Brilliant NHS

[mistermack]

In many ways, the failure of the american health system illustrates the inevitable failure of raw capitalism.

As organisations get bigger and bigger, the chance of genuine competition gets smaller and smaller. So little monopolistic niches creep in, where the competition is really non-existent. Once that happens, people naturally start feathering their nests, knowing that the punters have no real choice. ie they might have an apparent choice, but all of the providers are in on the same scam. They don't compete, they operate as a bidding ring, to keep their profits rising.

It becomes nearly impossible for new blood to start up so the consumers are locked in to paying huge fees to a small number of providers.

The one thing that might break the cycle is competition from abroad. That's already happening in some fields.
People are taking a holiday, and getting plastic surgery, or dental work, done at the same time for a quarter of the US rates.
And people in the UK are going for it in rising numbers too.

Some of the foreign providers have excellent standards, as high, or higher, than US and UK standards.
The US is wide open to this kind of competition, especially if people start financing their own healthcare, like Seth. I can't see the sense in running down your nest egg, when someone else would do an equal job for a quarter of the money.
When the amounts of money get really big, the cost of an air fare gets smaller and smaller in comparison.

If I was a billionaire, I'd be setting up hospitals in Mexico right now, they're bound to be able to undercut the US.

[mistermack]

I just came across this interesting little snippet that illustrates what is facing so many Americans.

The Navy Seal, who killed Bin Laden, has no health cover, now that he is out of the service :

[MrJonno]

If I was a billionaire, I'd be setting up hospitals in Mexico right now, they're bound to be able to undercut the US.

I would make a guess the difference in wages between the US and Mexico isnt as high as between the UK and India but more relative if a British citizen has treatment in the 3rd world and it goes wrong the NHS/Society has a duty to treat that person. Would an American insurance company deal with a cock up from a non-approved hospital?

[ronmcd]

One might have paid in enough to get a bunion removed, or a cast on a broken arm, but the hard economic fact is that for the sick individual who would be bankrupted by the cost of caring for a serious illness or injury they have not and never will contribute TO the system anywhere near what they have taken OUT of the system.

Re amount put in compared to taken out, that is the same in the NHS where the money comes from small contributions over a long time through taxation, and the US system where the money comes from insurance contributions (for those who have insurance). Many people will never consume the value they put in, many will consume much more than they put in. In either system.

In a weird way, your essay says the same thing, but with different (ideological) conclusions.

- by paying throughout our lives in the NHS, we are never ASKED for money, so never scared of seeking help for fear of the cost. There are rare or extreme exceptions, of course, same in an insurance system. But not being scared of needing help, it's worth having the NHS just for this reason. Even if it did cost more, which it doesnt.
- you rightly say the real difference between the systems is to do with government vs private companies. Companies want to make profit, that is money going OUT of the healthcare system into shareholders pockets. I prefer the money stays in the system. The absolutist ideological right wing view you adhere to would suggest commercial companies must always be leaner and provide better value and service than the government (where they don't go bust). I disagree. Unchecked capitalism leads to profit mattering MORE than people, profitability does not equate to quality. In healthcare, that's not acceptable, to me.

I personally don't have a problem with some sort of mixed system where people pay into an insurance policy, some taxation, whatever. The key for me is that the companies aren't there to put profit over the service, and that people should not need to worry about the money or having the right insurance in order to receive treatment.

The NHS is fucking brilliant. Everyone on this forum who lives in UK would agree I am sure, we can all cite examples of our family or friends being treated/saved/wonderfully looked after in their final days etc by the NHS. We can all I am sure also cite problems we have seen, waits that have been too long, mistakes made. But we wouldn't swap it.

Those that would tend to be people like Cameron, Osbourne, Hunt, and the Tory & UKIP parties generally. Those who have never needed to use the NHS because they have their own private clinics to go to, and who have an ideological view the same as yours. You are mistaken if you think those people speak for the rest of UK who do value the NHS and actually use it. Or work in it.

[mistermack]

If I was a billionaire, I'd be setting up hospitals in Mexico right now, they're bound to be able to undercut the US.

I would make a guess the difference in wages between the US and Mexico isnt as high as between the UK and India but more relative if a British citizen has treatment in the 3rd world and it goes wrong the NHS/Society has a duty to treat that person. Would an American insurance company deal with a cock up from a non-approved hospital?

I'm sure that they would, if they had approved the trip and the treatment.
The US insurance companies don't exist to prop up the US health service. If they can get better value abroad, they might start offering packages that include foreign treatment as an option, to keep premiums down.

I don't think the average wage difference is so critical. It's the health industry wage difference that counts, and wages for doctors etc.in the US are much higher, compared to other professionals.
Wages in the UK are not much different to the US, but medical professionals get nearly double in the US.

In any case, if you owned private hospitals in Mexico, you could probably import medical talent from India, China, anywhere where it was cheaper.

[Seth]

In many ways, the failure of the american health system illustrates the inevitable failure of raw capitalism.

As organisations get bigger and bigger, the chance of genuine competition gets smaller and smaller. So little monopolistic niches creep in, where the competition is really non-existent. Once that happens, people naturally start feathering their nests, knowing that the punters have no real choice. ie they might have an apparent choice, but all of the providers are in on the same scam. They don't compete, they operate as a bidding ring, to keep their profits rising.

Do you understand WHY and HOW the "health care insurance industry" (HMO) came into being in the first place?

It didn't evolve naturally from the free market, it was largely created and certainly fostered and mutated into what it is now by the socialist swine in the US government.

It becomes nearly impossible for new blood to start up so the consumers are locked in to paying huge fees to a small number of providers.

Yup, largely the result of socialist swine in the federal government making that system mandatory for employers

The one thing that might break the cycle is competition from abroad.

How about competition from a fucking different state? Once again, the socialist fuckwits in STATE governments, in collusion with the FEDERAL government (and the providers too) to make it illegal for a provider in Nevada to compete with an "authorized" provider in Colorado. This state-sponsored manipulation of the market that amounts to de facto monopolization of the health care industry is precisely WHY medical care costs so much here.

Get the government OUT of the health care industry and it will go back to the way it was: You pick a doctor, you pay the doctor.

That's already happening in some fields.
People are taking a holiday, and getting plastic surgery, or dental work, done at the same time for a quarter of the US rates.
And people in the UK are going for it in rising numbers too.

Yup. And that can only happen because neither the NHS or the DHHS can prevent people from leaving the country to do so. I'm sure if they could find a way to make "medical tourism" illegal they would precisely because it threatens their Marxist control of one-seventh of the economy.

Some of the foreign providers have excellent standards, as high, or higher, than US and UK standards.
The US is wide open to this kind of competition, especially if people start financing their own healthcare, like Seth. I can't see the sense in running down your nest egg, when someone else would do an equal job for a quarter of the money.

Exactly correct. I never said that I would always get my health care at the highest cost in the US now did I? I already order my regular meds from overseas, where it costs 10 percent of the identical medication here in the US. Being able to make individual health care choices doesn't mean one is stupid. Exactly the opposite. I shop for health care the same way I shop for anything else: I assess the value versus the cost an decide who gets my money. You don't.

When the amounts of money get really big, the cost of an air fare gets smaller and smaller in comparison.

Yup.

If I was a billionaire, I'd be setting up hospitals in Mexico right now, they're bound to be able to undercut the US.

I'd use Canada, or perhaps the Caymans or some other place than Mexico, which is far, far too corrupt and violent. People avoid Mexico these days and I can hardly blame them.

Panama, Costa Rica, even some places in Eastern Europe like Ukraine or some of the smaller northern satellites.

Hell, even Belarus would welcome such investment...not that I would invest there because it's a Communist country.

Set it up with package deals from the airlines for discount fares and MedJet services for the critically ill and you can indeed make a lot of money and undercut Obamacare.

[Audley Strange]

While they were about for ages HMO's became big under Nixon's adminstration Seth, were supported by Ford who was also a republican, were made even more fundamental under Reagan, who was a Republican and Bush who was a Republican. None of these guys or the regime at the time could reasonably be called socialist.

[Seth]

While they were about for ages HMO's became big under Nixon's adminstration Seth, were supported by Ford who was also a republican, were made even more fundamental under Reagan, who was a Republican and Bush who was a Republican. None of these guys or the regime at the time could reasonably be called socialist.

Wrong.

Health care insurance was first invented by and for the benefit of large corporations during World War II. At that time FDR enacted wage controls and prevented companies from offering higher wages to lure valuable employees away from what was considered to be essential war industries. Companies who were struggling to find qualified executives in non-defense related industries therefore had trouble finding them because they weren't allowed to approach someone with a free-market better wage offer. So, companies like IBM came up with the idea of offering "health care insurance" as a non-wage benefit to top executives to induce them to switch employers without violating the wage laws.

It was much later, as you say, that HMO coverage became mandatory for large corporations, but it was hardly the work of Republicans. The impetus came firmly from the left/Progressive forces in government, which happen to include BOTH Democrats and Republicans. The notion was typically Marxist; "It's not fair to the average laborer that the executives get "free" health care insurance and they don't, so we're going to make providing "free" health care coverage mandatory for all big businesses, after all they can afford it..."

And that was the beginning of socialized medicine in the US. It's a carefully constructed, devious and positively machiavellian plot that's been creeping along like cancer since Woodrow Wilson and his ilk first proposed it at the turn of the century.

Obama has cunningly taken a huge step towards "single payer" (socialized) medicine because he had a window of opportunity when Progressives controlled both houses and the White House and they could get through what they've been plotting and planning for a hundred years...and they did it in typical Progressive fashion, by executive and Congressional fiat, without due deliberation, without bi-partisan cooperation or even involvement, and it was a fait accompli because the law had been drafted years if not decades in advance, and constantly kept updated by NON-GOVERNMENTAL Progressive organizations who, along with their conspirators in Congress, were simply waiting for that window of opportunity.

The fact is that the majority of Americans now do not want Obamacare, but neither Obama nor the Progressives give a flying fuck what the people want, they are determined to advance the Marxist Progressive state in spite of the will and consent of the governed.

[Audley Strange]

Though some forms of group "managed care" did exist prior to the 1970s, they came about chiefly through the influence of U.S. President Richard Nixon and his friend Edgar Kaiser. In discussion in the White House on February 17, 1971, Nixon expressed his support for the essential philosophy of the HMO, which John Ehrlichman explained thus: "All the incentives are toward less medical care, because the less care they give them, the more money they make."

The earliest form of HMOs can be seen in a number of prepaid health plans. In 1910, the Western Clinic in Tacoma, Washington offered lumber mill owners and their employees certain medical services from its providers for a premium of $0.50 per member per month. This is considered by some to be the first example of an HMO. However, Ross-Loos Medical Group, established in 1929, is considered to be the first HMO in the United States; it was headquartered in Los Angeles and initially provided services for Los Angeles Department of Water and Power (DWP) and Los Angeles County employees. Approximately 500 DWP employees enrolled at a cost of $1.50 each per month. Within a year, the Los Angeles Fire Department signed up, then the Los Angeles Police Department, then the Southern California Telephone Company (now AT&T Inc.), and more. By 1951, enrollment stood at 35,000 and included teachers, county and city employees. In 1982 through the merger of the Insurance Company of North America (INA) founded in 1792 and Connecticut General (CG) founded in 1865 came together to become CIGNA. Ross-Loos Medical Group, became now known as CIGNA HealthCare. Also in 1929 Dr. Michael Shadid created a health plan in Elk City, Oklahoma in which farmers bought shares for $50 to raise the money to build a hospital. The medical community did not like this arrangement and threatened to suspend Shadid's licence. The Farmer's Union took control of the hospital and the health plan in 1934. Also in 1929, Baylor Hospital provided approximately 1,500 teachers with prepaid care. This was the origin of Blue Cross. Around 1939, state medical societies created Blue Shield plans to cover physician services, as Blue Cross covered only hospital services. These prepaid plans burgeoned during the Great Depression as a method for providers to ensure constant and steady revenue.

In 1970, the number of HMOs declined to less than 40. Paul M. Ellwood, Jr., often called the "father" of the HMO, began having discussions with what is today the U.S. Department of Health and Human Services that led to the enactment of the Health Maintenance Organization Act of 1973. This act had three main provisions:

Grants and loans were provided to plan, start, or expand an HMO
Certain state-imposed restrictions on HMOs were removed if the HMOs were federally certified
Employers with 25 or more employees were required to offer federally certified HMO options alongside indemnity upon request
This last provision, called the dual choice provision, was the most important, as it gave HMOs access to the critical employer-based market that had often been blocked in the past. The federal government was slow to issue regulations and certify plans until 1977, when HMOs began to grow rapidly. The dual choice provision expired in 1995.

In 1971, Gordon K. MacLeod MD developed and became the director of the United States' first federal Health Maintenance Organization (HMO) program. He was recruited by Elliot Richardson, the secretary of the U.S. Department of Health, Education and Welfare.

http://en.wikipedia.org/wiki/Health_mai ... ganization

Wiki disagrees. Not only that but I watched a documentary series a while ago about the "successes" of the vilified Nixon regime and they were all bragging proudly about it (which I cannot find but was what sparked my brain in the first place.)

The consent of the governed is given by voting. Primarily your country has mostly voted Republican. Since the second world war ended almost every administration until the late 90's (there is the odd exception) have been actively anti-socialist, funding coups and destabilising those countries south of you who showed any signs of socialist leanings. So I don't buy the evil Marxists did this. I agree it is a perversion of the Free Market Economy, but then I'd put it to you that it comes from the Right, especially plutocrats who are happy that the government is forcing businesses (and now individuals) into purchasing health insurance, because it was profitable for THEM.

[Tero]

It was entirely the Republican's choice not to get involved. Same thing they are doing now, Seth. Nothing.

[Seth]

It was entirely the Republican's choice not to get involved. Same thing they are doing now, Seth. Nothing.

Actually, the Republicans entirely shut out of the Obamacare debacle. When you say it was their "choice" you're being disingenuous in the extreme. They attempted to participate but the only thing the Democrats would take as "cooperation" was actually outright and complete capitulation.

There was never any attempt, nor is there now, to negotiate anything in re Obamacare. So the Republicans did exactly the right thing; they stood firmly on their principles and refused to let the Democrats have any chance at all to try to shift the blame for Obamacare (whose chickens are even now coming home to roost) from the Democrats to the Republicans, which is a hoary old tactic of Democrats when "bi-partisan" legislation they ram through goes wrong.

This one's all on the Progressives, and rightfully so.

[Ian]

Wow, is that a load of bullshit.

[Seth]

...
In 1970, the number of HMOs declined to less than 40. Paul M. Ellwood, Jr., often called the "father" of the HMO, began having discussions with what is today the U.S. Department of Health and Human Services that led to the enactment of the Health Maintenance Organization Act of 1973. This act had three main provisions:

Grants and loans were provided to plan, start, or expand an HMO
Certain state-imposed restrictions on HMOs were removed if the HMOs were federally certified
Employers with 25 or more employees were required to offer federally certified HMO options alongside indemnity upon request
This last provision, called the dual choice provision, was the most important, as it gave HMOs access to the critical employer-based market that had often been blocked in the past. The federal government was slow to issue regulations and certify plans until 1977, when HMOs began to grow rapidly. The dual choice provision expired in 1995.

In 1971, Gordon K. MacLeod MD developed and became the director of the United States' first federal Health Maintenance Organization (HMO) program. He was recruited by Elliot Richardson, the secretary of the U.S. Department of Health, Education and Welfare.

http://en.wikipedia.org/wiki/Health_mai ... ganization

Wiki disagrees.

So?

Not only that but I watched a documentary series a while ago about the "successes" of the vilified Nixon regime and they were all bragging proudly about it (which I cannot find but was what sparked my brain in the first place.)

Pointing to Nixon is not exactly a good way to pin anything on Republicanism. You do remember that he was a crook and was driven from office, right? Besides, I'm no great fan of Republicans either, as many of them are themselves Progressives. George Bush the Younger was one of the most egregious examples of a RINO Progressive. He presided over the largest expansion of the federal government and it's power in the history of the United States...until Obama came along and easily bested him.

The consent of the governed is given by voting.

Most times yes. But the consent of the governed is also explicitly stated in the Constitution itself, which is a charter of restrictions on what government is permitted to do. And the 13th Amendment says neither the government nor anybody else can force anyone other than a prisoner duly convicted of a crime into involuntary servitude. And if being forced to work and turn over my money for redistribution to other people isn't involuntary servitude I don't know what is. It's functionally no different from sending me to Siberia to build the Road of Bones.

Primarily your country has mostly voted Republican. Since the second world war ended almost every administration until the late 90's (there is the odd exception) have been actively anti-socialist, funding coups and destabilising those countries south of you who showed any signs of socialist leanings.

Thank God. Marxism would be much farther along had we not done so. Pity we weren't more aggressive here in the US though.

So I don't buy the evil Marxists did this.

But they did, in cahoots with the Progressives. Go read up on the Frankfurt School. What the Marxists in the US realized is that they could never accomplish it by revolution in the US, instead they would have to take the long view and infiltrate the government, but mostly the educational system, in order to change the way children were taught to think. And it's been going on for a hundred years and it's working pretty well precisely because people are being slowly boiled alive rather than dumped in the fire. The good news is that Obama appears to have badly overstepped and tipped the Marxist Progressive hand too soon and people are waking up to what he and his ilk have been trying to do, and they are rejecting it. Time will tell though.

I agree it is a perversion of the Free Market Economy, but then I'd put it to you that it comes from the Right, especially plutocrats who are happy that the government is forcing businesses (and now individuals) into purchasing health insurance, because it was profitable for THEM.

Oh I don't disagree at all that the insurance industry was not in collusion with and complicit in all this. They made a devil's bargain with the Progressives, just like Krupp Steel and other large industries in Weimar Germany made with Hitler, who told them "I'm a socialist, but as long as you toe the party line and support my regime, you will be allowed the privilege of profiting from your labor. If you don't cooperate however, I'm going to stand you all up against a wall, shoot you, and nationalize everything."

The insurance industry leaped at the chance to obtain government monopoly protection for their new "HMO" scam.

That doesn't mean it was the right thing to do, nor does collusion between big business and government axiomatically mean the programs and purposes emanate from the right. Clearly they don't, they emanate from a witch's brew of Marxism, socialism and Progressivism.

[Seth]

Wow, is that a load of bullshit.

Why did you post it then?

[mistermack]

What's amazing is that, people in the US are so thoroughly indoctrinated by Fox News and the like, that even people who won't use the private insurance system that's in place, still think it's better than the NHS.

This is in spite of the fact that survey after survey puts the US healthcare standards last when compared to countries of similar development. So they pay double, they get the lowest quality, they don't even USE it, but they still believe it's better.
That is just about as dumb as it gets. It just goes to show the gullibility levels in the US. It's the constant drip-drip of negative news about healthcare abroad, that keeps the US consumer tame, to be fleeced by their own robbing institutions.

Not that gullibility is confined to the US.
In surveys done in Britain, people constantly express satisfaction with their OWN treatment. The levels are up around the nineties percent.
But when asked whether they agreed with the question "My local NHS is providing me with a good service” only 67% of those surveyed agreed with it, and only 51% agreed with the statement “The NHS is providing a good service.

The fact is, people who have used the service recently are the most likely to rate it highly. ( way up in around ninety percent ) whereas people who HAVEN'T used it for a long time rate it the lowest.
This is obviously because they get their information from the media, which are mostly right-wing, and the BBC, who like to find a health story when they have no news. They constantly are fed a false story, and they buy it.
Then, when they actually use the service, their satisfaction levels shoot up into the nineties.

People are so fucking gullible. Why don't they question what they hear? I question absolutely everything, as a force of habit, having been lied to about almost everything in my time.