If your phone bill has increased for years, then you are not shopping.
My goal is for everyone to be rich.
But that is not the discussion, it's about healthcare. Well, at least this part of the thread is.
Yes, stuff happens. You shop for the rest, of course. Right now, no one can shop, can they? They can't take their insurance with them if they switch employers. There are too many restrictions.
I believe our current system provides excellent care, and it is for-profit. Americans like their healthcare. Almost half of voters now rate the U.S. health care system as good or excellent. Only 5 percent listed quality of care as the biggest problem with health care today.
I believe our current system can be improved so costs are lower, still be for-profit, and not tax people to death to make it happen.
My points are made, time to move on. Thanks for the discussion.
My goal is for everyone to be rich.
But that is not the discussion, it's about healthcare. Well, at least this part of the thread is. Yes, stuff happens. You shop for the rest, of course. Right now, no one can shop, can they? They can't take their insurance with them if they switch employers. There are too many restrictions.
I believe our current system provides excellent care, and it is for-profit. Americans like their healthcare. Almost half of voters now rate the U.S. health care system as good or excellent. Only 5 percent listed quality of care as the biggest problem with health care today.
I believe our current system can be improved so costs are lower, still be for-profit, and not tax people to death to make it happen.
My points are made, time to move on.
Thanks for the discussion.
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Long-distance rates were driven down, but:
1. That was not a part of the breakup of Bell, per se, but the decoupling of long-distance from local phone service;
2. Local service rates did not decline. There was little to no competition here because the infrastructure portion of any utility (much like health insurance) tends toward a natural monopoly because of the barriers to entry (it costs unreal sums of money to lay a bunch of cable and do last-mile to homes and businesses, just as it takes a commitment of unreal amounts of money to form a health insurance operation that covers enough people to make it).
This changed with internet telephony and cell service, where suddenly the phone call is just another bit of data. However, even cell service tends to be a natural monopoly or at most tri-opoly, because of the realities of infrastructure (cost and securing tower placement). Note how the Bells have now come back together as ATT, Qwest, and Verizon, all offering the same god-awful customer service and nearly identical prices (which are high enough that they each bring in a nearly identical 3 to 3.5 billion per quarter). T-Mobile is the only real competition, but the consequence of lower price and decent customer service is that they lag behind in coverage and many technologies.
The point here is that industries with high costs of entry are not part of the perfectly frictionless market that Adam Smith showed was required in order to make the "invisible hand" function. it's just a reality of human behavior. All efforts to induce "competition" will fail because that is simply not the nature of those particular beasts.
wgerrard
Mentor
I get the cheapest plan Bell South offers in my area, with no long distance. The few alternatives are more expensive.
Only for people who can afford insurance.
I believe market-based health providers are by nature incapable of providing universal health care.
BTW, nothing in either bill would "tax people to death". Nor would single payer. Meanwhile, we're all paying absurdly high amounts into the coffers of insurers. Why are you so dead set on preserving those profits? Why is it morally acceptable for the president of my non-profit insurer to make $12 million a year while increasing taxes on the wealthy is morally offensive? (BTW, BCBS-NC got caught sending out anti-reform propaganda to their customers. A fine use of customer premiums buy a non-profit.)
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antiquark
Derek Ross
Maybe there are ninjas assasinating all the centenarians... but who would be hiring said ninjas? (*cough* republicans *cough*)
antiquark
Derek Ross
You might be intereste in this article. Economists have know that for 45 years:
Why markets can’t cure healthcare
http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/
Roger Hicks
Mentor
Dear Stewart,
You think you're joking? The IRS explained kindly to me some years ago that as the spouse of a US citizen, I could opt to be taxed in the USA, even though I gave back my green card a decade ago. I declined.
You may even be eligible for the same privilege, regardless of your spouse's nationality.
And the USA is the only non-third-world country I know that requires all its citizens (and green card holders) who live overseas to file US taxes every year. That's the main reason I gave back my green card. I don't pay taxes in Albania or Burkina Faso, because I don't live there. Why on earth should I pay taxes in the USA?
Cheers,
R.
slm
Formerly nextreme
Hi Roger,
Please see my post #542 also. Be careful of your investments. A family member had investments in a US corporation (in certificate form, back from the day when people got certificates when buying stock), and when they passed, we were required to file an IRS tax return, pay to get the Will translated from french to english, and send it all to the fed, just so we could get the certificates transferred to our broker (this must be done by the company's stock transfer agent) so the assets could then be liquidated. Depending on the value of the stock and the value of the estate, there could be a tax hit (payable to the IRS).
Note the countries that have a Death Tax Treaty (hows that for a heading?) with the US.
Cheers
Steven
Roger Hicks
Mentor
Dear Steven.
Phew! I have to confess that I didn't follow the links on #542 on the grounds it didn't affect me. It still doesn't (and probably won't, though there's one last aunt), but it's worth knowing about.
Cheers,
R.
Phew! I have to confess that I didn't follow the links on #542 on the grounds it didn't affect me. It still doesn't (and probably won't, though there's one last aunt), but it's worth knowing about.
Cheers,
R.
Thardy
Mentor
Remember the Hospital was in BC.
http://www.hc-sc.gc.ca/hcs-sss/medi-assur/res/faq-eng.php#a13
"Each province and territory has considerable leeway in determining how its share of the cost of its health insurance plan will be financed. Financing can be through the payment of premiums (as is the case in Alberta and British Columbia), payroll taxes, sales taxes, other provincial or territorial revenues, or by a combination of methods. Health insurance premiums are permitted as long as residents are not denied coverage for medically necessary hospital and physician services because of an inability to pay such premiums.
Provinces that levy premiums have also instituted premium assistance schemes that are based on income, and those who cannot afford to pay premiums may apply for assistance through the provincial health insurance plans."
That's probably why the lady sneered when she mentioned people in the east.
Thardy
Mentor
Are premiums and profits really absurdly high? A family (whose bread winner is employed) pays about $3,000 per year for insurance, and if they are not part of an employers plan insurance premiums cost about $13000 per family. But look at what the per person expenditure is : close to $10000. Thats $40,000 for a family of four. So you pay between $3000 - $13000, and receive $40,000 worth of care.
Of course those are raw numbers, most health spending is shifted to the more elderly age groups, and with end of life care the cost skyrocket.
Insurance company profits are about 3%, Pharmaceutical companies profits are about 18-19%. The average Fortune 500 company is about 6%.
Thardy
Mentor
But then to comment on the original idea of this article, and eariler comments. Photography makes for a great hobby, but it would be very iffy for a profession.
Roger Hicks
Mentor
Dear Thomas,
True.
Been there, done that. No hope of paying for meaningful health insurance as a freelance in the USA. One of the most important reasons for leaving the country, as far as I was concerned.
What does this mean?
That we shouldn't have any freelance photographers. Just wage slaves who keep photography for a hobby and worry about the colour of the dot on their Leicas.
Cheers,
R.
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Paul T.
Mentor
Sadly, so true.
In my similar line, I get to contribute to appeals for medical fees maybe once a year, for writers, musicians, photographers - all of whom contribute to America's cultural exports & balance of payments, but are personae non gratae once they hit a health speed bump.
antiquark
Derek Ross
Thanks for the link! So when someone talks about Canadian health care, the next question should be "which province?" However the coverage is still universal in BC, even though they have to pay for insurance.
But the guy must have been really strapped for cash. Come on, is $54 too much to pay?
http://www.health.gov.bc.ca/msp/infoben/premium.html
Monthly rates are $54 for one person, $96 for a family of two and $108 for a family of three or more. Effective January 1, 2010 monthly rates will change to $57 for one person, $102 for a family of two and $114 for a family of three or more.
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wgerrard
Mentor
Thanks for the link.
I'm at a loss to understand why this is such a difficult idea for some people to grasp. If you want universal health care to be delivered by for-profit providers, then you must deal with those customers who cannot afford to pay for the treatment they need. You can decide not to treat people who can't afford it. You can decide to make up the loss by boosting prices of those members of the public who can pay. You can get government to provide subsidies, thereby again pushing the loss of onto the public.
So, if the only way to prop up for-profit universal care is to feed in public money, why not reduce the burden to the public by eliminating the unproductive people in the middle -- health care insurers-- and liberate the money that otherwise would be retained by the insurers as profit?
wgerrard
Mentor
Boy, do I know that, Roger. I've contemplated moving to, or living for an extended period in, the UK. But, I'd very likely end up paying U.S. and UK taxes, at least as I understand it.
wgerrard
Mentor
Well, the median household income in the U.S. is a tad over $50,000. So, $13000 a year for health insurance very likely puts it as the family's second largest cost, after housing.
The $3000 per year for a group plan fails to take into account the fact that the remaining $10,000 is paid by the employer, and passed on to the public.
If we were starting from scratch, how receptive do you think people who make $50,000 per year would be to a de facto requirement to spend $13,000 each year on health insurance?
And that's without considering the tens of millions of Americans who earn less than the median income and who will never work for an employer who offers a group plan.
wgerrard
Mentor
Don't recall the details, but I heard a news report today that a survey of people who considered themselves artists indicated their income had decreased an average of 50 percent since last year.
You can't eat art. You can't eat photojournalism, for that matter.
Apparently all is not peachy north of the border. Some very strong statements coming from the president of the Canadian Medical Association.
"unsustainable"
"imploding"
"wait lists"
"competition"
And lastly "the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump- sum budget"
Amazing: the current system doesn't 'focus on patients.'
Of course, if there are more patients than a "lump-sum budget" can support, that leads to what? Rationing, and wait lists.
Quite interesting that while the liberal controlled US Congress attempts to ram-rod a socialist health care system, the 'head doctor' in Canada appears to want to go in the exact opposite direction, because their current system is "not sustainable."
Overhauling health-care system tops agenda at annual meeting of Canada's doctors
Aug 15 11:28 AM US/Eastern
Jennifer Graham, THE CANADIAN PRESS SASKATOON - The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.
Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country - who will gather in Saskatoon on Sunday for their annual meeting - recognize that changes must be made.
"We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize," Doing said in an interview with The Canadian Press.
"We know that there must be change," she said. "We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands."
The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.
His thoughts on the issue are already clear. Ouellet has been saying since his return that "a health-care revolution has passed us by," that it's possible to make wait lists disappear while maintaining universal coverage and "that competition should be welcomed, not feared."
In other words, Ouellet believes there could be a role for private health-care delivery within the public system.
He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump- sum budget. This "activity-based funding" would be an incentive to provide more efficient care, he has said.
Doig says she doesn't know what a proposed "blueprint" toward patient- centred care might look like when the meeting wraps up Wednesday. She'd like to emerge with clear directions about where the association should focus efforts to direct change over the next few years. She also wants to see short-term, medium-term and long-term goals laid out.
"A short-term achievable goal would be to accelerate the process of getting electronic medical records into physicians' offices," she said. "That's one I think ought to be a priority and ought to be achievable."
A long-term goal would be getting health systems "talking to each other," so information can be quickly shared to help patients.
Doig, who has had a full-time family practice in Saskatoon for 30 years, acknowledges that when physicians have talked about changing the health-care system in the past, they've been accused of wanting an American-style structure. She insists that's not the case.
"It's not about choosing between an American system or a Canadian system," said Doig. "The whole thing is about looking at what other people do."
"That's called looking at the evidence, looking at how care is delivered and how care is paid for all around us (and) then saying 'Well, OK, that's good information. How do we make all of that work in the Canadian context? What do the Canadian people want?' "
Doig says there are some "very good things" about Canada's health-care system, but she points out that many people have stories about times when things didn't go well for them or their family.
"(Canadians) have to understand that the system that we have right now - if it keeps on going without change - is not sustainable," said Doig.
"They have to look at the evidence that's being presented and will be presented at (the meeting) and realize what Canada's doctors are trying to tell you, that you can get better care than what you're getting and we all have to participate in the discussion around how do we do that and of course how do we pay for it."
"unsustainable"
"imploding"
"wait lists"
"competition"
And lastly "the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump- sum budget"
Amazing: the current system doesn't 'focus on patients.'
Of course, if there are more patients than a "lump-sum budget" can support, that leads to what? Rationing, and wait lists.
Quite interesting that while the liberal controlled US Congress attempts to ram-rod a socialist health care system, the 'head doctor' in Canada appears to want to go in the exact opposite direction, because their current system is "not sustainable."
Overhauling health-care system tops agenda at annual meeting of Canada's doctors
Aug 15 11:28 AM US/Eastern
Jennifer Graham, THE CANADIAN PRESS SASKATOON - The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.
Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country - who will gather in Saskatoon on Sunday for their annual meeting - recognize that changes must be made.
"We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize," Doing said in an interview with The Canadian Press.
"We know that there must be change," she said. "We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands."
The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.
His thoughts on the issue are already clear. Ouellet has been saying since his return that "a health-care revolution has passed us by," that it's possible to make wait lists disappear while maintaining universal coverage and "that competition should be welcomed, not feared."
In other words, Ouellet believes there could be a role for private health-care delivery within the public system.
He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump- sum budget. This "activity-based funding" would be an incentive to provide more efficient care, he has said.
Doig says she doesn't know what a proposed "blueprint" toward patient- centred care might look like when the meeting wraps up Wednesday. She'd like to emerge with clear directions about where the association should focus efforts to direct change over the next few years. She also wants to see short-term, medium-term and long-term goals laid out.
"A short-term achievable goal would be to accelerate the process of getting electronic medical records into physicians' offices," she said. "That's one I think ought to be a priority and ought to be achievable."
A long-term goal would be getting health systems "talking to each other," so information can be quickly shared to help patients.
Doig, who has had a full-time family practice in Saskatoon for 30 years, acknowledges that when physicians have talked about changing the health-care system in the past, they've been accused of wanting an American-style structure. She insists that's not the case.
"It's not about choosing between an American system or a Canadian system," said Doig. "The whole thing is about looking at what other people do."
"That's called looking at the evidence, looking at how care is delivered and how care is paid for all around us (and) then saying 'Well, OK, that's good information. How do we make all of that work in the Canadian context? What do the Canadian people want?' "
Doig says there are some "very good things" about Canada's health-care system, but she points out that many people have stories about times when things didn't go well for them or their family.
"(Canadians) have to understand that the system that we have right now - if it keeps on going without change - is not sustainable," said Doig.
"They have to look at the evidence that's being presented and will be presented at (the meeting) and realize what Canada's doctors are trying to tell you, that you can get better care than what you're getting and we all have to participate in the discussion around how do we do that and of course how do we pay for it."
emraphoto
Mentor
there has been numerous "the Canadian health care system is imploding" claims over the years. so many that most if us pay little attention anymore.
regardless, no one is claiming our system is without fault. what we will claim is that national level health care is a part of the countries fabric and i can assure you any party intending to "scrap" it would have a monstrous task in convincing the masses to not hang them from the rafters.
regardless, no one is claiming our system is without fault. what we will claim is that national level health care is a part of the countries fabric and i can assure you any party intending to "scrap" it would have a monstrous task in convincing the masses to not hang them from the rafters.