Health Care for Everyone

[Sander 001]

IMO no one has a right to expect health care will be available when they need it most.

Barring people of nations who have demanded that right and stood up to the elite and powerful.

 

[mustafur]

Its not just the care thats a rip off its the medicine it self that is a massive rip off in America as well, If your a diabetic in the US with the need for insulin your paying 10 times more then Canada and Canada doesn't even subsidise it.

The people in the US are being played like fools.

 

[Sander 001]

 

[Joey D]

Its not just the care thats a rip off its the medicine it self that is a massive rip off in America as well, If your a diabetic in the US with the need for insulin your paying 10 times more then Canada and Canada doesn't even subsidise it.

The people in the US are being played like fools.

You can think lobbyists for that one. They've pushed so hard for regulations to be the way they are, there's practically zero competition in the market for drugs so they can charge whatever they want. Also, drug sales reps are typically shady people who will do anything to get doctors to prescribe their drugs over a competitor, even if the only difference is something like anti-nausea in the brand name vs. no anti-nausea in the generic. I've seen drug reps give doctors trips to Hawaii disguised as conferences, expensive tickets to sporting events, and pretty much anything you can think of. When I worked in clinics, we had different drug reps bring in lunch 2-3 times a week along with a whole box of swag.

Unfortunately, most patients don't understand that the generic form of a drug is 99% the same as the brand name drug. They assume, because for whatever reason drug companies pump billions into advertising, that the brand name will cure them while the generic won't. So patients pay a higher premium to get the brand name drug.

I work in the industry so thankfully I understand this, so when my doctor prescribed me an inhaler that was a brand name, I simply asked the pharmacy to switch it to the generic version. The cost? For the brand name, it was a $100 copay and with the generic, it was $5. I don't breathe any worse because I spent less.

The best way to fix this is to allow people to buy drugs from other countries legally. If I could go online and order something from say India, I'd be paying a fraction of the cost even after shipping and import fees. Of course, you run the risk of getting medicine that doesn't have the same quality but giving people the option to make that decision would go a long way. Also making it easier to get drugs approved for over the counter sales would help too. Allergy meds greatly benefited from this. I used to have to go to the doctor to get a script for them, pay $20 a month for a 30 day supply plus a co-pay to see the doc. Now I can buy a 365 day supply off Amazon for $12 with free Prime shipping and it comes the same day I order it.

 

[Danoff]

I have no direct experience with it so I can't give any anecdotes. I would assume there are wait times to see specialists for referrals and the surgeries themselves, and I would imagine depending on the province they could be into the year+ range which I agree is unacceptable. That being said I went back to that initial post and you said your relative is beginning with hormone therapy while considering surgical options. With my 20 minutes of research (take with a grain of salt) it appears that most provinces require you to be on hormones for at least 12 months before surgery regardless, which to me seems reasonable (I could be wrong and this might be wholly unnecessary) because some people may be satisfied with the results from just HRT.

Ultimately I'm not sure it's a great dunk or some hilarious grand irony. The response from me and presumably your socialist relative would be "yeah austerity sucks, and it's really unfortunate that decades of Canadian neoliberal governments have slashed health care funding by using the spectre of American private healthcare to manage discontent with the obviously underfunded system".

That's the rub about the government option. It's going to have budget controls which leave people waiting for service. You act like this is not expected or even inherent. There is not an infinite budget... people will wait.

It really isn't a political issue here in any meaningful capacity.

That's good. We have more.... diverse... views here.

And I don't like American wait times which can range from low to a lifetime. What I reject about this wait time argument is the premise there are much lower or no wait times in the US for health care, when that's only true (to the extent it even is true, in certain measures and procedures it's not true for reasons I'll get into later with a little zinger) because you're completely eliminating those who are priced out from the data.

Price is its own thing. Don't conflate these. Having to wait at any price is one issue, and having to pay a price is another. The problem with the US model (to the extent that it is not already socialist) is that it costs a lot to get full coverage.

My relative looking for transgender treatment is not waiting here, but would wait there. That's the issue I'm talking about. If you want to talk about people that can't afford therapy here, I'm happy to talk about that. But it's not the same issue.

You're already spending as much or more public money on health care than most other countries are for very good universal systems and then spending about the same amount privately. For that amount of money America should have the best gold-plated universal health care system the world has ever seen!

It is the best... at some things.

Instead the trade-off is an American life expectancy in the mid 30s between Cuba and Lebanon

We eat badly and don't exercise.

To indulge the aforementioned little zinger, something close to 70% of Canadian family doctors/GPs work out of their own private practices (meaning they own their own office/business and treat the public then bill the government) or in small clinics with a handful of offices while in the US that number is almost flipped with close to that number in hospitals or larger health centres. Turns out it's a lot easier for a doctor to run their own practice when there's only one provincial insurer to bill, and both sides don't need an army of lawyers and marketers.

Our legal issues are yet another separate concern from the healthcare system. I'll agree that it affects healthcare, but it the remedies to our legal problems are in the courts. I agree that it's much harder to sue the government, but of course that's a bad thing too. And I'll also agree that if you want something that's covered, and you want something for which there is no waiting line, the customer experience would be great in Canada. But if you want something that's covered and for which there is a waiting line, the customer experience sucks.

Don't whatabout the US. I know the US healthcare model has tons of problems.

I think it's insulting when people who had all the opportunity in the world scold others for not trying hard enough while they hoard their wealth because it's "too risky".

My parents are broke. They stole from me before I went to college. I paid every last dime of tuition. I worked my way through college, wondering whether my $13 grocery bill would clear my checking account. I came from a rural school with terrible graduation and college placement rates. I graduated from a class of 33 students, and was one of 3 to graduate college. To get by in college I slept on couches, lived on ramen, and wasted away studying in the "dungeons" of the engineering halls. You apparently have no idea where I come from. Tell me about how wonderful my opportunity was.

Yes, I'm going to lecture you. Because you have the audacity to tell me you're entitled to what I earned.

My "opportunity" consists of being mostly healthy and having parents that didn't abuse me physically.

Edit: And living in the US. Let's not forget that one.

Literally everything I do to advance my career is extremely risky: Simply going to college risked putting my parents into bankruptcy

Sounds like you had more opportunity than me.

After I gathered my inheritance and sold the house which I couldn't risk keeping, I continued school and lost money precipitously throughout the process.

You inherited? Jesus tapdancing....

You necessarily come from more wealth than me. My parents have been worth less than $0 my entire life. At no point if they kicked the bucket would I inherit jack. They were worth so little that they stole what I earned to pay their bills. They borrowed against their house to pay their taxes. I mean... they lived (still do) a ponzi scheme.

Don't presume that that you had it harder than I did.

Finishing my commercial certificate was so risky that I went from selling a house to $1000 to my name when I shipped off to fly around the country.

Maybe it was too risky to do. This was my point to you, perhaps you are in the position you are in because you were not careful. That's fine, that's your decision. But it doesn't entitle you to what I earned.

I can't risk getting my own apartment

If you're talking about government assistance, you should probably have a room mate, and not be day-trading.

The least risky move is to actually sit here and wait.

...and not try to time the stock market, literally gambling money you said a second ago that you don't have.

My entire career choice is a risk - I could either make $200,000 or I could break a bone (again) and be out of work for another year waiting on medical approval.

Sounds like a choice that you think was a bad one.

I have to take this risk just to get out of the machine shop rut the adults who raised me were in - or I could simply achieve nothing and live an unhappy life like they all did.

There are infinite options.

In my opinion, a person who drives a BMW, parks it in the garage at their house, has dual incomes, and is scared to lose $150, isn't minimizing risk, they're just greedy.

I'm not scared to lose $150. I'm saying that it's gambling. I could certainly afford it, but it's not likely enough to net a return, so why would I do it? I'd rather spend it on something I enjoy, or invest it (instead of speculating) and actually get a return.

You're DAY TRADING one of the most volatile and unpredictable stocks on the stock market with money you apparently don't have and telling me you deserve mine. So, unbelievably, entitled.

The people in the US are being played like fools.

We have a specific law which prevents us from buying and importing those same goods. Get rid of that law, and your system, not ours, would be hurting from that same imbalance.

In my opinion, that law is problematic.

Edit:

The best way to fix this is to allow people to buy drugs from other countries legally. If I could go online and order something from say India, I'd be paying a fraction of the cost even after shipping and import fees.

To be clear here, it's not because India has an outstanding pharmaceutical infrastructure. It's because the US drug companies are exporting the same drugs to India at a fraction of the price that they are selling them in the US. That's fine and dandy, but we should be able to call them on it by buying it back from India and into the US. That will eventually put a stop to it, India can't play the middle-man forever.

 

[Sander 001]

 

[Keef]

So, unbelievably, entitled.

it doesn't really matter. Once I get my cert back and ship off to American I'm sure my mind will revert back to protecting my own freedom and prosperity above all else as seems to happen as people age. Then we can both have dinner and laugh about how only if we would've worked harder we could've earned even more, and quicker. I'll have some of the best health coverage in the country so I won't be worried about what the free market conjures for other people.

 

[mustafur]

When Capitalism is the answer to everything including the problem.

 

[Danoff]

it doesn't really matter. Once I get my cert back and ship off to American I'm sure my mind will revert back to protecting my own freedom and prosperity above all else as seems to happen as people age. Then we can both have dinner and laugh about how only if we would've worked harder we could've earned even more, and quicker. I'll have some of the best health coverage in the country so I won't be worried about what the free market conjures for other people.

You seem like a smart person, and I expect that you'll do well. But if you do, start thinking about charity. Because some people are left behind by our government.

 

[Exorcet]

...

Sounds like a very valid question for businesses.

Just for reference though, solutions proposed in the report:

“Solution 1: Address large markets: Hemophilia is a $9-10bn WW market (hemophilia A, B), growing at ~6-7% annually.”

“Solution 2: Address disorders with high incidence: Spinal muscular atrophy (SMA) affects the cells (neurons) in the spinal cord, impacting the ability to walk, eat, or breathe.”

“Solution 3: Constant innovation and portfolio expansion: There are hundreds of inherited retinal diseases (genetics forms of blindness) … Pace of innovation will also play a role as future programs can offset the declining revenue trajectory of prior assets.”

ie find other problems to fix

 

[Keef]

You seem like a smart person, and I expect that you'll do well. But if you do, start thinking about charity. Because some people are left behind by our government.

I remember all the discussions we had beginning about ten years ago about ethics and economics and philosophy. Charity was one of those things, and soon I'll be able to contribute. But I can't help but think, "Why is it that myself and my people have to support each other while those who truly influence our government keep making it more difficult for us to support ourselves?"

This thread is about healthcare but my question is about the problem I identified. I'm not sure if we have a thread addressing it specifically. I believe cronyism is at the heart of a lot of our problems. It's like a rapidly accelerating machine that gets harder to stop every day. I think most of us would agree that it's a problem but how to fix it is where philosophies really differ.

EDIT: There's a fairly new economics thread. Sounds miserable.

 

[Danoff]

I remember all the discussions we had beginning about ten years ago about ethics and economics and philosophy. Charity was one of those things, and soon I'll be able to contribute. But I can't help but think, "Why is it that myself and my people have to support each other while those who truly influence our government keep making it more difficult for us to support ourselves?"

The people who want to be in power and control the government are people who want power and control. It's appealing to exactly the wrong kind of people.

This thread is about healthcare but my question is about the problem I identified. I'm not sure if we have a thread addressing it specifically. I believe cronyism is at the heart of a lot of our problems. It's like a rapidly accelerating machine that gets harder to stop every day.

The bigger government gets (and it just gets bigger), the more cronyism grows.

 

[PocketZeven]

You seem like a smart person, and I expect that you'll do well. But if you do, start thinking about charity. Because some people are left behind by our government.

I real wish I could be that optimistic and have faith in people that a voluntary system of charity would help the people that need it. The reality is that poverty would be much and much greater problem if not for socialism.

 

[Danoff]

I real wish I could be that optimistic and have faith in people that a voluntary system of charity would help the people that need it. The reality is that poverty would be much and much greater problem if not for socialism.

Maybe so. I can't tell for sure. But at least it would be moral. I just try to do my part.

 

[Joel]

That's the rub about the government option. It's going to have budget controls which leave people waiting for service. You act like this is not expected or even inherent. There is not an infinite budget... people will wait.

No I don't. I am saying I empathize with your relative and am frustrated at the waiting period. I just reject that it requires an infinite budget to bring under control. For example, France spends marginally more public dollars than Canada does (and slightly less as a whole), with under 4% of patients waiting 4 months or longer for elective surgeries. I would be happy with figures like this as an arbitrary target, even if it required spending more than France due to the geography differences. Budget cuts and austerity are not natural forces that rise and fall like the tides, they're a specific function of neoliberal ideology that's been the dominant status quo of western governments since the 80s, and in many ways it's a testament to the robustness of these systems that the NHS has survived for 40 years since Thatcher before the Tories even began to consider touching it, and the Canadian system has survived 40 years of austerity and remains a third rail where our conservatives run on expanding pipelines and cutting foreign aid to pay for more doctors.

I get it, the budget for "universal and immediate" is infinite. I accept and agree that waiting periods in Canada are too long, but I reject that "instantly if you can pay for it" is a standard by which a medical system should be judged, for reasons both squishy and practical. I feel genuine solidarity with the people in my community in knowing the knee replacement I wait for means someone who otherwise could never afford one will get one. I don't say that to be holier than thou, just to say this is a real ideological factor and it's a trade-off that most Canadians are happy to make. With 85-90% of Canadians categorically rejecting a private system, happily making this trade-off over a system with ostensibly better "customer experience" must count for customer satisfaction, no? Even the rich and business owners favour it because it's so much less of a headache to deal with than American insurance benefits.

What I'll offer for an efficiency argument is that wait times are not inherently bad things either provided they're not excessive. It means expensive equipment is efficiently scheduled based on medical need instead of having other appointments disrupted and leaving equipment idle because you can't reschedule other CT scans at the drop of a hat after someone pays for an immediate CT scan. Ultimately it's a rationing by triage and medical necessity rather than ability to pay. We can make the value judgment whether that's right or wrong, but there are legitimate efficiency benefits to this system as well.

That's good. We have more.... diverse... views here.

Like I said, my issue with this line of argument is it only seems to apply to the spectre of the MAGA hat guy in a Michigan diner. We never hear about Brooklyn socialists upset with the F-35's ballooning costs as a reason to scale back military procurement, or Portland environmentalists' anger as a reason to avoid oil and gas development. I understand the social wedge issues are fairly unique with the Fox/AM talk radio industrial complex (although I'd argue that in some places there's similar levels of hysteria about refugees), but off the top of my head I doubt the US is more socially conservative than somewhere like Italy, and the public system covers surgeries there. I dunno, is AIDS medication on insurance still a social issue beyond some grumbling? I'm genuinely asking because I don't know.

Price is its own thing. Don't conflate these. Having to wait at any price is one issue, and having to pay a price is another. The problem with the US model (to the extent that it is not already socialist) is that it costs a lot to get full coverage.

My relative looking for transgender treatment is not waiting here, but would wait there. That's the issue I'm talking about. If you want to talk about people that can't afford therapy here, I'm happy to talk about that. But it's not the same issue.

I'm not conflating these things. I'm giving my point of view about the trade-offs since we're talking about wait times which are a trade-off. Your relative is choosing between waiting for BC health to cover it, or paying to have it done faster in the US. My relatives can not afford to move to Vancouver from Halifax, let alone move internationally. If I had a trans relative in the US, the odds are pretty high they'd be unable to afford the procedure without going into mountains of debt, and forgoing a procedure until you can afford it is a wait list to me.

It is the best... at some things.

For that amount of money it should be the unquestioned best gold-plated system in the world where you're picked up in a limo and dropped off after surgery with celebratory bottles of champagne. I joke but I can not fathom a trade-off that would make me accept Cuba level life expectancy, 30M uninsured, and many more with garbage insurance and huge deductibles while outspending Canada and France combined and being 20% richer than those countries.

We eat badly and don't exercise.

The thing about a universal system is the future costs associated with unhealthy lifestyles incentivize government insurers to spend money and effort on preventative care, improved health education, better housing, and better access to nutritious food. It's not a direct correlation where a national Medicare would be subsidizing community produce markets or something, but even minor lifestyle improvements turn into massive cost savings on a national scale and it becomes an incentive to invest in earlier care. What I highlighted earlier about doctors being incentivzed to work as GPs in small clinics is a practical example. Salaries are flatter between GPs and specialists here, and perhaps if (through lower debt or flatter salaries and/or lower admin costs) American doctors were incentivized to be GPs treating the public in their communities, there would be less need for extremely expensive specialists.

Don't whatabout the US. I know the US healthcare model has tons of problems.

I'm not whatabouting, I'm making a similar argument that just as you argue the wait lists are inherent to a universal model, the admin/marketing costs and overcharging are inseparable from a private system. There aren't technocratic fixes to these issues, because private insurers are so powerful they have both a vested interest and the power to maintain the status quo. That isn't cronyism, it's a market that has very high costs and necessarily trends towards larger health systems for scalability, whether public or private.

it doesn't really matter. Once I get my cert back and ship off to American I'm sure my mind will revert back to protecting my own freedom and prosperity above all else as seems to happen as people age. I'll have some of the best health coverage in the country so I won't be worried about what the free market conjures for other people.

To the extent this (people becoming conservative as they age) is true, I would argue the second sentence is the primary driver of that in terms of who gets to live into old age.

 

[Danoff]

I get it, the budget for "universal and immediate" is infinite. I accept and agree that waiting periods in Canada are too long, but I reject that "instantly if you can pay for it" is a standard by which a medical system should be judged, for reasons both squishy and practical.

Why?

The UK has that. Australia has that (apparently). Why is "instantly if you can pay for it" not an acceptable standard?

I feel genuine solidarity with the people in my community in knowing the knee replacement I wait for means someone who otherwise could never afford one will get one.

That's not what's happening. One person is waiting for it so that they can not pay for it. It would be better if you could buy your way out of the public system and just let all those needy people get one faster.

Like I said, my issue with this line of argument is it only seems to apply to the spectre of the MAGA hat guy in a Michigan diner.

I'm not saying that's a reason to do or not do something. Just saying it's a reason why it doesn't happen. It's not as viable here because of that.

I'm not conflating these things. I'm giving my point of view about the trade-offs since we're talking about wait times which are a trade-off. Your relative is choosing between waiting for BC health to cover it, or paying to have it done faster in the US. My relatives can not afford to move to Vancouver from Halifax, let alone move internationally. If I had a trans relative in the US, the odds are pretty high they'd be unable to afford the procedure without going into mountains of debt, and forgoing a procedure until you can afford it is a wait list to me.

I don't understand why you're linking these. Why does someone who can't afford it require someone who can to wait in line, potentially in front of them.

For that amount of money it should be the unquestioned best gold-plated system in the world where you're picked up in a limo and dropped off after surgery with celebratory bottles of champagne. I joke but I can not fathom a trade-off that would make me accept Cuba level life expectancy, 30M uninsured, and many more with garbage insurance and huge deductibles while outspending Canada and France combined and being 20% richer than those countries.

We do waste some of it, mostly bad laws are the problem.

The thing about a universal system is the future costs associated with unhealthy lifestyles incentivize government insurers to spend money and effort on preventative care, improved health education, better housing, and better access to nutritious food.

Or require those things. It's one of the problems with Universal Healthcare. I should be able to drink a soda and shorten my life expectancy, but even without complete universal care we have people here trying to regulate that stuff to keep costs down. Exercise police.

I'm not whatabouting, I'm making a similar argument that just as you argue the wait lists are inherent to a universal model, the admin/marketing costs and overcharging are inseparable from a private system. There aren't technocratic fixes to these issues, because private insurers are so powerful they have both a vested interest and the power to maintain the status quo. That isn't cronyism, it's a market that has very high costs and necessarily trends towards larger health systems for scalability, whether public or private.

The US system has a bunch of legal constraints that are wrecking havoc. Those are not inherent. I think you're confusing the effects of free market with the effects of government.

 

[mustafur]

I would argue the Private health sector hurts the Public Sector in Australia as Doctors are under utilised compared to the Public system which in turn could help relieve wait times.

 

[Danoff]

I would argue the Private health sector hurts the Public Sector in Australia as Doctors are under utilised compared to the Public system which in turn could help relieve wait times.

The private sector creates doctors and equipment where they would not be. You can't just assume that all of that still exists in the absence of a private sector. Take the private sector money away, and you take the doctors and facilities that receive it away and add to the wait times.

 

[VFOURMAX1]

The private sector creates doctors and equipment where they would not be. You can't just assume that all of that still exists in the absence of a private sector. Take the private sector money away, and you take the doctors and facilities that receive it away and add to the wait times.

Which would possibly affect any " free health care for all" government system that was forced into being in this country.

Even today many private practice doctors will not take or accept any medicaid or medicare insured as patients due to the excess paperwork and lower fees these programs reimburse the doctor for services rendered as compared to the private sector.

I think that with the majority of hospitals and doctor offices and clinics being privately owned and operated it would be difficult for the government to force on to them just taking the one payment option legally. The government does not own or is not invested in most of these operations and hospitals at least in my area.

 

[Sander 001]

Take the private sector money away

Removing CEO'S, venture capitalists, shareholders and other middlemen leechers sure does sound like an awful idea

 

[FPV MIC]

I would argue the Private health sector hurts the Public Sector in Australia as Doctors are under utilised compared to the Public system which in turn could help relieve wait times.

It isn't widely known but sometimes the two work hand in hand here. I regularly go to the RAH Rheumatology Dept. for monitoring of my mild, in terms of others, condition but when needed I'm referred to private hospitals for ultrasounds and cortisone injections at no cost me (it's billed to the RAH). They do this because it's simply easier, quicker and more efficient. I don't know how common this is but it certainly makes my life much, much easier as the private hospital they send me to is less than five minutes away from my home.

 

[Joey D]

Which would possibly affect any " free health care for all" government system that was forced into being in this country.

We already have a free health care system that's forced on us in the form of Medicaid and Medicare.

Even today many private practice doctors will not take or accept any medicaid or medicare insured as patients due to the excess paperwork and lower fees these programs reimburse the doctor for services rendered as compared to the private sector.

That's not strictly true. Doctors don't flat our deny Medicaid or Medicare patients if they're contracted to take that insurance. Not every doctor is contracted though, so the ones that aren't, won't take it, but if they're contracted they will pretty much always see the patient. If the doctor is part of a large-ish health system, it pretty much goes against policy to deny someone service based on Medicaid or Medicare. I've seen doctors lose their jobs when they were caught denying Medicare patients. Patients can also sue for discrimination if they're able to prove they were turned away because of Medicaid and Medicare, it's difficult to do but not impossible.

The government does not own or is not invested in most of these operations and hospitals at least in my area.

The federal government is very invested in hospitals due to Medicare and Medicaid. Every health system that takes these has to pass a CMS audit conducted by the federal government and is a royal pain in the ass. If you fail the audit, you have so many days to correct it, if you continue to fail, you lose Medicare and Medicaid reimbursement and your health system goes under. Healthcare systems also have to abide by a ton of federal rules concerning things like referrals, data protection, and how money is exchanged for services. If a health system is found in violation, they owe the federal government a metric ton of money and the health system goes under. I've seen both of these happen more than once.

At a state level, the government is even more involved. Most states have a university health system and all of those are state-run. They also sponsor numerous programs at various other health systems too.

 

[VFOURMAX1]

That's not strictly true. Doctors don't flat our deny Medicaid or Medicare patients if they're contracted to take that insurance. Not every doctor is contracted though, so the ones that aren't, won't take it, but if they're contracted they will pretty much always see the patient.

The big word is "IF" and a privately owned practice is not compelled to contract to take the services that pretty much pay them a lot less than the private sector.

At a state level, the government is even more involved. Most states have a university health system and all of those are state-run. They also sponsor numerous programs at various other health systems too.

Within 65 miles of my location there are 6 hospitals with 4 of those being bigger hospitals. Out of those 6 one which is 65 miles away is a "state sponsored" university hospital that would fall under the state operated mandates. The rest are privately owned and over the last 10 years 3 of those privately owned hospitals are now under the same private ownership where they use to all be independent of each other.

The federal government is very invested in hospitals due to Medicare and Medicaid. Every health system that takes these has to pass a CMS audit conducted by the federal government and is a royal pain in the ass. If you fail the audit, you have so many days to correct it, if you continue to fail, you lose Medicare and Medicaid reimbursement and your health system goes under. Healthcare systems also have to abide by a ton of federal rules concerning things like referrals, data protection, and how money is exchanged for services. If a health system is found in violation, they owe the federal government a metric ton of money and the health system goes under.

They are invested to the point that they force more regulations and paperwork upon these privately owned businesses if they accept payment from the government insurance plans. But these same locations could not participate in accepting the federal insurance and rely on the private sector insurance and I do not see how they could be forced to abide by the government rules except as far as privacy, drug controls and ethics were concerned if they were to choose to go that way.

Also just about all the private doc in the box clinics and even a large percentage of the private practices and specialist offices and all the labs and xray facilities along with most rehab units have also been bought up and fall under one umbrella by this same company. I am only aware of 1 "low income" public clinic in the area of around a 35 mile radius they do not own and control and if you owe old doctor bills to a specialist from past visits those specialist will not schedule an appointment until the past due bill is paid.

So again some areas may be better suited for government mandated "one health care for all" than others. Other areas have a pretty good population that is fine and happy using the private payer health care system currently in effect.

 

[Joey D]

The big word is "IF" and a privately owned practice is not compelled to contract to take the services that pretty much pay them a lot less than the private sector.

Sure, the keyword is "if", but think about who needs the most healthcare. Older people. And what do older people typically use for insurance? Socialized Medicare.

Within 65 miles of my location there are 6 hospitals with 4 of those being bigger hospitals. Out of those 6 one which is 65 miles away is a "state sponsored" university hospital that would fall under the state operated mandates. The rest are privately owned and over the last 10 years 3 of those privately owned hospitals are now under the same private ownership where they use to all be independent of each other.

I can assure you all of those hospitals take state money and all them for sure get a significant portion of their revenue from Medicaid and Medicare reimbursements. So while they are privately owned, they rely heavily on the government to keep operating. Also, every health care facility is licensed by the bed which is controlled by the government. You can only have X amount of beds per X amount of people in a given radius. They also typically can't all be owned by the same organization either.

They are invested to the point that they force more regulations and paperwork upon these privately owned businesses if they accept payment from the government insurance plans. But these same locations could not participate in accepting the federal insurance and rely on the private sector insurance and I do not see how they could be forced to abide by the government rules except as far as privacy, drug controls and ethics were concerned if they were to choose to go that way.

If you completely took away government healthcare payments, most health systems wouldn't survive in their current state for longer than 90 days. Maybe even less depending on how many days of operating cash they have on hand.

Also just about all the private doc in the box clinics and even a large percentage of the private practices and specialist offices and all the labs and xray facilities along with most rehab units have also been bought up and fall under one umbrella by this same company. I am only aware of 1 "low income" public clinic in the area of around a 35 mile radius they do not own and control and if you owe old doctor bills to a specialist from past visits those specialist will not schedule an appointment until the past due bill is paid.

They don't need to be low-income clinics, most health systems will work with you if you can't afford your care. Almost every major health system operates as a non-profit or not-for-profit and gives out a substantial amount of charity care every single month. If they're a faith-based health system, the amount of charity care is even higher to the tune of tens of millions of dollars every year. I'm sure there are more low-income clinics and providers around you then you might think. Many operate a standard practice while also performing services for underserved people.

So again some areas may be better suited for government mandated "one health care for all" than others. Other areas have a pretty good population that is fine and happy using the private payer health care system currently in effect.

I can't think or know of one area in the US that has a health system that could survive solely on private insurance and I'm fairly in the know on these things. They need Medicaid and Medicare. If they lose that reimbursement then the hospital goes under. If the reimbursement number are lower than projected, people lose their jobs. I've seen it and even experienced it.

For the record, I'm not for any kind of government-funded health insurance. Medicaid and Medicare are full-blown socialist programs and I'm not down with that since they steal money from my paycheck twice a month. However, because both of those programs are so entwined with the way our healthcare system is set up, it would be very difficult to get rid of them without most of the country losing access to healthcare.

 

[Danoff]

Removing CEO'S, venture capitalists, shareholders and other middlemen leechers sure does sound like an awful idea

Almost every major health system operates as a non-profit or not-for-profit and gives out a substantial amount of charity care every single month. If they're a faith-based health system, the amount of charity care is even higher to the tune of tens of millions of dollars every year. I'm sure there are more low-income clinics and providers around you then you might think. Many operate a standard practice while also performing services for underserved people.

 

[mustafur]

The private sector creates doctors and equipment where they would not be. You can't just assume that all of that still exists in the absence of a private sector. Take the private sector money away, and you take the doctors and facilities that receive it away and add to the wait times.

So every Australian Doctor is Automatically working overseas?

I don't mind if the public sector uses private hospitals, France does it this way, and keep in mind Australia system was full private like the US until the 80s so there was plenty of Private hospitals before it, but from now it would work better for the public system if the private sector merged into the public sector that would be obvious to me.

 

[Sander 001]

 

[Dotini]

Is 80% of Pharma run by not just capitalists, but by authoritarian capitalists?

From a special just broadcast on CNBC:

80% of antibiotics and other generic ingredients in drugs and pharmaceuticals coming into the US annually are from China.
One Chinese plant shutdown could cause a global shortage.
Affected include antibiotics, ingredients for
Blood pressure
Oncology
Antidepressants
Epilepsy
Parkinson's
Birth Control
Ibuprofen 95%
Hydrocortizone 91%
Acetamenophen 70%
Heparin 50%
Clinical trials and approvals of new drugs
Nationalization of other offshore pharma facilities
China is its own 1st customer
There may be a 2 week to 2 month inventory on hand now in the US.

 

[Danoff]

So every Australian Doctor is Automatically working overseas?

What the what?

I don't mind if the public sector uses private hospitals, France does it this way, and keep in mind Australia system was full private like the US until the 80s so there was plenty of Private hospitals before it, but from now it would work better for the public system if the private sector merged into the public sector that would be obvious to me.

Presumably under the same amount of public cost... ergo... less doctors and facilities.

 

[Sander 001]