Obamacare and you

[Jacob]

The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) will lead to fewer people getting the healthcare they need.

But you understand what concern he has though - that under current systems people have fewer incentives to actually take care of their own health.  You can be a smoker for 40 years, never have insurance, then be diagnosed with throat cancer and be guaranteed treatment.

So the desired outcome is that someone who has smoked for 40 years and has treatable throat cancer should be denied treatment if they don't have insurance?

[Valmy]

So the desired outcome is that someone who has smoked for 40 years and has treatable throat cancer should be denied treatment if they don't have insurance?

The desired outcome is that treatment costs an insignificant amount so it is not anybody's business.  We sort of have the opposite problem.

[DGuller]

The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) will lead to fewer people getting the healthcare they need.

But you understand what concern he has though - that under current systems people have fewer incentives to actually take care of their own health.  You can be a smoker for 40 years, never have insurance, then be diagnosed with throat cancer and be guaranteed treatment.

Ka-ching!

[Barrister]

So the desired outcome is that someone who has smoked for 40 years and has treatable throat cancer should be denied treatment if they don't have insurance?

The desired outcome is that treatment costs an insignificant amount so it is not anybody's business.  We sort of have the opposite problem.

Um, no.  That's not the desired outcome, because then you have all the problems Canada has.

Our out-of-pocket expense for most health care is zero.  But of course health care resources are limited.  What it leads to is waiting lists.  You need to see a doctor?  Well you can go to a walk in clinic and wait for 4 hours, or they can schedule you an appointment for three months from now.   You need an MRI for a serious but not life threatening condition?  How does January 2015 work for you?

[Admiral Yi]

Once as a society you decide that everybody should have healthcare, honestly a universal system is the best. Most countries in Europe (dunno about Canada, but I suspect it will happen there too), provide universal healthcare for a similar % of GNP (or even less) than the US devotes to their very limited public healthcare programs (pre-ACA).

There are other factors that push up the cost of health care in the US apart from the insurance system, such as the cost of doctor training, the cost of patented medication, and malpractice insurance.

[Barrister]

The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) and making it harder to get treatment unless yourbplan allows it or you have ready cash will lead to fewer people getting the healthcare they need.

Once as a society you decide that everybody should have healthcare, honestly a universal system is the best. Most countries in Europe (dunno about Canada, but I suspect it will happen there too), provide universal healthcare for a similar % of GNP (or even less) than the US devotes to their very limited public healthcare programs (pre-ACA).

I don't think that's right.  Western Europe and Canada spend about the same, or a little bit less, of our total GDP on health care as does the US.  But that includes US public and private spending on health care.

[Grey Fox]

In 2012 the US governments spent 19% of it's total budgets on healthcare.

In 2012 Canadian provinces spent 44.3% of it's budgets on healthcare.


In absolute number, it's consistent with the US having 10 times more population than Canada.

[celedhring]

The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) and making it harder to get treatment unless yourbplan allows it or you have ready cash will lead to fewer people getting the healthcare they need.

Once as a society you decide that everybody should have healthcare, honestly a universal system is the best. Most countries in Europe (dunno about Canada, but I suspect it will happen there too), provide universal healthcare for a similar % of GNP (or even less) than the US devotes to their very limited public healthcare programs (pre-ACA).

I don't think that's right.  Western Europe and Canada spend about the same, or a little bit less, of our total GDP on health care as does the US.  But that includes US public and private spending on health care.

Just rechecked, and I'm right. I haven't found a nice graph online for compared public budgets so I have crossed these two tables:

http://data.worldbank.org/indicator/SH.XPD.PUBL

For the total of health care spending as % of GNP

http://data.worldbank.org/indicator/SH.XPD.PUBL

For the weight of the public sector in health care spending.

So, doing a little math (results rounded to the nearest decimal)

US spends 17,9*45,9= 8,2% on public healthcare.
UK spends 9,3*82,7=7,7%
Canada spends 11,2*70,4= 7,9%
Spain spends 9,4*73,6 = 6,9%

Thing is the spending levels in the US are just absurd, and I don't think they yield better overall care than in most Western nations. Whatever the reason, the system is completely broken.

[Sheilbh]

I don't think that's right.  Western Europe and Canada spend about the same, or a little bit less, of our total GDP on health care as does the US.  But that includes US public and private spending on health care.

It's unbelievable but correct. The government in America spends more on healthcare than the European average and certainly more than the NHS.

[crazy canuck]

Our out-of-pocket expense for most health care is zero.  But of course health care resources are limited.  What it leads to is waiting lists.  You need to see a doctor?  Well you can go to a walk in clinic and wait for 4 hours, or they can schedule you an appointment for three months from now.   You need an MRI for a serious but not life threatening condition?  How does January 2015 work for you?

If you want to make a point you should try not to bend the facts to fit your argument so much that you venture into fantasy.  If I picked up my phone now I would have an appointment with my doctor within the next 24 hours.  Of course it might be that the medical system in Alberta is really messed up and I should cut you some slack.

When my lung issue was originally diagnosed they had an operating room wating for me depending on what the scan showed.  If it was cancerous growth - as was first feared  -  they were going to wheel me directly from the scan to the operating room - this was 48 hours after I first saw a doctor about my symptoms.  Thankfully it wasnt that and I saw another specialist 48 hours after the scan.  In total, within one week I had full access.

When someone in my office was diagnosed with cancer she began her treatment within 24 hours.  Her treatment continues to be prompt.

Please stick to facts when making your argument.  Where we do have significant wait lists are for things that are more chronic in nature.  Hip replacements for the elderly seem to top the lists most of the time.  Now it would be nice to have those wait times reduced, and here in BC we have made some significant progress in that regard. 

[Grey Fox]

BC doctors are awesome.

Here it averages 3 days if you have a family doctor. Getting to see specialists is the hard part.

[Admiral Yi]

Maybe all the doctors and nurses in Alberta left to work in the tar sands.

[celedhring]

Once as a society you decide that everybody should have healthcare, honestly a universal system is the best. Most countries in Europe (dunno about Canada, but I suspect it will happen there too), provide universal healthcare for a similar % of GNP (or even less) than the US devotes to their very limited public healthcare programs (pre-ACA).

There are other factors that push up the cost of health care in the US apart from the insurance system, such as the cost of doctor training, the cost of patented medication, and malpractice insurance.

Well we do train our doctors too, at least I hope we do, and usage of patented meds is similar in Europe and in the US. Malpractice suits do happen over here too, although at least in Spain it is true that legislation is more restrictive on that regard than in the US.

The problem here is that the US misses out on all the massive savings of running your own hospital network and buying your meds from such a powerful bargaining position, and instead pays private hospitals to take care of patients, with all the accompanying increased costs. Now, the Federal or state governments aren't going to build their own hospital network anytime soon - that ship might have sailed for the US - but the current system is clearly not working.

[MadImmortalMan]

Tons of counties have their own hospitals. I wonder how hard it would be for them to form some sort of buying alliance. Maybe they already did, I dunno.

[Sheilbh]

Also even in the US medical malpractice accounts for 2.5% of health care expenditure. It's nothing.