Understanding the Issues 2008: Health Care
 

With the Presidential election just a few months away I thought it would be a good idea if every few weeks we took a look at one of the key issues and broke down each of the major candidate's stance on it. So we did this a few months ago with Iraq, and now we're going to follow up with Health Care. Initially I wasn't going to identify the candidates just to avoid any bias, but I found that to be too complicated.

Ok, well vote and discuss. Hopefully, this can spark some good debate that will either reinforce your view or make you reconsider.

[B]Hillary Clinton[/B]
-Require everyone to get health insurance, subsidized by employers and the government
-Pay for it by rolling back tax cuts for households earning over $250,000 and savings in the existing system.
-Require large employers to provide insurance or contribute to the cost.
-Provide tax credits to small businesses and subsidies for low-income people.
-Create a pool of private plans similar to the program for federal workers and one public plan similar to Medicare.
-Plans are portable from job to job. Expand Medicaid, State Children’s Health Insurance Program.

[url=http://www.hillaryclinton.com/feature/healthcareplan/]HillaryClinton.com - American's Health Choices Plan[/url]

[B]John Edwards[/B]
-Require everyone to get health insurance, subsidized by employers and the government
-Pay for it by rolling back tax cuts for households earning over $200,000.
-Require employers to provide insurance or contribute to cost, with subsidies for low-income people.
-Create regional nonprofit pools that offer private plans and at least one public plan like Medicare.
-Expand Medicaid and State Children’s Health Insurance Program to serve adults below the poverty line and children and parents below 250 percent of the line.

[url=http://johnedwards.com/issues/health-care/]John Edwards for President-Health Care[/url]

[B]Barack Obama[/B]
-Require that all children have health insurance
-Pay for it by rolling back tax cuts for households earning over $250,000; aims for universal coverage.
-Require employers to provide insurance or contribute to the cost. Exempt smallest businesses.
-Reimburse employers for catastrophic health costs.
-Provide subsidies for low-income people. Create purchasing pool with choice of competing private plans and one public plan like Medicare.
-Expand Medicaid, State Children’s Health Insurance Program.

[url=http://www.barackobama.com/issues/healthcare/]Barack Obama | Change We Can Believe In | Health Care[/url]

[B]Rudy Giuliani[/B]
-Free market, consumer based system
-Opposes mandate requiring everyone obtain health insurance
-Tax deductions for health care expenses: $7,500 for individuals and $15,000 for families. Provide additional tax deductions to low-income households.
-Allow people to buy insurance across state lines.
-Expand health savings accounts by simplifying the rules and regulations to participate in them.

[url=http://www.joinrudy2008.com/issues/view/11]JoinRudy2008 :: Issues[/url]

[B]Mike Huckabee[/B]
-Free market, consumer based system
-Opposes mandate requiring everyone obtain health insurance
-Use stats as "laboratories for new market-based approaches"
-Tax credits for low-income households
-Make plans portable from one job to another

[url=http://www.mikehuckabee.com/?FuseAction=Issues.View&Issue_id=8]Mike Huckabee for President - Issues[/url]

[B]John McCain[/B]
-Free market, consumer based system
-Opposes mandate requiring everyone obtain health insurance
-Make plans portable and accessible across state lines.
-Provide $2,500 tax credits ($5,000 for families)
-Move to compensate medical providers based on the quality of their work
-Bring greater competition to drug markets by safe reimportation of drugs and streamlining the process for introducing generic drugs.

[url=http://www.johnmccain.com/Informing/Issues/19ba2f1c-c03f-4ac2-8cd5-5cf2edb527cf.htm]John McCain 2008 - John McCain for President[/url]

[B]Mitt Romney[/B]
-Free market, consumer based system
-Opposes mandate requiring everyone obtain health insurance
-Give states flexibility to create programs and deregulate their insurance markets
-Make all health care expenses deductible
-Give tax credits for insurance not provided by an employer.

[url=http://www.mittromney.com/Issues/healthcare]Health Care[/url]

Re: Understanding the Issues 2008: Health Care
 

I like Obama's mainly because he's trying to make it required that all children have health care coverage. I'm really politically dumb to all these terms but. Being that I'm a democrat, I tend to like all the dem's views. Sigh. So hard to choose.

Re: Understanding the Issues 2008: Health Care
 

I think that as time goes on we should move more and more towards a government health system. I will go with Hillary on this, but she will most likely not get my vote.

Re: Understanding the Issues 2008: Health Care
 

im not for forcing people to have health care. the universal health care i would like to see is like the one that is in place over seas. you have health issues you go to the doctor. ALL doctors charge the same fees for the same procedures. it is a govt run program. rolling back the tax breaks would be one way to pay for it. the main problem with health care in this day and age is the sky rocketing cost. this would be one way to control it. not to hijack, but i love Edwards plan on how to replenish social security

Re: Understanding the Issues 2008: Health Care
 

John McCain's is by far the best. Though for my employer, the biggest provider of free and underreimbursed care in Pennsylvania, a Democrat would be the best for our financials. But John McCain is the only candidate who addresses the root causes for why healthcare is so expensive.

All of the Democrats are simply trying to find a way to get everybody in the US coverage. A noble cause, but it does nothing to address the factors driving the high growth in health care costs.

First, making plans portable across state lines increases competition amongst hospitals. All of a sudden Cooper University Hospital in South Jersey has to compete with places like the Hospital of University of Pennsylvania, and Jefferson University Hospital for patients. Plus, HMOs now have increased competition from each other as consumers can opt for plans from other states.

Compensating providers based on quality is a movement already taking place in the commercial insurance world. Independence Blue Cross and Aetna here in Philadelphia are already driving pay-for-performance. In other words, if your hospital shows above average mortality rates, rates of unplanned-return-to-surgery, and other quality metrics, then you get a bigger rate increase from the insurers. McCain is the ONLY CANDIDATE that wants to put this in place for government payers Medicare and Medicaid. Keep in mind, Medicare and Medicaid are responsible for a huge portion of payments to providers, so until they begin using pay-for-performance, the healthcare industry will not take quality seriously.

And one of the biggest reasons why healthcare costs have been increasing so rapidly in this counrty is the increase in pharmaceuticals. There are more drugs than ever before, and they all come with patents. McCain is suggesting to make it easier for generics to compete with patented drugs, and increasing price competition through importation. Without these moves, there will be no market factors in place to stop the momentum behind the unstoppable growth in drug prices.

I work in the Financial Planning department of a major metropolitan academic healthcare center. We treat a TON of medicaid patients. A democrat would definitely be best for my employer (they'd essentially just boost payments to us), McCain is by far the best for the country. He's the only candidate who truly rolls up his sleeves, gets his hands dirty, and digs into the issues to truly understand them.

Re: Understanding the Issues 2008: Health Care
 

Giuliani or McCain. In the spirit of common sense, I can't support a health care plan that deems it a legal necessity to have one. I would support government assistance for those who cannot afford it themselves, but are trying.

Allowing people to buy across states (Giuliani/McCain) would really open up the market.

Re: Understanding the Issues 2008: Health Care
 

[QUOTE=Schneed10;411089]And one of the biggest reasons why healthcare costs have been increasing so rapidly in this counrty is the increase in pharmaceuticals. There are more drugs than ever before, and they all come with patents. McCain is suggesting to make it easier for generics to compete with patented drugs, and increasing price competition through importation. Without these moves, there will be no market factors in place to stop the momentum behind the unstoppable growth in drug prices.[/QUOTE]

I agree with much of what you say but on drugs we might disagree. The incentive for companies to research and formulate new drugs is all in the profit. I think we can agree that drug companies need to maintain the highest level of motivation and increasing their exposure to generics would seem to drive profits down to me. I am not sure what the answer here is.

Re: Understanding the Issues 2008: Health Care
 

schneed, its funny you mention the companies blue cross and aetna. from 1999 until 2006, i had blue cross, that was company provided. last year our company switched to aetna. i never thought that much about it until i got a phone call from my brother. he said aetna is the worst. refuses to pay on just about everything. this year our company switched back. one of the big wheels wives got really sick. and aetna fought them tooth and nail over everything. thus the switch. you talk about compensating providers based on quality. in theory, this is a great idea. in reality, who makes this call? or is this another way for some one to make a ton of money for giving good marks to some providers that don't really deserve it? if its someone involved in the insurance industry that will be doing the grading, it definitely isn't going to work

Re: Understanding the Issues 2008: Health Care
 

[quote=dmek25;411187]schneed, its funny you mention the companies blue cross and aetna. from 1999 until 2006, i had blue cross, that was company provided. last year our company switched to aetna. i never thought that much about it until i got a phone call from my brother. he said aetna is the worst. refuses to pay on just about everything. this year our company switched back. one of the big wheels wives got really sick. and aetna fought them tooth and nail over everything. thus the switch. you talk about compensating providers based on quality. in theory, this is a great idea. in reality, who makes this call? or is this another way for some one to make a ton of money for giving good marks to some providers that don't really deserve it? if its someone involved in the insurance industry that will be doing the grading, it definitely isn't going to work[/quote]

Dmek, with all due respect, you apparently know nothing on how pay for performance works. Quality is not "judged" or "graded" by someone who comes in and peeks under the hood of your hospital. It is judged by hard numbers standardized within the industry:

- % of people dying compared to the expected death rate
- % of patients receiving unplanned return to surgery
- % of patients discharged within a predetermined time frame appropriate for their illness

You either meet those numbers or you don't, it's not subjective. If you meet them, IBC and Aetna give you a 5% increase on your reimbursement rates next year. If you fail, they only give you a 2% increase. Cut and dry. It's widely regarded as one of the best innovations to come about in healthcare reimbursement recently.

Re: Understanding the Issues 2008: Health Care
 

[quote=FRPLG;411171]I agree with much of what you say but on drugs we might disagree. The incentive for companies to research and formulate new drugs is all in the profit. I think we can agree that drug companies need to maintain the highest level of motivation and increasing their exposure to generics would seem to drive profits down to me. I am not sure what the answer here is.[/quote]

I disagree here. If you shorten the amount of time a patent can last, you open the drug companies up to generics sooner. This puts more pressure on the drug companies to come up with new drugs faster. If patents expire more quickly, it becomes imperative to cycle new drugs into the market faster and faster, else you end up with a slew of products exposed to competition from generics.

It will push margins down, yes. But if the drug company sits idle and brings no new drugs to market, they'll go out of business. Their only option will be to bring more new drugs, with patents, to market. If the patents don't last as long, you need more drugs in the market, or you dry up.

Re: Understanding the Issues 2008: Health Care
 

This is good stuff guys, I'm learning a lot. And I hope others are too.

I tend to believe that McCain has the best plan. I think, as Schneed has said, just saying you want universal coverage isn't enough and rolling back the tax cuts would do more harm than good.

Re: Understanding the Issues 2008: Health Care
 

It would have been interesting for us if you hadn't put names next to the plans and let us pick blindly (without bias?). May have been eye opening to some.

Re: Understanding the Issues 2008: Health Care
 

[QUOTE=cpayne5;411347]It would have been interesting for us if you hadn't put names next to the plans and let us pick blindly (without bias?). May have been eye opening to some.[/QUOTE]

I wanted to do that, and probably will with future issues. But there was just so much more information than the bullet points I presented that I felt I was going to have to link somewhere.

Next time you and I can create a page that has all the platforms but no names.

Re: Understanding the Issues 2008: Health Care
 

Why is John Edwards in there twice?

Re: Understanding the Issues 2008: Health Care
 

[QUOTE=Schneed10;411089]John McCain's is by far the best. Though for my employer, the biggest provider of free and underreimbursed care in Pennsylvania, a Democrat would be the best for our financials. But John McCain is the only candidate who addresses the root causes for why healthcare is so expensive.

All of the Democrats are simply trying to find a way to get everybody in the US coverage. A noble cause, but it does nothing to address the factors driving the high growth in health care costs.

First, making plans portable across state lines increases competition amongst hospitals. All of a sudden Cooper University Hospital in South Jersey has to compete with places like the Hospital of University of Pennsylvania, and Jefferson University Hospital for patients. Plus, HMOs now have increased competition from each other as consumers can opt for plans from other states.

Compensating providers based on quality is a movement already taking place in the commercial insurance world. Independence Blue Cross and Aetna here in Philadelphia are already driving pay-for-performance. In other words, if your hospital shows above average mortality rates, rates of unplanned-return-to-surgery, and other quality metrics, then you get a bigger rate increase from the insurers. McCain is the ONLY CANDIDATE that wants to put this in place for government payers Medicare and Medicaid. Keep in mind, Medicare and Medicaid are responsible for a huge portion of payments to providers, so until they begin using pay-for-performance, the healthcare industry will not take quality seriously.

And one of the biggest reasons why healthcare costs have been increasing so rapidly in this counrty is the increase in pharmaceuticals. There are more drugs than ever before, and they all come with patents. McCain is suggesting to make it easier for generics to compete with patented drugs, and increasing price competition through importation. Without these moves, there will be no market factors in place to stop the momentum behind the unstoppable growth in drug prices.

I work in the Financial Planning department of a major metropolitan academic healthcare center. We treat a TON of medicaid patients. A democrat would definitely be best for my employer (they'd essentially just boost payments to us), McCain is by far the best for the country. He's the only candidate who truly rolls up his sleeves, gets his hands dirty, and digs into the issues to truly understand them.[/QUOTE]

I'm with you on McCain's healthcare plan. I actually read through all the bullet points trying not to look at the names and ended up liking McCain's, which is odd considering I'm not a real big fan of his.

Re: Understanding the Issues 2008: Health Care
 

[QUOTE=mheisig;411362]Why is John Edwards in there twice?[/QUOTE]

typo. thanks for the catch

Re: Understanding the Issues 2008: Health Care
 

[QUOTE=SmootSmack;411368]typo. thanks for the catch[/QUOTE]

I thought you were just [b]really[/b] trying to push Edwards as the right candidate ;)

Re: Understanding the Issues 2008: Health Care
 

[quote=mheisig;411362]Why is John Edwards in there twice?[/quote]

Well since I'm an idiot and I responded to something that was already answered an hour ago....


:bump:

Re: Understanding the Issues 2008: Health Care
 

Nobody's voted for Guliani! Where's the love?

Re: Understanding the Issues 2008: Health Care
 

You know I always hear these nightmares about health ins. co and trying to get stuff covered but I have never had an issue with any of them. I my daughter while at college came down with this rare blood disorder (she is just fine now) the doctors tried several things and nothing worked. They decided to give this one treatment through I/V which cost $5,000 per bag and forgot to get approval from the ins. co.. They sent a rejection letter back for a claim of $36,000 because the doctor did not get prior approval and this was still in the exspermental stage. Doctor wrote them back and paid the bill in full.

Re: Understanding the Issues 2008: Health Care
 

[quote=DynamiteRave;411411]Nobody's voted for Guliani! Where's the love?[/quote]

Didn't you get the memo? He changed his name to 911.

Re: Understanding the Issues 2008: Health Care
 

Im a republican, but Obama seems like a man among boys, so i am siding democrat. I dont care about Hillary, she is nothing like her husband, and is simply unelectable.

Re: Understanding the Issues 2008: Health Care
 

With any government run health care system, you should expect all the compassion of the IRS and the efficiency of FEMA.

Just walk into any post office and ask yourself if that's the environment you'd like to find yourself in when you have to go to the doctor.

Re: Understanding the Issues 2008: Health Care
 

[QUOTE=Beemnseven;411814]With any government run health care system, you should expect all the compassion of the IRS and the efficiency of FEMA.

Just walk into any post office and ask yourself if that's the environment you'd like to find yourself in when you have to go to the doctor.[/QUOTE]

People don't want to hear this argument even though it is the best one out there. Can anyone name a major government program that runs well? And I mean well by quality and efficiency. All I get when I make this argument is "Well market forces aren't working and it's so broke that someone just needs to take it over" Nevermind that the government has empirically showed that it can't ever fix anything. They just make it worse usually.

Re: Understanding the Issues 2008: Health Care
 

LOL. I always end up laughing my ass off when health care is debated. I spent half my time in grad school getting the facts across all OECD countries (Organisation of Economic Cooperation and Development), which basically means first world countries, and then putting economic analysis to work.

First off, I'm independent politically like most folks i know here in the land of Cowboys and Indians, so I could give a shit about the partisan implications of the health care debate.

The first thing people need to understand is that our system is the most inefficient and ineffective among all OECD countries. The standard here is an apples to apples comparison ie percentage of total GDP (gross domestic product) spent on health in relation to the percent of the population covered. America spends about 17% of its GDP on health w/ the spottiest coverage. The average spent among OECD countries is around 11%, with Canada spending under 10% and Switzerland (the highest aside from us) at about 14%). However, every other modern country has 100% coverage.

My research focused on efficiency first and later on quality, which is more difficult to measure but there are some conclusive results. It's a simple explanation as to why our system is so inefficient but let me share a few important (and shocking) bits about quality. First of all, in overall quality America rates next to Cuba (that's right people, fucking Cuba) according to the World Health Org and several other major independant health studies. If memory serves, in 2006 we rated 36th (way below other modern countries) and Cuba 37th. The basic criterion here is longevity, infant mortality, death due to medical error, death from typically treatable diseases, etc. Among OECD countries the U.S. has just below average longevity, the worst infant mortality, by far the worst rate of death due to medical error, and an above average rate of death from typically treatable diseases. The major health studies do not place a lot of emphasis on the wait time for [B]non-emergency health issues[/B]. In other words, people in other modern nations have to wait longer for routine surgeries and much longer for cosmetic surgeries, but the health system also does a much better job keeping people alive. Here, with enough money you can have your tits and ass done tomorrow if you wish, but you may be turned down for cancer treatment (like my step-grandfather was) because the insurance doesn't want to cover it.

Ok, back to the big picture: efficiency and effectiveness (effectiveness means quality). Our system is the most inefficient because there is no uniformity across the healthcare community. As much as 30% of costs are unnecessary paperpushing, mailing, etc. etc. It's a little hard to grasp at first but a comparison can help. A country w/ a universal health system will logically use the same IT network, health forms and records format, etc. This means information does not have to be reproduced over and over and over and over for various providers, insurers, HMOs and what have you. In our system, the providers, insurers, HMOs etc have had little incentive to coordinate, largely because they're in competition. Thus, everything gets recorded over and over again which costs enormous sums of money. For example, the overhead among our best health insurance companies runs at 10% of revenue for all the paperpushing, HR, advertising, etc. Overhead in the more efficient health systems worldwide run less than 1% (not a typo, 1%). The other reason our system is so inefficient is because of fraud and we simply see the doctor more often.

The reason for our Cuban level quality is more complicated. America is off the charts, literally, when it comes to medical error. That has a lot to do w/ our lack of a uniform system. Example: somebody w/ a complicated medical history goes on vacation or simply moves, gets sick or in an accident. The records are scattered all over, an already stressed doctor makes a decision w/o pertinent information and you can figure out the rest... IMHO quality here also has a lot to do w/ our lifestyle. Too much stress and junk food, too little sleep make a bad combination and probably have a lot to do w/ our longevity.

I don't know if this really helps w/ the debate over candidates. Anyone who spends a day studying health care knows we have to address cost before coverage, but I sincerely doubt anyone has the political capital to get it done. Lowering cost will require significant government involvement no matter what: whether to force the health community to adopt a uniform system through severe penalties for not complying and tax benefits for doing so (the sticks and carrots people talk about); or to just create a universal system like the other modern nations.

Re: Understanding the Issues 2008: Health Care
 

[quote=Schneed10;411281]Dmek, with all due respect, you apparently know nothing on how pay for performance works. Quality is not "judged" or "graded" by someone who comes in and peeks under the hood of your hospital. It is judged by hard numbers standardized within the industry:

- % of people dying compared to the expected death rate
- % of patients receiving unplanned return to surgery
- % of patients discharged within a predetermined time frame appropriate for their illness

[B]You either meet those numbers or you don't, it's not subjective[/B]. If you meet them, IBC and Aetna give you a 5% increase on your reimbursement rates next year. If you fail, they only give you a 2% increase. Cut and dry. It's widely regarded as one of the best innovations to come about in healthcare reimbursement recently.[/quote]
this is where the issue is. you have to meet certain " goals " to get the reimbursement. if this happens, there will be an accountant in every hospital in charge of the numbers. those numbers will be scrutinized over and over again to make the " goal " you probably know as well as i do that anyone can make numbers look and say anything that they want. im lucky. i have a top 25 hospital right here in my home town. i have access to some of the very best care available.

Re: Understanding the Issues 2008: Health Care
 

[quote=dmek25;411913]this is where the issue is. you have to meet certain " goals " to get the reimbursement. if this happens, there will be an accountant in every hospital in charge of the numbers. those numbers will be scrutinized over and over again to make the " goal " you probably know as well as i do that anyone can make numbers look and say anything that they want. im lucky. i have a top 25 hospital right here in my home town. i have access to some of the very best care available.[/quote]

Incorrect. You have to report the numbers to the government via the Medicare Cost Report, and are subject to an annual audit. Allegheny (a former Philadelphia hospital group since taken over by Tenet) got themselves into a lot of hot water when they fudged some reimbursement documents in the 1990s. They were fined a crapload of money which weakened their balance sheet, and they were eventually taken over by Tenet.

It doesn't pay to fudge those kinds of numbers.

Re: Understanding the Issues 2008: Health Care
 

[QUOTE=Beemnseven;411814]With any government run health care system, you should expect all the compassion of the IRS and the efficiency of FEMA.

Just walk into any post office and ask yourself if that's the environment you'd like to find yourself in when you have to go to the doctor.[/QUOTE]

Best post on here so far.

Name one government agency that you've ever had a positive experience from a service and quality standpoint. USPS, IRS, your local DMV office, FEMA, the list goes on. I've worked for city government, my dad worked for the federal government for 30 years. Having also worked in the private sector, everything I know about ANY government agency leads me to believe that they are almost universally inefficient, mismanaged and miserable places to work.

I just don't understand this incredible desire people have for socialism. Capitalism works, folks. Let the free market do it's thing and pare this massive beast of a government down.

Re: Understanding the Issues 2008: Health Care
 

Granted this poll is a tiny sample, but I'm pretty damned surprised that McCain came out on top of the Republican side, and tied with Obama. Really not what I expected.

Re: Understanding the Issues 2008: Health Care
 

[quote=mheisig;411968]Best post on here so far.

Name one government agency that you've ever had a positive experience from a service and quality standpoint. USPS, IRS, your local DMV office, FEMA, the list goes on. I've worked for city government, my dad worked for the federal government for 30 years. Having also worked in the private sector, everything I know about ANY government agency leads me to believe that they are almost universally inefficient, mismanaged and miserable places to work.

I just don't understand this incredible desire people have for socialism. Capitalism works, folks. [B]Let the free market do it's thing[/B] and pare this massive beast of a government down.[/quote]
this is the issue. free market with health care isn't working. and the costs are skyrocketing. people are ready to try something new. even if it means the government gets involved

Re: Understanding the Issues 2008: Health Care
 

[quote=dmek25;412023]this is the issue. free market with health care isn't working. and the costs are skyrocketing. people are ready to try something new. even if it means the government gets involved[/quote]

None of the democrats are doing anything to address the rising costs. They're all interested in raising more tax revenue in order to pay those exhorbitant costs. That's not a fix, that's a bandaid. It gives everyone coverage, but it still means the coverage is going to continue getting more and more expensive.

McCain is the only one with a plan to actually curtail the growth in healthcare expenses.

Re: Understanding the Issues 2008: Health Care
 

[quote=MTRedskinsFan;411894]LOL. I always end up laughing my ass off when health care is debated. I spent half my time in grad school getting the facts across all OECD countries (Organisation of Economic Cooperation and Development), which basically means first world countries, and then putting economic analysis to work.

First off, I'm independent politically like most folks i know here in the land of Cowboys and Indians, so I could give a shit about the partisan implications of the health care debate.

The first thing people need to understand is that our system is the most inefficient and ineffective among all OECD countries. The standard here is an apples to apples comparison ie percentage of total GDP (gross domestic product) spent on health in relation to the percent of the population covered. America spends about 17% of its GDP on health w/ the spottiest coverage. The average spent among OECD countries is around 11%, with Canada spending under 10% and Switzerland (the highest aside from us) at about 14%). However, every other modern country has 100% coverage.

My research focused on efficiency first and later on quality, which is more difficult to measure but there are some conclusive results. It's a simple explanation as to why our system is so inefficient but let me share a few important (and shocking) bits about quality. First of all, in overall quality America rates next to Cuba (that's right people, fucking Cuba) according to the World Health Org and several other major independant health studies. If memory serves, in 2006 we rated 36th (way below other modern countries) and Cuba 37th. The basic criterion here is longevity, infant mortality, death due to medical error, death from typically treatable diseases, etc. Among OECD countries the U.S. has just below average longevity, the worst infant mortality, by far the worst rate of death due to medical error, and an above average rate of death from typically treatable diseases. The major health studies do not place a lot of emphasis on the wait time for [B]non-emergency health issues[/B]. In other words, people in other modern nations have to wait longer for routine surgeries and much longer for cosmetic surgeries, but the health system also does a much better job keeping people alive. Here, with enough money you can have your tits and ass done tomorrow if you wish, but you may be turned down for cancer treatment (like my step-grandfather was) because the insurance doesn't want to cover it.

Ok, back to the big picture: efficiency and effectiveness (effectiveness means quality). Our system is the most inefficient because there is no uniformity across the healthcare community. As much as 30% of costs are unnecessary paperpushing, mailing, etc. etc. It's a little hard to grasp at first but a comparison can help. A country w/ a universal health system will logically use the same IT network, health forms and records format, etc. This means information does not have to be reproduced over and over and over and over for various providers, insurers, HMOs and what have you. In our system, the providers, insurers, HMOs etc have had little incentive to coordinate, largely because they're in competition. Thus, everything gets recorded over and over again which costs enormous sums of money. For example, the overhead among our best health insurance companies runs at 10% of revenue for all the paperpushing, HR, advertising, etc. Overhead in the more efficient health systems worldwide run less than 1% (not a typo, 1%). The other reason our system is so inefficient is because of fraud and we simply see the doctor more often.

The reason for our Cuban level quality is more complicated. America is off the charts, literally, when it comes to medical error. That has a lot to do w/ our lack of a uniform system. Example: somebody w/ a complicated medical history goes on vacation or simply moves, gets sick or in an accident. The records are scattered all over, an already stressed doctor makes a decision w/o pertinent information and you can figure out the rest... IMHO quality here also has a lot to do w/ our lifestyle. Too much stress and junk food, too little sleep make a bad combination and probably have a lot to do w/ our longevity.

I don't know if this really helps w/ the debate over candidates. Anyone who spends a day studying health care knows we have to address cost before coverage, but I sincerely doubt anyone has the political capital to get it done. Lowering cost will require significant government involvement no matter what: whether to force the health community to adopt a uniform system through severe penalties for not complying and tax benefits for doing so (the sticks and carrots people talk about); or to just create a universal system like the other modern nations.[/quote]
I was reading that one of the reasons that we rank low in allot of the heath issues around the world is because we have better record keeping of how and whay people die. Take a third world country. When a cild dies most of the time the child is put to rest and no records of the child are recorded so it is very tough to compare us to them. So those stats are very skewed.

Re: Understanding the Issues 2008: Health Care
 

[quote=firstdown;412142]I was reading that one of the reasons that we rank low in allot of the heath issues around the world is because we have better record keeping of how and whay people die. Take a third world country. When a cild dies most of the time the child is put to rest and no records of the child are recorded so it is very tough to compare us to them. So those stats are very skewed.[/quote]

Umm, you're mostly being compared to first world countries unless you count the likes of Sweden and Japan as third world countries. Even if you drop the third world countries the US would still be trailing many European countries and developed nations.

Re: Understanding the Issues 2008: Health Care
 

saden fast approaching #3000. i think all the high ranking countries on the list have universal, government run health care

Re: Understanding the Issues 2008: Health Care
 

[quote=dmek25;412221]saden fast approaching #3000. i think all the high ranking countries on the list have universal, government run health care[/quote]

I'm afraid it is against my religion to reach 3000!

Re: Understanding the Issues 2008: Health Care
 

[QUOTE=dmek25;412023]this is the issue. [B]free market with health care isn't working. [/B]and the costs are skyrocketing. people are ready to try something new. even if it means the government gets involved[/QUOTE]

That's because we haven't really tried it.

We don't truly have a "free" market system here either. Government has its hands all over it.

Re: Understanding the Issues 2008: Health Care
 

[quote=dmek25;412221][B]saden fast approaching #3000.[/B] i think all the high ranking countries on the list have universal, government run health care[/quote]

Not to hijack but according to the bet between Matty and Saden (if that's still on) Saden is not allowed to reach 3000 until training camp starts. ;)

Re: Understanding the Issues 2008: Health Care
 

if you noticed, maybe thats why his count is stuck on 2999