QUOTE (Commodore @ Feb 9 2009, 23.43)

A state council of wise men deciding who deserves what care, and people want to make jokes...

We already have a council of greedy fucks whose sole purpose is to minimize costs and maximize profits (which is a nice way of saying denying you as much care as they can reasonably get away with), how is that preferable to a state run agency that actually has a public mandate to provide suitable care and is ostensibly accountable to the voting public if they fuck up too badly?

This is fucking nuts. We pay twice as much as most western nations for healthcare, can't cover 40 million people, and hundreds of millions more with insurance get fucked left and right by the insurance companies looking to cut costs. Your position is no longer defensible. Anyone not in favor of universal healthcare is either ignorant or willfully stupid.

QUOTE (Commodore @ Feb 9 2009, 23.09)

Bloomberg uncovers some interesting stuff in the stimulus bill:

Unreal.

Watch Sicko. Seriously.

QUOTE (Chataya de Venoge @ Feb 10 2009, 19.23)

That's what UHC boils down to. It's about cost, frankly. All the moral good in the world is a noble goal, but if no one has any money to pay for it, it's rather pointless.

Than based on the cost principle alone, why don't you support universal healthcare? It is substantially cheaper than our current system, in some countries costing half as much, yet it covers everyone and provides a good quality of care.

QUOTE (Take on Me @ Feb 10 2009, 23.33)

But different doctors have different rates. You'd have to use doctors that accepted the amount UHC covered would you not? More talented doctors will want to be compensated. I'm not skeptical of UHC itself, but of our government's ability to manage such a system.

Where are these more talented doctors gonna go? Whose gonna pay them substantially more than what we would? Every other Western Country is already on a Universal system. We are the wealthiest country in the world. Presumably our pay scale will be comparable to or somewhat above everyone elses. And its not like they're all gonna become engineers or lawyers either. Doctor is still probably about the most prestigious title out there and even under a universal system they're likely to have a more than comfortable living.

QUOTE (Take on Me @ Feb 10 2009, 23.48)

So the brilliant folks who are appointed to run this system will dictate salaries in the medical community? How would they not be resistant to this?

I fully agree that a basic system should be in place to handle situations such as those mentioned above, but I just don't see how the overlords could ever put something in place that would work for everyone. It's too big for them NOT to screw it up. Might be handled better at the State level?

On what do you base these presumptions that government = inefficient and incompetent? I know its popular in conservative rhetoric, but saying it a bunch don't make it true. Bigger doesn't have to mean less effective. Universal standards and practices can actually make for a more efficient system than a state by state hodgepodge that varies in every facet from what's covered (imagine the ideological battles on that one) to level of funding.

Look, there are alot of questions, but in my mind the only ones that need answers before going forward are this: Can we do it? Can we do it cheaper than our current system? And can we offer quality care to more people than we currently do? Looking at global examples, its pretty clear that he answer to all of those is yes. And since that is the case, why not go forward? Its an improvement in all the significant areas. And even if its riddled with bureaucratic inefficiencies it'd still be better than what we got now.

QUOTE (Take on Me @ Feb 11 2009, 00.13)

But how do you appease the insurance/drug companies that would most likely see limited growth under such a system?

Rich guys who risk losing money always seem to drag down the common good.

Who do you have to appease? There will be a single major block buyer and that buyer will pay what it likes for the drugs in question. The Big Pharms will simply have to deal with that reality like they do in every other country that has UHC. And really, that's a HUGE cost in healthcare right there that will be taken down a few dozen notches. Hardly a bad thing. There'll still be enough money going around to generate innovation in the field, its not like we'll slip into a medical dark age if the companies can't do 10,000% markups anymore.

QUOTE (Take on Me @ Feb 11 2009, 00.36)

And you don't see these folks putting up a major fight? With everyone else in UHC, we're the Golden Goose.

Sorry to be the big government pessimist, but well, I work for them. It's not pretty.

Oh they'll absolutely put up a fight. But in the end if there is a Democratic leadership dedicated eventually bringing about UHC, there's not much they can do but bitch. Obama's proposed policies are not UHC, but they're a step in that direction. And I believe either he or subsequent Democrats will push it even further. We just have to hope for the continued implosion of the Republican party.

QUOTE (Take on Me @ Feb 11 2009, 00.30)

I'm by no mean conservative, but this would require the creation of another huge government agency. (look at how well Homeland Security went) You're going to throw hundreds of billions of dollars through this agency. It's going to have a form of control over one of the most important aspects over people's lives. It's going to be run by appointed officials who'll have lobbyists/other government bottom feeders all over them. What if another crap administration like the Bush crew takes office?

I know the system can be done and done well, but based off what I've seen the last 10 years, I'm not confident in our government to do it properly. Maybe after The Great Cash Giveaway. Maybe.

The system right now isn't necessarily anymore efficient. Its mandate isn't towards helping people, serving citizens, or providing healthcare. Its purpose is the maximization of profit. And the surest way to maximize profits in a private healthcare system is to deny healthcare. Any excuse, any loophole, any reason valid or invalid, legal or illegal to ensure that they pay out as little as possible. Their middle management is actually rewarded for denying claims. They have minimum percentages of denied claims that they must reach. Their primary purpose is to fuck you. Now I have no delusions about the competence of government or the efficiency of a massive bureaucracy, but at the very least they have a mandate to serve the people and are ostensibly accountable to those people at the voting booth. Private insurers are accountable to noone. They're barely regulated (and you'll find as with alot of industries, they probably wrote half the regulations themselves), can charge pretty much what they want, and get away with denying the procedures people need and are entitled to on a regular basis. They fuck everyone with impunity.

A government system would have to be run by illiterate, braindead NAZI's to be much worse.

QUOTE (Kalbear @ Feb 16 2009, 18.47)

My last three jobs have either removed insurance completely or had to go to a much worse insurance system because of the cost - and they still ended up paying more (well, aside from the one that dropped it completely). Totally anecdotal, but yeah, it's happening.

Buddy of mine had this happen. Hell, he stormed out of the Orwellian double-speak corporate 'instructional' on the new health planned that explained how much 'better' it was than the old one. (Apparently tripling the deductible makes it a "Consumer driven" plan that's in your interests. No idea how, but trust me!) But instead of coming to the conclusion that there needs to be some serious reform, he jumped on his wife's better plan and remains one of the staunchest opponents you'll find to any sort of Universal Health Care.

Speaking of which, anyone have some studies that confirm or refute the HUGE LINES and 12 year wait for surgeries argument? I hear those a bunch lately.

QUOTE (Tormund Midgetsbane @ May 11 2009, 19.27)

Nah. Neither of them has anything on defense.

AIPAC AIPAC!!

QUOTE (the Blauer Dragon @ May 12 2009, 02.06)

It places a government entity in charge of determining who gets what care and when.

Meh...watch Sicko. HMO's already decide who gets care and what kind even when you have insurance. I highly doubt a government agency is gonna mandate claim denial quotas for their adjusters nor promote middle management based on higher rates of denial.

QUOTE (litechick @ May 12 2009, 01.36)

It's like A (delicate genius) + B (fear of litigation) = C (spare no expense) I think we've got to break that equation before a workable model for UHC can be acheived.

A good chunk of that equation is already broken with a UHC system. A large part of many Med mal settlements is the cost of continuing health care due to chronic conditions or grievous injuries. Under UHC, those damages don't exist. Further, a UHC might eliminate the need for malpractice insurance since it would (possibly) effectively be the government that's sued. Doctors would only need to worry about government regulatory boards rendering them unfit rather than much more fickle insurance companies jacking up their rates or refusing to cover them entirely. All of which pretty much neuters the chronic 'test everything', CYA mentality.