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InvisibleAsclepius
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Some thoughts on the American health care system * 1
    #25000029 - 02/17/18 12:00 AM (3 years, 2 months ago)

    The American Government has been trying to comprise a fair, just and affordable healthcare system for Americans without destroying the national budget.  Free market or single-payer systems are being debated, as to which is best for the citizens of America.  There appears to be a conundrum, as to whether the increase of taxes on American citizens as a viable solution to universal health care, or should the current Medicaid, Medicare, and private insurance best serve American citizens.




    One of the greatest issues Americans are confronted with is access to quality, yet affordable health insurance.  Regardless of conflicting views on how to best resolve flaws of the current health care model, a small but growing majority of Americans (60%) believe health care coverage is a fundamental human right, one that the government should ensure for all citizens (Bialik, 2017), and recognize the most obvious benefits that would proceed from the introduction of a single-payer health care system: improvement in quality of life, longer life expectancies, and a reduction in the overall expenditure of gross domestic product (GDP).


    Still, there are those who object to a national single-payer health care system –  particularly organizations like the FreedomWorks Foundation – who contend that implementation of a single-payer system would be deleterious to the U.S. economy, citing a $15 trillion cost over a period of 10 years (Pye, 2015).  With such seemingly prohibitive costs, it is no wonder that FreedomWorks has gained support from at least a small portion of the 38% of Americans averse to a single-payer system (Bialik, 2017), much less some people in favor of one who are fearful of the potential for negative economic repercussions.  No doubt the foundation ultimately aims to sway legislative opinion and further increase public support of its views. 




    Indeed, it would appear as though a single-payer system is not a viable solution to the health care problem, and organizations like FreedomWorks care deeply about the good health, and financial stability, of the average American citizen… Except that these notions are factually incorrect.  While it is true a single-payer system would cost upwards of $15 trillion over a cumulative period of 10 years, that seems a rather conservative expenditure when compared to the nation’s current annual health care cost: $3.3 trillion as of 2016, not accounting for future annual increases (National Health Accounts, 2018).  Even more alarming, because the individual mandate of the Affordable Care Act (ACA) has been repealed, the National Health Expenditure Data (NHED) project the annual cost of health care in the U.S. is going to reach $5.7 trillion by 2026 (NHE-Fact-Sheet, 2017). 




    Considering the previously mentioned data, it is apparent that David and Charles Koch, founders of the “grassroots” advocacy group FreedomWorks, have entirely different motives for opposing a single-payer health care system.  Perhaps it has something to do with the stakes they hold in pharmaceuticals, a fact they are not fond of sharing as fervidly as they are their opinions concerning single-payer health care.  Surely their indifference toward those unable to afford health care has nothing to do with their investments in pharmaceutical companies like Koch-Glitsch, Ortho-McNeil-Janssen Pharmaceuticals, and Koch Membrane Systems, never mind that reducing national health care costs and the Koch brothers’ bottom-line are not mutually exclusive.  The fact is, contrary to what the Koch brothers and the minority of Americans believe, “95% of all U.S. households would save money [under a single-payer system]” (Friedman, 2013).  A single-payer system would nevertheless have its own share of problems. 


    It is often reported by U.S. news media outlets that wait times for routine medical screenings and procedures in countries with single-payer systems are unnecessarily long.  One need only look to other Westernized countries that already have these types of health care systems in place, such as Canada, for a point of comparison.  It is noteworthy to mention, that while Canadians commonly refer to their health care system as Medicare, they technically have a total of 13 provincial and territorial health care insurance plans (Canada’s health care system, 2016); however, coverage provided across the country is virtually identical.


    No one likes waiting to see the doctor when they have health concerns regardless of how minor they may appear to be.  It is common knowledge that something as simple as the flu can potentially prove fatal if a person is not rendered the proper medical care, for example.  So, it is not difficult then to imagine why so many Americans, even those in favor of single-payer health care, are alarmed to hear about the long wait times in Canada.  Although universal coverage is great in principle, it serves little good if the slightest ailment cannot be treated within a reasonable amount of time.  Moreover, if Canada’s health care model gives any indication of what a single-payer system looks like, perhaps more Americans would be hesitant to support the idea of adopting one.


    Only 43% of Canadians report being seen by their primary care physician within 48 hours after scheduling an appointment, and most experience wait times of 4 or more hours during an average emergency department visit (Commonwealth Fund Survey, 2018).  There is no disputing these data are anything less than atrocious, to say nothing about Canadians having the longest wait times to see a specialist out of 11 Westernized countries surveyed in total (Commonwealth Fund Survey, 2018).  Indeed, the Government of Canada openly acknowledges upwards of 1.4 million ER visits annually are potentially avoidable if they were instead addressed by primary care physicians (Commonwealth Fund Survey, 2018).  However, contrary to what one might infer from these figures, Canadians have a longer lifespan than Americans, and the majority (74%) are satisfied with their quality of care (Commonwealth Fund Survey, 2018).  To put things into perspective, the United States ranks 8th out of the 11 countries surveyed in terms of speedy access to primary care physicians; 9th in terms of emergency department wait times (Commonwealth Fund Survey, 2018).  However, Canada spends approximately 40% less of its GDP on health care than does the United States, and, irrespective slightly longer wait times for medical appointments, is still able to provide better quality care to most citizens. 


    Despite its problems, for which there are more than a few, Canada’s health care system performs better than the U.S. model in large part because of its comprehensive triage system: a system designed to provide urgent care, even as it pertains to surgeries, to those most in need.  Whereas the United States health care model is setup in a fashion that prioritizes life-saving, non-emergency surgeries for patients who can pay the most money, Canada’s model is setup in a way that prioritizes life-saving, non-emergency surgeries for patients in terms of urgency (e.g., the sickest among the population are given top priority, and the economically disenfranchised will not be turned away). 




    The American health care system is comprised of a free market which is inadequate in ensuring that all American citizens have access to equal and affordable health care.  That is why there is a current discussion of legislation that can implement a health care system that is more conducive to the well-being of the average American citizen.  There has been legislation, such H.R. 676, that has been proposed as a resolution to this issue.  American citizens can advocate for single-payer legislation by voicing their opinions to their elected officials, by simply making a phone call (Jansson, 2011).

 
    It should come as no surprise that people who have access to adequate health care also have an overall better quality of life than those who do not.  Having access to quality health care can also produce a positive influence on one’s mental well-being.  In addition to having higher life expectancies than Americans, Canadians also have better access to mental health services: 59% report immediate access as opposed to the 54% average in other Westernized countries surveyed, according to the Commonwealth Fund.  This can make all the difference for those suffering from anxiety, depression, and many other illnesses.


    It is evident that Canadians do have longer than average wait times compared to many Westernized countries, but the difference is relatively small when compared to United States averages.  They also spend far less on health care than Americans per capita –an average of $4,506 compared to $9,204 – yet simultaneously pay lower tax rates: 15-29%, respectively (Mohr, 2011).  There is no reason America could not also adopt a single-payer health care system. 


    As of 2016, more than 28 million Americans went uninsured (National Center for Health Statistics, 2017) – a number that has and will continue to grow unless drastic legislative changes are made to the health care system.  However, organizations like FreedomWorks are fighting to keep tax rates for the top 5% low at the expense of tens of millions of uninsured Americans.  It is not as though the top income earners would no longer be able to afford to live lavish lifestyles, if their tax rates were increased for the good of the average citizen.  The ability of the wealthy to arbitrarily purchase 3 or more houses, and 10 or more vehicles, does not supersede the importance of the well-being of millions of uninsured people… At least it does not to most Americans.




    H.R. 676 is proposed legislation for expanded medical care for all: “This bill establishes the Medicare for All Program to provide all individuals residing in the United States and U.S. territories with free health care that includes all medically necessary care, such as primary care and prevention, dietary and nutritional therapies, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care (Conyers, 2017).”  This bill addresses the need for single-payer confidential electronic medical records, accessible and affordable quality access of integrated care for all, inclusive of the American Natives which must be fully integrated into the single-payer system within five years of its inception and is created for individuals residing in the United States. 





References



Bialik, K. (2017, January 13). More Americans say government should ensure health care coverage. Retrieved February 12, 2018, from http://www.pewresearch.org/fact-tank/2017/01/13/more-americans-say-government-should-ensure-health-care-coverage/.


Commonwealth Fund Survey 2016. (2018, January 18). Retrieved February 13, 2018, from https://www.cihi.ca/en/commonwealth-fund-survey-2016.


Conyers, J. (2017, February 10). H.R.676 - 115th Congress (2017-2018): Expanded & Improved Medicare For All Act. Retrieved February 14, 2018, from https://www.congress.gov/bill/115th-congress/house-bill/676.


Friedman, G. (2013, July 31). Funding HR 676: The Expanded and Improved Medicare for All Act. How we can afford a national single-payer health plan. Retrieved February 13, 2018, from http://pnhp.org/blog/2013/07/31/friedman-analysis-of-hr-676-medicare-for-all-would-save-billions/.


Health Canada. (2016, August 22). Canada's health care system. Retrieved February 13, 2018, from https://www.canada.ca/en/health-canada/services/canada-health-care-system.html.


Jansson, B. S. (2011). Developing political strategy and putting it into action. In B. S. Jansson (Ed.), Becoming an effective policy advocate: From policy practice to social justice (6th ed., pp. 385–442). Belmont, CA: Brooks-Cole. 


Mohr, A. (2011, March 21). Do Canadians Really Pay More Taxes Than Americans? Retrieved February 13, 2018, from https://www.investopedia.com/financial-edge/0411/do-canadians-really-pay-more-taxes-than-americans.aspx.


National Center for Health Statistics. (2017, March 31). Retrieved February 13, 2018, from https://www.cdc.gov/nchs/fastats/health-insurance.htm.


NationalHealthAccountsHistorical. (2018, January 08). Retrieved February 13, 2018, from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html.


NHE-Fact-Sheet. (2017, December 06). Retrieved February 13, 2018, from https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html;


Pye, J. (2015, September 16). Bernie Sanders: The $18 Trillion Man. Retrieved February 13, 2018, from http://www.freedomworks.org/content/bernie-sanders-18-trillion-man.


Edited by Asclepius (02/17/18 03:07 AM)


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OfflineThundermuscle75
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Re: Some thoughts on the American health care system [Re: Asclepius]
    #25000179 - 02/17/18 01:19 AM (3 years, 2 months ago)

Very well done. I hope that's available elsewhere on the interwebs.


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InvisibleAsclepius
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Re: Some thoughts on the American health care system [Re: Thundermuscle75]
    #25000185 - 02/17/18 01:25 AM (3 years, 2 months ago)

Thank you.  It's only available here at the Shroomery.


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Re: Some thoughts on the American health care system [Re: Asclepius] * 1
    #25001605 - 02/17/18 05:58 PM (3 years, 2 months ago)

An obvious thing that would lower costs considerably is competitive bidding on drugs. As it is now, we pay tip top dollar for drugs and the govt does too despite its hefty clout in buying million of dollars worth per year. We all know why this is, big pharma pays off the politicians and gets their way. That is the main thing we should fix.


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“A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves largesse from the public treasury. From that moment on, the majority always votes for the candidates promising the most benefits from the public treasury with the result that a democracy always collapses over loose fiscal policy, always followed by a dictatorship.” (attributed to Alexis de Tocqueville political philosopher Circa 1835)

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Re: Some thoughts on the American health care system [Re: Stonehenge] * 1
    #25001662 - 02/17/18 06:35 PM (3 years, 2 months ago)

Peanuts.


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Re: Some thoughts on the American health care system [Re: Thundermuscle75] * 1
    #25001849 - 02/17/18 07:55 PM (3 years, 2 months ago)

Many of those other areas include drug costs too like nursing, hospitals, research etc. Drug and equipment costs are a big part of it. Why is it the same drug made by the same company costs many times more here than in canada which does negotiate drug prices? And that is just one area, its all full of graft and corruption. We have to get rid of legal bribery before any major improvement can happen


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“A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves largesse from the public treasury. From that moment on, the majority always votes for the candidates promising the most benefits from the public treasury with the result that a democracy always collapses over loose fiscal policy, always followed by a dictatorship.” (attributed to Alexis de Tocqueville political philosopher Circa 1835)

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InvisibleAsclepius
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Re: Some thoughts on the American health care system [Re: Stonehenge]
    #25001967 - 02/17/18 08:36 PM (3 years, 2 months ago)

Quote:

Stonehenge said:
Many of those other areas include drug costs too like nursing, hospitals, research etc. Drug and equipment costs are a big part of it. Why is it the same drug made by the same company costs many times more here than in canada which does negotiate drug prices? And that is just one area, its all full of graft and corruption. We have to get rid of legal bribery before any major improvement can happen






Canadian law authorizes a review board to order a price reduction whenever the price of a drug exceeds the median of the prices in six European countries plus the United States.  Also, unlike the United States, Canadian politicians are not so easily bought off by big corporations -- they actually care about their citizens.  I agree that we must get rid of bribery, stone, but we also must adopt a single-payer system for this to work.  If we were to have a Medicare for all plan similar to Canada's -- not that it has to be exactly the same -- we would ultimately save trillions upon trillions of our GDP, boost the economy (because corporations would no longer have to pay for health insurance), and ensure all citizens have health coverage.  Another problem is the top 5% of income earners will complain how their taxes are too high, because like I said, it's not fair if they are unable to own several houses, cars,etc.  Well, Americans are getting sick of hearing these same old talking points.  We could literally have Medicare for all at half the price of what we are paying now.  The top 5% of income earners, even if they must pay higher taxes, will still be richer than the bottom 95%.  I don't feel bad for them.  However, the wealthiest Canadians still pay a lower tax rate than the wealthiest Americans: 29% is the top income tax for an individual; however, unlike in the United States, the wealthy do not have as many tax loopholes.  Still, a 29% tax rate and Medicare to boot does not seem like such a bad deal to me. 


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A society governed in terms of double standards is self-destructive




Edited by Asclepius (02/17/18 08:38 PM)


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Re: Some thoughts on the American health care system [Re: Asclepius] * 2
    #25002159 - 02/17/18 10:06 PM (3 years, 2 months ago)

Sure single payer could be good if it was run right. But with all the graft and corruption going on it will not be run right. Drug costs are a big deal. I'm sure canadian law has something to do with it, I really doubt your politicians are so concerned about the people they turn down bribes. They are concerned about getting locked up. We need better laws about that.


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“A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves largesse from the public treasury. From that moment on, the majority always votes for the candidates promising the most benefits from the public treasury with the result that a democracy always collapses over loose fiscal policy, always followed by a dictatorship.” (attributed to Alexis de Tocqueville political philosopher Circa 1835)

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Re: Some thoughts on the American health care system [Re: Stonehenge] * 1
    #25002639 - 02/18/18 03:59 AM (3 years, 2 months ago)

Quote:

Stonehenge said:
Many of those other areas include drug costs too like nursing, hospitals, research etc. Drug and equipment costs are a big part of it. Why is it the same drug made by the same company costs many times more here than in canada which does negotiate drug prices? And that is just one area, its all full of graft and corruption. We have to get rid of legal bribery before any major improvement can happen




The old excuse is that we have to so that Big Pharma can fund research.
We covered this in another thread a couple years ago, I can search for it later, but the gist is that if medicare negotiated prescription drug prices(the way the VA does now), the savings could be used to sub the research out to the pharma companies at the rates they would supposedly have to reduce R&D funding and still come out way ahead.


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Re: Some thoughts on the American health care system [Re: ballsalsa]
    #25002653 - 02/18/18 04:06 AM (3 years, 2 months ago)

You're making too much sense.  That's not allowed in my threads.  :cantarguewiththat:


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Re: Some thoughts on the American health care system [Re: ballsalsa]
    #25003058 - 02/18/18 10:25 AM (3 years, 2 months ago)

Give the money to big pharma so they can do research? Um no, lets use it to pay our many researchers like at the nih who do not work for rip offs. The only research big pharma wants to do is how to gouge us for more money. They will do that and still make a bundle even if they are forced to charge fair prices.

Its something way overdue along with cleaning up the system to stop bribery


--------------------
“A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves largesse from the public treasury. From that moment on, the majority always votes for the candidates promising the most benefits from the public treasury with the result that a democracy always collapses over loose fiscal policy, always followed by a dictatorship.” (attributed to Alexis de Tocqueville political philosopher Circa 1835)

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Re: Some thoughts on the American health care system [Re: Stonehenge] * 2
    #25003273 - 02/18/18 12:28 PM (3 years, 2 months ago)

Quote:

Stonehenge said:
Give the money to big pharma so they can do research? Um no, lets use it to pay our many researchers like at the nih who do not work for rip offs. The only research big pharma wants to do is how to gouge us for more money. They will do that and still make a bundle even if they are forced to charge fair prices.

Its something way overdue along with cleaning up the system to stop bribery




But the first thing Trump did when he got into office was significantly reduce NIH funding, as well as most other forms of government research funding for academics, and significantly reduce taxes on pharma profits. A couple people in our department had their grants expire because NIH could no longer pay them the grant money that they had contractually given them.

That's been a major republican talking point for a while. They're all about private pharma "research".


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Re: Some thoughts on the American health care system [Re: Kryptos] * 2
    #25003595 - 02/18/18 02:52 PM (3 years, 2 months ago)

Most basic drug discovery comes from publicly funded research


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Re: Some thoughts on the American health care system [Re: koods] * 1
    #25003617 - 02/18/18 02:59 PM (3 years, 2 months ago)

Healthcare is not a free market. Free markets require that participants are free to enter and exit the market voluntarily. People who are sick do not have a choice but to enter the market. This is the opposite of a free market, and because of this the market does not provide price controls: if you are facing death you will pay whatever you can to save your life.


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Re: Some thoughts on the American health care system [Re: koods] * 2
    #25004208 - 02/18/18 07:58 PM (3 years, 2 months ago)

Quote:

koods said:
Healthcare is not a free market. Free markets require that participants are free to enter and exit the market voluntarily. People who are sick do not have a choice but to enter the market. This is the opposite of a free market, and because of this the market does not provide price controls: if you are facing death you will pay whatever you can to save your life.





I regret not putting quotations around the word free market in the initial thread.  I'm right there with you, as I find it to be ironic we call the American health care system a "free market" -- there's nothing free about it.  We are slaves to a system that holds our lives in its hands, has the power to crush us with debt, and can refuse us the necessary procedures if deemed too costly.  It's hard to believe that in 2018 so many people in the U.S., nearly 30 million, still go without health insurance.  The irony is also not lost on me that we are the richest nation on earth and that countries not as wealthy provide better health care for their citizens than we do ours.


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Re: Some thoughts on the American health care system [Re: Stonehenge] * 1
    #25004237 - 02/18/18 08:11 PM (3 years, 2 months ago)

Quote:

Stonehenge said:
Give the money to big pharma so they can do research? Um no, lets use it to pay our many researchers like at the nih who do not work for rip offs. The only research big pharma wants to do is how to gouge us for more money. They will do that and still make a bundle even if they are forced to charge fair prices.

Its something way overdue along with cleaning up the system to stop bribery




I'm not saying we should, I'm saying we could, therefore the R&D excuse doesn't hold water.
I agree with everything in your post.


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Re: Some thoughts on the American health care system [Re: Stonehenge] * 1
    #25004758 - 02/19/18 01:58 AM (3 years, 2 months ago)

Quote:

Stonehenge said:
Give the money to big pharma so they can do research? Um no, lets use it to pay our many researchers like at the nih who do not work for rip offs. The only research big pharma wants to do is how to gouge us for more money. They will do that and still make a bundle even if they are forced to charge fair prices.

Its something way overdue along with cleaning up the system to stop bribery



Why do you think the NIH is less corrupt than big pharma, while you're convinced that the government is more corrupt than the rest of the healthcare system?


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Re: Some thoughts on the American health care system [Re: Thundermuscle75] * 2
    #25005948 - 02/19/18 05:06 PM (3 years, 2 months ago)

The nih is not a profit making money grubbing bunch of scum like those who run big pharma. We need to stop legal bribery but that is a separate issue


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Re: Some thoughts on the American health care system [Re: Stonehenge] * 3
    #25006056 - 02/19/18 05:44 PM (3 years, 2 months ago)

Yet you still continually support the party that cuts funding to places like the NIH and gives places like Big Pharma tax breaks...


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Re: Some thoughts on the American health care system [Re: Asclepius]
    #25006771 - 02/19/18 11:46 PM (3 years, 2 months ago)



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General Interest >> Political Discussion

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