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  1. #41
    Senior Member WobblyStilettos's Avatar
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    I always find it hard to beleive a country like the USA cannot give everyone the healthcare they need x_X I mean, everyone here (England ) is always moaning about the NHS, but we'd moan a hell of a lot more if they took it away...
    Where you used to be, there is a hole in the world, which I find myself constantly walking around in the daytime, and falling into at night. I miss you like hell. ~Edna St. Vincent Millay

  2. #42
    Senior Member creativeRhino's Avatar
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    I'm in Australia where we have a hybrid system - a universal safety net that will cover you promptly for critical/"non-elective" surgery/treatment for most conditions. The triage (sorting out of urgency etc) is sometimes flawed - but that is a medical assessment problem more than a financial one.

    We pay under 2% of our pay as a "Medicare levy" - the rest comes from general tax. Our tax rates are (for average income earners) at a marginal rate of 30% now (and a 10% GST/VAT on most goods).

    There are capacity problems in most countries in the world. Even in the private sector their can be waiting lists/overflow. Not enough medical specialists or hospital capacity could be the problem.

    In Australia all public hospital treatment if free, and all outpatient/private doctor's consultations are covered (up to 85% of cost). Getting sick is not a financial problem beyond the loss of income if there's not enough sick pay to cover it. There is also a subsidised medicines system (the US government has been pressuring us to abolish this for years).

    Our health and life expectancy are excellent.

    We also have a parallel private system - Doctors work in both systems on a salary or fee for service basis. There's a few who only "do private", but most do a mix.

    There is a competitive range of private hospitals, and many Health funds - who work on a reimbursment not "managed care" basis. They have to provide cover "universally" - ie not selective based on health etc.

    A family might pay US$300-400 a month for this cover. A night in a private hospital could cost $700. The main reason to have private health cover for elective surgery/treatments (eg sports injuries and chronic/non life threatening things).

    There are some resourcing problems, but none that great. The media will focus on a few cases that are bad, but overall we have a good system.

    My husband died of a brain tumour - not unlike the one featured in the Canadian story - the public or private treatment available here is just short of "leading edge" - there are some treatments/diagnostics that are only available in the US - but at a huge cost.

    There was one we could have gone for - but it would have cost over US$200,000 to pursue (medical and some accommodation/living costs) and it only had a 5-10% chance of helping. I know of 2 people who headed over there and spent way more and still died "on schedule" for the disease. Their families now have to rent, because they sold their homes...

    If we'd stuck in the public system and with "prescribed" treatments only his treatment would have cost us nothing. In the private sector all the costs (including 2 brain surgeries and 3 weeks in hospital, radiotherapy and other treatments) came to US$25,000 - with $20,000 being covered by health insurance - no questions asked. I met many folks dealing with the same thing in both the public and private systems - and there was not a huge difference in service levels - just maybe slightly longer waiting times for some treatments in the public sector. In the end we would have hardly noticed the difference.

    I used to work for a US company and I heard absolute horror stories of HMOs refusing to approve treatment, out of pocket (copays) that sent people to the wall financially when serious illness such as cancer came along. And these were all very well off IT professionals with top health cover, well above "average".


    The big issue is cost containment (which also means restraining profit margins!!) One of those costs is "professional liability" insurance- in Australia we are much less likely to sue if things go wrong. So, legal costs stay low, keeping prices lower. We have a government schedule of fees (that are the basis for our medicare claims) and our "AMA" fee schedule which is higher.
    Doctors usually set their own fees within that range. The concept of "what the market will bear" is much lower than in the US. A brain surgery in Australia will cost US$2500 - I gather it may be 10 times higher in the US. Doctors have high incomes here, just not as high as the US.

    With the current cost structure and legal liability costs/issues in the US providing a safety net will expensive. That is the real structural problem as I see it. But the fact that

    Many people in the US can't access the treatment they need in a timely manner (overstretched public system and lack of $ to "self fund")
    or
    most private bankruptcies occur because of medical costs (and even when the same people going bankrupt have had private health cover of some sort) is a pretty sorry situation.

    I've lived in the UK and the NHS is more rigid. No system is perfect, but the "free market" doesn't work for those who don't have the funds/resources to access treatment. Most medical treatments are not elective - they are not a matter of choice.

  3. #43
    Senior Member "?"'s Avatar
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    Quote Originally Posted by cafe View Post
    Taxing real consumerism would make sense. Taxing the necessities of life like food, energy, medical care (for real medical problems, not cosmetic stuff), and housing up to a certain point, doesn't make a lot of sense to me.

    Normally, the poorer the family, the larger percentage of their income they spend and spend on necessities, so putting a burden on those necessities would place the burden on the shoulders of those who can least afford to bear it.
    Good point Cafe, however the government needs taxes to run and the only way to do it in a fair manner where all get taxed equally is to tax you on how you buy. People on subsidized incomes buy clothing that I can't afford. I think the tax will put things in perspective and make people think twice about the impulsive buying.

    However the theory is all for naught since the act would create a paradigm shift and many retail business can't stay afloat unless the majority of consumers buy on impulse.

  4. #44
    Senior Member cafe's Avatar
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    Quote Originally Posted by "?" View Post
    Good point Cafe, however the government needs taxes to run and the only way to do it in a fair manner where all get taxed equally is to tax you on how you buy. People on subsidized incomes buy clothing that I can't afford. I think the tax will put things in perspective and make people think twice about the impulsive buying.

    However the theory is all for naught since the act would create a paradigm shift and many retail business can't stay afloat unless the majority of consumers buy on impulse.
    I disagree that that is the only fair manner in which to tax. It seems to me that there could be multiple fair manners in which to tax.

    Clothing could be taxed. It's a necessity, but can be purchased for very little money at second hand shops. Furniture, electronics, things like that could all be taxed. I think that would discourage frivolous spending by the underprivileged as well, if not better, than taxing necessities.

    The mentality behind why the underprivileged make those kinds of purchases has some reasoning behind it that makes sense if you have no hope of ever doing better than you are now. It's really easy to give up and live for the pleasures of today while you can when you believe that tomorrow is just going to be more of the same hopeless crap as yesterday. When you have hope for a better situation, you are more likely to sacrifice in order to get there.

    Also, poor people get treated badly a lot of times simply because they are poor, so they spend money on clothes to avoid appearing poor in public and also to avoid being accused of child neglect. The world is a scary place when you have no power, so you do what little things you can. Placing some kind of negative value judgment on that to me is just counterproductive.
    Last edited by cafe; 02-24-2008 at 05:55 PM.
    “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.”
    ~ John Rogers

  5. #45
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    Quote Originally Posted by YourLocalJesus View Post
    I'm probably making you kind of angry because I don't agree and that I seem to lack all respect for the "greatest country in the world".
    Lateralus is a hard core libertarian, so will tend to assume that more government involvement is automatically bad.
    Last edited by Zergling; 02-24-2008 at 04:21 PM.

  6. #46
    Senior Member Lateralus's Avatar
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    Quote Originally Posted by Zergling View Post
    Lateralus is a hard core libertarian, so will tend to assume that more government involvement is automatically bad.
    Hard core? Hahaha, no. I just find myself arguing a side in opposition to most people here and on INTPc since most posters just go along with the crowd.
    "We grow up thinking that beliefs are something to be proud of, but they're really nothing but opinions one refuses to reconsider. Beliefs are easy. The stronger your beliefs are, the less open you are to growth and wisdom, because "strength of belief" is only the intensity with which you resist questioning yourself. As soon as you are proud of a belief, as soon as you think it adds something to who you are, then you've made it a part of your ego."

  7. #47
    Courage is immortality Valiant's Avatar
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    Quote Originally Posted by Zergling View Post
    Lateralus is a hard core libertarian, so will tend to assume that more government involvement is automatically bad.
    In the american language I lean pretty heavily towards "totalitarian". I'm not very touchy-feely about "the individual".
    We don't use the terms over here though. In european language i'm a communist , marxist-leninist, active member of the Communist Party (Kommunistiska Partiet), fair and square.

    Mightier than the tread of marching armies is the power of an idea whose time has come

  8. #48
    Senior Member nemo's Avatar
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    Quote Originally Posted by YourLocalJesus View Post
    >>OMG THIS MAN HAS A PIPE HOW CAN YOU ARGUE WITH HIM!?!?!?! ALSO HIS NAME IS JESUS<<
    Dear Jesus,

    That is an awesome pipe in your avatar. You are clearly a Savior of refined and sophisticated tastes.

    That is all. Carry on.

    Humbly,
    Nemo
    You can't wait for inspiration. You have to go after it with a club. - Jack London

  9. #49
    Courage is immortality Valiant's Avatar
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    Well, right back at ya! I've always liked cornpipes.

    Mightier than the tread of marching armies is the power of an idea whose time has come

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