U.S. passes "historic" healthcare bill

[Coito ergo sum]

Coito, you seem to be a man of many faces.
In another debate, concerning prostitution, you couldn't stop bragging about the wonderful social safety net that exists in the US. But on this thread, you seem to resent any cent that is spent on it.

Being against the 2010 health care legislation says nothing about whether one is against the entire social safety net.

I never "bragged" about the US social safety net. I merely corrected the fundamental misconception that some folks have about the US safety net - i.e. some folks are under the faulty impression that we don't have one. We do.

Please - though - show me where I "couldn't stop bragging". Just a quick link to the thread...

I don't include you in this, but the US seems to be the land of sanctimonious two faced twats.

I won't argue with you there, except to the extent that you imply the US to be populated with more sanctimonious two-faced twats than other countries.

It's one of the most "christian" nations on earth, except when it comes to acting christian. What would jesus say about heathcare? All these so-called christians know exactly what he would have said, and ignore it completely.

Yes, it is unfortunately a very Christian nation in terms of population. However, it's also got one of the most "secular" legal systems, with one of the first and still one of the rare express limitations on the government to act in relation to religion. While there are forces which assail this "separation," we are very fortunate that the strength of the legal documents in the US have for the most part withstood these assaults. We are free from mandatory contributions and payments to religion (whereas some countries in Europe require taxes and fees to be paid to religious institutions) - we are free from an "official" religion - and yet many countries - like England - have an official church and even appoint clergymen to lifetime positions in the government (such as the House of Lords). We are free from constitutional provisions, like that in Norway, which requires Lutheran parents to bring their kids' up Lutheran (it's not much enforced, but it's still there).

Socially, the US is quite Christian. Legally, we have a secular government, for the most part. As long as religious beliefs are held privately, and free of government support or opposition, then I can live with freedom of thought - even freedom of dumb-ass thought.

The more rabidly christian they are, the less ready they are to part with a single dime in tax, that might get spent on the poor.
If they took all the money they spend on pets, and spent it on the poor instead, you really would have a safety net. How christian is that?

I don't think this accurately states US culture. Some completely un-Christian folks - like the Randian Objectivist crowd that follows the Atlas Shrugged and The Fountainhead - theories of economics - are quite adverse to taxes.

And, being against more taxes doesn't mean someone is not ready to part with a single dime in taxes. It's not like Americans pay less in taxes than most other countries. We already have just about the highest corporate tax rate in the world - which is what is driving US companies out of the US to set up shop elsewhere, so they can avoid high American taxes.

We already have people paying these income taxes to the federal government:

25% on the income between $34,000 and $82,400; plus $4,681.25
28% on the income between $82,400 and $171,850; plus $16,781.25
33% on the income between $171,850 and $373,650; plus $41,827.25
35% on the income over $373,650; plus $108,421.25

Most individual states also have income taxes - generally around 4%. Major cities like New York City have income taxes - New York City income tax averages between 3 and 4%. Detroit has a 1.5% income tax on residents and a 1% income tax on those that work in the city. Oregon and Hawaii have the highest rates of state income tax, with a maximum rate of 11%. California has about a 10.3 % marginal income tax rate.

So, the "rich" pay 33% or 35% to the federal government - between 4% and 11% to their State government. If they live in a big city, tack on another 1% to 3.5% in city income tax. Then tack on state sales taxes.

I mean - to suggest that it is "unChristian" to oppose paying MORE than that....bollocks.

And I find your quibbling about waiting times in the US compared to the UK rather silly. You are not comparing like with like.
Our NHS is open to all. And the two coutries have very different economies.

How health care system is open to all too, and not just those who pay. Hospitals cannot turn people away.

And, I reject your suggestion that I can't compare aspects of the US health care system to the UK. People have been comparing the US health care system to that of other "industrialized nations" when it suits them because they think it reflects negatively on the US. That should cut both ways, shouldn't it?

If the US took all the money currently spent on health in the country and spent it on a national health system, your NHS would be enormously superior to ours.
.

Evidence?

We have a national health care system called "Medicare" and it is available to retired persons. Is that "enormously superior" to your system? We have a national health care system called "Medicaid" which applies to people who are poor. Likewise, is that "enormously superior" to yours?

[mistermack]

Evidence?

Coito, you don't look very far, and with your usual body-swerve, you don't answer the actual point made.
Read what I wrote. I said if you took all the money spent on health in the US and spent it on an NHS, it would be vastly superior to the UK NHS.
Evidence? Well, start with good old Wikipedia :

More money per person is spent on health care in the USA than in any other nation in the world,[2][3] and a greater percentage of total income in the nation is spent on health care in the USA than in any United Nations member state except for East Timor.[3]

And :

The USA pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy,

And :

The World Health Organization (WHO), in 2000, ranked the U.S. health care system as the highest in cost, first in responsiveness, 37th in overall performance, and 72nd by overall level of health (among 191 member nations included in the study).[14][15] The Commonwealth Fund ranked the United States last in the quality of health care among similar countries,[16] and notes U.S. care costs the most.[17]

Here's your link :
(Link)

[Coito ergo sum]

Evidence?

Coito, you don't look very far, and with your usual body-swerve, you don't answer the actual point made.
Read what I wrote. I said if you took all the money spent on health in the US and spent it on an NHS, it would be vastly superior to the UK NHS.
Evidence? Well, start with good old Wikipedia :

More money per person is spent on health care in the USA than in any other nation in the world,[2][3] and a greater percentage of total income in the nation is spent on health care in the USA than in any United Nations member state except for East Timor.[3]

And :

The USA pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy,

And :

The World Health Organization (WHO), in 2000, ranked the U.S. health care system as the highest in cost, first in responsiveness, 37th in overall performance, and 72nd by overall level of health (among 191 member nations included in the study).[14][15] The Commonwealth Fund ranked the United States last in the quality of health care among similar countries,[16] and notes U.S. care costs the most.[17]

Here's your link :
(Link)

And, none of that supports the specific assertion you made, that if we "took all the money currently spent on health care and spent it on an NHS that it would be vastly superior to the UK's system." That's what I was suggesting needed evidence.

On what basis do you claim, for example, that spending the money through a nationalized system would improve health care performance? Again, we have a national health care, single payer, for people who are retired. Is that vastly superior? What makes us think that making Medicare applicable to all it would be vastly superior?

[mistermack]

And, none of that supports the specific assertion you made, that if we "took all the money currently spent on health care and spent it on an NHS that it would be vastly superior to the UK's system." That's what I was suggesting needed evidence.

Yes it does, it totally supports it. I can't make it any clearer for you.
You spend vastly more per person than our NHS does. For a level of care that is clearly not up to scratch.
Or perhaps you are claiming that the US is somehow fundamentally incapable of doing such things as efficiently as the UK?
If we spent the same proportion as you, WE would have a vastly superior system to the one we have now.
.

[Coito ergo sum]

And, none of that supports the specific assertion you made, that if we "took all the money currently spent on health care and spent it on an NHS that it would be vastly superior to the UK's system." That's what I was suggesting needed evidence.

Yes it does, it totally supports it. I can't make it any clearer for you.
You spend vastly more per person than our NHS does. For a level of care that is clearly not up to scratch.
Or perhaps you are claiming that the US is somehow fundamentally incapable of doing such things as efficiently as the UK?
If we spent the same proportion as you, WE would have a vastly superior system to the one we have now.
.

The facts you stated do not demonstrate the specific assertion you made. They support different assertions, but not the one you made. You assert that the US already spends more money as a percentage of GDP than most, if not all, other countries. So your thesis is that if the US government took that money and funded a national health care service with it, that it would be far superior to the UK NHS. Suggesting that the US is 37th According to the WHO doesn't support that thesis, because the WHO doesn't base its rankings on actual health care effectiveness or success at curing or resolving/treating health care issues.

If you actually look at the study - and not just bare facts reported on wikipedia - you'd know that the WHO based its list on five factors, three of which involve political value judgments. For example, one of the criteria is "financial fairness," related to the percentage of household income spent on health. That doesn't have anything to do with the quality of health care, but it is one of the five factors that the WHO used to rank nations on the effectiveness of their health care. The rankings are, in short, designed in a manner that favors greater government involvement in health care.

The rankings are also adjusted to reflect a country's performance relative to how well it theoretically could have performed. So, where a country falls on the list of effectiveness of health care systems is "graded on a curve," so-to-speak. LOL

Let me also point out that: The WHO claims that the following countries are ranked higher than the US in terms of performance of their health care systems: Oman, Portugal, Greece, Colombia, Cyprus, Saudi Arabia, United Arab Emirates, Morocco, Chile, Dominica and Costa Rica. These are countries among the "36" that rank above the US, at 37th.

Now, when we look at studies that compare ACTUAL EFFECTIVENESS of health care systems, the US doesn't fair too badly at all. For example. A study published in Lancet Oncology in 2007 calculates cancer survival rates for both men and women in the United States, the United Kingdom, and the European Union as a whole. The study claims that the most important determinants of cancer survival are early diagnosis, early treatment, and access to the best drugs, and that the United States does very well on all three criteria. The calculated five-year survival rates are much better in the U.S.

So, we need to look at this in more of an in depth fashion than just to conclude that the US health care system is less effective and provides worse care than some pretty poor countries. There is the real possibility that taking the money currently spent on health care and funneling it through a government bureaucracy would actually reduce the effectiveness of the American system.

[mistermack]

Coito, I can't believe you quote beaurocracy as a problem with national systems.
The US system is top-heavy with beaurocracy. That's the problem. You have armies of insurance companies, with their workers, management, equipment, buildings, shareholders and pensions, as well as hospital staff administering invoicing, including debt collection agencies and lawyers fighting financial disputes. All taking a huge slice of the available money.
With national systems, that money can be spent on care.
.

[Coito ergo sum]

Coito, I can't believe you quote beaurocracy as a problem with national systems.
The US system is top-heavy with beaurocracy. That's the problem. You have armies of insurance companies, with their workers, management, equipment, buildings, shareholders and pensions, as well as hospital staff administering invoicing, including debt collection agencies and lawyers fighting financial disputes. All taking a huge slice of the available money.
With national systems, that money can be spent on care.
.

More money is spent on administrative costs in Medicare than in private health insurance. That's our experience here.

In the reports that say that Medicare administrative costs were lower than private sector administrative costs, the figures are misleading because for Medicare they exclude things like the salaries of managers and administrators or the marketing costs associated with advertising new policies like the Medicare Part D drug benefit. Private health care providers, on the other hand, include all of these expenses in their estimates of administrative costs.

When apples are compared to apples - we find that the government administrative costs are higher, and government waste is higher on top of that.

I don't know the figures with NHS and their administrative costs. All I can tell you is that in our "national health care for the elderly" (medicare) the administrative costs and waste are tremendous, and they are not spending what would otherwise be administrative costs in the private sector on health care.

I'd be willing to look at an apples to apples comparison of NHS to other systems. I won't assume, however, that the administrative costs and wasted money are lower. I'd like to see the proof.

[mistermack]

I'd be willing to look at an apples to apples comparison of NHS to other systems.

You're nowhere near apples for apples at the moment. You're comparing the cost of financing and administration for a commercial system. Medicare is just doing the same work that the insurance companies do, administering payments to privately run health providers. So it's not surprising that there ain't much saving.
The point of a national system is that this is work that isn't needed.
Why you liken medicare to an NHS, I can't imagine. A proper NHS involves a publicly owned health service that doesn't need a medicare system to administer payments to privately owned hospitals.
.

[Coito ergo sum]

I'd be willing to look at an apples to apples comparison of NHS to other systems.

You're nowhere near apples for apples at the moment. You're comparing the cost of financing and administration for a commercial system. Medicare is just doing the same work that the insurance companies do, administering payments to privately run health providers. So it's not surprising that there ain't much saving.
The point of a national system is that this is work that isn't needed.
Why you liken medicare to an NHS, I can't imagine. A proper NHS involves a publicly owned health service that doesn't need a medicare system to administer payments to privately owned hospitals.
.

You can't get around the fact that there have to be service providers. Those service providers can only provide covered services (even in NHS you don't get whatever you want - public policy dictates what services are available and in what quantities). Service providers have to fill out forms for the services they provide and submit the paperwork so that payment from the NHS can be forthcoming. It's just a single payer, instead of a multiple payer.

I don't "liken" Medicare to NHS - I told you I only have the numbers regarding Medicare, which is a single payer system here in the US for those covered by Medicare (most retired folks). I don't have the numbers for the overhead at UK NHS. If you will provide them, I'd love to look at those administrative costs.

Plainly, there are administrative costs to UK NHS. It's not "zero." So, if we could look at the numbers, it would make the conversation make sense. And, I'd like to be able to see some detail as to how the administrative cost numbers are calculated - government programs usually don't have to count all the same things that private organizations do. That's what I mean by apples to apples.

[mistermack]

I'm simply pointing out that there is a huge amount of work being done in the US that is not necessary in the UK.
I listed it. Insurance work. Invoice work. Debt collection. Legal work. You could add advertising by insurance companies to that. And no doubt plenty that I am unaware of. All incurred because it's private.
All that extra work is being paid for, by money that could go into care.
Of course there is admin work in all systems. But all this is extra.
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[Coito ergo sum]

I'm simply pointing out that there is a huge amount of work being done in the US that is not necessary in the UK.
I listed it. Insurance work. Invoice work. Debt collection. Legal work. You could add advertising by insurance companies to that. And no doubt plenty that I am unaware of. All incurred because it's private.
All that extra work is being paid for, by money that could go into care.
Of course there is admin work in all systems. But all this is extra.
.

I'd love to see the numbers.

[mistermack]

I'd love to see the numbers.

Well, even I was shocked when I read these numbers :
(Link)

[Coito ergo sum]

I'd love to see the numbers.

Well, even I was shocked when I read these numbers :
(Link)

Those numbers can't be taken in a vacuum. The typical American family spends just 5.4 percent of its income on health care, as opposed to 40.8 percent on housing, 18.3 per- cent on transportation, and 18.2 percent on food. 4.5 Percent is spent on clothing. Economically, American healthcare spending increased with the wealth of the country. Until very recently, the US was the wealthiest country in the world by almost every measure.

And, those numbers do not necessarily lead one to the conclusion that there should be a national health care service. We can, alternatively, make regulatory adjustments to address inefficiencies in the system and address unnecessarily rising costs and expenses.

[Trolldor]

Bullshit you could. You're America, you're built off the principle of voting in assholes who take paychecks from lobby groups founded by large corporations.

[Coito ergo sum]

Bullshit you could. You're America, you're built off the principle of voting in assholes who take paychecks from lobby groups founded by large corporations.

LOL -- what country are you from? Let's make a fair comparison of the election of assholes and the reasons for doing so...