa are reported to have the longest life expectancy in the world. This has in part been attributed to the local diet, but also to other variables such as genetic factors, lifestyle, and environmental factors.

Generally, the traditional diet.. is 20% lower in calories than the Japanese average and contains 300% of the green/yellow vegetables (particularly heavy on sweet potatoes). The Okinawan diet is low in fat and has only 25% of the sugar and 75% of the grains of the average Japanese dietary intake.[1]  The traditional diet also includes a relatively small amount of fish (less than half a serving per day) and somewhat more in the way of soy and other legumes (6% of total caloric intake). With exception of pork, almost no meat is consumed; virtually no eggs or dairy products are consumed either.[3]  Okinawans include pork in their diets. However, the fat content of the pork is eliminated; prior to the preparation of the pork, the fat is boiled off.

Healthcare is not the be-all end-all when it comes to life expectancy, this is why life expectancy by itself is not considered an accurate barometer of a countries "healthiness." If we all ate like that, and danced and laughed daily (as is apparently Okinawan culture) I'm sure we would be a healthier country, but we don't and so we need to revitalize a functioning but sub-prime system of healthcare.

but can you use the same argument with infant mortality? surely healthcare is practically the only thing that counts there. and you still lose.

Agreed.

Quote from: RickJ on Thu 25/03/2010 08:35:02

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The UK takes another approach, which is statistically more efficient (fewer people die from        insufficient care), but certainly has its own drawbacks.

Such decisions are inevitably based on political expediency.   Can you not see the immorality of a system where a group group of human beings decide who shall live and who shall die so as to derive the maximum benefit for their benefactors?   In the US system (up til now) the people at least retain their freedom to choose.

In the UK, anyone can always go for the US option and pay out of their own pocket for private treatment if they feel the NHS is failing them.  In the US, paying for treatment yourself one way or another is the ONLY  option, rather than the worst-case scenario.

Besides, doctors decide all the time on priority of treatment,a s there is always SOME resource that is limited, e.g. organs, blood, etc. Are you saying that they are beign immoral? Is it immoral to prioritise non-smokers over smokers for lung transplants?

In the USA, a guy who was really lazy and worthless but whose grandfather was very rich and gave him a good inheritance can get better care than someone who has moderate income but is self-employed, e.g. Dave Gilbert. How is that moral?

QuoteGovernment intervention and regulation can make the marketplace more efficient as a whole, by reducing externalities and forcing each party to bear the costs of its own actions (similar to forcing polluters to pay for the cost of their destruction).

I just wanted to point out that this is hogwash and has never been true.  Historically, any interests taken over by government result in lower efficiency by virtue of greater bureaucracy (more red tape, more pointless interim government oversight,etc).  Better quality and higher efficiency only ever come from free market practice where the people decide what works best and cheapest by voting with their money.  What America should have is less bureaucracy in medicine, not more.

This is a good article to cut your teeth on actual government policy.  I also recommend The Cure by Dr. David Gratzer and any of Milton Friedman or Murray Rothbard's books on government provided services.  They're all good and both men are rightly considered pillars of sound economics theory and practice -- but don't take my word for it, I'd rather you actually read articles from these gentlemen and formed a better opinion of government's role.  http://mises.org/daily/3793

Progz, this idea that government intervention is always bad just isnt true.

We all accept that free market capitalism works for the vast majority of cases. We wouldnt expect to see government run supermarkets, shoe shops or record stores. However, when we are talking about community services, regulation is almost always a good thing.

Many people consider true laissez-faire capitalism to be the purest form of democracy. If you dont like it, take your patronage elsewhere. However as I understand it (please correct me if i'm wrong) most americans get their healthcare through their employer. This means there is a disconnect between the provider and the customer. The employer will likely go to the lowest bidder since they are paying for the cover. This upsets the basic ethos of capitalism.

As i've said, my objection to the american system is mainly a moral one. My knowledge of economics simply isnt good enough to form a good argument. Even if universal healthcare turned out to be the worst choice in terms of economy i would still support universal healthcare.

Americans seem to have a real problem with tax in my experience. Some americans even oppose income tax as unconstitutional. I'm happy to pay my taxes and from what I can tell the more a country leans towards libertarian socialism, the better life becomes.

Quote from: ProgZmax on Sun 28/03/2010 06:00:29

QuoteGovernment intervention and regulation can make the marketplace more efficient as a whole, by reducing externalities and forcing each party to bear the costs of its own actions (similar to forcing polluters to pay for the cost of their destruction).

I just wanted to point out that this is hogwash and has never been true.  Historically, any interests taken over by government result in lower efficiency by virtue of greater bureaucracy (more red tape, more pointless interim government oversight,etc).  Better quality and higher efficiency only ever come from free market practice where the people decide what works best and cheapest by voting with their money.  What America should have is less bureaucracy in medicine, not more.

A moment's thought should show that this is nonsense. Capitalism couldn't function without government regulation. Governments institute and enforce property rights, they establish contract law, they provide a stable currency. Government regulation allows a company to declare bankruptcy. Try doing that in a completely unregulated economy!

On a smaller scale, governments break up monopolies and cartels, leading to clear improvements in market competitiveness and service to consumers (the clearest example of this in recent times is probably the breakup of AT&T). And as mentioned before, government regulation is one of the only ways to eliminate market externalities, so that among other things you can avoid tragedy of the commons scenarios. Government regulation imposes disclosure requirements, so rational actors have more perfect knowledge and there make better decisions, leading to more efficient markets. Finally, with the development of behavioral economics, we have a way to predict and identify how people make e.g. purchase decisions in non-rational ways, and with regulation we can manipulate that, giving people incentives to act in their own interest. (For example subsidies to weatherize homes, on the principle that people tend to discount running energy costs compared to an up-front investment in insulation.)

Does government regulation come at a cost? Definitely; and just as definitely there are many examples of unwise or at best sub-optimal regulations. But the only people who think regulation is always a bad thing are extremists like the von Mises Institute, who should be soundly discredited by the recent economic crisis. (Hell, even Greenspan admitted as much!)

Actually I would be fine with the government providing all products and services assuming that there was also competition from private companies. It is far preferable to a system where the government provides absolutely NOTHING and people have to turn to private companies even for things like police and fire protection. If you don't want medicare or medicaid you can get private insurance, however the option for government run health insurance should be available to provide competition to private companies. Likewise if you don't want to get your power from the government you can buy it from private companies. Regulation is also very much needed, lets say a company makes a product and to improve sales they add an ingredient to make it highly addictive, are saying there should be no regulation to prevent companies from doing something like this?