WHY NOT A NATIONAL HEALTHCARE SERVICE FOR EVERYBODY?

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I sent my kids to university in France (which is almost entirely public*) for a tuition-only fee of 2700€ a year, which is what the French version of an MBA also costs. Of course, one can obtain that course in good-English but not for 2700€ ...

Which is what happens in the US, and why the "cases" are typically more severe ...

 

fearmongering media? did not Trump declare himself a war time President against an invisible enemy, even declared a national emergency and issued guidelines to the States to shut down

 

I didn't mean for it to sound too rosy. Those in the upper incomes of course have little problem with cost. The poor have programs such as Medicaid, which is Federally funded and administered by the states, meaning 50 different ways of doing things. The two hospitals in my area, one a historic world class teaching university, have income scales that go to 100% coverage. Now this coverage doesn't apply to medical groups that contract with with them. At the closest that includes ER doctors (ouch) and anesthesiologists. And as usual the brunt is borne by the ever suffering middle class, who have too little to pay out of pocket and to much to qualify for financial assistance. Oh, and dental care, forget it, if you have insurance you have to pay extra for that coverage and even then out of pocket costs are astronomical. There is a local low income dental clinic but the waiting list damn near stretch's into the next century. To be blunt, our system is a sorry assed mess by any measure, and I see little hope for any meaningful change near term as there's too many well funded and well connected players fighting tooth and nail against a universal, single payer system.

 

MEDICAID COVERAGE IN AMERICA

Bollocks! Get your facts right!

From here: Medicaid coverage in America

And the other 77% of Americans - what do they do? Especially when they don't have a job? Especially when a visit to see a doctor costs like this:

PS: Minus the top 15% of Yanks who earn more than $10K a month, that is. They could care less.

 

You will note I also said " To be blunt, our system is a SORRY ASSED MESS BY ANY MEASURE...."

 

Careful when you reply to someone without quoting them ...

 

I just created, a new thread, UNIVERSAL/SINGLE PAYER HEALTH CARE?, please respond to it.

 

That's the impression we have in the UK. Though we still have a tidy few who want to give up our wonderful NHS for a pay as you go disaster.
Its nice to talk to some folks your side of the pond and see what you all think.
One of Trumps ambitions was to get his teeth into it, but that will never sell to the British public.

 

I'm a Yank who has lived all around Europe and that includes London. Great medical-service from the two doctors I had the good fortune to visit at that time!

When did this happen? How?

Let's remember that your National Healthcare System originated in 1948. And it is still pretty-good! I figure it was the only Good Thing that came out of WW2 - largely because it had to accommodate British wounded. (I suppose.)

We never learned that lesson in the US.

One key factor only, from here:

Which has resulted from a bit of foresight that never happened in the US. You see, we Yanks mustn't have that Socialist Bunkum they have in Europe ... ;^)

 

It was widely muted in the UK press that a trade deal with Trump would have to include U.S access to our NHS market on favourable terms.

I have never understood why healthcare free at the point of contact was considered socialist. Surely a healthy population is very much part of a healthy economy. And some things can only be done well by governments.

 

GUNS OR BUTTER?

True enough! Anyone alive wants naturally to live as long as possible. (Unless sick-in-the-head.)

So, why not offer them an NHS that can accomplish that end? Because it is too expensive. So, pray tell, why does a sole key government-function in the US swallow-whole 57% of the US's "Discretionary Budget"! (See that visually here.)

Yes, that's what the DoD costs "you-plural" in America!

Guns or butter history-lesson-of-the-day:

If Uncle Sam wants to privilege a tiny, tiny portion of its upper-income population with low taxation that generates Massive Bank Accounts, then it's up to the American people to react.

Or just shut-up, bend over, and take the shafting ...

PS: Yes, that graphic above is not entirely fair. For it to be really correct there should be two expenditure comparisons - the US vs the EU. But even with that, the total EU expenditure-line would come nowhere near that of the US.

 

Total per capita Defense spending (percent GDP):
EU - 1.35
US - 3.4

Nearly twice the per-capota amount is spent in the US in order, of course, to protect the world-we-live-in. (As if some country were on the verge of taking it away! ;^)

Yup! As if the "US world" is twice as expensive as the "EU-world"?!?

Nope: Because the US Defense Contractors exact higher-prices in the US than in Europe. And, like anywhere, the major-cost is manpower. And though I cannot find the actual numbers, I suspect there are far more people in the US defense establishment than in the total other one shown in the diagram below!

In 2014 the pie-chart of country comparative spending looked like this:

(That gargling sound your hear is me choking on those numbers shown above ... ;^)

PS:That black bit for South Korea is or should be close to $42B in 2008 - making a total of around 480B if counted or a total of around 100B less than the US.

 

I created a new thread, "UNIVERSAL/SINGLE PAYER HEALTH CARE?" because I want to hear from people who ACTUALLY LIVE under such systems. Americans know NOTHING about the real workings of those systems, just propaganda about their "horrors". I want to know peoples personal experiences with service they received, how it is accessed, out of pocket costs for care and prescriptions, their likes and dislikes with it. If you can find the time please post your personal experiences with your country's system.

 

I have a better Idea; why not eliminate all socialist programs in the country. Think of what you'd save in dollars; no more fire dept (when your house catches fire, you put it out), no more police dept (someone is attempting to kill you, its on you to defend yourself); no more EMS service (if you are having a heat attack, call a cab to get to the hospital), no more public schools (home school your own kids), no more highway dept (plow and maintain your own roads), no more prisons (you take care of the prisoners), no more OSHA (so what if conditions are unsafe at work, deal with it), and the list goes on and on.

 

What is incredible of the Far-Rightists is the fact that they have no or little understanding of Social Benefits of which profit presently. Besides, they are all a "waste of money", they think.

It's always, "No more! No more! No more .... Too expensive and useless".

Makes one wonder on which Mental Planet they hibernate ... !

 

It's just a damn-good idea. It lengthens people's lives.

And one need not be a Socialist to understand that benefit.

But, then again, when your only True North in life is profits, profits, profits one doesn't particularly think of social-benefits.

An MD in the US earns on average $294,00 annually in the US. In France s/he earns 60K€ ($150K) working in a hospital - about half as much. Which is just one indication of the comparative cost of health-care in the two countries ...

PS: My visit to the doctor here in France will cost me about $24. Which the NHS reimburses to me at 70% of cost.

 

Nor any longer to Americans!

I must celebrate that fact with a glass of wine now. (Given the historical importance, maybe two glasses ... ? ;^)

 

Oh right. I'll have a look.

 

I've lived with it all my life. It's incredible, and I would never swap it for a privatised system. Prescriptions aren't covered (except for age pensioners, for some medications), but there are otherwise no out of pocket costs. Complaining about not having a private room in hospital (something I've heard many Americans complain about) is ridiculous, IMO - your room has nothing to do with the quality of your medical care. That's like saying the thing you don't like about your hospital care is the colour of the building! The other great thing about it is that you don't have to use it. You're 100% free to pay a small fortune to be made to feel special via private health insurance and private hospitals (though our private hospitals are mostly terrible, but if a private bathroom is more important to you than surviving a complex surgery, go for it).

The 'downside', such as it is .. is that there are waiting lists for non-urgent procedures and treatments. You will always share a hospital room (usually with three others). You'll be seen by the first available doctor in an emergency, and you'll likely see the consulting specialist for scheduled procedures. As to that last, it's important to remember that consulting specialists to public hospitals are almost always the same specialists who operate out of private rooms in the same area, so will sometimes be the same person you'd have consulted had you paid for private care. Not always, but it happens far more frequently than you'd expect. It's amazing how many people who use private health cover don't actually realise this. I remember when an elderly relative was being treated for something complex years ago, and his expensive private specialist would see him for ten minutes each morning, then go directly to the public patient in the next bed to do the same thing. My relative paid something like $36k (with a good chunk of that out of pocket) in total for this service, and the guy next to him paid zip. He was not happy, I can tell you! NB - you can be treated in a public hospital as a private patient here. Many people choose to do that, because public are safer and much better equipped. They're prepared to share a room for that advantage.

Another 'downside' is in obstetrics, where optional 'comfort' interventions aren't covered. You can't elect a c-section, for example. Pregnancy care and delivery are handled by midwives, not doctors (and this alone is a huge advantage in terms of neonatal and maternal outcomes .,. as midwife assisted births mean fewer mortalities). I see these things as positives of course, but there are women out there who find it objectionable. God knows why, since it reduces maternal and infant deaths. People are weird.

That's it really. Hard to find any flaws, and when you pay only a 2% tax levy, it really does feel free.

PS: I would add that the overall cost to the nation is higher than it needs to be, because access is unconditional in terms of health qualification. I would like to see smokers, obese people, addicts, people engaging in dangerous sports, etc disqualified for treatment of any related conditions.

 

REDUCTION TO ESSENTIALS

Total Defense Expenditures ($):
EU: 162B-€ (162/1.21 = 134B-$)
US: 676B-$

Defense cost-per-person comparison (dollars):
EU: $134,000,000,000 per 714,000 population = $187,600 per 1000 people = $188 per person
US: $676,000,000,000 per 328,000 population = $2,060,975 per 1000 people = $2061 per person
Or, cost is 11 times more expensive per person to the US than to the EU ...

*Also, Defense Expenditures (as a percent of GDP):
EU: 1.2 % [2018]
US: 3.2 % [2019]

 

Hmm, I bet if we threw public funded education out the window, we could find the funds to pay for medical coverage.

Trade-offs, trade-offs.

 

No, no trade-offs as regard two key attributes nowadays of anybody's necessity to learn. One cannot remain with only a base-competence for jobs all their lives or they end up below Poverty Threshold, which are mistakenly called "Guidelines".

Which today look like this here - for a family of four the PT-income level is $26,200 annually ....

 

I never understand the ambition to go backwards on health and education when there is so much wealth sloshing around out there.

 

"Values" are the most important components of our existence. The way we construct them defines how we live and often how well meaning with one another. Which is why tolerance is the key element to our mutual existence. We must tolerate the differences that will distinguish us one-from-another.

And the desire to impose only one set of values must never ever be acceptable. Because that destroys an elemental freedom. That of self-determination, that is, to feel, act and think as we desire. Thus, these values must have a common-thread for all of us to adhere to ... and yet allow us to remain distinctive in the beings that we are and wish to be. That is, respectful for the beliefs, needs and desires of others.

And all that aint easy!

But the alternative, that is, the lack-of-values or a fixation on a limited set of values will affect the way a country may develop (or not evolve). The values a people select are the most important elements of any nation or groups of individuals. It must be done with determination to be all inclusive and not simply selective.

Because the essence of Values is that we should all want to establish them together, with respect for the differences. But how do we do that?

By selecting those who represent us at each level of political office - city, state and country. Their duty is to make laws that affect our behaviour, which is fundamental in any collective of human-beings. For example, "Though shalt not kill!" is a crucial religious value, but also it pertains to the legislation that protects our "civil liberties". The most fundamental of which is life-itself.

Creating a Civil Structure by which we live should be as simple as that, but it aint. Because we have not sufficiently inculcated our children with Civic Values. For instance, not "who to vote for" but "why do we vote those who represent us?" Only proper courses in Civics can ask those questions and inculcate the answers in human sentiments/beliefs.

Meaning we must search and chose those values we think we want to live by and institute them by making laws. Which is an enormously difficult debate of many colors, complexions and kinds ...

 

Thanks for the essay.
I still don't understand the ambition to go backwards on health and education when there is so much wealth sloshing around out there.
As regards teaching values. I believe that's already being done.