Large Scale Central

Free Health Care?

General Discussion
#1

There was a news segment last night on Perth TV about a recent offer of free health care in Virginia. Here are the salient facts:

  1. A wealthy man organised a day of free medical and dental care for all comers. Apparently he’s already done this for natives in the Amazonian jungle.

  2. The queue started forming around 3:00 AM. When the clinic opened, there were over a thousand people waiting. The doctors, dentists and nurses were flat out all day.

  3. The wealthy bloke was interviewed, but didn’t have a lot to say. The governor of Virginia was also interviewed, and had the decency to seem embarrassed.

  4. The news commentator reckoned the provision of health care is a major election issue in the US, especially for those who can’t afford it.

I can’t Google anything about this story. My innate suspicion of the media leads me to ask if any of you know anything about this event. Did it actually happen?

#2

I can’t comment on whether it took place, but here’s some insight into a free clinic being swamped.

  1. Yes a LOT of people ARE having trouble affording health care.

  2. It often doesn’t help those with the most need. MANY people will take advantage of something being “free” (actually somebody usually IS paying for it), whether they NEED it or not, just because it’s, well…free. Others who really DO need it won’t come, either because they are suspicious of undisclosed “strings”, or just stubborn pride.

#3

Dave,

Here’s a couple of articles from some that have had care at these Virginia clinics, sounds like a noble effort but one that falls short.

http://www.associatedcontent.com/article/338354/my_day_of_free_dental_care_i_survived.html?cat=5

http://www.newsweek.com/id/150846

#4

The day government takes over health care, will be one hell of a dark day for us all. I’ve seen first-hand what Medi-Cal (the federally-mandated, state-run healthcare for poor/elderly) is like, and the only thing I can say for it is that, if you’re truly desperate, it’s better than nothing at all. But not much.

Government healthcare has all the warmth, compassion and understanding of an IRS audit; combined with the efficiency of, well, any government bureaucracy.

#5

Whilst I take no position on “free” medical care in the USA I can comment on the “free” medical care available in Australia.

First of all it is not free here in OZ unless you are eligible to some sort of pension. EG disability or aged pension.

For the general population we all contribute a small (as in about 2%) percentage of our taxable income as a tax.
This contribution finances universal Health care for all in public hospitals. It can also defray all costs if the patient uses what we call bulk billing doctors.
Sure you may have to wait for elective surgery but for all emergency treatment and patients who require treatment for potentially life threatening conditions, that treatment is free in public ward hospitals.
Whilst I have never had to use such services I am well acquainted with some who have.
Jennifer had treatment for a malignant tumour in her gums a few years ago which was successfully treated. All the follow up consultations for observations of the end result were free.
Sure it isn’t perfect but most here in Australia are happy with it and don’t want to hange the status quo.
Everyone is free to take optional private health insurance if they so wish.

There are punitive “incentives” for the working population to opt for private cover. Many, including me, would still prefer to use the public system.

Successive (extreme) Conservative Governments here in Australia have tried unsuccessfully to destroy this system which was established many years ago by the Labour Govenment of Gough Whitlam and refined by the Conservative Government of Malcolm Fraser in the late '70’s.

#6
David Ross said:
Dave,

Here’s a couple of articles from some that have had care at these Virginia clinics, sounds like a noble effort but one that falls short.

http://www.associatedcontent.com/article/338354/my_day_of_free_dental_care_i_survived.html?cat=5

http://www.newsweek.com/id/150846


Thanks, Dave - second one is it.

#7

How many of of my fellow Americans think they have really good health care? How many have a “family doctor” they know and have seen for years? How many find the experience of dealing with the health insurance company confusing and frustrating?

The system we have now is not working well. We have too many uninsured, and the incentives to manage costs are skewed the wrong way. Cost managing is all directed and minimizing the patient’s time in the office and maximizing the technology end. I’d be happy to see a national health care plan–it would cost me less than the health insurance we have now.

Insurance works because you generalize and aggregate risk. The bigger the risk pool, the better the insurance works. If you have a national health care plan you have the largest possible risk pool. The healthy, in any private insurance plan, are always subsidizing the sick. It makes sense to me to generalize the risk pool and make it as large as possible. I want to pay less of health care and get better quality. A national health care plan seems like a way to make that happen.

What’s the alternative?

#8

I’m not sure what the answer is–I’ve heard stories from my wife’s family up in Canada about their system, which on one hand is quite nice, but seems to have its share of bumps and illogical situations as well. Unfortunately, the only health the health insurance companies in this country are worried about is that of their bottom line.

Two examples… My delightful prescription drug plan decided that it was no longer going to cover my medication because it found a cheaper alternative. (They did have the heart to say that if my doctor considered it medically necessary to continue on that particular brand, they would cover it, but my costs would go up–but not quite to full price. How nice of them.) The drug they wanted to switch me to (and pay them for) is available over the counter! And, at a cheaper price than what they wanted to charge me! Putting my health first, my hindquarters…

Second example… I had to call my insurance company a few years ago with some questions about coverage. During the course of the conversation about what was and wasn’t covered, I could sense some curious tension in her voice as we were talking. When I asked her about it, she mentioned that we had better coverage than they did! Now, I know little about how health coverage is payed for by companies, but typically half of the expense is on the employee, the other half on the employer. When the employer is the company being paid, it stands to reason that they could absorb that cost as a benefit, and give their own customers the same coverage they’re giving their larger clients. There may be some tax issues buried in there somewhere, but still… if you’re not willing to give your own employees the best health care, how committed are you to the rest of your clients?

Later,

K

#9

If you think health care is expensive now, just wait until it is free. :stuck_out_tongue:

Tony’s plan seems reasonable, and Kevin has been able to convince me that Canada is usually able to provide decent medical care, except that Canada has problems finding people to go to medical school, and to go to school for other trades within the medical community, sometimes producing long waits for care. Here in Washington State, I have found a lot of physicians who have emigrated from Canada for a higher wage, so that might be part of the problem. Also, if you don’t pay your physicians well, you won’t attract the best and the brightest, and you won’t attract the second or third tier in sufficient numbers to fill the necessary slots. Do I have the answer? No. As long as we insist that gummint be involved in health care, I don’t think that there will ever be an answer.

Hawaii recently tried a program to ensure that all uninsured kids, from birth to age 18 had a form of insurance, specifically, those not eligible for Medicaid or who did not have private insurance. The program lasted 7 months. Why? It got to be too expensive. Now, the usual suspects will say that it was killed by a Republican Guv’nor, but she is the one who thought it was a good idea and signed it into law, so I don’t think that will fly… Why did it really fail? Because it was free. Folks who had insurance for their kids started canceling that insurance and enrolling them in the “free” program. I coulda told you so. Here is the article from CNN and from Fox News

#10

We will not have reasonable health care until something is done to contain the costs.
My daughter had out-patient surgery on her throat. The bill was almost $50,000 for a couple hours total, probably 30 minutes in “surgery”.
Our local hospital here( not where my daughter had surgery ) is a small non-profit. They run some 43 non-profit corporations out of this hospital. Why? So they can siphon cash out of the system in the way of salaries.
This is going on everywhere.
Ralph

#11

I agree, Ralph, costs are high. Where do you suggest we skimp? Be specific.

#12
Steve Featherkile said:
I agree, Ralph, costs are high. Where do you suggest we skimp? Be specific.
$50 for a non prescription strength Tylenol or $75 for a Tampon. You would think after spending several thousand dollars a day for the room, you might get a discount rate :lol:

We don’t need to skimp. We need to cut the excessive charges and the skimming off the top.
Our local hospital is just one example.
Running 43 non-profit corporations out of a hospital with considerably less than 100 beds. This same hospital gets millions from the county every year for indigent care.
The only indigent care they do is when somebody doesn’t pay their co-pay, as they will turn you away without insurance. They don’t deliver babies and most of their business is removing body parts from wealthy senior citizens. They are making money. Lots of money. But they have 43 ways to “suck” the money out of the hopspital and retain their non-profit status.
Ralph

#13
Ralph Berg said:
We will not have reasonable health care until something is done to contain the costs.
This is where the discussion needs to be - on the cost of health care.

No system’s perfect, but some are better than others. A few years ago, I seriously considered moving back to the US permanently. I did the numbers, and the cost advantage of the Australian health system was a crucial factor.

Tony’s outline of how the Aussie system works is accurate. I have had quite a bit of personal experience with it, all of which has been satisfactory. Maybe that’s just good luck.

I tend to agree that talent follows money, and there’s a sustainable argument that the US has one of the best health care systems in the world for those who can afford it. For those who can’t, though, US health care, by the standards of a developed country, isn’t a pretty sight.

I know, from a family member’s experience, that Ray’s comments about public health care in California are accurate. Maintaining high standards in any health system that’s not run for profit will always be a challenge. However, it’s possible to mix public and private.

As Tony points out, Australians pay a mandatory levy that supports the public system. Our family supplements that with private cover, the main benefits of which are dental (not covered by the levy) and the subsidised cost of a private hospital (the waiting lists in the public hospitals for elective surgery can be lengthy).

Private health insurance costs us around A$2300 per year, about US$1600 at the current exchange rate. As in the US, plans and costs vary - our daughter and her husband pay double that for a higher standard of cover, a reasonable thing for younger people having babies.

When I last worked in the US, I knew a bloke who was paying more than US$1600 a month on health insurance for himself, his wife and their three kids ages 9 - 14. That’s insane.

Medications (i.e., prescription drugs) are heavily subsidised if the drug is covered under the Australian government’s Pharmaceutical Benefits Scheme (PBS). The Australian government has a lot more leverage getting a good deal from the drug companies than individual taxpayers could ever have, and the PBS covers a wide variety of medicines.

Again, I know from personal experience that Australians get a better deal on some prescription drugs than their American counterparts, even though the drug in question is manufactured by an American company. Kevin, this is one area where having a government buying on your behalf beats an insurance company “looking after you” by a country mile!

I remember an American work colleague describing the Australian health system as “socialist”. I was startled that a mix of private and public, which is what the Australian health system is about, could be dismissed with that kind of pseudo-sophisticated name-calling.

Americans have always been good at getting things done. It’s high time something was done to contain health care costs. Let’s hope the next President assumes a leadership role in this critical area.

#14
Dave Healy said:
Ralph Berg said:
We will not have reasonable health care until something is done to contain the costs.
This is where the discussion needs to be - on the cost of health care.

When I last worked in the US, I knew a bloke who was paying more than US$1600 a month on health insurance for himself, his wife and their three kids ages 9 - 14. That’s insane.


$1600 a month is what health insurance would cost for my family through my employer. I say would, because I can’t afford it. It amounts to more than half of my gross pay.
Insurance for just me is almost $2200 a year. My employer pays another $2200.
More companies are driven from the USA by the high cost of health care than “taxes”, as some would have you believe. Even General Motors has stated that health care costs are their biggest problem trying to compete with foreign manufacturers.
Ralph

#15

Funding for a universal health care system would be easy. Privatise the military. Let the rich pay the cost of having their foreign interests protected.

But I would advocate a mixed public and private military. Should US territory be invaded then it would be a common cause. But when some foreign dictator takes over an American oil facility in a foreign country, send in the RandCorp Task Force headed by the USS Gates and the USS Buffet.

The money saved could pay for a completely free medical system, new schools, highways, housing for the poor, universities, national parks, etc., etc.

You Yanks talk about “freedom” as if you had some sort of copyright on the word. In my opinion, the truest of all “freedoms” is good health.

#16

There’s no such thing as “free healthcare”. Whether you pay it directly, or buy insurance, or get it from the government, SOMEBODY is footing the bill. If you’re getting it from the government, that “somebody” is the taxpayer.

#17

Precisely.

The question is then, what is the most equitable way of funding and administering universal health care?

#18

By a huge over bloated fraud-laden corrupt gov’t bureaucracy that’s a couple trillion in dept now …the same one that gave us this housing crisis?..No thanx!

A wise man once said" Big gov’t isn’t the solution, big gov’t is the problem"…

#19

It seems pretty clear to me that if everyone had to pay into a national healthcare system, overall costs would be lower, for the same reason that having a larger insured pool lowers private insurance rates–it generalizes the risk and the costs over a larger area. It’s true that there is no “free” healthcare. But I would be happy to pay taxes for healthcare if it meant I got lower healthcare costs overall. I’d be saving money.

Is the government always inefficient? Are you criticizing our military? That’s the government. Meanwhile, it was private enterprise that got us into the economic crisis, particularly the faliure of private bond rating agencies to do their job. Were was the efficiency? My Healthcare plan, my old one, seemed to specialize in inefficiency, making it as hard as possible to submit clams for reimbursement. Their favorite tactic was to delay the response, then claim that too much time had passed. There was no efficiency at all for me. I switched to Kaiser and could not be happier.

Also I’m not that worried if government is inefficient, to some extent. Government isn’t a business and shouldn’t be run like one. It’s not a profit-making entity. The government could technically lose money on national healthcare–similar to the way we’ve lost huge amounts of money in Iraq–but the nation as a whole could gain by improvements in health, which would mean increased productivity and prosperity. Maybe you imagine the cost of the Iraq war as an investment in freedom. You could think of taxing for health care as an investment in national productivity in the same way as the freeway system.

But then, Bush didn’t tax people to pay for the Iraq war, he just printed money and passed the debt on. But that’s another debate

#20

One more thing about the contribution by taxpayers to the health care system in Australia.

The actual contribution is a line item in our returns and not buried in general revenue.
As I understand it, it is calculated after all deductions are made to arrive at our taxable income at the end of the year.