OBAMA/TRUMPCARE MEGATHREAD

[Jenksismyhero]

If the spending were equal and the systems were all universal, I'd say you'd ahve a point here. I think the French/German system works the best, but yes, wait times for elective surgeries for people with insurance are longer there. If we both spent the same amount on the system, and we had better coverage for some drugs than they did, while they had longer/shorter wait times, great. That's just not the case though.

 

If we spent the same %age of GDP on health care as the french, that would save this country somewhere between $500 billion and $1 trillion per year.

 

And we're spending that money and still missing nearly 20% of the population. Yes, our wait times are lower for surgeries...but they're not lower when you factor in the number of people who put off procedures because they're uninsured or because they simply can't afford it. When you add in the people who never get the procedures they need, those averages would shoot up. If we're spending that much more money than everyone else, then we ought to get care that is vastly better than everyone else, not competitive with...and we don't.

 

Solve those issues and I'll agree that there are pros and cons to each side...but these are the 2 things that are simply completely broken about the U.S. system. It leaves a huge chunk of it's population out to dry, and it costs an absolute fortune at the same time...and that is compared to systems that have much more government intrusion than ours. The PPACA is hopefully a big step towards solving both of them and letting the U.S. actually innovate its way to a quality health care system.

 

The spending arguments IMO are weak because the countries are difficult to compare side by side. We're an unhealthy nation that needs more medical care to begin with. We undergo more elective procedures. We're probably more medicated than your average European. And we definitely seek out more preventative care. So there's a lot of your cost difference right there. Again, not suggesting the costs aren't out of control or that the money is justified. But it's not like we're spending 5 times as much for the same level (and amount) of care.

Edited July 2, 2012 by Jenksismybitch

[EvilMonkey]

Why LOL? Really a funny situation to mock here.

I'm saying the bill of $997,000 was for the initial surgery of the poor baby.

I'm asking a simple question, asking people to educate me on why our system is so great when in Europe a friend of mine walked into a hospital for emergency care, had to stay a couple days and there's no bill. Free.

As far as not treating the baby and throwing him on the street to die ... educate me again. If you have no insurance and head to emergency room, a.) will they treat you at all? b.) if you do get treated and they immediately find a brain tumor on the MRI, you mean to tell me they will do brain surgery for free? I don't think so. I think they tell you about free clinics, etc.

I'm asking if Europe's system is better; cause it seems so. 997,000 bucks?? For one surgery?

What is his tax rate over there? Or is he a ward of the state? I'll wager it is a lot more than whatever rate you are paying here. So it isn't 'free', he has been paying for it all along. An exchange student that used to live with us from France recently closed his business because the taxes were killing him. He wasn't even sure how to tell me what the rate was but when we tried adding up what he made vs what he had to pay it looked like it was a little over 60%. Not counting the taxers on good, and the VAT on just about any purchase you make.

[Balta1701]

The spending arguments IMO are weak because the countries are difficult to compare side by side. We're an unhealthy nation that needs more medical care to begin with. We undergo more elective procedures. We're probably more medicated than your average European. And we definitely seek out more preventative care. So there's a lot of your cost difference right there. Again, not suggesting the costs aren't out of control or that the money is justified. But it's not like we're spending 5 times as much for the same level (and amount) of care.

First of all...none of those should come close to accounting for a trillion dollars of spending per year. Secondly...none of that deals with the fact that 50 million people were still getting left behind inexcusably.

 

And perhaps most interestingly is the other detail buried in your post..."We're an unhealthy nation" but "We undergo more elective procedures", "Seek out more preventative care (I'd be surprised if that were true, especially if you factor in the fraction who have no insurance, but would be happy to see data proving me wrong), and we're "more medicated".

 

If all of those things are true...and yet we're still an unhealthy nation...then those things you quoted are simply failing to produce the kinds of health improvements that the spending on them should produce. That means the money being spent there simply is not working.

 

I'd actually agree with that part that I dragged my way to. We're spending a lot of money on things that don't work, or don't work as well as they can...because, in part, we never do the research to see what works best. That research is funded by the PPACA, which is one of the better things it does. And also, because we treat people not for health outcomes, but to maximize profits. The PPACA has some efforts to shift that system to paying for improving health outcomes rahter than total # of procedures done...but we'll see if those work.

[Jenksismyhero]

First of all...none of those should come close to accounting for a trillion dollars of spending per year. Secondly...none of that deals with the fact that 50 million people were still getting left behind inexcusably.

 

And perhaps most interestingly is the other detail buried in your post..."We're an unhealthy nation" but "We undergo more elective procedures", "Seek out more preventative care (I'd be surprised if that were true, especially if you factor in the fraction who have no insurance, but would be happy to see data proving me wrong), and we're "more medicated".

 

If all of those things are true...and yet we're still an unhealthy nation...then those things you quoted are simply failing to produce the kinds of health improvements that the spending on them should produce. That means the money being spent there simply is not working.

 

I'd actually agree with that part that I dragged my way to. We're spending a lot of money on things that don't work, or don't work as well as they can...because, in part, we never do the research to see what works best. That research is funded by the PPACA, which is one of the better things it does. And also, because we treat people not for health outcomes, but to maximize profits. The PPACA has some efforts to shift that system to paying for improving health outcomes rahter than total # of procedures done...but we'll see if those work.

 

Not sure how much medicine/medical care can stop the country from being fat and needing more treatment later in life.

[EvilMonkey]

Not sure how much medicine/medical care can stop the country from being fat and needing more treatment later in life.

Give them time, they will figure it out. Bloomburg already tryign to. Remember, they know what is best for you.

[mr_genius]

Not sure how much medicine/medical care can stop the country from being fat and needing more treatment later in life.

 

Dude, I was just looking at random people out and about and like 90% are extreme fatsos. Even little kids are super fat!

 

 

[Reddy]

Give them time, they will figure it out. Bloomburg already tryign to. Remember, they know what is best for you.

 

They DO when it comes to nutrition. People in this country are nutritionally retarded. I'm all for Bloomberg's plan.

[Reddy]

Dude, I was just looking at random people out and about and like 90% are extreme fatsos. Even little kids are super fat!

it's true.

[Soxbadger]

Govt shouldnt be able to tell you what you can eat and drink. Although a great argument against Healthcare would be that if the govt is paying for it, they have a better argument to ban unhealthy things and further control our lives.

 

 

[Reddy]

Govt shouldnt be able to tell you what you can eat and drink. Although a great argument against Healthcare would be that if the govt is paying for it, they have a better argument to ban unhealthy things and further control our lives.

 

here's the giant problem though. people are stupid and make themselves sick because of the foods they eat. THAT puts a burden on the entire healthcare system. If Americans would just f***ing eat better, they wouldn't get sick so damn much. Someone's gotta get america off its high fructose corn syrup addiction. I applaud Bloomberg and Mrs. Obama for getting things going on the right track.

[Soxbadger]

Who are you to tell me what to eat?

 

People are stupid, that is not new. People make stupid decisions all the time, but isnt the point of America that we have the freedom to make our own stupid decisions?

 

What if the govt could prove that if I had been forced to be a scientist or doctor, I could have reduced the burden on the entire healthcare system. Would you think that it would be okay for the US govt to force me to become a scientist or doctor because that would help everyone else?

 

Seems safer that we let people make bad decisions and if they die, oh well.

[Jenksismyhero]

here's the giant problem though. people are stupid and make themselves sick because of the foods they eat. THAT puts a burden on the entire healthcare system. If Americans would just f***ing eat better, they wouldn't get sick so damn much. Someone's gotta get america off its high fructose corn syrup addiction. I applaud Bloomberg and Mrs. Obama for getting things going on the right track.

 

You scare me.

[Jenksismyhero]

Who are you to tell me what to eat?

 

People are stupid, that is not new. People make stupid decisions all the time, but isnt the point of America that we have the freedom to make our own stupid decisions?

 

What if the govt could prove that if I had been forced to be a scientist or doctor, I could have reduced the burden on the entire healthcare system. Would you think that it would be okay for the US govt to force me to become a scientist or doctor because that would help everyone else?

 

Seems safer that we let people make bad decisions and if they die, oh well.

 

I was just reading a story about this (from a few years ago) yesterday, about how some countries like France, with that amazing healthcare system, have higher death rates for more "preventative" cancers because the costs of the drugs/tests to "prevent" or "control" the cancers early on are way too expensive. So, they don't offer them. Do we really want the government deciding what prescription drugs we can/can't get, especially potentially life-savings drugs, because of cost? Especially once everyone is on-board the "oh the gov't will provide everything I need in life!" bandwagon?

Edited July 3, 2012 by Jenksismybitch

[Balta1701]

I was just reading a story about this (from a few years ago) yesterday, about how some countries like France, with that amazing healthcare system, have higher death rates for more "preventative" cancers because the costs of the drugs to "prevent" or "control" the cancers early on are way too expensive. So, they don't offer them. Do we really want the government deciding what drugs we can/can't get? Especially once everyone is on-board the "oh the gov't will provide everything I need in life!" bandwagon?

There are drugs that prevent cancer?

[Jenksismyhero]

There are drugs that prevent cancer?

 

I meant preventative as "early detection."

 

Still About Money

 

A further downside for residents of Britain: The cash-strapped NHS places less emphasis than the U.S. or France on preventive care. Annual physicals aren't insured. And screening programs are less generous than in the U.S. So despite the fact that pap smears can help detect cervical cancer, the second leading cause of death for women, they are only offered once every three years, as opposed to the recommended annual test in the U.S.

What neither the French nor the British system can overcome is the stark math of cost-benefit analysis. A cancer drug like Avastin, which can extend a patient's life by a few months, costs $48,000 annually per patient. It's far too expensive, by NICE's reckoning, to provide to all colon cancer patients, so it's available to none. In France, the state pays a portion and the wealthy are free to make up the difference. Money, in other words, buys good health—on both sides of the Atlantic.

 

http://www.businessweek.com/stories/2007-0...inancial-advice

 

 

Edit: I now can't find the article I was reading about a similar drug used to combat melanoma in the early stages. I was interested because I thought it was the same drug my mom was on for a while, and it was crazy expensive. But there are other examples. For people with psoriasis you can take Enbrel at 4k a shot (normally need one per week). I'll go out on a limb and guess that France/the UK aren't happy about paying those prices either.

Edited July 3, 2012 by Jenksismybitch

[Balta1701]

I can't say I'm familiar at all with the drug Avastin, but some brief googling suggests that the issue may be far more complex than "the NHS doesn't want to pay the high cost" and there is legitimate question over the drug's safety/effectiveness as well.

 

Here is an article describing the US FDA cutting back on the things it can be used for due to effectiveness questions.

Here is one statement in another article describing the complex questions going around with it:

Cancer sufferers living in France, Germany, Italy, Scandinavia and Canada are all prescribed it for free.s

 

and another

Now some researchers are wondering if after Avastin is stopped, cancer cells spread more aggressively than before, dulling the drug's effect. Such a "rebound effect" could explain why Avastin therapy is not resulting in bigger survival gains even as the drug makes pictures on imaging scans look better. Much of the new evidence is based on studies in mice and anecdotal evidence in brain cancer.

 

One thing definitely worth noting here is that any particular drug, especially the pricey ones...have big money pushing for increased use, so it's going to be very easy to find the person on the street to say "drug x saved my life!" even if the 2 people who would say "side effects of drug x killed me" can't be found on air for some reason. The people who swear by the drug's usefulness will give you only 1 side, and very few places do the kind of comparative effectiveness research needed to really see whether there's a big benefit to these drugs (and again, the PPACA funds this type of research).

[southsider2k5]

Govt shouldnt be able to tell you what you can eat and drink. Although a great argument against Healthcare would be that if the govt is paying for it, they have a better argument to ban unhealthy things and further control our lives.

 

And this is how your rights go away, step by step...

[Soxbadger]

Unfortunately its the lesser of 2 evils, 1 evil actively platforms on the govt controlling your life (Republicans) the other evil doesnt explicitly say it, but it potentially could be the natural end of their current platform (Democrats).

 

Since I put social freedom above economic issues, I have to be a Democrat, just no reconciliation with anti-gay rights, etc. Basically the exact opposite of giving people personal freedom.

[farmteam]

On Volokh a few weeks ago, they had stuff from the guys the who authored the study that Bloomberg mentioned (relied on, even?) to support his plan. They said Bloomberg had it wrong. Lemme see if I can find it.

 

EDIT: Here it is.

Edited July 3, 2012 by farmteam

[Reddy]

There are drugs that prevent cancer?

it's called eating right.

[Reddy]

And this is how your rights go away, step by step...

haha yeah ok.

[Soxbadger]

You really dont see the correlation between the govt telling you what size drink you can buy and your rights being taken away?

 

[Balta1701]

You really dont see the correlation between the govt telling you what size drink you can buy and your rights being taken away?

Serious Q: is it taking away people's rights to make some beverages cheaper and others more expensive using the laws/tax code?

 

Because through all the corn subsidies, we're already subsidizing every soda sold in this country.

[Reddy]

You really dont see the correlation between the govt telling you what size drink you can buy and your rights being taken away?

its a matter of scope.

[Y2HH]

its a matter of scope.

 

Actually, it's a matter of precedent.

 

And your former comment about eating right...there are people that eat right and get cancer anyway. I'm not saying eating right won't help some people...but there are those, due to genetic defect, that it doesn't matter for...at all. If they live long enough, they're predisposed to getting it.